12 research outputs found
Global economic burden of unmet surgical need for appendicitis
- Author
- Aahlin E. K.
- Aamer A.
- Aaniana K.
- Ababneh A.
- Abaliksta T.
- Abantanga F.
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- Publication venue
- Oxford University Press
- Publication date
- 01/01/2022
- Field of study
Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US 92492millionusingapproach1and73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was 95004millionusingapproach1and75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
- Author
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- El Shoura Y
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- Elena G
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- Elfouly Y
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- Elhadad A
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- Elhalawany E
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- Elhelbawy MS
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- Elhoseny G
- Elhusseiny AAE
- Elizabeth Lopez C
- Elkadsh I
- Elkady F
- Elkelany A
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- Elkhadrawi M
- Elkhalek EA
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- Elsherbiny AS
- Elsherif FA
- Elshobary M
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- Elsorogy DEAA
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- Elzahed N
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- Elzowawi F
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- Eng C
- English W
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- Espin-Basany E
- Espinoza F
- Essam A
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- Farouk SAM
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- Farrugia A
- Farrugia A
- Faruq A
- Fathy AM
- Fattah AA
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- Faturoti O
- Faturoti O
- Faure A
- Fautz T
- Favero A
- Fawzy A
- Feidantsis T
- Felipe CO
- Fergany A
- Fergusson SJ
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- Jubran AF
- Juciute S
- Julaihi R
- Jurdell E
- Kaafarani H
- Kabariti R
- Kabariti R
- Kabba J
- Kabongo K
- Kache S
- Kaci AA
- Kadiwar S
- Kalakouti E
- Kalles V
- Kalles V
- Kalles V
- Kamarajah SK
- Kamarulzamil SNA
- Kamil R
- Kamya S
- Kanani A
- Kandil AM
- Kandil H
- Kang MK
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- Karabacak U
- Karabelias G
- Karabulut K
- Karahan SR
- Karakahya M
- Karandikar S
- Karandikar S
- Kariem N
- Karim A
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- Karismaningtyas H
- Karjiker P
- Karkeet M
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- Karlo R
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- Karousos D
- Karumnas P
- Kaselis N
- Kaselis N
- Kasem E
- Kasem EA
- Kasputyte S
- Kaul A
- Kazanavicius D
- Kedar A
- Kefalidi E
- Keke KR
- Kelany M
- Kenibar A
- Kennedy ED
- Kennedy M
- Kennedy R
- Keogh K
- Kerley R
- Kershaw S
- Kesinger M
- Khafagy T
- Khairy H
- Khairy H
- Khajanchi M
- Khaled H
- Khalifah E
- Khalili M
- Khalique A
- Khallaf S
- Khamajeet A
- Khan A
- Khan K
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- Khan ZA
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- Khatri C
- Khatri C
- Khattab K
- Khedr AE-RH
- Khoja A
- Khoja A
- Khokha D
- Khokha V
- Khosla S
- Khouri Ferreira SA
- Khreishi R
- Khreishi R
- Khulu LB
- Khyrallh A
- Kiasat A
- Kidd T
- Kielty P
- Kim MY-H
- Kim S-H
- Kim SB
- Kimaro M
- Kinandu K
- King R
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- Kiran RP
- Kirby A
- Kirishnan A
- Kirupagaran A
- Kiudelis M
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- Klappenbach R
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- Kojo ATT
- Kojo ATT
- Kojo ATT
- Kolosov A
- Komolafe O
- Kondrotas P
- Kong C
- Kong SN
- Kong V
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- Konstantina K
- Kontos M
- Kordorwu HEK
- Korkolis D
- Kosai NR
- Kosai NR
- Kose E
- Koskenvuo L
- Kostov E
- Kotb AHE-B
- Kotecha D
- Koto MZ
- Kotobi H
- Koumpa F
- Kouraklis G
- Kourdouli A
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- Kretzmann H
- Krishna K
- Kruspi S
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- Kushwaha S
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- Kwizera S
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- Kyriazanos I
- Kyrou G
- Kyziridis D
- L'Heveder A
- La Brocca A
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- Labib P
- Ladukas A
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- Lakhani SM
- Lakshmi HN
- Lam FY
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- Lam WH
- Lamanna GL
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- Landolfo G
- Lap G
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- Lasheen A
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- Latif A
- Laugzemys E
- Laugzemys E
- Laurie K
- Lauzikas G
- Law JH
- Lawal A
- Lawal AO
- Lawal T
- Lawal TA
- Lawani I
- Lawther R
- Lazzari G
- Lazzari V
- Lazzarini Cury AD
- Le VTH
- Leal A
- Leal M
- Leanne Almanon C
- Lecompte J-F
- Lee C
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- Lee F
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- Leppaniemi A
- Leppaniemi A
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- Leusink A
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- Li KKK
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- Liew I
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- Lilford R
- Lilford R
- Lim G
- Lim H
- Lim J
- Lim PJ
- Lim SJ
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- Lim SY
- Limache S
- Limaye N
- Limoges B
- Linares Delgado MSDFT
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- loaloa MR
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- Macchitella Y
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- Macfarlane A
- Machaca M
- Machain Vega GM
- Machain Vega GM
- Maciejec L
- Madiba T
- Madkor MH
- Madrid Barrientos LA
- Maffioli A
- Maffioli A
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- Manchego Bautista AC
- Manchego Bautista AC
- Manfreda S
- Mangan C
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- Manipal CE
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- Mano MJB
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- Marroquin Rodriguez DE
- Marshall DC
- Martian B-V
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- Mironescu A
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- Mirza A
- Mirza S
- Mistry A
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- Mitroudi M
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- Moe TT
- Mogan YP
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- Mohamed AM
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- Mohamed B
- Mohamed F
- Mohamed I
- Mohamed M
- Mohamed MA
- Mohamed MAEH
- Mohamed MM
- Mohamed O
- Mohamed SR
- Mohameden A
- Mohammad A
- Mohammad A
- Mohammed A
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- Mohammed H
- Mohammed MM
- Mohammed MMH
- Mohammed S
- Mohan H
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- Monteleone M
- Monteleone M
- Montes I
- Montes I
- Montoya Botero JA
- Montrimaite M
- Montrimaite M
- Moodley Y
- Moore R
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- Mora JJV
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- Moreira G
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- Morsi A
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- Mosalum O
- Mostafa HA
- Mostafa M
- Mostafa M
- Mousa M
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- Mshelbwala P
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- Negida A
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- Nepogodiev D
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- Nwabuoku E
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- Punja V
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- Ruiz-Tovar J
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- Runigamugabo E
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- Sahel S
- Saidbadr A
- Sakr A
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- Salah OM
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- Salma M
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- Salma U
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- Samaraweera DI
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- Samison LH
- Sammarco G
- Sammut K
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- Samy S
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- Sandoval Barrantes AM
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- Publication venue
- Publication date
- 15/10/2018
- Field of study
Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
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- de Leó
- De Leon MZP
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- Dell A
- Dempster E
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- Devadasar Gh
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- Elkorashy Am
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- Farouk Sam
- Farquharson A
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- Fattah Aa
- Fatuga A
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- Faturoti O
- Faure A
- Fautz T
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- Fawzy A
- Feidantsis T
- Felipe Co
- Fergany A
- Fergusson Sj
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- Kharsa S
- Khatri C
- Khatri C
- Khattab K
- Khedr Aeh
- Khg Li
- Khoja A
- Khoja A
- Khokha D
- Khokha V
- Khosla S
- Khreishi R
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- Khulu Lb
- Khyrallh A
- Kiasat A
- Kidd T
- Kielty P
- Kim My
- Kim Sb
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- Kinandu K
- King R
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- Kinnera Sv
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- Kirby A
- Kirishnan A
- Kirupagaran A
- Kiudelis M
- Kjellin A
- Kkk Li
- Klappenbach R
- Knight S
- Koay Kl
- Kobal Bb
- Koh C
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- Kojo Att
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- Kolosov A
- Komolafe O
- Kondrotas P
- Kong C
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- Kong V
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- Konstantina K
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- Kordorwu Hek
- Korkolis D
- Kosai Nr
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- Kose E
- Koskenvuo L
- Kostov E
- Kotb Ahe
- Kotecha D
- Koto Mz
- Kotobi H
- Koumpa F
- Kouraklis G
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- Kretzmann H
- Krishna K
- Kruspi S
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- Kumwenda D
- Kushwaha S
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- Kusi K
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- Kwakyeafriyie P
- Kwatiwani C
- Kwizera S
- Kwok Sh
- Kyereh M
- Kyriazanos I
- Kyrou G
- Kyziridis D
- Ló
- L&apos
- La Brocca A
- la Medina AR
- la Medina AR
- la Medina AR
- Labib P
- Ladukas A
- Lafferty K
- Lagunavicius K
- Lai Ac
- Lakhani Sm
- Lakshmi Hn
- Lam Fy
- Lam Jcy
- Lam Wh
- Lamanna Gl
- Lanau Miv
- Lando J
- Landolfo G
- Landolfo G
- Lap G
- Lapitan Mc
- Lapitan Mc
- Larsen Jw
- Lasek A
- Lasheen A
- Lasheen Kt
- Latif A
- Laufer Lav
- Laugzemys E
- Laugzemys E
- Laurie K
- Lauzikas G
- Law Jh
- Lawal A
- Lawal Ao
- Lawal T
- Lawal Ta
- Lawani I
- Lawther R
- Lazzari G
- Lazzari V
- Leal A
- Leal M
- Lecompte Jf
- Lee C
- Lee Ex
- Lee F
- Lee K
- Lee Kc
- Lee Ky
- Lee Tsb
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- Leone N
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- Leppä
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- Leung Kw
- Leung Mf
- Leusink A
- Lewis J
- Li Ws
- Licari L
- Lieske B
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- Liew I
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- Lilford R
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- Lim G
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- Lim J
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- Lim Sy
- Limache S
- Limaye N
- Limoges B
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- Lipnickas V
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- Livingston M
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- Lo Conte A
- Loaloa Mr
- Lockey J
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- Loizides S
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- Longstaff L
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- Lorenzon L
- Lossius Wj
- Loughran D
- Low X
- Luc Ar
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- Luck J
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- Luglio G
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- Lundgren Po
- Luque Gb
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- Lytras D
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- Má
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- Mabrouk M
- Macchiavello R
- Macchitella Y
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- Macdonald A
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- Maceviciute K
- Macfarlane A
- Machaca M
- Maciejec L
- Madiba T
- Madkor Mh
- Maffioli A
- Maffioli A
- Magdy A
- Magdy B
- Magdy E
- Magdy H
- Magdy M
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- Magee C
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- Margaritis M
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- Marinkovic B
- Marinos C
- Marks E
- Marples L
- Marret Jb
- Marshall Dc
- Martian Bv
- Martin A
- Mas R
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- Matheu A
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- Mendoza I
- Menegussi J
- Mensah E
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- Mentula P
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- Milligan W
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- Minocha A
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- Miranda C
- Mircea H
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- Mironescu A
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- Mirza A
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- Mistry A
- Mitrasinovic S
- Mitroudi M
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- Modolo Mm
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- Mogan Yp
- Moghazy Me
- Mohamed A
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- Mohamed Am
- Mohamed Ar
- Mohamed B
- Mohamed F
- Mohamed I
- Mohamed M
- Mohamed Ma
- Mohamed Maeh
- Mohamed Mm
- Mohamed O
- Mohamed Sr
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- Mohammad A
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- Mohammed H
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- Mohammed S
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- Molina G
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- Monaghan E
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- Monrad-Hansen Pw
- Montejo Msg
- Monteleone M
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- Montes I
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- Montrimaite M
- Montrimaite M
- Moodley Y
- Moore R
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- Mora Jjv
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- Mostafa Ha
- Mostafa M
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- Moussa O
- Moustafa A
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- Mowafy B
- Mphatsoe Am
- Mshelbwala P
- Msiska N
- Msosa V
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- Mukuzunga C
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- Nanthakumaran S
- Napolitano L
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- Naqvi Sa
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- Naranjo Aristizã
- Narayanan R
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- Ndegwa W
- Ndlovu Sr
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- Negida A
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- Nepogodiev D
- Nepogodiev D
- Nepogodiev D
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- Nesaratnam A
- Nessa A
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- Nevieraite V
- Newton T
- Ng S
- Ng Yk
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- Nikoloudis N
- Nikoloudis N
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- Njokanma I
- Nnajiuba H
- Nocito A
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- Nofal E
- Noor F
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- Notarnicola M
- Notarnicola M
- Nouh T
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- Noukpozounkou B
- Novak A
- Nowers J
- Nsengimana Vjp
- Nsengiyumva C
- Ntirenganya F
- Nur&apos
- Nurqistan Hd
- Nwabuoku E
- Nwinee V
- Nwokoro C
- Nyberg J
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- O&apos
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- Odutola O
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- Ogunyemi A
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- Olaolorun A
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- Samaniego Cs
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- Soldevila-Verdeguer C
- Soley R
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- Soliman A
- Soliman A
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- Soliman N
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- Soliman S
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- Song J
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- Steccanella F
- Stefanopoulos A
- Stephen A
- Stewart D
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- Stock S
- Stoddart M
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- Stoddart M
- Stourton F
- Strazdas A
- Strupas K
- Strupas K
- Strupas K
- Stuva J
- Stuva Jpg
- Styles K
- Suá
- Suarez A
- Suarez Aab
- Subocius A
- Suleiman Si
- Summerour V
- Sund M
- Sund M
- Sunderland G
- Sundstrom Sm
- Suresh S
- Sutandi N
- Sutanto Epr
- Sutton P
- Sutton P
- Suyadi A
- Swann J
- Swaroop M
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- Syibrah Kz
- Sykes M
- Szczap A
- Szeto Ccl
- Szeto Kj
- Tabiri S
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- Tabiri S
- Tabiri S
- Tackie E
- Taddei A
- Tade A
- Tafazal H
- Taha Ems
- Tahboub H
- Taher Aa
- Taher M
- Taher Mm
- Taieb C
- Taiwo A
- Taiwo O
- Taiwo O
- Talaat M
- Tale F
- Tale L
- Talukder S
- Talukder S
- Talving P
- Talving P
- Tammam A
- Tan C
- Tan Cl
- Tan Cy
- Tan Jj
- Tan Jk
- Tan Ksk
- Tan Rck
- Tan Yk
- Tan Yw
- Tanase A
- Tanase A
- Tang A
- Tang L
- Tani Si
- Tansoker I
- Tarek A
- Tarek A
- Tarek D
- Targa S
- Tariq S
- Tata Md
- Tatagiba Ls
- Tawfik Ba
- Tawfik G
- Tawfik G
- Taylor F
- Teasdale E
- Teasdale E
- Teasdale E
- Teasdale E
- Tedeschi U
- Tedjaatmadja C
- Telfah Mm
- Tembo T
- Temoche E
- Tennakoon A
- Teo Sy
- Ter Ez
- Tessera G
- Teufelberger G
- Tew Yy
- Tew Yy
- Tewari S
- Th&apos
- Thabet W
- Thalgaspitiya Spb
- Tham Jc
- Thanusan V
- Tharmalingam S
- Theodosopoulos T
- Thollot A
- Thomas E
- Thompson B
- Thomson P
- Thorarinsdottir H
- Thorarinsdottir H
- Thorell A
- Thorell A
- Thorsen K
- Thurairaja R
- Ticona Wa
- Tierney G
- Tilston Tw
- Timothy Ok
- Ting Jrs
- To K
- To K
- Todd O
- Toeema Ag
- Tolba H
- Tolg C
- Tolonen M
- Tolotra Tec
- Tori Sa
- Torrance Hd
- Torrance Hd
- Torres Cpg
- Torres Sg
- Toto Ö
- Tou S
- Townsend D
- Tracy J
- Trompetto M
- Tselos A
- Tshisola Sk
- Tugnoli G
- Tugnoli G
- Tun Ak
- Tun M
- Tun M
- Turati L
- Turati L
- Turkustani S
- Turner M
- Tutino R
- Tverskis Z
- Tyler R
- Tyler R
- Tze Rge
- Tze Rge
- Tzikos G
- Uš
- Ubhi Hk
- Ubiali P
- Ugalde P
- Ukwenya Y
- Uluş
- Ulusahin M
- Upadhyaya V
- Upchurch E
- Urbanavicius L
- Urbonas T
- Urbonas T
- Urniež
- Urniezius Z
- Urquizu Mc
- Usaityte A
- Utter M
- Uzabumwana N
- Vaicius A
- Valcarcel-Saldañ
- Valioulis I
- Van Der Naald N
- Van Duren B
- Van Niekerk M
- Van Straten S
- Varcada M
- Vargas M
- Varkalys K
- Vartanoglu T
- Vartic M
- Vartic M
- Vasquez G
- Vasquez I
- Veen T
- Vega Gmm
- Vega Gmm
- Velá
- Velá
- Velasquez R
- Vella-Baldacchino M
- Venclauskas L
- Vendramin E
- Venskutonis D
- Venskutonis D
- Venskutonis D
- Venskutonis D
- Venugopal C
- Verbeek A
- Vergara Alc
- Verjee A
- Vermaas M
- Veronese E
- Viš
- Vianna P
- Vicario E
- Vico Td
- Vida Lc
- Vida Lc
- Vilč
- Villa R
- Villalobos S
- Villegas Mi
- Vimalachandran D
- Vincent J
- Violi P
- Vivekanantham S
- Vlachogiorgos A
- Voulgaris E
- Vth Le
- Wael N
- Wagener M
- Wakefield R
- Walę
- Waleed H
- Walker M
- Walker N
- Walls L
- Walsh M
- Walsh U
- Waqar M
- Ward Ae
- Ward S
- Warda M
- Warren O
- Warren O
- Warwick Am
- Waterman A
- Watson Nf
- Watts A
- Weber B
- Weber P
- Weber P
- Weinstein Ms
- Werder G
- Wheeler J
- Whewell H
- Whitaker J
- White R
- White T
- Whitehurst K
- Wiborg J
- Widiastini Ta
- Widmer Lw
- Wijayarathna Ls
- Wild Jrl
- Williams E
- Williams G
- Williams O
- Williams O
- Williamson A
- Wilson A
- Wilson L
- Wilson M
- Wilson M
- Wilson Ms
- Wilson Msj
- Wimalge Pmsn
- Winstanley J
- Witherspoon P
- Wogensen F
- Wogensen F
- Wogensen F
- Woin E
- Wold Tb
- Wolf B
- Wolf B
- Wondimu S
- Wondoh P
- Wondoh P
- Wong Cs
- Wong Cy
- Wong F
- Wong Hy
- Wood G
- Woodward H
- Worku M
- Worku M
- Worku T
- Wredberg C
- Wright N
- Wright Nj
- Xerri T
- Xerri T
- Yahaya Mt
- Yakubu M
- Yallop L
- Yam Sy
- Yang J
- Yap S
- Yaseen T
- Yaseen Tm
- Yau Jd
- Yavuz Ma
- Ye J
- Yeang Lj
- Yee J
- Yeo Ls
- Yeung En
- Yeung Mha
- Yifieyeh A
- Yildirim R
- Yip C
- Yip Sbs
- Ymeri S
- Yoganathan P
- Yolcu S
- Yong Co
- Yong Gl
- Younis A
- Youssef D
- Youssef H
- Youssef M
- Youssif Jh
- Yuksek Ma
- Yusufali T
- Zaa&apos
- Zachariades Dc
- Zadoroznas A
- Zahran D
- Zakaria E
- Zakaria M
- Zakaria Y
- Zaki A
- Zakir M
- Zalabia Mf
- Zamarin K
- Zammit S
- Zampitis N
- Zani A
- Zani A
- Zani A
- Zanini N
- Zanini N
- Zapata F
- Zarb C
- Zardab A
- Zegarra S
- Zeidan S
- Zerihun Ab
- Zhang Z
- Zheng F
- Zidan H
- Zidan H
- Zidan M
- Zielinski M
- Ziff O
- Zikry M
- Zil-E-Ali A
- Zilinskas J
- Zilinskas J
- Zilinskas J
- Zilinskas J
- Zilinskiene R
- Zimmermann Ef
- Zohair A
- Zorrilla Cd
- Zuber M
- Zuber M
- Zuk G
- Zulkifli A
- Zumbü
- Publication venue
- 'Wiley'
- Publication date
- 27/11/2018
- Field of study
Background
End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection.
Methods
This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model.
Results
In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001).
Conclusion
Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone
Multiscale performance and environmental impact assessment of slag and Portland blended cement for optimum carbonation curing
- Publication venue
- Elsevier
- Publication date
- 01/12/2023
- Field of study
This article presents an investigation into the potential use of ground granulated blast-furnace slag (addressed as Slag cement or ‘SC’) as a replacement to Ordinary Portland Cement (OPC) in hybrid (carbonation and hydration) cured cement-based materials. To investigate the effects of carbonation on mechanical performances and microstructures, 0 %–100 % OPC was replaced with slag cement (SC). Thermogravimetric analysis (TGA) and Fourier transformed infrared (FTIR) spectra were utilized to investigate the carbonation reaction extent, rate, and microstructural phase formations. Slag cement was found to improve the efficiency and rate of carbonation. This study revealed that a minimum of 72 h of carbonation in a CO2-containing environment yields better mechanical performance compared to the traditional curing method. Specifically, the incorporation of 72 h of carbonation curing was observed to increase the strength of concrete up to 30 % after 28 days of total curing duration (carbonation and hydration). The chloride permeability of the carbonation cured samples was observed to reduce by 80 % due to the addition of SC. Finally, it was observed that, the carbonated concrete sample with slag has nearly 60 % lower global warming potential compared to the carbonated and non-carbonated concrete sample with 100 % OPC binder
Enhancing the properties of carbonation cured gamma dicalcium silicates (γ-C<sub>2</sub>S) using biomimetic molecules
- Publication venue
- Publication date
- 28/02/2024
- Field of study
This study investigates the effectiveness of three different organic molecules to enhance the properties of carbonated gamma dicalcium silicate (γ-C2S) based cementitious system. These molecules are addressed as biomimetic molecules due to their ability to mimic the biomineralization process. Low dosages (2.5% and 5%) of L-aspartic acid (LAsp), L-glutamic acid (LGlu) and polyacrylic acid (PAA) were incorporated to the γ-C2S paste. The effects of these molecules on the microstructure, CO2 sequestration capacity and strengths of the CO2-activated γ-C2S pastes were monitored. To understand the effectiveness of molecules at different temperature, the compressive and flexural strengths of γ-C2S pastes carbonated at 25 °C and 50 °C were evaluated. It was observed that all the molecules enhanced the strength of the composites by altering the CaCO3 formation and subsequent densification of the matrix. However, the effectiveness of the molecules varies depending on the temperature. Specifically, LGlu and LAsp were found to be the most and the least, respectively, effective molecule at high temperature (50 °C) carbonation curing condition; whereas, PAA remained nearly equally effective at both temperatures.</p
Stability and Feasibility of Dried Blood Spots for Hepatitis E Virus Serology in a Rural Setting
- Author
- Publication venue
- MDPI AG
- Publication date
- 01/01/2022
- Field of study
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. In many low-income countries it causes large outbreaks and disproportionally affects pregnant women and their offspring. Surveillance studies to find effective preventive interventions are needed but are hampered by the lack of funding and infrastructure. Dried blood spots (DBS) offer an easier and more robust way to collect, transport, and store blood samples compared to plasma/serum samples, and could ease some of the barriers for such studies. In this study we optimize an HEV IgG ELISA for DBS samples and validate it on 300 paired DBS and plasma samples collected in rural areas of Bangladesh from participants in a HEV vaccine study. We demonstrate that HEV IgG in blood stored as DBS is stable for two months at up to 40 °C, and for five freeze-thaw cycles. The specificity was 97% and the overall sensitivity of the DBS assay was 81%. The sensitivity was higher in samples from vaccinated participants (100%) compared to previously infected participants (59%), reflecting a positive correlation between IgG titer and sensitivity. We found a strong correlation between DBS and plasma samples with an r2 of 0.90, but with a higher degree of difference between individual paired samples. Our study shows that DBS offers a stable alternative to plasma/serum for HEV IgG measurements and can facilitate serological studies, particularly in resource limited areas
A randomized Phase I/II study to evaluate safety and reactogenicity of a heat-stable rotavirus vaccine in healthy adults followed by evaluation of the safety, reactogenicity, and immunogenicity in infants
- Author
- Publication venue
- Taylor & Francis Group
- Publication date
- 01/03/2020
- Field of study
Objectives: To assess the safety and reactogenicity of single oral dose of heat-stable rotavirus vaccine (HSRV) in healthy adults aged 18–45 years followed by assessment of safety, reactogenicity, and immunogenicity of three doses of HSRV in healthy infants aged 6–8 weeks at enrollment. Trial Design: Single-center randomized controlled, sequential, blinded (adults) and open-label (infants). Setting: Single site at International Center for Diarrheal Disease Research, Bangladesh (icddr,b). Participants: Fifty eligible adults randomized in 1:1 ratio (HSRV: Placebo) followed by 50 eligible infants randomized in 1:1 ratio (HSRV: Comparator (RotaTeq®, pentavalent human-bovine (WC3) reassortant live-attenuated, rotavirus vaccine)). Intervention: Adults received either a single dose of HSRV or placebo and followed for 14 days. Infants received three doses of either HSRV or comparator with a follow-up for 28 days after each dose. Main Outcome Measures: Solicited and unsolicited adverse events (AEs) along with any serious adverse events (SAEs) were part of the safety and reactogenicity assessment in adults and infants whereas serum anti-rotavirus IgA response rates were part of immunogenicity assessment in infants only. Post-vaccination fecal shedding of vaccine-virus rotavirus strains was also determined in adults and infants. Results: In this study, HSRV, when compared with placebo, did not result in increase in solicited adverse events (solicited AEs) in adults. In infants, HSRV had a safety profile similar to comparator vis-à-vis solicited AEs. In infants, fecal shedding of vaccine-virus strains was not detected in HSRV recipients but was observed in two comparator recipients. Percentage of infants exhibiting threefold rise in serum anti-rotavirus IgA titers from baseline to 1-month post-dose 3 in HSRV group was 88% (22/25) and 84% (21/25) in comparator group. Conclusion: HSRV was found to be generally well-tolerated in both adults and infants and immunogenic in infants
HEV study protocol : design of a cluster- randomised, blinded trial to assess the safety, immunogenicity and effectiveness of the hepatitis E vaccine HEV 239 (Hecolin) in women of childbearing age in rural Bangladesh
- Author
- Aziz Asma
- Bhuiyan Taufiqur R.
- Clemens John D.
- Dembinski Jennifer Lynn
- Dudman Susanne Gjeruldsen
- Gurley Emily S.
- Halle Cathinka Lønning
- Haque Warda
- Julin Cathinka Halle
- Khan Jahangir
- Khanam Mahbuba
- Nahar Quamrun
- Overbo Joakim
- Qadri Firdausi
- Rahman Anisur
- Rahman Mustafizur
- Sandbu Synne
- Stene- Johansen Kathrine
- Streatfield Peter Kim
- Yunus Md
- Zaman K
- Publication venue
- 'BMJ'
- Publication date
- 01/01/2020
- Field of study
Introduction Hepatitis E virus (HEV) is a leading cause of acute viral hepatitis in the developing world and is a public health problem, in particular among pregnant women, where it may lead to severe or fatal complications. A recombinant HEV vaccine, 239 (Hecolin; Xiamen Innovax Biotech, Xiamen, China), is licensed in China, but WHO calls for further studies to evaluate the safety and immunogenicity of this vaccine in vulnerable populations, and to evaluate protection in pregnancy. We are therefore conducting a phase IV trial to assess the effectiveness, safety and immunogenicity of the HEV 239 vaccine when given in women of childbearing age in rural Bangladesh, where HEV infection is endemic.
Methods and analysis Enrolment of a target of approximately 20 000 non-pregnant women, aged 16–39 years, started on 2 October 2017 in Matlab, Bangladesh. Sixty-seven villages were randomised by village at a 1:1 ratio to receive either the HEV vaccine or the control vaccine (hepatitis B vaccine). A 3-dose vaccination series at 0, 1 and 6 months is ongoing, and women are followed up for 24 months. The primary outcome is confirmed HEV disease among pregnant women. After vaccination, participants are requested to report information about clinical hepatitis symptoms. Participants who become pregnant are visited at their homes every 2 weeks to collect information about pregnancy outcome and to screen for clinical hepatitis. All suspected hepatitis cases undergo laboratory testing for diagnostic evaluation. The incidence of confirmed HEV disease among pregnant and non-pregnant women will be compared between the HEV vaccinated and control groups, safety and immunogenicity of the vaccine will also be evaluated.
Ethics and dissemination The protocol was reviewed and approved by the International Centre for Diarrhoeal Disease Research, Bangladesh Research Review Committee and Ethical Review Committee, and the Directorate General of Drug Administration in Bangladesh, and by the Regional Ethics Committee in Norway. This article is based on the protocol version 2.2 dated 29 June 2017. We will present the results through peer-reviewed publications and at international conferences.
Trial registration number The trial is registered at clinicaltrials.gov with the registry name “Effectiveness Trial to Evaluate Protection of Pregnant Women by Hepatitis E Vaccine in Bangladesh” and the identifier NCT02759991
HEV study protocol : design of a cluster- randomised, blinded trial to assess the safety, immunogenicity and effectiveness of the hepatitis E vaccine HEV 239 (Hecolin) in women of childbearing age in rural Bangladesh
- Author
- Aziz Asma
- Bhuiyan Taufiqur R.
- Clemens John D.
- Dembinski Jennifer Lynn
- Dudman Susanne Gjeruldsen
- Gurley Emily S.
- Halle Cathinka Lønning
- Haque Warda
- Julin Cathinka Halle
- Khan Jahangir
- Khanam Mahbuba
- Nahar Quamrun
- Overbo Joakim
- Qadri Firdausi
- Rahman Anisur
- Rahman Mustafizur
- Sandbu Synne
- Stene- Johansen Kathrine
- Streatfield Peter Kim
- Yunus Md
- Zaman K
- Publication venue
- Publication date
- 01/01/2020
- Field of study
Global economic burden of unmet surgical need for appendicitis
- Author
- A A Essam
- Abd El-Rahman Hegazy Khedr
- Abd Elkhalek Sallam
- Abd Elrahman Elshafay
- Abdalla Gamal Saad
- Abdalla Gharib
- Abdalla Kenibar
- Abdallah Salah Elsherbiny
- Abdalrahman Adel
- Abdelaziz Abdelaal
- Abdelaziz Osman Abdelaziz Elhendawy
- Abdelfatah Hussein
- Abdelkader Belkouchi
- Abdelmalek Hrora
- Abdelrahman Adelshone
- Abdelrahman Alkammash
- Abdelrahman Assal
- Abdelrahman Geuoshy
- Abdelrahman Haroun
- Abdelrahman Mohammed
- Abdelrahman Sayed
- Abdelrahman Soliman
- Abdelrhman Essam Elnemr
- Abdelrhman Kz Darwish
- Abdelrhman Osama Elsebaaye
- Abdul Khalique
- Abdul Rehman Alvi
- Abdul Wahid Anwar
- Abdulaziz Altwijri
- Abdullah Al-Mallah
- Abdullah Almoflihi
- Abdullah Altamimi
- Abdullah Daqeeq
- Abdullah Dwydar
- Abdullah Gouda
- Abdullah Hashim
- Abdulmalik Altaf
- Abdulmalik Huwait
- Abdulrahman Abdel-Aty
- Abdulrahman M Altwigry
- Abdulrahman Sheshe
- Abdulrasheed A Nasir
- AbdulRazzaq Oluwagbemiga Lawal
- Abdulshafi Khaled Abdrabou
- Abdurrahaman Sheshe
- Abdussemiu Abdurrazzaaq
- Abebe Bekele Zerihun
- Abeer Al-Shammari
- Abeer El Gendy
- Abeer Esam
- Abeer Marey
- Abhishek Mittal
- Abiboye Yifieyeh
- Abid Bin Mahamood
- Abidemi Adesuyi
- Abouelatta Khairy Aly
- Abrar Nawawi
- Adam Gyedu
- Ade Waterman
- Adedapo Osinowo
- Adedeji Fatuga
- Adel Albiety
- Adel B Hassanein
- Adel Denewar
- Adeleke Adekoya
- Ademola Adebanjo
- Ademola Adeyeye
- Ademola Popoola
- Adesina Adedeji
- Adesoji O Ademuyiwa
- Adesoji Tade
- Adewale Adeniyi
- Adewale O Adisa
- Adham Tarek
- Adomas Ladukas
- Adrian F Palma
- Afifatun Hasanah
- Afizah Salleh
- Afnan Abdelfatah
- Afnan Altamimi
- Afnan Altamini
- Agazi Fitsum
- Agboola Taiwo
- Ahamed Hassan
- Ahed Ghaben
- Ahmad Abdel Fattah
- Ahmad Abdel Razaq Al Rafati
- Ahmad Aboelkassem Ibrahem
- Ahmad Aldalaq
- Ahmad Ali
- Ahmad Almallah
- Ahmad Alrifaie
- Ahmad Ashour
- Ahmad Bakr
- Ahmad Bani-Sadar
- Ahmad Bin Adnan
- Ahmad Elbatahgy
- Ahmad Faraz
- Ahmad Gudal
- Ahmad Hasan
- Ahmad Khaled Sabe
- Ahmad Khoja
- Ahmad Nashaat
- Ahmad Qaissieh
- Ahmad Sabe
- Ahmad Saber Sleem
- Ahmad Sakr
- Ahmad Shalabi
- Ahmad Uzair Qureshi
- Ahmed Aamer
- Ahmed Abd El Galeel
- Ahmed Abd Elmoen Elhusseiny
- Ahmed Abd Elsameea
- Ahmed Abdelkareem
- Ahmed Abdelmotaleb Ghazy
- Ahmed Abo El Magd
- Ahmed Abo Elazayem
- Ahmed Adamu
- Ahmed Adel
- Ahmed Afandy
- Ahmed Ahmed
- Ahmed Al-Khatib
- Ahmed Alghamdi
- Ahmed Ali
- Ahmed Altibi
- Ahmed Alzahrani
- Ahmed Ata
- Ahmed Badr
- Ahmed Dahy
- Ahmed Diab
- Ahmed El Kashash
- Ahmed El Kholy
- Ahmed El-Sehily
- Ahmed Elgaili Khalid Musa
- Ahmed Elgebaly
- Ahmed Elkelany
- Ahmed Elkholy
- Ahmed Essam
- Ahmed Fahiem
- Ahmed Farag
- Ahmed Fawzy
- Ahmed Fouad
- Ahmed Gad
- Ahmed Ghanem
- Ahmed Gheith
- Ahmed Gomaa
- Ahmed Hafez El-Badri Kotb
- Ahmed Hammad
- Ahmed Hassan
- Ahmed Hossam Eldin Fouad Rida
- Ahmed Ismail
- Ahmed Karim
- Ahmed Khyrallh
- Ahmed Lasheen
- Ahmed M Rashed
- Ahmed Magdy
- Ahmed Mahmoud Abdelraouf
- Ahmed Menshawy
- Ahmed Meshref
- Ahmed Mohamed Afifi
- Ahmed Mohamed Ibrahim
- Ahmed Mohameden
- Ahmed Mohammed
- Ahmed Mokhtar
- Ahmed Mosad
- Ahmed Moustafa
- Ahmed Moustafa Saeed
- Ahmed Negida
- Ahmed Rabeih Mohammed
- Ahmed Rabie Mohamed
- Ahmed Ragab Nayel
- Ahmed Ragab Soliman
- Ahmed Raslan
- Ahmed Raza
- Ahmed Refaat
- Ahmed Rslan
- Ahmed Sabry
- Ahmed Sabry El-Hamouly
- Ahmed Safwan Marey
- Ahmed Saidbadr
- Ahmed Sakr
- Ahmed Samir
- Ahmed Shahine
- Ahmed Sheta
- Ahmed Soliman
- Ahmed Tammam
- Ahmed Tarek Abdelbaset Hassan
- Ahmed W Shamsedine
- Ahmed Zaki
- Ahmed Zaki Eldeeb
- Ahmed Zohair
- Ahmedali M Kandil
- Ahmedglal Elnagar
- Ahsan Zil-E-Ali
- Aijaz Jabbar
- Ailsa Claire Snaith
- Ainhoa Costas-Chavarri
- Aiste Austraite
- Ajayesh Mistry
- Akin Olaolorun
- Akinlabi E Ajao
- Al Faifi Jubran
- Ala Shamasneh
- Alaa Abouelnasr
- Alaa Al-Buhaisi
- Alaa Bowabsak
- Alaa El Jamassi
- Alaa Elazab
- Alaa Elhadad
- Alaa Fergany
- Alaa Habeebullah
- Alaa Hassan
- Alaa Shabkah
- Alaa Shaheen
- Alaba Adesina
- Alan Baird
- Alan Grant
- Alasdair Ball
- Alban Cacurri
- Albert Mohale Mphatsoe
- Alberto Realis Luc
- Alejandro Matheu
- Alejandro Munera
- Alemayehu Ginbo Bedada
- Alessandro Favero
- Alessio Maniscalco
- Alexander Canta Calua
- Alexander J Fowler
- Alexandra Gerosa
- Alexandre Horobjowsky
- Alexandre Venancio De Sousa
- Alexia Farrugia
- Alexis Pierre Arnaud
- Alfio Alessandro Russo
- Alfredo Gulielmi
- Ali Ababneh
- Ali Abo El Dahab
- Ali Amin Ahmed Ata
- Ali Khan Niazi
- Ali Kiasat
- Ali Mohamed Hammad
- Ali Zardab
- Ali Zeynel Abidin Balkan
- Aliaa Gamal Toeema
- Aliaa Sadek
- Aliaksandr Filatau
- Aliang Latif
- Alibeth Andres Baquero Suarez
- Alice Faure
- Alice Niragire
- Alina Robledo-Rabanal
- Aline Broch
- Alireza Hasheminia
- Alisdair Macdonald
- Aliyu Ndajiwo
- Allan Novak
- Alphonse Zeta Mutabazi
- Alvaro Enrique Mendoza Beleño
- Alvin Ee Zhiun Cheah
- Aly Abd Elrazek
- Aly Nasr
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- Simon Ng
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- Simona Juciute
- Simona Kasputyte
- Simone Conci
- Simone Sandler
- Simone Targa
- Sir Young Yam
- Siti Mohd Desa Asilah
- Siti Nur Alia Kamarulzamil
- Sivasuriya Sivaganesh
- Siyaka Itopa Suleiman
- Siyi Chung
- Soaad Elsobky
- Sofia Mouttalib
- Soha Abushamleh
- Sohaila Elmihy
- Soliman Magdy Ahmed
- Sondos Turkustani
- Sophian Hmila
- South Africa
- Srinivas Pai
- Sriram Bhat
- Stassen Paul
- Stavros Parasyris
- Stefan Botes
- Stefan Breitenstein
- Stefan Zammit
- Stefano Berti
- Stefano Cucumazzo
- Stefano M M Basso
- Stefano Roncali
- Stella Binna Kim
- Sten Saar
- Stephanie Hiu-Wai Kwok
- Stephanie Van Straten
- Stephen Dias
- Stephen J Chapman
- Stephen Kache
- Stephen Mcaleer
- Stephen R Knight
- Stephen Tabiri
- Steponas Petrikenas
- Stuart J Fergusson
- Styliani Parpoudi
- Stylianos Germanos
- Sudipta Roy
- Sukrit Suresh
- Sule Burger
- Suleiman Baba
- Sultan Almuallem
- Sung-Hee Kim
- Sunil Kumar
- Suparna Das
- Suraya Bahar
- Susan Aviles
- Susan Limache
- Susan Wndy Mathew
- Susana Yrma Aranzabal Durand
- Svetlana Doris Brincat
- Swantje Kruspi
- Swapnil Roy
- Syed Abdul Wahhab Eusoffee Wan Ali
- Syed Altaf Naqvi
- Syed Asaat Ul Razi
- Sylvia Batista Lemaire
- Sylvie Mochet
- Syrine Rekhis
- T Ariani Widiastini
- Tagang Ebogo Ngwa
- Taha Yusufali
- Taher Al-Taher
- Tahir Muhammad Yaseen
- Tahir Yaseen
- Tahira Naqvi
- Taiwo Akeem Lawal
- Taiwo Lawal
- Tan Arulampalam
- Tanzeela Gala
- Tapan Kumar
- Tara Grima
- Tarek Ezzat
- Tarek Razek
- Tasneem Idress
- Tasnia Hamid Kanta
- Tatsiana Shachykava
- Taufiq Khan
- Tebian Hassanein Ahmed Ali
- Tessa Fautz
- Tewodros Worku
- Thamer Nouh
- Thays Brunelli Pugliesi
- Thea Dimech
- Thelma Tembo
- Thelma Xerri
- Theodore Pezas
- Theodosios Theodosopoulos
- Thiago Fernandes Giuriato
- Thierry Alihonou
- Thomas Feidantsis
- Thomas Fozard
- Thomas G Weiser
- Thomas M Drake
- Thomas Olagboyega Olajide
- Thomas Pinkney
- Thomas Prudhomme
- Thomas Sherman
- Thomas Tetens Moe
- Thuraya Alzayat
- Thusitha Sampath Hettiarachchi
- Tien Seng Bryan Lee
- Timothy White
- Tina Gaarder
- Tobias Schuetz
- Todisoa Emmanuella Christina Tolotra
- Tolg Cecilia
- Tom Am Malik
- Tom Arthur
- Tom Falconer Hall
- Tomas Abaliksta
- Tomas Jankus
- Tomas Poškus
- Tommaso Bocchetti
- Tommaso Campagnaro
- Tommaso Fontana
- Tony Mak
- Toqa Khafagy
- Torhild Veen
- Trude Beate Wold
- Tsz-Yan Katie Chan
- Tuan Nur'Azmah Tuan Mat
- Tunde Sholadoye
- Twc Mak
- Tyler Rouse
- Tzu-Ling Chen
- Uday Muddebihal
- Ufuk Karabacak
- Ulf Gunnarsson
- Ulf Gustafsson
- Umar Muktar
- Umberto Tedeschi
- Umme Salma
- Usama Hantour
- Uthman Alamoudi
- Valdemaras Jotautas
- Valentine Parent
- Vanessa Dina Palomino Castillo
- Vanessa Msosa
- Vania Guglielmo
- Vania Silvestri
- Vasileios Despotidis
- Vasileios Kalles
- Vasiliki Soulou
- Vassilis Kalles
- Veereanna Shatkar
- Venerand Barendegere
- Veronica Grassi
- Veronica Lazzari
- Vicky Jennings
- Victor Dassah
- Victor Etwire
- Victor Kong
- Victor Manuel Quintero Riaza
- Victor Nwinee
- Victoria K Proctor
- Vijaid Upadhyaya
- Vijay Gadhvi
- Viktorija Ambrozeviciute
- Viktorija Nevieraite
- Ville Sallinen
- Vimalakanthan Thanusan
- Vincas Jonas Banaitis
- Virgilijus Beisa
- Viviana Sollazzo
- Vivien Graffieille
- Vizir Jean Paul Nsengimana
- Vladimir Khokha
- Vollmer Sebastian
- Vu Thanh Hien Le
- Vytautas Gaižauskas
- Vytautas Lipnickas
- Wahid Anwer
- Wai Cheong Soon
- Wai Him Lam
- Wairimu Ndegwa
- Waleed Thabet
- Walid Adham
- Walter Forno
- Walter Ruiz Panez
- Wan Nurul 'Ain Wan Mohd Nasir
- Wanigasekara Senanayake Mudiyanselage Kithsiri Janakantha Senanayake
- Ward Hamsho
- Wasim Dar
- Wedyan Alhazmi
- Wei Guo
- Weiguang Ho
- Weihei Dao
- Wendy Leslie Messa Aguilar
- Wennweoi Goh
- Wifanto Saditya Jeo
- Wilfredo Pino
- William Appeadu-Mensah
- William Beasley
- William Bonney
- William Hutch
- William J Lossius
- William Milligan
- Willy Alcca Ticona
- Wing Sum Li
- Witold Chachulski
- Xavier Delforge
- Xianelle Rodriguez
- Xinwei Low
- Xue Wei Chan
- Ya Theng Neo
- Yacoubou Imorou Souaibou
- Yahaya Ukwenya
- Yahya Salama
- Yaseen Rajjoub
- Yasmein Ibrahim
- Yasmin Abd-Elrasoul
- Yasmin Elfouly
- Yasmin Hegazy
- Yasmin Soliman
- Yasser Abd El Salam
- Yee Wen Tan
- Yehia Zakaria
- Yella Reddy
- Yi Koon Tan
- Yi Ting Mok
- Yih Jeng Cheong
- Yiing Yee Gan
- Yishan Der
- Yogendra Praveen Mogan
- Yomna Allam
- Yomna Hosny Asar
- Yong Yong Tew
- Yousef Abuowda
- Yousra El Shoura
- Ysabel Esthefany Alejos Bermúdez
- Yuk Hong Eric Cheung
- Yuksel Altinel
- Yung Kok Ng
- Yuri Macchitella
- Yves Aigrain
- Yücel Cengiz
- Zaher Mikwar
- Zahra Jaffry
- Zain Ali Khan
- Zainab Iftikhar
- Zaynab M Elsayed
- Zhongtao Zhang
- Zi Hao Sam
- Zigmantas Urniežius
- Zilvinas Dambrauskas
- Zineb Bentounsi
- Zygimantas Tverskis
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2022
- Field of study
Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US 92492millionusingapproach1and73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was 95004millionusingapproach1and75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially