Category Archives: BMC Public Health

Effectiveness of a problem-solving based intervention to prolong the working life of ageing workers.

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Effectiveness of a problem-solving based intervention to prolong the working life of ageing workers.

BMC Public Health. 2015;15:76

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When children play, they feel better: organized activity participation and health in adolescents.

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When children play, they feel better: organized activity participation and health in adolescents.

BMC Public Health. 2015;15(1):1090

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The association of health literacy with adherence in older adults, and its role in interventions: a systematic meta-review.

The association of health literacy with adherence in older adults, and its role in interventions: a systematic meta-review.

BMC Public Health. 2015;15(1):903

Authors: Geboers B, Brainard JS, Loke YK, Jansen CJ, Salter C, Reijneveld SA, deWinter AF

Abstract
BACKGROUND: Low health literacy is a common problem among older adults. It is often suggested to be associated with poor adherence. This suggested association implies a need for effective adherence interventions in low health literate people. However, previous reviews show mixed results on the association between low health literacy and poor adherence. A systematic meta-review of systematic reviews was conducted to study the association between health literacy and adherence in adults above the age of 50. Evidence for the effectiveness of adherence interventions among adults in this age group with low health literacy was also explored.
METHODS: Eight electronic databases (MEDLINE, ERIC, EMBASE, PsycINFO, CINAHL, DARE, the Cochrane Library, and Web of Knowledge) were searched using a variety of keywords regarding health literacy and adherence. Additionally, references of identified articles were checked. Systematic reviews were included if they assessed the association between health literacy and adherence or evaluated the effectiveness of interventions to improve adherence in older adults with low health literacy. The AMSTAR tool was used to assess the quality of the included reviews. The selection procedure, data-extraction, and quality assessment were performed by two independent reviewers. Seventeen reviews were selected for inclusion.
RESULTS: Reviews varied widely in quality. Both reviews of high and low quality found only weak or mixed associations between health literacy and adherence among older adults. Reviews report on seven studies that assess the effectiveness of adherence interventions among low health literate older adults. The results suggest that some adherence interventions are effective for this group. The interventions described in the reviews focused mainly on education and on lowering the health literacy demands of adherence instructions. No conclusions could be drawn about which type of intervention could be most beneficial for this population.
CONCLUSIONS: Evidence on the association between health literacy and adherence in older adults is relatively weak. Adherence interventions are potentially effective for the vulnerable population of older adults with low levels of health literacy, but the evidence on this topic is limited. Further research is needed on the association between health literacy and general health behavior, and on the effectiveness of interventions.

PMID: 26377316 [PubMed – in process]

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The NLstart2run study: health effects of a running promotion program in novice runners, design of a prospective cohort study.

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The NLstart2run study: health effects of a running promotion program in novice runners, design of a prospective cohort study.
BMC Public Health. 2013;13:685
Authors: Kluitenberg B, van Middelkoop M,… Continue reading

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Efficient national surveillance for health-care-associated infections.

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Efficient national surveillance for health-care-associated infections.

BMC Public Health. 2015;15:832

Authors: van Bunnik BA, Ciccolini M,…

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Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring: design of a prospective cohort study.

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Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring: design of a prospective cohort study.
BMC Public Health. 2014;14:… Continue reading

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Equity in human papilloma virus vaccination uptake?: sexual behaviour, knowledge and demographics in a cross-sectional study in (un)vaccinated girls in the Netherlands.

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Equity in human papilloma virus vaccination uptake?: sexual behaviour, knowledge and demographics in a cross-sectional study in (un)vaccinated girls in the Netherlands.

BMC Public Health. 2014;14:288

Authors: Mollers M, Lubbers K, Spoelstra SK, Weijmar-Schultz WC, Daemen T, Westra TA, van der Sande MA, Nijman HW, de Melker HE, Tami A

Abstract
BACKGROUND: In the Netherlands, human papillomavirus (HPV) vaccination is part of a national program equally accessible for all girls invited for vaccination. To assess possible inequalities in vaccine uptake, we investigated differences between vaccinated and unvaccinated girls with regard to various characteristics, including education and ethnicity, (both associated with non-attendance to the national cervical screening program), sexual behaviour and knowledge of HPV.
METHODS: In 2010, 19,939 nationwide randomly-selected 16-17 year-old girls (2009 vaccination campaign) were invited to fill out an online questionnaire. A knowledge scale score and multivariable analyses identified variables associated with vaccination status.
RESULTS: 2989 (15%) of the selected girls participated (65% vaccinated, 35% unvaccinated). The participants were comparable with regard to education, ethnicity, most sexual risk behaviour and had similar knowledge scores on HPV transmission and vaccination. However, unvaccinated girls lived in more urbanised areas and were more likely to have a religious background. Irrespective of vaccination status, 81% of the girls were aware of the causal relationship between HPV and cervical cancer, but the awareness of the necessity of cervical screening despite being vaccinated was limited.
CONCLUSIONS: HPV vaccine uptake was not associated with knowledge of HPV and with factors that are known to be associated with non-attendance to the cervical cancer screening program in the Netherlands. Furthermore, most sexual behaviour was not related to vaccination status meaning that teenage unvaccinated girls were not at a disproportionally higher risk of being exposed to HPV. Routine HPV vaccination may reduce the social inequity of prevention of cervical cancer.

PMID: 24679163 [PubMed – indexed for MEDLINE]

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Use of antibiotics in rural and urban regions in The Netherlands: an observational drug utilization study.

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Use of antibiotics in rural and urban regions in The Netherlands: an observational drug utilization study.

BMC Public Health. 2014;14:677

Authors: de Jong J, Bos JH, de Vries TW, de Jong-van den Berg LT

Abstract
BACKGROUND: Large livestock farms might increase the infection risk for the nearby human population because of an increased risk for disease outbreaks and because antibiotic-resistant bacteria are more likely to be present. We hypothesized that populations residing in rural areas have more contact with cattle compared with populations in urban areas, and will use more antibiotics or more frequently require a new course of antibiotics.
METHODS: Using data from the prescription database IADB.nl, we compared antibiotic use by patients living in rural areas to the use by patients living in urban areas. We also followed cohorts of antibiotic users and determined the patients who required a second antibiotic within 14 days after beginning the first antibiotic.
RESULTS: The yearly prevalence of antibiotic use was greater in rural areas compared with urban areas (2009: 23.6% versus 20.2% (p < 0.001), especially in the younger age groups. More adult patients residing in rural areas required a second course of antibiotic treatment within 14 days after starting the first treatment.
CONCLUSION: Individuals use more antibiotics, and adults more frequently require a second antibiotic prescription within 14 days, in rural areas compared with urban areas. Although the differences were small and the risks for the general rural population were not high, this difference should be investigated further.

PMID: 24992967 [PubMed – indexed for MEDLINE]

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Predictors of sickness absence in college and university educated self-employed: a historic register study.

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Predictors of sickness absence in college and university educated self-employed: a historic register study.

BMC Public Health. 2014;14:420

Authors: Wijnvoord LE, Van der Klink JJ, De Boer MR, Brouwer S

Abstract
BACKGROUND: Despite a large proportion of the workforce being self-employed, few studies have been conducted on risk factors for sickness absence in this population. The aim of this study is to identify risk factors for future sickness absence in a population of college and university educated self-employed.
METHODS: In a historic register study based on insurance company files risk factors were identified by means of logistic regression analysis. Data collected at application for private disability insurance from 634 applicants were related to subsequent sickness absence periods of 30 days or more during a follow-up period of 7.95 years. Variables studied were self-reported lifestyle variables, variables concerning medical history and present health conditions and variables derived from the general medical examination including blood tests and urinary analysis.
RESULTS: Results from analysis of data from 634 applicants for private disability insurance show that previous periods of sickness absence (OR 2.07), female gender (OR 2.04), health complaints listed in the health declaration (OR 1.88), elevated erythrocyte sedimentation rate (ESR) (OR 4.05) and the nature of the profession were related to a higher risk of sickness absence.
CONCLUSIONS: Sickness absence was found to be related to demographic variables (gender, profession), medical variables (health complaints and erythrocyte sedimentation rate) and to variables with both a medical and a behavioural component (previous sickness absence).

PMID: 24886527 [PubMed – indexed for MEDLINE]

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Cost-effectiveness of Multisystemic Therapy for adolescents with antisocial behaviour: study protocol of a randomized controlled trial.

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Cost-effectiveness of Multisystemic Therapy for adolescents with antisocial behaviour: study protocol of a randomized controlled trial.
BMC Public Health. 2013;13:369
Authors: Jansen DE, Vermeulen K… Continue reading

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Caste-based social inequalities and childhood anemia in India: results from the National Family Health Survey (NFHS) 2005-2006.

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Caste-based social inequalities and childhood anemia in India: results from the National Family Health Survey (NFHS) 2005-2006.

BMC Public Health. 2015;15(1):537

Authors: Vart P, Jaglan A, Shafique K

Abstract
BACKGROUND: Caste is one of the traditional measures of social segregation in India and differs from other indicators as it is both, endogamous and hereditary. Evidence suggests that belonging to lower castes exposes one to social inequalities and affects health adversely. We examined the association of caste with childhood anemia in India and explored the effect modifying role of adult education and household wealth.
METHODS: A cross-sectional analysis of National Family Health Survey (NFHS) data of 43,484 children aged 6-59 months was performed. Poisson regression analysis was conducted to study the association between caste and childhood anemia accounting for various maternal, child, and household related variables. Caste was categorized as “other caste” (least disadvantageous), “other backward caste”, “scheduled tribe” and “scheduled caste” (most disadvantageous). Anemia was defined as mild (hemoglobin level 7-11 g/dL), moderate (hemoglobin level 5-7 g/dL) and severe (hemoglobin level <5 g/dL).
RESULTS: We found that children in scheduled caste had higher risk of having anemia [mild anemia: RR = 1.10, 95 % CI = 1.05-1.15; moderate anemia: RR = 1.19, 95 % CI = 1.14-1.24; severe anemia: RR = 1.87, 95 % CI = 1.51 – 2.31] after accounting for child, maternal and household covariates including adult education and household wealth. The interaction of caste with adult education and household wealth was not statistically significant for any level of anemia. Sensitivity analyses for children born to mothers of age ≥ 18 years at first child birth and body mass index (BMI) ≥ 18.5 kg/m(2), resulted in similar findings.
CONCLUSION: Caste is an independent determinant of childhood anemia in India. The level of adult education and household wealth did not modify the association between caste and childhood anemia. The findings may be used for countering childhood anemia and it may be beneficial to target future public health actions towards disadvantageous castes in India.

PMID: 26044618 [PubMed – as supplied by publisher]

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Cost-effectiveness of a multifaceted implementation strategy for the Dutch multidisciplinary guideline for nonspecific low back pain: design of a stepped-wedge cluster randomised controlled trial.

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Cost-effectiveness of a multifaceted implementation strategy for the Dutch multidisciplinary guideline for nonspecific low back pain: design of a stepped-wedge cluster…

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Motives of Dutch persons aged 50 years and older to accept vaccination: a qualitative study.

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Motives of Dutch persons aged 50 years and older to accept vaccination: a qualitative study.

BMC Public Health. 2015 May 16;15(1):493

Authors: Eilers R, Krabbe PF, de Melker HE

Abstract
BACKGROUND: Elderly in several European countries are currently being vaccinated against influenza and pneumococcal disease, and various reasons have been put forward to expand these programs. To successfully immunize the older adult population, however, it is crucial for the target group to accept such interventions. This study aims to elucidate the motives of Dutch persons aged ≥50 years for accepting vaccination.
METHODS: Thirteen focus groups were composed with persons aged 50 years and older. A semi-structured topic list with open-ended questions was used to guide the focus groups. The transcripts were analyzed according the principles of thematic survey. By an inductive process, the main themes and related subthemes were extracted from the responses.
RESULTS: Eight themes were found to play an important role in accepting vaccination: healthy aging; usefulness of vaccination in older age; risk of getting an infectious disease; vaccine characteristics; severity of the disease and its implications; the experiences of previous vaccinations; the influence of healthcare workers and other people; and the need for information.
CONCLUSIONS: This qualitative study reveals that acceptance of vaccination is not based on a single argument. The most important one appears to be the risk of getting an infectious disease. In that light, vaccination campaigns may emphasize the susceptibility of older adults. It is also advisable to consider the usefulness of vaccination in older age as an overall argument. A tailored approach to offering vaccination may be considered. Further research would be needed to determine the relative importance of the factors identified in this study.

PMID: 25981624 [PubMed – as supplied by publisher]

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Moderate-to-vigorous physically active academic lessons and academic engagement in children with and without a social disadvantage: a within subject experimental design.

Moderate-to-vigorous physically active academic lessons and academic engagement in children with and without a social disadvantage: a within subject experimental design.

BMC Public Health. 2015;15(1):404

Authors: Mullender-Wijnsma MJ, Hartman E, de Greeff JW, Bosker RJ, Doolaard S, Visscher C

Abstract
BACKGROUND: Integration of physical active academic lessons in the school curriculum may be an innovative way to improve academic outcomes. This study examined the effect of physically active academic lessons (Fit en Vaardig op school) on academic engagement of socially disadvantaged children and children without this disadvantage. In addition, the relationship between lesson time spent in moderate to vigorous physical activity and academic engagement was examined.
METHODS: From four elementary schools, 86 children who participated in the 22-weeks intervention were recruited (23 socially disadvantaged children). Academic engagement was determined by observing time-on-task during three classroom observation moments (start, midway and end observation). Every moment consisted of lesson observations after intervention lessons (post-intervention) and after regular classroom lessons (post-control). Differences in time-on-task between socially disadvantaged children and children without this disadvantage were analyzed using independent samples t-test. Differences between post-intervention and post-control observations were analyzed using multilevel analysis. Heart rate monitors measured the lesson time spent in moderate to vigorous physical activity. The relationship between percentage of moderate to vigorous physical activity during the intervention lessons and time-on-task was analyzed by calculation of partial correlations.
RESULTS: Time-on-task of socially disadvantaged children was lower than that of children without this disadvantage, differences were significant at the start post-control (t(65) = 2.39, p < 0.05) and post-intervention (t(71) = 2.75, p < 0.05) observation and at the midway post-control (t(68) = 2.45, p < 0.05) observation. Multilevel analysis showed that the time-on-task of all children was significantly higher during post-intervention in comparison with post-control lessons (ES = 0.41). No significant difference was found at the start observation, but there were significant differences at the midway (ES = 0.60) and end (ES = 0.59) observation. On average, the children were exercising in moderate to vigorous physical activity during 60% of de lesson time (14 minutes of an average lesson of 23 minutes). No significant relationships were found between percentage of moderate to vigorous physical activity during the intervention and time-on-task in the post-intervention lessons.
CONCLUSIONS: Physically active academic lessons may positively influence time-on-task in children, which can contribute to academic success in the long term.

PMID: 25927371 [PubMed – as supplied by publisher]

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A web-based self-help intervention for partners of cancer patients based on Acceptance and Commitment Therapy: a protocol of a randomized controlled trial.

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A web-based self-help intervention for partners of cancer patients based on Acceptance and Commitment Therapy: a protocol of a randomized controlled trial.

BMC Public Health. 2015;15(1):303

Authors: Köhle N, Drossaert CH, Schreurs KM, Hagedoorn M, Verdonck-de Leeuw IM, Bohlmeijer ET

Abstract
BACKGROUND: There is a growing recognition that cancer not only affects the lives of the patients, but also the lives of their partners. Partners of cancer patients are highly involved in the illness trajectory by providing informal care and they often experience distress. However, supporting interventions for this group are scarce and existing interventions bear several limitations. On the basis of the need for theory- and evidence-based supportive interventions for partners of cancer patients, the web-based self-help intervention Hold on, for each other has been developed. This intervention is based on Acceptance and Commitment Therapy. The primary objective of the RCT is to investigate the (cost-) effectiveness of the intervention. Additional goals are (1) to examine if psychological flexibility, self-compassion, mastery, supportive behavior, posttraumatic growth and resilience are mediators of the intervention’s effects on the partners’ mental health; (2) to examine the moderating effects of the socio demographics (age, gender, education, working situation, family situation) and disease-related characteristics of the patients (sort of cancer, stage of disease, duration and treatment of cancer); and (3) to investigate to what extend participants are satisfied with the intervention, which parts of the intervention are mostly used, and how adherent the users are.
METHODS/DESIGN: A three-armed randomized controlled trial (RCT) will be conducted to compare two versions of the intervention Hold on, for each other with a waiting list control condition. Both intervention conditions contain the same content and differ only with regard to the form of professional support (personal support versus automatic support). Adult partners of cancer patients with mild to moderate depressive and anxiety symptoms, will be recruited through a multi-component strategy. Online measurements by self-assessment will be made on four measurement points (prior to randomization (baseline-measurement) and 3, 6 and 12 months after baseline).
DISCUSSION: When proven effective, Hold on, for each other can be an invaluable contribution to the healthcare system and it could be offered to all partners of cancer patients who are in need for additional support.
TRIAL REGISTRATION: Dutch Trial Register, trial registration number NTR4035 , date of registration: 17 March 2013.

PMID: 25884187 [PubMed – as supplied by publisher]

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“In a situation of rescuing life”: meanings given to diabetes symptoms and care-seeking practices among adults in Southeastern Tanzania: a qualitative inquiry.

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“In a situation of rescuing life”: meanings given to diabetes symptoms and care-seeking practices among adults in Southeastern Tanzania: a qualitative inquiry.
BMC Public Health. 2015;15(1):224
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The prospective association between obesity and major depression in the general population: does single or recurrent episode matter?

The prospective association between obesity and major depression in the general population: does single or recurrent episode matter?

BMC Public Health. 2015 Apr 10;15(1):350

Authors: Nigatu YT, Bültmann U, Reijneveld SA

Abstract
BACKGROUND: Obesity and major depressive disorder (MDD) are important public health problems. MDD is a heterogeneous disorder and the direction of its association with obesity remains unclear. Evidence grows that recurrent MDD (MDD-R) differs in etiology and prognosis from single episode MDD (MDD-S), which could affect associations with obesity. However, evidence on this differential effect is lacking. The aim of this study was to examine the direction of the association between obesity and MDD, single or recurrent episode.
METHODS: A longitudinal study was performed in a cohort of 1094 participants of the PREVEND study, on whom data were collected at baseline and at an average 2-year follow-up. MDD-S and MDD-R were assessed by the Composite International Diagnostic Interview (CIDI 2.1). Obesity was defined as Body Mass Index ≥ 30 kg/m(2). Binary logistic regression analyses were conducted to examine whether obesity predicts MDD-S/MDD-R or vice versa, adjusted for potential confounders.
RESULTS: Prospective analyses showed that BMI at baseline was associated with the onset of MDD-R (Odds ratio, OR = 1.32; 95% confidence interval, 95%CI: 1.11; 1.57) during 2-year follow-up, but not with the onset of MDD-S (OR = 0.98; 95%CI: 0.89; 1.07). Obesity at baseline was not associated with the onset of MDD-S during follow-up (OR = 0.75; 95%CI: 0.25; 2.30), but associated with the onset of MDD-R during follow-up (OR = 11.63; 95%CI: 1.05; 128.60). Neither MDD-S nor MDD-R were associated with the development of obesity during 2-year follow-up (OR = 1.67, 95%CI: 0.64; 4.29 and OR = 2.32, 95%CI: 0.82; 6.58, respectively).
CONCLUSIONS: Our findings add to the available evidence that obesity might specifically be associated with the onset of multiple episodes of major depression (MDD-R). Although the reverse association was not found, MDD-R tends to be also associated with subsequent development of obesity, but larger studies are needed to fully assess this issue. The heterogeneity of MDD should be considered when examining the effect of obesity on MDD.

PMID: 25880736 [PubMed – as supplied by publisher]

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The effectiveness of the Allen Carr smoking cessation training in companies tested in a quasi-experimental design.

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The effectiveness of the Allen Carr smoking cessation training in companies tested in a quasi-experimental design.

BMC Public Health. 2014;14(1):952

Authors: Dijkstra A, Zuidema R, Vos D, van Kalken M

Abstract
BACKGROUND: The Allen Carr training (ACt) is a popular one-session smoking cessation group training that is provided by licensed organizations that have the permission to use the Allen Carr method. However, few data are available on the effectiveness of the training.
METHODS: In a quasi-experimental design the effects of the existing practice of providing the ACt to smokers (n = 124) in companies on abstinence, were compared to changes in abstinence in a cohort of similar smokers in the general population (n = 161). To increase comparability of the smokers in both conditions, smokers in the control condition were matched on the group level on baseline characteristics (fourteen variables) to the smokers in the ACt. The main outcome measure was self-reported continuous abstinence after 13 months, which was validated using a CO measurement in the Act condition.
RESULTS: Logistic regression analyses showed that when baseline characteristics were comparable, significantly more responding smokers were continuously abstinent in the ACt condition compared to the control condition, Exp(B) = 6.52 (41.1% and 9.6%, respectively). The all-cases analysis was also significant, Exp(B) = 5.09 (31.5% and 8.3%, respectively).
CONCLUSION: Smokers following the ACt in their company were about 6 times more likely to be abstinent, assessed after 13 months, compared to similar smokers in the general population. Although smokers in both conditions did not differ significantly on 14 variables that might be related to cessation success, the quasi-experimental design allows no definite conclusion about the effectiveness of the ACt. Still, these data support the provision of the ACt in companies.

PMID: 25218267 [PubMed – in process]

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Effect of breastfeeding promotion interventions on cost-effectiveness of rotavirus immunization in Indonesia.

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Effect of breastfeeding promotion interventions on cost-effectiveness of rotavirus immunization in Indonesia.

BMC Public Health. 2013;13:1106

Authors: Suwantika AA, Postma MJ

Abstract
BACKGROUND: Rotavirus infection has been reported to be responsible for the majority of severe diarrhea in children under-5-years-old in Indonesia. Breast milk is considered to give protection against rotavirus infection. Increasing breastfeeding promotion programs could be an alternative target to reduce the incidence of rotavirus diarrhea. This study aims to investigate the effect of breastfeeding promotion interventions on cost-effectiveness of rotavirus immunization in Indonesia, focusing on breastfeeding education and support interventions.
METHODS: An age-structured cohort model was developed for the 2011 Indonesia birth cohort. We compared four interventions in scenarios: (i) base-case (I₀) reflecting the current situation for the population of under-5-years-old, (ii) with an additional breastfeeding education intervention (I₁), (iii) with a support intervention on initiation and duration (I₂) and (iv) with both of these two interventions combined (I₃). The model applied a 5-years time horizon, with 1 month analytical cycles for children less than 1 year of age and annually thereafter. Monte Carlo simulations were used to examine the economic acceptability and affordability of rotavirus vaccination.
RESULTS: Rotavirus immunization would effectively reduce severe cases of rotavirus during the first 5 years of a child’s life even assuming various breastfeeding promotion interventions. The total yearly vaccine cost would amount to US$ 64 million under the market vaccine price. Cost-effectiveness would increase to US$ 153 per quality-adjusted-life-year (societal perspective) with an optimal breastfeeding promotion intervention. Obviously, this is much lower than the 2011 Gross Domestic Product (GDP) per capita of US$ 3,495. Affordability results showed that at the market vaccine price, rotavirus vaccination could be affordable for the Indonesian health system.
CONCLUSIONS: Rotavirus immunization would be a highly cost-effective public health intervention for Indonesia even under various breastfeeding promotion interventions based on the WHO’s criteria for cost-effectiveness in universal immunization.

PMID: 24289227 [PubMed – indexed for MEDLINE]

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A comparative analysis of early child health and development services and outcomes in countries with different redistributive policies.

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A comparative analysis of early child health and development services and outcomes in countries with different redistributive policies.

BMC Public Health….

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