Estimating the global distribution and disease burden of intestinal nematode infections: adding up the numbers--a review

Abstract

Intestinal nematode infections are among the most common infections of humans in developing countries, but precise estimates of the populations at risk of infection, morbidity and mortality are difficult to derive. Careful evaluation of the global distribution and disease burden of nematodes is essential to determine the cost-effectiveness of control and ensure that control programmes are focused appropriately. In turn, understanding the disease burden depends on a summary measure of health as well as reliable data on risks of infection, morbidity and mortality. This review provides an overview of data sources and methods adopted in the Global Burden of Disease study to estimate the burden of intestinal nematodes, including the empirical and modelling challenges in its estimation. Particular attention is paid to efforts to improve our ability to define at-risk populations, based on a Global Atlas of Helminth Infection, and to better estimate attributable morbidity.

Fig. 1

Distribution of the 9620 prevalence surveys identified and geo-referenced for sub-Saharan Africa included in the Global Atlas of Helminth Infection by 12th April 2010. See: <www.thiswormyworld.org>. Note that a few countries have undertaken national prevalence surveys, but the data are yet to be included in the Global Atlas, including Angola, Mozambique, Equatorial Guinea and Sierra Leone.