Decision-model estimation of the age-specific disability weight for schistosomiasis japonica: a systematic review of the literature.
Decision-model estimation of the age-specific disability weight for schistosomiasis japonica: a systematic review of the literature.
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DOI：
10.1371/journal.pntd.0000158
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发表时间：
2008-03-05
影响因子：
3.8
通讯作者：
McGarvey ST
中科院分区：
文献类型：
--
作者：
Finkelstein JL;Schleinitz MD;Carabin H;McGarvey ST
血吸虫病是世界上最普遍的寄生虫感染之一。然而，目前的全球疾病负担（GBD）残疾调整生命年估计表明，其对人口水平的影响可以忽略不计。最近的研究表明，GBD方法可能严重低估了包括血吸虫病在内的寄生虫病的负担。此外，尚未建立血吸虫病的菌株特异性残疾权重，日本血吸虫引起的人类疾病负担的大小仍然存在争议。我们使用决策模型来量化日本血吸虫引起的人类疾病负担的另一种残疾体重估计。我们回顾了日本血吸虫发病率数据，并为所有感染者和<15岁和≥15岁两个年龄层构建了决策树。我们对每个模型进行了随机和概率敏感性分析。日本血吸虫感染的平均残疾体重为0.132，年龄特异性残疾体重分别为0.098（<15岁）和0.186（≥15岁）。重新估计的残疾权重是目前GBD测量值的7至46倍；没有模拟产生低于0.009的残疾体重估计值。在<15岁模型中，营养疾病对日本血吸虫残疾体重的贡献最大，而主要器官病理是老年组中最关键的变量。迫切需要修订血吸虫病GBD残疾权重，并建立特定物种的残疾权重。即使目前的估计数略有增加，也会导致估计的全球血吸虫病负担大幅增加，并对公共卫生的优先次序和用于血吸虫病研究、监测和控制的资源分配产生重大影响。血吸虫病是一种由扁虫引起的寄生虫感染，对世界上最贫困人口的影响尤为严重。血吸虫病是世界上最常见的感染之一，影响76个国家的2.07亿多人。目前的国际估计表明，血吸虫病在人口一级的影响很小。这导致其在全球卫生和随后用于疾病控制的资源分配中的优先地位较低。然而，最近的研究表明，这些措施低估了包括血吸虫病在内的被忽视的热带病的严重程度。尽管世界卫生组织提出了建议，但十多年来一直没有重新审查血吸虫病的负担，而且对不同类型的血吸虫病没有确定的估计数。与日本血吸虫亚洲毒株相关的症状影响仍有争议。本研究是为了提供日本血吸虫负荷的另一种测量方法。我们回顾了文献并计算了日本血吸虫的总估计值，该估计值是目前血吸虫病测量值的7至46倍。研究结果表明，目前的措施严重低估了血吸虫病的程度，迫切需要加以修订。需要进一步研究，以审查血吸虫病和其他被遗忘的热带病对流行国家世界上最贫穷人口造成的负担。
Schistosomiasis is among the most prevalent parasitic infections worldwide. However, current Global Burden of Disease (GBD) disability-adjusted life year estimates indicate that its population-level impact is negligible. Recent studies suggest that GBD methodologies may significantly underestimate the burden of parasitic diseases, including schistosomiasis. Furthermore, strain-specific disability weights have not been established for schistosomiasis, and the magnitude of human disease burden due to Schistosoma japonicum remains controversial. We used a decision model to quantify an alternative disability weight estimate of the burden of human disease due to S. japonicum. We reviewed S. japonicum morbidity data, and constructed decision trees for all infected persons and two age-specific strata, <15 years (y) and ≥15 y. We conducted stochastic and probabilistic sensitivity analyses for each model. Infection with S. japonicum was associated with an average disability weight of 0.132, with age-specific disability weights of 0.098 (<15 y) and 0.186 (≥15 y). Re-estimated disability weights were seven to 46 times greater than current GBD measures; no simulations produced disability weight estimates lower than 0.009. Nutritional morbidities had the greatest contribution to the S. japonicum disability weight in the <15 y model, whereas major organ pathologies were the most critical variables in the older age group. GBD disability weights for schistosomiasis urgently need to be revised, and species-specific disability weights should be established. Even a marginal increase in current estimates would result in a substantial rise in the estimated global burden of schistosomiasis, and have considerable implications for public health prioritization and resource allocation for schistosomiasis research, monitoring, and control. Schistosomiasis is a parasitic infection caused by a flatworm that disproportionately affects the world's poorest populations. Schistosomiasis is one of the most common infections worldwide, affecting over 207 million people in 76 countries. Current international estimates indicate that schistosomiasis has a minimal impact at the population level. This has contributed to its low prioritization in global health and subsequent resource allocation for disease control. However, recent studies indicate that these measures underestimate the extent of neglected tropical diseases, including schistosomiasis. Despite World Health Organization recommendations, the burden of schistosomiasis has not been re-examined in over a decade, and there are no established estimates for different types of schistosomiasis. The impact of symptoms associated with the Asian strain, Schistosoma japonicum, remains controversial. This study was conducted to provide an alternate measure of the burden of S. japonicum. We reviewed the literature and calculated a summary estimate for S. japonicum which was seven to 46 times greater than current measures for schistosomiasis. Findings suggest that current measures severely underestimate the extent of schistosomiasis, and urgently need to be revised. Further research is needed to examine the burden of schistosomiasis and other forgotten tropical diseases affecting the world's poorest people in endemic countries.
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影响因子：
2.7
作者：
Engels D;Chitsulo L;Montresor A;Savioli L
通讯作者：
Savioli L
DOI：
10.4269/ajtmh.1980.29.858
发表时间：
1980-01-01
影响因子：
3.3
作者：
DOMINGO, EO;TIU, E;HOUSER, HB
通讯作者：
HOUSER, HB
DOI：
10.4269/ajtmh.1989.41.63
发表时间：
1989-07-01
影响因子：
3.3
作者：
DOEHRINGSCHWERDTFEGER, E;MOHAMEDALI, G;EHRICH, JHH
通讯作者：
EHRICH, JHH
影响因子：
9.6
作者：
Bergquist, NR;Leonardo, LR;Mitchell, GF
通讯作者：
Mitchell, GF
影响因子：
4.2
作者：
Coutinho, HM;Acosta, LP;Friedman, JF
通讯作者：
Friedman, JF