. "4. Comparison of Disease Burdens." New Vaccine Development: Establishing Priorities: Volume II, Diseases of Importance in Developing Countries. Washington, DC: The National Academies Press, 1986.
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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries
TABLE 4.5 Example of an Individual Scheme of Infant Mortality Equivalence Values
Infant Mortality Equivalence Values
Morbidity Category
Description
Unit
Under 5 Years
5–14 Years
15–59 Years
60 Years and Over
A
Moderate localized pain and/or mild systemic reaction, or impairment requiring minor change in normal activities, and associated with some restriction of work activity
Days
20,000
7,500
3,000
15,000
B
Moderate pain and/or moderate impairment requiring moderate change in normal activities, e.g., housebound or in bed, and associated with temporary loss of ability to work
Days
10,000
5,000
1,500
1,500
C
Severe pain, severe short-term impairment, or hospitalization
Days
1,000
250
60
300
D
Mild chronic disability (not requiring hospitalization, institutionalization, or other major limitation of normal activity, and resulting in minor limitation of ability to work)
Cases
100
50
60
600
E
Moderate to severe chronic disability (requiring hospitalization, special care, or other major limitation of normal activity, and seriously restricting ability to work)
Cases
5
2.5
3
6
F
Total impairment
Cases
1
0.5
0.3
6
G
Reproductive impairment resulting in infertility
Cases
5
2.5
0.6
300
H
Death
Cases
1
0.5
0.3
3
Procedures Used in Deriving Disease Estimates
The committee solicited information that would enable estimates to be made in the format shown in Table 4.3 from individuals knowledgeable about particular diseases. If the disease was not one for which the World Health Organization collects information, the committee used other sources. Committee staff integrated information from various sources with the assistance of consultants. Reviews of preliminary estimates were obtained from initial sources and other individuals. Revised estimates were generated on the basis of reviews, with committee members arbitrating if reviewers made conflicting recommendations for modification of preliminary efforts.
Estimates of disease burden for the diseases that are candidates for accelerated vaccine development are included in Appendixes D-1 through D-19. For some of the diseases included in this comparison, only limited data exist on their incidence in developing countries. Estimates sometimes had to be made on the basis of reports from a few
