Public Health Care Costs Research Articles

The economic burden of type 2 diabetes on the public healthcare system in Kenya: a cost of illness study

BackgroundThe burden of chronic non-communicable diseases (NCDs) is a growing public health concern. The availability of cost-of-illness data, particularly public healthcare costs for NCDs, is limited in Sub-Saharan Africa (SSA), yet such data evidence is needed for policy action.ObjectiveThe objective of this study was to estimate the economic burden of type 2 diabetes (T2D) on Kenya’s public healthcare system in 2021 and project costs for 2045.MethodsThis was a cost-of-illness study using the prevalence-based bottom-up costing approach to estimate the economic burden of T2D in the year 2021. We further conducted projections on the estimated costs for the year 2045. The costs were estimated corresponding to the care, treatment, and management of diabetes and some diabetes complications based on the primary data collected from six healthcare facilities in Nairobi and secondary costing data from previous costing studies in low and middle-income countries (LMICs). The data capture and costing analysis were done in Microsoft Excel 16, and sensitivity analysis was conducted on all the parameters to estimate the cost changes.ResultsThe total cost of managing T2D for the healthcare system in Kenya was estimated to be US$ 635 million (KES 74,521 million) in 2021. This was an increase of US$ 2 million (KES 197 million) considering the screening costs of undiagnosed T2D in the country. The major cost driver representing 59% of the overall costs was attributed to T2D complications, with nephropathy having the highest estimated costs of care and management (US$ 332 million (KES 36, 457 million). The total cost for T2D was projected to rise to US$ 1.6 billion (KES 177 billion) in 2045.ConclusionThis study shows that T2D imposes a huge burden on Kenya’s healthcare system. There is a need for government and societal action to develop and implement policies that prevent T2D, and appropriately plan care for those diagnosed with T2D.

Pharmacists as educators: Enhancing patient understanding and access to specialty medications through community workshops

Pharmacists are increasingly recognized as vital educators within the healthcare system, particularly in improving patient understanding and access to specialty medications. This review explores the expanding role of pharmacists as educators, emphasizing their unique expertise in providing accurate, accessible information and their impact on patient outcomes. The paper highlights community workshops as an effective tool for delivering education, focusing on the structure, content, and accessibility of these workshops to diverse patient populations. Furthermore, it examines patients' barriers to accessing specialty medications and how pharmacists can help overcome these challenges through education, support, and coordination with other healthcare providers. The review also discusses future directions for enhancing the educator role of pharmacists, the need for supportive policies, and the potential long-term benefits of pharmacist-led education on public health and healthcare costs. Recommendations for implementing and expanding community-based education initiatives are provided, emphasizing integrating these efforts into broader healthcare strategies. Keywords: Pharmacist-led education; Specialty medications; Community workshops; Healthcare access; Patient outcomes; Public health

The Role of Health Education in Preventing Chronic Diseases

Health education is a critical element in the preventive medicine toolkit, particularly for chronic diseases, which pose a significant burden globally. Chronic diseases such as diabetes, cardiovascular diseases, and cancer are leading causes of morbidity and mortality worldwide, significantly impacting public health and healthcare costs. This paper reviews the impact of health education programs on preventing chronic diseases and discusses the effectiveness of various educational strategies. The review will focus on the role of technology in enhancing health education, examine implementation obstacles, and highlight successful interventions based on recent studies. Additionally, the review will identify gaps in current research and provide recommendations for future studies, emphasising the need for culturally tailored and sustainable health education programs.

Impact of Rapid Economic Development with Rising Carbon Emissions on Public Health And Healthcare Costs in Bangladesh

Background: Bangladesh, a rapidly developing country, is experiencing a critical phase where economic growth and environmental sustainability must be balanced. The swift industrialization and urbanization have led to increased energy consumption and carbon emissions, negatively impacting public health and healthcare expenditures. This study determined the intricate relationships between healthcare expenditure and its determinants—economic growth, CO2 emissions, urbanization, and natural resource use—in Bangladesh. Methods: Utilizing a dataset from 2004 to 2023, this study applies advanced econometric methods, including the dual adjustment approach, spectral causality, fully modified ordinary least squares (FMOLS), dynamic ordinary least squares (DOLS), and canonical cointegrating regression (CCR). Results: Results demonstrate a significant positive correlation between economic growth, urbanization, natural resources, and CO2 emissions on healthcare spending. The findings underscore that CO2 emissions and urbanization are substantial contributors to rising healthcare costs, while natural resources and economic growth present varying impacts based on different econometric models. The dual adjustment approach provides robust evidence of cointegration, revealing the long-term interactions among these variables. Conclusion: In conclusion, the study emphasizes the urgent need for effective national policies to mitigate healthcare costs driven by environmental degradation and economic growth. By understanding these relationships, policymakers can better manage health expenditures while promoting sustainable development in Bangladesh. The research highlights the necessity of integrating environmental and health policies to achieve a balanced growth trajectory.

Effects of Pycnogenol® in people with post-COVID-19 condition (PYCNOVID): study protocol for a single-center, placebo controlled, quadruple-blind, randomized trial

BackgroundA significant proportion of the global population has been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at some point since the onset of the pandemic. Although most individuals who develop coronavirus disease 2019 (COVID-19) recover without complications, about 6% have persistent symptoms, referred to as post-COVID-19 condition (PCC). Intervention studies investigating treatments that potentially alleviate PCC-related symptoms and thus aim to mitigate the global public health burden and healthcare costs linked to PCC are desperately needed. The PYCNOVID trial investigates the effects of Pycnogenol®, a French maritime pine bark extract with anti-inflammatory and antioxidative properties, versus placebo on patient-reported health status in people with PCC.MethodsThis is a single-center, placebo-controlled, quadruple blind, randomized trial. We aim to randomly assign 150 individuals with PCC (1:1 ratio) to receive either 200 mg Pycnogenol® or placebo daily for 12 weeks. Randomization is stratified for duration of PCC symptoms (≤ 6 months versus > 6 months) and presence of symptomatic chronic disease(s). The primary endpoint is perceived health status at 12 weeks (EuroQol—Visual Analogue Scale) adjusted for baseline values and stratification factors. Secondary endpoints include change in self-reported PCC symptoms, health-related quality of life, symptoms of depression and anxiety, cognitive function, functional exercise capacity, physical activity measured with accelerometry, and blood biomarkers for endothelial health, inflammation, coagulation, platelet function, and oxidative stress. Investigators, study participants, outcome assessors, and data analysts are blinded regarding the intervention assignment. Individuals with PCC were involved in the design of this study.DiscussionThis is the first trial to investigate the effects of Pycnogenol® versus placebo on patient-reported health status in people with PCC. Should the trial proof clinical effectiveness, Pycnogenol® may serve as a therapeutic approach to mitigate symptoms associated with PCC.Trial registrationThe study is registered at ClinicalTrials.gov. :NCT05890534, June 6, 2023.

Effectiveness of community-based diabetes and hypertension prevention and management programmes in Indonesia and Viet Nam: a quasi-experimental study

IntroductionNon-communicable diseases (NCDs) have surpassed infectious diseases as the leading global cause of death, with the Southeast Asian region experiencing a significant rise in NCD prevalence over the past decades....

The contemporaneous healthcare cost of particulate matter pollution for youth and older adult populations

This paper estimates the impact of particulate matter pollutants, measured by PM10 levels, on public healthcare costs for youth and older adult populations using administrative data from two large UK hospitals and exploiting spatial and temporal variation in PM10 levels. We find that patient enrolment increases when their neighborhood experiences higher levels of PM10. Specifically, a standard deviation increase in PM10 levels increases the enrolment of patients aged 60 years and older by 6.2% and the enrolment of patients under 18 years of age by 3.1%. Using detailed costing information, we estimate that a standard deviation increase in PM10 increases public healthcare costs by £873,985.20 per year in the municipality studied.

Current Evidence Using Pulsed Electromagnetic Fields in Osteoarthritis: A Systematic Review.

(1) Background: Osteoarthritis (OA) significantly impacts patients' quality of life and negatively affects public healthcare costs. The aim of this systematic review is to identify the effectiveness of pulsed electromagnetic fields (PEMFs) in OA treatment across different anatomical districts, determining pain reduction and overall improvement in the patient's quality of life. (2) Methods: In this systematic review following PRISMA guidelines, PubMed and Google Scholar were searched for randomized controlled trials involving patients with osteoarthritis undergoing PEMF therapy. Seventeen studies (1197 patients) were included. (3) Results: PEMF therapy demonstrated positive outcomes across various anatomical districts, primarily in knee osteoarthritis. Pain reduction, assessed through VAS and WOMAC scores, showed significant improvement (60% decrease in VAS, 42% improvement in WOMAC). The treatment duration varied (15 to 90 days), with diverse PEMF devices used. Secondary outcomes included improvements in quality of life, reduced medication usage, and enhanced physical function. (4) Conclusions: Diverse PEMF applications revealed promising results, emphasizing pain reduction and improvement in the quality of life of patients. The variability in the treatment duration and device types calls for further investigation. This review informs future research directions and potential advancements in optimizing PEMF therapies for diverse osteoarthritic manifestations.

The impact of an ‘evergreening’ strategy nearing patent expiration on the uptake of biosimilars and public healthcare costs: a case study on the introduction of a second administration form of trastuzumab in The Netherlands

In this paper, we explore dynamic market share and public healthcare costs of trastuzumab’s evergreening (subcutaneous) variant during introduction of trastuzumab’s competitive biosimilar variants in the Netherlands. We used a time series design to assess dynamic market share of trastuzumab’s evergreening variant after introducing trastuzumab’s biosimilar variants, focusing on the number of treatments and patients. The public healthcare costs of this evergreening strategy were estimated using administrative claims data. Our results show that the original trastuzumab was completely replaced by the subcutaneous and biosimilar variants. The uptake of the subcutaneous form peaked at 50% market share but after the introduction of biosimilars progressively reduced to a market share of 20%, resulting in a more competitive market structure. The public healthcare costs for trastuzumab significantly decreased after the introduction of the biosimilars. After the introduction of the biosimilars, a substantial price drop is visible, with the subcutaneous version, still under patent, also falling sharply in price but less strongly than the iv/biosimilar version. As the costs are publicly funded, we recommend a more explicit societal debate to consider if the potential benefits of subcutaneous Herceptin® (and other similar medicines) are worth the additional costs, and at which price it should be reimbursed as the part of the benefit package.

Purinergic P2X7R expressed on regulatory T cells potentially links molecular mimicry to autoimmune responses

<abstract> <p>The immune system is meant to protect against invading microbes. Although this system is effective against many microbes, some can use molecular mimicry to turn the immune system against the host and activate autoimmune responses. The resulting autoimmunity has significant implications for public health and healthcare costs. It is well known that regulatory T cells (Tregs) are crucial for self-tolerance and that their function is impaired after exposure to self-antigens or antigens with molecular mimicry, leading to the activation of autoimmune responses. How molecular mimicry disrupts Tregs in this manner remains under debate. This review contributes to the field of the pathogenesis of autoimmunity by proposing that purinergic signaling in the lymph nodes, with extracellular ATP, ADP, and adenosine as ligands, plays a pivotal role in this process. Repeated or high-dose microbial infection causes the release of large amounts of extracellular ATP sufficient to reach the threshold of extracellular ATP levels for activating P2X7 purinergic receptors (P2X7Rs) on dendritic cells and Tregs. This hampers the ability of Tregs to suppress autoimmune responses. Crucially, P2X7Rs are activated at very high extracellular ATP levels, thus only after repeated or high-dose infection with microbes. Arguably, in contrast to the rapid elimination of microbes with foreign antigens, the clearance of invading microbes that employ molecular mimicry requires the activation of P2X7Rs at the expense of self-tolerance. Because all processes required to activate autoimmune responses occur in secondary lymphoid organs, this article hypothesizes that, contrary to current convention, microbes do not need to enter organs to initiate autoimmunity. However, some types of microbes can prevent P2X7R-induced Treg disruption by converting extracellular ATP to adenosine, mitigating autoimmune responses resulting in chronic diseases with less severe inflammation. The proposed hypothesized mechanism has potential implications for the understanding and treatment of autoimmune disorders.</p> </abstract>

Exploring the OTITIS Research Landscape Through a Scientometric Approach.

Otitis media is a common health problem affecting people of all ages and significantly impacting public health and healthcare costs. Otitis media, a type of middle ear disease, is one of the most common types. This scientometric study aimed to provide an overview of the knowledge domain in otitis media research. Documents were retrieved from the Web of Science database. A scientometric study was then performed on a sample of 27,213 documents. This study found that research on otitis media has increased significantly in recent years, with an annual growth rate of 4.58%. The average age of the documents analyzed was 18years, with an average of 21.88 citations and an average of 4.58 authors. The United States, the United Kingdom, and Japan ranked first to third in terms of number of publications. Still, the United States, China, and Sweden were in a better position in terms of impact on the research network. Co-occurrence word analysis showed that significant attention was given to topics such as chronic inflammation in autism, acute inflammation in otitis media, and increased fluid in the middle ear. This study highlights the need to prioritize and focus attention on otitis, particularly otitis media, due to its prevalence and impact on public health. The use of scientometric software, such as Biblioshiny and CiteSpace, provides a valuable means of assessing research trends and identifying important areas for future study in the field of knowledge.

Association between serum omega-3 PUFAs levels and cognitive impairment in never medically treated first-episode patients with geriatric depression: A cross-sectional study

BackgroundGeriatric depression increases the public health burden and health care costs, reduces quality of life. Studies have shown the association between ω-3 PUFAs levels and inflammatory markers levels and depression, but few have explored the relationship between omega-3 PUFAs, inflammatory markers, and cognitive function in geriatric depression. This study aimed to compare the differences in ω-3 PUFAs levels and inflammatory markers between geriatric depression with cognitive impairment (CI) and those without CI. MethodsA total of three hundred and five elderly patients were recruited. In addition to collecting basic information, their blood specimens were collected to detect serum EPA, DHA, AA, TC, LDL-C, IL-6, TNF-α, and hs-CRP levels. The Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and The Montreal cognitive assessment (MoCA) were used to assess their depression, anxiety, and cognitive function, respectively. ResultsCompared to those without CI, geriatric depression patients with CI had higher serum TC, LDL-C levels, lower EPA, DHA, and AA levels, and more elevated IL-6, TNF-α, and hs-CRP levels (all P < 0.05). Further linear regression analysis showed that EPA, DHA, and TNF-α, hs-CRP levels were significantly associated with the occurrence and the severity of CI. LimitationsNo causal relationship could be drawn due to the cross-sectional design. ConclusionsOmega-3 PUFAs and inflammatory factors levels may predict CI in elderly patients with MDD in the future. Our findings suggest that ω-3 PUFAs (EPA and DHA) and inflammatory factors (TNF-α and CRP) may predict the occurrence and the severity of CI among elderly MDD patients.

A-249 Theranostic Algorithm: sensitivity and Specificity of a Composite Index Test for Guiding Treatment in Severe COVID-19

Abstract Background Since the outbreak of the pandemic, severely affected COVID-19 patients receive standard of care at intensive care unit (ICU), but clinical trials are still ongoing for new expensive treatments. There is a need for guiding therapeutic decisions to restrain the public healthcare costs and to target the most efficient therapy. Based on the pathophysiology of SARS-CoV-2 on its ACE2-receptor, the angiotensin pathway is activated and circulating biomarkers of interest can be measured. This diagnostic test accuracy study describes how to classify COVID-19 patients in severe vs mild cases with the intention of guiding treatment decisions, to prevent long term sequels like pulmonary fibrosis. A theranostic approach is proposed, which combines in vitro diagnostics and personalized therapeutics. Methods N = 17 severely affected COVID-19 with acute respiratory distress syndrome (ARDS) at ICU were included and compared to N = 7 mild or asymptomatic COVID-19 cases and to N = 10 healthy controls. Follow-up samples have been collected during pulmonology consultation at three time points during one year post-ICU (N = 39). Non-parametrical statistics were used; data are expressed as [median (IQR)] and P &amp;lt; 0.05 is considered to be statistically significant. The biological markers angiotensin-(1-7) (Ang-(1-7)), transforming growth factor beta (TGF-β), ferritin, C-reactive protein (CRP from Roche) and Krebs von den Lungen 6 (KL-6 from Fujirebio) were measured in plasma samples. Those biomarkers represent a disequilibrium in lung protection, fibrogenesis, inflammation and hyperplasia of alveolar epithelial cells type II. Cut-off for a composite index was obtained through receiver operating curve (ROC). Results COVID-19 patients show higher Ang-(1-7) concentrations than healthy controls (P &amp;lt; 0.05). Critical patients at ICU show Ang-(1-7) deficit [124 pg/mL (81–154)], compared to asymptomatic COVID-19 cases [147 pg/mL (138–201)] (P &amp;lt; 0.05). COVID-19 patients with insufficient Ang-(1-7) are eligible for substitution therapy and novel expensive therapies beside standard of care, while the subpopulation of high Ang-(1-7) is analyzed with a composite index test including TGF-β, ferritin and CRP. A composite index of &amp;lt;34 differentiates asymptomatic COVID-19 from severe COVID-19 at ICU having acute respiratory distress syndrome (sensitivity = 100%, specificity = 80%, AUC = 0.933, LR = 5). The patients without risk for pulmonary sequels are not eligible for expensive treatment.After 1 year, KL-6 (&amp;lt;275 U/mL) and TGF- β (&amp;lt;34 968 pg/mL) normalise in only 25%, respectively 33% of severe COVID-19 patients. Within the first year of FU post-ICU, the mean KL-6 value in the patient population does not significantly change at different measuring moments (P = 0.63), while TGF-β decreases gradually at 3, 6 and 12 months post-ICU (P &amp;lt; 0.0001). Conclusion This theranostic algorithm predicts whether a patient infected by SARS-CoV-2 is at risk of developing clinical complications and supports clinical decision making concerning therapy. A supported therapeutic choice, based on objective biomarker measurements, could diminish long-term sequelae like pulmonary fibrosis. Clinical trials using companion drugs (e.g. Ang-(1-7) substitution therapy, MAS-receptor agonist), anti-fibrotics, interferon therapy, or monoclonal antibodies, could also rely on those biomarkers. The measurement of Ang-(1-7) for example, could categorize patients in the targeted subpopulation before administrating Ang-(1-7) substitution therapy, aiming at obtaining better treatment efficacy.

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Purpose: This article aims to identify the main tendencies and features of public-private partnerships in the environmental sphere regarding developing environmental and economic security in Ukraine. Theoretical framework: Business cost savings when implementing the latest technologies in pursuit of economic results are accompanied by a deterioration of the environmental situation at the regional and national levels, increased risks of negative impact on population health, and reduced labor productivity, which, accordingly, causes a potential increase in public healthcare costs. As a result, the search for forms and methods to ensure effective cooperation between the state and business in solving natural resources management problems is intensifying. Design/methodology/approach: The study used analytical and bibliographic methods to study the scientific literature on implementing the ecological and economic security doctrine and the features of various types of public-private partnerships related to it, as well as induction, deduction, analysis, synthesis of information, systemic and structural, comparative, logical, and linguistic methods, abstraction, idealization for studying and processing data, and a questionnaire survey conducted by the research authors online to clarify the most critical issues related to this issue practically. Findings: The study identified the principal and most important theoretical aspects of public-private partnership issues in the environmental sector. Research, Practical &amp; Social implications: Also, it examined the opinion of representatives of public environmental organizations and executives of local government departments on the critical aspects of the problem. Originality/value: One of the most effective forms of combining the efforts of all stakeholders is a public-private partnership, which in a market economy allows directing limited resources of business and the state to solve the most pressing problems of both certain regions and the country as a whole through the mechanism of joint implementation of socially significant projects.

Public-Private Partnerships in Natural Resource Management as a Basis for the Implementation of the Ecological and Economic Security Doctrine of Ukraine's Development

Purpose: This article aims to identify the main tendencies and features of public-private partnerships in the environmental sphere regarding developing environmental and economic security in Ukraine.&#x0D; &#x0D; Theoretical framework: Business cost savings when implementing the latest technologies in pursuit of economic results are accompanied by a deterioration of the environmental situation at the regional and national levels, increased risks of negative impact on population health, and reduced labor productivity, which, accordingly, causes a potential increase in public healthcare costs. As a result, the search for forms and methods to ensure effective cooperation between the state and business in solving natural resources management problems is intensifying.&#x0D; &#x0D; Design/methodology/approach: The study used analytical and bibliographic methods to study the scientific literature on implementing the ecological and economic security doctrine and the features of various types of public-private partnerships related to it, as well as induction, deduction, analysis, synthesis of information, systemic and structural, comparative, logical, and linguistic methods, abstraction, idealization for studying and processing data, and a questionnaire survey conducted by the research authors online to clarify the most critical issues related to this issue practically.&#x0D; &#x0D; Findings: The study identified the principal and most important theoretical aspects of public-private partnership issues in the environmental sector.&#x0D; &#x0D; Research, Practical &amp; Social implications: Also, it examined the opinion of representatives of public environmental organizations and executives of local government departments on the critical aspects of the problem.&#x0D; &#x0D; Originality/value: One of the most effective forms of combining the efforts of all stakeholders is a public-private partnership, which in a market economy allows directing limited resources of business and the state to solve the most pressing problems of both certain regions and the country as a whole through the mechanism of joint implementation of socially significant projects.

A Quantitative Framework to Identify and Prioritize Opportunities in Biomedical Product Innovation

Prioritization and funding for health initiatives, including biomedical innovation, may not consistently target unmet public health needs. To (1) develop a quantitative, databased framework to identify and prioritize opportunities for biomedical product innovation investments based on a multicriteria decision-making model (MCDM) that includes comprehensive measures of public health burden and health care costs, and (2) pilot test the model. The Department of Health and Human Services (HHS) convened public and private experts to develop a model, select measures, and complete a longitudinal pilot study to identify and prioritize opportunities for investment in biomedical product innovations that have the greatest public health benefit. Cross-sectional and longitudinal data (2012-2019) for 13 pilot medical disorders were obtained from the Institute for Health Metrics Global Burden of Disease database (IHME GBD) and the National Center for Health Statistics (NCHS). The main outcome measure was an overall gap score reflecting high public health burden (composite measure of mortality, prevalence, years lived with disability, and health disparities), or high health care costs (composite measure of total, public, and out-of-pocket health spending) relative to low biomedical innovation. Sixteen innovation metrics were selected to reflect the pipeline of biomedical products from research and development to market approval. A higher score indicates a greater gap. Normalized composite scores were calculated for public health burden, cost, and innovation investment using the MCDM Technique for Order of Preference by Similarity to Ideal Solution method. Among the 13 conditions tested in the pilot study, diabetes (0.61), osteoarthritis (0.46), and drug-use disorders (0.39) had the highest overall gap score reflecting high public health burden, or high health care costs relative to low biomedical innovation in these medical disorders. Chronic kidney disease (0.05), chronic obstructive pulmonary disease (0.09), and cirrhosis and other liver diseases (0.10) had the least amount of biomedical product innovation despite similar public health burden and health care cost scores. In this cross-sectional pilot study, we developed and implemented a data-driven, proof-of-concept model that can help identify, quantify, and prioritize opportunities for biomedical product innovation. Quantifying the relative alignment between biomedical product innovation, public health burden, and health care cost may help identify and prioritize investments that can have the greatest public health benefit.

Factors associated with Indonesian family physicians' knowledge of depression: A cross-sectional study.

Depression is a common mental disorder in primary care settings both globally and locally. Even with considerable impacts on patients' quality of life and public healthcare costs, most people with depression do not receive evidence-based treatment. Integrating mental healthcare services into primary care is essential to address the treatment gap for depression. As counsellors and care coordinators, family physicians have a vital role in providing primary mental healthcare services. This study aims to assess Indonesian family physicians' knowledge of depression and identify the associated factors. This cross-sectional observational study included a total of 83 family physicians from the Association of Indonesian Family Physicians. Data were collected using online questionnaires, including demographic and knowledge assessment instruments and the Care Coordinator Scale (CCS). Descriptive and multiple linear regression analyses were performed. The knowledge of depression, particularly in terms of prevention, diagnosis, pharmacological treatment, and post-referral treatment, was insufficient among the family physicians. The medication education (P=0.006) and follow-up care plan (P=0.04) domains of the CCS were associated with the family physicians' knowledge of the management of depression in the linear regression analysis (R2=0.077). Interventions to improve Indonesian family physicians' knowledge of depression, focusing on medication/pharmacological treatment and considering them as care coordinators, are essential.

Estimation of the economic benefits for the public health system related to salt reduction in Costa Rica.

to estimate the economic benefits for the public health system related to salt reduction in Costa Rica for the year 2018. estimation of the economic benefits for the public healthcare costs and productivity losses associated to reducing the per capita salt consumption of Costa Ricans to 5g/day, including the estimation of the Years of Life Productive Lost and of the direct costs on consultations, hospitalizations, and medications for the Costa Rica Social Security System. The total annual costs of hospitalization, consultations, and medications attributable to excessive salt intake in the population older than 15 years of age for the year 2018, were estimated at USD $15.1 million. The highest were in hospitalizations (53%), followed by consultations and medications (32% and 15%, respectively). NCDs caused by excessive salt intake represent important economic losses for the country, not only in terms of direct health costs, but also indirect due to the increase in years of potential life lost due to premature deaths because of CVD, which causes significant losses of human capital and, therefore, to the economy and the development of Costa Rica.

Approaches and Challenges for Biosensors for Acute and Chronic Heart Failure

Heart failure (HF) is a cardiovascular disease defined by several symptoms that occur when the heart cannot supply the blood needed by the tissues. HF, which affects approximately 64 million people worldwide and whose incidence and prevalence are increasing, has an important place in terms of public health and healthcare costs. Therefore, developing and enhancing diagnostic and prognostic sensors is an urgent need. Using various biomarkers for this purpose is a significant breakthrough. It is possible to classify the biomarkers used in HF: associated with myocardial and vascular stretch (B-type natriuretic peptide (BNP), N-terminal proBNP and troponin), related to neurohormonal pathways (aldosterone and plasma renin activity), and associated with myocardial fibrosis and hypertrophy (soluble suppression of tumorigenicity 2 and galactin 3). There is an increasing demand for the design of fast, portable, and low-cost biosensing devices for the biomarkers related to HF. Biosensors play a significant role in early diagnosis as an alternative to time-consuming and expensive laboratory analysis. In this review, the most influential and novel biosensor applications for acute and chronic HF will be discussed in detail. These studies will be evaluated in terms of advantages, disadvantages, sensitivity, applicability, user-friendliness, etc.

Studies on Suitability to Incorporate Tropical Fruit Pulp in Whey-based Probiotic Beverage

Background: The present investigation was planned to standardize a method for preparation of whey-based fermented probiotic beverage containing Alfonso mango (Mangifera indica) pulp. This study was undertaken in view of the fact that the probiotic foods can play an important role in promoting health and reducing public health care costs in a developing country like India. As such the whey is the major dairy by-product, which causes enormous environmental problems leading to enforcement of stringent laws by the pollution control authorities. The Indian dairy industry is exploring the ways to utilize whey in more economical way. Methods: The lab-made paneer whey (Indian milk curd) was utilized in the study. The fresh Alfonso pulp was used for value-addition of the product. The probiotic culture of Lactobacillus rhamnosus-MTCC-5463 was used for fermentation. The method was standardized and the product was subjected for its sensory evaluation. Result: It was observed that the whey-based probiotic beverage containing 15% Alfonso pulp (v/w) was liked most with mean score of 8.75 followed by 10% pulp with mean score 5.39 out of 9.0 in the nine-point Hedonic scale. The product containing 5% Alfonso pulp was disliked by the judges with a mean score of 4.54. It was concluded that the whey-based probiotic beverage containing 10-15% mango pulp can be prepared with probiotic viable counts of 107 cfu/ml. This would be one of the promising ways to utilize the whey and developing gastrointestinal health promoting product.