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Catastrophic total costs in tuberculosisaffected households and their determinants since Indonesia’s implementation of universal health coverage

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Infectious Diseases of Poverty 2018年第1期7卷 30-43页

作者： Ahmad Fuady tanja a.j.houweling Muchtaruddin Mansyur jan Hendrik Richardus Department of Public Health Erasmus MCUniversity Medical Center RotterdamP.O.Box 20403000CA RotterdamThe Netherlands Department of Community Medicine Faculty of MedicineUniversitas IndonesiaJakartaIndonesia

Background:As well as imposing an economic burden on affected households,the high costs related to tuberculosis(TB)can create access and adherence *** highlights the particular urgency of achieving one of the End TB Strategy’s targets:that no TB-affected households have to face catastrophic costs by *** Indonesia,as elsewhere,there is also an emerging need to provide social protection by implementing universal health coverage(UHC).We therefore assessed the incidence of catastrophic total costs due to TB,and their determinants since the implementation of ***:We interviewed adult TB and multidrug-resistant TB(MDR-TB)patients in urban,suburban and rural areas of Indonesia who had been treated for at least one month or had finished treatment no more than one month *** the WHO recommendation,we assessed the incidence of catastrophic total costs due to *** also analyzed the sensitivity of incidence relative to several thresholds,and measured differences between poor and non-poor households in the incidence of catastrophic *** linear mixed-model analysis was used to identify determinants of the catastrophic total ***:We analyzed 282 TB and 64 MDR-TB *** TB-related services,the median(interquartile range)of total costs incurred by households was 133 USD(55-576);for MDR-TB-related services,it was 2804 USD(1008-4325).The incidence of catastrophic total costs in all TB-affected households was 36%(43%in poor households and 25%in non-poor households).For MDR-TB-affected households,the incidence was 83%(83%and 83%).In TB-affected households,the determinants of catastrophic total costs were poor households(adjusted odds ratio[aOR]=3.7,95%confidence interval[CI]:1.7-7.8);being a breadwinner(aOR=2.9,95%CI:1.3-6.6);job loss(aOR=21.2;95%CI:8.3-53.9);and previous TB treatment(aOR=2.9;95%CI:1.4-6.1).In MDR-TB-affected households,having an income-earning job before diagnosis was the only determinant of catastrophic to

关键词： Tuberculosis Catastrophic total cost Determinant Indonesia

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Effect of financial support on reducing the incidence of catastrophic costs among tuberculosis-affected households in Indonesia:eight simulated scenarios

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Infectious Diseases of Poverty 2019年第1期8卷 100-100页

作者： Ahmad Fuady tanja a.j.houweling Muchtaruddin Mansyur Erlina Burhan jan Hendrik Richardus Departm ent of Public Health Erasmus MCUniversity Medical Centre RotterdamP.O.Box 20403000CARotterdamthe Netherlands Department of Community Medicine Faculty of MedicineUniversitas IndonesiaJakartaIndonesia 不详

Background:The World Health Organization's End Tuberculosis Strategy states that no tuberculosis(TB)-affected households should endure catastrophic costs due to *** achieve this target,it is essential to provide adequate social *** only a few studies in many countries have evaluated social-protection programs to determine whether the target is being reached,we assessed the effect of financial support on reducing the incidence of catastrophic costs due to TB in ***:From july to Septem ber 2016,we interviewed adult patients receiving treatment for TB in 19 primary health centres in urban,sub-urban and rural area of Indonesia,and those receiving multidrug-resistant(MDR)TB treatment in an Indonesian national referral *** on the needs assessment,we developed eight scenarios for financial *** assessed the effect of each simulated scenario by measuring reductions in the incidence of catastrophic ***:We analysed data of 282 TB and 64 MDR-TB *** incidences of catastrophic costs in affected households were 36 and 83%,***'primary needs for social protection were financial support to cover costs related to income loss,transportation,and food *** optimum scenario,in which financial support would be provided for these three items,would reduce the respective incidences of catastrophic costs in TB and MDR-TB-affected households to 11 and 23%.The patients experiencing catastrophic costs in this scenario would,however,have to pay high rem aining costs(median of USD 910;[interquartile range(IQR)662]in the TB group,and USD 2613;[IQR 3442]in the MDR-TB group).Conclusions:Indonesia's current level of social protection is not sufficient to mitigate the socioeconom ic im pact of *** support for income loss,transportation costs,and food-supplem ent costs will substantially reduce the incidence of catastrophic costs,but financial support alone will not be sufficient to achieve the target of

关键词： Tuberculosis Multidrug-resistant tuberculosis Catastrophic cost Social protection Financial support Cash transfer Indonesia

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膜传氧生物膜反应器在污水厂升级改造中的应用

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中国给水排水 2020年第17期36卷 1-5页

作者：龙泽波罗敏马文超 Dwight houweling 陈建刚步春梅苏伊士水务技术加拿大公司加拿大苏伊士水务技术<上海>有限公司上海201210

ZeeLungTM膜传氧生物膜反应器工艺(ZeeLungTM MABR工艺)在美国伊利诺斯州YBSD污水处理厂成功应用,成为目前世界上最大的MABR污水处理厂。ZeeLungTM MABR工艺将原有的好氧活性污泥系统改造成A2 O工艺系统,ZeeLungTM膜箱安装于改造后的缺... 详细信息

ZeeLungTM膜传氧生物膜反应器工艺(ZeeLungTM MABR工艺)在美国伊利诺斯州YBSD污水处理厂成功应用,成为目前世界上最大的MABR污水处理厂。ZeeLungTM MABR工艺将原有的好氧活性污泥系统改造成A2 O工艺系统,ZeeLungTM膜箱安装于改造后的缺氧池,在不新建生化构筑物的条件下,即可满足日益增长的有机负荷及新的出水总磷指标要求(低于1 mg/L,通过生物除磷即可实现)。为期1年的运行数据表明,升级后系统的出水水质可稳定达到目标要求,实现了生物除磷及ZeeLungTM池内的同步硝化反硝化。ZeeLungTM生物膜优先进行硝化,平均传氧速率为12.0 g/(m^2·d),在平均硝化速率为2.1 g/(m^2·d)的条件下,80%的传氧用于硝化,在保持传氧能力的前提下确保氨氮及总氮的同步去除效果。半经验动力学模型可用于模拟ZeeLungTM的硝化速率,其温度系数接近于1,表明水温对ZeeLungTM硝化速率的影响很小。

关键词：膜传氧生物膜反应器同步硝化反硝化传氧速率硝化速率

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肺动脉高压患者骨形态发生蛋白受体2突变

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中华高血压杂志 2016年第3期24卷 299-299页

作者： Van Der Bruggen CE Happé CM Dorfmüller P Trip P Spruijt OA Rol N Hoevenaars F houweling AC Girerd B Marcus jT Mercier O Humbert M Handoko ML Van Der Velden j Vonk Noordegraaf A Bogaard Hj Goumans Mj de Man FS 刘莉叶鹏

骨形态发生蛋白受体2（bone morphogenetic protein receptor 2,BMPR2）基因突变对肺动脉高压（pulmonary arterial hypertension,PAH）患者右心室压力负荷的影响尚未知。研究人员通过体内功能检查联合右、左心室分子与组织学分析,对伴... 详细信息

骨形态发生蛋白受体2（bone morphogenetic protein receptor 2,BMPR2）基因突变对肺动脉高压（pulmonary arterial hypertension,PAH）患者右心室压力负荷的影响尚未知。研究人员通过体内功能检查联合右、左心室分子与组织学分析,对伴或不伴BMPR2突变的PAH患者的右心室功能进行评估。方法与结果：纳入原发性或家族性PAH患者95例进行基因筛选,结果示28例患者存在BMPR2突变,67例无突变。应用右心导管术和心脏核磁共振检测。

关键词：骨形态发生蛋白受体基因突变肺动脉高压患者 hypertension 受体2 receptor arterial

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