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Determinants of household catastrophic costs for drug sensitive tuberculosis patients in Kenya

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Infectious Diseases of Poverty 2021年第4期10卷 18-32页

作者： Beatrice Kirubi Jane Ong'angto Peter Nguhiu Knut Lonnroth Aiban Rono Kristi Sidney-Annerstedt Department of Global Public Health Karolinska InstitutetStockholmSweden who collaborating centre for tuberculosis and social medicine StockholmSweden The Health and social Protection Action Research&Knowledge Sharing Network(SPARKS) StockholmSweden centre for Respiratory Disease Research Kenya Medical Research InstituteNairobiKenya Health Economics Research Unit KEMRI-WellcomeTrust Research ProgramNairobiKenya Monitoring Evaluation&ResearchNational TuberculosisLeprosy and Lung Disease ProgramMinistry of HealthNairobiKenya

Background::Despite free diagnosis and treatment for tuberculosis(TB),the costs during treatment impose a significant financial burden on patients and their *** study sought to identify the determinants for cata-strophic costs among patients with drug-sensitive TB(DSTB)and their households in ***::The data was collected during the 2017 Kenya national patient cost survey from a nationally representative sample(n=1071).Treatment related costs and productivity losses were *** costs exceeding 20%of household income were defined as catastrophic and used as the *** Poisson regression analysis was performed to measure the association between selected individual,household and disease characteristics and occurrence of catastrophic costs.A deterministic sensitivity analysis was carried using different thresholds and the significant predictors were ***::The proportion of catastrophic costs among DSTB patients was 27%(n=294).Patients with catastrophic costs had higher median productivity losses,39 h[interquartile range(IQR):20-104],and total median costs of USD 567(IQR:299-1144).The incidence of catastrophic costs had a dose response with household *** poorest quintile was 6.2 times[95%confidence intervals(CI):4.0-9.7]more likely to incur catastrophic costs compared to the *** prevalence of catastrophic costs decreased with increasing household expenditure quintiles(proportion of catastrophic costs:59.7%,32.9%,23.6%,15.9%,and 9.5%)from the lowest quintile(Q1)to the highest quintile(Q5).Other determinants included hospitalization:prevalence ratio(PR)=2.8(95%CI:1.8-4.5)and delayed treatment:PR=1.5(95%CI:1.3-1.7).Protective factors included receiving care at a public health facility:PR=0.8(95%CI:0.6-1.0),and a higher body mass index(BMI):PR=0.97(95%CI:0.96-0.98).Pre TB expenditure,hospitalization and BMI were significant predictors in all sensitivity analysis ***::There are signif

关键词： tuberculosis Health expenditure Income loss social protection Kenya

Projecting the proliferation risk of Oncomelania hupensis in China driven by SSPs:A multi-scenario comparison and integrated modeling study

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Advances in Climate Change Research 2022年第2期13卷 258-265页

作者： Yan-Feng GONG Xiao-Kang HU Yu-Wan HAO Zhuo-Wei LUO Jia-Xin FENG Jing-Bo XUE Zhao-Yu GUO Yin-Long LI Li-Juan ZHANG Shang XIA Shan LYU Jing XU Shi-Zhu LI National Institute of Parasitic Diseases Chinese Center for Disease Control and Prevention(Chinese Center for Tropical Diseases Research)NHC Key Laboratory of Parasite and Vector BiologyWHO Collaborating Centre for Tropical DiseasesNational Center for International Research on Tropical DiseasesShanghai 200025China School of Global Health Chinese Centre for Tropical Diseases ResearchShanghai Jiao Tong University School of MedicineShanghai 200025China

Climate change has been known to cause variations in the geographically suitable areas for the schistosome-transmitting Oncomelania hupensis(***).The spread of snails not only depends on the degree of warming but also on the socioeconomic development of the next few *** socioeconomic pathways(SSPs)published by CMIP6 consider carbon emission pathways as well as influences of distinct types of social development and land use on the regional climate,providing the possibility to accurately evaluate the impact of socioeconomic development and climate variation on the spread of *** study employed SSP126,SSP245,SSP370,and SSP585 and the correlative approach to explore the impacts of climate change and socioeconomic development on the potential diffusion areas for *** in *** results exhibited strong evidence that *** will spread in the north of the middle and lower reaches of the Yangtze River and disappear from a small part of its current southern habitat,whereas in Sichuan and Yunnan,*** may spread slightly to the *** projection also demonstrated that fossil fuel-driven development(SSP585)will be more conducive to the spread of *** breeding sites in the 2030s,whereas the continuous increase in snail breeding habitats under the regional rivalry path(SSP370)may lead to great challenges in snail control in the long term(2020-2080).

关键词： Oncomelania hupensis Shared socioeconomic pathways(SSPs) Climate change China

Threats of Zika virus transmission for Asia and its Hindu-Kush Himalayan region

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Infectious Diseases of Poverty 2018年第1期7卷 387-393页

作者： Meghnath Dhimal Sushma Dahal Mandira Lamichhane Dhimal Shiva Raj Mishra Khem BKarki Krishna Kumar Aryal Ubydul Haque Md Iqbal Kabir Pradeep Guin Azeem Mehmood Butt Harapan Harapan Qi-Yong Liu Cordia Chu Doreen Montag David Alexander Groneberg Basu Dev Pandey Ulrich Kuch Ruth Muller Nepal Health Research Council(NHRC) Ramshah PathKathmanduNepal Institute of Occupational edicine Social Medicine and Environmental MedicineGoethe UniversityFrankfurt am MainGermany Faculty of social Sciences Goethe UniversityFrankfurt am MainGermany The University of Queensland BrisbaneAustralia Department of Public Health Baldwin Wallace UniversityBereaOhioUSA Department of Epidemiology National Institute of Preventive and Social MedicineMinistry of Health and Family WelfareDhakaBangladesh Public Health Foundation of India GurgaonHaryanaIndia centre for Environmental Health GurgaonHaryanaIndia Translational Genomics Laboratory Department of BiosciencesCOMSATS Institute of Information Technology(CIIT)Islamabad 45550Pakistan Medical Research Unit School of MedicineSyiah Kuala UniversityBanda AcehIndonesia who collaborating centre for Vector Surveillance and Management SKLIDCCIDICDCChina CDCBeijingChina centre for Environment and Population Health Griffith UniversityNathanQueenslandAustralia Barts and the London School of medicine Centre for Primary Care and Public HealthQueen Mary University of LondonLondonUK Department of Health Services Ministry of HealthGovernment of NepalKathmanduNepal

Asia and its Hindu Kush Himalayan(HKH)region is particularly vulnerable to environmental change,especially climate and land use changes further influenced by rapid population growth,high level of poverty and unsustainable *** has been a hotspot of dengue fever and chikungunya mainly due to its dense human population,unplanned urbanization and *** an urban cycle,dengue virus(DENV)and chikungunya virus(CHIKV)are transmitted by Aedes aegypti and *** mosquitoes which are also competent vectors of Zika virus(ZIKV).Over the last decade,DENV and CHIKV transmissions by *** have extended to the Himalayan countries of Bhutan and Nepal and ZIKV could follow in the footsteps of these viruses in the HKH *** already established distribution of human-biting Aedes mosquito vectors and a naïve population with lack of immunity against ZIKV places the HKH region at a higher risk of *** of the countries in the HKH region have already reported ZIKV *** have documented an increasing threat of ZIKV in Asia and its HKH region because of the high abundance and wide distribution of human-biting mosquito vectors,climate change,poverty,report of indigenous cases in the region,increasing numbers of imported cases and a naïve population with lack of immunity against *** outbreak anywhere is potentially a threat ***,in order to ensure international health security,all efforts to prevent,detect,and respond to ZIKV ought to be intensified now in Asia and its HKH *** prepare for possible ZIKV outbreaks,Asia and the HKH region can also learn from the success stories and strategies adopted by other regions and countries in preventing ZIKV and associated *** future control strategies for DENV,CHIKV and ZIKV should be considered in tandem with the threat to human well-being that is posed by other emerging and re-emerging vector-borne and zoonotic diseases,and by the continuing urgent need to strengthen public

关键词： Aedes aegypti Aedes albopictus Dengue virus Chikungunya virus Hindu Kush Himalayas Mountain Poverty Zika virus

Is convenience really king?Comparative evaluation of catastrophic costs due to tuberculosis in the public and private healthcare sectors of Viet Nam:a longitudinal patient cost study

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Infectious Diseases of Poverty 2024年第2期13卷 17-28页

作者： Hoa Binh Nguyen Luan Nguyen Quang Vo Rachel Jeanette Forse Anja Maria Christine Wiemers Huy Ba Huynh Thuy Thi Thu Dong Yen Thi Hoang Phan Jacob Creswell Thi Minh Ha Dang Lan Huu Nguyen Jad Shedrawy Knut Lönnroth Tuan Dinh Nguyen Luong Van Dinh Kristi Sidney Annerstedt Andrew James Codlin National Lung Hospital Ha NoiViet Nam Friends for International TB Relief Ha NoiViet Nam Department of Global Public Health WHO Collaboration Centre On Tuberculosis and Social MedicineKarolinska InstituteStockholmSweden Stop TB Partnership GenevaSwitzerland Pham Ngoc Thach Hospital Ho Chi Minh CityViet Nam

Background In Viet Nam,tuberculosis(TB)represents a devastating life-event with an exorbitant price tag,partly due to lost income from daily directly observed therapy in public sector ***,persons with TB may seek care in the private sector for its flexibility,convenience,and *** study aimed to measure income changes,costs and catastrophic cost incurrence among TB-affected households in the public and private *** Between October 2020 and March 2022,we conducted 110 longitudinal patient cost interviews,among 50 patients privately treated for TB and 60 TB patients treated by the National TB Program(NTP)in Ha Noi,Hai Phong and Ho Chi Minh City,Viet *** a local adaptation of the who TB patient cost survey tool,participants were interviewed during the intensive phase,continuation phase and *** compared income levels,direct and indirect treatment costs,catastrophic costs using Wilcoxon rank-sum and chi-squared tests and associated risk factors between the two cohorts using multivariate *** The pre-treatment median monthly household income was significantly higher in the private sector versus NTP cohort(USD 868 vs USD 578;P=0.010).However,private sector treatment was also significantly costlier(USD 2075 vs USD 1313;P=0.005),driven by direct medical costs which were 4.6 times higher than costs reported by NTP participants(USD 754 vs USD 164;P<0.001).This resulted in no significant difference in catastrophic costs between the two cohorts(Private:55%vs NTP:52%;P=0.675).Factors associated with catastrophic cost included being a single-person household[adjusted odds ratio[(a OR=13.71;95%confidence interval(CI):1.36-138.14;P=0.026)],unemployment during treatment(a OR=10.86;95%CI:2.64-44.60;P<0.001)and experiencing TB-related stigma(a OR=37.90;95%CI:1.72-831.73;P=0.021)].Conclusions Persons with TB in Viet Nam face similarly high risk of catastrophic costs whether treated in the public or private *** costs coul

关键词： tuberculosis Patient cost Catastrophic cost Private sector Comparative analysis Viet Nam

Ending the“Neglect”to End Neglected Tropical Diseases

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China CDC weekly 2022年第8期4卷 153-156页

作者： Pin Yang Xiao-nong Zhou National Institute of Parasitic Diseases Chinese Center for Disease Control and PreventionChinese Center for Tropical Diseases ResearchWHO Collaborating Centre for Tropical DiseasesNational Center for International Research on Tropical DiseasesMinistry of Science and TechnologyKey Laboratory of Parasite and Vector BiologyMinistry of HealthShanghaiChina School of Global Health Chinese Center for Tropical Diseases ResearchShanghai Jiao Tong University School of MedicineShanghaiChina

January 30,2022 will mark the third World Neglected Tropical Diseases(NTD)*** slogan for this year World NTD Day is“A New Day in the fight against NTDs”(https://***/).While human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS),tuberculosis,and malaria were regarded as the three major infectious diseases and have received greater treatment and research funding,NTDs have almost disappeared in the global health policy agenda to gain recognition in 2015 with the Sustainable Development Goals(SDG target 3.3).

关键词： Diseases diseases tuberculosis

Diagnostic delay and associated factors among patients with pulmonary tuberculosis in Dar es Salaam,Tanzania

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Infectious Diseases of Poverty 2017年第1期6卷 548-557页

作者： Khadija Said Jerry Hella Grace Mhalu Mary Chiryankubi Edward Masika Thomas Maroa Francis Mhimbira Neema Kapalata Lukas Fenner Ifakara Health Institute Bagamoyo Research and Training Centre(BRTC)P O Box 74BagamoyoTanzania Swiss Tropical and Public Health Institute Socinstrasse 574002 BaselSwitzerland University of Basel Petersplatz 14003 BaselSwitzerland National tuberculosis and Leprosy Programme Dar es SalaamTanzania Institute of social and Preventive medicine University of BernBernSwitzerland

Background:Tanzania is among the 30 countries with the highest tuberculosis(TB)*** TB has a long infectious period,early diagnosis is not only important for reducing transmission,but also for improving treatment *** assessed diagnostic delay and associated factors among infectious TB ***:We interviewed new smear-positive adult pulmonary TB patients enrolled in an ongoing TB cohort study in Dar es Salaam,Tanzania,between November 2013 and June *** patients were interviewed to collect information on socio-demographics,socio-economic status,health-seeking behaviour,and residential *** categorized diagnostic delay into≤3 or>3 *** used logistic regression models to identify risk factors for diagnostic delay,presented as crude(OR)and adjusted Odds Ratios(aOR).We also assessed association between geographical distance(incremental increase of 500 meters between household and the nearest pharmacy)with binary ***:We analysed 513 patients with a median age of 34 years(interquartile range 27-41);353(69%)were ***,444(87%)reported seeking care from health care providers prior to TB diagnosis,of whom 211(48%)sought care>2 *** six(1%)visited traditional healers before TB *** delay was positively associated with absence of chest pain(aOR=7.97,95%confidence intervals[CI]:3.15-20.19;P<0.001),and presence of hemoptysis(aOR=25.37,95%CI:11.15-57.74;P<0.001)and negatively associated with use of medication prior to TB diagnosis(aOR=0.31,95%CI:0.14-0.71;P=0.01).Age,sex,HIV status,education level,household income,and visiting health care facilities(HCFs)were not associated with diagnostic *** living far from pharmacies were less likely to visit a HCF(incremental increase of distance versus visit to any facility:OR=0.51,95%CI:0.28-0.96;P=0.037).Conclusions:TB diagnostic delay was common in Dar es Salaam,and was more likely among patients without prior use of medication and presenting with

关键词： Tanzania tuberculosis Diagnostic delay Health-seeking Geographic information system Pharmacy Transmission

Weather Information Acquisition and Health Significance during Extreme Cold Weather in a Subtropical City:A Crosssectional Survey in Hong Kong

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International Journal of Disaster Risk Science 2017年第2期8卷 134-144页

作者： Emily Ying Yang Chan Zhe Huang Carman Ka Man Mark Chunlan Guo collaborating centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC) The Jockey Club School of Public Health and Primary CareThe Chinese University of Hong Kong Nuffield Department of medicine University of Oxford Franois-Xavier Bagnoud Center for Health and Human Rights Harvard University

Health and disaster risk reduction are important and necessary components in building a smart city,especially when climate change may increase the frequency of extreme temperatures and the health risks of urban ***,limited knowledge is available about the best way to disseminate weather warnings and health protection *** study explores the weather information acquisition patterns of the Hong Kong public and examines the sociodemographic predictors of these patterns to establish the potential public health implications of smart city development.A population-based,stratified crosssectional,random digit dialing telephone survey was conducted among the Cantonese-speaking population aged over 15 years in Hong Kong in early *** were conducted based on 1017 valid samples,with a response rate of 63.6%.Cold Weather Warnings were well disseminated in Hong Kong,with 95.7% of the respondents reporting awareness of the public *** and smartphone apps were the two most important channels for weather information *** and education level are the main social-demographic variables associated with the current utilization and future preference of smartphone *** those who were not using a preferredchannel to acquire weather information,61.3% considered switching to a smartphone ***,the patterns of individual health protection measures and self-reported health impacts were significantly different between smartphone app users and *** information dissemination should be tailored to the sociodemographic characteristics of the users.

关键词： Cold weather warnings Public health emergencies Smart cities Subtropical city Weather information dissemination systems

Developing a Research Network of Early Warning Systems for Infectious Diseases Transmission Between China and Australia

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China CDC weekly 2024年第30期6卷 740-753页

作者： Cynthia Lu Liping Wang Ian Barr Stephen Lambert Kerrie Mengersen Weizhong Yang Zhongjie Li Xiaohan Si Hannah McClymont Shovanur Haque Ting Gan Sotiris Vardoulakis Hilary Bambrick Wenbiao Hu Ecosystem Change and Population Health Research Group School of Public Health and Social WorkQueensland University of TechnologyBrisbaneAustralia Division of Infectious Disease National Key Laboratory of Intelligent Tracking and Forcasting for Infectious DiseasesChinese Centre for Disease Control and PreventionBeijingChina who collaborating centre for Reference and Research on Influenza VIDRLDoherty InstituteMelbourneAustralia Department of Microbiology and Immunology University of MelbourneVictoriaAustralia Communicable Disease Branch Queensland HealthBrisbaneQueenslandAustralia National centre for Immunisation Research and Surveillance Sydney Children’s Hospitals NetworkWestmeadNSWAustralia School of Mathematical Sciences Faculty of ScienceQueensland University of TechnologyBrisbaneQueenslandAustralia School of Population medicine&Public Health Chinese Academy of Medical Science/Peking Union Medical CollegeBeijingChina HEAL Global Research centre Health Research InstituteUniversity of CanberraAustralian Capital TerritoryAustralia National centre for Epidemiology and Population Health College of Health and MedicineThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia.

This article offers a thorough review of current early warning systems(EWS)and advocates for establishing a unified research network for EWS in infectious diseases between China and *** propose that future research should focus on improving infectious disease surveillance by integrating data from both countries to enhance predictive models and intervention *** article highlights the need for standardized data formats and terminologies,improved surveillance capabilities,and the development of robust spatiotemporal predictive *** concludes by examining the potential benefits and challenges of this collaborative approach and its implications for global infectious disease *** is particularly relevant to the ongoing project,early warning systems for Infectious Diseases between China and Australia(NetEWAC),which aims to use seasonal influenza as a case study to analyze influenza trends,peak activities,and potential interhemispheric transmission *** project seeks to integrate data from both hemispheres to improve outbreak predictions and develop a spatiotemporal predictive modeling system for seasonal influenza transmission based on socio-environmental factors.

关键词： Australia integrating establishing

Time to Integrate Malaria and Neglected Tropical Diseases Control and Elimination

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China CDC weekly 2021年第17期3卷 372-374页

作者： Dirk Engels Fang Huang Xiao-nong Zhou Secretariat Uniting Forum To Combate NTDsGenevaSwitzerland NHC Key Laboratory for Parasite and Vector Biology National Institute of Parasitic DiseasesChinese Center for Disease Control and PreventionShanghaiChina Chinese Center for Tropical Diseases Research WHO Collaborating Centre for Tropical Diseases School of Global Health Chinese Center for Tropical Diseases ResearchShanghai Jiao Tong University School of MedicineShanghaiChina.

Traditionally,malaria has always been considered one of the tropical *** only has changed in the late 1990s,with the World Health Organization(who)profiling HIV,tuberculosis(TB),and malaria as priority“poverty-related”killing diseases(1).This has led to the creation of the Global Fund to Fight AIDS,tuberculosis,and Malaria(2),that has mobilized substantial resources to advance the control of all three diseases,even if mostly in a siloed manner.

关键词： Malaria diseases malaria