Skip header and navigation

Refine By

343 records – page 1 of 35.

2nd-generation HIV surveillance and injecting drug use: uncovering the epidemiological ice-berg.

https://arctichealth.org/en/permalink/ahliterature84543
Source
Int J Public Health. 2007;52(3):166-72
Publication Type
Article
Date
2007
Author
Reintjes Ralf
Wiessing Lucas
Author Affiliation
Department of Public Health, Faculty Life Sciences, Hamburg University of Applied Sciences, Hamburg, Germany. Ralf.Reintjes@rzbd.haw-hamburg.de
Source
Int J Public Health. 2007;52(3):166-72
Date
2007
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - epidemiology - prevention & control - therapy
Cost-Benefit Analysis
Europe - epidemiology
HIV Infections - epidemiology - prevention & control - therapy
Hepatitis C - epidemiology
Humans
Norway - epidemiology
Population Surveillance
Prevalence
Risk factors
Risk-Taking
Substance Abuse, Intravenous - epidemiology
Turkey - epidemiology
Abstract
OBJECTIVES: HIV/AIDS surveillance methods are under revision as the diversity of HIV epidemics is becoming more apparent. The so called "2nd generation surveillance (SGS) systems" aim to enhance surveillance by broadening the range of indicators to prevalence, behaviors and correlates, for a better understanding and a more complete and timely awareness of evolving epidemics. METHODS: Concepts of HIV SGS are reviewed with a special focus on injecting drug users, a major at-risk and hard to reach group in Europe, a region with mainly low or concentrated epidemics. RESULTS: The scope of HIV/AIDS surveillance needs to be broadened following principles of SGS. Specifically for IDUs we propose including hepatitis C data as indicator for injecting risk in routine systems like those monitoring sexually transmitted infections and information on knowledge and attitudes as potential major determinants of risk behavior. CONCLUSIONS: The suggested approach should lead to more complete and timely information for public health interventions, however there is a clear need for comparative validation studies to assess the validity, reliability and cost-effectiveness of traditional and enhanced HIV/AIDS surveillance systems.
PubMed ID
17958283 View in PubMed
Less detail

The 2003 Canadian recommendations for dyslipidemia management: revisions are needed.

https://arctichealth.org/en/permalink/ahliterature175311
Source
CMAJ. 2005 Apr 12;172(8):1027-31
Publication Type
Article
Date
Apr-12-2005
Author
Douglas G Manuel
Peter Tanuseputro
Cameron A Mustard
Susan E Schultz
Geoffrey M Anderson
Sten Ardal
David A Alter
Andreas Laupacis
Author Affiliation
Institute for Clinical Evaluative Sciences, Toronto, Ont. doug.manuel@ices.on.ca
Source
CMAJ. 2005 Apr 12;172(8):1027-31
Date
Apr-12-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada
Cholesterol, LDL - blood
Coronary Disease - mortality - prevention & control
Cost-Benefit Analysis
Health Expenditures
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hyperlipidemias - drug therapy
Hypolipidemic Agents - therapeutic use
Middle Aged
Practice Guidelines as Topic
Risk factors
Notes
Cites: Eur Heart J. 2003 Sep;24(17):1601-1012964575
Cites: CMAJ. 2003 Jun 24;168(13):1644-5; author reply 1645-612821610
Cites: Can J Cardiol. 2003 Nov;19(12):1359-6614631469
Cites: Can J Cardiol. 2003 Dec;19(13):1499-50214760440
Cites: Am J Med. 2004 Apr 15;116(8):540-515063816
Cites: JAMA. 2004 Apr 21;291(15):1864-7015100205
Cites: Am Heart J. 1991 Jan;121(1 Pt 2):293-81985385
Cites: N Engl J Med. 1998 Nov 5;339(19):1349-579841303
Cites: Can J Cardiol. 1999 Apr;15(4):445-5110322254
Cites: CMAJ. 2003 Oct 28;169(9):921-414581310
Cites: Fam Pract. 2003 Feb;20(1):16-2112509365
Cites: JAMA. 2002 Jul 24-31;288(4):462-712132976
Cites: JAMA. 2002 Jul 24-31;288(4):455-6112132975
Cites: JAMA. 1999 Dec 22-29;282(24):2340-610612322
Cites: CMAJ. 2000 May 16;162(10):1441-710834048
Cites: CMAJ. 2000 Aug 22;163(4):403-810976255
Cites: Lancet. 2002 Jul 6;360(9326):7-2212114036
Comment In: CMAJ. 2005 Nov 8;173(10):1210; author reply 121016275979
Comment In: CMAJ. 2005 Nov 8;173(10):1207; author reply 121016275976
Comment In: CMAJ. 2005 Apr 12;172(8):1033-4; discussion 103715824410
Erratum In: CMAJ. 2005 Jul 19;173(2):133
PubMed ID
15824409 View in PubMed
Less detail

The ADDITION study: proposed trial of the cost-effectiveness of an intensive multifactorial intervention on morbidity and mortality among people with Type 2 diabetes detected by screening.

https://arctichealth.org/en/permalink/ahliterature47804
Source
Int J Obes Relat Metab Disord. 2000 Sep;24 Suppl 3:S6-11
Publication Type
Article
Date
Sep-2000
Author
T. Lauritzen
S. Griffin
K. Borch-Johnsen
N J Wareham
B H Wolffenbuttel
G. Rutten
Author Affiliation
Department of General Practice, University of Aarhus, Denmark.
Source
Int J Obes Relat Metab Disord. 2000 Sep;24 Suppl 3:S6-11
Date
Sep-2000
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood Glucose - analysis
Cost-Benefit Analysis
Denmark - epidemiology
Diabetes Mellitus, Type 2 - diagnosis - economics - epidemiology - therapy
England - epidemiology
Female
Humans
Hyperglycemia - complications - economics - therapy
Intervention Studies
Male
Mass Screening - economics
Middle Aged
Multicenter Studies
Netherlands - epidemiology
Practice Guidelines
Prevalence
Primary Health Care - economics
Randomized Controlled Trials - methods
Risk factors
Vascular Diseases - etiology - mortality - therapy
Abstract
OBJECTIVE: The overall aims of the ADDITION study are to evaluate whether screening for prevalent undiagnosed Type 2 diabetes is feasible, and whether subsequent optimised intensive treatment of diabetes, and associated risk factors, is feasible and beneficial. DESIGN: Population-based screening in three European countries followed by an open, randomised controlled trial. SUBJECTS AND METHODS: People aged 40-69 y in the community, without known diabetes, will be offered a random capillary blood glucose screening test by their primary care physicians, followed, if equal to or greater than 5.5 mmol/l, by fasting and 2-h post-glucose-challenge blood glucose measurements. Three thousand newly diagnosed patients will subsequently receive conventional treatment (according to current national guidelines) or intensive multifactorial treatment (lifestyle advice, prescription of aspirin and ACE-inhibitors, in addition to protocol-driven tight control of blood glucose, blood pressure and cholesterol). Patients allocated to intensive treatment will be further randomised to centre-specific interventions to motivate adherence to lifestyle changes and medication. Duration of follow-up is planned for 5 y. Endpoints will include mortality, macrovascular and microvascular complications, patient health status and satisfaction, process-of-care indicators and costs.
PubMed ID
11063279 View in PubMed
Less detail

Advantages and limitations of web-based surveys: evidence from a child mental health survey.

https://arctichealth.org/en/permalink/ahliterature147314
Source
Soc Psychiatry Psychiatr Epidemiol. 2011 Jan;46(1):69-76
Publication Type
Article
Date
Jan-2011
Author
Einar Heiervang
Robert Goodman
Author Affiliation
Centre for Child and Adolescent Mental Health, Unifob Health, Bergen, Norway. Einar.Heiervang@rbup.uib.no
Source
Soc Psychiatry Psychiatr Epidemiol. 2011 Jan;46(1):69-76
Date
Jan-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Child
Cost-Benefit Analysis - statistics & numerical data
Costs and Cost Analysis - methods - statistics & numerical data
Cross-Sectional Studies - economics - statistics & numerical data
Emigrants and Immigrants - statistics & numerical data
Female
Health Surveys - economics - methods - standards
Humans
Internet - economics - standards - statistics & numerical data
Interviews as Topic - methods - standards - utilization
Male
Mental Disorders - diagnosis - epidemiology - psychology
Norway - epidemiology
Poverty - psychology - statistics & numerical data
Prevalence
Questionnaires - economics - standards
Risk factors
Urban Population - statistics & numerical data
Abstract
Web-based surveys may have advantages related to the speed and cost of data collection as well as data quality. However, they may be biased by low and selective participation. We predicted that such biases would distort point-estimates such as average symptom level or prevalence but not patterns of associations with putative risk-factors.
A structured psychiatric interview was administered to parents in two successive surveys of child mental health. In 2003, parents were interviewed face-to-face, whereas in 2006 they completed the interview online. In both surveys, interviews were preceded by paper questionnaires covering child and family characteristics.
The rate of parents logging onto the web site was comparable to the response rate for face-to-face interviews, but the rate of full response (completing all sections of the interview) was much lower for web-based interviews. Full response was less frequent for non-traditional families, immigrant parents, and less educated parents. Participation bias affected point estimates of psychopathology but had little effect on associations with putative risk factors. The time and cost of full web-based interviews was only a quarter of that for face-to-face interviews.
Web-based surveys may be performed faster and at lower cost than more traditional approaches with personal interviews. Selective participation seems a particular threat to point estimates of psychopathology, while patterns of associations are more robust.
PubMed ID
19921078 View in PubMed
Less detail

Aflibercept vs. Ranibizumab: cost-effectiveness of treatment for wet age-related macular degeneration in Sweden.

https://arctichealth.org/en/permalink/ahliterature279115
Source
Acta Ophthalmol. 2016 Aug;94(5):441-8
Publication Type
Article
Date
Aug-2016
Author
Hemangi R Panchmatia
Karen M Clements
Erin Hulbert
Marianne Eriksson
Kim Wittrup-Jensen
Jonas Nilsson
Milton C Weinstein
Source
Acta Ophthalmol. 2016 Aug;94(5):441-8
Date
Aug-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Angiogenesis Inhibitors - administration & dosage - economics
Cost-Benefit Analysis
Female
Health Care Costs
Humans
Intravitreal Injections
Male
Markov Chains
Middle Aged
Models, Statistical
Quality-Adjusted Life Years
Randomized Controlled Trials as Topic
Ranibizumab - administration & dosage - economics
Receptors, Vascular Endothelial Growth Factor - administration & dosage
Recombinant Fusion Proteins - administration & dosage - economics
Sweden
Vascular Endothelial Growth Factor A - antagonists & inhibitors
Visual Acuity - drug effects
Wet Macular Degeneration - drug therapy - economics
Abstract
Monthly dosing with ranibizumab (RBZ) is needed to achieve maximal visual gains in patients with neovascular ('wet') age-related macular degeneration (wAMD). In Sweden, dosing is performed as needed (RBZ PRN), resulting in suboptimal efficacy. Intravitreal aflibercept (IVT-AFL) every 2 months after three initial monthly doses was clinically equivalent to RBZ monthly dosing (RBZ q4) in wAMD clinical trials. We assessed the cost-effectiveness of IVT-AFL versus RBZ q4 and RBZ PRN in Sweden.
A Markov model compared IVT-AFL to RBZ q4 or RBZ PRN over 2 years. Health states were based on visual acuity in better-seeing eye; a proportion discontinued treatment monthly or upon visual acuity
PubMed ID
27061020 View in PubMed
Less detail

Analysis of cost effectiveness of screening Danish men aged 65 for abdominal aortic aneurysm.

https://arctichealth.org/en/permalink/ahliterature88585
Source
BMJ. 2009;338:b2243
Publication Type
Article
Date
2009
Author
Ehlers Lars
Overvad Kim
Sørensen Jan
Christensen Søren
Bech Merete
Kjølby Mette
Author Affiliation
Institute of Public Health, Aarhus University, Vennelyst Boulevard 6, 8000 Aarhus C, Denmark. le@folkesundhed.au.dk
Source
BMJ. 2009;338:b2243
Date
2009
Language
English
Publication Type
Article
Keywords
Aged
Aortic Aneurysm, Abdominal - economics - prevention & control - ultrasonography
Aortic Rupture - economics - prevention & control - ultrasonography
Cost-Benefit Analysis
Denmark
Humans
Male
Markov Chains
Mass Screening - economics
Quality of Life
Quality-Adjusted Life Years
Abstract
OBJECTIVE: To assess the cost effectiveness of screening men aged 65 for abdominal aortic aneurysm. DESIGN: Cost effectiveness analysis based on a probabilistic, enhanced economic decision analytical model from screening to death. POPULATION AND SETTING: Hypothetical population of men aged 65 invited (or not invited) for ultrasound screening in the Danish healthcare system. DATA SOURCES: Published results from randomised trials and observational epidemiological studies retrieved from electronic bibliographic databases, and supplementary data obtained from the Danish Vascular Registry. DATA SYNTHESIS: A hybrid decision tree and Markov model was developed to simulate the short term and long term effects of screening for abdominal aortic aneurysm compared with no systematic screening on clinical and cost effectiveness outcomes. Probabilistic sensitivity analyses using Monte Carlo simulation were carried out. Results were presented in a cost effectiveness acceptability curve, an expected value of perfect information curve, and a curve showing the expected (net) number of avoided deaths from abdominal aortic aneurysm over time after the introduction of screening. The model was validated by calibrating base case health outcomes and expected activity levels against evidence from the recent Cochrane review of screening for abdominal aortic aneurysm. RESULTS: The estimated costs per quality adjusted life year (QALY) gained discounted at 3% per year over a lifetime for costs and QALYs was pound43 485 (euro54,852; $71,160). At a willingness to pay threshold of pound30,000 the probability of screening for abdominal aortic aneurysm being cost effective was less than 30%. One way sensitivity analyses showed the incremental cost effectiveness ratio varying from pound32,640 to pound66,001 per QALY. CONCLUSION: Screening for abdominal aortic aneurysm does not seem to be cost effective. Further research is needed on long term quality of life outcomes and costs.
Notes
Comment In: BMJ. 2009;338:b218519553266
Comment In: BMJ. 2009;339:b304419638382
PubMed ID
19553267 View in PubMed
Less detail

An economic evaluation of strontium ranelate in the treatment of osteoporosis in a Swedish setting: based on the results of the SOTI and TROPOS trials.

https://arctichealth.org/en/permalink/ahliterature80464
Source
Osteoporos Int. 2006 Dec;17(12):1781-93
Publication Type
Article
Date
Dec-2006
Author
Borgström F.
Jönsson B.
Ström O.
Kanis J A
Author Affiliation
Stockholm Health Economics, Vasagatan 38, 2nd floor, SE-111 21 Stockholm, Sweden. fredrik.b@healtheconomics.se
Source
Osteoporos Int. 2006 Dec;17(12):1781-93
Date
Dec-2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Bone Density Conservation Agents - economics - therapeutic use
Clinical Trials, Phase III
Cost-Benefit Analysis - economics
Female
Fractures, Bone - epidemiology - etiology
Health Care Costs
Humans
Markov Chains
Organometallic Compounds - economics - therapeutic use
Osteoporosis, Postmenopausal - drug therapy - economics - epidemiology
Quality of Life
Quality-Adjusted Life Years
Risk factors
Sweden - epidemiology
Thiophenes - economics - therapeutic use
Treatment Outcome
Abstract
INTRODUCTION: Strontium ranelate is a new therapy for the treatment and prevention of osteoporosis that has been shown in two phase III clinical trials (the Spinal Osteoporosis Therapeutic Intervention [SOTI] and the Treatment Of Peripheral OSteoporosis Study [TROPOS] trials) to reduce the risk of osteoporotic fractures at the vertebral, non-vertebral and hip level in postmenopausal women. The aim of this study was to estimate the potential cost-effectiveness of strontium ranelate in the treatment of osteoporosis in postmenopausal Swedish patients. METHODS: A Markov cohort model was adapted to fit patients corresponding to the patients in the SOTI and TROPOS clinical trials. The model was populated with Swedish cost and epidemiological data. In the base case, the cost-effectiveness was estimated for 69-year old women with low bone mineral density (BMD) and prevalent vertebral fractures (SOTI) and for 77-year old women with low BMD (TROPOS). The cost-effectiveness analysis had a societal perspective. RESULTS: In the base case analysis, the cost per quality-adjusted life years (QALY) gained of strontium ranelate patients compared to no treatment patients was estimated at SEK 472,586 and SEK 259,643, including costs in added life years, based on the SOTI and the TROPOS trials, respectively. Excluding cost in added life years, the cost per QALY gained was estimated at SEK 336,420 (SOTI) and SEK 165,680 (TROPOS). In subgroup analyses, in patients 74 years and older with a T-score lower than -2.4 and patients older than 80 years of age, strontium ranelate was found to be cost saving compared to no treatment. CONCLUSIONS: The results in the base case analyses and the sensitivity analyses of this study indicate that, compared to no treatment, strontium ranelate is cost-effective in the treatment of postmenopausal women with low BMD.
PubMed ID
17009083 View in PubMed
Less detail

An economic model to evaluate cost-effectiveness of computer assisted knee replacement surgery in Norway.

https://arctichealth.org/en/permalink/ahliterature112465
Source
BMC Musculoskelet Disord. 2013;14:202
Publication Type
Article
Date
2013
Author
Øystein Gøthesen
James Slover
Leif Havelin
Jan Erik Askildsen
Henrik Malchau
Ove Furnes
Author Affiliation
Department of Orthopaedic Surgery, Haugesund Hospital, Karmsundsgate 120, 5528, Haugesund, Norway. oystein.gothesen@helse-fonna.no
Source
BMC Musculoskelet Disord. 2013;14:202
Date
2013
Language
English
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Knee - economics - methods
Cost-Benefit Analysis
Humans
Markov Chains
Middle Aged
Models, Economic
Norway
Prosthesis Failure
Quality of Life
Quality-Adjusted Life Years
Surgery, Computer-Assisted - economics
Survival Rate
Abstract
The use of Computer Assisted Surgery (CAS) for knee replacements is intended to improve the alignment of knee prostheses in order to reduce the number of revision operations. Is the cost effectiveness of computer assisted surgery influenced by patient volume and age?
By employing a Markov model, we analysed the cost effectiveness of computer assisted surgery versus conventional arthroplasty with respect to implant survival and operation volume in two theoretical Norwegian age cohorts. We obtained mortality and hospital cost data over a 20-year period from Norwegian registers. We presumed that the cost of an intervention would need to be below NOK 500,000 per QALY (Quality Adjusted Life Year) gained, to be considered cost effective.
The added cost of computer assisted surgery, provided this has no impact on implant survival, is NOK 1037 and NOK 1414 respectively for 60 and 75-year-olds per quality-adjusted life year at a volume of 25 prostheses per year, and NOK 128 and NOK 175 respectively at a volume of 250 prostheses per year. Sensitivity analyses showed that the 10-year implant survival in cohort 1 needs to rise from 89.8% to 90.6% at 25 prostheses per year, and from 89.8 to 89.9% at 250 prostheses per year for computer assisted surgery to be considered cost effective. In cohort 2, the required improvement is a rise from 95.1% to 95.4% at 25 prostheses per year, and from 95.10% to 95.14% at 250 prostheses per year.
The cost of using computer navigation for total knee replacements may be acceptable for 60-year-old as well as 75-year-old patients if the technique increases the implant survival rate just marginally, and the department has a high operation volume. A low volume department might not achieve cost-effectiveness unless computer navigation has a more significant impact on implant survival, thus may defer the investments until such data are available.
Notes
Cites: Clin Orthop Relat Res. 1999 Oct;(367):210-510546617
Cites: J Bone Joint Surg Br. 1991 Sep;73(5):709-141894655
Cites: Acta Orthop Scand. 2002 Apr;73(2):117-2912079006
Cites: Clin Orthop Relat Res. 2002 Nov;(404):40-5012439236
Cites: Clin Orthop Relat Res. 1993 Jan;(286):94-1028425373
Cites: Med Decis Making. 1993 Apr-Jun;13(2):89-1028483408
Cites: Clin Orthop Relat Res. 1994 Feb;(299):153-68119010
Cites: Clin Orthop Relat Res. 1998 Nov;(356):93-1109917673
Cites: Health Econ. 2005 Jan;14(1):39-5315386674
Cites: J Bone Joint Surg Am. 2005 Jun;87(6):1222-815930530
Cites: J Arthroplasty. 2005 Oct;20(7 Suppl 3):132-816214014
Cites: Clin Orthop Relat Res. 2005 Nov;440:162-916239801
Cites: Acta Orthop. 2006 Feb;77(1):49-5616534702
Cites: J Bone Joint Surg Am. 2007 Feb;89(2):261-917272438
Cites: J Bone Joint Surg Am. 2007 Mar;89(3):519-2517332100
Cites: Tidsskr Nor Laegeforen. 2008 Feb 14;128(4):47218274585
Cites: J Bone Joint Surg Am. 2008 Jul;90(7):1492-50018594098
Cites: J Arthroplasty. 2009 Jun;24(4):570-818534396
Cites: Acta Orthop. 2011 Jun;82(3):293-30021504309
Cites: Tidsskr Nor Laegeforen. 2003 May 15;123(10):1367-912806680
Cites: Clin Orthop Relat Res. 2003 Nov;(416):254-6414646768
Cites: J Bone Joint Surg Am. 2004 May;86-A(5):963-7415118039
Cites: Tidsskr Nor Laegeforen. 2004 Sep 23;124(18):239515467812
Cites: Acta Orthop Scand. 2004 Oct;75(5):524-3215513482
Cites: Acta Orthop Scand. 2000 Aug;71(4):337-5311028881
PubMed ID
23829478 View in PubMed
Less detail

An evaluation of the Ontario Rapid Risk Factor Surveillance System.

https://arctichealth.org/en/permalink/ahliterature175106
Source
Can J Public Health. 2005 Mar-Apr;96(2):145-50
Publication Type
Article
Author
Catherine L Bingle
Philippa H Holowaty
Irene E Koren
Louise Picard
Paula J Stewart
Sarah L Feltis
Author Affiliation
Simcoe County District Health Unit, Barrie, ON. cbingle@simcoehealth.org
Source
Can J Public Health. 2005 Mar-Apr;96(2):145-50
Language
English
Publication Type
Article
Keywords
Cost-Benefit Analysis
Health Surveys
Humans
Ontario
Population Surveillance - methods
Public Health
Risk factors
Abstract
The Rapid Risk Factor Surveillance System (RRFSS) is an ongoing population health survey conducted by a collaborating group of Ontario public health units. This formative evaluation examined the process effectiveness, collaboration, utility and cost-effectiveness of RRFSS during its first year of operation.
An Evaluation Framework was developed with reference to guidelines for evaluation of surveillance systems developed by the World Health Organization and the U.S. Centers for Disease Control and Prevention. The study focussed on evaluable performance areas in a young surveillance system and on information needed to inform stakeholder decisions about future participation and improvement. Data were collected through surveys and interviews of key informants in participating health units, non-participating health units, the survey research house, and the provincial health ministry.
Findings documented early use and dissemination of RRFSS data in health units after less than a year of surveillance system operation, stakeholder perceptions overall of data impact and value, and satisfaction with system functioning. Challenges to effectiveness were documented concerning data analysis, barriers to data use, and sustainability. Performance improvement strategies were identified for survey implementation and supports, data use, system participation, and reduced costs.
In its first year, RRFSS was an effective collaborative method to collect population data for public health program planning and evaluation. The evaluation provided valuable information on use, functioning, effectiveness, strategic issues and areas for improvement in a young surveillance system, created opportunities for stakeholder input into evaluation and planning, and provided a baseline for future evaluations.
PubMed ID
15850037 View in PubMed
Less detail

An integrated approach to rapid diagnosis of tuberculosis and multidrug resistance using liquid culture and molecular methods in Russia.

https://arctichealth.org/en/permalink/ahliterature148389
Source
PLoS One. 2009;4(9):e7129
Publication Type
Article
Date
2009
Author
Yanina Balabanova
Francis Drobniewski
Vladyslav Nikolayevskyy
Annika Kruuner
Nadezhda Malomanova
Tatyana Simak
Nailya Ilyina
Svetlana Zakharova
Natalya Lebedeva
Heather L Alexander
Rick O'Brien
Hojoon Sohn
Anastasia Shakhmistova
Ivan Fedorin
Author Affiliation
National Mycobacterium Reference Laboratory, Institute of Cell and Molecular Sciences, Queen Mary College, Barts and the London School of Medicine, University of London, London, United Kingdom. y.balabanova@qmul.ac.uk
Source
PLoS One. 2009;4(9):e7129
Date
2009
Language
English
Publication Type
Article
Keywords
Bacterial Typing Techniques
Bacteriological Techniques - methods
Communicable Disease Control - methods
Cost-Benefit Analysis
Humans
Isoniazid - pharmacology
Microbial Sensitivity Tests
Mycobacterium tuberculosis - genetics
Phenotype
Rifampin - pharmacology
Risk factors
Russia
Tuberculosis - diagnosis - genetics
Tuberculosis, Multidrug-Resistant - diagnosis - genetics
Abstract
To analyse the feasibility, cost and performance of rapid tuberculosis (TB) molecular and culture systems, in a high multidrug-resistant TB (MDR TB) middle-income region (Samara, Russia) and provide evidence for WHO policy change.
Performance and cost evaluation was conducted to compare the BACTEC MGIT 960 system for culture and drug susceptibility testing (DST) and molecular systems for TB diagnosis, resistance to isoniazid and rifampin, and MDR TB identification compared to conventional Lowenstein-Jensen culture assays.
698 consecutive patients (2487 sputum samples) with risk factors for drug-resistant tuberculosis were recruited. Overall M. tuberculosis complex culture positivity rates were 31.6% (787/2487) in MGIT and 27.1% (675/2487) in LJ (90.5% and 83.2% for smear-positive specimens). In total, 809 cultures of M. tuberculosis complex were isolated by any method. Median time to detection was 14 days for MGIT and 36 days for LJ (10 and 33 days for smear positive specimens) and indirect DST in MGIT took 9 days compared to 21 days on LJ. There was good concordance between DST on LJ and MGIT (96.8% for rifampin and 95.6% for isoniazid). Both molecular hybridization assay results correlated well with MGIT DST results, although molecular assays generally yielded higher rates of resistance (by approximately 3% for both isoniazid and rifampin).
With effective planning and logistics, the MGIT 960 and molecular based methodologies can be successfully introduced into a reference laboratory setting in a middle incidence country. High rates of MDR TB in the Russian Federation make the introduction of such assays particularly useful.
Notes
Cites: Arch Pathol Lab Med. 2000 Jan;124(1):82-610629136
Cites: BMJ. 2005 Dec 10;331(7529):136416282379
Cites: Int J Tuberc Lung Dis. 2000 Sep;4(9):866-7010985656
Cites: J Clin Microbiol. 2001 Apr;39(4):1501-511283077
Cites: J Clin Microbiol. 2002 Jan;40(1):150-411773109
Cites: J Clin Microbiol. 2002 Feb;40(2):607-1011825978
Cites: J Clin Microbiol. 2002 Jun;40(6):1930-712037045
Cites: Int J Tuberc Lung Dis. 2002 Sep;6(9):748-5612234129
Cites: Emerg Infect Dis. 2002 Nov;8(11):1320-612453364
Cites: Diagn Microbiol Infect Dis. 2003 Jan;45(1):53-6112573551
Cites: Lancet Infect Dis. 2003 Mar;3(3):141-712614730
Cites: J Clin Microbiol. 2003 Jul;41(7):2822-612843007
Cites: J Microbiol Methods. 2004 Jun;57(3):323-3515134881
Cites: J Clin Microbiol. 2004 Oct;42(10):4498-50215472300
Cites: J Clin Microbiol. 1997 Feb;35(2):364-89003597
Cites: J Clin Microbiol. 2006 Mar;44(3):811-816517859
Cites: Respir Res. 2006;7:4416556324
Cites: J Clin Microbiol. 2006 Jun;44(6):2314-516757650
Cites: Eur Respir J. 2006 Nov;28(5):903-916899481
Cites: J Clin Microbiol. 2006 Nov;44(11):4014-717005737
Cites: J Clin Microbiol. 2006 Dec;44(12):4459-6317035488
Cites: J Clin Microbiol. 2007 Aug;45(8):2635-4017537937
Cites: Int J Tuberc Lung Dis. 2007 Sep;11(9):986-9117705976
Cites: Clin Infect Dis. 2008 Mar 15;46(6):958-918288911
Cites: J Med Microbiol. 2008 May;57(Pt 5):605-1118436594
Cites: Diagn Microbiol Infect Dis. 2008 Aug;61(4):402-718440177
Cites: BMJ. 1998 May 9;316(7142):1423-59572751
Cites: J Clin Microbiol. 1998 Jul;36(7):1969-739650946
Cites: J Clin Microbiol. 1999 Jan;37(1):45-89854062
Cites: J Clin Microbiol. 1999 Mar;37(3):748-529986844
Cites: Lancet. 2005 Jan 22-28;365(9456):318-2615664227
Cites: Thorax. 2005 Feb;60(2):130-515681501
Cites: Int J Tuberc Lung Dis. 2005 Feb;9(2):170-415732736
Cites: JAMA. 2005 Jun 8;293(22):2726-3115941801
Cites: Int J Tuberc Lung Dis. 2005 Jun;9(6):646-5315971392
Cites: Emerg Infect Dis. 2005 Sep;11(9):1461-316229783
Cites: J Med Microbiol. 2000 Mar;49(3):271-810707947
PubMed ID
19774085 View in PubMed
Less detail

343 records – page 1 of 35.