Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda
Zoonotic sleeping sickness, or HAT (Human African Trypanosomiasis), caused by infection with Trypanosoma brucei rhodesiense, is an under-reported and neglected tropical disease. Previous assessments of the disease burden expressed as Disability-Adjusted Life Years (DALYs) for this infection have not...
| Main Authors: | , , , , |
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| Format: | Journal Article |
| Language: | Inglés |
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Springer
2008
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| Online Access: | https://hdl.handle.net/10568/61864 |
| _version_ | 1855529087006670848 |
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| author | Fèvre, Eric M. Odiit, M. Coleman, P.G. Woolhouse, Mark E.J. Welburn, S.C. |
| author_browse | Coleman, P.G. Fèvre, Eric M. Odiit, M. Welburn, S.C. Woolhouse, Mark E.J. |
| author_facet | Fèvre, Eric M. Odiit, M. Coleman, P.G. Woolhouse, Mark E.J. Welburn, S.C. |
| author_sort | Fèvre, Eric M. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Zoonotic sleeping sickness, or HAT (Human African Trypanosomiasis), caused by infection with Trypanosoma brucei rhodesiense, is an under-reported and neglected tropical disease. Previous assessments of the disease burden expressed as Disability-Adjusted Life Years (DALYs) for this infection have not distinguished T.b. rhodesiense from infection with the related, but clinically distinct Trypanosoma brucei gambiense form. T.b. rhodesiense occurs focally, and it is important to assess the burden at the scale at which resource-allocation decisions are made.The burden of T.b. rhodesiense was estimated during an outbreak of HAT in Serere, Uganda. We identified the unique characteristics affecting the burden of rhodesiense HAT such as age, severity, level of under-reporting and duration of hospitalisation, and use field data and empirical estimates of these to model the burden imposed by this and other important diseases in this study population. While we modelled DALYs using standard methods, we also modelled uncertainty of our parameter estimates through a simulation approach. We distinguish between early and late stage HAT morbidity, and used disability weightings appropriate for the T.b. rhodesiense form of HAT. We also use a model of under-reporting of HAT to estimate the contribution of un-reported mortality to the overall disease burden in this community, and estimate the cost-effectiveness of hospital-based HAT control.Under-reporting accounts for 93% of the DALY estimate of rhodesiense HAT. The ratio of reported malaria cases to reported HAT cases in the same health unit was 133:1, however, the ratio of DALYs was 3:1. The age productive function curve had a close correspondence with the HAT case distribution, and HAT cases occupied more patient admission time in Serere during 1999 than all other infectious diseases other than malaria. The DALY estimate for HAT in Serere shows that the burden is much greater than might be expected from its relative incidence. Hospital based control in this setting appears to be highly cost-effective, highlighting the value of increasing coverage of therapy and reducing under-reporting.We show the utility of calculating DALYs for neglected diseases at the local decision making level, and emphasise the importance of improved reporting systems for acquiring a better understanding of the burden of neglected zoonotic diseases. |
| format | Journal Article |
| id | CGSpace61864 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2008 |
| publishDateRange | 2008 |
| publishDateSort | 2008 |
| publisher | Springer |
| publisherStr | Springer |
| record_format | dspace |
| spelling | CGSpace618642024-10-03T07:40:54Z Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda Fèvre, Eric M. Odiit, M. Coleman, P.G. Woolhouse, Mark E.J. Welburn, S.C. trypanosomiasis animal diseases livestock zoonoses Zoonotic sleeping sickness, or HAT (Human African Trypanosomiasis), caused by infection with Trypanosoma brucei rhodesiense, is an under-reported and neglected tropical disease. Previous assessments of the disease burden expressed as Disability-Adjusted Life Years (DALYs) for this infection have not distinguished T.b. rhodesiense from infection with the related, but clinically distinct Trypanosoma brucei gambiense form. T.b. rhodesiense occurs focally, and it is important to assess the burden at the scale at which resource-allocation decisions are made.The burden of T.b. rhodesiense was estimated during an outbreak of HAT in Serere, Uganda. We identified the unique characteristics affecting the burden of rhodesiense HAT such as age, severity, level of under-reporting and duration of hospitalisation, and use field data and empirical estimates of these to model the burden imposed by this and other important diseases in this study population. While we modelled DALYs using standard methods, we also modelled uncertainty of our parameter estimates through a simulation approach. We distinguish between early and late stage HAT morbidity, and used disability weightings appropriate for the T.b. rhodesiense form of HAT. We also use a model of under-reporting of HAT to estimate the contribution of un-reported mortality to the overall disease burden in this community, and estimate the cost-effectiveness of hospital-based HAT control.Under-reporting accounts for 93% of the DALY estimate of rhodesiense HAT. The ratio of reported malaria cases to reported HAT cases in the same health unit was 133:1, however, the ratio of DALYs was 3:1. The age productive function curve had a close correspondence with the HAT case distribution, and HAT cases occupied more patient admission time in Serere during 1999 than all other infectious diseases other than malaria. The DALY estimate for HAT in Serere shows that the burden is much greater than might be expected from its relative incidence. Hospital based control in this setting appears to be highly cost-effective, highlighting the value of increasing coverage of therapy and reducing under-reporting.We show the utility of calculating DALYs for neglected diseases at the local decision making level, and emphasise the importance of improved reporting systems for acquiring a better understanding of the burden of neglected zoonotic diseases. 2008-12 2015-03-25T09:09:38Z 2015-03-25T09:09:38Z Journal Article https://hdl.handle.net/10568/61864 en Open Access Springer BioMed Central Public Health;8:96. |
| spellingShingle | trypanosomiasis animal diseases livestock zoonoses Fèvre, Eric M. Odiit, M. Coleman, P.G. Woolhouse, Mark E.J. Welburn, S.C. Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda |
| title | Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda |
| title_full | Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda |
| title_fullStr | Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda |
| title_full_unstemmed | Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda |
| title_short | Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda |
| title_sort | estimating the burden of rhodesiense sleeping sickness during an outbreak in serere eastern uganda |
| topic | trypanosomiasis animal diseases livestock zoonoses |
| url | https://hdl.handle.net/10568/61864 |
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