Down syndrome in  adults: success and challenge

Gorzoni, Milton Luiz; Pinto, Carla; Ferreira, Aleksandro Belo

doi:10.5327/z2447-211520191900022

Cited by 3 publications

(7 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to the Thailand Migration Report 2019, migrant workers contributed only 4.3-6.6% of Thailand's GDP [20], thus labor productivity in this study was relied on the average GDP per worker in 2021. In this study, we calculated the productivity loss of both caregivers and T21 patients with the average expected survival of 50 years [2], while we considered the productivity loss of only caregivers for T13 and T18 patients who had average survival of only one year according to published studies [1,21,22]. Therefore, productivity loss of caregivers for T21 patients was estimated by the average expected survival of 50 years, since caregivers have to leave their jobs for caring multiplied by the Thai GDP per capita per year (7,233.4 USD) [23], whereas that of patients with T21 was estimated by the average expected working year of T21 patients (35 years) i.e., average survival years (50 years) minus working age adults at 15 years multiplied by the Thai GDP per capita per year.…”

Section: Plos Onementioning

confidence: 99%

“…Indirect costs GDP per capita per year [23] Annual income growth rate [24] Discount rate [19] Survival of patients with T13 [1] Survival of patients with T18 [1] Survival of patients with T21 [2] https://doi.org/10.1371/journal.pone.0291918.t001…”

Section: Average Length Of Stay Hospital Databasementioning

confidence: 99%

“…Aneuploidies or chromosomal abnormalities affecting 0.5 to 1.0% of live births may cause a variety of health problems, with trisomy 21, 18, and 13 being the most prevalent [1]. One in every 700-800 live births is affected with trisomy 21 (T21) or Down syndrome, and the average life expectancy of those affected has grown by 50 years in the last century [2]. There are several clinical issues with varying degrees of severity, including poor muscle tone, intellectual and developmental disabilities, heart disease, gastrointestinal defect, hematologic abnormalities, are ethical restrictions on publicly sharing a sensitive data set.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Economic cost of patients with trisomy 13, 18, and 21 in a tertiary hospital in Thailand

Wongkrajang,

Jittikoon,

Udomsinprasert

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

The purpose of this study was to determine direct and indirect costs of patients with trisomy (T) 13, 18, and 21 in Thailand. Direct medical costs were obtained from Siriraj Informatics and Data Innovation Center (SiData+), Faculty of Medicine, Siriraj Hospital, and indirect costs were estimated using a human capital approach. About 241 patients with T21 had outpatient care visits and 124 patients received inpatient care. For T13 and T18, five and seven patients were analyzed for outpatient and inpatient cares, respectively. For patients with T13, T18, and T21 receiving outpatient care, total annual mean direct medical costs ranged from 183.2 USD to 655.2 USD. For inpatient care, average yearly direct medical costs varied between 2,507 USD to 14,790 USD. The mean and median increased with age. In outpatient care, costs associated with drugs and medical devices were a major factor for both T13 and T21 patients, whereas laboratory costs were substantial for T18 patients. For inpatient care, costs of drug and medical devices were the greatest for T13 patients, while service fee and operation costs were the highest for T18 and T21 patients, respectively. For outpatient care, adult patients with congenital heart disease (CHD) had significantly higher mean annual direct medical costs than those without CHD. However, all adult and pediatric patients with CHD receiving inpatient care had significantly higher costs. Patients with T13, T18, and T21 had relative lifetime costs of 22,715 USD, 11,924 USD, and 1,022,830 USD, respectively.

show abstract

Section: Plos Onementioning

confidence: 99%

Section: Average Length Of Stay Hospital Databasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Economic cost of patients with trisomy 13, 18, and 21 in a tertiary hospital in Thailand

Wongkrajang,

Jittikoon,

Udomsinprasert

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Life expectancy of individuals with DS has increased considerably in recent years, resulting in an increasing number of adults with DS 2 . This adult population suffers from complications in addition to those already presented in the pediatric period (facial changes, malformed limbs, affected skin and muscles, atrioventricular abnormalities, and higher incidence of leukemia, among others) 3 . As these individuals age, they may present more immunological and metabolic disorders, with obesity and dyslipidemia being prevalent, 4 as well as early senile dementia and neurodegenerative processes 5 .…”

Section: Introductionmentioning

confidence: 99%

“…2 This adult population suffers from complications in addition to those already presented in the pediatric period (facial changes, malformed limbs, affected skin and muscles, atrioventricular abnormalities, and higher incidence of leukemia, among others). 3…”

mentioning

confidence: 99%

Identifying metabolic parameters related to severity and extent of periodontitis in down syndrome patients

Mouchrek

Franco

Silva

et al. 2022

J of Periodontal Research

View full text Add to dashboard Cite

Background and Objective Systemic metabolic status and periodontitis can be related in patients with Down syndrome (DS). The objective of this study was to identify metabolic indicators (anthropometric measurements, blood pressure, and serum markers) related to severity and extent of periodontitis in DS patients. Methods A cross‐sectional study was conducted with 49 patients with DS. Periodontal evaluation included the periodontal probing depth (PPD), clinical attachment level (CAL), gingival bleeding index (GBI), and visible plaque index (VPI). Periodontitis severity was classified by the stages system. The extent of periodontitis was assessed as the percentage of sites with CAL ≥3 mm, CAL ≥4 mm, PPD ≥4 mm, and PPD ≥5 mm. The metabolic condition of the participants was determined by analyzing anthropometric parameters, blood pressure, and serum markers. Data were analyzed using the Mann–Whitney test, Spearman's correlation coefficient, and multivariate regression analysis. Results Periodontitis stage 3/4 was detected in 32.7% of patients, with high values of VPI (54.6 ± 35.8) and GBI (42.4 ± 33.3). The severity of periodontitis was related to higher mean corpuscular hemoglobin (β = .291, p = .028) and mean corpuscular volume values (β = .293, p = .046). Arm circumference measurements were inversely related to CAL ≥3 mm (β = −.408, p = .023), PPD ≥4 mm (β = −.475, p = .006), and PPD ≥5 mm (β = −.443, p = .010). Conclusions The findings suggest that the severity and extent of periodontitis may be related to some metabolic parameters in DS patients.

show abstract

Economic evaluation of prenatal screening for fetal aneuploidies in Thailand

Wongkrajang,

Jittikoon,

Udomsinprasert

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

Historically, there has been a lack of cost-effectiveness data regarding the inclusion of universal non-invasive prenatal testing (NIPT) for trisomy 21, 18, and 13 in the benefit package of the Universal Health Coverage (UHC) in Thailand. Therefore, this study aimed to perform the cost-benefit analysis of prenatal screening tests and calculate the budget impact that would result from the implementation of a universal NIPT program. A decision-tree model was employed to evaluate cost and benefit of different prenatal chromosomal abnormalities screenings: 1) first-trimester screening (FTS), 2) NIPT, and 3) definitive diagnostic (amniocentesis). The comparison was made between these screenings and no screening in three groups of pregnant women: all ages, < 35 years, and ≥ 35 years. The analysis was conducted from societal and governmental perspectives. The costs comprised direct medical, direct non-medical, and indirect costs, while the benefit was cost-avoidance associated with caring for children with trisomy and the loss of productivity for caregivers. Parameter uncertainties were evaluated through one-way and probabilistic sensitivity analyses. From a governmental perspective, all three methods were found to be cost-beneficial. Among them, FTS was identified as the most cost-beneficial, especially for pregnant women aged ≥ 35 years. From a societal perspective, the definitive diagnostic test was not cost-effective, but the other two screening tests were. The most sensitive parameters for FTS and NIPT strategies were the productivity loss of caregivers and the incidence of trisomy 21. Our study suggested that NIPT was the most cost-effective strategy in Thailand, if the cost was reduced to 47 USD. This evidence-based information can serve as a crucial resource for policymakers when making informed decisions regarding the allocation of resources for prenatal care in Thailand and similar context.

show abstract

Down syndrome in adults: success and challenge

Cited by 3 publications

References 36 publications

Economic cost of patients with trisomy 13, 18, and 21 in a tertiary hospital in Thailand

Economic cost of patients with trisomy 13, 18, and 21 in a tertiary hospital in Thailand

Identifying metabolic parameters related to severity and extent of periodontitis in down syndrome patients

Economic evaluation of prenatal screening for fetal aneuploidies in Thailand

Contact Info

Product

Resources

About