PubMed Health⌕ Search

Biomedical subjects

Camilo Acosta

Publications and source records attributed to Camilo Acosta.

5 recordsLinked to original sources

Household demand for typhoid fever vaccines in Hue, Vietnam.

The demand function for vaccines against typhoid fever was estimated using stated preference data collected from a random sample of 1065 households in Hue, Vietnam, in 2002. These are the first estimates of private willingness-to-pay (WTP) and demand functions for typhoid vaccines in a developing country. Mean respondent WTP for a single typhoid fever vaccine ranged from USD 2.30 to USD 4.80. Mean household WTP estimates (vaccinating all members of the household) ranged from USD 21 to USD 27. Demand was similar for vaccines with different degrees of effectiveness and intervals of duration. These results suggest a significant potential for private sector provision of typhoid fever vaccines in Hue.

Adult↗

Efficacy calculation in randomized trials: global or local measures?

This study tests whether the effect of a vaccine trial varies in space and why. Analytical z-score maps identify unusually high- and low-efficacy values in a trial area. Relationships between neighborhood efficacy and ecological variables are measured to explain why efficacy varies in space. Efficacy was found to vary regardless of neighborhood size and the variation is related to several ecological determinants. Local efficacy measures can help public health practitioners make better decisions about when and where to vaccinate populations. The concepts offered in this study are pertinent for any health intervention trial, not just vaccines.

Adolescent↗

Health care utilization for diarrhea and fever in 4 urban slums in Karachi.

OBJECTIVE: To estimate the fraction of fever and diarrhea patients making use of private practitioners, self-treatment, hospital care, drug vendors, community health centers and traditional healers. DESIGN: A cross-sectional survey. PLACE AND DURATION OF STUDY: Four slums in and around Karachi during October and November, 2001. PATIENTS AND METHODS: A sample of 1842 households was selected with probability proportional to size of the slum. The household head or a representative was asked regarding the treatment providers for diarrhea and cases of fever persistent for 3 days or more. Only households with an actual case of fever and/or diarrhea were included in the analysis. RESULTS: The study found that more than half of diarrhea and fever cases are seen by private practitioners. Self medication with medicines available in the home or specifically purchased for the disease episode from a drug vendor combined provides 13% to 18% of health care. Only between 11% and 13% of patients are seen by the public sector, hospitals and community health centers. There was no significant difference between the choice of health care provider for diarrhea and fever cases. CONCLUSION: In this survey, the majority of fever and diarrhea patients presented first to private practitioners and not to drug vendors or the public sector. Successful passive surveillance of febrile or diarrheal illness in these communities has to integrate private practitioners.

Adolescent↗

Diarrhoea episodes and treatment-seeking behaviour in a slum area of North Jakarta, Indonesia.

Visits to household during a census in an impoverished area of north Jakarta were used for exploring the four-week prevalence of diarrhoea, factors associated with episodes of diarrhoea, and the patterns of healthcare use. For 160,261 urban slum-dwellers, information was collected on the socioeconomic status of the household and on diarrhoea episodes of individual household residents in the preceding four weeks. In households with a reported case of diarrhoea, the household head was asked which form of healthcare was used first. In total, 8,074 individuals (5%)--13% of children aged less than five years and 4% of adults--had a diarrhoea episode in the preceding four weeks. The two strongest factors associated with a history of diarrhoea were a diarrhoea episode in another household member in the four weeks preceding the interview (adjusted odds ratio [OR] 11.1; 95% confidence interval [CI] 10.4-11.8) and age less than five years (adjusted OR 3.4; 95% CI 3.2-3.5). Of the 8,074 diarrhoea cases, 1,969 (25%) treated themselves, 1,822 (23%) visited a public-health centre (PHC), 1,462 (18%) visited a private practitioner or a private clinic, 1,318 (16%) presented at a hospital, 753 (9%) bought drugs from a drug vendor, and 750 (9%) used other healthcare providers, such as belian (traditional healers). Children with diarrhoea were most often brought to a PHC, a private clinic, or a hospital for treatment. Compared to children, adults with diarrhoea were more likely to treat themselves. Individuals from households in the lowest-income group were significantly more likely to attend a PHC for treatment of diarrhoea compared to individuals from households in the middle- and higher-income groups.

Adolescent↗

Evaluation of efficacy of community-based vs. institutional-based direct observed short-course treatment for the control of tuberculosis in Kilombero district, Tanzania.

Tuberculosis (TB) has reappeared as a serious public health problem. Non-compliance to antituber-culous drug treatment is cited as one of the major obstacles to the containment of the epidemic. Compliance may be optimized by Directly Observed Treatment (DOT) and short-course treatment regimens. Since 1986, Tanzanian TB patients have received daily DOT at health facilities for the first 2 months of the treatment course. However, adherence and cure rates have been falling as the number of TB cases continues to increase and the burden on already stretched health facilities threatens to become unmanageable. We used an open cluster randomized controlled trial to compare community-based DOT (CBDOT) using a short-course drug regimen with institutional-based DOT (IBDOT). A total of 522 (301 IBDOT and 221 CBDOT) patients with sputum-positive TB were recruited. Overall, there was no significant difference in conversion and cure rates between the two strategies [M-H pooled odds ratio (OR) 0.62; 95% confidence interval (CI) 0.23, 1.71 and OR = 1.58; 95% CI 0.32, 7.88, respectively] suggesting that CBDOT may be a viable alternative to IBDOT. CBDOT may be particularly useful in parts of the country where people live far from health facilities.

Adult↗