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Global Burden of Leptospirosis: Estimated in Terms of Disability Adjusted Life Years.

Torgerson PR, Hagan JE, Costa F, Calcagno J, Kane M, Martinez-Silveira MS, Goris MG, Stein C, Ko AI, Abela-Ridder B - PLoS Negl Trop Dis (2015)

Bottom Line: The study suggested that globally approximately 2.90 million DALYs are lost per annum (UIs 1.25-4.54 million) from the approximately annual 1.03 million cases reported previously.Males are predominantly affected with an estimated 2.33 million DALYs (UIs 0.98-3.69) or approximately 80% of the total burden.For comparison, this is over 70% of the global burden of cholera estimated by GBD 2010.

View Article: PubMed Central - PubMed

Affiliation: Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland.

ABSTRACT

Background: Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis can cause life-threatening disease, there is no global burden of disease estimate in terms of Disability Adjusted Life Years (DALYs) available.

Methodology/principal findings: We utilised the results of a parallel publication that reported global estimates of morbidity and mortality due to leptospirosis. We estimated Years of Life Lost (YLLs) from age and gender stratified mortality rates. Years of Life with Disability (YLDs) were developed from a simple disease model indicating likely sequelae. DALYs were estimated from the sum of YLLs and YLDs. The study suggested that globally approximately 2.90 million DALYs are lost per annum (UIs 1.25-4.54 million) from the approximately annual 1.03 million cases reported previously. Males are predominantly affected with an estimated 2.33 million DALYs (UIs 0.98-3.69) or approximately 80% of the total burden. For comparison, this is over 70% of the global burden of cholera estimated by GBD 2010. Tropical regions of South and South-east Asia, Western Pacific, Central and South America, and Africa had the highest estimated leptospirosis disease burden.

Conclusions/significance: Leptospirosis imparts a significant health burden worldwide, which approach or exceed those encountered for a number of other zoonotic and neglected tropical diseases. The study findings indicate that highest burden estimates occur in resource-poor tropical countries, which include regions of Africa where the burden of leptospirosis has been under-appreciated and possibly misallocated to other febrile illnesses such as malaria.

No MeSH data available.


Related in: MedlinePlus

Frequency distribution of the global burden of leptospirosis.
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pntd.0004122.g002: Frequency distribution of the global burden of leptospirosis.

Mentions: The global burden of leptospirosis was estimated at 2·90 million DALYs per annum (UIs 1·25–4·54 million). This consisted of 2·80 million YLLs (1·16 million– 4·46 million) and 103,200 (38,800–188,100) YLDs. This represents an incidence of 41·8 DALYs per 100,000 population per year (UI 18·1–65·5). The frequency distribution of the global DALY estimate is illustrated in Fig 2. Males were predominantly affected with an estimated 2·33 million DALYs (0·95–3·66 million) or approximately 80% of the total burden. Young adults aged 20–49 had an estimated burden of 1·5 million DALYs (0·65–2·32 million) or approximately 52% of the total. Of these young men age 20–49 have a burden of 1·30 million (0·56–2·03 million) or 45% of the total burden. The proportion of the burden of leptospirosis by gender and age is illustrated in Fig 3. Results are given by WHO and GBD region in Tables 3 and 4 respectively. The global burden in terms of DALYs per 100,000 is illustrated in Fig 4. Individual country estimates can be found in the on line supporting information (S2 File). Sensitivity analysis indicated that DWs had very little influence on the estimates for the global burden of disease. Thus the YLLs resulted in 96·4% of the DALYs. This would be the DALY estimate of the burden if the DW was set at zero for all sequelae. When the DW is set at the highest possible of 1 during the acute phase for all cases, the burden is estimated at 3·03 million DALYs (UIs 1·40–4·71 million), of which YLDs are 248,200 (83,800–417,300). In this scenario, the YLLs still represent 91·8% of the total burden. In addition because the uncertainty intervals of the central estimate includes the two extreme estimates by a wide margin, it illustrates that choice of DW has little influence on the burden estimate. Likewise foetal losses suffered by pregnant women affected by leptospirosis resulted in approximately 12,200 YLLs (UIs 8200–16700), representing just 0·4% of total YLLs. The YLDs contributed by leptospirosis associated uveitis was a mean of just 14 and thus make a trivial contribution to the burden of disease.


Global Burden of Leptospirosis: Estimated in Terms of Disability Adjusted Life Years.

Torgerson PR, Hagan JE, Costa F, Calcagno J, Kane M, Martinez-Silveira MS, Goris MG, Stein C, Ko AI, Abela-Ridder B - PLoS Negl Trop Dis (2015)

Frequency distribution of the global burden of leptospirosis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4591975&req=5

pntd.0004122.g002: Frequency distribution of the global burden of leptospirosis.
Mentions: The global burden of leptospirosis was estimated at 2·90 million DALYs per annum (UIs 1·25–4·54 million). This consisted of 2·80 million YLLs (1·16 million– 4·46 million) and 103,200 (38,800–188,100) YLDs. This represents an incidence of 41·8 DALYs per 100,000 population per year (UI 18·1–65·5). The frequency distribution of the global DALY estimate is illustrated in Fig 2. Males were predominantly affected with an estimated 2·33 million DALYs (0·95–3·66 million) or approximately 80% of the total burden. Young adults aged 20–49 had an estimated burden of 1·5 million DALYs (0·65–2·32 million) or approximately 52% of the total. Of these young men age 20–49 have a burden of 1·30 million (0·56–2·03 million) or 45% of the total burden. The proportion of the burden of leptospirosis by gender and age is illustrated in Fig 3. Results are given by WHO and GBD region in Tables 3 and 4 respectively. The global burden in terms of DALYs per 100,000 is illustrated in Fig 4. Individual country estimates can be found in the on line supporting information (S2 File). Sensitivity analysis indicated that DWs had very little influence on the estimates for the global burden of disease. Thus the YLLs resulted in 96·4% of the DALYs. This would be the DALY estimate of the burden if the DW was set at zero for all sequelae. When the DW is set at the highest possible of 1 during the acute phase for all cases, the burden is estimated at 3·03 million DALYs (UIs 1·40–4·71 million), of which YLDs are 248,200 (83,800–417,300). In this scenario, the YLLs still represent 91·8% of the total burden. In addition because the uncertainty intervals of the central estimate includes the two extreme estimates by a wide margin, it illustrates that choice of DW has little influence on the burden estimate. Likewise foetal losses suffered by pregnant women affected by leptospirosis resulted in approximately 12,200 YLLs (UIs 8200–16700), representing just 0·4% of total YLLs. The YLDs contributed by leptospirosis associated uveitis was a mean of just 14 and thus make a trivial contribution to the burden of disease.

Bottom Line: The study suggested that globally approximately 2.90 million DALYs are lost per annum (UIs 1.25-4.54 million) from the approximately annual 1.03 million cases reported previously.Males are predominantly affected with an estimated 2.33 million DALYs (UIs 0.98-3.69) or approximately 80% of the total burden.For comparison, this is over 70% of the global burden of cholera estimated by GBD 2010.

View Article: PubMed Central - PubMed

Affiliation: Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland.

ABSTRACT

Background: Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis can cause life-threatening disease, there is no global burden of disease estimate in terms of Disability Adjusted Life Years (DALYs) available.

Methodology/principal findings: We utilised the results of a parallel publication that reported global estimates of morbidity and mortality due to leptospirosis. We estimated Years of Life Lost (YLLs) from age and gender stratified mortality rates. Years of Life with Disability (YLDs) were developed from a simple disease model indicating likely sequelae. DALYs were estimated from the sum of YLLs and YLDs. The study suggested that globally approximately 2.90 million DALYs are lost per annum (UIs 1.25-4.54 million) from the approximately annual 1.03 million cases reported previously. Males are predominantly affected with an estimated 2.33 million DALYs (UIs 0.98-3.69) or approximately 80% of the total burden. For comparison, this is over 70% of the global burden of cholera estimated by GBD 2010. Tropical regions of South and South-east Asia, Western Pacific, Central and South America, and Africa had the highest estimated leptospirosis disease burden.

Conclusions/significance: Leptospirosis imparts a significant health burden worldwide, which approach or exceed those encountered for a number of other zoonotic and neglected tropical diseases. The study findings indicate that highest burden estimates occur in resource-poor tropical countries, which include regions of Africa where the burden of leptospirosis has been under-appreciated and possibly misallocated to other febrile illnesses such as malaria.

No MeSH data available.


Related in: MedlinePlus