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Ajouter le résultat dans votre panier Affiner la rechercheCost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa / Nicolas A. Menzies (2016)
Titre : Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa : a combined analysis of nine models Type de document : document électronique Auteurs : Nicolas A. Menzies, Auteur ; Gabriela B. Gomez, Auteur ; Fiammetta Bozzani, Auteur Editeur : Elsevier Année de publication : 2016 Collection : Lancet Global Health num. vol. 4 issue 11 Importance : e816-e826 Présentation : graph. Langues : Anglais (eng) Catégories : [DIVERS] géographie:Afrique:Afrique subsaharienne:Afrique du Sud
[DIVERS] géographie:Asie:Asie du Sud:Inde
[DIVERS] géographie:Asie:Extrême-Orient:Chine
[TUBER] dépistage
[TUBER] étude:épidémiologie
[TUBER] traitement:traitement préventifIndex. décimale : TU 8.3. Traitement préventif Résumé : Background: The post-2015 End TB Strategy sets global targets of reducing tuberculosis incidence by 50% and mortality by 75% by 2025. We aimed to assess resource requirements and cost-effectiveness of strategies to achieve these targets in China, India, and South Africa.
Methods: We examined intervention scenarios developed in consultation with country stakeholders, which scaled up existing interventions to high but feasible coverage by 2025. Nine independent modelling groups collaborated to estimate policy outcomes, and we estimated the cost of each scenario by synthesising service use estimates, empirical cost data, and expert opinion on implementation strategies. We estimated health effects (ie, disability-adjusted life-years averted) and resource implications for 2016-35, including patient-incurred costs. To assess resource requirements and cost-effectiveness, we compared scenarios with a base case representing continued current practice.
Findings: Incremental tuberculosis service costs differed by scenario and country, and in some cases they more than doubled existing funding needs. In general, expansion of tuberculosis services substantially reduced patient-incurred costs and, in India and China, produced net cost savings for most interventions under a societal perspective. In all three countries, expansion of access to care produced substantial health gains. Compared with current practice and conventional cost-effectiveness thresholds, most intervention approaches seemed highly cost-effective.
Interpretation: Expansion of tuberculosis services seems cost-effective for high-burden countries and could generate substantial health and economic benefits for patients, although substantial new funding would be required. Further work to determine the optimal intervention mix for each country is necessary.
Funding: Bill & Melinda Gates Foundation.En ligne : https://doi.org/10.1016/s2214-109x(16)30265-0 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10857 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa, China, and India : a combined analysis of 11 mathematical models Type de document : document électronique Auteurs : Rein MGJ Houben, Auteur ; Nicolas A. Menzies, Auteur ; Tom Sumner, Auteur Editeur : Elsevier Année de publication : 2016 Collection : Lancet Global Health num. vol. 4 issue 11 Importance : e806-e815 Présentation : graph. ; tab. Langues : Anglais (eng) Catégories : [DIVERS] géographie:Afrique:Afrique subsaharienne:Afrique du Sud
[DIVERS] géographie:Asie:Asie du Sud:Inde
[DIVERS] géographie:Asie:Extrême-Orient:Chine
[TUBER] dépistage
[TUBER] étude:épidémiologie
[TUBER] traitement:traitement préventifIndex. décimale : TU 8.3. Traitement préventif Résumé : Background
The post-2015 End TB Strategy proposes targets of 50% reduction in tuberculosis incidence and 75% reduction in mortality from tuberculosis by 2025. We aimed to assess whether these targets are feasible in three high-burden countries with contrasting epidemiology and previous programmatic achievements.
Methods
11 independently developed mathematical models of tuberculosis transmission projected the epidemiological impact of currently available tuberculosis interventions for prevention, diagnosis, and treatment in China, India, and South Africa. Models were calibrated with data on tuberculosis incidence and mortality in 2012. Representatives from national tuberculosis programmes and the advocacy community provided distinct country-specific intervention scenarios, which included screening for symptoms, active case finding, and preventive therapy.
Findings
Aggressive scale-up of any single intervention scenario could not achieve the post-2015 End TB Strategy targets in any country. However, the models projected that, in the South Africa national tuberculosis programme scenario, a combination of continuous isoniazid preventive therapy for individuals on antiretroviral therapy, expanded facility-based screening for symptoms of tuberculosis at health centres, and improved tuberculosis care could achieve a 55% reduction in incidence (range 31–62%) and a 72% reduction in mortality (range 64–82%) compared with 2015 levels. For India, and particularly for China, full scale-up of all interventions in tuberculosis-programme performance fell short of the 2025 targets, despite preventing a cumulative 3·4 million cases. The advocacy scenarios illustrated the high impact of detecting and treating latent tuberculosis.
Interpretation
Major reductions in tuberculosis burden seem possible with current interventions. However, additional interventions, adapted to country-specific tuberculosis epidemiology and health systems, are needed to reach the post-2015 End TB Strategy targets at country level.
Funding
Bill and Melinda Gates FoundationEn ligne : https://doi.org/10.1016/s2214-109x(16)30199-1 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10856 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : The global burden of tuberculosis mortality in children : a mathematical modelling study Type de document : document électronique Auteurs : Peter J. Dodd, Auteur ; Courtney M. Yuen, Auteur ; Charalambos Sismanidis, Auteur ; James A. Seddon, Auteur ; Helen E. Jenkins, Auteur Editeur : Elsevier Année de publication : 2017 Collection : Lancet Global Health num. 5 Importance : p.e898–906 Présentation : ill. ; graph. ; tab. Langues : Anglais (eng) Catégories : [DIVERS] personne:famille:enfant
[TUBER] type de tuberculose:tuberculose-maladieIndex. décimale : TU 3.4. Enfant Résumé : Background: Tuberculosis in children is increasingly recognised as an important component of the global tuberculosis burden, with an estimated 1 million cases in 2015. Although younger children are vulnerable to severe forms of tuberculosis disease, no age-disaggregated estimates of paediatric tuberculosis mortality exist, and tuberculosis has never been included in official estimates of under-5 child mortality. We aimed to produce a global mortality burden estimate in children using a complementary approach not dependent on vital registration data.
Methods: In this mathematical modelling study, we estimated deaths in children younger than 5 years and those aged 5-14 years for 217 countries and territories using a case-fatality-based approach. We used paediatric tuberculosis notification data and HIV and antiretroviral treatment estimates to disaggregate the WHO paediatric tuberculosis incidence estimates by age, HIV, and treatment status. We then applied systematic review evidence on corresponding case-fatality ratios.
Findings: We estimated that 239 000 (95% uncertainty interval [UI] 194 000-298 000) children younger than 15 years died from tuberculosis worldwide in 2015; 80% (191 000, 95% UI 132 000-257 000) of these deaths were in children younger than 5 years. More than 70% (182 000, 140 000-239 000) of deaths occurred in the WHO southeast Asia and Africa regions. We estimated that 39 000 (17%, 23 000-73 000) paediatric tuberculosis deaths worldwide were in children with HIV infections, with 31 000 (36%, 19 000-59 000) in the WHO Africa region. More than 96% (230 000, 185 000-289 000) of all tuberculosis deaths occurred in children not receiving tuberculosis treatment.
Interpretation: Tuberculosis is a top ten cause of death in children worldwide and a key omission from previous analyses of under-5 mortality. Almost all these deaths occur in children not on tuberculosis treatment, implying substantial scope to reduce this burden.En ligne : https://doi.org/10.1016/s2214-109x(17)30289-9 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10915 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Tobacco use and second-hand smoke exposure in young adolescents aged 12–15 years: data from 68 low-income and middle-income countries Type de document : document électronique Auteurs : Bo Xi, Auteur ; Yajun Liang, Auteur ; Yunxia Liu, Auteur Editeur : Elsevier Année de publication : 2016 Collection : Lancet Global Health num. 4:11 Importance : 11 p. Présentation : tab., ill. Langues : Anglais (eng) Catégories : [DIVERS] géographie:Asie:Extrême-Orient:Chine
[DIVERS] géographie:pays en développement
[DIVERS] personne:par âge:jeune
[NICO] étude:enquête
[NICO] tabagisme:tabagisme actif
[NICO] tabagisme:tabagisme passifMots-clés : milieu scolaire Index. décimale : TA 2.4.1 Enfants et jeunes Résumé : Summary
Background Tobacco use is an important risk factor for non-communicable diseases worldwide. However, the global extent and prevalence of tobacco use in adolescents is poorly described. Using previously collected survey data, we aimed to assess tobacco use and second-hand smoke exposure in young adolescents aged 12–15 years in 68 low-income and middle-income countries.
Methods
We used data from the Global School-based Student Health Survey (2006–13) and the China Global Tobacco Youth Survey (2013), which are school-based surveys of young adolescents aged 12–15 years that assess health behaviours using a standardised, anonymous, self-reported questionnaire. We calculated the prevalence of current
tobacco use and exposure to second-hand smoke in young adolescents from 68 low-income and middle-income countries that collected these data in the surveys. We used a multilevel model to estimate the association between parental tobacco use, second-hand smoke, and adolescent tobacco use, adjusting for sex, age, school, school class,
country’s purchasing power parity, smoking initiation age, national prevalence of tobacco use among adults, year the WHO FCTC was ratifi ed for each country, proxy of socioeconomic status, and survey year.
Findings
The mean prevalence of current tobacco use was 13·6%, ranging from 2·8% in Tajikistan to 44·7% in Samoa. In most countries, the prevalence of tobacco use was higher for boys than girls, and higher for adolescents aged 14–15 years than for those aged 12–13 years. The overall prevalence of second-hand smoke exposure was 55·9%,
ranging from 16·4% in Tajikistan to 85·4% in Indonesia. Parental tobacco use (as reported by the young adolescents), especially maternal use, was associated with tobacco use in young adolescents (odds ratio 2·06, 95% CI 1·93–2·19, for maternal and 1·29, 1·23–1·35 for paternal use). Second-hand smoke exposure was also a risk factor for young adolescents’ tobacco use (2·56, 2·43–2·69). However, the prevalence of tobacco use was not associated with a country’s purchasing power parity.
Interpretation Tobacco use and second-hand smoke exposure were frequent among young adolescents aged 12–15 years in low-income and middle-income countries. Parental tobacco use and second-hand smoke exposure were strongly associated with young adolescents’ tobacco use. The data emphasise the need to strengthen tobacco
control interventions and programmes in young adolescents from low-income and middle-income countriesEn ligne : http://dx.doi.org/10.1016/ S2214-109X(16)30187-5 Format de la ressource électronique : Page de l'éditeur Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9577 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
