Knut Lönnroth
Biographic Data
| ID | 1739807 |
|---|---|
| NAME | Knut Lönnroth |
| GIVEN NAMES | Knut |
| FAMILY NAME | Lönnroth |
| SIGNATURE | LÖNNROTH K |
| AFFILIATIONS | Karolinska Institutet |
| ORCID | 0000-0001-6944-0256 |
| VERIFIED | Yes |
| TOTAL WORKS | 26 |
| TOTAL CITATIONS | 41 |
| AUTHOR COUNT | 26 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2001 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Association Between Mental Health Screening and Healthcare Utilization Among Refugees and Asylum Seekers in Sweden
Background: Asylum seekers and refugees are at increased risk of mental illness. Previous research suggests underutilization and delayed access to care in this the population. This study aims to explore if screening during a health examination is associated with mental health care utilization among refugees and asylum seekers. Methods: A retrospective cohort study examined mental healthcare utilization patterns during the five months following vo…
Estimating the impact of nutritional transition and ending hunger on tuberculosis in 12 high-burden countries
BACKGROUND: Nutrition is a critical determinant of tuberculosis (TB), providing a protective effect at high body mass index (BMI) and incurring an increased risk of TB disease at low BMI. Global nutritional transition and interventions to end hunger could directly affect the TB epidemic in high TB burden countries. METHODS: We constructed dynamic TB transmission models for 12 high TB burden countries with low HIV prevalence. We explicitly account…
Identifying mechanisms by which social determinants of health impact TB diagnostic evaluation uptake in Uganda
Biomedical interventions alone are unlikely to address the spectrum of SDoH-related barriers to equitable completion of TB diagnostic evaluation. Linking barriers to a behavior change model such as COM-B may help guide the design and evaluation of appropriate people-centered strategies that integrate social and economic supports with clinical and public health programs or services
One year on - the long-term impact of Covid-19 pandemic and government restrictions on the health-seeking behaviour, financial security and mental health of TB survivors
Clinical trial number: not applicable
Understanding treatment initiation pathways and associated costs among people with pulmonary tuberculosis in a peri-urban area of Mozambique
Most people with TB symptoms sought care within two weeks but TB treatment initiation was delayed to nearly two months after symptoms onset. This suggests that delays in TB treatment initiation may be attributable to health system factors rather than the care-seeking behaviour of people with TB in Maputo, Mozambique. Additionally, there was a substantial financial burden of care-seeking exacerbated by additional healthcare provider visits. Eviden…
They didn’t look at me with good eyes' – experiences of the socioeconomic impact of tuberculosis and support needs among adults in a semi-rural area in Mozambique
Tuberculosis is recognised as a disease of the economically disadvantaged people due to its association with financial vulnerability. Mozambique still faces the challenge of the high burden of TB and associated costs. We aimed to understand the social and economic impacts of TB and the need for social support among people with TB in Mozambique. We conducted a qualitative study using a phenomenological approach focusing on the lived experiences an…
A qualitative assessment on the acceptability of providing cash transfers and social health insurance for tuberculosis-affected families in Ho Chi Minh City, Vietnam
To achieve the Sustainable Development Goal’s targets of universal health coverage (UHC) and poverty reduction, interventions are required that strengthen and harmonize both UHC and social protection. Vietnam is committed to achieving financial protection and over 90% of the general population has enrolled in its social health insurance (SHI) scheme. However, an estimated 63% of tuberculosis (TB)-affected households in Vietnam still face catastro…
Determinants of catastrophic costs among households affected by multi-drug resistant tuberculosis in Ho Chi Minh City, Viet Nam
Despite good social protection coverage, most people with MDR-TB in HCMC experienced catastrophic costs. Incurrence of catastrophic costs was independently associated with being the household's primary income earner or being unemployed. Revision and expansion of strategies to mitigate TB-related catastrophic costs, in particular avoiding unemployment and income loss, are urgently required
TB morbidity estimates overlook the contribution of post-TB disability
Introduction Despite growing evidence of the long-term impact of tuberculosis (TB) on quality of life, Global Burden of Disease (GBD) estimates of TB-related disability-adjusted life years (DALYs) do not include post-TB morbidity, and evaluations of TB interventions typically assume treated patients return to pre-TB health. Using primary data, we estimate years of life lost due to disability (YLDs), years of life lost due to premature mortality (…
Adaptation of WHO’s generic tuberculosis patient cost instrument for a longitudinal study in Africa
The WHO developed a generic ‘TB patient cost survey’ tool and a standardized approach to assess the direct and indirect costs of TB incurred by patients and their households, estimate the proportion of patients experiencing catastrophic costs, and measure the impact of interventions to reduce patient costs. While the generic tool is a facility-based cross-sectional survey, this standardized approach needs to be adapted for longitudinal studies. A…
How to reduce household costs for people with tuberculosis
The aim of this study was to compare costs and socio-economic impact of tuberculosis (TB) for patients diagnosed through active (ACF) and passive case finding (PCF) in Nepal. A longitudinal costing survey was conducted in four districts of Nepal from April 2018 to October 2019. Costs were collected using the WHO TB Patient Costs Survey at three time points: intensive phase of treatment, continuation phase of treatment and at treatment completion.…
Income security in times of ill health
international interdisciplinary research network. SPARKS' multi-sectoral team characterizes and evaluates the direct and indirect effects of social protection strategies on health, economic, and wider outcomes
Income security during public health emergencies
The COVID-19 poverty trap is shaped by barriers to accessing prevention, vulnerability to economic disruption and financial uncertainties, and incurrence of catastrophic costs as people try to cope with the outbreak. To ensure socioeconomic stability and confidence during public health crises and in the long run, social protection schemes (e.g. social insurance, microfinancing) must be in place to help people cope with the loss of income security…
Income security during periods of ill health
The COVID-19 pandemic is a reminder that insufficient income security in periods of ill health leads to economic hardship for individuals and hampers disease control efforts as people struggle to stay home when sick or advised to observe quarantine. Evidence on income security during periods of ill health is growing but has not previously been reviewed as a full body of work concerning low-income and middle-income countries (LMICs). We performed …
Build back stronger universal health coverage systems after the Covid-19 pandemic
box The need for a systemic approach to complex challenges and for better understanding the relationship between population health and its economic consequences have been recognised for years as the basis towards sustainable solutions in global health. The emergence of a movement promoting Universal Health Coverage (UHC) as the ultimate means to ensuring equitable access to health for all people, raised the attention to the importance of re-imagi…
A comparative impact evaluation of two human resource models for community-based active tuberculosis case finding in Ho Chi Minh City, Viet Nam
Both salaried and volunteer CHW human resource models demonstrated additionality in case notifications compared to routine case finding by the government TB program. The salaried employee CHW model achieved a greater impact on notifications and should be prioritized for scale-up, given sufficient resources
Diagnostic pathways and delay among tuberculosis patients in Stockholm, Sweden
Screening at a health examination was the main pathway of active TB detection among mainly asymptomatic and non-contagious asylum seekers but contributed modestly to total overall TB case detection. In these patients TB was diagnosed early in a non-contagious phase of the disease. Further research is required to assess the effectiveness and cost-effectiveness of HE TB screening as well as inclusion of other groups of migrants from high incidence …
Modelling the impact of social protection on tuberculosis
Results are to be confirmed with further analysis. However, by developing a generalizable modelling framework, S-PROTECT proved that the modelling of social protection is complex, but doable and allowed to draw the research road map for the future in this field
WHO's new End TB Strategy
Financial burden for tuberculosis patients in low- and middle-income countries
In order to inform the development of appropriate strategies to improve financial risk protection, we conducted a systematic literature review of the financial burden of tuberculosis (TB) faced by patients and affected families. The mean total costs ranged from $55 to $8198, with an unweighted average of $847. On average, 20% (range 0–62%) of the total cost was due to direct medical costs, 20% (0–84%) to direct non-medical costs, and 60% (16–94%)…
A descriptive study of TB cases finding practices in the three largest public general hospitals in Vietnam
Chest X-ray is the preferred first test for TB in the largest hospitals in Vietnam. Chest X-ray is a sensitive screening tool for TB, which should be followed by a confirmatory TB test. While the majority of those with chest X-ray abnormalities are investigated with smear-microscopy, the high sputum-smear positivity ratio among them suggests that sputum-smear microscopy is done mainly for persons with quite clear TB signs or symptoms. TB screenin…
Drivers of tuberculosis epidemics
Social franchising of TB care through private GPs in Myanmar
This article assesses whether social franchising of tuberculosis (TB) services in Myanmar has succeeded in providing quality treatment while ensuring equity in access and financial protection for poor patients. Newly diagnosed TB patients receiving treatment from private general practitioners (GPs) belonging to the franchise were identified. They were interviewed about social conditions, health seeking and health care costs at the time of startin…
Using pooled budgets to integrate health and welfare services
The lack of collaboration between health, social and other welfare services is believed to impair efficiency and reduce effectiveness in addressing the complex problems of patients. Differences in funding streams, political accountabilities, organisational structures and professional cultures are all alleged to contribute to barriers between services. Drawing on their respective evaluations, this paper describes experiments in England and Sweden …
Evaluation of the effect of co-financing on collaboration between health care, social services and social insurance in Sweden
In this paper, we present an ongoing research project aimed to determine the impact of co-financing on collaboration around patients with musculoskeletal disorders. A trial legislation that allows the social insurance, social services and health care services to unite in co-financing under joint political steering has been tested in different areas in Sweden. In a series of studies, we compare collaboration processes and health outcome for patien…
Drivers of tuberculosis epidemics
Using pooled budgets to integrate health and welfare services
The lack of collaboration between health, social and other welfare services is believed to impair efficiency and reduce effectiveness in addressing the complex problems of patients. Differences in funding streams, political accountabilities, organisational structures and professional cultures are all alleged to contribute to barriers between services. Drawing on their respective evaluations, this paper describes experiments in England and Sweden …
Social franchising of TB care through private GPs in Myanmar
This article assesses whether social franchising of tuberculosis (TB) services in Myanmar has succeeded in providing quality treatment while ensuring equity in access and financial protection for poor patients. Newly diagnosed TB patients receiving treatment from private general practitioners (GPs) belonging to the franchise were identified. They were interviewed about social conditions, health seeking and health care costs at the time of startin…
Evaluation of the effect of co-financing on collaboration between health care, social services and social insurance in Sweden
In this paper, we present an ongoing research project aimed to determine the impact of co-financing on collaboration around patients with musculoskeletal disorders. A trial legislation that allows the social insurance, social services and health care services to unite in co-financing under joint political steering has been tested in different areas in Sweden. In a series of studies, we compare collaboration processes and health outcome for patien…
Utilization of private and public health-care providers for tuberculosis symptoms in Ho Chi Minh City, Vietnam
In Vietnam, as in many other countries, tuberculosis (TB) control has long been organized exclusively within the public health-care system. However, recently the private health-care sector has become more important and private health-care providers currently have a role in TB care delivery in Vietnam. Through a retrospective survey of patients at District Tuberculosis Units (DTUs) of the National Tuberculosis Programme in Ho Chi Minh City, we inv…
Evaluation of the effect of co-financing on collaboration between health care, social services and social insurance in Sweden
In this paper, we present an ongoing research project aimed to determine the impact of co-financing on collaboration around patients with musculoskeletal disorders. A trial legislation that allows the social insurance, social services and health care services to unite in co-financing under joint political steering has been tested in different areas in Sweden. In a series of studies, we compare collaboration processes and health outcome for patien…
Using pooled budgets to integrate health and welfare services
The lack of collaboration between health, social and other welfare services is believed to impair efficiency and reduce effectiveness in addressing the complex problems of patients. Differences in funding streams, political accountabilities, organisational structures and professional cultures are all alleged to contribute to barriers between services. Drawing on their respective evaluations, this paper describes experiments in England and Sweden …
Social franchising of TB care through private GPs in Myanmar
This article assesses whether social franchising of tuberculosis (TB) services in Myanmar has succeeded in providing quality treatment while ensuring equity in access and financial protection for poor patients. Newly diagnosed TB patients receiving treatment from private general practitioners (GPs) belonging to the franchise were identified. They were interviewed about social conditions, health seeking and health care costs at the time of startin…
Drivers of tuberculosis epidemics
A descriptive study of TB cases finding practices in the three largest public general hospitals in Vietnam
Chest X-ray is the preferred first test for TB in the largest hospitals in Vietnam. Chest X-ray is a sensitive screening tool for TB, which should be followed by a confirmatory TB test. While the majority of those with chest X-ray abnormalities are investigated with smear-microscopy, the high sputum-smear positivity ratio among them suggests that sputum-smear microscopy is done mainly for persons with quite clear TB signs or symptoms. TB screenin…
Financial burden for tuberculosis patients in low- and middle-income countries
In order to inform the development of appropriate strategies to improve financial risk protection, we conducted a systematic literature review of the financial burden of tuberculosis (TB) faced by patients and affected families. The mean total costs ranged from $55 to $8198, with an unweighted average of $847. On average, 20% (range 0–62%) of the total cost was due to direct medical costs, 20% (0–84%) to direct non-medical costs, and 60% (16–94%)…
WHO's new End TB Strategy
Modelling the impact of social protection on tuberculosis
Results are to be confirmed with further analysis. However, by developing a generalizable modelling framework, S-PROTECT proved that the modelling of social protection is complex, but doable and allowed to draw the research road map for the future in this field
Diagnostic pathways and delay among tuberculosis patients in Stockholm, Sweden
Screening at a health examination was the main pathway of active TB detection among mainly asymptomatic and non-contagious asylum seekers but contributed modestly to total overall TB case detection. In these patients TB was diagnosed early in a non-contagious phase of the disease. Further research is required to assess the effectiveness and cost-effectiveness of HE TB screening as well as inclusion of other groups of migrants from high incidence …
Income security in times of ill health
international interdisciplinary research network. SPARKS' multi-sectoral team characterizes and evaluates the direct and indirect effects of social protection strategies on health, economic, and wider outcomes
Income security during public health emergencies
The COVID-19 poverty trap is shaped by barriers to accessing prevention, vulnerability to economic disruption and financial uncertainties, and incurrence of catastrophic costs as people try to cope with the outbreak. To ensure socioeconomic stability and confidence during public health crises and in the long run, social protection schemes (e.g. social insurance, microfinancing) must be in place to help people cope with the loss of income security…
Income security during periods of ill health
The COVID-19 pandemic is a reminder that insufficient income security in periods of ill health leads to economic hardship for individuals and hampers disease control efforts as people struggle to stay home when sick or advised to observe quarantine. Evidence on income security during periods of ill health is growing but has not previously been reviewed as a full body of work concerning low-income and middle-income countries (LMICs). We performed …
Build back stronger universal health coverage systems after the Covid-19 pandemic
box The need for a systemic approach to complex challenges and for better understanding the relationship between population health and its economic consequences have been recognised for years as the basis towards sustainable solutions in global health. The emergence of a movement promoting Universal Health Coverage (UHC) as the ultimate means to ensuring equitable access to health for all people, raised the attention to the importance of re-imagi…
A comparative impact evaluation of two human resource models for community-based active tuberculosis case finding in Ho Chi Minh City, Viet Nam
Both salaried and volunteer CHW human resource models demonstrated additionality in case notifications compared to routine case finding by the government TB program. The salaried employee CHW model achieved a greater impact on notifications and should be prioritized for scale-up, given sufficient resources
Adaptation of WHO’s generic tuberculosis patient cost instrument for a longitudinal study in Africa
The WHO developed a generic ‘TB patient cost survey’ tool and a standardized approach to assess the direct and indirect costs of TB incurred by patients and their households, estimate the proportion of patients experiencing catastrophic costs, and measure the impact of interventions to reduce patient costs. While the generic tool is a facility-based cross-sectional survey, this standardized approach needs to be adapted for longitudinal studies. A…
How to reduce household costs for people with tuberculosis
The aim of this study was to compare costs and socio-economic impact of tuberculosis (TB) for patients diagnosed through active (ACF) and passive case finding (PCF) in Nepal. A longitudinal costing survey was conducted in four districts of Nepal from April 2018 to October 2019. Costs were collected using the WHO TB Patient Costs Survey at three time points: intensive phase of treatment, continuation phase of treatment and at treatment completion.…
TB morbidity estimates overlook the contribution of post-TB disability
Introduction Despite growing evidence of the long-term impact of tuberculosis (TB) on quality of life, Global Burden of Disease (GBD) estimates of TB-related disability-adjusted life years (DALYs) do not include post-TB morbidity, and evaluations of TB interventions typically assume treated patients return to pre-TB health. Using primary data, we estimate years of life lost due to disability (YLDs), years of life lost due to premature mortality (…
A qualitative assessment on the acceptability of providing cash transfers and social health insurance for tuberculosis-affected families in Ho Chi Minh City, Vietnam
To achieve the Sustainable Development Goal’s targets of universal health coverage (UHC) and poverty reduction, interventions are required that strengthen and harmonize both UHC and social protection. Vietnam is committed to achieving financial protection and over 90% of the general population has enrolled in its social health insurance (SHI) scheme. However, an estimated 63% of tuberculosis (TB)-affected households in Vietnam still face catastro…
Determinants of catastrophic costs among households affected by multi-drug resistant tuberculosis in Ho Chi Minh City, Viet Nam
Despite good social protection coverage, most people with MDR-TB in HCMC experienced catastrophic costs. Incurrence of catastrophic costs was independently associated with being the household's primary income earner or being unemployed. Revision and expansion of strategies to mitigate TB-related catastrophic costs, in particular avoiding unemployment and income loss, are urgently required
They didn’t look at me with good eyes' – experiences of the socioeconomic impact of tuberculosis and support needs among adults in a semi-rural area in Mozambique
Tuberculosis is recognised as a disease of the economically disadvantaged people due to its association with financial vulnerability. Mozambique still faces the challenge of the high burden of TB and associated costs. We aimed to understand the social and economic impacts of TB and the need for social support among people with TB in Mozambique. We conducted a qualitative study using a phenomenological approach focusing on the lived experiences an…
Estimating the impact of nutritional transition and ending hunger on tuberculosis in 12 high-burden countries
BACKGROUND: Nutrition is a critical determinant of tuberculosis (TB), providing a protective effect at high body mass index (BMI) and incurring an increased risk of TB disease at low BMI. Global nutritional transition and interventions to end hunger could directly affect the TB epidemic in high TB burden countries. METHODS: We constructed dynamic TB transmission models for 12 high TB burden countries with low HIV prevalence. We explicitly account…
Identifying mechanisms by which social determinants of health impact TB diagnostic evaluation uptake in Uganda
Biomedical interventions alone are unlikely to address the spectrum of SDoH-related barriers to equitable completion of TB diagnostic evaluation. Linking barriers to a behavior change model such as COM-B may help guide the design and evaluation of appropriate people-centered strategies that integrate social and economic supports with clinical and public health programs or services
One year on - the long-term impact of Covid-19 pandemic and government restrictions on the health-seeking behaviour, financial security and mental health of TB survivors
Clinical trial number: not applicable
Understanding treatment initiation pathways and associated costs among people with pulmonary tuberculosis in a peri-urban area of Mozambique
Most people with TB symptoms sought care within two weeks but TB treatment initiation was delayed to nearly two months after symptoms onset. This suggests that delays in TB treatment initiation may be attributable to health system factors rather than the care-seeking behaviour of people with TB in Maputo, Mozambique. Additionally, there was a substantial financial burden of care-seeking exacerbated by additional healthcare provider visits. Eviden…
Medicine (20 works) · Tuberculosis Research and Epidemiology (16 works) · Environmental health (15 works) · Tuberculosis (15 works) · Economic growth (12 works) · Public health (11 works) · Business (10 works) · Economics (10 works) · Health care (10 works) · Nursing (9 works)