Publications by authors named "A Zwerling"

Article Synopsis
  • A tuberculosis outbreak in Qikiqtarjuaq Nunavut led to community-wide screening (CWS) initiated by local leaders and the territorial government, aiming to evaluate its cost-effectiveness despite high medical service costs in the Arctic.
  • A hybrid decision analysis and Markov model was used to analyze the impact of CWS compared to no screening over a 20-year period, revealing that CWS results in health gains by preventing active TB cases.
  • The study concluded that while CWS incurs increased costs, it is highly cost-effective, with a low incremental cost-effectiveness ratio of $25.10 per quality adjusted life year (QALY) gained, supporting its use during TB outbreaks in remote communities.*
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Reducing systemic inequities in testing, access to care, social protection - and in the scientific process - is essential to end TB. Incorporating social science methods and expertise on inequity into the mainstream TB response would help ensure that political commitments to equity move beyond symbolic gestures. We convened a meeting between TB social scientists, people with lived experience, civil society and community members to discuss equity within the global TB response.

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Objectives: HIV self-testing (HIVST) has been proposed as an innovative strategy to diagnose human immunodeficiency virus (HIV). While HIVST offers the potential to broaden accessibility of early HIV diagnosis and treatment initiation, this testing strategy incurs additional cost and requires confirmatory testing and treatment. We have conducted the first systematic review to summarize the current economic literature for HIVST in low- and middle-income countries (LMICs).

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Background: (CT) and (GC) resulted in over 200 million new sexually transmitted infections last year. Self-sampling strategies alone or combined with digital innovations (ie, online, mobile or computing technologies supporting self-sampling) could improve screening methods. Evidence on all outcomes has not yet been synthesised, so we conducted a systematic review and meta-analysis to address this limitation.

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