New Vaccine Development Establishing Priorities: Volume II, Diseases of Importance in Developing Countries (1986) / Chapter Skim
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Appendix C: The Burden of Disease Resulting from Diarrhea
Appendix C: The Burden of Disease Resulting from Diarrhea
Pages 159-169
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From page 159... ...
Few publications, if any, however, provide the data necessary for estimating the global morbidity and mortality burdens that arise from specific pathogens. To arrive at such estimates in the form required for comparing diseases and vaccine benefits, the committee adopted the approach described below.
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From page 160... ...
These estimates were derived from expert Judgment aster a review of available publications and from personal field experience. Only those etiologies for which vaccine prospects are reasonably promising were considered.
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60 and Region Under 5 5-14 15-59 Over Africa 484,010 141,459 79,635 8,186 Asia 1,031,100 333,201 294,448 35,931 Latin America 228,940 100,220 53,604 6,283 Oceania 1,644 643 524 55 Total 1,745,694 575,523 428,211 50,455 TABLE C.4 Estimated Proportion of Diarrheal Episodes by Severity and Consequences, Assuming Current Levels of Interventiona Age Group (years) 60 and Category Under 5 5-14 15-59 Over A (mild)
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From page 162... ...
25 20 Rotavirus Salmonella Shigella 10 5 2 1 10 22.5 1 25 l 8 10 10 20 20 1 2 15 aPercentages do not total 100 because some pathogens that cause diarrhea are not included due to poor vaccine prospects. TABLE C.7 Distribution of Severe Diarrheal Episodes and Deaths by Etiology (percent)
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Realizing this benefit may be impeded by the increasing prevalence of antibiotic-resistant strains of shigella; the consequent need for accurate diagnosis/resistance testing, which may not be available; and in some cases, the need for more expensive antibiotics, which may not be affordable to developing countries. If desired, the effect of wider antibiotic use on the shigellosis disease burden and the ultimate rankings of vaccine benefits can be tested in a manner s imilar to that used for E
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From page 169... ...
Such estimate modifications and their effect on the ultimate ranking can be evaluated. Preliminary calculations of the example cited above suggest an increase in disease burdens of less than 20 percent.
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