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Morbidity and cost of helminth infections: fitting existing and investigating missing pieces of evidence

English title Morbidity and cost of helminth infections: fitting existing and investigating missing pieces of evidence
Applicant Fürst Thomas
Number 154634
Funding scheme Advanced Postdoc.Mobility
Research institution Institut für Sozial- und Präventivmedizin Universität Basel Swiss TPH
Institution of higher education Institution abroad - IACH
Main discipline Infectious Diseases
Start/End 01.09.2014 - 31.03.2016
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All Disciplines (2)

Discipline
Infectious Diseases
Methods of Epidemiology and Preventive Medicine

Keywords (8)

Helminth infections; Neglected tropical diseases; Morbidity; Summary measures of population health; Health economics; Health policy; Systematic review and meta-analysis; Mathematical modelling

Lay Summary (German)

Lead
Wurminfektionen gehören zu den häufigsten parasitären Infektionen des Menschen, aber ihre Folgen für die Gesundheit und ihre ökonomischen Kosten sind unklar, weshalb sie zu den vernachlässigten Tropenkrankheiten zählen. Einige Experten vermuten, dass auch Mängel in häufig verwendeten Masszahlen zur Volksgesundheit zur (ungerechtfertigten?) Vernachlässigung von Wurminfektionen beitragen. Die Verwendung solcher Masszahlen in Fragen der öffentlichen Gesundheit und die wahre Bedeuteung von Wurminfektionen für die öffentliche Gesundheit bedürfen deshalb weiterer Abklärungen.
Lay summary

Ziel: Dieses Projekt soll unser Wissen von durch Wurminfektionen verursachten Gesundheitsbeeinträchtigungen und Kosten verbessern und eruieren inwiefern diese Konsequenzen in Masszahlen zur Volksgesundheit berücksichtigt sind. Teilziele sind (1) unser Wissen wie verschiedene Gesundheitszustände von Individuen bewertet und in Masszahlen zur Volksgesundheit berücksichtigt werden können zu verbessern, (2) unser Wissen zu den ökonomischen Kosten von Wurminfektionen und Wurmkontrolle zu verbessern, (3) die Kosten von Wurminfektionen und Wurmkontrolle mit Infektions- und Krankheitsmodellen zu verbinden und Analysen zu Kosteneffizienz und Wissenslücken durchzuführen, und (4) erste bevölkerungsbezogene Studien zu entwerfen, welche helfen Wissenslücken zu Krankheit und Kosten von Wurminfektionen zu schliessen und Mängel in Masszahlen zur Volksgesundheit zu beheben.

Wissenschaftlicher und sozialer Kontext: Der Gebrauch bestimmter Masszahlen zur Volksgesundheit zur Entscheidungsfindung in Fragen der öffentlichen Gesundheit ist heute weit verbreitet. Deshalb ist es wichtig, dass Mängel in solchen Masszahlen entdeckt und behoben und auch Krankheiten wie Wurminfektionen korrekt erfasst und miteingeschlossen werden.

Direct link to Lay Summary Last update: 28.07.2014

Lay Summary (English)

Lead
Worm infections are among the most common parasitic infections in humans, but their health consequences and economic costs are not well understood and hence, they belong to the neglected tropical diseases. Some experts also presume that flaws in the currently most widely used summary measures of population health may play a role in the (unjustified?) neglect of worm infections. Hence, the functioning of summary measures of population health for public health decision making and the true public health relevance of worm infections should be further assessed.
Lay summary

Aims: This research project aims to improve our understanding of health impairments and costs due to worm infections and how summary measures of population health reflect these consequences. The four specific objectives pursued are (1) to summarise and improve our understanding of how different health states of individuals are valued and considered in summary measures of population health; (2) to summarise and deepen our understanding of the economic costs of worm infections and respective control interventions; (3) to link the costs of worm infections and control interventions with disease and morbidity models and perform cost-effectiveness and knowledge gap analyses; and (4) to start designing appropriate population-based studies to address identified knowledge gaps regarding morbidity and costs associated with worm infections and to improve flaws in summary measures of population health.

Scientific and societal context: Nowadays, summary measures of population health are widely used in public health decision making. Hence, it is crucial that flaws in these summary measures are detected and corrected and that diseases such as worm infections are correctly evaluated and incorporated.

Direct link to Lay Summary Last update: 28.07.2014

Responsible applicant and co-applicants

Employees

Publications

Publication
Effect of sanitation and water treatment on intestinal protozoa infection: a systematic review and meta-analysis.
Speich Benjamin, Croll David, Fürst Thomas, Utzinger Jürg, Keiser Jennifer (2016), Effect of sanitation and water treatment on intestinal protozoa infection: a systematic review and meta-analysis., in The Lancet. Infectious diseases, 16(1), 87-99.
Global and National Burden of Diseases and Injuries Among Children and Adolescents Between 1990 and 2013: Findings From the Global Burden of Disease 2013 Study.
Global Burden of Disease Pediatrics Collaboration, Kyu Hmwe H, Pinho Christine, Wagner Joseph A, Brown Jonathan C, Bertozzi-Villa Amelia, Charlson Fiona J, Coffeng Luc Edgar, Dandona Lalit, Erskine Holly E, Ferrari Alize J, Fitzmaurice Christina, Fleming Thomas D, Forouzanfar Mohammad H, Graetz Nicholas, Guinovart Caterina, Haagsma Juanita, Higashi Hideki, Kassebaum Nicholas J, Larson Heidi J, Lim Stephen S, Mokdad Ali H, Moradi-Lakeh Maziar, Odell Shaun V, Roth Gregory A (2016), Global and National Burden of Diseases and Injuries Among Children and Adolescents Between 1990 and 2013: Findings From the Global Burden of Disease 2013 Study., in JAMA pediatrics, 170(3), 267-87.
Assessing numbers and faces: a prerequisite for improving access to lymphatic filariasis morbidity care.
Becker Sören L, Fürst Thomas, Addiss David G, Utzinger Jürg (2015), Assessing numbers and faces: a prerequisite for improving access to lymphatic filariasis morbidity care., in Transactions of the Royal Society of Tropical Medicine and Hygiene, 109(6), 357-9.
Causes of death in the Taabo health and demographic surveillance system, Côte d'Ivoire, from 2009 to 2011.
Koné Siaka, Fürst Thomas, Jaeger Fabienne N, Esso Emmanuel L J C, Baïkoro Nahoua, Kouadio Kouamé A, Adiossan Lukas G, Zouzou Fabien, Boti Louis I, Tanner Marcel, Utzinger Jürg, Bonfoh Bassirou, Dao Daouda, N'Goran Eliézer K (2015), Causes of death in the Taabo health and demographic surveillance system, Côte d'Ivoire, from 2009 to 2011., in Global health action, 8, 27271-27271.
Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
Newton John N, Briggs Adam D M, Murray Christopher J L, Dicker Daniel, Foreman Kyle J, Wang Haidong, Naghavi Mohsen, Forouzanfar Mohammad H, Ohno Summer Lockett, Barber Ryan M, Vos Theo, Stanaway Jeffrey D, Schmidt Jürgen C, Hughes Andrew J, Fay Derek F J, Ecob Russell, Gresser Charis, McKee Martin, Rutter Harry, Abubakar Ibrahim, Ali Raghib, Anderson H Ross, Banerjee Amitava, Bennett Derrick A, Bernabé Eduardo (2015), Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013., in Lancet (London, England), 386(10010), 2257-74.
Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
GBD 2013 Mortality and Causes of Death Collaborators (2015), Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013., in Lancet (London, England), 385(9963), 117-71.
Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition.
GBD 2013 DALYs and HALE Collaborators, Murray Christopher J L, Barber Ryan M, Foreman Kyle J, Abbasoglu Ozgoren Ayse, Abd-Allah Foad, Abera Semaw F, Aboyans Victor, Abraham Jerry P, Abubakar Ibrahim, Abu-Raddad Laith J, Abu-Rmeileh Niveen M, Achoki Tom, Ackerman Ilana N, Ademi Zanfina, Adou Arsène K, Adsuar José C, Afshin Ashkan, Agardh Emilie E, Alam Sayed Saidul, Alasfoor Deena, Albittar Mohammed I, Alegretti Miguel A, Alemu Zewdie A, Alfonso-Cristancho Rafael (2015), Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition., in Lancet (London, England), 386(10009), 2145-91.
Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
Global Burden of Disease Study 2013 Collaborators (2015), Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013., in Lancet (London, England), 386(9995), 743-800.
Health & Demographic Surveillance System Profile: The Taabo Health and Demographic Surveillance System, Côte d'Ivoire.
Koné Siaka, Baikoro Nahoua, N'Guessan Yao, Jaeger Fabienne N, Silué Kigbafori D, Fürst Thomas, Hürlimann Eveline, Ouattara Mamadou, Séka Marie-Chantal Y, N'Guessan Nicaise A, Esso Emmanuel L J C, Zouzou Fabien, Boti Louis I, Gonety Prosper T, Adiossan Lukas G, Dao Daouda, Tschannen Andres B, von Stamm Thomas, Bonfoh Bassirou, Tanner Marcel, Utzinger Jürg, N'Goran Eliézer K (2015), Health & Demographic Surveillance System Profile: The Taabo Health and Demographic Surveillance System, Côte d'Ivoire., in International journal of epidemiology, 44(1), 87-97.
World Health Organization Estimates of the Global and Regional Disease Burden of 11 Foodborne Parasitic Diseases, 2010: A Data Synthesis.
Torgerson Paul R, Devleesschauwer Brecht, Praet Nicolas, Speybroeck Niko, Willingham Arve Lee, Kasuga Fumiko, Rokni Mohammad B, Zhou Xiao-Nong, Fèvre Eric M, Sripa Banchob, Gargouri Neyla, Fürst Thomas, Budke Christine M, Carabin Hélène, Kirk Martyn D, Angulo Frederick J, Havelaar Arie, de Silva Nilanthi (2015), World Health Organization Estimates of the Global and Regional Disease Burden of 11 Foodborne Parasitic Diseases, 2010: A Data Synthesis., in PLoS medicine, 12(12), 1001920-1001920.
World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010.
Havelaar Arie H, Kirk Martyn D, Torgerson Paul R, Gibb Herman J, Hald Tine, Lake Robin J, Praet Nicolas, Bellinger David C, de Silva Nilanthi R, Gargouri Neyla, Speybroeck Niko, Cawthorne Amy, Mathers Colin, Stein Claudia, Angulo Frederick J, Devleesschauwer Brecht, Devleesschauwer Brecht (2015), World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010., in PLoS medicine, 12(12), 1001923-1001923.
Health-related quality of life among school children with parasitic infections: findings from a national cross-sectional survey in Côte d'Ivoire.
Hürlimann Eveline, Houngbedji Clarisse A, Yapi Richard B, Ndri Prisca B, Silué Kigbafori D, Soro Gotianwa, Kouamé Ferdinand N, Fürst Thomas, Utzinger Jürg, N'Goran Eliézer K, Raso Giovanna (2014), Health-related quality of life among school children with parasitic infections: findings from a national cross-sectional survey in Côte d'Ivoire., in PLoS neglected tropical diseases, 8(12), 3287-3287.

Collaboration

Group / person Country
Types of collaboration
Dr Wilma Stolk, Erasmus University Medical Center Netherlands (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Dr Brecht Devleesschauwer, University of Florida United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Dr Jason Madan, Warwick University Great Britain and Northern Ireland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Dr Lesong Conteh, Imperial College London Great Britain and Northern Ireland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Prof. Chris Murray, Institute for HEalth Metrics and Evaluation United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Prof Paul Torgerson, University of Zürich Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Prof Deridre Hollingsworth, Warwick University Great Britain and Northern Ireland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Prof Charles King, Case Western Reserve University United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
Prof John Newton, Public Health England Great Britain and Northern Ireland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Prof Maria-Gloria Basanez, Imperial College London Great Britain and Northern Ireland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Prof Juanita Haagsma, Institute for Health Metrics and Evaluation United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Dr Claudia Stein, WHO Europe Denmark (Europe)
- in-depth/constructive exchanges on approaches, methods or results

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
9th European Congress on Tropical Medicine and International Health (ECTMIH) Poster Critical appraisal of global burden of disease studies: experiences and findings from working on estimates for foodborne trematodiases 06.09.2015 Basel, Switzerland Fürst Thomas;
63rd Annual Meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) Talk given at a conference Disability- and quality-adjusted life years: measuring health or…? 06.11.2014 New Orleans, United States of America Fürst Thomas;


Associated projects

Number Title Start Funding scheme
146869 Morbidity and cost of helminth infections: learning from the past to prepare for the future 01.07.2013 Fellowships for prospective researchers

Abstract

Background: Helminth infections are among the most common parasitic infections in humans. Nevertheless, helminthiases belong to the neglected tropical diseases and there is a paucity of high-quality data on these infections in general and on their health consequences and economic costs in particular. Hence, their true public health relevance still has to be elucidated. Helminthiases thrive in socio-economically deprived, marginalized populations with poor hygiene, inadequate sanitation and access to clean water, insufficient information and education, lack of access to health care and high exposure to disease vectors and thereby further deprive the already deprived. Tools for the diagnosis of helminth infections are still inadequate, but generally safe and efficacious anthelminthic drugs are available. The current mainstay of helminthiasis control is preventive chemotherapy, which means repeated drug administration to populations at-risk without prior diagnosis, with the primary objective to control morbidity and transmission. However, this approach raises questions about permanent helminth recurrence, re-infection, the need for more integrated approaches, and hence the cost-effectiveness and sustainability of helminth control strategies.Goal and objectives: The overarching goal of the here proposed research project is to improve our understanding of summary measures of population health in general and with a focus on morbidity and costs due to helminth infections in particular. The following four specific and interrelated objectives will be pursued in order to achieve this goal: (1) to summarise and improve our understanding of health state valuation techniques; (2) to summarise and deepen our understanding of the economic costs of helminth infections and respective control interventions; (3) to link disease and morbidity models with data on the costs of helminth infections and respective control interventions and perform cost-effectiveness and knowledge gap analyses; and (4) to further consolidate my research findings and collaborations and design appropriate population-based studies to address identified knowledge gaps regarding summary measures of population health in general and morbidity and costs associated with helminth infections in particular.Approaches taken: Systematic reviews on health state valuation techniques and the economic costs of helminth infections and respective control interventions will be performed. The information on health state valuation techniques will be used for complementing the currently ongoing theoretical work on an integrated conceptualization of well-being and health and serve also as a key input for the objectives (3) and (4) of the here proposed project. The data from the review on the economic costs of helminth infections and related control interventions will be juxtaposed with the results of a currently ongoing project aiming at incorporating helminth morbidity data into mathematical disease models. Suitable cost data will be subjected to meta-analyses and linked with the dynamic infection and morbidity models to generate costing and cost-effectiveness simulations. Depending on the results of the currently ongoing morbidity review and the here proposed review on health state valuation techniques, the effects of helminth infections and related control interventions could be expressed in different summary measures of population health. Knowledge gap analysis will be performed throughout the project and enable the design of highly innovative population-based studies to address the identified gaps in the future.Expected results and their importance: Databases containing the currently available evidence with regard to health state valuation techniques and the economic costs of helminth infections and related control interventions will be established. While the currently ongoing work about the elaboration of an integrated conceptualization of well-being and health will help to better define descriptive health state profiles, the here proposed work on health state valuation techniques will provide essential insights into how these refined health state profiles could be transformed into the crucial disability- or quality-weights for summary measures of population health. Such findings will have important ramifications on the definition and calculation of summary measures of population health (e.g. disability-adjusted life years, quality-adjusted life years) and consequentially also for public health, health economic and health policy analyses. In addition, new or improved mathematical models will help to elucidate the link between helminth infection, morbidity and economic costs and thereby deepen our understanding of the epidemiology and public health relevance of these neglected tropical diseases. Differences in recommendations for decision making resulting solely from different approaches to express the effects of helminth infections and respective control interventions will be disclosed. Hence, the expected results will be of critical importance not only for managers of helminthiases control interventions but also for more general public health decision makers. The identified knowledge gaps will help to shape the future research agenda with regard to more theoretical, conceptual, reviewing and modelling desktop work and also with regard to primary data collection through innovative fieldwork.Host institution and personal career development: The proposed 2-years prolongation of my postdoctoral research at Imperial College London constitutes a logical continuation of my work in a truly world class, multi-disciplinary and multi-cultural research environment. It will allow me to further deepen my understanding of summary measures of population health, disease modelling, health economics and health policy. All these fields are highly relevant and interlinked in modern epidemiology. A 1-year return grant would enable me to further consolidate my research findings and collaborations and to capitalise on this potential in order to successfully launch my post postdoc career at the Swiss Tropical and Public Health Institute.
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