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dc.contributor.advisorSejong Bae
dc.creatorPasipanodya, Jotam Garaimunashe
dc.description.abstractPasipanodya, Jotam G. Disability-Adjusted Life Years lost due to adult pulmonary tuberculosis in Tarrant County, 2005-2006: An analysis of the role of post tuberculosis impairment. Doctor of Public Health (Health Management and Policy), May 2008. 145 pages, 18 tables, 11 illustrations, 135 references. Pulmonary impairment after tuberculosis treatment (PIAT) is not yet incorporated in assessing burden of tuberculosis. Previous global and national TB burden estimates therefore did not fully reflect the consequences of surviving tuberculosis disease. This study was conducted to assess burden of TB in Tarrant County, Texas, using Disability-Adjusted Life Years (DALY). DALY is a composite measure of premature mortality and disability that equates years of healthy life lost. DALY, stratified by gender and race were calculated for 118 adult TB subjects seen between July 2005 and October 2006. Years of Life Lost (YLL) were calculated from the difference between standard life expectancy and age at death from TB, summed across county population. Years Lived with Disability (YLD) were derived from age and gender-specific disease incidence weight-adjusted for impairment levels; using disability weights obtained from literature. Three percent discount rate per year was used. One hundred and eighteen subjects lost 444.25 DALY during the study period. Years of life lost to premature mortality (YLL) contributed 159.62 (36%) and years of life lived with disability (YLD) contributed majority of total DALY. Pulmonary impairment after tuberculosis (YLD PIAT) contributed 234.6 (53%), while YLD Acute contributed only 50.03 (11 %) of total DALYS. Contrary to previous estimates; disability contributes more than mortality to TB burden in areas with low TB adult and child mortality. PIA T contributes significantly to TB burden, but was previously unrecognized. These findings suggest that the greatest health savings will be achieved through strategies to prevent tuberculosis from developing rather than strategies to shorten treatment once it has developed.
dc.subjectEconomic Policy
dc.subjectHealth Policy
dc.subjectMedicine and Health Sciences
dc.subjectOther Public Health
dc.subjectPublic Affairs, Public Policy and Public Administration
dc.subjectPublic Health
dc.subjectRespiratory Tract Diseases
dc.subjectSocial and Behavioral Sciences
dc.subjectpulmonary impairment
dc.subjecttuberculosis treatment
dc.subjectTarrant County
dc.subjectDisability-Adjusted Life years
dc.subjectYears Lived With Disability
dc.subjectYears of Life Lost
dc.subjecthealth savings
dc.titleDisability-Adjusted Life Years Lost Due to Adult Pulmonary Tuberculosis in Tarrant County, 2005-2006: An Analysis of the Role of Post Tuberculosis Impairment
dc.typeDissertation of Public Health Management and Policy of North Texas Health Science Center at Fort Worth of Public Health
dc.contributor.committeeMemberKristine Lykens
dc.contributor.committeeMemberPeter Hilsenrath

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