Calculating disability-adjusted-life-years lost (DALYs) in discrete-time

Larson, Bruce A.

doi:10.1186/1478-7547-11-18

Cited by 29 publications

(16 citation statements)

References 12 publications

(6 reference statements)

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“…Discounting aligns with empirical economic evidence [ 36 , 37 ], in assigning a higher weight to years lost now or in the near future, as compared to years lost in the more distant future [ 37 ]). The non-discounted, non-age-weighted DALY estimate is non-discriminatory for age and was adopted as the baseline method for calculation of DALYs for males and females [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

Estimating the economic and social consequences for patients diagnosed with human African trypanosomiasis in Muchinga, Lusaka and Eastern Provinces of Zambia (2004–2014)

et al. 2017

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BackgroundAcute human African trypanosomiasis (rHAT) caused by Trypanosoma brucei rhodesiense is associated with high mortality and is fatal if left untreated. Only a few studies have examined the psychological, social and economic impacts of rHAT. In this study, mixed qualitative and quantitative research methods were used to evaluate the socio-economic impacts of rHAT in Mambwe, Rufunsa, Mpika and Chama Districts of Zambia.MethodsIndividuals diagnosed with rHAT from 2004 to 2014 were traced using hospital records and discussions with communities. Either they, or their families, were interviewed using a structured questionnaire and focus group discussions were conducted with affected communities. The burden of the disease was investigated using disability adjusted life years (DALYs), with and without discounting and age-weighting. The impact of long-term disabilities on the rHAT burden was also investigated.ResultsSixty four cases were identified in the study. The majority were identified in second stage, and the mortality rate was high (12.5%). The total number of DALYs was 285 without discounting or age-weighting. When long-term disabilities were included this estimate increased by 50% to 462. The proportion of years lived with disability (YLD) increased from 6.4% to 37% of the undiscounted and un-age-weighted DALY total. When a more active surveillance method was applied in 2013–2014 the cases identified increased dramatically, suggesting a high level of under-reporting. Similarly, the proportion of females increased substantially, indicating that passive surveillance may be especially failing this group.An average of 4.9 months of productive time was lost per patient as a consequence of infection. The health consequences included pain, amnesia and physical disability. The social consequences included stigma, dropping out of education, loss of friends and self-esteem. Results obtained from focus group discussions revealed misconceptions among community members which could be attributed to lack of knowledge about rHAT.ConclusionsThe social and economic impact of rHAT on rural households and communities is substantial. Improved surveillance and strengthening of local medical services are needed for early and accurate diagnosis. Disease prevention should be prioritised in communities at risk of rHAT, and interventions put in place to prevent zoonotic disease spill over from domestic animals and wildlife. Supportive measures to mitigate the long-term effects of disability due to rHAT are needed.Electronic supplementary materialThe online version of this article (10.1186/s40249-017-0363-6) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Estimating the economic and social consequences for patients diagnosed with human African trypanosomiasis in Muchinga, Lusaka and Eastern Provinces of Zambia (2004–2014)

et al. 2017

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“…Life expectancy at birth in Zambia is estimated at 55 years in 2011 [14] . With a 3% discount rate, disability adjusted life years lost for 55 years is 26.93 (see [15] for details). For every stillbirth/fetal loss or neonatal death, which essentially means full life expectancy at birth is lost, we therefore assume that 26.93 DALYs are lost.…”

Section: Methodsmentioning

confidence: 99%

Finding a Needle in the Haystack: The Costs and Cost-Effectiveness of Syphilis Diagnosis and Treatment during Pregnancy to Prevent Congenital Syphilis in Kalomo District of Zambia

Larson

Lembela-Bwalya²,

Bonawitz

et al. 2014

PLoS ONE

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BackgroundIn March 2012, The Elizabeth Glaser Pediatric AIDS Foundation trained maternal and child health workers in Southern Province of Zambia to use a new rapid syphilis test (RST) during routine antenatal care. A recent study by Bonawitz et al. (2014) evaluated the impact of this roll out in Kalomo District. This paper estimates the costs and cost-effectiveness from the provider's perspective under the actual conditions observed during the first year of the RST roll out.MethodsInformation on materials used and costs were extracted from program records. A decision-analytic model was used to evaluate the costs (2012 USD) and cost-effectiveness. Basic parameters needed for the model were based on the results from the evaluation study.ResultsDuring the evaluation study, 62% of patients received a RST, and 2.8% of patients tested were positive (and 10.4% of these were treated). Even with very high RST sensitivity and specificity (98%), true prevalence of active syphilis would be substantially less (estimated at <0.7%). For 1,000 new ANC patients, costs of screening and treatment were estimated at $2,136, and the cost per avoided disability-adjusted-life year lost (DALY) was estimated at $628. Costs change little if all positives are treated (because prevalence is low and treatment costs are small), but the cost-per-DALY avoided falls to just $66. With full adherence to guidelines, costs increase to $3,174 per 1,000 patients and the cost-per-DALY avoided falls to $60.ConclusionsScreening for syphilis is only useful for reducing adverse birth outcomes if patients testing positive are actually treated. Even with very low prevalence of syphilis (a needle in the haystack), cost effectiveness improves dramatically if those found positive are treated; additional treatment costs little but DALYs avoided are substantial. Without treatment, the needle is essentially found and thrown back into the haystack.

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“…YLD is calculated considering recovery times together with the decrease in any capability because of the disease until the moment of death, whereas YLL is calculated as the number of deaths multiplied by the life expectancy at the age of death. Altogether, DALY is calculated as the sum of the number of adjusted life years with disability and the number of life-lost years due to premature mortality (Larson 2013;WHO 2013;Devleesschauwer et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Estimating the Lost Economic Production Caused by Internal Displacement Because of Disasters

Salgado‐Gálvez

2018

Int J Disaster Risk Sci

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Disasters are a large cause of internal displacement at the global level, in 2017 alone affecting more than 19 million people. This dimension of disaster risk is usually overlooked in many disaster risk management strategies and assessments. It is only very recently that efforts to quantify displacement risk and integrate that dimension into existing physical risk models have been made. A key component of internal displacement assessment is the quantification of its economic impacts, both direct and indirect, not only to make a figure available but to raise awareness and increase accountability among governments, stakeholders, policymakers, and decision makers. This article presents a novel and peril-agnostic methodology with which to estimate, using a scenario-based approach, the economic production lost because of internal population displacement. The methodology is applied by using as a triggering event the April 2015 Gorkha, Nepal M7.8 earthquake. The method quantifies the indirect cost caused by internal population displacement because of that event in terms of lost economic production and estimates the loss to be between USD 400 and 850 million.

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Calculating disability-adjusted-life-years lost (DALYs) in discrete-time

Cited by 29 publications

References 12 publications

Estimating the economic and social consequences for patients diagnosed with human African trypanosomiasis in Muchinga, Lusaka and Eastern Provinces of Zambia (2004–2014)

Estimating the economic and social consequences for patients diagnosed with human African trypanosomiasis in Muchinga, Lusaka and Eastern Provinces of Zambia (2004–2014)

Finding a Needle in the Haystack: The Costs and Cost-Effectiveness of Syphilis Diagnosis and Treatment during Pregnancy to Prevent Congenital Syphilis in Kalomo District of Zambia

Estimating the Lost Economic Production Caused by Internal Displacement Because of Disasters

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