Updated global burden of cholera in endemic countries.
Updated global burden of cholera in endemic countries.
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DOI：
10.1371/journal.pntd.0003832
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发表时间：
2015
影响因子：
3.8
通讯作者：
Sack DA
中科院分区：
文献类型：
--
作者：
Ali M;Nelson AR;Lopez AL;Sack DA
霍乱的全球负担在很大程度上是未知的，因为大多数病例没有报告。报告率低可归因于流行病学监测和实验室能力有限，以及报告的社会、政治和经济障碍。我们此前估计，在51个霍乱流行国家，每年有280万例霍乱病例和9.1万人死亡。我们先前估计的一个主要限制是，根据国家报告的霍乱病例来界定流行和非流行国家。我们通过使用空间建模技术来确定流行国家，从而克服了这一局限性，并相应地更新了对全球霍乱负担的估计。根据空间回归模型是否预测五年中至少三年(2008-2012年)的发病率超过某一阈值，将国家归类为霍乱地方病、霍乱非地方病或无霍乱。根据不能持续获得改善的卫生设施的国家的百分比，计算了每个国家的高危人口。以人口为基础的已发表研究的发病率被用来计算流行国家每年的估计病例数量。每年的霍乱死亡人数是使用基于文献的CFR估计的逆方差加权平均病死率(CFR)计算的。我们发现，在霍乱流行国家，大约有13亿人面临感染霍乱的风险。据估计，霍乱流行国家每年发生286万例霍乱病例(不确定性范围：130万-400万)。在这些病例中，估计有95,000人死亡(不确定性范围：21,000-143,000)。全球霍乱的负担仍然很重。撒哈拉以南非洲是这一负担的主要来源。我们的发现可以为霍乱控制的规划决策提供参考。霍乱的全球负担在很大程度上是未知的，因为大多数病例没有报告。报告率低可归因于流行病学监测和实验室能力有限，以及报告的社会、政治和经济障碍。我们此前估计，在51个霍乱流行国家，每年有280万例霍乱病例和9.1万人死亡。我们先前估计的一个主要限制是，根据国家报告的霍乱病例来界定流行和非流行国家。如果一个国家即使有霍乱，但没有报告病例，则该国家被归类为无霍乱国家。这一次，我们通过使用空间建模技术解决了这一限制，该技术帮助我们根据该国获得改善的水和卫生设施以及邻国的霍乱发病率来确定霍乱流行国家。我们的新估计显示，69个流行国家有290万个病例和9.5万人死亡，其中大部分负担在撒哈拉以南非洲。霍乱的持续高负担表明有必要进行综合和改进的控制工作，这些发现可能有助于在流行国家控制疾病的方案决策。
The global burden of cholera is largely unknown because the majority of cases are not reported. The low reporting can be attributed to limited capacity of epidemiological surveillance and laboratories, as well as social, political, and economic disincentives for reporting. We previously estimated 2.8 million cases and 91,000 deaths annually due to cholera in 51 endemic countries. A major limitation in our previous estimate was that the endemic and non-endemic countries were defined based on the countries’ reported cholera cases. We overcame the limitation with the use of a spatial modelling technique in defining endemic countries, and accordingly updated the estimates of the global burden of cholera. Countries were classified as cholera endemic, cholera non-endemic, or cholera-free based on whether a spatial regression model predicted an incidence rate over a certain threshold in at least three of five years (2008-2012). The at-risk populations were calculated for each country based on the percent of the country without sustainable access to improved sanitation facilities. Incidence rates from population-based published studies were used to calculate the estimated annual number of cases in endemic countries. The number of annual cholera deaths was calculated using inverse variance-weighted average case-fatality rate (CFRs) from literature-based CFR estimates. We found that approximately 1.3 billion people are at risk for cholera in endemic countries. An estimated 2.86 million cholera cases (uncertainty range: 1.3m-4.0m) occur annually in endemic countries. Among these cases, there are an estimated 95,000 deaths (uncertainty range: 21,000-143,000). The global burden of cholera remains high. Sub-Saharan Africa accounts for the majority of this burden. Our findings can inform programmatic decision-making for cholera control. The global burden of cholera is largely unknown because the majority of cases are not reported. The low reporting can be attributed to limited capacity of epidemiological surveillance and laboratories, as well as social, political, and economic disincentives for reporting. We previously estimated 2.8 million cases and 91,000 deaths annually due to cholera in 51 endemic countries. A major limitation in our previous estimate was that the endemic and non-endemic countries were defined based on the countries’ reported cholera cases. If a country did not report cases even though the country had cholera, the country was classified as cholera free. This time we addressed this limitation by using a spatial modelling technique, which helped us define the cholera-endemic countries based on access to improved water and sanitation in the country as well as cholera incidence in neighboring countries. Our new estimate illustrates 2.9 million of cases and 95,000 deaths in 69 endemic countries, with the majority of the burden in Sub-Saharan Africa. The sustained high burden of cholera points to the necessity for integrated and improved control efforts, and these findings may help programmatic decision-making for controlling the disease in endemic countries.
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影响因子：
158.5
作者：
Lucas, MES;Deen, JL;Clemens, JD
通讯作者：
Clemens, JD
影响因子：
3.9
作者：
Masuet Aumatell C;Ramon Torrell JM;Zuckerman JN
通讯作者：
Zuckerman JN
影响因子：
168.9
作者：
Harris, Jason B.;LaRocque, Regina C.;Calderwood, Stephen B.
通讯作者：
Calderwood, Stephen B.
影响因子：
3.7
作者：
Agtini MD;Soeharno R;Lesmana M;Punjabi NH;Simanjuntak C;Wangsasaputra F;Nurdin D;Pulungsih SP;Rofiq A;Santoso H;Pujarwoto H;Sjahrurachman A;Sudarmono P;von Seidlein L;Deen JL;Ali M;Lee H;Kim DR;Han O;Park JK;Suwandono A;Ingerani;Oyofo BA;Campbell JR;Beecham HJ;Corwin AL;Clemens JD
通讯作者：
Clemens JD
DOI：
10.2471/blt.11.093427
发表时间：
2012-03-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Ali, Mohammad;Lopez, Anna Lena;Clemens, John
通讯作者：
Clemens, John