Charge de morbidité | EPFL Graph Search

La charge de morbidité est un indicateur utilisé par l'Organisation mondiale de la santé évaluant l'impact des problèmes de santé en quantifiant la perte de vie en pleine santé d'une population donnée. Indicateurs utilisés Elle utilise le facteur de pondération QUALY (années de vie ajustées sur la qualité) permettant d'évaluer une espérance de vie corrigée de l'incapacité (EVCI) et le nombre d'années de vie corrigées de l'incapacité (AVCI).

Le QALY permet d'évaluer une année de vie avec une valeur de 0 (décès) à 1 (vie sans pathologie). Les valeurs intermédiaires permettent de quantifier l'impact d'une année de vie avec une pathologie ou un handicap.
L'AVCI est la somme des années vécues avec un handicap pondérées par le facteur de qualité de vie et du nombre d'années perdues par décès par rapport à l'espérance de vie.

:: AVCI = AVH x QALY + AVP ::: AVH : années vécues avec un handicap ::: AVP : années de vie perdues par rapport à l'espérance de vie. :: L'AVCI d'une

Alcohol consumption, alcohol dependence, and related mortality in Italy in 2004: effects of treatment-based interventions on alcohol dependence

Gerrit Gmel

Background: The tradition of consuming alcohol has long been a part of Italian culture and is responsible for a large health burden. This burden may be reduced with effective interventions, one of the more important of which is treatment for Alcohol Dependence (AD). The aim of this article is to estimate the burden of disease in Italy attributable to alcohol consumption, heavy alcohol consumption, and AD. An additional aim of this paper is to examine the effects of increasing the coverage of treatment for AD on the alcohol-attributable burden of disease. Methods: Alcohol-attributable deaths and the effects of treatments for AD were estimated using alcohol-attributable fractions and simulations. Deaths, potential years of life lost, years lived with disability, and disability adjusted life years lost were obtained for 2004 for Italy and for the European Union from the Global Burden of Disease study. Alcohol consumption data were obtained from the Global Information System on Alcohol and Health. The prevalences of current drinkers, former drinkers, and lifetime abstainers were obtained from the GENder Alcohol and Culture International Study. The prevalence of AD was obtained from the World Mental Health Survey. Alcohol relative risks were obtained from various meta-analyses. Results: 5,320 deaths (1,530 female deaths; 3,790 male deaths) or 5.9% of all deaths (4.9% of all female deaths; 6.3% of all male deaths) of people 15 to 64 years of age were estimated to be alcohol-attributable. Of these deaths, 74.5% (61.3% for females; 79.8% for males) were attributable to heavy drinking, and 26.9% (25.6% for females; 27.5% for males) were attributable to AD. Increasing pharmacological AD treatment coverage to 40% would result in an estimated reduction of 3.3% (50 deaths/year) of all female and 7.6% (287 deaths/year) of all male alcohol-attributable deaths. Conclusions: Alcohol was responsible for a large proportion of the burden of disease in Italy in 2004. Increasing treatment coverage for AD in Italy could reduce that country's alcohol-attributable burden of disease.

Biomed Central Ltd2013

Multidrug-resistant tuberculosis: household transmission and associated risk factors

Laurence Läser

Given the global burden of tuberculosis, and more precisely of multidrug-resistant (MDR) tuberculosis (TB), one of the most pressing epidemiological issues is the study and prevention of transmission. The study aims to assess transmission within households that present at least two cases of MDR-TB and the possible risk factors, from MDR-TB isolates collected in Lima, Peru and further characterized by genotyping methods, spoligotyping and mycobacterial interspersed repetitive units (MIRU) - variable number tandem repeat (VNTR), used for DNA fingerprinting. Apart from the genotyping results, the data set also provides the drug susceptibility testing (DST) profile for each isolate, as well as information on the households and the patients. The key assumption to transform molecular data into epidemiological data is that all identical isolates are classified in the same cluster, the cluster belong to a unique strain of tuberculosis, and a unique strain infecting more than one individual is presumed to be the result of direct transmission. The analysis is divided in two parts, first the establishment of household transmission or outside transmission for each isolate and then the following epidemiological analysis; and requires the use of Matlab and Stata software. The main results are the cohort characteristics, the concordance between the two genotyping methods, the clusters' composition and size frequency, the transmission analysis, the amplification of resistance analysis and the risk factors analysis for household transmission. From there, the main findings are the high rate of household transmission (more than 80%) of the isolates and drug resistance amplification (up to 10 new resisitances within one household clustered strain). The risk factor analysis did not present any significant results, but a few trends that are worth to explore in the future

2010

Global burden of injuries attributable to alcohol consumption in 2004: a novel way of calculating the burden of injuries attributable to alcohol consumption

Gerrit Gmel

Background: Alcohol consumption is a major risk factor for injuries; however, international data on this burden are limited. This article presents new methods to quantify the burden of injuries attributable to alcohol consumption and quantifies the number of deaths, potential years of life lost (PYLL), and disability-adjusted life years (DALYs) lost from injuries attributable to alcohol consumption for 2004. Methods: Data on drinking indicators were obtained from the Comparative Risk Assessment study. Data on mortality, PYLL, and DALYs for injuries were obtained from the World Health Organization. Alcohol-attributable fractions were calculated based on a new risk modeling methodology, which accounts for average and heavy drinking occasions. 95% confidence intervals (CIs) were calculated using a Monte Carlo simulation method. Results: In 2004, 851,900 ( 95% CI: 419,400 to 1,282,500) deaths, 19,051,000 ( 95% CI: 9,767,000 to 28,243,000) PYLL, and 21,688,000 (95% CI: 11,097,000 to 32,385,000) DALYs for people 15 years and older were due to injuries attributable to alcohol consumption. With respect to the total number of deaths, harms to others were responsible for 15.1% of alcohol-attributable injury deaths, 14.5% of alcohol-attributable injury PYLL, and 11.35% of alcohol-attributable injury DALYs. The overall burden of injuries attributable to alcohol consumption corresponds to 17.3% of all injury deaths, 16.7% of all PYLL, and 13.6% of all DALYs caused by injuries, or 1.4% of all deaths, 2.0% of all PYLL, and 1.4% of all DALYs in 2004. Conclusions: The novel methodology described in this article to calculate the burden of injuries attributable to alcohol consumption improves on previous methodology by more accurately calculating the burden of injuries attributable to one's own drinking, and for the first time, calculates the burden of injuries attributable to the alcohol consumption of others. The burden of injuries attributable to alcohol consumption is large and is entirely avoidable, and policies and strategies to reduce it are recommended.

Biomed Central Ltd2012

Global burden of injuries attributable to alcohol consumption in 2004: a novel way of calculating the burden of injuries attributable to alcohol consumption

Gerrit Gmel

Biomed Central Ltd2012

Alcohol consumption, alcohol dependence, and related mortality in Italy in 2004: effects of treatment-based interventions on alcohol dependence

Gerrit Gmel

Biomed Central Ltd2013