Revised estimates of leprosy disability weights for assessing the global burden of disease: A systematic review and individual patient data meta-analysis

Autor: Bob Bowers, Juanita A. Haagsma, Anselmo Alves Lustosa, Renata Bilion Ruiz Prado, Betül Demir, Hiroyuki Watanabe, Anuj Tiwari, Rachel Gimenes Albuquerque, Shri Lak Nanjan Chandran, Saba M. Lambert, Jan Hendrik Richardus
Přispěvatelé: Public Health
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Bacterial Diseases
Gerontology
Physical disability
Physiology
RC955-962
Disease
Global Health
Global Burden of Disease
Database and Informatics Methods
Medical Conditions
Mathematical and Statistical Techniques
0302 clinical medicine
Arctic medicine. Tropical medicine
Medicine and Health Sciences
Public and Occupational Health
030212 general & internal medicine
Database Searching
Statistics
Metaanalysis
Infectious Diseases
Physiological Parameters
Meta-analysis
Physical Sciences
Leprosy
Public aspects of medicine
RA1-1270
Research Article
Neglected Tropical Diseases
Inclusion (disability rights)
Disabilities
030231 tropical medicine
Pain
Research and Analysis Methods
03 medical and health sciences
Signs and Symptoms
Quality of life (healthcare)
SDG 3 - Good Health and Well-being
Mental Health and Psychiatry
medicine
Humans
Disabled Persons
Statistical Methods
Disease burden
Estimation
business.industry
Body Weight
Public Health
Environmental and Occupational Health
Biology and Life Sciences
Tropical Diseases
medicine.disease
Quality of Life
Clinical Medicine
business
Mathematics
Zdroj: PLoS Neglected Tropical Diseases, Vol 15, Iss 3, p e0009209 (2021)
PLoS Neglected Tropical Diseases (print), 15(3):e0009209. Public Library of Science
PLoS Neglected Tropical Diseases
ISSN: 1935-2735
1935-2727
DOI: 10.1371/journal.pntd.0009209
Popis: Background Leprosy is a chronic bacterial infection caused by Mycobacterium leprae, which may lead to physical disability, stigma, and discrimination. The chronicity of the disease and disabilities are the prime contributors to the disease burden of leprosy. The current figures of the disease burden in the 2017 global burden of disease study, however, are considered to be under-estimated. In this study, we aimed to systematically review the literature and perform individual patient data meta-analysis to estimate new disability weights for leprosy, using Health-Related Quality of Life (HRQOL) data. Methodology/principal findings The search strategy included all major databases with no restriction on language, setting, study design, or year of publication. Studies on human populations that have been affected by leprosy and recorded the HRQOL with the Short form tool, were included. A consortium was formed with authors who could share the anonymous individual-level data of their study. Mean disability weight estimates, sorted by the grade of leprosy disability as defined by WHO, were estimated for individual participant data and pooled using multivariate random-effects meta-analysis. Eight out of 14 studies from the review were included in the meta-analysis due to the availability of individual-level data (667 individuals). The overall estimated disability weight for grade 2 disability was 0.26 (95%CI: 0.18–0.34). For grade 1 disability the estimated weight was 0.19 (95%CI: 0.13–0.26) and for grade 0 disability it was 0.13 (95%CI: 0.06–0.19). The revised disability weight for grade 2 leprosy disability is four times higher than the published GBD 2017 weights for leprosy and the grade 1 disability weight is nearly twenty times higher. Conclusions/significance The global burden of leprosy is grossly underestimated. Revision of the current disability weights and inclusion of disability caused in individuals with grade 0 leprosy disability will contribute towards a more precise estimation of the global burden of leprosy.
Author summary Leprosy is a chronic, disabling disease that causes various kinds of disability in the affected person. This includes physical impairment, activity limitation, and participation restriction. However, the published global burden of disease estimates for leprosy is considered to be a gross under-estimation. Disability weights form an integral component in the calculation of the burden estimates. But the methodology for calculation of the weights focuses only on physical impairment and lacks the perspective of the patient. In this study, we systematically reviewed the literature and performed an individual patient data meta-analysis for revising the disability weights for leprosy using domain scores from health-related quality of life instruments. The domains of these instruments cover all aspects of disability from a patient’s perspective. We found that the revised weights were considerably higher than the current weights, and were more reflective of the actual disability caused by leprosy. We also found that for individuals without any severe disability due to leprosy (grade 0), they still experience comparable suffering. Revision of the current disability weights and inclusion of the disability caused in grade 0 individuals will contribute towards better estimation of the global burden of leprosy.
Databáze: OpenAIRE
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