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1.
Public Health Rev ; 45: 1606649, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38689833

RESUMO

Objectives: In 2008, an analysis investigating health impact assessment (HIA) practice found that only 6% of HIA-related peer-reviewed publications had a focus on low- and medium-developed countries, whereas 94% were conducted in countries with a high or very high development state. We aimed to update and deepen these observations. Methods: We conducted a systematic review, searching PubMed and Web of Science for HIA-related papers published in the scientific literature from June 2007 to January 2023. Only applied HIA and papers with HIA as a subject were included. Results: The search yielded 3,036 publications and the final selection consisted of 1,019 publications. The annual number of total publications increased considerably over the past 15 years. Whereas research-driven HIA (n = 460) showed a steep increase, step-by-step HIA (n = 71) did not show a clear trend. Conclusion: The gap between the number of HIA-related peer-reviewed publications focusing on low/medium and high/very high developed countries has diminished from 6/94 to 11/89. There is a growing tendency to apply the terminology HIA for health impact modelling studies and quantitative health risk assessments.

2.
Diseases ; 10(4)2022 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-36278583

RESUMO

It is widely acknowledged that the 10-year World Bank Loan Project (WBLP) on schistosomiasis control in the People's Republic of China played an important role in raising the public and political profile of schistosomiasis, particularly regarding its prevention, control, and elimination. The WBLP adopted large-scale administration of praziquantel as the main control measure. At the end of the 10-year project in 2001, data from high-, medium-, and low-endemic areas suggested that the infection rates of both humans and domestic animals had fallen to the expected levels. However, major floods in the Yangtze River basin, coupled with reduced funding for schistosomiasis control, resulted in a rebound of the disease in endemic areas. Since 2005, a steady decline in infection rates was observed and it was hypothesized that the experiences and technological advances accumulated during the WBLP played a role. Nonetheless, relatively little is known about the long-term effects of the WBLP on schistosomiasis, particularly management mechanisms, technological innovations, epidemiological changes, and long-term economic impact. To fill these gaps, we systematically searched the literature for articles in English and Chinese on the WBLP on schistosomiasis from 1 January 1992 to 30 July 2022. Relevant studies were analyzed for short-, mid-, and long-term epidemiological and economic effects of the WBLP on schistosomiasis prevention, control, and elimination. Overall, 81 articles met our inclusion criteria, of which 17 were related to management mechanism reform, 20 pertained to technological innovation, and 44 examined epidemiological changes and economic effects. Most papers documented the WBLP as a positive contribution to schistosomiasis prevention and control in the People's Republic of China. Regarding the long-term effects, there was a significant contribution to the national schistosomiasis control and elimination programme in terms of renewed management mechanisms, talent development, and technological innovation. In conclusion, the WBLP contributed to enhanced control of schistosomiasis and shaped the ultimate response towards schistosomiasis elimination in the People's Republic of China. Experiences and lessons learned might guide schistosomiasis control and elimination elsewhere.

3.
Infect Dis Poverty ; 11(1): 57, 2022 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-35599310

RESUMO

BACKGROUND: A One Health approach has been increasingly mainstreamed by the international community, as it provides for holistic thinking in recognizing the close links and inter-dependence of the health of humans, animals and the environment. However, the dearth of real-world evidence has hampered application of a One Health approach in shaping policies and practice. This study proposes the development of a potential evaluation tool for One Health performance, in order to contribute to the scientific measurement of One Health approach and the identification of gaps where One Health capacity building is most urgently needed. METHODS: We describe five steps towards a global One Health index (GOHI), including (i) framework formulation; (ii) indicator selection; (iii) database building; (iv) weight determination; and (v) GOHI scores calculation. A cell-like framework for GOHI is proposed, which comprises an external drivers index (EDI), an intrinsic drivers index (IDI) and a core drivers index (CDI). We construct the indicator scheme for GOHI based on this framework after multiple rounds of panel discussions with our expert advisory committee. A fuzzy analytical hierarchy process is adopted to determine the weights for each of the indicators. RESULTS: The weighted indicator scheme of GOHI comprises three first-level indicators, 13 second-level indicators, and 57 third-level indicators. According to the pilot analysis based on the data from more than 200 countries/territories the GOHI scores overall are far from ideal (the highest score of 65.0 out of a maximum score of 100), and we found considerable variations among different countries/territories (31.8-65.0). The results from the pilot analysis are consistent with the results from a literature review, which suggests that a GOHI as a potential tool for the assessment of One Health performance might be feasible. CONCLUSIONS: GOHI-subject to rigorous validation-would represent the world's first evaluation tool that constructs the conceptual framework from a holistic perspective of One Health. Future application of GOHI might promote a common understanding of a strong One Health approach and provide reference for promoting effective measures to strengthen One Health capacity building. With further adaptations under various scenarios, GOHI, along with its technical protocols and databases, will be updated regularly to address current technical limitations, and capture new knowledge.


Assuntos
Saúde Única , Previsões , Saúde Global
4.
Acta Trop ; 226: 106155, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34634266

RESUMO

Acta Tropica is an international, peer-reviewed journal advancing scientific research in the fields of tropical medicine and parasitology. This article elucidates the rich history of the journal and speculates about its future. Acta Tropica was launched in 1944 and formed an integral part of the establishment and running of the Swiss Tropical Institute in Basel. After two distinct periods of relatively small publication activities (1944-1976 and 1977-1988), in 1989, Acta Tropica was transferred to the Dutch publisher Elsevier. Subsequently, the annual number of publications steadily increased and the scope of the journal broadened to the biology of pathogens and their vectors, to genetics, host-parasite relationships, mechanisms of pathogenicity, diagnostics, and treatment of tropical diseases. The body of published articles contributed to an improved understanding of the prevention, surveillance, control, and elimination of diseases that are intimately linked to poverty, such as malaria and neglected tropical diseases. In recent years, the scope of Acta Tropica was widening to target emerging and re-emerging infectious diseases, epidemics and pandemics, interrelations of microbes, viruses, and parasites, co-dependencies of epidemiology, ecology, environment, and climate change. Importantly, non-communicable diseases are gaining interest in low- and middle-income countries due to urbanization, globalization, and rapidly changing life styles, and hence, these issues receive growing prominence. Acta Tropica continues to embrace inter- and, indeed, transdisciplinary research to address pressing global health issues and sustainable development.


Assuntos
Medicina Tropical , Mudança Climática , Saúde Global , Humanos , Doenças Negligenciadas , Desenvolvimento Sustentável
5.
Acta Trop ; 225: 106175, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34627762

RESUMO

The inaugural issue of Acta Tropica has been published in 1944, at a time of utmost international isolation and uncertainty due to World War II. Now, more than seven decades later, Acta Tropica is a trusted outlet to communicate and disseminate scientific advances in the fields of parasitology and tropical medicine. As a scholarly, peer-reviewed journal, Acta Tropica contributes to the 2030 Agenda for Sustainable Development, particularly the Sustainable Development Goal (SDG) 3, that is "Ensure healthy lives and promote well-being for all of all ages". This article explores how Acta Tropica has evolved over time. Our analysis is based on a systematic review of keywords derived from all issues published in a specific year, arbitrarily selected at decadal snapshots (1950, 1960, 1970, 1980, 1990, 2000, 2010, and 2020). Results indicate a decrease in interdisciplinarity in favour of more specialised expertise in various fields of infectious diseases research and public health with a particular emphasis on low- and middle-income countries. Yet, by examining first and last authors' institutional affiliations and classifying countries by the Human Development Index (HDI), we find that most authors are affiliated with institutions in high- and very high-HDI countries. Over time, the mean number of authors on a paper has increased severalfold (from 1.35 in 1950 to 7.51 in 2020). Taken together, Acta Tropica has become increasingly globally anchored and contributes not only to SDG 3, but increasingly also to SDG 17, that is "Revitalize the global partnership for sustainable development".


Assuntos
Desenvolvimento Sustentável , Medicina Tropical , Nível de Saúde , Humanos , Motivação , Saúde Pública
6.
Infect Dis Poverty ; 10(1): 134, 2021 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-34895355

RESUMO

BACKGROUND: The economic impact of schistosomiasis and the underlying tradeoffs between water resources development and public health concerns have yet to be quantified. Schistosomiasis exerts large health, social and financial burdens on infected individuals and households. While irrigation schemes are one of the most important policy responses designed to reduce poverty, particularly in sub-Saharan Africa, they facilitate the propagation of schistosomiasis and other diseases. METHODS: We estimate the economic impact of schistosomiasis in Burkina Faso via its effect on agricultural production. We create an original dataset that combines detailed household and agricultural surveys with high-resolution geo-statistical disease maps. We develop new methods that use the densities of the intermediate host snails of schistosomiasis as instrumental variables together with panel, spatial and machine learning techniques. RESULTS: We estimate that the elimination of schistosomiasis in Burkina Faso would increase average crop yields by around 7%, rising to 32% for high infection clusters. Keeping schistosomiasis unchecked, in turn, would correspond to a loss of gross domestic product of approximately 0.8%. We identify the disease burden as a shock to the agricultural productivity of farmers. The poorest households engaged in subsistence agriculture bear a far heavier disease burden than their wealthier counterparts, experiencing an average yield loss due to schistosomiasis of between 32 and 45%. We show that the returns to water resources development are substantially reduced once its health effects are taken into account: villages in proximity of large-scale dams suffer an average yield loss of around 20%, and this burden decreases as distance between dams and villages increases. CONCLUSIONS: This study provides a rigorous estimation of how schistosomiasis affects agricultural production and how it is both a driver and a consequence of poverty. It further quantifies the tradeoff between the economics of water infrastructures and their impact on public health. Although we focus on Burkina Faso, our approach can be applied to any country in which schistosomiasis is endemic.


Assuntos
Esquistossomose , Agricultura , Animais , Burkina Faso/epidemiologia , Humanos , Saúde Pública , Esquistossomose/epidemiologia , Caramujos
7.
Artigo em Inglês | MEDLINE | ID: mdl-34769535

RESUMO

BACKGROUND: Health equity features prominently in the 2030 Agenda for Sustainable Development, yet there are wide disparities in health between and within countries. In settings of natural resource extraction (e.g., industrial mines), the health of surrounding communities is affected through myriad changes in the physical, social, and economic environment. How changes triggered by such projects translate into health inequities is poorly understood. METHODS: This qualitative study explores potential layers of inequities by systematically coding perceived inequities of affected communities. Drawing on the framework method, we thematically analyzed data from 83 focus group discussions, which enrolled 791 participants from 10 study sites in Burkina Faso, Mozambique, and Tanzania. RESULTS: Participants perceived inequities related to their individual characteristics, intermediate factors acting on the community level, and structural conditions. Due to environmental pollution and land loss, participants were concerned about unsecured livelihoods. Positive impacts, such as job opportunities at the mine, remained scarce for local communities and were claimed not to be equally distributed among community members. CONCLUSION: Extractive industries bear considerable risks to widen existing health gaps. In order to create equal opportunities among affected populations, the wider determinants of health must be considered more explicitly in the licensing process of resource extraction projects.


Assuntos
Equidade em Saúde , Mineração , Burkina Faso , Humanos , Moçambique , Tanzânia
8.
Infect Dis Poverty ; 10(1): 2, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33397510

RESUMO

BACKGROUND: The damage inflicted by the coronavirus diseases 2019 (COVID-19) pandemic upon humanity is and will continue to be considerable. Unprecedented progress made in global health over the past 20 years has reverted and economic growth has already evaporated, giving rise to a global recession, the likes of which we may not have experienced since the Second World War. Our aim is to draw the attention of the neglected tropical disease (NTD) community towards some of the major emerging economic opportunities which are quickly appearing on the horizon as a result of COVID-19. MAIN TEXT: This scoping review relied on a literature search comprised of a sample of articles, statements, and press releases on initiatives aimed at mitigating the impact of COVID-19, while supporting economic recovery. Of note, the donor scenario and economic development agendas are highly dynamic and expected to change rapidly as the COVID-19 pandemic unfolds, as are donor and lender priorities. CONCLUSIONS: The NTD community, particularly in low- and middle-income countries (LMICs), will need to work quickly, diligently, and in close collaboration with decision-makers and key stakeholders, across sectors at national and international level to secure its position. Doing so might enhance the odds of grasping potential opportunities to access some of the massive resources that are now available in the form of contributions from corporate foundations, trust funds, loans, debt relieve schemes, and other financial mechanisms, as part of the ongoing and future economic development agendas and public health priorities driven by the COVID-19 pandemic. This paper should serve as a starting point for the NTD community to seek much needed financial support in order to sustain and revitalize control and elimination efforts pertaining to NTDs in LMICs.


Assuntos
COVID-19/economia , COVID-19/epidemiologia , Doenças Negligenciadas/economia , Doenças Negligenciadas/epidemiologia , Status Econômico , Saúde Global , Humanos , Pandemias , Pobreza , Saúde Pública , Fatores de Risco , SARS-CoV-2 , Clima Tropical , Nações Unidas , Organização Mundial da Saúde
9.
Acta Trop ; 213: 105165, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31518573

RESUMO

Elsevier's 2nd conference on "Impact of Environmental Changes on Infectious Diseases" (IECID), convened in May 2017 in Trieste, Italy, brought together some 120 researchers from more than 20 countries. They presented the latest findings and discussed the impact of current and predicted future environmental changes on infectious disease dynamics in humans, livestock and wildlife in different parts of the world. Particular emphasis was placed on food-, vector- and water-borne diseases within the general theme of infectious diseases of poverty and emerging and re-emerging diseases. The potential impact of mobility, travel, population growth, trade and globalization on infectious disease dynamics against the background of a changing climate, land use, air quality and urbanization on individual, population, ecosystem and planetary health were addressed. Speakers at the conference were encouraged to put forth their talks into stand-alone manuscripts, which resulted in a unique collection of 13 articles, now brought together into a thematic issue of Acta Tropica. In this umbrella piece, we synthesize key findings from the published articles and highlight potential actions that might be taken forward to prevent and mitigate the impact of environmental change on infectious diseases. The work presented is salient in the current era of the Sustainable Development Goals.


Assuntos
Doenças Transmissíveis/epidemiologia , Fenômenos Ecológicos e Ambientais , Animais , Mudança Climática , Doenças Transmissíveis/transmissão , Doenças Transmissíveis/veterinária , Vetores de Doenças , Ecossistema , Humanos , Crescimento Demográfico , Desenvolvimento Sustentável , Viagem , Urbanização
10.
Infect Dis Poverty ; 9(1): 140, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028426

RESUMO

Most human pathogens originate from non-human hosts and certain pathogens persist in animal reservoirs. The transmission of such pathogens to humans may lead to self-sustaining chains of transmission. These pathogens represent the highest risk for future pandemics. For their prevention, the transmission over the species barrier - although rare - should, by all means, be avoided. In the current COVID-19 pandemic, surprisingly though, most of the current research concentrates on the control by drugs and vaccines, while comparatively little scientific inquiry focuses on future prevention. Already in 2012, the World Bank recommended to engage in a systemic One Health approach for zoonoses control, considering integrated surveillance-response and control of human and animal diseases for primarily economic reasons. First examples, like integrated West Nile virus surveillance in mosquitos, wild birds, horses and humans in Italy show evidence of financial savings from a closer cooperation of human and animal health sectors. Provided a zoonotic origin can be ascertained for the COVID-19 pandemic, integrated wildlife, domestic animal and humans disease surveillance-response may contribute to prevent future outbreaks. In conclusion, the earlier a zoonotic pathogen can be detected in the environment, in wildlife or in domestic animals; and the better human, animal and environmental surveillance communicate with each other to prevent an outbreak, the lower are the cumulative costs.


Assuntos
Doenças Transmissíveis Emergentes/prevenção & controle , Pandemias/prevenção & controle , Zoonoses/prevenção & controle , Doenças dos Animais/epidemiologia , Doenças dos Animais/prevenção & controle , Doenças dos Animais/transmissão , Animais , Betacoronavirus , COVID-19 , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/transmissão , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Reservatórios de Doenças/veterinária , Reservatórios de Doenças/virologia , Monitoramento Epidemiológico/veterinária , Humanos , Itália/epidemiologia , Saúde Única , Pandemias/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , SARS-CoV-2 , Zoonoses/epidemiologia , Zoonoses/transmissão
11.
Am J Trop Med Hyg ; 103(6): 2260-2267, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32996446

RESUMO

We estimated the financial costs of different interventions against urogenital schistosomiasis, implemented by the Zanzibar Elimination of Schistosomiasis Transmission (ZEST) project, on Pemba and Unguja islands, Tanzania. We used available data on project activities, resources used, and costs reported in the accounting information systems of ZEST partners. The costs were estimated for all the activities related to snail control, behavior change interventions, the impact assessment surveys, and management of the whole program. Costs are presented in US$ for the full duration of the ZEST project from 2011/2012 to 2017. The total financial costs of implementing snail control activities over 5 years, excluding the costs for donated Bayluscide, were US$55,796 on Pemba and US$73,581 on Unguja, mainly driven by personnel costs. The total financial costs of implementing behavior change activities were US$109,165 on Pemba and US$155,828 on Unguja, with costs for personnel accounting for 47% on Pemba and 69% on Unguja. Costs of implementing biannual mass drug administration refer to the estimated 2.4 million treatments provided on Pemba over 4 years (2013-2016), and do not include the costs of donated praziquantel. The total cost per provided treatment was, on average, US$0.21. This study showed the value of exploiting administrative data to estimate costs of major global health interventions. It also provides an evidence base for financial costs and main cost drivers of implementing multiple combinations of intervention sets that inform decisions regarding the feasibility and affordability of implementing schistosomiasis control and elimination strategies.


Assuntos
Anti-Helmínticos/uso terapêutico , Erradicação de Doenças/economia , Praziquantel/uso terapêutico , Schistosoma haematobium/efeitos dos fármacos , Esquistossomose Urinária/tratamento farmacológico , Caramujos/parasitologia , Animais , Humanos , Ilhas , Esquistossomose Urinária/economia , Esquistossomose Urinária/epidemiologia , Esquistossomose Urinária/parasitologia , Inquéritos e Questionários , Tanzânia/epidemiologia
12.
Acta Trop ; 212: 105670, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32841589

RESUMO

Helminth infections, many of them listed as neglected tropical diseases by the World Health Organization, remain a public health issue in many parts of the world. The People's Republic of China (P.R. China) stands out due to impressive progress in the control and local elimination of helminth infections. An important contextual factor is P.R. China's sustained social and economic development that allowed implementation of health-related poverty alleviation, improving water, sanitation and hygiene, enhancing information, education and communication, coupled with major engineering and infrastructure development and intersectoral collaboration. Nonetheless, food-borne trematodiases, soil-transmitted helminthiases, echinococcosis, cysticercosis/taeniasis and schistosomiasis still exert a considerable burden in P.R. China, even though the numbers of infected people have decreased substantially since the new millennium. This special issue of Acta Tropica provides a comprehensive update of the current knowledge of the main helminth infections in P.R. China, summarises progress in research and discusses future prospects for gaining and sustaining control towards the final goal of breaking transmission and hence, eliminating helminthiases. It consists of 34 articles with a wide coverage that can be grouped into six domains: (i) epidemiological assessment and disease burden estimates; (ii) diagnostics and antigen characterisation; (iii) drug and vaccine development; (iv) host-parasite interactions and snail genetics; (v) surveillance and public health response; and (vi) capacity building and international cooperation. The control and elimination of helminthiases not only furthers the health and wellbeing of the Chinese people, but also provides innovative approaches, tools and strategies, which can be adopted and applied in other countries and regions of the world where helminthiases still prevail.


Assuntos
Helmintíase/epidemiologia , Animais , China/epidemiologia , Helmintíase/prevenção & controle , Humanos , Cooperação Internacional , Saúde Pública
13.
Infect Dis Poverty ; 9(1): 86, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32646512

RESUMO

Emerging and re-emerging zoonotic diseases represent a public health challenge of international concern. They include a large group of neglected tropical diseases (NTDs), many of which are of zoonotic nature. Coronavirus disease 2019 (COVID-19), another emerging zoonotic disease, has just increased the stakes exponentially. Most NTDs are subject to the impact of some of the very same human-related activities triggering other emerging and re-emerging diseases, including COVID-19, severe acute respiratory syndrome (SARS), bird flu and swine flu. It is conceivable that COVID-19 will exacerbate the NTDs, as it will divert much needed financial and human resources. There is considerable concern that recent progress achieved with control and elimination efforts will be reverted. Future potential strategies will need to reconsider the determinants of health in NTDs in order to galvanize efforts and come up with a comprehensive, well defined programme that will set the stage for an effective multi-sectorial approach. In this Commentary, we propose areas of potential synergies between the COVID-19 pandemic control efforts, other health and non-health sector initiatives and NTD control and elimination programmes.


Assuntos
Doenças Transmissíveis Emergentes/prevenção & controle , Infecções por Coronavirus/epidemiologia , Doenças Negligenciadas/prevenção & controle , Pneumonia Viral/epidemiologia , Medicina Tropical/métodos , Animais , Betacoronavirus , COVID-19 , Doenças Transmissíveis Emergentes/epidemiologia , Infecções por Coronavirus/prevenção & controle , Saúde Global , Humanos , Colaboração Intersetorial , Doenças Negligenciadas/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Alocação de Recursos , SARS-CoV-2 , Medicina Tropical/tendências , Zoonoses/epidemiologia , Zoonoses/prevenção & controle
14.
Artigo em Inglês | MEDLINE | ID: mdl-32532108

RESUMO

Natural resource extraction projects, including those in the mining sector, have various effects on human health and wellbeing, with communities in resource-rich areas in sub-Saharan Africa (SSA) being particularly vulnerable. While impact assessments (IA) can predict and mitigate negative effects, it is unclear whether and to what extent health aspects are included in current IA practice in SSA. For collecting IA reports, we contacted 569 mining projects and 35 ministries regulating the mining sector. The reports obtained were complemented by reports identified in prior research. The examination of the final sample of 44 IA reports revealed a heavy focus on environmental health determinants and included health outcomes were often limited to a few aspects, such as HIV, malaria and injuries. The miniscule yield of reports (1.6% of contacted projects) and the low response rate by the contacted mining companies (18%) might indicate a lack of transparency in the IA process of the mining sector in SSA. To address the shortcomings identified, policies regulating IA practice should strengthen the requirements for public disclosure of IA reports and promote a more comprehensive inclusion of health in IA, be it through stand-alone health impact assessment or more rigorous integration of health in other forms of IA.


Assuntos
Avaliação do Impacto na Saúde , África Subsaariana , Testes Diagnósticos de Rotina , Humanos , Malária , Mineração
15.
Artigo em Inglês | MEDLINE | ID: mdl-32455773

RESUMO

The application of a health impact assessment (HIA) for a large-scale copper mining project in rural Zambia triggered the long-term monitoring and evaluation of determinants of health and health outcomes in communities living in proximity to the mine. Three consecutive cross-sectional surveys were conducted at intervals of four years; thus, at baseline (2011), four (2015) and eight (2019) years into the project's development. Using the same field and laboratory procedures, the surveys allowed for determining changes in health indicators at the household level, in young children (<5 years), school attendees (9-14 years) and women (15-49 years). Results were compared between communities considered impacted by the project and communities outside the project area (comparison communities). The prevalence of Plasmodium falciparum infection increased in both the impacted and comparison communities between 2011 and 2019 but remained consistently lower in the impacted communities. Stunting in children < 5 years and the prevalence of intestinal parasite infections in children aged 9-14 years mostly decreased. In women of reproductive age, selected health indicators (i.e., anaemia, syphilis, underweight and place of delivery) either remained stable or improved. Impacted communities generally showed better health outcomes than comparison communities, suggesting that the health interventions implemented by the project as a consequence of the HIA have mitigated potential negative effects and enhanced positive effects. Caution is indicated to avoid promotion of health inequalities within and beyond the project area.


Assuntos
Cobre , Mineração , Saúde Pública , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Adulto Jovem , Zâmbia
16.
PLoS Negl Trop Dis ; 14(3): e0008098, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32226008

RESUMO

BACKGROUND: Schistosomiasis, a disease caused by blood flukes of the genus Schistosoma, belongs to the neglected tropical diseases. Left untreated, schistosomiasis can lead to severe health problems and even death. An estimated 800 million people are at risk of schistosomiasis and 250 million people are infected. The global strategy to control and eliminate schistosomiasis emphasizes large-scale preventive chemotherapy with praziquantel targeting school-age children. Other tools are available, such as information, education, and communication (IEC), improved access to water, sanitation, and hygiene (WASH), and snail control. Despite available evidence of the effectiveness of these control measures, analyses estimating the most cost-effective control or elimination strategies are scarce, inaccurate, and lack standardization. We systematically reviewed the literature on costs related to public health interventions against schistosomiasis to strengthen the current evidence-base. METHODOLOGY: In adherence to the PRISMA guidelines, we systematically searched three readily available electronic databases (i.e., PubMed, WHOLIS, and ISI Web of Science) from inception to April 2019 with no language restrictions. Relevant documents were screened, duplicates eliminated, specific rules on studies to consider were defined, and the eligible studies fully reviewed. Costs of schistosomiasis interventions were classified in three groups: (i) preventive chemotherapy; (ii) preventive chemotherapy plus an individual diagnostic test to identify at-risk population; and (iii) test-and-treat interventions. PRINCIPAL FINDINGS: Fifteen articles met our inclusion criteria. In general, it was hard to compare the reported costs from the different studies due to different approaches used to estimate and classify the costs of the intervention assessed. Costs varied considerably from one study to another, ranging from US$ 0.06 to US$ 4.46 per person treated. The difference between financial and opportunity costs only played a minimal role in the explanation of the costs' variation, even if delivery costs were two times higher in the analyses including economic costs. Most of the studies identified in our systematic review focused on sub-Saharan African countries. CONCLUSIONS/SIGNIFICANCE: The degree of transparency of most of the costing studies of schistosomiasis interventions found in the current review was limited. Hence, there is a pressing need for strategies to improve the quality of cost analyses, and higher reporting standards and transparency that should be fostered by peer-review journal policies. Cost information on these interventions is crucial to inform resource allocation decisions and those regarding the affordability of scaling-up interventions.


Assuntos
Anti-Helmínticos/economia , Quimioprevenção/economia , Controle de Doenças Transmissíveis/economia , Análise Custo-Benefício , Praziquantel/economia , Esquistossomose/economia , Esquistossomose/prevenção & controle , Adolescente , Anti-Helmínticos/administração & dosagem , Quimioprevenção/métodos , Criança , Controle de Doenças Transmissíveis/métodos , Humanos , Praziquantel/administração & dosagem , Esquistossomose/diagnóstico , Esquistossomose/epidemiologia , Resultado do Tratamento
19.
BMC Public Health ; 19(1): 1330, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640635

RESUMO

BACKGROUND: To reduce the under-five mortality (U5M), fine-gained spatial assessment of the effects of health interventions is critical because national averages can obscure important sub-national disparities. In turn, sub-national estimates can guide control programmes for spatial targeting. The purpose of our study is to quantify associations of interventions with U5M rate at national and sub-national scales in Uganda and to identify interventions associated with the largest reductions in U5M rate at the sub-national scale. METHODS: Spatially explicit data on U5M, interventions and sociodemographic indicators were obtained from the 2011 Uganda Demographic and Health Survey (DHS). Climatic data were extracted from remote sensing sources. Bayesian geostatistical Weibull proportional hazards models with spatially varying effects at sub-national scales were utilized to quantify associations between all-cause U5M and interventions at national and regional levels. Bayesian variable selection was employed to select the most important determinants of U5M. RESULTS: At the national level, interventions associated with the highest reduction in U5M were artemisinin-based combination therapy (hazard rate ratio (HRR) = 0.60; 95% Bayesian credible interval (BCI): 0.11, 0.79), initiation of breastfeeding within 1 h of birth (HR = 0.70; 95% BCI: 0.51, 0.86), intermittent preventive treatment (IPTp) (HRR = 0.74; 95% BCI: 0.67, 0.97) and access to insecticide-treated nets (ITN) (HRR = 0.75; 95% BCI: 0.63, 0.84). In Central 2, Mid-Western and South-West, largest reduction in U5M was associated with access to ITNs. In Mid-North and West-Nile, improved source of drinking water explained most of the U5M reduction. In North-East, improved sanitation facilities were associated with the highest decline in U5M. In Kampala and Mid-Eastern, IPTp had the largest associated with U5M. In Central1 and East-Central, oral rehydration solution and postnatal care were associated with highest decreases in U5M respectively. CONCLUSION: Sub-national estimates of the associations between U5M and interventions can guide control programmes for spatial targeting and accelerate progress towards mortality-related Sustainable Development Goals.


Assuntos
Serviços de Saúde da Criança/organização & administração , Mortalidade da Criança/tendências , Proteção da Criança/estatística & dados numéricos , Determinantes Sociais da Saúde/estatística & dados numéricos , Antimaláricos/uso terapêutico , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Inseticidas/uso terapêutico , Modelos de Riscos Proporcionais , Fatores de Risco , Uganda
20.
Infect Dis Poverty ; 8(1): 86, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31578147

RESUMO

Since the founding of the People's Republic of China in 1949, considerable progress has been made in the control and elimination of the country's initial set of 11 neglected tropical diseases. Indeed, elimination as a public health problem has been declared for lymphatic filariasis in 2007 and for trachoma in 2015. The remaining numbers of people affected by soil-transmitted helminth infection, clonorchiasis, taeniasis, and echinococcosis in 2015 were 29.1 million, 6.0 million, 366 200, and 166 100, respectively. In 2017, after more than 60 years of uninterrupted, multifaceted schistosomiasis control, has seen the number of cases dwindling from more than 10 million to 37 600. Meanwhile, about 6000 dengue cases are reported, while the incidence of leishmaniasis, leprosy, and rabies are down at 600 or fewer per year. Sustained social and economic development, going hand-in-hand with improvement of water, sanitation, and hygiene provide the foundation for continued progress, while rigorous surveillance and specific public health responses will consolidate achievements and shape the elimination agenda. Targets for poverty elimination and strategic plans and intervention packages post-2020 are important opportunities for further control and elimination, when remaining challenges call for sustainable efforts.


Assuntos
Erradicação de Doenças , Doenças Negligenciadas/prevenção & controle , China , Humanos , Medicina Tropical/estatística & dados numéricos
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