A comparison between health research output and burden of disease in Arab countries: evidence from Palestine

Loai Albarqouni,Niveen M E Abu-Rmeileh,Khamis Elessi

doi:10.1186/s12961-018-0302-4

Abstract

BackgroundResearch conducted on conditions responsible for the greatest disease burden should be given the highest priority, particularly in resource-limited settings. The present study aimed to assess the research output in relation to disease burden in Palestine and to identify the conditions which are under- or over-investigated, if any.MethodsWe searched PubMed and Scopus for reports of original research relevant to human health or healthcare authored by researchers affiliated with Palestinian institutions and published between January 2000 and December 2015. We categorised the condition studied in included articles using the Global Burden of Disease (GBD) taxonomy. Data regarding burden of disease (percentage of deaths and disability-adjusted life years (DALYs)) was obtained from the Palestine profile in the GBD study. We examined the degree of discordance between the observed number of published articles for each disease/condition with the expected number based on the proportion of disease burden of that disease/condition.ResultsOur search identified 2469 potentially relevant records, from which 1650 were excluded following the screening of titles and abstracts. Of the remaining 819 full-text articles, we included 511 in our review. Communicable (infectious) diseases (n = 103; 20%) was the condition with the highest number of published studies. However, cancer (n = 15; 3%) and chronic respiratory diseases (n = 15; 3%) were the conditions with the lowest number of published studies. Research output was poorly associated with disease burden, irrespective of whether it was measured in terms of DALYs (rho = −0.116, P = 0.7) or death (rho = 0.217, P = 0.5). Cardiovascular disease, cancer, and maternal and neonatal deaths accounted for more than two-thirds of the total deaths in Palestine (67%), but were infrequently addressed (23%) in published articles.ConclusionsThere is evidence of research waste measured by a mismatch between the health burden of certain diseases/conditions and the number of published research reports on those diseases/conditions in Palestine. A national research priority-setting agenda should be developed to meet the local community’s need for quality evidence to implement independent and informed health policies.

Highlights

Research conducted on conditions responsible for the greatest disease burden should be given the highest priority, in resource-limited settings
Palestinians have undergone a rapid epidemiological transition characterised by a growing burden of non-communicable diseases (NCDs) such as cardiovascular disease (CVD), diabetes and cancer [3]
We plotted the total number of research articles for each disease/condition category against their associated deaths and DALYs

Summary

Introduction

Research conducted on conditions responsible for the greatest disease burden should be given the highest priority, in resource-limited settings. A Middle East and North Africa (MENA) region country, consists of the West Bank, including East Jerusalem, and the Gaza Strip [1] It has a population of 4.8 million, 42% of whom are registered refugees – 26% and 68% of those living in the West Bank and Gaza, respectively, are refugees [2]. It is of paramount importance to maximise the utilisation of the, albeit inadequate, resources allocated to health research by prioritising the necessary evidence required by the Palestinian community to develop independent and informed health policies. Substantial gaps exist between the health research that is needed and that which is conducted, indicating a lack of appropriate prioritisation of health research [5]. The burden of disease is a measure that represents the relative impact of different diseases and conditions on population health, and is frequently measured by two indices – mortality (i.e. total deaths) and morbidity (i.e. disability-adjusted life years (DALYs))

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