Federico Girosi

Reducing the Global Burden of Tuberculosis: The Contribution of Improved Diagnostics

We estimated the impact of hypothetical new diagnostic tests for tuberculosis (TB) in patients with persistent cough in developing countries. We found that a variety of new tests could help better identify TB cases and target treatment, thereby reducing the burden of disease.

Reducing the burden of childhood malaria in Africa: the role of improved

Malaria kills > 1 million children aged < 5 years in sub-Saharan Africa annually. Current control efforts are hampered by increasing drug resistance, unreliable diagnostics, widespread overtreatment and rising drug costs. In this environment, new and widely available malaria diagnostics have the potential to save lives and drastically reduce overtreatment.

Developing and Interpreting Models to Improve Diagnostics in Developing Countries

Developing a strategy for investment in diagnostic technologies requires an understanding of the need for, and the health impact of, potential new tools, as well as the necessary performance characteristics and user requirements. In this paper, we outline an approach for modelling the health benefits of new diagnostic tools.

Reducing stunting among children: the potential contribution of diagnostics

Stunting affects ~ 147 million children in developing countries. Studies have pointed to a relationship between stunting and different pathogens that are associated with diarrhoeal illness. New easy-to-use tools for diagnosing these pathogens could help to identify children at risk for growth shortfall, and reduce the prevalence of stunting and the large burden of disease associated with it.PREFACE The numbers of acquired immunodeficiency syndrome (AIDS)-related deaths among infants in developing countries are exceptionally high, largely because human immunodeficiency virus (HIV) infection remains undiagnosed in many cases. Current HIV testing methods are either impractical for developingcountry settings or inaccurate for use in infants. There is an urgent need to develop and deploy a new, easy-to-use HIV test, which could transform the management of paediatric HIV/AIDS in developing countries and avert millions of infant deaths.

The Benefits of Risk Factor Prevention in Americans Aged 51 Years and Older

OBJECTIVES We assessed the potential health and economic benefits of reducing common risk factors in older Americans. METHODS A dynamic simulation model tracked a national cohort of persons 51 and 52 years of age to project their health and medical spending in prevention scenarios for diabetes, hypertension, obesity, and smoking. RESULTS The gain in life span from successful treatment of a person aged 51 or 52 years for obesity would be 0.85 years; for hypertension, 2.05 years; and for diabetes, 3.17 years. A 51- or 52-year-old person who quit smoking would gain 3.44 years. Despite living longer, those successfully treated for obesity, hypertension, or diabetes would have lower lifetime medical spending, exclusive of prevention costs. Smoking cessation would lead to increased lifetime spending. We used traditional valuations for a life-year to calculate that successful treatments would be worth, per capita,

Prevalence and sociodemographic correlates of DSM-5 eating disorders in the Australian population

198,018 (diabetes),

Reducing the burden of sexually transmitted infections in resource-limited settings: the role of improved diagnostics.

137,964 (hypertension),

Reducing the global burden of acute lower respiratory infections in children: the contribution of new diagnostics

118,946 (smoking), and

Clustering Multivariate Time Series Using Hidden Markov Models

51,750 (obesity). CONCLUSIONS Effective prevention could substantially improve the health of older Americans, and--despite increases in longevity--such benefits could be achieved with little or no additional lifetime medical spending.

Modeling Health Care Policy Alternatives

BackgroundNew DSM-5 diagnostic criteria for eating disorders were published in 2013. Adolescent cohort studies in the Australian community indicate that the point prevalence of DSM-5 eating disorders may be as high as 15% in females and 3% in males. The goal of the current study was to determine the 3-month prevalence of DSM-5 disorders in a representative sample of Australian older adolescents and adults. A secondary aim was to explore the demographic correlates of these disorders, specifically, age, gender, income, and educational attainment and presence of obesity.MethodsWe conducted and merged sequential cross-sectional population survey data of adults (aged over 15 years) collected in 2008 and in 2009 (n = 6041). Demographic information and the occurrence of regular (at least weekly over the past 3 months) objective and subjective binge eating, extreme dietary restriction, purging behaviors, and overvaluation of weight and/or shape, were assessed.ResultsThe 3-month prevalence of anorexia nervosa and bulimia nervosa were both under 1% whereas the prevalence of binge eating disorder (BED) and sub-threshold BED were 5.6-6.9%. The prevalence of BED including overvaluation of weight/shape was 3%. Other specified and unspecified eating disorders including purging disorder were less common, under 1% to 1.4%. While people with eating disorders were generally younger than others, the mean age was in the fourth decade for anorexia nervosa and bulimia nervosa and in the fourth or fifth decade for all other disorders. Most people with eating disorders had similar household incomes and educational attainments to the general population. People with bulimia nervosa, BED and sub-threshold bulimia nervosa were more likely to be obese than people without an eating disorder.ConclusionsThe findings support the expanded demographic distribution of eating disorders. There is a relatively high prevalence of BED compared to anorexia nervosa and bulimia nervosa. As it is in BED, obesity is a very common co-morbidity in bulimia nervosa.