Global Health Research and Policy最新文献

{"title":"Impact of access to coronary angiography and percutaneous coronary intervention on in-hospital and five-year mortality in patients with acute coronary syndrome: a propensity-matched cohort study in Thailand.","authors":"Ponlagrit Kumwichar, Jutatip Thungthong, Tippawan Liabsuetrakul, Hisateru Tachimori, Mariko Hosozawa, Eiko Saito, Yuta Taniguchi, Virasakdi Chongsuvivatwong, Hiroyasu Iso","doi":"10.1186/s41256-024-00390-x","DOIUrl":"10.1186/s41256-024-00390-x","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery angiography (CAG) and percutaneous coronary intervention (PCI) are superior to non-invasive approaches in reducing mortality in patients with ST-segment elevation myocardial infarction (STEMI). However, their efficacy remains uncertain in non-ST-elevation acute coronary syndromes (NSTE-ACS) and limited in low-resource settings. This study aimed to compare in-hospital and 5-year mortality rates between patients with a first event of STEMI and NSTE-ACS who underwent CAG and PCI and those with similar severity who did not undergo CAG and PCI.</p><p><strong>Methods: </strong>A propensity-matched retrospective cohort study was conducted using population-based claims data of national universal coverage of Thailand for identification of patients with acute coronary syndromes. The mortality of recruited patients was additionally linked to the national database of vital registration. Patients aged ≥ 40 years who were hospitalized for STEMI and NSTE-ACS in 2017, with a focus on access to CAG and PCI were included. For each condition either STEMI or NSTE-ACS, patients who underwent CAG and PCI were matched to those who did not undergo using propensity score matching (PSM) to balance measured confounders, such as age, sex, and underlying conditions. In-hospital mortality rate ratio and 5-year mortality were analyzed as measures.</p><p><strong>Results: </strong>Through PSM, 2,702 non-intervention STEMI patients were paired with an equal number of intervention patients, and similarly, 5,072 non-intervention NSTE-ACS patients were matched with an equivalent group who received interventions. For patients with STEMI, the in-hospital mortality rate ratio (95% confidence interval (CI)) for those who underwent CAG and PCI compared to those who did not was 30.1% (30.0%, 30.2%). Similar trends were observed in patients with NSTE-ACS with a mortality rate of 34.7% (34.6%, 34.8%). For the five-year mortality comparison, the hazard ratios (95% CI) of mortality after discharge were 0.55 (0.50, 0.62) for STEMI and 0.57 (0.54, 0.61) for NSTE-ACS cases.</p><p><strong>Conclusions: </strong>Access to CAG and PCI was significantly associated with lower in-hospital and 5-year mortality rates in patients who experienced their first event of ACS, despite the limited availability of some unmeasured or residual confounders. Healthcare systems should expand their resources for CAG and PCI in Thailand and other countries to equitably enhance longevity.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"48"},"PeriodicalIF":4.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of potential drug‒drug interactions and associated factors among elderly patients in Ethiopia: a systematic review and meta-analysis.","authors":"Tekletsadik Tekleslassie Alemayehu, Yilkal Abebaw Wassie, Abaynesh Fentahun Bekalu, Addisu Afrassa Tegegne, Wondim Ayenew, Gebresilassie Tadesse, Demis Getachew, Abebaw Setegn Yazie, Bisrat Birke Teketelew, Mekonnen Derese Mekete, Setegn Fentahun, Tesfaye Birhanu Abebe, Tefera Minwagaw, Gebremariam Wulie Geremew","doi":"10.1186/s41256-024-00386-7","DOIUrl":"10.1186/s41256-024-00386-7","url":null,"abstract":"<p><strong>Background: </strong>The occurrence of potential drug‒drug interactions (pDDIs) is a serious global issue that affects all age groups, with the elderly population being the most vulnerable. This is due to their relatively high rates of comorbidity and polypharmacy, as well as physiological changes that can increase the potential for DDIs and the likelihood of adverse drug reactions. The aim of this study was to estimate the prevalence of pDDIs and associated factors among elderly patients in Ethiopia.</p><p><strong>Methods: </strong>A comprehensive literature search using the preferred reporting items for systematic review and meta-analysis statement was conducted on HINARI, Science Direct, Embase, PubMed/MEDLINE, Google Scholar, and Research Gate. Data were extracted via a Microsoft Excel spreadsheet and analyzed via STATA version 11.0. Egger regression tests and funnel plot analysis were used to check publication bias, and the I² statistic was used to evaluate statistical heterogeneity. Sensitivity and subgroup analyses were also conducted to identify potential causes of heterogeneity.</p><p><strong>Results: </strong>Seven articles were analyzed, and a total of 1897 pDDIs were identified in 970 patients, resulting in an average of 1.97 DDIs per patient. The number of DDIs per patient ranged from 0.18 to 5.86. The overall prevalence of pDDIs among elderly patients was 50.69% (95% CI 18.77-82.63%). However, the prevalence of pDDIs ranged widely from 2.80 to 90.1%. When the severity of the interactions was considered, the prevalence of potential DDIs was found to be 28.74%, 70.68%, and 34.20% for major, moderate, and minor pDDIs, respectively. Polypharmacy and long hospital stays were identified as factors associated with pDDIs among elderly patients in Ethiopia.</p><p><strong>Conclusions: </strong>The overall prevalence of pDDIs among elderly patients was high, with a wide range of prevalence rates. Moderate-severity interactions were the most prevalent. Polypharmacy and long hospital stays were identified as factors associated with pDDIs among elderly patients. The study suggests that DDIs identification database itself could have modified the DDIs prevalence rate. As a result, a single DDIs identification database needs to be authorized; otherwise, clinical knowledge should be taken into account when interpreting the information obtained.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"46"},"PeriodicalIF":4.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"El Niño southern oscillation, weather patterns, and bacillary dysentery in the Yangtze River Basin, China.","authors":"Caiji Li, Xiaowen Wang, Zehua Liu, Liangliang Cheng, Cunrui Huang, Jing Wang","doi":"10.1186/s41256-024-00389-4","DOIUrl":"10.1186/s41256-024-00389-4","url":null,"abstract":"<p><strong>Background: </strong>Increasingly intense weather anomalies associated with interannual climate variability patterns, like El Niño-southern oscillation (ENSO), could exacerbate the occurrence and transmission of infectious diseases. However, research in China remains limited in understanding the impacts and intermediate weather changes of ENSO on bacillary dysentery (BD). This study aimed to reveal the relationship between ENSO, weather conditions, and the incidence of BD, and to identify the potential meteorological pathways moderated by ENSO in the ENSO-BD connections.</p><p><strong>Methods: </strong>BD disease data and meteorological data, as well as ENSO index, from 2005 to 2020 were obtained for 95 cities in the Yangtze River Basin. We first established the associations between ENSO events and BD, ENSO and weather, as well as weather and BDs using two-stage statistical models. Then, we applied a causal mediation analysis to identify the specific meteorological changes in the ENSO-BD relationship.</p><p><strong>Results: </strong>In the Yangtze River Basin, both El Niño (IRR: 1.06, 95%CI: 1.04 ~ 1.08) and La Niña (IRR: 1.03, 95%CI: 1.02 ~ 1.05) events were found to increase the risk of BD. Variations of ENSO index were associated with changes in local weather conditions. Both the increases in regional temperatures and rainfall were associated with a higher risk of BD. In the casual mediation analyses, we identified that higher temperatures and excessive rainfall associated with La Niña and El Niño events mediated the ENSO's effect on BD, with mediation proportions of 38.58% and 34.97%, respectively.</p><p><strong>Conclusions: </strong>Long-term climate variability, like ENSO, can affect regional weather conditions and lead to an increased risk of BD. We identified the mediating weather patterns in the relationship between ENSO and BD, which could improve targeted health interventions and establish an advanced early warning system in response to the BD epidemic.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"45"},"PeriodicalIF":4.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges associated with the implementation of institutional quarantine and isolation strategies during major multicountry viral outbreaks in Africa (2000-2023): a scoping review.","authors":"Jimoh Amzat, Ebunoluwa Oduwole, Saheed Akinmayowa Lawal, Olusola Aluko-Arowolo, Rotimi Afolabi, Isaac Akinkunmi Adedeji, Ige Angela Temisan, Ayoyinka Oludiran, Kafayat Aminu, Afeez Abolarinwa Salami, Kehinde Kazeem Kanmodi","doi":"10.1186/s41256-024-00385-8","DOIUrl":"10.1186/s41256-024-00385-8","url":null,"abstract":"<p><strong>Background: </strong>Quarantine and isolation (Q&I) are interrelated but not mutually exclusive public health practices for disease control, which may face public resistance in the context of health emergencies due to associated challenges. Hence, it is often tough for most countries to implement Q&I even in the context of health emergencies. Therefore, this scoping review examines the challenges associated with the implementation of institutional Q&I strategies during major multicountry viral outbreaks (Ebola, Lassa and COVID-19) in Africa between 2000 and 2023.</p><p><strong>Methods: </strong>This scoping review was designed based on Arksey and O'Malley's guidelines. A systematic literature search, using nine online research databases, was conducted with the aid of relevant search terms, Boolean operators and truncations. All articles obtained from the literature search were electronically imported into Rayyan web application for deduplication based on specific inclusion and exclusion criteria. From the included literature, relevant data were charted, summarized, collated, and presented.</p><p><strong>Results: </strong>This review included 24 of the 787 retrieved articles. Sixteen of the 24 selected articles investigated issues related to COVID-19 prevention and control in Africa. Two assessed precautionary practices for Lassa fever, while five were on Ebola virus disease. However, one article explored knowledge, preventive practices, and general isolation precautions. The review identified various challenges that hindered the implementation of successful Q&I practices during viral infection outbreaks in Africa. Essential healthcare infrastructure, equipment (medical supplies including personal protective equipment and testing kits) and facilities that are essential for Q&I were deficient. Q&I implementation was often threatened by low human resource capacity and inefficiencies in the healthcare system which portray Africa as unprepared to handle complex public health crises.</p><p><strong>Conclusions: </strong>This review shows that Q&I implementation in Africa is often threatened by low human resource capacity and inefficiencies in the healthcare system and also portrays Africa as unprepared to handle complex public health crises. Hence, Q&I for major multicountry outbreaks in Africa is very challenging. Therefore, continuous efforts to address these identified challenges are crucial to enhancing health emergency preparedness in Africa.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"44"},"PeriodicalIF":4.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to leverage implementation research for equity in global health.","authors":"Olakunle Alonge","doi":"10.1186/s41256-024-00388-5","DOIUrl":"https://doi.org/10.1186/s41256-024-00388-5","url":null,"abstract":"<p><p>Implementation research (IR) is important for addressing equity in global health. However, there is limited knowledge on how to operationalize IR for health equity, and pathways for improving health equity through IR in global health settings. This paper provides an overview of guidance and frameworks for thinking about health equity as part of IR while noting the gaps in how this guidance and frameworks apply to global health. It proposes an approach to guide implementation teams in the application of IR for achieving equity in global health considering these gaps. It describes key equity considerations for different aspects of IR (i.e., implementation contexts, strategies, outcomes, and research designs). These considerations can be applied prospectively and retrospectively, and at different stages of IR. The paper further describes causal pathways, intervention levers, and strategies for achieving health equity in global health settings through IR. Central to these pathways is the power asymmetries among different actors involved in IR in global health and how these contribute to health inequities. The paper suggests recommendations and strategies for shifting the balance of power among these actors while addressing the structural and systemic determinants of health inequities as part of IR. Explicit considerations for health equity as part of implementation research and practice are needed for the achievement of global health goals. Such explicit considerations should look back as much as possible, and entail defining and analyzing health inequities and intervening on the underlying causes and mechanisms of health inequities as part of IR on a routine basis.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"43"},"PeriodicalIF":4.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From silos to synergy: a consortium approach to air pollution and public health in Abu Dhabi.","authors":"Barrak Alahmad, Ernani F Choma, Basem Al-Omari, Eman Alefishat, Abdu Adem, John S Evans, Petros Koutrakis, Senthil Rajasekaran","doi":"10.1186/s41256-024-00383-w","DOIUrl":"10.1186/s41256-024-00383-w","url":null,"abstract":"<p><p>Financial resources alone cannot guarantee effective public health policy. In Abu Dhabi, massive economic growth in the desert climate resulted in concentrated urbanization and led to challenges in the regulation of air pollution. The Environment Agency in Abu Dhabi commissioned us to scope the regulatory challenges for air pollution. Part of this project relied on the participation and involvement of key stakeholders. We found three barriers: (1) limited appreciation of uncertainties in risk estimates and discussion on the importance of considering control costs and the societal trade-offs between health and wealth inherent in such decisions, (2) compartmentalization of efforts, and (3) challenges to decide how to prioritize risks in policy agendas. We propose a consortium-like approach that brings stakeholders together and places risk, uncertainty, and tradeoffs between health and wealth at the forefront of decision-making. Expected outcomes include improved collaboration and information sharing, strategic prioritization of emission controls, and a better understanding and consideration of uncertainty to guide future public health research.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"41"},"PeriodicalIF":4.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11453071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptake of biosimilars in China: a retrospective analysis of the case of trastuzumab from 2018 to 2023.","authors":"Qiyou Wu, Zhitao Wang, Yihan Fu, Ren Luo, Jing Sun","doi":"10.1186/s41256-024-00372-z","DOIUrl":"10.1186/s41256-024-00372-z","url":null,"abstract":"<p><strong>Background: </strong>The Chinese biosimilar industry has demonstrated rapid growth in recent years. Limited evidence is available about biosimilar uptake at the national level. This study aimed to assess biosimilar uptake in the case of trastuzumab and to explore potential factors influencing the biosimilar penetration at national and provincial levels.</p><p><strong>Methods: </strong>This study employed an interrupted time series analysis to assess the level and trend changes of national trastuzumab originator consumption and the overall trastuzumab consumption after the price reduction of the originator and the introduction of the first biosimilar using the China Hospital Pharmacy Audit procurement data from March 2018 to February 2023. A latent class trajectory model (LCTM) was also adopted to estimate the biosimilar penetration across 30 provincial-level administrative divisions (PLADs). Based on the LCTM grouping results, provincial characteristics were analyzed.</p><p><strong>Results: </strong>After rapid growth, the penetration of biosimilars demonstrated a moderate ascending trend at the national level, reaching 27% in February 2023. Following the introduction of the first biosimilar in July 2021, the consumption of the originator decreased by 0.5% per month (P = 0.008), and the growth rate of overall trastuzumab consumption decreased by 1.1% per month (P = 0.014). LCTM fit the best when the number of trajectory classes was two, dividing 30 PLADs into a group demonstrating a faster increase in biosimilar penetration and the other with a slower increase. The PLADs in the fast-increasing group had a higher proportion of the population covered by the national basic health insurance, a lower proportion of the urban population, a lower proportion of the population covered by the urban employee health insurance program, a lower gross domestic product per capita, a lower total health expenditure per capita, and a lower out-of-pocket expenditure.</p><p><strong>Conclusions: </strong>The uptake of trastuzumab biosimilars in China was lower compared with major European countries. The introduction of trastuzumab biosimilars presented a substitutional effect. Perceptions of physicians and patients, the medicines procurement model, competition from other biologics, and health insurance payment methods may influence biosimilar uptake. Enhancing a comprehensive understanding of biosimilars among physicians and patients, including biologics with biosimilars in the national pooled procurement, and implementing provider payment reforms could foster biosimilar penetration.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"42"},"PeriodicalIF":4.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11453021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The gender gap in outpatient care for non-communicable diseases in Mexico between 2006 and 2022.","authors":"Edson Serván-Mori, Ileana Heredia-Pi, Carlos M Guerrero-López, Stephen Jan, Laura Downey, Rocío Garcia-Díaz, Gustavo Nigenda, Emanuel Orozco-Núñez, María de la Cruz Muradás-Troitiño, Laura Flamand, Robyn Norton, Rafael Lozano","doi":"10.1186/s41256-024-00377-8","DOIUrl":"https://doi.org/10.1186/s41256-024-00377-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Equitable health service utilization is key to health systems' optimal performance and universal health coverage. The evidence shows that men and women use health services differently. However, current analyses have failed to explore these differences in depth and investigate how such gender disparities vary by service type. This study examined the gender gap in the use of outpatient health services by Mexican adults with non-communicable diseases (NCDs) from 2006 to 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional population-based analysis of data drawn from National Health and Nutrition Surveys of 2006, 2011-12, 2020, 2021, and 2022 was performed. Information was gathered from 300,878 Mexican adults aged 20 years and older who either had some form of public health insurance or were uninsured. We assessed the use of outpatient health services provided by qualified personnel for adults who reported having experienced an NCD and seeking outpatient care in the 2 weeks before the survey. Outpatient service utilization was disaggregated into four categories: non-use, use of public health services from providers not corresponding to the user's health insurance, use of public health services from providers not corresponding to the user's health insurance, and use of private services. This study reported the mean percentages (with 95% confidence intervals [95% CIs]) for each sociodemographic covariate associated with service utilization, disaggregated by gender. The percentages were reported for each survey year, the entire study period, the types of service use, and the reasons for non-use, according to the type of health problem. The gender gap in health service utilization was calculated using predictive margins by gender, type of disease, and survey year, and adjusted through a multinomial logistic regression model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, we found that women were less likely to fall within the \"non-use\" category than men during the entire study period (21.8% vs. 27.8%, P &lt; 0.001). However, when taking into account the estimated gender gap measured by incremental probability and comparing health needs caused by NCDs against other conditions, compared with women, men had a 7.4% lower incremental likelihood of falling within the non-use category (P &lt; 0.001), were 10.8% more likely to use services from providers corresponding to their health insurance (P &lt; 0.001), and showed a 12% lower incremental probability of using private services (P &lt; 0.001). Except for the gap in private service utilization, which tended to shrink, the others remained stable throughout the period analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Over 16 years of outpatient service utilization by Mexican adults requiring care for NCDs has been characterized by the existence of gender inequalities. Women are more likely either not to receive care or resort to using private outpatient services, often resulting in catastrophic out-o","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"40"},"PeriodicalIF":4.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthesized economic evidence on the cost-effectiveness of screening familial hypercholesterolemia.","authors":"Mengying Wang, Shan Jiang, Boyang Li, Bonny Parkinson, Jiao Lu, Kai Tan, Yuanyuan Gu, Shunping Li","doi":"10.1186/s41256-024-00382-x","DOIUrl":"https://doi.org/10.1186/s41256-024-00382-x","url":null,"abstract":"<p><strong>Background: </strong>Familial hypercholesterolemia (FH) is a prevalent genetic disorder with global implications for severe cardiovascular diseases. Motivated by the growing recognition of the need for early diagnosis and treatment of FH to mitigate its severe consequences, alongside the gaps in understanding the economic implications and equity impacts of FH screening, this study aims to synthesize the economic evidence on the cost-effectiveness of FH screening and to analyze the impact of FH screening on health inequality.</p><p><strong>Methods: </strong>We conducted a systematic review on the economic evaluations of FH screening and extracted information from the included studies using a pre-determined form for evidence synthesis. We synthesized the cost-effectiveness components involving the calculation of synthesized incremental cost-effectiveness ratios (ICERs) and net health benefit (NHB) of different FH screening strategies. Additionally, we applied an aggregate distributional cost-effectiveness analysis (DCEA) to assess the impact of FH screening on health inequality.</p><p><strong>Results: </strong>Among the 19 studies included, over half utilized Markov models, and 84% concluded that FH screening was potentially cost-effective. Based on the synthesized evidence, cascade screening was likely to be cost-effective, with an ICER of $49,630 per quality-adjusted life year (QALY). The ICER for universal screening was $20,860 per QALY as per evidence synthesis. The aggregate DCEA for six eligible studies presented that the incremental equally distributed equivalent health (EDEH) exceeded the NHB. The difference between EDEH and NHB across the six studies were 325, 137, 556, 36, 50, and 31 QALYs, respectively, with an average positive difference of 189 QALYs.</p><p><strong>Conclusions: </strong>Our research offered valuable insights into the economic evaluations of FH screening strategies, highlighting significant heterogeneity in methods and outcomes across different contexts. Most studies indicated that FH screening is cost-effective and contributes to improving overall population health while potentially reducing health inequality. These findings offer implications that policies should promote the implementation of FH screening programs, particularly among younger population. Optimizing screening strategies based on economic evidence can help identify the most effective measures for improving health outcomes and maximizing cost-effectiveness.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"38"},"PeriodicalIF":4.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of an infectious disease control competency scale for public health professionals.","authors":"Yiguo Zhou, Wan-Xue Zhang, Shan-Shan Zhang, Ning-Hua Huang, Jing Zeng, Han Yang, Qin-Yi Ma, Le Ao, Ya-Qiong Liu, Juan Du, Xiao-Ling Tian, Qing-Bin Lu, Fuqiang Cui","doi":"10.1186/s41256-024-00381-y","DOIUrl":"https://doi.org/10.1186/s41256-024-00381-y","url":null,"abstract":"<p><strong>Background: </strong>Infectious diseases persistently pose global threats, and it is imperative to accelerate the professionalization of public health workforce. This study aimed to develop and validate the infectious disease control competency scale (IDCCS) for public health professionals to fill a theoretical gap and elevate practical capabilities by informing public health professionals' development goals.</p><p><strong>Methods: </strong>The initial item pool was generated through a literature review, and categorized into three dimensions (knowledge, practical skills, and leadership) based on the competency iceberg model and public health leadership framework. A two-round Delphi process was conducted to determine indicators within the scale. A pilot survey was utilized for item analysis and exploratory factor analysis (EFA). A formal survey was employed for confirmatory factor analysis (CFA). The weight value of each indicator was calculated using the analytic hierarchy process.</p><p><strong>Results: </strong>An initial scale with three primary items, 14 secondary items, and 81 tertiary items was generated. Twenty experts participated in the two rounds of the Delphi process. Authority coefficients exceeded 0.9 in both rounds. Kendall's W was 0.29 and 0.19, respectively (both P < 0.001). Item analysis presented a Cronbach's Alpha of 0.98, with corrected item-total correlation coefficients ranging from 0.33 to 0.78. EFA demonstrated that cumulative variance explanations for the four primary dimensions (knowledge, practical skills, leadership, and personal quality) were 77.463%, 73.976%, 81.174%, and 68.654%, respectively. CFA indicated that all composite reliability values and average variance extracted surpassed 0.8 and 0.5, respectively. The standardized factor loadings of the items ranged from 0.630 to 0.977. Among the seven model fit indices, each of the four dimensions satisfied at least five criteria. A final three-level scale comprising four primary items, 14 secondary items, and 64 tertiary items was constructed. The weight values for the four primary items were 0.4064, 0.2878, 0.2082, and 0.0981, respectively.</p><p><strong>Conclusions: </strong>The IDCCS was established to evaluate the competencies of knowledge, practical skills, leadership, and personal quality for public health professionals in infectious disease control. This scale demonstrates good reliability and validity, and can be used for performance evaluation, recruitment processes, curriculum development, and individual self-assessment.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"39"},"PeriodicalIF":4.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}