University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Lancet Infect Dis. 2016 May;16(5):584-591. doi: 10.1016/S1473-3099(16)00003-7. Epub 2016 Feb 12.
High-quality epidemiological studies evaluating the burden of cutaneous leishmaniasis worldwide are lacking. We compared the burden of cutaneous leishmaniasis in each country to the overall global burden and assessed the equality of cutaneous leishmaniasis burden across different countries and regions.
Data were extracted from scientific literature, hospital sources, country reports, and WHO sources on the prevalence of sequalae of both acute and chronic cutaneous leishmaniasis. Prevalence data were combined with a disability weight to yield years lived with disability. Disability-adjusted life-years (DALYs) are a sum of the years lived with disability and years of life lost (or mortality, assumed to be zero). We compared DALYs due to cutaneous leishmaniasis for 152 countries using standard Z score analysis with Bonferroni correction (p<0·003) and generation of Lorenz curves with a Gini coefficient.
In 2013, the global mean age-standardised DALYs for cutaneous leishmaniasis was 0·58 per 100 000 people. Nine countries had significantly greater DALYs from cutaneous leishmaniasis than the mean: Afghanistan (87·0), Sudan (20·2), Syria (9·2), Yemen (6·2), Iraq (6·0), Burkina Faso (4·8), Bolivia (4·6), Haiti (4·1), and Peru (4·0). The Gini coefficient was 0·89. Andean Latin America, North Africa and Middle East, western sub-Saharan Africa, and south Asia had the highest DALYs from cutaneous leishmaniasis. Among males, Palestine had the highest incidence rates (616·2 cases per 100 000 people) followed by Afghanistan (566·4), Syria (357·1), and Nicaragua (354·8). Among females, Afghanistan had the highest incidence rates (623·9) followed by Syria (406·3), Palestine (222·1), and Nicaragua (180·8). Similar proportions of males and females had cutaneous leishmaniasis in most countries with a high incidence.
The burden from cutaneous leishmaniasis mainly falls on countries in Africa and the Middle East. Global and national data on the burden of cutaneous leishmaniasis disease are pivotal to promote field studies and initiate behavioural change.
Bill & Melinda Gates Foundation.
缺乏高质量的评估全球皮肤利什曼病负担的流行病学研究。我们将各国的皮肤利什曼病负担与全球总负担进行了比较，并评估了不同国家和地区皮肤利什曼病负担的均等性。
从科学文献、医院资料、国家报告和世卫组织来源中提取了急性和慢性皮肤利什曼病后遗症的患病率数据。将患病率数据与残疾权重相结合，得出残疾生命年。残疾调整生命年（DALYs）是残疾生命年和生命损失年（或假设为零的死亡率）的总和。我们使用标准 Z 分数分析和 Bonferroni 校正（p<0·003）比较了 152 个国家因皮肤利什曼病而导致的 DALYs，并生成了 Lorenz 曲线和基尼系数。
2013 年，全球标准化 DALYs 因皮肤利什曼病而每 10 万人中有 0.58 人。有 9 个国家的皮肤利什曼病 DALYs 明显高于平均值：阿富汗（87.0）、苏丹（20.2）、叙利亚（9.2）、也门（6.2）、伊拉克（6.0）、布基纳法索（4.8）、玻利维亚（4.6）、海地（4.1）和秘鲁（4.0）。基尼系数为 0.89。安第斯拉丁美洲、北非和中东、撒哈拉以南非洲西部和南亚地区因皮肤利什曼病而导致的 DALYs 最高。在男性中，巴勒斯坦的发病率最高（每 10 万人 616.2 例），其次是阿富汗（566.4）、叙利亚（357.1）和尼加拉瓜（354.8）。在女性中，阿富汗的发病率最高（623.9），其次是叙利亚（406.3）、巴勒斯坦（222.1）和尼加拉瓜（180.8）。在大多数高发病率国家，男性和女性患皮肤利什曼病的比例相似。
皮肤利什曼病的负担主要落在非洲和中东国家。全球和国家有关皮肤利什曼病疾病负担的数据对于促进实地研究和启动行为改变至关重要。
比尔和梅琳达·盖茨基金会。
