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Title: Health system resource gaps and associated mortality from pandemic influenza across six asian territories
Authors: James W. Rudge
Piya Hanvoravongchai
Ralf Krumkamp
Irwin Chavez
Wiku Adisasmito
Pham Chau
Bounlay Phommasak
Weerasak Putthasri
Chin Shui Shih
Mart Stein
Aura Timen
Sok Touch
Ralf Reintjes
Richard Coker
London School of Hygiene & Tropical Medicine
Hochschule fur Angewandte Wissenschaften Hamburg
Mahidol University
Universitas Indonesia
Vietnam Military Medical University
Ministry of Health
International Health Policy Program, Thailand
Taiwan Centres for Disease Control
National Institute of Public Health and the Environment
Ministry of Health Cambodia
Keywords: Agricultural and Biological Sciences;Biochemistry, Genetics and Molecular Biology
Issue Date: 21-Feb-2012
Citation: PLoS ONE. Vol.7, No.2 (2012)
Abstract: Background: Southeast Asia has been the focus of considerable investment in pandemic influenza preparedness. Given the wide variation in socio-economic conditions, health system capacity across the region is likely to impact to varying degrees on pandemic mitigation operations. We aimed to estimate and compare the resource gaps, and potential mortalities associated with those gaps, for responding to pandemic influenza within and between six territories in Asia. Methods and Findings: We collected health system resource data from Cambodia, Indonesia (Jakarta and Bali), Lao PDR, Taiwan, Thailand and Vietnam. We applied a mathematical transmission model to simulate a "mild-to-moderate" pandemic influenza scenario to estimate resource needs, gaps, and attributable mortalities at province level within each territory. The results show that wide variations exist in resource capacities between and within the six territories, with substantial mortalities predicted as a result of resource gaps (referred to here as "avoidable" mortalities), particularly in poorer areas. Severe nationwide shortages of mechanical ventilators were estimated to be a major cause of avoidable mortalities in all territories except Taiwan. Other resources (oseltamivir, hospital beds and human resources) are inequitably distributed within countries. Estimates of resource gaps and avoidable mortalities were highly sensitive to model parameters defining the transmissibility and clinical severity of the pandemic scenario. However, geographic patterns observed within and across territories remained similar for the range of parameter values explored. Conclusions: The findings have important implications for where (both geographically and in terms of which resource types) investment is most needed, and the potential impact of resource mobilization for mitigating the disease burden of an influenza pandemic. Effective mobilization of resources across administrative boundaries could go some way towards minimizing avoidable deaths. © 2012 Rudge et al.
ISSN: 19326203
Appears in Collections:Scopus 2011-2015

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