Hypertension affects more than a quarter of the world adult population, with ruralurban disparities. In Côte d’Ivoire, the prevalence was 21.7% in 2005. The aim of this study was to determine factors associated with hypertension in a peri-urban community in Abidjan. A cross-sectional study was conducted at Anonkoi 3 a peri-urban area in Abidjan. The sample was of 360 subjects aged 18 and older. Behavioral, anthropometric and blood pressure characteristics were determined using WHO STEPS questionnaire and multivariate logistic regression was performed. Prevalence of hypertension was 18.61%. Subjects were low fruit and vegetable consumption (3.3%), low level of physical activity (64.2%) and abdominal obesity at 40%. The risk of hypertension was significant from age 45, in subjects living with a partner and in those with low level of physical activity. Health education programs are essential to prevent cardiovascular risks.

Personal hygiene has an impact on the health, quality of life and academic performance of schoolchildren. The factors associated with it can be complex. We carried out our analysis based on a database on hookworms in schoolchildren in Côte d'Ivoire. This is a cross-sectional retrospective study, on 2,035 schoolchildren recruited from 30 schools in the western region of Côte d'Ivoire. The predictors of good personal hygiene for schoolchildren were the existence of a good level of sanitation at home (OR = 1.62; 95% CI = 1.24–2.13) and a primary school education as the minimum level of education for the father (OR = 1.48; 95% CI = 1.12–1.96). In contrast, students below the age of ten attending poor sanitary establishments are more likely to have poor personal hygiene (OR = 0.40; 95% CI = 0.22–0.73); therefore, it becomes necessary to provide good basic environmental sanitation for families and schools.

Objectives: To evaluate the cost-effectiveness of ranibizumab compared with laser photocoagulation or no treatment (observation) in patients with macular edema secondary to branch retinal vein occlusion (BRVO-ME) and macular edema secondary to central retinal vein occlusion (CRVO-ME), respectively, from the Chinese societal perspective. Methods: A Markov model was constructed to simulate the longterm outcomes and costs of Chinese BRVO-ME and CRVO-ME patients. Model health states were defined by increments of 10 letters in best corrected visual acuity (BCVA) ranging from # 25 letters to 86-100 letters, with an extra absorbing state 'death'. Lifetime horizon was used, with a 1-month cycle length. Transition probabilities were calculated from the BLOSSOM clinical trial and CAMELLIA clinical trial. Health state utilities were estimated through literature, and costs were estimated from experts consultation of 6 hospitals in China and published literature. The primary outcomes of the model were costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). Uncertainty was addressed via univariate and probabilistic sensitivity analyses. Results: For BRVO-ME patients, lifetime costs of ranibizumab and laser photocoagulation were U80,834 and U44,799, respectively; lifetime QALYs gained were 8.95 and 8.31, respectively. Adopting a willingness to pay of U180,000/ QALY (3 times per-capita GDP, 2017 China) as the threshold, ranibizumab was found to be cost-effective compared with laser photocoagulation, with the ICER of U56,303/QALY. For CRVO-ME patients, lifetime costs of ranibizumab and observation were U120,246 and U117,757, respectively; lifetime QALYs gained were 9.48 and 8.93, respectively. Ranibizumab was found to be cost-effective compared with observation, with the ICER of U4,525/QALY. Univariate and probabilistic sensitivity analysis demonstrated the robustness of the results. Conclusions: From Chinese societal perspective, ranibizumab is the cost-effective therapy for both the treatment of BRVO-ME and CRVO-ME when compared to laser photocoagulation and observation, respectively.

Objectives: Cancer drugs shortages have a significant impact on patient access to essential treatment. This study shows the extent of cancer drugs shortages in Romania during 2015-2017 and analyses for the first time its causes. The study proposes a framework which can be used for identification of cancer drugs with high risk of shortage. Methods: Complains officially notified to the Romanian health authorities were obtained and analyzed. The status of pharmaceuticals reimbursed under the publicly-funded National Oncology Program was analyzed in terms of availability on the market, price and parallel trade. A decision tree to identify the risk of shortages was developed. Main causes of shortages risk were identified. The analysis was performed separately for each pharmaceutical product and generic alternatives were included. Results: During 2015-2017, a number of 2683 complains of shortages were registered, with a peak of 741 during the first half of 2017. Available administrative data shows that from the 113 cancer medicines analyzed, 17 INNs were temporary unavailable on the Romanian market, 8 had their market authorization withdrawn, 39 were at least once parallel traded, 9 were more expensive than in the referenced EU countries thus not complying with the national regulations on external reference pricing, and 1 was registered with manufacturing difficulties. Results at product level are also available. By applying the decision tree developed, 13 cancer drugs were identified as having a high shortage risk. Shortage risk causes were identified, with the biggest preponderance being parallel trade, followed by pricing and regulatory policies, manufacturers' commercial interest and manufacturing difficulties. Conclusions: Cancer drugs status should be periodically monitored in order to identify those with a high shortage risk and to enable early mitigation actions of the highly negative shortages impact on patients. Policy tools and frameworks can be developed to implement proactive mechanisms.

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