卫生经济学家评估登革热的经济影响2016-05-19 SIFIC热点团队 SIFIC官微
卫生经济学家评估登革热的经济影响Health Economists Determine Dengue Fever's Economic Impact 译者：刘金淑 陈志锦 审核：唐文瑞 陈志锦 In keeping with the Schneider Institutes for Health Policy (SIHP)'s mandate to inform health policy through rigorous economic analyses, a group of SIHP health economists at Brandeis University's Heller School for Social Policy and Management has published a comprehensive assessment of the economic burden that dengue fever imposes on 141 countries and territories around the world where active dengue transmission has been identified. 一组施耐德卫生政策研究所（SIHP）的卫生经济学家根据SIHP布置的工作任务，经过严格的经济学分析，发表了一份在已确认登革热活跃传播的全球141个国家和地区的经济负担综合评估报告。
In summary, the group found that the global cost of dengue is substantial. At an estimated cost of $8.9 billion annually, the price tag for dengue exceeds that of several other major infectious diseases such as cholera, rotavirus gastroenteritis, canine rabies and Chagas, notes lead author Donald Shepard.
概括地说，该小组发现全球的登革热成本是巨大的。唐纳德•谢帕德指出，每年治疗登革热预计的费用达89亿美元，其费用超过了其他几种主要传染病（如霍乱、轮状病毒性肠道炎、狂犬病和锥虫病）的总费用。 Dengue is the world's fastest growing mosquito-borne disease, currently threatening about half the world's population or almost 4 billion people and leading to an estimated 60-100 million symptomatic dengue cases every year. The disease's common nickname in the tropical and subtropical countries where it is found is 'break-bone fever,' which attests to the degree of suffering it can inflict. 登革热是全球增长最快的蚊媒传播性疾病，目前大约一半的地球人口（近40亿人 口）受到威胁，每年导致约六千万至一亿有症状的登革热病例。该病常见于热带和亚热带地区，被称为“断骨热”，这证明了它能造成痛苦的程度。 Since it is transmitted by four distinct types of viruses, dengue can hit the same individual up to four times. Dengue fever is prone to resource-intensive outbreaks that tend to hit hardest in the urban growth centers of endemic countries, like Brazil, Indonesia and India. In this way, dengue can literally break the back of local healthcare systems and lead to intensive associated costs, related both to medical care and lost productivity. 由于它有四个不同类型的病毒株，所以同一个体可以感染登革热多达四次。登革热的特点是倾向于密集型暴发，往往流行于发展中国家的城市中心，巴西、印度尼西亚和印度受灾最严重。如此一来，登革热就能轻易地摧毁当地的医疗体系，导致大量的医疗费用以及相关生产损失。
But dengue fever is not a highly fatal disease and, therefore, it does not typically garner as much attention in terms of traditional measures of disease burden as malaria, for example. Shepard and this team are an exception, however, as they published their first paper on the economics of dengue in 1993. Since then, they have also published several studies on the economic burden of dengue at the level of individual countries where dengue is a major public health threat such as India, Malaysia, Mexico, and the Philippines. 但登革热不是高致命性的疾病，因此在传统传染病防控投入方面，它通常不会获得像疟疾一样多的关注。然而，谢帕德和该团队是个例外，因为早在1993年他们已经发表了第一篇关于登革热的经济学论文。从那以后，他们还根据不同国家的情况，发表了一些关于登革热经济负担的研究，印度、马来西亚、墨西哥和菲律宾这些国家的登革热疫情是其公共卫生的主要威胁。
Therefore, the Lancet Infectious Diseases article titled, "The Global Economic Burden of Dengue: A Systematic Estimate." provides a much-needed update on the economic impact of this disease worldwide. The paper took a comprehensive view to assemble all existing evidence to generate a systematic estimate of global economic burden and, for the first time, to replicate this process 1,000 times to generate uncertainty intervals around the central estimate. 因此，《柳叶刀·传染病》一篇题为《登革热的全球经济负担：系统评估》的文章，指出了更新全球范围登革热疾病经济负担的迫切需要。本文采取综述方式，通过对集合全球所有现有的证据进行系统性经济学评估，并首次重复评估过程1000次，以确定其可信区间。
"The dearth of population-based data for many elements was the biggest challenge of us. For important parts of the tropics-especially South Asia and Africa-almost no such studies exist, in fact," notes Shepard. 谢帕德指出：“基于人口的数据，因许多分析因素的缺失，给我们带来了巨大的挑战。事实上，虽然登革热主要发现在亚热带地区，但是南亚和非洲几乎没有进行登革热经济学研究。“ The study provides both global and regional estimates on the cost of dengue, broken down by country and various short- and long-term costs. By putting a value on the size of the dengue problem, these estimates will help governments and donors make better-informed decisions around their dengue programs. 该研究按国家和各种短长期费用进行分解，提供了全球和各地区的登革热成本预算。各个政府和捐助者可以根据登革热问题的程度来给予相应的经济支持，这些费用预算可以帮助他们在制定登革热相关方案时能够做出更明智的决策。 "In every country the public purse has more demands than it can satisfy," says Shepard. "Defining dengue in monetary terms means the disease can be compared with other economic problems. Public health systems can then leverage that information to secure resources from their Ministry of Finance -- and possibly the donor community -- to control the disease." 谢帕德接着说：“每个国家的公共财政都是供不应求的，以货币形式来定义登革热，意味着它可以与其他经济问题相提并论。然后公共卫生系统可以利用这些预算信息从财政部获取资源，或者得到社会捐助，来控制登革热。”
In quantifying the uncertainty around the study's estimates, the study highlights the importance of conducting additional cohort studies and linking the results with routine surveillance data. 鉴于研究的评估中存在不确定的量化，该研究强调了结合附加队列研究和常规监测数据结果的重要性。
"Our hope is that a greater understanding of the main factors driving uncertainty around the burden of dengue will allow current estimates to be improved and, consequently, drive the evaluation of existing and potential future preventive and treatment approaches," says Shepard. 谢帕德说：“我们的希望是，进一步了解登革热经济负担的主要不确定因素，改善当前的预算，从而推动现有评估和未来可能的防治方法。” Source: Brandeis University 来源:布兰迪斯大学 译者：刘金淑 河南省濮阳市油田总医院 陈志锦 广东医科大学附属东莞市厚街医院 审核：唐文瑞 湖南省湘潭市中心医院 陈志锦 广东医科大学附属东莞市厚街医院
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