Snow R W, Craig M H, Deichmann U, le Sueur D
Kenya Medical Research Institute/Wellcome Trust Collaborative Programme, PO Box 43640, Nairobi, Kenya.
Parasitol Today. 1999 Mar;15(3):99-104. doi: 10.1016/s0169-4758(99)01395-2.
Approaches to global public health are increasingly driven by an understanding of regional patterns of disease-specific mortality and disability. Current estimates of disease risks associated with Plasmodium falciparum in sub-Saharan Africa remain poorly defined. Through the integration of high-resolution population and climate probability models of P. falciparum transmission, geographical information systems have been used to define the spatial limits of populations exposed to the risk of infection in Africa. These estimates were combined with a range of annual malaria-specific mortality rates, derived from a variety of epidemiological approaches, among children aged 0-4 years. The best estimates of malaria-attributable mortality using this approach ranged between 0. 43 million and 0.68 million deaths per annum among an exposed population of approximately 66 million children in 1990. Despite the limitations of modelled transmission and population distributions, these empirical approaches to probabilities of infection risk and epidemiological data on mortality provide a novel approach to present and projected burdens of malaria mortality, as discussed here by Bob Snow, Marlies Craig, Uwe Deichmann and Dave le Sueur.
全球公共卫生方法越来越受到对特定疾病死亡率和残疾区域模式的理解的驱动。目前对撒哈拉以南非洲地区与恶性疟原虫相关的疾病风险估计仍不明确。通过整合恶性疟原虫传播的高分辨率人口和气候概率模型,地理信息系统已被用于确定非洲面临感染风险人群的空间范围。这些估计值与一系列通过各种流行病学方法得出的0至4岁儿童年度特定疟疾死亡率相结合。使用这种方法得出的疟疾归因死亡率的最佳估计值在1990年约6600万暴露儿童中每年为43万至68万例死亡。尽管模型化传播和人口分布存在局限性,但这些关于感染风险概率的实证方法和死亡率的流行病学数据为呈现和预测疟疾死亡负担提供了一种新方法,鲍勃·斯诺、玛莉丝·克雷格、乌韦·戴希曼和戴夫·勒叙厄尔在此进行了讨论。