Dataset Information

Added socioeconomic burden of non-communicable disease on HIV/AIDS affected households in the Asia Pacific region: A systematic review.

ABSTRACT:

Background

HIV/AIDS causes significant socioeconomic burden to affected households and individuals, which is exacerbated by non-communicable diseases (NCDs). The Asia Pacific Region (APR) comprises about 60% of the global population and has been significantly affected by HIV/AIDS with 5.8 million after Sub-Saharan Africa in 2019. We investigated socioeconomic impacts of HIV/AIDS alone and the added burden of NCDs on HIV-affected households (HIV-HHs) and individuals in the APR.

Method

We searched multiple databases for studies published in English over 30 years on socioeconomic impact of HIV/AIDS alone and HIV/AIDS with NCDs on affected households or individuals in APR. Findings were synthesised across six domains: employment, health-related expenditure, non-health expenditure, strategies for coping with household liabilities, food security, and social protection.

Findings

HIV-HHs had a significantly higher socioeconomic burden compared to Non-HIV households. Total household expenditure was lower in HIV-HHs but with higher expenditure on health services. HIV-HHs experienced more absenteeism, lower wages, higher unemployment, and higher food insecurity. There is a paucity of evidence on the added burden of NCDs on HIV-HHs with only a single study from Myanmar.

Interpretation

Understanding the socioeconomic impact of HIV/AIDS with and without NCD is important. The evidence indicates that HIV-HHs in APR suffer from a significantly higher socioeconomic burden than Non-HIV-HHs. However, evidence on the additional burden of NCDs remains scarce and more studies are needed to understand the joint socioeconomic impact of HIV/AIDS and NCDs on affected households.

Funding

Deakin University School of Health and Social Development grant and Career Continuity grant.

SUBMITTER: Wanni Arachchige Dona S

PROVIDER: S-EPMC8315338 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundNon-communicable diseases (NCDs) are the leading global cause of death and disproportionately concentrate among those living in low-income and middle-income countries. However, its economic impact on households remains less well known in the Indian context. This study aims to assess the economic impact of NCDs in terms of out-of-pocket expenditure (OOPE) and its catastrophic impact on NCDs affected households in India.Materials and methodsData were collected from the 75th round of the National Sample Survey Office, Government of India, conducted in the year 2017-18. This is the latest round of data available on health, which constitutes a sample of 113,823 households. The collection of data is based on a stratified multi-stage sampling method. Generalised Linear Regression model was employed to identify the socio-economic covariates associated with the catastrophic health expenditure (CHE) on hospitalisation.ResultsThe result shows a higher burden of OOPE on NCDs affected households. The mean expenditure by NCDs households in public hospitals is INR 13,170 which is more than twice as compared to the non-NCDs households INR 6,245. Particularly, the proportion of total medical expenditure incurred on medicines (0.39) and diagnostics (0.15) is troublesome for households with NCDs, treated in public hospitals. Moreover, results from the generalised linear regression model confirm the significant relationship between CHE with residence, caste, religion, household size, and economic status of households. The intensity of CHE is more for the households who are poor, drinking unsafe water, using firewood as cooking fuel, and household size of 1-5 members.ConclusionTherefore, an urgent need for a prevention strategy should be made by the government to protect households from the economic burden of NCDs. Specifically, to reduce the burden of CHE associated with NCDs, a customised disease-specific health insurance package should be introduced by the government of India in both public and private facilities.

Project description:BackgroundExamining the distribution of the burden of different communicable and non-communicable diseases and injuries worldwide can present proper evidence to global policymakers to deal with health inequality. The present study aimed to determine socioeconomic inequality in the burden of 25 groups of diseases between countries around the world in 2019.MethodsIn the current study data according to 204 countries in the world was gathered from the Human Development Report and the Global Burden of Diseases study. Variables referring to incidence, prevalence, years of life lost (YLL), years lived with disability (YLD) and disability adjusted life years (DALY) resulting by 25 groups of diseases and injuries also human development index was applied for the analysis. For measurement of socioeconomic inequality, concentration index (CI) and curve was applied. CI is considered as one of the popular measures for inequality measurement. It ranges from - 1 to + 1. A positive value implies that a variable is concentrated among the higher socioeconomic status population and vice versa.ResultsThe findings showed that CI of the incidence, prevalence, YLL, YLD and DALY for all causes were - 0.0255, - 0.0035, - 0.1773, 0.0718 and - 0.0973, respectively. CI for total Communicable, Maternal, Neonatal, and Nutritional Diseases (CMNNDs) incidence, prevalence, YLL, YLD and DALY were estimated as - 0.0495, - 0.1355, - 0.5585, - 0.2801 and - 0.5203, respectively. Moreover, estimates indicated that CIs of incidence, prevalence, YLL, YLD and DALY for Non-Communicable Diseases (NCDs) were 0.1488, 0.1218, 0.1552, 0.1847 and 0.1669, respectively. Regarding injuries, the CIs of incidence, prevalence, YLL, YLD and DALY were determined as 0.0212, 0.1364, - 0.1605, 0.1146 and 0.3316, respectively. In the CMNNDs group, highest and lowest CI of DALY were related to the respiratory infections and tuberculosis (- 0.4291) and neglected tropical diseases and malaria (- 0.6872). Regarding NCDs, the highest and lowest CI for DALY is determined for neoplasms (0.3192) and other NCDs (- 0.0784). Moreover, the maximum and minimum of CI of DALY for injuries group were related to the transport injuries (0.0421) and unintentional injuries (- 0.0297).ConclusionsThe distribution of all-causes and CMNNDs burden were more concentrated in low-HDI countries and there are pro-poor inequality. However, there is a pro-rich inequality for NCDs' burden i.e. it was concentrated in high-HDI countries. On the other hand, the concentration of DALY, YLD, prevalence, and incidence in injuries was observed in the countries with higher HDI, while YLL was concentrated in low-HDI countries.

Project description:Importance:Since the terrorist attacks on September 11, 2001, the US government has promoted household disaster preparedness, but preparedness remains low. Objective:To identify disparities in disaster preparedness among US households. Design, Setting, and Participants:This cross-sectional study used data from a nationally representative sample of US households from the 2017 American Housing Survey's topical section on preparedness to assess associations of disaster preparedness with households' socioeconomic characteristics, composition, and region. Logistic regressions were used to assess associations of household characteristics with overall preparedness, resource- and action-based preparedness, and specific preparedness items. Data analyses were completed on March 27, 2020. Exposures:Combined household income, head of household's education level, race/ethnicity, marital status of head of household, head of household aged 65 years or older, presence of children or a household member with a disability, and region. Main Outcomes and Measures:Nine actionable preparedness items, such as having an emergency carry-on kit (resource), food and water stockpiles (resource), and alternative communication plans and meeting locations (action). Items were summed for the measures of overall, resource-based, and action-based preparedness, with preparedness defined as meeting at least half of the criteria. Results:Among 16?725 included households, 9103 household heads were men (54.4%), 11?687 were married (69.9%), and 10?749 (66.1%) had some college education or higher. In all, 1969 household heads (11.8%) were black, while 2696 were Hispanic/Latino (16.1%); 3579 household heads (21.4%) were 65 years or older. A total of 7163 households (42.8%) included children, and 3533 households (21.2%) included a person with a disability. Households were more likely to fulfill at least half of the criteria for resource-based preparedness (10?950 households [65.5%]) than for action-based preparedness (6876 households [41.1%]). Wealthy households and those with household heads aged 65 years or older were more likely to fulfill at least half of resource-based items (wealthy households: adjusted odds ratio [aOR] by logged income, 1.18 [95% CI, 1.13-1.22]; household heads age ?65 years: aOR, 1.42 [95% CI, 1.29-1.55) but less likely to fulfill action-based items (wealthy households: aOR: 0.96 [95% CI, 0.93-0.99]; household heads age ?65 years: aOR, 0.92 [95% CI, 0.84-0.99]). Households with black household heads were more likely to fulfill items directly related to emergencies (carry-on emergency kit: aOR, 1.26 [95% CI, 1.14-1.39]; alternative communication plan: aOR, 1.55 [95% CI, 1.39-1.72]; alternative meeting location: aOR, 1.18 [95% CI, 1.07-1.31]) but less likely to fulfill resource-based items (at least half of resource items: aOR, 0.89 [95% CI, 0.80-0.99]). Conclusions and Relevance:These findings suggest that types of preparedness vary by household characteristics. Targeted strategies are needed to promote preparedness across communities.

Project description:This article reviews available evidence regarding hypertension management in the Asia-Pacific region, focussing on five research questions that deal with specific aspects: blood pressure (BP) control, guideline recommendations, role of renin-angiotensin-aldosterone system (RAAS) inhibitors in clinical practice, pharmacological management and real-world adherence to guideline recommendations. A PubMed search identified 2537 articles, of which 94 were considered relevant. Compared with Europeans, Asians have higher systolic/diastolic/mean arterial BP, with a stronger association between BP and stroke. Calcium channel blockers are the most-commonly prescribed monotherapy in Asia, with significant variability between countries in the rates of angiotensin-converting enzyme inhibitors (ACEis)/angiotensin-receptor blockers (ARBs) and single-pill combination (SPC) use. In clinical practice, ARBs are used more commonly than ACEis, despite the absence of recommendation from guidelines and clinical evidence supporting the use of one class of drug over the other. Ideally, antihypertensive treatment should be tailored to the individual patient, but currently there are limited data on the characteristics of hypertension in Asia-Pacific individuals. Large outcome studies assessing RAAS inhibitor efficacy and safety in multi-national Asian populations are lacking. Among treated patients, BP control rates were ~ 35 to 40%; BP control in Asia-Pacific is suboptimal, and disproportionately so compared with Western nations. Strategies to improve the management of hypertension include wider access/availability of affordable treatments, particularly SPCs (which improve adherence), effective public health screening programs targeting patients to drive health-seeking behaviours, an increase in physician/patient awareness and early implementation of lifestyle changes. A unified Asia-Pacific guideline on hypertension management with pragmatic recommendations, particularly in resource-limited settings, is essential.