Background Dengue is a major global health threat with varied clinical manifestations across age groups,countries,and regions.This study aims to estimate global dengue disability weights(DWs)based on clinical manifest...Background Dengue is a major global health threat with varied clinical manifestations across age groups,countries,and regions.This study aims to estimate global dengue disability weights(DWs)based on clinical manifestations data and examine variations across different demographics and geographical areas.These findings will inform public health strategies and interventions to reduce the global burden of dengue.Methods We conducted a systematic search across six databases(Scopus,Web of Science,PubMed,China National Knowledge Infrastructure,Wanfang Data,and Database of Chinese sci-tech periodicals)for studies on human dengue clinical manifestations or infection from the establishment of each database through December 31,2023.DWs were estimated by combining clinical manifestations frequencies with corresponding DW values derived from the Global Burden of Disease(GBD)study,using Monte Carlo simulations to generate uncertainty intervals.Odds ratios(ORs)with 95%confidence intervals(CI)and Chi-square tests were performed to compare clinical manifestations between adults and children.Results A total of 35 adult studies(7109 cases)and 17 pediatric studies(2996 cases)were analysed.Adults had higher rates of muscle pain(OR=9.18;95%CI:8.17–10.33)and weak(OR=4.95;95%CI 4.12–5.98).Children showed higher frequencies of decreased appetite(OR=0.12;95%CI:0.11–0.14)and lymphadenectasis(OR=0.04;95%CI:0.03–0.06).Severe dengue was more prevalent in children(8.2%)than adults(4.6%).The global DW for universal dengue was 0.3258 in adults and 0.4022 in children,with Indian children showing the highest DW for severe dengue(0.6991)and Chinese adult showing the highest DW for severe dengue(0.7214).Regionally,most studies were from South and Southeast Asia,with India contributing the largest number of publications(80 articles).Additionally,India had the highest dengue disease burden in 2021(352,468.54 person-years).Conclusions These findings reveal important age and regional differences in dengue disease burden.There is a relative lack of research on dengue clinical manifestations in several high-burden countries in the Americas,and these gaps may affect the comprehensiveness and accuracy of global dengue disability weight estimates.These highlight the urgent need for targeted interventions and optimized resource allocation to mitigate its global impact.展开更多
Background:Paragonimiasis,caused by helminths of the genus Paragonimus spp.,is a neglected tropical disease.Human suffering from paragonimiasis is often misunderstood and its quantification by the disability weight of...Background:Paragonimiasis,caused by helminths of the genus Paragonimus spp.,is a neglected tropical disease.Human suffering from paragonimiasis is often misunderstood and its quantification by the disability weight of the disability-adjusted life years largely varies in different global burden of disease(GBD)estimates.This paper is to systematically review clinical paragonimiasis cases and requantify the disability weight of human paragonimiasis.Methods:A systematic analysis was conducted using articles from the following databases:PubMed,Institute for Scientific Information Web of Science,China National Knowledge Infrastructure,the Chinese scientific journal databases Wanfang Data and CQVIP,Africa Journal Online,and the System for Information on Grey Literature in Europe.Search terms were the combination of“paragonim*”with“clinical”or“infection”.Only articles fulfilling the following conditions were recruited for this study:the occurrence of clinical signs and symptoms of paragonimiasis in human beings were reported;diagnosis was confirmed;no comorbidities were reported;the reviewed clinical cases or epidemiological findings were not already included in any other articles.The information and frequencies of paragonimiasis outcomes from included articles using predefined data fields were extracted two times by two separate individuals.Outcome disability weights were selected mainly from the GBD 2004 and GBD 2013 datasets.Frequencies and disability weights of paragonimiasis outcomes were modelled into a decision tree using the additive approach and multiplicative approach,respectively.Monte Carlo simulations were run 5000 times for an uncertainty analysis.Results:The disability weight estimates of paragonimiasis were simulated with 5302 clinical cases from 80 general articles.The overall disability weight was estimated at 0.1927(median 0.1956)with a 95%uncertainty interval(UI)of 0.1632-0.2378 using the additive approach,and 0.1791(median 0.1816)with a 95%UI of 0.1530-0.2182 using the multiplicative approach.The simulated disability weights of Paragonimus westermani cases were higher than that of P.skrjabini cases.Lung outcomes and headache were the top two contributors to disability weight for both species.Conclusions:The use of paragonimiasis disability weight needs to be reconsidered with regard to availability of morbidity data and species variation.Calculating the disease burden of paragonimiasis requires further modification and thus has considerable implications for public health prioritization in research,monitoring,and control.展开更多
Background:Most studies have evaluated disability-adjusted life years(DALYs)of colorectal cancer(CRC)patients based on a set of generic disability weights(DWs).This study aimed to apply local CRC-stage-specific DWs to...Background:Most studies have evaluated disability-adjusted life years(DALYs)of colorectal cancer(CRC)patients based on a set of generic disability weights(DWs).This study aimed to apply local CRC-stage-specific DWs to estimate the burden of DALYs for CRC(CRC-DALYs)in populations in China and consider the influence of local screening coverage of CRC.Methods:A prevalence-based model was constructed using data from various sources.Years lived with disability(YLDs)were estimated mainly via cumulative prevalence data(based on CRC incidence rates,population numbers,and survival rates),stage-specific proportions of CRC,and DWs of the local population.Years of life lost(YLLs)were calculated based on the CRC mortality rates and standard life expectancies.CRC incidence and mortality rates for the years 2020,2025,and 2030 were estimated by joinpoint regression,and the corresponding DALYs were predicted.The main assumption was made for CRC screening coverage.Sensitivity analyses were used to assess the impact of population,DWs,and coverage.Results:In 2017,among the Chinese population,the estimated number of CRC-DALYs was 4,303,314(11.9%for YLDs).If CRC screening coverage rate in China(2.3%)remains unchanged,the overall DALYs in 2030 are predicted to increase by 37.2%(45.1%of those aged≥65 years).More optimistically,the DALYs would then decrease by 0.7%in 2030(from 5,902,454 to 5,860,200)if the coverage could be increased to 25.0%.A sensitivity analysis revealed that using local DWs would change the base-case values by 5.7%.Conclusions:The estimated CRC-DALYs in China using population-specific DWs were considerably lower(with a higher percentage of YLDs)than the global burden of disease(GBD)estimates(5,865,004,of 4.6%for YLDs),suggesting the impact extent of applying local parameters.Sustainable scale-up CRC screening needs to be in place to moderate the growth trend of CRC-DALYs in China.展开更多
Background:Since the 1990s,evidence has accumulated of an increased prevalence of epilepsy in onchocerciasisendemic areas in Africa as compared to onchocerciasis-free areas.Although the causal relationship between onc...Background:Since the 1990s,evidence has accumulated of an increased prevalence of epilepsy in onchocerciasisendemic areas in Africa as compared to onchocerciasis-free areas.Although the causal relationship between onchocerciasis and epilepsy has yet to be proven,there is likely an association.Here we discuss the need for disease burden estimates of onchocerciasis-associated epilepsy(OAE),provide them,detail how such estimates should be refined,and discuss the socioeconomic impact of OAE,including a cost-estimate for anti-epileptic drugs.Main body:Providing OAE burden estimates may aid prevention of epilepsy in onchocerciasis-endemic areas by inciting and informing collaboration between onchocerciasis control programmes and mental health services.Epilepsy not only massively impacts the health of those affected,but it also carries a high socioeconomic burden for the households and communities involved.We used previously published geospatial estimates of onchocerciasis in Africa and a separately published logistic regression model quantifying the association between onchocerciasis and epilepsy to estimate the number of OAE cases.We then applied disability weights for epilepsy to quantify the burden in terms of years of life lived with disability(YLD)and estimate the cost of treatment.We estimate that in 2015 roughly 117000 people were affected by OAE across onchocerciasis-endemic areas previously under the African Programme for Onchocerciases control(APOC)mandate where OAE has ever been reported or suspected,and another 264000 persons in onchocerciasis-endemic areas where OAE has never been investigated before.The total number of YLDs due to OAE was 39300 and 88700 in these areas respectively,based on a weighted mean disability weight of 0.336.The burden of OAE is approximately 13%of the total YLDs attributable to onchocerciasis and 10%of total YLDs attributable to epilepsy.We estimated that by 2015 the total costs of treatment with antiepileptic drug for OAE cases would have been a minimum of 12.4 million US$.Conclusions:These estimates suggest a considerable health,social and economic burden of OAE in Africa.The treatment and care for people with epilepsy,especially in hyperendemic onchocerciasis areas with high epilepsy prevalence thus requires more financial and human resources.展开更多
In the context of the continuous growth of the aging population,priority has been given to the health promotion strategy of"orientation toward prevention and reduction of disease occurrence."On the basis of ...In the context of the continuous growth of the aging population,priority has been given to the health promotion strategy of"orientation toward prevention and reduction of disease occurrence."On the basis of the assessment of disability weights in the Global Burden of Disease(GBD),we assigned disability weights to the data on health conditions in the China Health and Retirement Longitudinal Study(CHARLS),using Years Lived with Disability(YLDs)as a quantitative indicator to evaluate the predictive effect of early psychosocial risks on health in old age.The results show that early psychosocial risks significantly increase YLDs in old age and have significant predictive power for high-risk health conditions among the elderly,and that the relationship between the two is causal.In addition,the study identifies four early psychosocial risks that lead to serious deterioration of the quality of life in old age:physical violence,childhood migration,maternal mental health and paternal physical health.These findings have significant implications for preventing the occurrence of aging diseases derived from the distal period of the individual’s lifetime and for implementing"full life cycle health management."展开更多
基金supported by the National Natural Science Foundation of China(82260655)the National Key Research and Development Program of People’s Republic of China(Grant No.2021YFC2300800 and 2021YFC2300804)+1 种基金the Basic and applied basic research project jointly funded by the University of Guangzhou(Grant No.2023A03J0810)the Key R&D Program of Guangdong Province(Grant No.2022B1111030002).
文摘Background Dengue is a major global health threat with varied clinical manifestations across age groups,countries,and regions.This study aims to estimate global dengue disability weights(DWs)based on clinical manifestations data and examine variations across different demographics and geographical areas.These findings will inform public health strategies and interventions to reduce the global burden of dengue.Methods We conducted a systematic search across six databases(Scopus,Web of Science,PubMed,China National Knowledge Infrastructure,Wanfang Data,and Database of Chinese sci-tech periodicals)for studies on human dengue clinical manifestations or infection from the establishment of each database through December 31,2023.DWs were estimated by combining clinical manifestations frequencies with corresponding DW values derived from the Global Burden of Disease(GBD)study,using Monte Carlo simulations to generate uncertainty intervals.Odds ratios(ORs)with 95%confidence intervals(CI)and Chi-square tests were performed to compare clinical manifestations between adults and children.Results A total of 35 adult studies(7109 cases)and 17 pediatric studies(2996 cases)were analysed.Adults had higher rates of muscle pain(OR=9.18;95%CI:8.17–10.33)and weak(OR=4.95;95%CI 4.12–5.98).Children showed higher frequencies of decreased appetite(OR=0.12;95%CI:0.11–0.14)and lymphadenectasis(OR=0.04;95%CI:0.03–0.06).Severe dengue was more prevalent in children(8.2%)than adults(4.6%).The global DW for universal dengue was 0.3258 in adults and 0.4022 in children,with Indian children showing the highest DW for severe dengue(0.6991)and Chinese adult showing the highest DW for severe dengue(0.7214).Regionally,most studies were from South and Southeast Asia,with India contributing the largest number of publications(80 articles).Additionally,India had the highest dengue disease burden in 2021(352,468.54 person-years).Conclusions These findings reveal important age and regional differences in dengue disease burden.There is a relative lack of research on dengue clinical manifestations in several high-burden countries in the Americas,and these gaps may affect the comprehensiveness and accuracy of global dengue disability weight estimates.These highlight the urgent need for targeted interventions and optimized resource allocation to mitigate its global impact.
基金This study is supported by the International Development Research Centre(IDRC),Canada(grant no.105509–00001002-024)Public Health Research Center,Jiangnan University(grant no.BM2015024)+3 种基金Outstanding Youth Fund,Jiangsu Institute of Parasitic DiseasesJiangsu Provincial Project of Invigorating Health Care through Science,Technology and Educationand in part by a grant from the National Nature Science Foundation(grant no.81573261)the Health Promotion Project,Outstanding Person Fund,Jiangsu Provincial Department of Health(2011).
文摘Background:Paragonimiasis,caused by helminths of the genus Paragonimus spp.,is a neglected tropical disease.Human suffering from paragonimiasis is often misunderstood and its quantification by the disability weight of the disability-adjusted life years largely varies in different global burden of disease(GBD)estimates.This paper is to systematically review clinical paragonimiasis cases and requantify the disability weight of human paragonimiasis.Methods:A systematic analysis was conducted using articles from the following databases:PubMed,Institute for Scientific Information Web of Science,China National Knowledge Infrastructure,the Chinese scientific journal databases Wanfang Data and CQVIP,Africa Journal Online,and the System for Information on Grey Literature in Europe.Search terms were the combination of“paragonim*”with“clinical”or“infection”.Only articles fulfilling the following conditions were recruited for this study:the occurrence of clinical signs and symptoms of paragonimiasis in human beings were reported;diagnosis was confirmed;no comorbidities were reported;the reviewed clinical cases or epidemiological findings were not already included in any other articles.The information and frequencies of paragonimiasis outcomes from included articles using predefined data fields were extracted two times by two separate individuals.Outcome disability weights were selected mainly from the GBD 2004 and GBD 2013 datasets.Frequencies and disability weights of paragonimiasis outcomes were modelled into a decision tree using the additive approach and multiplicative approach,respectively.Monte Carlo simulations were run 5000 times for an uncertainty analysis.Results:The disability weight estimates of paragonimiasis were simulated with 5302 clinical cases from 80 general articles.The overall disability weight was estimated at 0.1927(median 0.1956)with a 95%uncertainty interval(UI)of 0.1632-0.2378 using the additive approach,and 0.1791(median 0.1816)with a 95%UI of 0.1530-0.2182 using the multiplicative approach.The simulated disability weights of Paragonimus westermani cases were higher than that of P.skrjabini cases.Lung outcomes and headache were the top two contributors to disability weight for both species.Conclusions:The use of paragonimiasis disability weight needs to be reconsidered with regard to availability of morbidity data and species variation.Calculating the disease burden of paragonimiasis requires further modification and thus has considerable implications for public health prioritization in research,monitoring,and control.
基金supported by grants from the National Natural Science Foundation of China(No.81773521)an Open Competition Grant,Health Policy and System Sciences from the China Medical Board(No.19-340)a Talent Incentive Plan sponsored by the Cancer Hospital,Chinese Academy of Medical Sciences.
文摘Background:Most studies have evaluated disability-adjusted life years(DALYs)of colorectal cancer(CRC)patients based on a set of generic disability weights(DWs).This study aimed to apply local CRC-stage-specific DWs to estimate the burden of DALYs for CRC(CRC-DALYs)in populations in China and consider the influence of local screening coverage of CRC.Methods:A prevalence-based model was constructed using data from various sources.Years lived with disability(YLDs)were estimated mainly via cumulative prevalence data(based on CRC incidence rates,population numbers,and survival rates),stage-specific proportions of CRC,and DWs of the local population.Years of life lost(YLLs)were calculated based on the CRC mortality rates and standard life expectancies.CRC incidence and mortality rates for the years 2020,2025,and 2030 were estimated by joinpoint regression,and the corresponding DALYs were predicted.The main assumption was made for CRC screening coverage.Sensitivity analyses were used to assess the impact of population,DWs,and coverage.Results:In 2017,among the Chinese population,the estimated number of CRC-DALYs was 4,303,314(11.9%for YLDs).If CRC screening coverage rate in China(2.3%)remains unchanged,the overall DALYs in 2030 are predicted to increase by 37.2%(45.1%of those aged≥65 years).More optimistically,the DALYs would then decrease by 0.7%in 2030(from 5,902,454 to 5,860,200)if the coverage could be increased to 25.0%.A sensitivity analysis revealed that using local DWs would change the base-case values by 5.7%.Conclusions:The estimated CRC-DALYs in China using population-specific DWs were considerably lower(with a higher percentage of YLDs)than the global burden of disease(GBD)estimates(5,865,004,of 4.6%for YLDs),suggesting the impact extent of applying local parameters.Sustainable scale-up CRC screening needs to be in place to moderate the growth trend of CRC-DALYs in China.
基金WAS acknowledges the financial support from the Test-and-Treat(TNT)grant(Bill and Melina Gates Foundation(BMGF))WAS,LEC and SJdV acknowledges the financial support from the Neglected Tropical Diseases(NTD)Modelling Consortium(Bill and Melina Gates Foundation(BMGF))+2 种基金In addition,LEC work is co-funded by the Netherlands Organisation for Scientific Research(NWO).RC work is funded by the European Research Council(ERC)(AdG671055)the Proof of Concept grant from the European Research Council(ERCpoc)(G768815)All other authors did not receive additional funding.
文摘Background:Since the 1990s,evidence has accumulated of an increased prevalence of epilepsy in onchocerciasisendemic areas in Africa as compared to onchocerciasis-free areas.Although the causal relationship between onchocerciasis and epilepsy has yet to be proven,there is likely an association.Here we discuss the need for disease burden estimates of onchocerciasis-associated epilepsy(OAE),provide them,detail how such estimates should be refined,and discuss the socioeconomic impact of OAE,including a cost-estimate for anti-epileptic drugs.Main body:Providing OAE burden estimates may aid prevention of epilepsy in onchocerciasis-endemic areas by inciting and informing collaboration between onchocerciasis control programmes and mental health services.Epilepsy not only massively impacts the health of those affected,but it also carries a high socioeconomic burden for the households and communities involved.We used previously published geospatial estimates of onchocerciasis in Africa and a separately published logistic regression model quantifying the association between onchocerciasis and epilepsy to estimate the number of OAE cases.We then applied disability weights for epilepsy to quantify the burden in terms of years of life lived with disability(YLD)and estimate the cost of treatment.We estimate that in 2015 roughly 117000 people were affected by OAE across onchocerciasis-endemic areas previously under the African Programme for Onchocerciases control(APOC)mandate where OAE has ever been reported or suspected,and another 264000 persons in onchocerciasis-endemic areas where OAE has never been investigated before.The total number of YLDs due to OAE was 39300 and 88700 in these areas respectively,based on a weighted mean disability weight of 0.336.The burden of OAE is approximately 13%of the total YLDs attributable to onchocerciasis and 10%of total YLDs attributable to epilepsy.We estimated that by 2015 the total costs of treatment with antiepileptic drug for OAE cases would have been a minimum of 12.4 million US$.Conclusions:These estimates suggest a considerable health,social and economic burden of OAE in Africa.The treatment and care for people with epilepsy,especially in hyperendemic onchocerciasis areas with high epilepsy prevalence thus requires more financial and human resources.
基金the National Social Science Fund key project“Research on Progress in Contemporary Western Cultural Identity Theory”(18ASH008)。
文摘In the context of the continuous growth of the aging population,priority has been given to the health promotion strategy of"orientation toward prevention and reduction of disease occurrence."On the basis of the assessment of disability weights in the Global Burden of Disease(GBD),we assigned disability weights to the data on health conditions in the China Health and Retirement Longitudinal Study(CHARLS),using Years Lived with Disability(YLDs)as a quantitative indicator to evaluate the predictive effect of early psychosocial risks on health in old age.The results show that early psychosocial risks significantly increase YLDs in old age and have significant predictive power for high-risk health conditions among the elderly,and that the relationship between the two is causal.In addition,the study identifies four early psychosocial risks that lead to serious deterioration of the quality of life in old age:physical violence,childhood migration,maternal mental health and paternal physical health.These findings have significant implications for preventing the occurrence of aging diseases derived from the distal period of the individual’s lifetime and for implementing"full life cycle health management."
