Global Health Epidemiology and Genomics最新文献

{"title":"Evolving perspectives on broad consent for genomics research and biobanking in Africa. Report of the Second H3Africa Ethics Consultation Meeting, 11 May 2015.","authors":"J de Vries,&nbsp;K Littler,&nbsp;A Matimba,&nbsp;S McCurdy,&nbsp;O Ouwe Missi Oukem-Boyer,&nbsp;J Seeley,&nbsp;P Tindana","doi":"10.1017/gheg.2016.5","DOIUrl":"https://doi.org/10.1017/gheg.2016.5","url":null,"abstract":"<p><p>A report on the Second H3Africa Ethics Consultation Meeting, which was held in Livingstone, Zambia on 11 May 2015. The meeting demonstrated considerable evolution by African Research Ethics Committees on thinking about broad consent as a consent option for genomics research and biobanking. The meeting concluded with a call for broader engagement with policy makers across the continent in order to help these recognise the need for guidance and regulation where these do not exist and to explore harmonisation where appropriate and possible.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"1 ","pages":"e13"},"PeriodicalIF":1.9,"publicationDate":"2016-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2016.5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36192737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainable development goals, universal health coverage and equity in health systems: the Orang Asli commons approach.","authors":"Y S Wong, P Allotey, D D Reidpath","doi":"10.1017/gheg.2016.8","DOIUrl":"10.1017/gheg.2016.8","url":null,"abstract":"<p><p>Universal health coverage is a key health target in the Sustainable Development Goals (SDGs) that has the means to link equitable social and economic development. As a concept firmly based on equity, it is widely accepted at international and national levels as important for populations to attain 'health for all' especially for marginalised groups. However, implementing universal coverage has been fraught with challenges and the increasing privatisation of health care provision adds to the challenge because it is being implemented in a health system that rests on a property regime that promotes inequality. This paper asks the question, 'What does an equitable health system look like?' rather than the usual 'How do you make the existing health system more equitable?' Using an ethnographic approach, the authors explored via interviews, focus group discussions and participant observation a health system that uses the commons approach such as which exists with indigenous peoples and found features that helped make the system intrinsically equitable. Based on these features, the paper proposes an alternative basis to organise universal health coverage that will better ensure equity in health systems and ultimately contribute to meeting the SDGs.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"1 ","pages":"e12"},"PeriodicalIF":1.9,"publicationDate":"2016-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2016.8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36192736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Australian model of the First 1000 Days: an Indigenous-led process to turn an international initiative into an early-life strategy benefiting indigenous families.","authors":"R Ritte,&nbsp;S Panozzo,&nbsp;L Johnston,&nbsp;J Agerholm,&nbsp;S E Kvernmo,&nbsp;K Rowley,&nbsp;K Arabena","doi":"10.1017/gheg.2016.7","DOIUrl":"https://doi.org/10.1017/gheg.2016.7","url":null,"abstract":"<p><p>Internationally, the 1000 days movement calls for action and investment in improving nutrition for the period from a child's conception to their second birthday, thereby providing an organising framework for early-life interventions. To ensure Australian Indigenous families benefit from this 1000 days framework, an Indigenous-led year-long engagement process was undertaken linking early-life researchers, research institutions, policy-makers, professional associations and human rights activists with Australian Indigenous organisations and families. The resultant model, First 1000 Days Australia, broadened the international concept beyond improving nutrition. The First 1000 Days Australia model was built by adhering to Indigenous methodologies, a recognition of the centrality of culture that reinforces and strengthens families, and uses a holistic view of health and wellbeing. The First 1000 Days Australia was developed under the auspice of Indigenous people's leadership using a collective impact framework. As such, the model emphasises Indigenous leadership, mutual trust and solidarity to achieve early-life equity.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"1 ","pages":"e11"},"PeriodicalIF":1.9,"publicationDate":"2016-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2016.7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36192735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women and global health: a personal view.","authors":"J A Whitworth","doi":"10.1017/gheg.2016.6","DOIUrl":"https://doi.org/10.1017/gheg.2016.6","url":null,"abstract":"Women have been recognised as playing a central role in global health over millennia. Hygieia in both Greek and Roman mythology was the goddess of good health, cleanliness and sanitation, and her sisters Panacea, Acesco and Laso were goddesses of remedy, healing and recuperation, respectively. Florence Nightingale became a cult figure during the Crimean War and was a key figure in social reforms designed to improve health care across all levels of society. She is credited as the founder of modern nursing. More recently, a few women have made it to the top in global health, e.g. at international level Gro Harlem Bruntland and now Margaret Chan as Directors General of WHO, and at national level Dame Sally Davies as Chief Medical Officer of the UK (I was the Australian equivalent in the late nineties).","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"1 ","pages":"e10"},"PeriodicalIF":1.9,"publicationDate":"2016-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2016.6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36192734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a role of pharmacogenomics in Africa.","authors":"A Matimba,&nbsp;M Dhoro,&nbsp;C Dandara","doi":"10.1017/gheg.2016.4","DOIUrl":"https://doi.org/10.1017/gheg.2016.4","url":null,"abstract":"<p><p>Pharmacogenomics has the potential of transforming clinical research and improving healthcare in sub-Saharan Africa (SSA). The role of African genome diversity and the opportunities for pharmacogenomics research are highlighted and will enable discovery of novel genetic mechanisms and validation of established markers. African genomics and biobank consortia will play an important role in building capacity for pharmacogenomics in SSA.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"1 ","pages":"e9"},"PeriodicalIF":1.9,"publicationDate":"2016-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2016.4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36192733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excess cost burden of diabetes in Southern India: a clinic-based, comparative cost-of-illness study.","authors":"K M Sharma,&nbsp;H Ranjani,&nbsp;A Zabetian,&nbsp;M Datta,&nbsp;M Deepa,&nbsp;C R Anand Moses,&nbsp;K M V Narayan,&nbsp;V Mohan,&nbsp;M K Ali","doi":"10.1017/gheg.2016.2","DOIUrl":"https://doi.org/10.1017/gheg.2016.2","url":null,"abstract":"<p><strong>Background: </strong>There are few data on excess direct and indirect costs of diabetes in India and limited data on rural costs of diabetes. We aimed to further explore these aspects of diabetes burdens using a clinic-based, comparative cost-of-illness study.</p><p><strong>Methods: </strong>Persons with diabetes (<i>n</i> = 606) were recruited from government, private, and rural clinics and compared to persons without diabetes matched for age, sex, and socioeconomic status (<i>n</i> = 356). We used interviewer-administered questionnaires to estimate direct costs (outpatient, inpatient, medication, laboratory, and procedures) and indirect costs [absence from (absenteeism) or low productivity at (presenteeism) work]. Excess costs were calculated as the difference between costs reported by persons with and without diabetes and compared across settings. Regression analyses were used to separately identify factors associated with total direct and indirect costs.</p><p><strong>Results: </strong>Annual excess direct costs were highest amongst private clinic attendees (INR 19 552, US$425) and lowest amongst government clinic attendees (INR 1204, US$26.17). Private clinic attendees had the lowest excess absenteeism (2.36 work days/year) and highest presenteeism (0.06 work days/year) due to diabetes. Government clinic attendees reported the highest absenteeism (7.48 work days/year) and lowest presenteeism (-0.31 work days/year). Ten additional years of diabetes duration was associated with 11% higher direct costs (<i>p</i> < 0.001). Older age (<i>p</i> = 0.02) and longer duration of diabetes (<i>p</i> < 0.001) were associated with higher total lost work days.</p><p><strong>Conclusions: </strong>Excess health expenditures and lost productivity amongst individuals with diabetes are substantial and different across care settings. Innovative solutions are needed to cope with diabetes and its associated cost burdens in India.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"1 ","pages":"e8"},"PeriodicalIF":1.9,"publicationDate":"2016-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2016.2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36192824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of gender inequality with child malnutrition and mortality across 96 countries.","authors":"A A Marphatia,&nbsp;T J Cole,&nbsp;C Grijalva-Eternod,&nbsp;J C K Wells","doi":"10.1017/gheg.2016.1","DOIUrl":"https://doi.org/10.1017/gheg.2016.1","url":null,"abstract":"<p><p>National efforts to reduce low birth weight (LBW) and child malnutrition and mortality prioritise economic growth. However, this may be ineffective, while rising gross domestic product (GDP) also imposes health costs, such as obesity and non-communicable disease. There is a need to identify other potential routes for improving child health. We investigated associations of the Gender Inequality Index (GII), a national marker of women's disadvantages in reproductive health, empowerment and labour market participation, with the prevalence of LBW, child malnutrition (stunting and wasting) and mortality under 5 years in 96 countries, adjusting for national GDP. The GII displaced GDP as a predictor of LBW, explaining 36% of the variance. Independent of GDP, the GII explained 10% of the variance in wasting and stunting and 41% of the variance in child mortality. Simulations indicated that reducing GII could lead to major reductions in LBW, child malnutrition and mortality in low- and middle-income countries. Independent of national wealth, reducing women's disempowerment relative to men may reduce LBW and promote child nutritional status and survival. Longitudinal studies are now needed to evaluate the impact of efforts to reduce societal gender inequality.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"1 ","pages":"e6"},"PeriodicalIF":1.9,"publicationDate":"2016-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2016.1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36192823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of a localised HIV epidemic and the associated excess mortality burden in a rural area of South Africa.","authors":"P Mee, K Kahn, C W Kabudula, R G Wagner, F X Gómez-Olivé, S Madhavan, Mark A Collinson, S M Tollman, P Byass","doi":"10.1017/gheg.2016.3","DOIUrl":"10.1017/gheg.2016.3","url":null,"abstract":"<p><p>The human immunodeficiency virus (HIV) epidemic in South Africa rapidly developed into a major pandemic. Here we analyse the development of the epidemic in a rural area of the country. The data used were collected between 1992 and 2013 in a longitudinal population survey, the Agincourt Health and Demographic Surveillance Study, in the northeast of the country. Throughout the period of study mortality rates were similar in all villages, suggesting that there were multiple index cases evenly spread geographically. These were likely to have been returning migrant workers. For those aged below 39 years the HIV mortality rate was higher for women, above this age it was higher for men. This indicates the protective effect of greater access to HIV testing and treatment among older women. The recent convergence of mortality rates for Mozambicans and South Africans indicates that the former refugee population are being assimilated into the host community. More than 60% of the deaths occurring in this community between 1992 and 2013 could be attributed directly or indirectly to HIV. Recently there has been an increasing level of non-HIV mortality which has important implications for local healthcare provision. This study demonstrates how evidence from longitudinal analyses can support healthcare planning.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"1 ","pages":"e7"},"PeriodicalIF":1.9,"publicationDate":"2016-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2016.3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35709849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"H3Africa multi-centre study of the prevalence and environmental and genetic determinants of type 2 diabetes in sub-Saharan Africa: study protocol.","authors":"K Ekoru, E H Young, C Adebamowo, N Balde, B J Hennig, P Kaleebu, S Kapiga, N S Levitt, M Mayige, J C Mbanya, M I McCarthy, O Nyan, M Nyirenda, J Oli, K Ramaiya, L Smeeth, E Sobngwi, C N Rotimi, M S Sandhu, A A Motala","doi":"10.1017/gheg.2015.6","DOIUrl":"10.1017/gheg.2015.6","url":null,"abstract":"<p><p>The burden and aetiology of type 2 diabetes (T2D) and its microvascular complications may be influenced by varying behavioural and lifestyle environments as well as by genetic susceptibility. These aspects of the epidemiology of T2D have not been reliably clarified in sub-Saharan Africa (SSA), highlighting the need for context-specific epidemiological studies with the statistical resolution to inform potential preventative and therapeutic strategies. Therefore, as part of the Human Heredity and Health in Africa (H3Africa) initiative, we designed a multi-site study comprising case collections and population-based surveys at 11 sites in eight countries across SSA. The goal is to recruit up to 6000 T2D participants and 6000 control participants. We will collect questionnaire data, biophysical measurements and biological samples for chronic disease traits, risk factors and genetic data on all study participants. Through integrating epidemiological and genomic techniques, the study provides a framework for assessing the burden, spectrum and environmental and genetic risk factors for T2D and its complications across SSA. With established mechanisms for fieldwork, data and sample collection and management, data-sharing and consent for re-approaching participants, the study will be a resource for future research studies, including longitudinal studies, prospective case ascertainment of incident disease and interventional studies.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"1 ","pages":"e5"},"PeriodicalIF":1.1,"publicationDate":"2016-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5732581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35687822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulatory developments in the conduct of clinical trials in India.","authors":"R Roy Chaudhury,&nbsp;D Mehta","doi":"10.1017/gheg.2015.5","DOIUrl":"https://doi.org/10.1017/gheg.2015.5","url":null,"abstract":"<p><p>There has been a drop in clinical research in India following stringent conditions put in place by the Indian Supreme Court in 2013. The Court's orders came in the wake of irregularities highlighted in the conduct of clinical trials in the country. This paper highlights the steps taken by the Indian regulator, the Central Drugs Standard Control Organisation to comply with these directions. These are of three kinds: strengthening regulatory institutions, protecting participant safety and creating regulatory certainty for sponsors and investigators. Examples include the large-scale training of Ethics Committees, framing detailed guidelines on compensation and audiovisual recording of the informed consent process, as well as reducing the time taken to process applications. It is expected that these measures will inspire confidence for the much-needed resumption of clinical research.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"1 ","pages":"e4"},"PeriodicalIF":1.9,"publicationDate":"2016-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2015.5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36192822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}