1. Omesh K. Bharti
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  3. lundi 14 novembre 2011
Dear Friends, Sharing with you the PPT by Katie Hampson for comments, that was telecasted world over in a webinar by World Rabies Day.
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Hello everyone, Just to follow up on the discussion. I think that it is fair to say that the global burden of Hepatitis B far exceeds that of rabies in terms of total deaths (600,000 for Hepititis B globally versus 55,000 for rabies in Africa and Asia). Recent but preliminary and ongoing analyses suggest that rabies deaths globally may well be higher than the 55,000 previously reported by Knobel and colleagues (for Africa and Asia only) and possibly approaching the 70,000 figure (similar to reports of Hepatitis deaths in Africa and Asia from the previously published global burden of disease reports). However the main purpose of the rabies burden research is to identify where in the world the disease remains a problem and where effort should be directed for its control. So far the study has highlighted the lack of accurate data from many pars of the world, which further emphasizes the need for improved surveillance to combat this vaccine preventable disease. It probably doesn't make sense at this early stage to draw comparisons with other diseases, but to try and ensure the estimates for rabies are as accurate as possible and to try and validate these through detailed surveillance studies. With best wishes Katie
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Dear Moderator, I understand that Dr. Omesh Kumar Bharti now wants to re-frame the argument in terms of two regions, Asia and Africa. If we are going to shift the debate, then it is important to see new references for the burden of rabies in these regions or perhaps one for the 99% figure used. For hepatitis B burden, Goldstein et al published estimates (Goldstein, International J Epidemiology, 2005) that estimate 87% of HBV burden is found in Asia and Africa (SEARO, WPRO and AFRO WHO regions) In this paper, these areas accounted for an estimated 537,000 HBV-related deaths in 2000 and 1.225 million future deaths alone in the singe year birth cohort born in 2000. My conclusion remains: While the burden of rabies should not be downplayed, clearly this sort of comparison is misleading. Regards, Dr. Steven Wiersma
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Deleted User Réponse acceptée
Dr. Omesh Kumar Bharti poses a very provocative but very misleading question: Rabies now comparable to Hepatitis-B in vaccine preventable deaths? In the very interesting presentation by Dr. Katie Hampson, the global burden of rabies includes an estimated 70,000 deaths. The global burden of hepatitis B virus infections includes 600,000 deaths (ref: http://www.who.int/mediacentre/factsheets/fs204/en/index.html). Over 100,000 of these deaths are a result of acute infection (http://www.who.int/healthinfo/global_burden_disease/en/) and the rest are through hepatitis B virus related liver disease including cirrhosis and liver cancer. What this means is that, in terms of mortality, hepatitis B virus has a burden of over 8 times that of rabies. While the burden of rabies should not be downplayed, clearly this sort of comparison is misleading. Steven Wiersma, M.D., M.P.H. | Medical Officer | Global Hepatitis Programme | Health Security and Environment | World Health Organization | 20, avenue Appia, 1211 Geneva 27, Switzerland | L340 | +41.22.791.1511 | ?wiersmas@who.int
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Omesh K. Bharti Réponse acceptée
Would now all of us think to give preventive vaccination to kids in Asia and Africa at least!
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I do not see any attachment!
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