Total Burden (total + burden)

Distribution by Scientific Domains


Selected Abstracts


Sexual activity as a risk factor for hepatitis C

HEPATOLOGY, Issue S1 2002
M.P.H., Norah A. Terrault M.D.
The accumulated evidence indicates that hepatitis C virus (HCV) can be transmitted by sexual contact but much less efficiently than other sexually transmitted viruses, including hepatitis B virus and human immunodeficiency virus (HIV). However, because sex is such a common behavior and the reservoir of HCV-infected individuals is sizable, sexual transmission of HCV likely contributes to the total burden of infection in the United States. Risk of HCV transmission by sexual contact differs by the type of sexual relationship. Persons in long-term monogamous partnerships are at lower risk of HCV acquisition (0% to 0.6% per year) than persons with multiple partners or those at risk for sexually transmitted diseases (0.4% to 1.8% per year). This difference may reflect differences in sexual risk behaviors or differences in rates of exposure to nonsexual sources of HCV, such as injection drug use or shared razors and toothbrushes. In seroprevalence studies in monogamous, heterosexual partners of HCV-infected, HIV-negative persons, the frequency of antibody-positive and genotype-concordant couples is 2.8% to 11% in Southeast Asia, 0% to 6.3% in Northern Europe, and 2.7% in the United States. Among individuals at risk for sexually transmitted diseases (STDs), the median seroprevalence of antibody to HCV (anti-HCV) is 4% (range, 1.6% to 25.5%). HIV coinfection appears to increase the rate of HCV transmission by sexual contact. Current recommendations about sexual practices are different for persons with chronic HCV infection who are in steady monogamous partnerships versus those with multiple partners or who are in short-term sexual relationships. (HEPATOLOGY 2002;36:S99,S105). [source]


The Estimated Direct Medical Cost of Sexually Transmitted Diseases Among American Youth, 2000

PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 1 2004
Harrell W. Chesson
CONTEXT: Each year, millions of U.S. youth acquire sexually transmitted diseases (STDs). Estimates of the economic burden of STDs can help to quantify the impact of STDs on the nation's youth and on the payers of the cost of their medical care. METHODS: We synthesized the existing literature on STD costs to estimate the lifetime medical cost per case of eight major STDs,HIV, human papillomavirus (HPV), genital herpes simplex virus type 2, hepatitis B, chlamydia, gonorrhea, trichomoniasis and syphilis. We then estimated the total burden of disease by multiplying these cost-per-case estimates by the approximate number of new cases of STDs acquired by youth aged 15,24. RESULTS: The total estimated burden of the nine million new cases of these STDs that occurred among 15,24-yearolds in 2000 was $6.5 billion (in year 2000 dollars). Viral STDs accounted for 94% of the total burden ($6.2 billion), and nonviral STDs accounted for 6% of the total burden ($0.4 billion). HIV and HPV were by far the most costly STDs in terms of total estimated direct medical costs, accounting for 90% of the total burden ($5.9 billion). CONCLUSIONS: The large number of infections acquired by persons aged 15,24 and the high cost per case of viral STDs, particularly HIV, create a substantial economic burden. [source]


The long-term impact of bereavement upon spouse health: a 10-year follow-up

ACTA NEUROPSYCHIATRICA, Issue 5 2010
Michael P. Jones
Jones MP, Bartrop RW, Forcier L, Penny R. The long-term impact of bereavement upon spouse health: a 10-year follow-up. Objectives: This study is the first to examine the effect of bereavement of a first-degree family member on subsequent morbidity over a 10-year follow-up period. Methods: A sample of bereaved subjects (n = 72) were compared with a control group (n = 80) recruited in the same period with respect to morbidity experience during follow-up. Morbidity events were ascertained from the subject themselves, their health care providers and these sources were also compared. Results: Bereavement was associated with an elevated total burden of illness as well as with mental health and circulatory system categories diagnosed according to the International Classification of Diseases - Clinically Modified (ICD-9) classification system. The elevation ranged from approximately 20% for any illness to 60,100% among circulatory system disorders. Although in an earlier study there was a downregulation of T-cell function in the bereaved during the first 8 weeks, there was no evidence that the bereavement was associated with increased morbidity in the respiratory or immune system ICD-9 categories long-term. Conclusions: Past epidemiological research has indicated that bereavement of a close family member is associated with adverse health consequences of a generalised morbidity. Our study suggests an increase in mental health and circulatory system effects in particular. Further research is required to determine whether other systems are also affected by bereavement. [source]


Assessing the burden of injury in six European countries

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2007
Richard Reading
Assessing the burden of injury in six European countries . PolinderS, MeerdingWJ, MulderS, PetridouE, Van BeeckE, and EUROCOST Reference Group . ( 2007 ) Bulletin of the World Health Organization , 85 , 27 , 34 . Objective To assess injury-related mortality, disability and disability-adjusted life years (DALYs) in six European countries. Methods Epidemiological data (hospital discharge registers, emergency department registers, mortality databases) were obtained for Austria, Denmark, Ireland, Netherlands, Norway and the United Kingdom (England and Wales). For each country, the burden of injury was estimated in years lost due to premature mortality (YLL), years lived with disability (YLD), and DALYs (per 1000 persons). Findings We observed marked differences in the burden of injury between countries. Austria lost the largest number of DALYs (25 per 1000 persons), followed by Denmark, Norway and Ireland (17,20 per 1000 persons). In the Netherlands and the United Kingdom, the total burden due to injuries was relatively low (12 per 1000 persons). The variation between countries was attributable to a high variation in premature mortality (YLL varied from 9 to 17 per 1000 persons) and disability (YLD varied from 2 to 8 per 1000 persons). In all countries, males aged 25,44 years represented one-third of the total injury burden, mainly due to traffic and intentional injuries. Spinal cord injury and skull,brain injury resulted in the highest burden due to permanent disability. Conclusion The burden of injury varies considerably among the six participating European countries, but males aged 15,24 years are responsible for a disproportionate share of the assessed burden of injury in all countries. Consistent injury control policy is supported by high-quality summary measures of population health. There is an urgent need for standardized data on the incidence and functional consequences of injury. [source]