Gaps in health research in the Dominican Republic.

Objective To provide a basic profile of health research in the Dominican Republic by identifying health problems or diseases that have been addressed by studies implemented during the period 2009-2013 and to determine how well that research correlates with the burden of disease in the Dominican population. Methods This was a descriptive study that searched for primary and secondary data sources to identify health research implemented in the Dominican Republic in the years 2009 to 2013. Data about these projects were collected from the registries of clinicaltrials.gov and the Consejo Nacional de Bioética en Salud, as well as from a questionnaire directed to researchers and managers. Disability-adjusted life years (DALYs) were derived from the Global Burden of Disease Study 2013 for males and females of all ages in the Dominican Republic and then compared with the number of research studies conducted on each specific health condition. Results This study identified 313 health research projects conducted in the Dominican Republic during the years 2009-2013. HIV/AIDS and lower respiratory infections were the two main topics researched; however, they accounted for a relatively small percentage of total DALYs in males and females of all ages in the Dominican Republic in 2013. Conclusions Limited research is directed toward addressing the health needs of Dominicans. The ongoing process of setting priorities for health research in the Dominican Republic should direct its efforts toward fixing this imbalance.

Gaps in health research in the Dominican Republic / Brechas en la investigación en el ámbito de la salud en la República Dominicana

ABSTRACT Objective To provide a basic profile of health research in the Dominican Republic by identifying health problems or diseases that have been addressed by studies implemented during the period 2009–2013 and to determine how well that research correlates with the burden of disease in the Dominican population. Methods This was a descriptive study that searched for primary and secondary data sources to identify health research implemented in the Dominican Republic in the years 2009 to 2013. Data about these projects were collected from the registries of clinicaltrials.gov and the Consejo Nacional de Bioética en Salud, as well as from a questionnaire directed to researchers and managers. Disability-adjusted life years (DALYs) were derived from the Global Burden of Disease Study 2013 for males and females of all ages in the Dominican Republic and then compared with the number of research studies conducted on each specific health condition. Results This study identified 313 health research projects conducted in the Dominican Republic during the years 2009–2013. HIV/AIDS and lower respiratory infections were the two main topics researched; however, they accounted for a relatively small percentage of total DALYs in males and females of all ages in the Dominican Republic in 2013. Conclusions Limited research is directed toward addressing the health needs of Dominicans. The ongoing process of setting priorities for health research in the Dominican Republic should direct its efforts toward fixing this imbalance.

RESUMEN Objetivo Proporcionar un perfil básico de la investigación en el ámbito de la salud en la República Dominicana a través de la identificación de los problemas de salud o las enfermedades que han sido abordadas por los estudios realizados en el período 2000-2013, y determinar en qué medida esa investigación se corresponde con la carga de morbilidad en la población dominicana. Métodos Este fue un estudio descriptivo que buscó fuentes de datos primarias y secundarias para identificar las investigaciones en el ámbito de la salud realizadas en la República Dominicana desde el año 2009 hasta el 2013. Los datos sobre estos proyectos se recopilaron de los registros de clinicaltrials.gov y del Consejo Nacional de Bioética en Salud, así como de un cuestionario dirigido a los investigadores y los gerentes. Los años de vida ajustados en función de la discapacidad se derivaron del Estudio de Carga Mundial de Morbilidad 2013, para los hombres y las mujeres de todas las edades en la República Dominicana, y luego se compararon con el número de estudios de investigación sobre cada afección específica. Resultados Se identificaron 313 proyectos de investigación en salud realizados en la República Dominicana desde el 2009 hasta el 2013. La infección por el VIH/sida y las infecciones de las vías respiratorias inferiores fueron los dos principales temas investigados; sin embargo, representaban un porcentaje relativamente pequeño del total de años de vida ajustados en función de la discapacidad en los hombres y las mujeres de todas las edades en la República Dominicana en el 2013. Conclusiones La investigación dirigida a abordar las necesidades de salud de los dominicanos es limitada. El proceso en curso de fijación de prioridades para la investigación en el ámbito de la salud en la República Dominicana debe dirigir sus esfuerzos a corregir este desequilibrio.

National mass drug administration costs for lymphatic filariasis elimination.

BACKGROUND: Because lymphatic filariasis (LF) elimination efforts are hampered by a dearth of economic information about the cost of mass drug administration (MDA) programs (using either albendazole with diethylcarbamazine [DEC] or albendazole with ivermectin), a multicenter study was undertaken to determine the costs of MDA programs to interrupt transmission of infection with LF. Such results are particularly important because LF programs have the necessary diagnostic and treatment tools to eliminate the disease as a public health problem globally, and already by 2006, the Global Programme to Eliminate LF had initiated treatment programs covering over 400 million of the 1.3 billion people at risk. METHODOLOGY/PRINCIPAL FINDINGS: To obtain annual costs to carry out the MDA strategy, researchers from seven countries developed and followed a common cost analysis protocol designed to estimate 1) the total annual cost of the LF program, 2) the average cost per person treated, and 3) the relative contributions of the endemic countries and the external partners. Costs per person treated ranged from $0.06 to $2.23. Principal reasons for the variation were 1) the age (newness) of the MDA program, 2) the use of volunteers, and 3) the size of the population treated. Substantial contributions by governments were documented - generally 60%-90% of program operation costs, excluding costs of donated medications. CONCLUSIONS/SIGNIFICANCE: MDA for LF elimination is comparatively inexpensive in relation to most other public health programs. Governments and communities make the predominant financial contributions to actual MDA implementation, not counting the cost of the drugs themselves. The results highlight the impact of the use of volunteers on program costs and provide specific cost data for 7 different countries that can be used as a basis both for modifying current programs and for developing new ones.