Socio-demographic correlates of multimorbidity in SAGE countries.

<p>Notes</p><p>1. Multimorbidity defined as two or more chronic conditions in the same individual</p><p>2. Additional covariates included in the model in China: provinces; Ghana: ethnic groups (Akan, Ga-Adangbe, and others); India: states; South Africa: provinces, ethnic groups (back, white, coloured, and others).</p><p>3. Country dummy variables were included in the model to adjust for heterogeneity among countries in the pooled analysis.</p><p>Socio-demographic correlates of multimorbidity in SAGE countries.</p

Results for studies on preventive therapy in HIV-infected individuals and in household contacts.

a<p>For example, comparing patients with positive versus negative tuberculin skin tests.</p>b<p>Including studies that addressed effects on treatment outcomes.</p>c<p>Studies testing a hypothesis about measures to improve treatment completion or adherence.</p>d<p>As specific study objective, no hypothesis testing about measures to improve treatment completion or adherence.</p>e<p>Two multi-country studies situated at locations with different TB incidences and HIV prevalence; one of these in various regions.</p>f<p>Number of studies evaluating effects on health outcomes.</p><p>HAART, highly active antiretroviral treatment.</p

Prevalence of multimorbidity by age groups in SAGE countries.

<p>Prevalence of multimorbidity by age groups in SAGE countries.</p

Results for studies on clinical algorithms for diagnosis of smear-negative TB in patients presenting with symptoms (“rule-in”) and for screening of HIV-infected individuals (“rule-out”).

a<p>Excluding one that generated an algorithm that was subsequently evaluated in a separate (prediction) dataset.</p>b<p>Additional diagnostic procedures evaluated include bronchoalveolar lavage, nasopharyngeal aspirate, stool culture, fluorescence microscopy, PCR, urinary lipoarabinomannan, microscopic observation of drug susceptibility (MODS), endobroncheal ultrasound, repeat of smear examination after 1 mo.</p>c<p>These studies also assessed effects on health outcomes.</p>d<p>Excluding one multi-country study <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001358#pmed.1001358-Cain1" target="_blank">[65]</a>.</p>e<p>Excluding two multi-country studies <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001358#pmed.1001358-Cain1" target="_blank">[65]</a>,<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001358#pmed.1001358-Monkongdee1" target="_blank">[66]</a>.</p>f<p>Number of studies evaluating effects on health outcomes.</p

Association between number of NCDs and healthcare utilisation.

<p>Association between number of NCDs and healthcare utilisation.</p

Association between number of NCDs and out-of-pocket spending.

<p><b>Notes:</b> Figures in the last column are regression coefficients and 95% CI for the variable “number of NCD” from regression models adjusting for all covariates. Log-linear models is used to estimate both outpatient and inpatient out-of-pocket spending outcomes.</p><p>Association between number of NCDs and out-of-pocket spending.</p

GH cases, spending on GH treatment, wage losses due to GH, HIV cases attributable to HSV-2, related ART spending, and QALY losses due to GH in 90 LMICs, by WHO region (2019).

Spending on treatment includes spending on medicines and outpatient care. Estimates assume a single clinic visit per year. Wage losses are due to genital herpes related absenteeism. Estimates assume 1 absent day per year due to a first episode infection in incident cases. The attributable HIV population is represented as a regional mean and is due to incident and prevalent HSV-2 infections where the RR is assumed to be 2.7 for prevalent HSV-2 infections and 4.7 for incident HSV-2 infections8. Total ART spending includes service delivery and laboratory diagnostics costs and assumes midyear initiation. The total QALY losses represent losses if the serostatus is known where the asymptomatic QALY weight is assumed to be 0.8933. WHO regions include the Africa (AFRO), Americas (AMRO), Southeast Asian (SERO), European (EURO), Eastern Mediterranean (EMRO), and the Western Pacific (WPRO) regions. Base map from Natural Earth, http://www.naturalearthdata.com/about/terms-of-use/ (https://www.naturalearthdata.com/downloads/50m-cultural-vectors/50m-admin-0-countries-2/). ART, antiretroviral therapy; GH, genital herpes; HSV-2, herpes simplex virus type 2; LMIC, low- and middle-income country; QALY, quality-adjusted life year; RR, relative risk; WHO, World Health Organization.</p

Percentage of out-of-pocket spending for each type of outpatient service in persons with multimorbidity (Fig 5a); Percentage of out-of-pocket spending for each type of inpatient service in persons with multimorbidity (Fig 5b).

<p>Estimates presented here are based on respondent’s healthcare visit that was not free of charge.</p

Distribution of published studies on provision of second-line treatment for drug-resistant TB, by geography, objective, and study setting.

<p>Effectiveness studies relate to studies designed to address effectiveness as well as mixed effectiveness-efficacy for health-related outcomes, done in programmatic settings or “DOTS-Plus” pilots. Delivery relates to studies designed to address treatment completion and adherence, and organization of services. One non-comparative delivery study and two cost-effectiveness studies were also included as effectiveness studies.</p

Distribution of published studies on clinical algorithms for diagnosing smear-negative TB in patients presenting with symptoms (“rule-in”), by geography, objective, and study setting.

<p>Effectiveness studies, algorithm relate to studies designed to evaluate predefined clinical algorithms, and effectiveness studies, diagnostics to studies designed to evaluate combined diagnostic methods, both for diagnosing smear-negative TB among TB suspects done in routine or mixed routine-research settings. Delivery relates to studies designed to address diagnostic practices and improvement of smear examination or sputum collection to improve diagnosis of smear-negative TB. One study evaluated both combined diagnostic methods and a predefined clinical algorithm. Two cost-effectiveness studies were also included as evaluations of combined diagnostic methods.</p