DALY calculation in practice: a stepwise approach

Summary Background Listeriosis, caused by Listeria monocytogenes, is an important foodborne disease that can be difficult to control and commonly results in severe clinical outcomes. We aimed to provide the first estimates of global numbers of illnesses, deaths, and disability-adjusted life-years (DALYs) due to listeriosis, by synthesising information and knowledge through a systematic review. Methods We retrieved data on listeriosis through a systematic review of peer-reviewed and grey literature (published in 1990–2012). We excluded incidence data from before 1990 from the analysis. We reviewed national surveillance data where available. We did a multilevel meta-analysis to impute missing country-specific listeriosis incidence rates. We used a meta-regression to calculate the proportions of health states, and a Monte Carlo simulation to generate DALYs by WHO subregion. Findings We screened 11 722 references and identified 87 eligible studies containing listeriosis data for inclusion in the meta-analyses. We estimated that, in 2010, listeriosis resulted in 23 150 illnesses (95% credible interval 6061–91 247), 5463 deaths (1401–21 497), and 172 823 DALYs (44 079–676 465). The proportion of perinatal cases was 20·7% (SD 1·7). Interpretation Our quantification of the global burden of listeriosis will enable international prioritisation exercises. The number of DALYs due to listeriosis was lower than those due to congenital toxoplasmosis but accords with those due to echinococcosis. Urgent efforts are needed to fill the missing data in developing countries. We were unable to identify incidence data for the AFRO, EMRO, and SEARO WHO regions. Funding WHO Foodborne Diseases Epidemiology Reference Group and the Université catholique de Louvain.

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“…20 This model enabled the quantification of the global burden of listeriosis, expressed in DALYs (figure 1). 21 …”

Section: Methodsmentioning

confidence: 99%

The global burden of listeriosis: a systematic review and meta-analysis

Noordhout

Devleesschauwer

Angulo

et al. 2014

The Lancet Infectious Diseases

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“…The World Bank and World Health Organization (WHO), along with academic researchers, developed the DALY in the 1990s as a generic measure of population health for assessing the burden imposed by a wide range of diseases and conditions [5,6]. DALYs capture both mortality in terms of years of life lost (YLL) and morbidity in terms of years of life with disability (YLD) [7]. The YLD component represents a duration that is scaled by disability severity weights that range from 0 (no adverse impact on quality of life) to 1 (burden equivalent in preference to being dead) [8,9].…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted

et al. 2016

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IntroductionCalculating the cost per disability-adjusted life years (DALYs) averted associated with interventions is an increasing popular means of assessing the cost-effectiveness of strategies to improve population health. However, there has been no systematic attempt to characterize the literature and its evolution.MethodsWe conducted a systematic review of cost-effectiveness studies reporting cost-per-DALY averted from 2000 through 2015. We developed the Global Health Cost-Effectiveness Analysis (GHCEA) Registry, a repository of English-language cost-per-DALY averted studies indexed in PubMed. To identify candidate studies, we searched PubMed for articles with titles or abstracts containing the phrases “disability-adjusted” or “DALY”. Two reviewers with training in health economics independently reviewed each article selected in our abstract review, gathering information using a standardized data collection form. We summarized descriptive characteristics on study methodology: e.g., intervention type, country of study, study funder, study perspective, along with methodological and reporting practices over two time periods: 2000–2009 and 2010–2015. We analyzed the types of costs included in analyses, the study quality on a scale from 1 (low) to 7 (high), and examined the correlation between diseases researched and the burden of disease in different world regions.ResultsWe identified 479 cost-per-DALY averted studies published from 2000 through 2015. Studies from Sub-Saharan Africa comprised the largest portion of published studies. The disease areas most commonly studied were communicable, maternal, neonatal, and nutritional disorders (67%), followed by non-communicable diseases (28%). A high proportion of studies evaluated primary prevention strategies (59%). Pharmaceutical interventions were commonly assessed (32%) followed by immunizations (28%). Adherence to good practices for conducting and reporting cost-effectiveness analysis varied considerably. Studies mainly included formal healthcare sector costs. A large number of the studies in Sub-Saharan Africa addressed high-burden conditions such as HIV/AIDS, tuberculosis, neglected tropical diseases and malaria, and diarrhea, lower respiratory infections, meningitis, and other common infectious diseases.ConclusionThe Global Health Cost-Effectiveness Analysis Registry reveals a growing and diverse field of cost-per-DALY averted studies. However, study methods and reporting practices have varied substantially.

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“…YLDs are estimated by multiplying the number of incident cases with the duration and the disability weight (DW) of a health state, while YLLs are estimated by multiplying the number of deaths and life expectancy at the age of death [16]. DWs express the proportional reduction of quality of life due to sequelae on a scale from 0 to 1, where 0 means perfect health and 1 equals death [17], and were obtained from the Global Burden of Disease 2013 study [15] and Havelaar et al (2007) [18]. We calculated DALYs for 2014, and used the Danish life expectancy table [19] to estimate YLDs and the frontier national life expectancy projected for the year 2050 by the World Population Prospects 2012 (UN Population Division, 2013) [20] to estimate YLLs.…”

Section: Methodsmentioning

confidence: 99%

The disease burden of congenital toxoplasmosis in Denmark, 2014

et al. 2017

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BackgroundCongenital toxoplasmosis (CT) causes a substantial disease burden worldwide. The aim of this study was to estimate the disease burden of CT in Denmark, a developed country with free public healthcare and nationwide data available.MethodsUsing data primarily from two public health surveillance programmes conducted between 1992 and 2007, we estimated the incidence, occurrence of sequelae, mortality and the burden of disease in terms of disability-adjusted life years (DALYs) of CT in Denmark in 2014.FindingsWe estimated that 14 children were born with CT in 2014, of which six will have developed sequelae by the age of 12. CT resulted in a total disease burden of 123 DALYs (95% uncertainty interval [UI], 100–148), of which 78 (95% UI, 64–94) were due to foetal loss and 2 (95% UI, 1–3) were due to neonatal death; the remaining burden was due to moderate to severe life-long sequelae. A comparison of the estimated incidence of CT with the number of reported CT cases in 2008–2014 indicated that for each reported CT case, at least five other CT cases could be expected to have occurred and gone unreported.InterpretationEarly onset, severity, and life-long duration of sequelae have a major effect on the disease burden of CT. Our data suggest that CT is under-diagnosed or under-reported in Denmark. The estimated disease burden and public health impact in Denmark is lower than in other European countries, highlighting the need for country-specific studies.

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DALY calculation in practice: a stepwise approach

Cited by 108 publications

References 17 publications

The global burden of listeriosis: a systematic review and meta-analysis

The global burden of listeriosis: a systematic review and meta-analysis

A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted

The disease burden of congenital toxoplasmosis in Denmark, 2014

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