GBD 2010: design, definitions, and metrics.

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98121, USA. Electronic address: .
The Lancet (Impact Factor: 39.21). 12/2013; 380(9859):2063-6. DOI: 10.1016/S0140-6736(12)61899-6
Source: PubMed
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    ABSTRACT: This study introduces methods for estimating the cost of liver disease and presents useful and reliable sources of data. The available evidence on the costs associated with liver disease is also discussed. Costing methodology can be used to identify, measure, and value relevant resources incurred during the care of patients with liver diseases. It adjusts for discounting, skewed distribution, and missing or censored cost data. The human capital approach for productivity cost assumes that deceased patients would have lived to a normal expected life expectancy, and have earned a salary in line with the current age profile of wages, in order to measure potential earnings lost due to premature death or job loss. The number of deaths due to liver cancer (C22) increased from 6,384 in 1983 to 11,405 in 2013, while deaths due to other liver diseases (K70-K76) increased from 12,563 in 1983 to 13,458 in 1995, and then declined to 6,665 in 2013. According to the Global Burden of Disease study conducted by the World Health Organization, liver cancer caused 325,815 disability-adjusted life years (DALYs), and cirrhosis of the liver caused 206,917 DALYs in 2012. The total cost of liver disease was estimated at 1,941 billion Korean won in 2001 and 5,689 billion Korean won in 2008. Much of this cost is attributable to productivity cost, and especially that of economically active men. The economic burden of liver disease is immense because of the associated high mortality and morbidity, especially among the economically active population. This indicates the need to prioritize the development of appropriate health interventions.
    03/2015; 21(1):14-21. DOI:10.3350/cmh.2015.21.1.14
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    ABSTRACT: Arachidonic acid (ARA), an omega-6 fatty acid, is a potent schistosomicide that displayed significant and safe therapeutic effects in Schistosoma mansoni-infected schoolchildren in S. mansoni low-prevalence regions. We here report on ARA efficacy and safety in treatment of schoolchildren in S. mansoni high-endemicity areas of Kafr El Sheikh, Egypt. The study was registered with (NCT02144389). In total, 268 schoolchildren with light, moderate, or heavy S. mansoni infection were assigned to three study arms of 87, 91, and 90 children and received a single dose of 40 mg/kg praziquantel (PZQ), ARA (10 mg/kg per day for 15 days), or PZQ combined with ARA, respectively. The children were examined before and after treatment for stool parasite egg counts and blood biochemical, hematological, and immunological parameters. ARA, like PZQ, induced moderate cure rates (50% and 60%, respectively) in schoolchildren with light infection and modest cure rates (21% and 20%, respectively) in schoolchildren with high infection. PZQ and ARA combined elicited 83% and 78% cure rates in children with light and heavy infection, respectively. Biochemical and immunological profiles were either unchanged or ameliorated after ARA therapy. Combination of PZQ and ARA might be useful for treatment of children with schistosomiasis in high-endemicity regions. © The American Society of Tropical Medicine and Hygiene.
    The American journal of tropical medicine and hygiene 01/2015; 92(4). DOI:10.4269/ajtmh.14-0675 · 2.74 Impact Factor
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    ABSTRACT: Background Globally, diarrhoea is the second leading cause of morbidity and mortality, responsible for the annual loss of about 10% of the total global childhood disease burden. In Tanzania, Rotavirus infection is the major cause of severe diarrhoea and diarrhoeal mortality in children under five years. Immunisation can reduce the burden, and Tanzania added rotavirus vaccine to its national immunisation programme in January 2013. This study explores the cost effectiveness of introducing rotavirus vaccine within the Tanzania Expanded Programme on Immunisation (EPI). Methods We quantified all health system implementation costs, including programme costs, to calculate the cost effectiveness of adding rotavirus immunisation to EPI and the existing provision of diarrhoea treatment (oral rehydration salts and intravenous fluids) to children. We used ingredients and step down costing methods. Cost and coverage data were collected in 2012 at one urban and one rural district hospital and a health centre in Tanzania. We used Disability Adjusted Life Years (DALYs) as the outcome measure and estimated incremental costs and health outcomes using a Markov transition model with weekly cycles up to a five-year time horizon. Results The average unit cost per vaccine dose at 93% coverage is US$ 8.4, with marked difference between the urban facility US$ 5.2; and the rural facility US$ 9.8. RV1 vaccine added to current diarrhoea treatment is highly cost effective compared to diarrhoea treatment given alone, with incremental cost effectiveness ratio of US$ 112 per DALY averted, varying from US$ 80–218 in sensitivity analysis. The intervention approaches a 100% probability of being cost effective at a much lower level of willingness-to-pay than the US$609 per capita Tanzania gross domestic product (GDP). Conclusions The combination of rotavirus immunisation with diarrhoea treatment is likely to be cost effective when willingness to pay for health is higher than USD 112 per DALY. Universal coverage of the vaccine will accelerate progress towards achievement of the child health Millennium Development Goals.
    Cost Effectiveness and Resource Allocation 04/2015; 13(1). DOI:10.1186/s12962-015-0033-0 · 0.87 Impact Factor