Leprosy Mailing List – June 25, 2015
Ref.: (LML) Disability Adjusted Life Years (DALYs)
From: David M Scollard, Louisiana, USA
Dear Pieter,
In response to Dr. Almeida and others, I agree that better indicators of the social and economic impact of HD are needed. The measurement of DALY (or DAWLY) seems at first to fill this need, but the results, when compared with other diseases, make me wonder about the way this is calculated and used.
For example, the following (Table 3) from Mathers, Ezzati, and Lopez, Measuring the Burden of Neglected Tropical Diseases: The Global Burden of Disease Framework, PLOS 2007, using DALY as a measurement, puts leprosy at the bottom of the list of ‘neglected tropical diseases’ (see attachment).
This seems intuitively incorrect to those of us who see the disabling effects of HD, but it has a persuasive, negative impact on foundations and policy makers interested in actions that will bring about global improvements in health. It appears to them that HD is not a disease problem in which to ‘invest’.
Though we may argue about the accuracy of incidence and prevalence numbers for HD, this is not the full explanation for the low ranking of HD here, since other diseases with higher DALYs have lower incidence and prevalence. It is apparent that some diseases may rank highly on this scale because they are fatal. If that is a contributing factor in the high DALY ranking for some diseases, it may be obscuring the serious impact of non-fatal disabling diseases, such as HD.
Can Drs. Almeida and Rao and others enlighten us as to why DALY ranks HD so low in comparison to these other diseases, and if there are ways to address this to make our concerns about HD more persuasive to those outside of the field?
Thank you!
David M. Scollard, M.D., Ph.D.
Director
National Hansen’s Disease Programs
Tel: 225-756-3713 (Clinical) or 756-3776 (Administration)
Fax: 225-756-3819 or 756-3806
E-mail: dscollard@hrsa.gov
LML - S Deepak, B Naafs, S Noto and P Schreuder
Contact: Dr Pieter Schreuder << editorlml@gmail.com
 |
This email has been checked for viruses by Avast antivirus software.
www.avast.com |
No comments:
Post a Comment