Deconstructing the differences: a comparison of GBD 2010 and CHERG’s approach to estimating the mortality burden of diarrhea, pneumonia, and their etiologies

BMC Infectious Diseases

Correspondence

Duncan Steele¹  Julia Bosch¹  John T Grove¹  Ibrahim Khalil¹  Colin D Mathers²  Kate O’Brien³  Umesh Parashar⁴  Mohammad H Forouzanfar⁵  Stephen Lim⁵  Ali H Mokdad⁵  Li Liu⁶  Kim Mullholland⁷  Stephen E Hawes⁸  Torin T Schaafsma⁸  Stephanie D Kovacs⁸  Stephen N Maley⁸  Alastair Matheson⁸  Harry Campbell⁹ 

[1] Bill & Melinda Gates Foundation, Seattle, WA, USA;Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland;Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA;Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA;Institute of International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;London School of Hygiene & Tropical Medicine, Melbourne, Australia;Murdoch Childrens Research Institute, Melbourne, Australia;Menzies School of Health Research, Charles Darwin University, Darwin, Australia;Strategic Analysis, Research and Training Program, University of Washington, Seattle, WA, USA;University of Edinburgh, Edinburgh, Scotland;

关键词: Acute Respiratory Infection;    Verbal Autopsy;    Vital Registration;    Child Health Epidemiology Reference Group;    Etiologic Fraction;   

DOI  :  10.1186/s12879-014-0728-4

 received in 2014-06-26, accepted in 2014-12-18,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundPneumonia and diarrhea are leading causes of death for children under five (U5). It is challenging to estimate the total number of deaths and cause-specific mortality fractions. Two major efforts, one led by the Institute for Health Metrics and Evaluation (IHME) and the other led by the World Health Organization (WHO)/Child Health Epidemiology Reference Group (CHERG) created estimates for the burden of disease due to these two syndromes, yet their estimates differed greatly for 2010.MethodsThis paper discusses three main drivers of the differences: data sources, data processing, and covariates used for modelling. The paper discusses differences in the model assumptions for etiology-specific estimates and presents recommendations for improving future models.ResultsIHME’s Global Burden of Disease (GBD) 2010 study estimated 6.8 million U5 deaths compared to 7.6 million U5 deaths from CHERG. The proportional differences between the pneumonia and diarrhea burden estimates from the two groups are much larger; GBD 2010 estimated 0.847 million and CHERG estimated 1.396 million due to pneumonia. Compared to CHERG, GBD 2010 used broader inclusion criteria for verbal autopsy and vital registration data. GBD 2010 and CHERG used different data processing procedures and therefore attributed the causes of neonatal death differently. The major difference in pneumonia etiologies modeling approach was the inclusion of observational study data; GBD 2010 included observational studies. CHERG relied on vaccine efficacy studies.DiscussionGreater transparency in modeling methods and more timely access to data sources are needed. In October 2013, the Bill & Melinda Gates Foundation (BMGF) hosted an expert meeting to examine possible approaches for better estimation. The group recommended examining the impact of data by systematically excluding sources in their models. GBD 2.0 will use a counterfactual approach for estimating mortality from pathogens due to specific etiologies to overcome bias of the methods used in GBD 2010 going forward.

【 授权许可】

Unknown   
© Kovacs et al.; licensee BioMed Central. 2015. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.