DOCSLIB.ORG

Mahatma Gandhi the Issue of Healthcare Is

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Mahatma Gandhi the Issue of Healthcare Is INTRODUCTION It is health that is real wealth and not pieces of gold and silver -Mahatma Gandhi The issue of healthcare is frequently debated worldwide. Because citizen health is a top priority for nearly every government worldwide, its experts perform much research to discover the most efficient and effective means of providing quality health care services to their community members. Specifically, the non-metropolitan healthcare sector continues to present difficulties for a country’s healthcare system. In order to reveal potential solutions to the problems of non-metropolitan healthcare, this thesis will investigate the health care services that are provided to communities of this type. Comparing and contrasting the health care provided by Blount Memorial Hospital of East Tennessee with that of health care in the Chinese city of Shangri-La, will provide a case study to discover potential health care improvements. It will first examine the common injuries and illnesses that are prevalent in these communities, to reveal the demand for services of the citizens in the community. Next, it will discuss the health care services that are provided by health care facilities both internally and externally, thus, disclosing the way each community has chosen to supply services for their respective citizens. Then, it will analyze the quality care issues that ensure that the hospital provides a high standard of medical treatment to citizens. Finally, 1 it will evaluate the accessibility of these services to citizens in the community by displaying time-efficiency as well as the affordability of health care treatment. Once all of the data is analyzed and discussed, the thesis will suggest potential solutions that could improve the health care of each community. This structure of research will allow both positives and negatives of each system to be exposed and will yield beneficial solutions that each of the facilities could adopt as policy or procedure. Through the research of health care facilities in both non-metropolitan areas of United States and China, each health care organization will be able to view areas in which they succeed and areas where they could improve. 2 CHAPTER I DEMAND FOR HEALTH CARE When it comes to health simply eat less -Confucius Consumers of a particular community create the demand for health care. Consumer demand stems from community members requiring healthcare treatment for the countless injuries and illnesses that individuals are likely to experience. Demands for health care vary for different geographical regions within a country. The demand for health care for both United States and Chinese non-metropolitan cities are the focus for this particular study. Accordingly, a brief historical background is necessary to effectively analyze each region. Also, the definitions of crucial terms provide clarity for this particular research topic. One of the locations that will be used for comparison for this thesis is Blount Memorial Hospital that is located south of Knoxville at the foothills of the Appalachian Mountain region in East Tennessee. This healthcare organization is in continuous competition for resources and consumers (patients) against other health care facilities in the region. Blount Memorial Hospital was founded in 1947 as one of thirteen original county-chartered hospitals statewide. The combined efforts of many community members and businesses led to the creation of Blount Memorial Hospital. It opened July 3 24, 1947, and was named in honor of all the Blount Countians who served in the United States’ armed forces. Since its opening, Blount Memorial has confronted the task of providing quality healthcare services to a once isolated community. Over time as the community has grown, Blount Memorial has chosen to broaden its services and capacity in order to accommodate the increasing demand from the community (Blount Memorial Hospital). Today, of the original thirteen hospitals chartered in Tennessee, Blount Memorial is the only one that remains owned by the community; larger private healthcare systems purchased the bulk of community hospitals. Blount Memorial currently has a 334-bed capacity and serves the citizens of Blount County as well as other four other surrounding counties (Blount Memorial Hospital). Figure 1 shows that Blount County is located in the Southeast region of Tennessee. Figure 1: Tennessee County Map Source: “Tennessee County Map” 4 The other location for the study is the city of Shangri-La located in the southwest Yunnan province of China. This city has a population of approximately 30,000 residents comprised mostly people of Tibetan ancestry (Briggs). This area of China relies heavily upon the tourism industry for economic prosperity. Much as Maryville is the so-called gateway to the “Smoky Mountains,” Shangri-La is a gateway to the Himalayan Mountains. During China’s Cultural Revolution of the 1960s, the Chinese government instituted a healthcare system that specialized in cheap preventative healthcare to citizens through a group of people known as barefoot doctors. Barefoot doctors were both selected and trained by government officials; afterwards, barefoot doctors provided preventative health care education to members of rural communities. This grassroots program had great success up until the 1980s when funding was cut by the Chinese government in anticipation that capitalism would be able to provide adequate healthcare services to the Chinese citizens (Brant et al.). Over the next two decades the healthcare system declined rapidly in remote areas. Shangri-La was amongst the many regions that suffered during this time. Geographic remoteness, lack of funding, and increasing medical costs made healthcare highly inefficient and unaffordable. Thus, by 2006, healthcare services were minimal at best in these areas (Brant et al. 2-4). Figure 2 is a map of China broken into the numerous provinces. The city that will be used for the purpose of this research is located in the Yunnan province in the southwest region (Brant et al.). 5 Figure 2: Map of Chinese Provinces Source: “Chinese Province Map” When discussing healthcare issues there are certain terms that are used ambiguously in common conversation; therefore, for clarity purposes, these terms will be defined to attach specific meaning for the purpose of this research. These terms will be used throughout the duration of the report and can be referenced in Table 1 below. TERM DEFINITION Accessibility The ability of citizens to receive the necessary healthcare services External Services Services provided away from the main healthcare facility campus Health Care Institution The healthcare facility or hospital itself Health Care System The healthcare facility and all other organizations that stem from the main facility Internal Services Practices that are performed within main healthcare facility Non-Metropolitan Region An area in which all cities have less than 50,000 citizens OSHA Federal agency that enforces health and safety regulations for American hospitals Quality Care The expectations that citizens have towards hospital facility and personnel Rural Region The population of an area of which there are 2500 citizens or less Cost-Shifting Process of increasing prices from one party to the next to offset costs Table 1: Definition of Health Care Terms Source: Sumaya 6 The first step necessary to compare and contrast the health care systems of both Blount County, Tennessee, and Shangri-La city of rural China will be to examine common injuries and illnesses that warrant the need for health care services. These ailments are the equivalent to the consumer demands of modern businesses. The most common injuries and illnesses that citizens of their respective communities experience are the driving force that dictates the appropriate health care services to be provided by the respective health care facility. This comparison will reveal both similarities and differences for the demand determinants for healthcare treatments in both Blount County and Shangri-La. Blount County: Demand for Health Care Non-metropolitan areas, such as Blount County, possess unique health statistics that differ greatly from other parts of the United States. As of 2004, Blount County ranked fourth in the state of Tennessee for total number of accidental deaths (“Tennessee Health Statistics”). A study performed by the U.S. Department of Health and Human Studies found, in the year 2000, the most common cause of death for Blount County citizens between the ages of 15 and 44 was due to injury. In 2001, the Center for Health Statistics completed research about Blount County that discovered a listing of common injuries within the community. Injuries that occurred with most frequently were motor- vehicle related, suffocation, poisoning, fire, falls, and drowning. These injuries resulted in a total of twenty-seven deaths and nearly half of which were motor vehicle related. The remainder of the death resulting injuries yielded no more than two over the course of the year. However, not all injuries have such dismal results (Community Health Status 5). 7 The largest majority of injuries is quite treatable and simply requires minor medical attention. Therefore, the next area of focus will discuss common causes for emergency room visits at Blount Memorial Hospital for the month of March in 2008. In 2007, Blount Memorial reported over 50,000 emergency rooms visits (Annual Board Report 11). Studies have shown that citizens who perform tasks that involve heavy lifting, over 20 pounds, or repetitive movements are most likely to incur sprains and strains, mostly in the back region (Ricketts 641). After viewing data from the Blount Memorial emergency department, it becomes quite clear that back problems are frequently a cause for injury in this community. In fact, of the top 75 diagnoses upon entry into the emergency department, there are six different categories designated for back injuries. If all back pain ailments were lumped into one category, it would render over 1800 cases in a single month for Blount Memorial. Other injuries that occupy the top of the diagnosis list are lacerations, contusions, and wound/suture checks.
Load more

Recommended publications
  • Vol. 3 No. 12 Mar. 19, 2021 the WORLD TB DAY ISSUE
    Vol. 3 No. 12 Mar. 19, 2021 THE WORLD TB DAY ISSUE Foreword Facing the Challenge of Tuberculosis: March 24, 2021 Towards “End TB in China by 2035” 243 Preplanned Studies National Proficiency Testing of Molecular Diagnostics for Tuberculosis and Drug Resistance Detection — China, 2014–2019 247 Implementation Performance of Tuberculosis Control in China: 2011–2020 252 Commentary Implementing New Approaches to THE CL CK IS TICKING Tuberculosis Control 256 The COVID-19 Pandemic and Elimination of Tuberculosis in China 260 China CDC Weekly Editorial Board Editor-in-Chief George F. Gao Deputy Editor-in-Chief Liming Li Gabriel M Leung Zijian Feng Executive Editor Feng Tan Members of the Editorial Board Xiangsheng Chen Xiaoyou Chen Zhuo Chen (USA) Xianbin Cong Gangqiang Ding Xiaoping Dong Mengjie Han Guangxue He Xi Jin Biao Kan Haidong Kan Qun Li Tao Li Zhongjie Li Min Liu Qiyong Liu Jinxing Lu Huiming Luo Huilai Ma Jiaqi Ma Jun Ma Ron Moolenaar (USA) Daxin Ni Lance Rodewald (USA) RJ Simonds (USA) Ruitai Shao Yiming Shao Xiaoming Shi Yuelong Shu Xu Su Chengye Sun Dianjun Sun Hongqiang Sun Quanfu Sun Xin Sun Jinling Tang Kanglin Wan Huaqing Wang Linhong Wang Guizhen Wu Jing Wu Weiping Wu Xifeng Wu (USA) Yongning Wu Zunyou Wu Fujie Xu (USA) Wenbo Xu Hong Yan Hongyan Yao Zundong Yin Hongjie Yu Shicheng Yu Xuejie Yu (USA) Jianzhong Zhang Liubo Zhang Rong Zhang Tiemei Zhang Wenhua Zhao Yanlin Zhao Zhijie Zheng (USA) Maigeng Zhou Xiaonong Zhou Advisory Board Director of the Advisory Board Jiang Lu Vice-Director of the Advisory Board Yu Wang Jianjun
    [Show full text]
  • Notifiable Respiratory Infectious Diseases in China
    International Journal of Environmental Research and Public Health Article Notifiable Respiratory Infectious Diseases in China: A Spatial–Temporal Epidemiology Analysis Ying Mao 1,2,*, Rongxin He 1,2, Bin Zhu 1,2,3 , Jinlin Liu 1,2,4 and Ning Zhang 1,2 1 School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China; [email protected] (R.H.); [email protected] (B.Z.); [email protected] (J.L.); [email protected] (N.Z.) 2 Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China 3 Department of Public Policy, City University of Hong Kong, Hong Kong 999077, China 4 Walter H. Shorenstein Asia-Pacific Research Center, Stanford University, Stanford, CA 94305, USA * Correspondence: [email protected]; Tel.: +86-029-8266-5482 Received: 19 October 2019; Accepted: 26 March 2020; Published: 29 March 2020 Abstract: Nowadays, tuberculosis, scarlet fever, measles, influenza, and mumps are five major notifiable respiratory infectious diseases (RIDs) in China. The objective of this study was to describe, visualize, and compare the spatial-temporal distributions of these five RIDs from 2006 to 2016. In addition to descriptive epidemiology analysis, seasonality and spatial autocorrelation analysis were also applied to explore the epidemiologic trends and spatial changing patterns of the five RIDs, respectively. The results indicated that the incidence of tuberculosis, measles, and mumps presented a downtrend trend, while those of scarlet fever and influenza was in a strong uptrend across the research period.
    [Show full text]
  • Tuberculosis Control in China
    Policy & practice Tuberculosis control in China: use of modelling to develop targets and policies Hsien-Ho Lin,a Lixia Wang,b Hui Zhang,b Yunzhou Ruan,b Daniel P Chinc & Christopher Dyed Abstract It is unclear if current programmes in China can achieve the post-2015 global targets for tuberculosis – 50% reduction in incidence and a 75% reduction in mortality by 2025. Chinese policy-makers need to maintain the recent decline in the prevalence of tuberculosis, while revising control policies to cope with an epidemic of drug-resistant tuberculosis and the effects of ongoing health reform. Health reforms are expected to shift patients from tuberculosis dispensaries to designated hospitals. We developed a mathematical model of tuberculosis control in China to help set appropriate targets and prioritize interventions that might be implemented in the next 10 years. This model indicates that, even under the most optimistic scenario – improved treatment in tuberculosis dispensaries, introduction of a new effective regimen for the treatment of drug-susceptible tuberculosis and optimal care of cases of multidrug-resistant tuberculosis – the current global targets for tuberculosis are unlikely to be reached. However, reductions in the incidence of multidrug-resistant tuberculosis should be feasible. We conclude that a shift of patients from tuberculosis dispensaries to designated hospitals is likely to hamper efforts at tuberculosis control if cure rates in the designated hospitals cannot be maintained at a high level. Our results can inform the planning of tuberculosis control in China. Introduction result of unsuccessful treatment in the hospital system, a large proportion of all incident MDR tuberculosis probably results In China, between 1990 and 2010, the prevalence of smear- from person-to-person transmission.
    [Show full text]
  • Evidence for Heterogeneity in China's Progress Against Pulmonary Tuberculosis: Uneven Reductions in a Major Center of Ongoing Transmission, 2005-2017
    UC Berkeley UC Berkeley Previously Published Works Title Evidence for heterogeneity in China's progress against pulmonary tuberculosis: uneven reductions in a major center of ongoing transmission, 2005-2017. Permalink https://escholarship.org/uc/item/8n706492 Journal BMC infectious diseases, 19(1) ISSN 1471-2334 Authors Li, Ting Cheng, Qu Li, Charles et al. Publication Date 2019-07-12 DOI 10.1186/s12879-019-4262-2 Peer reviewed eScholarship.org Powered by the California Digital Library University of California Li et al. BMC Infectious Diseases (2019) 19:615 https://doi.org/10.1186/s12879-019-4262-2 RESEARCHARTICLE Open Access Evidence for heterogeneity in China’s progress against pulmonary tuberculosis: uneven reductions in a major center of ongoing transmission, 2005–2017 Ting Li1†, Qu Cheng2†, Charles Li2, Everleigh Stokes2, Philip Collender2, Alison Ohringer2, Xintong Li3, Jing Li1, Jonathan L. Zelner4, Song Liang5, Changhong Yang6, Justin V. Remais2† and Jin’ge He1*† Abstract Background: China contributed 8.9% of all incident cases of tuberculosis globally in 2017, and understanding the spatiotemporal distribution of pulmonary tuberculosis (PTB) in major transmission foci in the country is critical to ongoing efforts to improve population health. Methods: We estimated annual PTB notification rates and their spatiotemporal distributions in Sichuan province, a major center of ongoing transmission, from 2005 to 2017. Time series decomposition was used to obtain trend components from the monthly incidence rate time series. Spatiotemporal cluster analyses were conducted to detect spatiotemporal clusters of PTB at the county level. Results: From 2005 to 2017, 976,873 cases of active PTB and 388,739 cases of smear-positive PTB were reported in Sichuan Province, China.
    [Show full text]
  • Epidemiology of Tuberculosis in Chongqing, China
    www.nature.com/scientificreports OPEN Epidemiology of tuberculosis in Chongqing, China: a secular trend from 1992 to 2015 Received: 12 January 2017 Bo Wu1,2, Ya Yu2, Weijia Xie1, Ying Liu2, Yao Zhang1, Daiyu Hu2 & Yafei Li1 Accepted: 3 July 2017 Chongqing is a southwest city of China with high tuberculosis (TB) burden. An observational Published: xx xx xxxx retrospective study has been performed based on routine TB surveillance data in Chongqing from 1992 to 2015. The TB notifcation rate has declined to 70.8 cases per 100,000 population from the peak of 106 cases per 100,000 in 2005. The TB notifcation rate in population over-65 years has become the highest among all-ages population since 2010. The average proportion of farmers in all notifed cases from 2008 to 2015 was 62.5%, and the notifcation rate of farmers has become the highest among all occupations since 2011. The TB notifcation showed a regional disparity in Chongqing. Despite the improvement achieved since 1992, the TB control eforts has been threatened by new challenges such as the demographic shift towards an aging population, the prevalence of MDR-TB and TB/HIV co-infection, and the regional disparity of TB notifcation. More efective interventions should be implemented. Our study can serve as a guidance for the future development of TB control in Chongqing, and we believe it has general relevance to TB control in other regions with similar situations. China is one of the top 22 countries with high tuberculosis (TB) burden, and has the third largest numbers of cases accounting for 10% of the global total1.
    [Show full text]
  • Scale-Up of a Comprehensive Model to Improve Tuberculosis Control in China
    Long et al. Infect Dis Poverty (2021) 10:41 https://doi.org/10.1186/s40249-021-00828-1 EDITORIAL Open Access Scale-up of a comprehensive model to improve tuberculosis control in China: lessons learned and the way forward Qian Long1, Fei Huang2†, Shi‑Tong Huan3† and Yan‑Lin Zhao2* Background the challenges of TB control in China continue to include Te World Health Organization’s End TB Strategy an increase in MDR-TB patients; poor patient adher- (2016–2035) sets the goal of ending the tuberculosis (TB) ence to TB treatment, particularly MDR-TB treatment; epidemic, in line with the United Nations Sustainable patients’ difculty in afording TB and MDR-TB care; and Development Goals [1, 2]. In addition to setting indica- low efciency of TB service delivery [3]. tors for measuring the decline in TB incidence and mor- Te National Health Commission (NHC) of China, tality, the End TB Strategy highlights the need to alleviate formerly the Ministry of Health, oversees the national the fnancial hardship faced by many TB-afected families program for TB and MDR-TB prevention and control [1]. Te international community has acknowledged that in China. With support from the Bill & Melinda Gates progress toward universal health coverage with a “whole Foundation, the NHC has, since 2009, developed an system” approach will be fundamental to achieving the innovative program to strengthen TB control, and the ambitious goal of ending TB globally. Many low- and China CDC led the implementation. Tis program, the middle-income countries with high TB burden struggle “China National Health Commission and Gates Founda- to aford and acquire new tools (e.g., new technologies tion TB Prevention and Control Project” (China-Gates and drugs for diagnosis and treatment) and adapt their TB project), was carried out in three phases, from 2009 health systems to strengthen TB control.
    [Show full text]
  • Three Patients with COVID-19 and Pulmonary Tuberculosis, Wuhan
    RESEARCH LETTERS We acknowledge that our assessment could be 7. Leung CC, Lam TH, Cheng KK. Mass masking in the limited by the application of retrospective and de- COVID-19 epidemic: people need guidance. Lancet. 2020;395:945. https://doi.org/10.1016/S0140-6736(20)30520-1 scriptive methods involving analyses of publicly available surveillance data. It is possible that the tem- Address for correspondence: Shui-Shan Lee, Stanley Ho Centre poral relationship between the seasonal influenza for Emerging Infectious Diseases, The Chinese University of pattern and social distancing strategy implementa- Hong Kong, 2/F Postgraduate Education Centre, Prince of Wales tion had occurred coincidentally by chance because Hospital, 32 Ngan Shing St, Shatin, Hong Kong, China; email: heterogeneity of influenza seasons is a well-known [email protected] phenomenon. Previous research suggested that de- spite the marked fluctuations of peak amplitudes and peak times, epidemic duration is often conserved (2). However, occurrence of a deformed seasonal pattern in the setting of the outbreak of infection with SARS- CoV-2 served as a natural experiment for supporting the evaluation of the impacts of social distancing in mitigating influenza virus transmission (6,7). Acknowledgment We thank the Li Ka Shing Institute of Health Sciences, Hong Kong, for providing technical support during the study. Three Patients with COVID-19 and Pulmonary About the Author Tuberculosis, Wuhan, China, Dr. Wong is a research assistant professor at the Stanley January–February 2020 Ho Centre for Emerging Infectious Diseases, the Chinese University of Hong Kong, Hong Kong, China. Her 1 1 1 1 primary research interests are epidemiology, HIV/AIDS, Zhi Yao, Junbo Chen, Qianli Wang, Weiyong Liu, 1 and spatial–temporal analyses.
    [Show full text]
  • Childhood Tuberculosis: a Preventable Disease Not Being Prevented
    Childhood Tuberculosis: A Preventable Disease Not Being Prevented In March 2012, childhood tuberculosis (TB) was the focus of World TB AUTHORS: Andrea T. Cruz, MD, MPH,a,b,c Anna M. Day. This neglected disease still accounts for at least 1 million annual Mandalakas, MD, MSEpi,a,d and Jeffrey R. Starke, MDa,c cases and 100 000 deaths in children. The World Health Organization aThe Tuberculosis Initiative of Texas Children’s Hospital, Houston, b c 1 Texas; and Sections of Emergency Medicine, Infectious (WHO) estimates that 9.7 million children have been orphaned by TB. Diseases, and dRetrovirology and Global Health, Department of The articles in this edition of Pediatrics by Wu et al2 from China Pediatrics, Baylor College of Medicine, Houston, Texas and Winston and Menzies3 from the United States remind us of the ABBREVIATIONS ongoing scourge of this ancient disease in both high- and low- LTBI—latent tuberculosis infection prevalence countries and highlight many issues that need to be TB—tuberculosis TST—tuberculin skin test addressed to control it. WHO—World Health Organization The study from the Beijing Children’s Hospital reveals the continued Dr Cruz conceptualized the commentary, drafted the initial high global morbidity and mortality of childhood TB. This study details article, and approved the final article as submitted; Dr Mandalakas conceptualized the commentary, reviewed and many unsolved problems in childhood TB globally: huge burden of revised the article, and approved the final article as submitted; disease; high propensity for severe forms of extrapulmonary disease; and Dr Starke conceptualized the commentary, reviewed and incomplete protection afforded by BCG vaccines; diagnostic delays; revised the article, and approved the final article as submitted.
    [Show full text]
  • A Long-Term Trend Study of Tuberculosis Incidence in China, India and United States 1992–2017: a Joinpoint and Age–Period–Cohort Analysis
    International Journal of Environmental Research and Public Health Article A Long-Term Trend Study of Tuberculosis Incidence in China, India and United States 1992–2017: A Joinpoint and Age–Period–Cohort Analysis Yiran Cui 1, Hui Shen 1, Fang Wang 1, Haoyu Wen 1, Zixin Zeng 1, Yafeng Wang 1 and Chuanhua Yu 1,2,* 1 Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China; [email protected] (Y.C.); [email protected] (H.S.); [email protected] (F.W.); [email protected] (H.W.); [email protected] (Z.Z.); [email protected] (Y.W.) 2 Global Health Institute, Wuhan University, Wuhan 430071, China * Correspondence: [email protected]; Tel.: +86-27-687-592-99 Received: 25 March 2020; Accepted: 8 May 2020; Published: 11 May 2020 Abstract: Tuberculosis (TB) is one of the major infectious diseases with the largest number of morbidity and mortality. Based on the comparison of high and low burden countries of tuberculosis in China, India and the United States, the influence of age-period-cohort on the incidence of tuberculosis in three countries from 1992 to 2017 was studied based on the Global burden of Disease Study 2017. We studied the trends using Joinpoint regression in the age-standardized incidence rate (ASIR). The regression model showed a significant decreasing behavior in China, India and the United States between 1992 and 2017. Here, we analyzed the tuberculosis incidence trends in China, India, as well as the United States and distinguished age, period and cohort effects by using age-period-cohort (APC) model.
    [Show full text]
  • First Independent Evaluation of Quantiferon-TB Plus Performance
    11 Ministry of Health of the People’s Republic of China. National Tuberculosis Control Programme (2006–2010). Beijing, Ministry of Health, 2006. 12 Chen S, Liu B, Wang X, et al. Analysis of human resource situation about TB control in Zhejiang. Chin J Antituberc 2006; 28: 345–347. 13 Zhao Y, et al. National survey of drug-resistant tuberculosis in China. N Engl J Med 2012; 366: 2161–2170. 14 Li W, Sun Q, Yan Y, et al. Investigation of the second line anti TB drugs usage in specialist hospitals and tuberculosis control institutions. Chin J Antituberc 2010; 32: 706–709. 15 Liu X, Wang L, Du Y, et al. Current status of case referring and treatment of tuberculosis inpatients in four tuberculosis specialist hospitals in China. Chin J Antituber 2010; 32: 775–778. Eur Respir J 2016; 47: 1584–1587 | DOI: 10.1183/13993003.01854-2015 | Copyright ©ERS 2016 First independent evaluation of QuantiFERON-TB Plus performance To the Editor: Tuberculosis elimination requires an effective strategy to diagnose and treat people infected with Mycobacterium tuberculosis who would otherwise be at high risk of developing and transmitting active disease [1, 2]. The diagnostic tools for latent tuberculosis infection (LTBI) are the tuberculin skin test (TST) and the T-cell interferon-γ release assays (IGRAs). Two IGRAs are commercially available, QuantiFERON-TB Gold In-Tube (QFT-GIT) (Qiagen, Hilden, Germany) and T-SPOT.TB (Oxford Immunotec, Abingdon, UK). Compared to the TST, IGRAs offer operational advantages and higher specificity in the bacille Calmette–Guérin (BCG)-vaccinated population [3], and they are at least as sensitive for LTBI [4].
    [Show full text]
  • Human Resources for Tuberculosis Care in China: Gaps and Challenges from a Physicians’ Perspective
    Human Resources for Tuberculosis Care in China: Gaps and Challenges from a Physicians’ Perspective By Lei Guo Graduate Program in Global Health Duke Kunshan University and Duke University Date:_______________________ Approved: ___________________________ Shenglan Tang, Supervisor ___________________________ Truls Ostbye ___________________________ Xiaoyun Liu Thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in the Graduate Program in Global Health in the Graduate School of Duke Kunshan University and Duke University 2018 ABSTRACT Human Resources for Tuberculosis Care in China: Gaps and Challenges from a Physicians’ Perspective By Lei Guo Graduate Program in Global Health Duke Kunshan University and Duke University Date:_______________________ Approved: ___________________________ Shenglan Tang, Supervisor ___________________________ Truls Ostbye ___________________________ Xiaoyun Liu An abstract of a thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in the Graduate Program in Global Health in the Graduate School of Duke Kunshan University and Duke University 2018 Copyright by Lei Guo 2018 Abstract The human resources for health is one of the key building blocks in tuberculosis control. As the implementer of disease control policies and medical practices, physicians are at a core position for the health of tuberculosis patients. Unfortunately, while the tuberculosis control system is under the transition to the Trinity Model nationwide, little attention was paid to this particular workforce. This study filled the gap of little information about the challenges of tuberculosis physicians by researching on the gaps and challenges of tuberculosis physicians at prefecture‐city and county level. A mixed method approach was used to collect both quantitative and qualitative data through survey and in‐depth interview with physicians, directors of clinical departments and officials at disease control agencies.
    [Show full text]
  • The Chinese Hukou System & Its Impacts on Healthcare for Rural-To
    The Chinese Hukou System & its Impacts on Healthcare for Rural-to-Urban Migrants A Case Study of Tuberculosis Treatment Access in Urban Centres by Samantha Veronica Samuels 5202611 A Masters Research Paper Submitted to the Faculty of Graduate and Postdoctoral Studies in Fulfilment of the Requirements for Obtaining a Master of Arts in Globalization and International Development School of International Development & Global Studies Faculty of Social Sciences April 2017 ©Samantha Samuels, Ottawa, 2017 Table of Contents Acknowledgements ................................................................................................................................. i Abstract .................................................................................................................................................iii Résumé .................................................................................................................................................. iv List of Figures ....................................................................................................................................... vi List of Tables ........................................................................................................................................ vii Chapter 1: Introduction .......................................................................................................................... 1 1.1 Context .........................................................................................................................................
    [Show full text]