Abstract
BackgroundExpert opinion-derived disability weights are widely employed for estimating the global burden of diseases and injuries. For chronic diseases such as soil-transmitted helminthiasis and schistosomiasis, it has been suggested that a patient-based quality of life (QoL) approach should be considered for a more accurate appraisal of disability weights.Methods and ResultsWe carried out a cross-sectional survey and assessed the prevalence and intensity of soil-transmitted helminth infections as well as self-rated QoL indicators among 252 students attending grades 5-8 in two schools (Bulangshan and Pu'er) in Yunnan province, People's Republic of China. Each student provided a single stool sample, which was subjected to duplicate Kato-Katz thick smear readings and a single FLOTAC examination for parasitological diagnosis. Prevalence rates for hookworm, Trichuris trichiura and Ascaris lumbricoides were high in Bulangshan (75.9%, 70.0% and 68.2%), while the respective prevalence rates in Pu'er were 66.9%, 56.5% and 9.2%. Students were interviewed with two standardised questionnaires, the EuroQoL-5 Dimensions (EQ-5D) and ShortForm-12 (SF-12) Health Survey. Impairment in any of the five dimensions of the EQ-5D was reported by 87% of the students. However, no clear differences could be observed between individuals with and those without helminth infections, and there were discrepancies between the two schools. A multivariate logistic regression model revealed no differences between students with varying infection status in the domains of the SF-12 (odds ratio close to 1.0). Somewhat more pronounced, yet not statistically significant differences were observed when end-of-school-term marks were compared with students' helminth infection status: infected individuals had lower marks in Chinese, English and mathematics, but not in sports, compared to their helminth-free counterparts.ConclusionsOur results point to unresolved issues and challenges regarding the cultural appropriateness of the widely used standard QoL questionnaires. Hence, new research is needed to further develop these instruments and to validate them in connection with chronic parasitic diseases.
Highlights
Expert opinion-derived disability weights are widely employed for estimating the global burden of diseases and injuries
The SF-12 tool consists of 12 questions and the results are combined into eight domains: physical health (PH), role-physical (RP), bodily pain (BP), general health (GH), vitality (V), social functioning (SF), role-emotional (RE) and mental health (MH)
Compliance and study cohort A total of 351 individuals were invited to participate in the study; 223 in Bulangshan and 128 in Pu’er
Summary
Expert opinion-derived disability weights are widely employed for estimating the global burden of diseases and injuries For chronic diseases such as soil-transmitted helminthiasis and schistosomiasis, it has been suggested that a patient-based quality of life (QoL) approach should be considered for a more accurate appraisal of disability weights. Other sources put forth an 8-fold higher species infections, it is difficult to estimate the specific burden due to the different soil-transmitted helminth species [8] Another approach for assessing the burden related to a particular condition is based on patient-based quality of life (QoL) interviews. Two types of instruments are available: (i) generic instruments, which include general health profiles; and (ii) specific instruments, which focus on problems associated with individual diseases, patient groups or areas of function Both types are multifactorial constructs and assess the individual’s perception of physical, mental and social functioning [9,10]. Two component scores, the physical component summary (PCS) and the mental component summary (MCS), are evaluated [12]
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