We assessed the impact of the coronavirus disease 2019 (COVID-19) epidemic in India on the consumption of antibiotics and hydroxychloroquine (HCQ) in the private sector in 2020 compared to the ...expected level of use had the epidemic not occurred. We performed interrupted time series (ITS) analyses of sales volumes reported in standard units (i.e., doses), collected at regular monthly intervals from January 2018 to December 2020 and obtained from IQVIA, India. As children are less prone to develop symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we hypothesized a predominant increase in non-child-appropriate formulation (non-CAF) sales. COVID-19-attributable changes in the level and trend of monthly sales of total antibiotics, azithromycin, and HCQ were estimated, accounting for seasonality and lockdown period where appropriate. A total of 16,290 million doses of antibiotics were sold in India in 2020, which is slightly less than the amount in 2018 and 2019. However, the proportion of non-CAF antibiotics increased from 72.5% (95% CI: 71.8% to 73.1%) in 2019 to 76.8% (95% CI: 76.2% to 77.5%) in 2020. Our ITS analyses estimated that COVID-19 likely contributed to 216.4 million (95% CI: 68.0 to 364.8 million; P = 0.008) excess doses of non-CAF antibiotics and 38.0 million (95% CI: 26.4 to 49.2 million; P < 0.001) excess doses of non-CAF azithromycin (equivalent to a minimum of 6.2 million azithromycin treatment courses) between June and September 2020, i.e., until the peak of the first epidemic wave, after which a negative change in trend was identified. In March 2020, we estimated a COVID-19-attributable change in level of +11.1 million doses (95% CI: 9.2 to 13.0 million; P < 0.001) for HCQ sales, whereas a weak negative change in monthly trend was found for this drug. Study limitations include the lack of coverage of the public healthcare sector, the inability to distinguish antibiotic and HCQ sales in inpatient versus outpatient care, and the suboptimal number of pre- and post-epidemic data points, which could have prevented an accurate adjustment for seasonal trends despite the robustness of our statistical approaches. A significant increase in non-CAF antibiotic sales, and particularly azithromycin, occurred during the peak phase of the first COVID-19 epidemic wave in India, indicating the need for urgent antibiotic stewardship measures.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
More leaders of global health organisations are alumni of Harvard than are women from low-income and middle-income countries (LMICs). Martin Luther King Jr (1929–68) AFP/Getty Images The supremacy ...that manifests in global health is not peculiar to global health. In this imagined future, global health practitioners in HICs and those who are otherwise privileged, have embraced an appropriately modest view of their importance, and mastered the art of critical allyship, where they see their primary role as allies and enablers rather than leaders. Rather than drawing from a limited talent pool of elite HIC institutions, Black, Indigenous, and other people of colour are the real leaders of global health.
Rather, it is the successful use at the POC that defines a diagnostic process as POC testing. ...the focus must be on POC testing programs, rather than POC technologies. * We discuss a framework that ...envisions POC testing as a spectrum of technologies (simplest to more sophisticated), users (lay persons to highly trained), and settings (homes, communities, clinics, peripheral laboratories, and hospitals). * A deeper appreciation of this diversity in target product profiles, and likely barriers in each setting, might help test developers and public health managers to identify the most impactful product and delivery model. ...donors and funding agencies must consider the downstream implications of the health technologies that they are funding, and ensure that product development initiatives are simultaneously coordinated with pricing and delivery mechanisms, supported by innovative business models for scale-up.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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