Rev Epidemiol Sante
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Rev Epidemiol Sante · Nov 2005
Comparative Study[Comparison of insurance coverage of tobacco cessation pharmacotherapies in five countries from the Organisation for Economic Co-operation and Development].
Reports in the literature demonstrate effectiveness and cost-effectiveness of tobacco treatments including drug and behavioral therapies. The health insurance coverage of smoking cessation treatments could lower financial barriers which limit the access to these services. The purpose of this paper was to compare health insurance coverage for pharmacotherapies for smoking cessation in five countries from the Organisation for Economic Co-operation and Development. ⋯ The financial coverage of smoking cessation pharmacotherapies is often the result of a political decision. Taking into consideration the situation of developed countries, France should first consider the financial coverage of smoking cessation pharmacotherapies for socially precarious persons and populations with tobacco-related diseases. In addition, a population-based study should be conducted in France to measure the efficacy of financial coverage on smoking cessation.
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Rev Epidemiol Sante · Nov 2005
Trends and geographic inequalities in the prevalence of Down syndrome in Europe, 1980-1999.
EUROCAT is a network of population-based registries for the epidemiologic surveillance of congenital anomalies covering approximately one quarter of births in the European Union. Down syndrome constitutes approximately 8% of cases of registered congenital anomaly in Europe, with over 7000 affected pregnancies in the 15 current member states of the European Union each year. In this paper, we aim to examine trends in the live birth prevalence of Down syndrome in Europe in the light of trends in maternal age and in prenatal diagnosis. ⋯ The rise in average maternal age in Europe has brought with it an increase in the number of pregnancies affected by Down syndrome. The widespread practice of prenatal screening and termination of pregnancy has in most of the regions covered by EUROCAT counteracted the effect of maternal age in its effect on live birth prevalence. Under the joint influences of maternal age and prenatal screening the pattern of geographic inequalities in Down syndrome live birth prevalence in Europe has also been changed.
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Rev Epidemiol Sante · Nov 2005
[Estimation of the epidemiological impact of various BCG vaccination scenarios in France].
Within the current process of revising the vaccination policy against tuberculosis in France, we have estimated the epidemiological impact of three future possible options for BCG primo-vaccination: continuation of routine vaccination of all children, targeting on high risk children or discontinuation. ⋯ BCG vaccination of high risk children seems to be an efficient strategy. However, its current effectiveness would depend on the capacity to maintain a high vaccination coverage in this population in the context of the abrogation of mandatory vaccination and the impending disappearance of BCG administered by multipuncture, which is the technique used in France for the vast majority of primo-vaccinations. Beyond the economical and epidemiological parameters, the decision will have to consider the operational, social and ethical issues raised by a vaccination strategy targeting children mainly of foreign origin.