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The Journal of Health, Population and Nutrition
icddr,b
ISSN: 1606-0997 EISSN: 1606-0997
Vol. 22, No. 3, 2004, pp. 232-239
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Bioline Code: hn04030
Full paper language: English
Document type: Research Article
Document available free of charge
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The Journal of Health, Population and Nutrition, Vol. 22, No. 3, 2004, pp. 232-239
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Multidisciplinary Studies of Disease Burden in the Diseases of the Most Impoverished Programme
Deen, Jacqueline L.; Seidlein, Lorenz von & Clemens, John D.
Abstract
With limited healthcare resources, rational prioritization of healthcare interventions requires knowledge
and analysis of disease burden. In the absence of actual disease-burden data from less-developed
countries, various types of morbidity and mortality estimates have been made. Besides having questionable
reliability, these estimates do not capture the full burden of a disease since they provide only
the number of cases and deaths. The modelling methods that include disability are more comprehensive
but are difficult to understand, and their reliability is affected by baseline approximations. To provide
policy-makers with information needed for rational decision-making, the Diseases of the Most
Impoverished (DOMI) Programme of the International Vaccine Institute has used a multidisciplinary
approach to describe the burden of disease due to typhoid fever, shigellosis, and cholera. Recognizing
the relative advantages and disadvantages of various methodologies, the programme employs passive
clinic-based surveillance in defined communities to provide prospective data. The prospective data are
complemented with retrospectively-collected information from existing sources, frequently less accurate
and complete but readily available for the whole population over extended periods. To create a
more complete picture, economic and qualitative studies specific to each disease are incorporated in
these prospective studies. The goal is to achieve a more complete and realistic picture by combining
the results of these various methodologies, acknowledging the strengths and limitations of each. These
projects also build in-country capacity in terms of treatment, diagnosis, epidemiology, and data management.
Keywords
Morbidity; Mortality; Disease burden; Typhoid; Dysentery; Bacillary; Cholera; Vaccines
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