Your browser doesn't support javascript.
loading
Estimating the distribution of morbidity and mortality of childhood diarrhea, measles, and pneumonia by wealth group in low- and middle-income countries.
Chang, Angela Y; Riumallo-Herl, Carlos; Salomon, Joshua A; Resch, Stephen C; Brenzel, Logan; Verguet, Stéphane.
Afiliação
  • Chang AY; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Riumallo-Herl C; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
  • Salomon JA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Resch SC; Erasmus School of Economics, Erasmus University of Rotterdam, Rotterdam, The Netherlands.
  • Brenzel L; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Verguet S; Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
BMC Med ; 16(1): 102, 2018 07 04.
Article em En | MEDLINE | ID: mdl-29970074
BACKGROUND: Equitable access to vaccines has been suggested as a priority for low- and middle-income countries (LMICs). However, it is unclear whether providing equitable access is enough to ensure health equity. Furthermore, disaggregated data on health outcomes and benefits gained across population subgroups are often unavailable. This paper develops a model to estimate the distribution of childhood disease cases and deaths across socioeconomic groups, and the potential benefits of three vaccine programs in LMICs. METHODS: For each country and for three diseases (diarrhea, measles, pneumonia), we estimated the distributions of cases and deaths that would occur across wealth quintiles in the absence of any immunization or treatment programs, using both the prevalence and relative risk of a set of risk and prognostic factors. Building on these baseline estimates, we examined what might be the impact of three vaccines (first dose of measles, pneumococcal conjugate, and rotavirus vaccines), under five scenarios based on different sets of quintile-specific immunization coverage and disease treatment utilization rates. RESULTS: Due to higher prevalence of risk factors among the poor, disproportionately more disease cases and deaths would occur among the two lowest wealth quintiles for all three diseases when vaccines or treatment are unavailable. Country-specific context, including how the baseline risks, immunization coverage, and treatment utilization are currently distributed across quintiles, affects how different policies translate into changes in cases and deaths distribution. CONCLUSIONS: Our study highlights several factors that would substantially contribute to the unequal distribution of childhood diseases, and finds that merely ensuring equal access to vaccines will not reduce the health outcomes gap across wealth quintiles. Such information can inform policies and planning of programs that aim to improve equitable delivery of healthcare services.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia / Fatores Socioeconômicos / Diarreia / Sarampo Tipo de estudo: Etiology_studies / Prognostic_studies Limite: Female / Humans / Male Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia / Fatores Socioeconômicos / Diarreia / Sarampo Tipo de estudo: Etiology_studies / Prognostic_studies Limite: Female / Humans / Male Idioma: En Ano de publicação: 2018 Tipo de documento: Article