Screening for tuberculosis with Xpert MTB/RIF versus fluorescent microscopy among adults newly diagnosed with HIV in rural Malawi: a cluster randomized trial (CHEPETSA).
27 July - Tuberculosis (TB) remains the leading cause of death among HIV-positive individuals globally. Screening for TB at the point of HIV diagnosis with a high-sensitivity assay presents an opportunity to reduce mortality.
Specific human antibody responses to Aedes aegypti and Aedes polynesiensis saliva: A new epidemiological tool to assess human exposure to disease vectors in the Pacific
24 AUG - In Pacific islands like in most tropical regions, Aedes mosquitoes affect the health of human populations by transmitting diseases like dengue, chikungunya, Zika and filariasis. The biting nuisance of Aedes mosquitoes also impacts local tourism, affecting the sustainability of island economies. Mosquito saliva is injected during the biting process, and the response triggered by the human immune system to proteins contained in mosquito saliva was shown to be a relevant biomarker of exposure to mosquito bites. Using this approach, we have developed an immuno-epidemiological tool to investigate the exposure of people to the bites of Aedes aegypti and Aedes polynesiensis, two significant mosquito vectors of infectious diseases in French Polynesia and other island countries and territories in the Pacific. This novel tool proved specific and reliable. It will improve the assessment of disease transmission risk and be useful for measuring the efficacy of both conventional and innovative vector control strategies.
Financial protection analysis in eight countries in the WHO South-East Asia Region
17 JUL - The aim of this study was to document the financial protection status of eight countries of the South-East Asian region and to investigate the main components of out-of-pocket expenditure on health care. The authors calculated two financial protection indicators using data from living standards surveys or household income and expenditure surveys in Bangladesh, Bhutan, India, Maldives, Nepal, Sri Lanka, Thailand and Timor-Leste. First, they calculated the incidence of catastrophic health expenditure, defined as the proportion of the population spending more than 10% or 25% of their total household expenditure on health. Second, using World Bank poverty lines, they determined the impoverishing effect of health-care spending by households. Across countries in this study, 242.7 million people experienced catastrophic health expenditure at the 10% threshold, and 56.4 million at the 25% threshold. It was calculated that 58.2 million people were pushed below the extreme poverty line of 1.90 United States dollars (US$) and 64.2 million people below US$ 3.10 (per capita per day values in 2011 purchasing power parity), due to out-of-pocket spending on health. Spending on medicines was the main component of out-of-pocket spending in most of the countries.
TIPS FROM VIETNAM: DESIGNING TECHNOLOGY TO REDUCE ANTIBIOTIC USE AND RESISTANCE
7 JUL - Working on a mobile application has made me realise how much our life depends on technological solutions, yet we understand so little about them. This is not so different from how antibiotics have helped enable a more productive society through better health - although few of us know how they came about.
End of Project Evaluation of the Foundation for Innovative New Diagnostics (FIND) project on sustainable Global and National Quality Control for Malaria Rapid Diagnostic Tests (RDTs)
24 JUN - The purpose of this evaluation was to conduct an end-of-project evaluation of the Foundation for Innovative New Diagnostics (FIND) project on sustainable global and national quality control of malaria rapid diagnostic tests (mRDTs).
Life satisfaction, QALYs, and the monetary value of health [Subscription may be required]
18 June - The monetary value of a quality-adjusted life-year (QALY) is frequently used to assess the benefits of health interventions and inform funding decisions. However, there is little consensus on methods for the estimation of this monetary value. In this study, we use life satisfaction as an indicator of ‘experienced utility’, and estimate the dollar equivalent value of a QALY using a fixed effect model with instrumental variable estimators. Using a nationally-representative longitudinal survey including 28,347 individuals followed during 2002–2015 in Australia, we estimate that individual's willingness to pay for one QALY is approximately A$42,000-A$67,000, and the willingness to pay for not having a long-term condition approximately A$2000 per year.
The One Health Concept: 10 Years Old and a Long Road Ahead
Human population increase, industrialization, and geopolitical problems accelerate global changes causing significant damage to biodiversity, extensive deterioration of ecosystems, and considerable migratory movement of both mankind and species in general. These rapid environmental changes are linked to the emergence and re-emergence of infectious and non-infectious diseases. Some key examples illustrate the degree to which the adoption of a “One Health” approach is both consensual and particularly effective in deciphering the processes underlying the emergence and re-emergence of diseases. Promoting the integrative benefits expected of the “One Health” concept requires a new interface with human, social, and legal sciences that remains to be built.
Fifty years of Asian experience in the spread of education and healthcare
30 AUG - UNU-WIDER Working Paper no. 2018/97
This paper analyses the dramatic spread of education and healthcare in Asia, and also the large variations in that spread across and within countries over 50 years. Apart from differences in initial conditions and income levels, the nature of the state has also been an important determinant of these variations. This is because social development has typically been led by the state. But in most countries, public resource constraints and the growing dependence on private provision and private spending have generated a pattern of nested disparities in the access to education and healthcare between rich and poor regions, between rural and urban areas within regions, and between rich and poor households within these areas. However, as the better-off regions, areas, and households approach the upper limits of achievable education and health standards, a process of convergence is also underway as those left behind begin to catch up.