The global burden of cholera
The global burden of cholera
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DOI：
10.2471/blt.11.093427
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发表时间：
2012-03-01
期刊：
影响因子：
--
通讯作者：
Clemens, John
中科院分区：
文献类型：
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作者：
Ali, Mohammad;Lopez, Anna Lena;Clemens, John
目的：利用基于人群的发病率数据和报告来评估霍乱的全球负担。
方法：根据在最近五年中是否至少有三年报告过霍乱病例，将近期有霍乱病史的国家分为流行国家和非流行国家。利用每个国家无法获得改善的卫生设施的人口百分比来计算霍乱的高危人群，将已发表研究中的发病率应用于不同国家组，以估计流行国家中每年的霍乱病例数。非流行国家的霍乱病例估计数基于2000年至2008年报告的平均病例数。利用基于文献的霍乱病死率（CFR）估计值来计算方差加权平均霍乱病死率，以估计霍乱死亡人数。
结果：在流行国家中约有14亿人面临霍乱风险。据估计，此类国家每年发生280万例霍乱（不确定范围：140万 - 430万），非流行国家每年约有8.7万例霍乱病例。据估计，5岁以下儿童的发病率最高。在流行国家中，每年约有9.1万人（不确定范围：2.8万 - 14.2万）死于霍乱，在非流行国家中有2500人死于该疾病。
结论：通过一项有明确假设的系统综述确定的霍乱全球负担很高。本研究的结果为规划控制霍乱的公共卫生干预措施提供了当代依据。
Objective To estimate the global burden of cholera using population-based incidence data and reports.Methods Countries with a recent history of cholera were classified as endemic or non-endemic, depending on whether they had reported cholera cases in at least three of the five most recent years. The percentages of the population in each country that lacked access to improved sanitation were used to compute the populations at risk for cholera, and incidence rates from published studies were applied to groups of countries to estimate the annual number of cholera cases in endemic countries. The estimates of cholera cases in non-endemic countries were based on the average numbers of cases reported from 2000 to 2008. Literature-based estimates of cholera case-fatality rates (CFRs) were used to compute the variance-weighted average cholera CFRs for estimating the number of cholera deaths.Findings About 1.4 billion people are at risk for cholera in endemic countries. An estimated 2.8 million cholera cases occur annually in such countries (uncertainty range: 1.4-4.3) and an estimated 87 000 cholera cases occur in non-endemic countries. The incidence is estimated to be greatest in children less than 5 years of age. Every year about 91 000 people (uncertainty range: 28 000 to 142000) die of cholera in endemic countries and 2500 people die of the disease in non-endemic countries.Conclusion The global burden of cholera, as determined through a systematic review with clearly stated assumptions, is high. The findings of this study provide a contemporary basis for planning public health interventions to control cholera.