Articles: health.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cost-effectiveness of improved treatment services for sexually transmitted diseases in preventing HIV-1 infection in Mwanza Region, Tanzania.
A community-randomised trial was undertaken to assess the impact, cost, and cost-effectiveness of averting HIV-1 infection through improved management of sexually transmitted diseases (STDs) by primary-health-care workers in Mwanza Region, Tanzania. ⋯ Improved management of STDs in rural health units reduced the incidence of HIV-1 infection in the general population by about 40%. The estimated cost-effectiveness of this intervention ($10 per DALY) compares favourably with that of, for example, childhood immunisation programmes ($12-17 per DALY). Cost-effectiveness should be further improved when the intervention is applied on a larger scale. Resources should be made available for this highly cost-effective HIV control strategy.
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This paper describes what the Wellcome Trust has done and aims to do through its population initiative. The Trust is required to spend its funds to improve the physical welfare of mankind, and in this context there can be no more important issue than the rapid changes that are occurring in the human population. ⋯ Through this programme, the Trust hopes to bring about improved understanding of the relationship between reproductive health, population growth, and sustainable development and create cadres of high quality research scientists in relevant disciplines. Uniquely, funding is available under this programme to suitably qualified applicants from any country other than the USA.
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This study considers how to compare programs which are designed to save lives. "To estimate the discount rate for lives saved in the future a number of studies have been carried out on the trade-off between saving lives now and in the future. A telephone survey is administered to about 1,700 individuals [in Sweden] to test if the framing of the question affects the estimated trade-off. In one sample the question is framed as saving 100 lives today versus saving x future lives and in one sample the question is framed as saving 100 future lives versus saving y lives today. The result shows that the framing has a major impact on the trade-off."
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The effects of maternal age on low birth weight, newborns' hospital costs and infant mortality were estimated based on individual 1989 and 1990 vital statistics records from New Jersey that were linked with uniform billing hospital discharge records. Results of multivariate analyses show a U-shaped relationship between maternal age and low birth weight among whites, with the youngest (younger than 15) and oldest (aged 40 and older) mothers being at higher risk than 25-29-year-olds; older teenagers were not at any significantly increased risk. ⋯ The multivariate analysis also showed that newborn hospitalization costs increased with maternal age among both blacks and whites. The seemingly poorer birth outcomes of teenage mothers appear to result largely from their adverse socioeconomic circumstances, not from young maternal age per se.