Garchitorena Andrés, Ngonghala Calistus N, Guegan Jean-Francois, Texier Gaëtan, Bellanger Martine, Bonds Matthew, Roche Benjamin
UMR MIVEGEC 5290 CNRS - IRD - Université de Montpellier I, Université de Montpellier II, Montpellier, France Ecole des Hautes Etudes en Santé Publique, Rennes, France Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA.
Proc Biol Sci. 2015 Nov 7;282(1818):20151426. doi: 10.1098/rspb.2015.1426.
Neglected tropical diseases (NTDs) have received increasing attention in recent years by the global heath community, as they cumulatively constitute substantial burdens of disease as well as barriers for economic development. A number of common tropical diseases such as malaria, hookworm or schistosomiasis have well-documented economic impacts. However, much less is known about the population-level impacts of diseases that are rare but associated with high disability burden, which represent a great number of tropical diseases. Using an individual-based model of Buruli ulcer (BU), we demonstrate that, through feedbacks between health and economic status, such NTDs can have a significant impact on the economic structure of human populations even at low incidence levels. While average wealth is only marginally affected by BU, the economic conditions of certain subpopulations are impacted sufficiently to create changes in measurable population-level inequality. A reduction of the disability burden caused by BU can thus maximize the economic growth of the poorest subpopulations and reduce significantly the economic inequalities introduced by the disease in endemic regions.
被忽视的热带病（NTDs）近年来受到了全球卫生界越来越多的关注，因为它们累计构成了巨大的疾病负担以及经济发展的障碍。一些常见的热带病，如疟疾、钩虫病或血吸虫病，都有充分记录的经济影响。然而，对于那些罕见但与高残疾负担相关的疾病在人群层面的影响却知之甚少，而这类疾病占了大量的热带病。通过使用基于个体的布鲁里溃疡（BU）模型，我们证明，通过健康与经济状况之间的反馈，即使在低发病率水平下，这类被忽视的热带病也会对人群的经济结构产生重大影响。虽然平均财富仅受到布鲁里溃疡的轻微影响，但某些亚人群的经济状况受到的影响足以导致可衡量的人群层面不平等现象发生变化。因此，减轻布鲁里溃疡造成的残疾负担可以使最贫困亚人群的经济增长最大化，并显著减少该疾病在流行地区造成的经济不平等。
