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One Health. 2017 Nov 28;5:40-45. doi: 10.1016/j.onehlt.2017.11.003. eCollection 2018 Jun.

zDALY: An adjusted indicator to estimate the burden of zoonotic diseases.

Author information

1
Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 270, CH-8057 Zurich, Switzerland.
2
Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle aux champs, 30, 1200 Bruxelles, Belgium.
3
Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium.
4
Department of Food Safety and Zoonoses (FOS), World Health Organization, Avenue Appia 20, CH-1211 Geneva 27, Switzerland.
5
Institute for Sustainable Food Systems, Emerging Pathogens Institute and Animal Sciences Department, University of Florida, Gainesville, FL, USA.
6
Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
7
Division of Infection and Pathway Medicine, Edinburgh Medical School: Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK.
8
A P Consultants, 22 Walworth Enterprise Centre, Duke Close, Andover SP10 5AP, UK.
9
Institute of Infection and Global Health, University of Liverpool, UK.

Abstract

The burden of human diseases in populations, or for an individual, is frequently estimated in terms of one of a number of Health Adjusted Life Years (HALYs). The Disability Adjusted Life Year (DALY) is a widely accepted HALY metric and is used by the World Health Organization and the Global Burden of Disease studies. Many human diseases are of animal origin and often cause ill health and production losses in domestic animals. The economic losses due to disease in animals are usually estimated in monetary terms. The monetary impact on animal health is not compatible with HALY approaches used to measure the impact on human health. To estimate the societal burden of zoonotic diseases that have substantial human and animal disease burden we propose methodology which can be accommodated within the DALY framework. Monetary losses due to the animal disease component of a zoonotic disease can be converted to an equivalent metric using a local gross national income per capita deflator. This essentially gives animal production losses a time trade-off for human life years. This is the time required to earn the income needed to replace that financial loss. This can then be assigned a DALY equivalent, termed animal loss equivalents (ALE), and added to the DALY associated with human ill health to give a modified DALY. This is referred to as the "zDALY". ALEs could also be estimated using willingness-to-pay for animal health or survey tools to estimate the replacement time value for animals with high societal or emotional value (for example pets) that cannot be calculated directly using monetary worth. Thus the zDALY estimates the impact of a zoonotic disease to animal and human health. The losses due to the animal disease component of the modified DALY are straightforward to calculate. A number of worked examples such as echinococcosis, brucellosis, Q fever and cysticercosis from a diverse spectrum of countries with different levels of economic development illustrate the use of the zDALY indicator.

KEYWORDS:

Animal disease losses; Burden of disease; Disability-adjusted life years; Societal impact; Zoonotic diseases

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