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Cost effectiveness of strategies to combat cardiovascular disease, diabetes, and tobacco use in sub-Saharan Africa and South East Asia: mathematical modelling study

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dc.creatorOrtegón, Mónicaspa
dc.creatorLim, Stephenspa
dc.creatorChisholm, Danspa
dc.creatorMendis, Shanthispa
dc.date.accessioned2020-06-11T13:20:49Z
dc.date.available2020-06-11T13:20:49Z
dc.date.created2012-03-02spa
dc.description.abstractObjective To determine the relative costs and health effects of interventions to combat cardiovascular disease, diabetes, and tobacco related disease in order to guide the allocation of resources in developing countries.Design Cost effectiveness analysis of 123 single or combined prevention and treatment strategies for cardiovascular disease, diabetes, and smoking by means of a lifetime population model.Setting Two World Health Organization sub-regions of the world: countries in sub-Saharan Africa with very high adult and high child mortality (AfrE) and countries in South East Asia with high adult and high child mortality (SearD).Data sources Demographic and epidemiological data were taken from the WHO databases of mortality and global burden of disease. Estimates of intervention coverage, effectiveness, and resource needs were drawn from clinical trials, observational studies, and treatment guidelines. Unit costs were taken from the WHO-CHOICE (Choosing Interventions that are Cost-Effective) price database.Main outcome measures Cost per disability adjusted life year (DALY) averted, expressed in international dollars ($Int) for the year 2005.Results Most of the interventions studied were considered highly cost effective, meaning they generate one healthy year of life at a cost of <$Int2000 (which is the gross domestic product per capita of the two regions considered here). Interventions that offer particularly good monetary value, and which could be considered for prioritised implementation or scale up, include demand reduction strategies of the Framework Convention for Tobacco Control (<$Int950 and <$Int200 per DALY averted in AfrE and SearD respectively); combination drug therapy for people with a >25% chance of experiencing a cardiovascular event over the next decade, either alone or together with specific multidrug regimens for the secondary prevention of post-acute ischaemic heart disease and stroke (<$Int150 and <$Int230 per DALY averted in AfrE and SearD respectively); and retinopathy screening and glycaemic control for patients with diabetes (<$Int2100 and <$Int950 per DALY averted in AfrE and SearD respectively).Conclusion This comparative economic assessment has identified a set of population-wide and individual strategies for prevention and control of cardiovascular disease that are inexpensive and cost effective in low resource settings.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1136/bmj.e607
dc.identifier.issn1756-1833
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/24590
dc.language.isoeng
dc.publisherThe BMJspa
dc.relation.citationIssueNo. mar02 1
dc.relation.citationStartPagee607
dc.relation.citationTitleThe BMJ
dc.relation.citationVolumeVol. 344
dc.relation.ispartofThe BMJ, ISSN: 1756-1833, Vol.344, No.mar02 1 (2012-03-02); pp. e607spa
dc.relation.urihttps://www.bmj.com/content/344/bmj.e607.full.pdfspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordAdultspa
dc.subject.keywordAfrica South of the Saharaspa
dc.subject.keywordAgedspa
dc.subject.keywordAgedspa
dc.subject.keyword80 and overspa
dc.subject.keywordAsiaspa
dc.subject.keywordSoutheasternspa
dc.subject.keywordCardiovascular Diseasesspa
dc.subject.keywordCost-Benefit Analysisspa
dc.subject.keywordDiabetes Mellitusspa
dc.subject.keywordFemalespa
dc.subject.keywordHumansspa
dc.subject.keywordMalespa
dc.subject.keywordMiddle Agedspa
dc.subject.keywordModelsspa
dc.subject.keywordTheoreticalspa
dc.subject.keywordSmokingspa
dc.subject.keywordSmoking Preventionspa
dc.subject.keywordTobacco Use Disorderspa
dc.titleCost effectiveness of strategies to combat cardiovascular disease, diabetes, and tobacco use in sub-Saharan Africa and South East Asia: mathematical modelling studyspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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