Quantifying the Burden of Rhodesiense Sleeping Sickness in Urambo District, Tanzania 英文参考文献.docVIP

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Quantifying the Burden of Rhodesiense Sleeping Sickness in Urambo District, Tanzania 英文参考文献.doc

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Quantifying the Burden of Rhodesiense Sleeping Sickness in Urambo District, Tanzania 英文参考文献

QuantifyingtheBurdenofRhodesienseSleeping SicknessinUramboDistrict,Tanzania LucasE.Matemba1,2,EricM.Fe`vre3,StaffordN.Kibona1,KimPicozzi2,SarahCleaveland4,AlexandraP. Shaw5,SusanC.Welburn2* 1TaboraResearchCentre,NationalInstituteforMedicalResearch,Tabora,Tanzania,2CentreforInfectiousDiseases,SchoolofBiomedicalSciences,CollegeofMedicine and Veterinary Medicine, University ofEdinburgh, Edinburgh, United Kingdom, 3Ashworth Laboratories, Centre for InfectiousDiseases, School ofBiological Sciences, CollegeofScienceandEngineering,UniversityofEdinburgh,Edinburgh,UnitedKingdom,4DivisionofEcologyandEvolutionaryBiology,UniversityofGlasgow,Glasgow, UnitedKingdom,5APConsultants,AbbottsAnn,Andover,UnitedKingdom Abstract Background:HumanAfricantrypanosomiasisisaseverelyneglectedvector-bornediseasethatisalwaysfatalifuntreated.In Tanzaniaitishighlyfocalisedandofmajorsocio-economicandpublichealthimportanceinaffectedcommunities. Objectives:ThisstudyaimedtoestimatethepublichealthburdenofrhodesienseHATintermsofDALYsandfinancialcosts inahighlydiseaseendemicareaofTanzaniausinghospitalrecords. MaterialsandMethods:Datawasobtainedfrom143patientsadmittedin2004fortreatmentforHATatKaliuaHealthCentre, UramboDistrict.Thedirectmedicalandotherindirectcostsincurredbyindividualpatientsandbythehealthserviceswere calculated.DALYswereestimatedusingmethodsrecommendedbytheGlobalBurdenofDiseaseProjectaswellasthoseused inpreviousrhodesienseHATestimatesassumingHATunderreportingof45%,afigurespecificforTanzania. Results:TheDALYestimateforHATinUramboDistrictwithandwithoutage-weightingwere215.7(95%CI:155.3–287.5) and 281.6 (95% CI: 209.1–362.6) respectively. When 45% under-reporting was included, the results were 622.5 (95% CI: 155.3–1098.9)and978.9(95%CI:201.1–1870.8)respectively.Thecostsoftreating143patientsintermsofadmissioncosts, diagnosis,hospitalizationandsleepingsicknessdrugswereestimatedatUS$15,514,ofwhichpatientsthemselvespaidUS$ 3,673 and the health services US$ 11,841. The burden in terms of indire