Disease and economic burdens of dengue.
Disease and economic burdens of dengue.
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DOI：
10.1016/s1473-3099(16)30545-x
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发表时间：
2017-03-01
期刊：
影响因子：
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通讯作者：
Bloom, David E
中科院分区：
文献类型：
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作者：
Castro, Marcia C;Wilson, Mary E;Bloom, David E
登革热的负担很大，而且还在不断增加。全球一半以上的人口生活在有登革热传播风险的地区。然而，负担估计的不确定性对政策制定者确定优先事项、分配资源和规划干预措施的能力提出了挑战。在本报告（登革热系列报告中的第一篇）中，我们探讨了登革热疾病和经济负担的估计，以及估计的主要挑战、局限性和不确定性来源。我们还反思了弥补这些缺陷的机会。尽管这些估计值的置信区间重叠，但对明显登革热感染的点估计值差异很大。成本估算包括不同的项目，大多基于单年数据，使用不同的货币参考，从不同的角度计算，并且难以比较。分解不同利益相关者的成本（如我们的框架中提出的）、考虑流行年的成本以及考虑生产力和旅游业损失的综合估计很少。在这些估计的基础上，我们提出了最全面的框架来估计任何地区登革热的经济负担，该框架按四个截然不同的成本项目领域和承担成本的三个潜在利益相关者进行区分。该框架可以为未来对登革热经济负担的估计提供信息，并产生对额外常规行政数据收集的需求，或在登革热流行国家的全国代表性调查中系统纳入额外问题的需求。此外，学者们可以使用该框架来指导情景模拟，考虑尚未获得数据的成本项目的可能值范围。结果对于政策制定者来说很有价值，也将提高社区的认识，从而有可能改善登革热控制工作。
The burden of dengue is large and growing. More than half of the global population lives in areas with risk of dengue transmission. Uncertainty in burden estimates, however, challenges policy makers' ability to set priorities, allocate resources, and plan for interventions. In this report, the first in a Series on dengue, we explore the estimations of disease and economic burdens of dengue, and the major estimation challenges, limitations, and sources of uncertainty. We also reflect on opportunities to remedy these deficiencies. Point estimates of apparent dengue infections vary widely, although the confidence intervals of these estimates overlap. Cost estimates include different items, are mostly based on a single year of data, use different monetary references, are calculated from different perspectives, and are difficult to compare. Comprehensive estimates that decompose the cost by different stakeholders (as proposed in our framework), that consider the cost of epidemic years, and that account for productivity and tourism losses, are scarce. On the basis of these estimates, we propose the most comprehensive framework for estimating the economic burden of dengue in any region, differentiated by four very different domains of cost items and by three potential stakeholders who bear the costs. This framework can inform future estimations of the economic burden of dengue and generate demand for additional routine administrative data collection, or for systematic incorporation of additional questions in nationally representative surveys in dengue-endemic countries. Furthermore, scholars could use the framework to guide scenario simulations that consider ranges of possible values for cost items for which data are not yet available. Results would be valuable to policy makers and would also raise awareness among communities, potentially improving dengue control efforts.