. "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 4.2 Estimated 1984 Population by Age Groups for Regions in Which Developing Countries Predominate (thousands)
Age Group (years)
Region
Under 1
1–4
Under 5
5–14
15–59
60 and Over
Total
Latin America
12,736
44,499
57,235
100,220
214,415
25,130
397,000
Africa
23,040
73,762
96,802
141,459
265,451
27,288
531,000
Asia
73,400
270,300
343,700
666,402
1,472,242
179,656
2,662,000
Oceania
187
635
822
1,285
2,620
273
5,000
Total
109,363
389,196
498,559
909,366
1,954,728
232,347
3,595,000
(Percentage)
(3)
(11)
(14)
(25)
(54)
(6)
treatment averted by vaccine candidates in the developing world. This does not mean that these techniques cannot be applied in developing regions. Individuals setting priorities for a single country or region who have access to information (or reliable estimates) necessary to calculate treatment costs and potential cost savings from vaccines could employ the methods presented in Volume I (Institute of Medicine, 1985).
ELEMENTS OF THE SYSTEM FOR COMPARING MORBIDITY AND MORTALITY BURDENS ARISING FROM VARIOUS DISEASES
The system described below was designed not only to incorporate information relating to a disease (i.e., incidence, severity, complications, sequelae, duration, and distribution), but also to allow expression of individual value judgments on the undesirability (disutility) of various consequences resulting from that disease. Such value judgments are an inevitable part of the ranking process, whether they are explicit or implicit. The committee chose to make them explicit.
A format was devised with generic categories for estimates of the annual number of cases, complications, sequelae, and deaths associated with each disease. The scheme was designed to cover all major conditions that result from infectious diseases. Three levels of severity were established for both acute and chronic morbidity, and provision was made for recording the duration of an acute illness. The scheme also was designed to allow distribution of cases, complications, sequelae, and deaths among four age groups. An example of the matrix used to compile these estimates is shown in Table 4.3; the methods used to determine the entries are described below. Data on individual diseases are presented in Appendixes D-1 through D-19.
