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TABLE 4.10 Ranking of Diseases by Total Disease Burden Values

Disease

Total Disease Burden Value (IME units)a

Streptococcus pneumoniae

6,612,261

Hepatitis B virus

2,394,256

Plasmodium spp.

2,111,795

Salmonella typhi

1,308,121

Escherichia coli

978,248

Rotavirus

925,042

Shigella spp.

828,068

Streptococcus Group A

811,477

Mycobacterium leprae

657,349

(Escherichia coli)

(550,248)b

(Rotavirus)

(488, 542)b

Hemophilus influenzae type b

471,336

Vibrio cholera

229,217

Respiratory syncytial virus

183,326

Parainfluenza virus

145,954

Neisseria meningitidis

68,252

Rabies virus

67,821

Dengue virus

34,365

Yellow fever virus

32,887

Hepatitis A virus

30,229

Japanese encephalitis virus

18,075

aInfant mortality equivalence units.

bValues represent the anticipated disease burden from certain diarrheal pathogens if a plausible increase in oral rehydration therapy is assumed (see Appendix C) .

disease burden value for each disease may be regarded by some as obscuring important differences among disease consequences. Although they are assigned to the same generic morbidity category, some disease conditions may be regarded as more severe (more undesirable) than those of another disease. This problem exists with any category system; to assign trade-off (or IME) values to the whole spectrum of conditions arising from all diseases would be too complex and unmanageable.

Additionally, the system does not, as presently conceived, permit differentiation of diseases on the basis of episode duration. That is, it does not indicate whether hospitalization of 100 individuals for 2 days each is more or less desirable than 1 individual for 200 days, or 10 individuals for 20 days.

Other disease characteristics not recognized by the proposed system include the following:

  • The epidemic potential of the disease: the average annual incidence is used for comparative purposes, but certain epidemic



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