| 91. |
- Wai, K. T., et al.
(författare)
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Community-centred eco-bio-social approach to control dengue vectors: an intervention study from Myanmar
- 2012
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Ingår i: Pathogens and Global Health. - : Informa UK Limited. - 2047-7724 .- 2047-7732. ; 106:8, s. 461-468
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To build up and analyse the feasibility, process, and effectiveness of a partnership-driven ecosystem management intervention in reducing dengue vector breeding and constructing sustainable partnerships among multiple stakeholders. Methods: A community-based intervention study was conducted from May 2009 to January 2010 in Yangon city. Six high-risk and six low-risk clusters were randomized and allocated as intervention and routine service areas, respectively. For each cluster, 100 households were covered. Bi-monthly entomological evaluations (i.e. larval and pupal surveys) and household acceptability surveys at the end of 6-month intervention period were conducted, supplemented by qualitative evaluations. Intervention description: The strategies included eco-friendly multi-stakeholder partner groups (Thingaha) and ward-based volunteers, informed decision-making of householders, followed by integrated vector management approach. Findings: Pupae per person index (PPI) decreased at the last evaluation by 5.7% (0.35-0.33) in high-risk clusters. But in low-risk clusters, PPI remarkably decreased by 63.6% (0.33-0.12). In routine service area, PPI also decreased due to availability of Temephos after Cyclone Nargis. As for total number of pupae in all containers, when compared to evaluation 1, there was a reduction of 18.6% in evaluation 2 and 44.1% in evaluation 3 in intervention area. However, in routine service area, more reduction was observed. All intervention tools were found as acceptable, being feasible to implement by multi-stakeholder partner groups. Conclusions: The efficacy of community-controlled partnership-driven interventions was found to be superior to the vertical approach in terms of sustainability and community empowerment.
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| 92. |
- Wai, K. T., et al.
(författare)
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Estimating dengue vector abundance in the wet and dry season: implications for targeted vector control in urban and peri-urban Asia
- 2012
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Ingår i: Pathogens and Global Health. - : Informa UK Limited. - 2047-7724 .- 2047-7732. ; 106:8, s. 436-445
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Tidskriftsartikel (refereegranskat)abstract
- Background: Research has shown that the classical Stegomyia indices (or "larval indices'') of the dengue vector Aedes aegypti reflect the absence or presence of the vector but do not provide accurate measures of adult mosquito density. In contrast, pupal indices as collected in pupal productivity surveys are a much better proxy indicator for adult vector abundance. However, it is unknown when it is most optimal to conduct pupal productivity surveys, in the wet or in the dry season or in both, to inform control services about the most productive water container types and if this pattern varies among different ecological settings. Methods: A multi-country study in randomly selected twelve to twenty urban and peri-urban neighborhoods ("clusters'') of six Asian countries, in which all water holding containers were examined for larvae and pupae of Aedes aegypti during the dry season and the wet season and their productivity was characterized by water container types. In addition, meteorological data and information on reported dengue cases were collected. Findings: The study reconfirmed the association between rainfall and dengue cases ("dengue season'') and underlined the importance of determining through pupal productivity surveys the "most productive containers types'', responsible for the majority (> 70%) of adult dengue vectors. The variety of productive container types was greater during the wet than during the dry season, but included practically all container types productive in the dry season. Container types producing pupae were usually different from those infested by larvae indicating that containers with larval infestations do not necessarily foster pupal development and thus the production of adult Aedes mosquitoes. Conclusion: Pupal productivity surveys conducted during the wet season will identify almost all of the most productive container types for both the dry and wet seasons and will therefore facilitate cost-effective targeted interventions.
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| 93. |
- Wang, W. B., et al.
(författare)
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Cost-effectiveness of the Health X Project for tuberculosis control in China
- 2014
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Ingår i: International Journal of Tuberculosis and Lung Disease. - : International Union Against Tuberculosis and Lung Disease. - 1027-3719. ; 18:8, s. 939-945
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Between 2002 and 2008, China's National Tuberculosis Control Programme created the Health X Project, financed in part by a World Bank loan, with additional funding from the UK Department for International Development. OBJECTIVES: To assess the cost-effectiveness of the Project and its impact from a financial point of view on tuberculosis (TB) control in China. METHODS: A decision-analytic model was used to evaluate the cost-effectiveness of the Project. Sensitivity analysis was used to assess the impact of different scenarios and assumptions on results. The primary outcome of the study was cost per disability-adjusted life-year (DALY) saved and incremental DALYs saved. RESULTS: In comparison with alternative scenario 1, the Project detected 1.6 million additional cases, 44 000 deaths were prevented and a total of 18.4 million DALYs saved. The Project strategies cost approximately Chinese yuan (CNY) 953 per DALY saved (vs. CNY1140 in the control areas), and saved an estimated CNY17.5 billion in comparison with the unchanged alternative scenario (scenario 1) or CNY10.8 billion with the control scenario (scenario 2). CONCLUSION: The Project strategies were affordable and of comparable cost-effectiveness to those of other developing countries. The results also provide strong support for the existing policy of scaling up DOTS in China.
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| 94. |
- Wettermark, B., et al.
(författare)
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The Nordic prescription databases as a resource for pharmacoepidemiological researcha literature review
- 2013
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Ingår i: Pharmacoepidemiology and Drug Safety. - : Wiley. - 1053-8569 .- 1099-1557. ; 22:7, s. 691-699
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Forskningsöversikt (refereegranskat)abstract
- Purpose All five Nordic countries have nationwide prescription databases covering all dispensed drugs, with potential for linkage to outcomes. The aim of this review is to present an overview of therapeutic areas studied and methods applied in pharmacoepidemiologic studies using data from these databases. Methods The study consists of a Medline-based structured literature review of scientific papers published during 2005-2010 using data from the prescription databases in Denmark, Finland, Iceland, Norway, and Sweden, covering 25 million inhabitants. Relevant studies were analyzed in terms of pharmacological group, study population, outcomes examined, type of study (drug utilization vs. effect of drug therapy), country of origin, and extent of cross-national collaboration. Results A total of 515 studies were identified. Of these, 262 were conducted in Denmark, 97 in Finland, 4 in Iceland, 87 in Norway, and 61 in Sweden. Four studies used data from more than one Nordic country. The most commonly studied drugs were those acting on the nervous system, followed by cardiovascular drugs and gastrointestinal/endocrine drugs. A total of 228 studies examined drug utilization and 263 focused on the effects and safety of drug therapy. Pregnant women were the most commonly studied population in safety studies, whereas prescribers' adherence to guidelines was the most frequent topic of drug utilization studies. Conclusions The Nordic prescription databases, with their possibility of record-linkage, represent an outstanding resource for assessing the beneficial and adverse effects of drug use in large populations, under routine care conditions, and with the potential for long-term follow-up. Copyright (c) 2013 John Wiley & Sons, Ltd.
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