Rethinking Tuberculosis Morbidity Quantification: A Systematic Review and Critical Appraisal of TB Disability Weights in Cost-Effectiveness Analyses. | LitMetric
Background: The disability-adjusted life year (DALY), a key metric for health resource allocation, encompasses morbidity through disability weights. Widely used in tuberculosis cost-effectiveness analysis (CEAs), DALYs play a significant role in informing intervention adopt/reject decisions. This study reviews the values and consistency of disability weights applied in tuberculosis-related CEAs.
Methods: We conducted a systematic review using the Tufts CEA database, updated to July 2023 with searches in Embase, Scopus and PubMed. Eligible studies needed to have included a cost-per-DALY ratio, and additionally either evaluated a tuberculosis (TB) intervention or included tuberculosis-related weights. We considered all tuberculosis health states: with/without human immunodeficiency virus (HIV) coinfection, TB treatments and treatment side effects. Data were screened and extracted independently by combinations of two authors.
Findings: A total of 105 studies spanning 2002-2023 across 50 countries (mainly low- and middle-income countries) were extracted. Disability weights were sourced primarily from the Global Burden of Disease (GBD; 100/165; 61%), with 17 non-GBD studies additionally referenced, along with primary derivation. Inconsistencies in the utilisation of weights were evident: of the 100 usages of GBD-sourced weights, only in 47 instances (47%) had the weight value been explicitly specified with an appropriate up-to-date reference cited (constituting 28% of all weight usages, 47/165). Sensitivity analyses on weight values had been conducted in 30% of studies (31/105). Twelve studies did not clearly specify weights or their sources; nine further calculated DALYs without morbidity. The review suggests methodological gaps in current approaches for representing important aspects of TB, including TB-HIV coinfection, treatment, drug-resistance, extrapulmonary TB and psychological impacts. We propose a set of best practice recommendations.
Interpretation: There is a need for increased rigour in the application, sensitivity testing and reporting of TB disability weights. Furthermore, there appears a desire among researchers to reflect elements of the tuberculosis experience beyond those allowed for by GBD disability weights.
Objective: To investigate the nutritional status, height development and intellectual development level of rural children aged 10-12 years in Linxia Hui Autonomous Prefecture, Gansu Province, and to analyze the relationship between the nutritional status and height development of local schoolchildren and their intellectual development.
Methods: In 2019, a total of 1721 students were selected from 8 counties(cities) under the jurisdiction of Linxia Prefecture in Gansu Province, with 1 township selected from each county in 5 directions: east, west, south, north, and central. One primary school was randomly selected from each township, and 45 students aged 10-12 were selected from each primary school.
Fetal alcohol spectrum disorders (FASD) are among the most common neurodevelopmental disabilities. Individuals with FASD experience postnatal adversity (PA; i.e.
Background: Learning disabilities, categorized as neurodevelopmental disorders, profoundly impact the cognitive development of young children. These disabilities affect text comprehension, reading, writing and problem-solving abilities. Specific learning disabilities (SLDs), most notably dyslexia and dysgraphia, can significantly hinder students' academic achievement.
Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Women's Research Institute, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address:
Background: Preconception health education is critical to improve pregnancy and neonatal outcomes, but people with mobility disabilities have specific, often unique issues related to preparing for pregnancy. This study sought to develop consensus-based domains for a preconception education curriculum for people with mobility disabilities.
Methods: We used a mixed methods approach, including a literature review and a Delphi method to develop consensus.
