Very relevant viewpoint!!!
In the recently published “Integrating Neglected Tropical Diseases into Global Health and Development “ (WHO, 2017) in page 241 addressing schistosomiasis disease burden the only information provided are the 3.514.142 DALYs. On the other hand the DALY reported in 2006 was 4.500.000 (reference 7). One may wonder if this difference is commensurable with the tremendous upscale of praziquantel treatment doses delivered and the changes of infection prevalence in the last 10 years or if the DALYs really reflect the burden of disease. Back in 2005 under TDR auspices a scientific working group (SWG) addressed the schistosomiasis research needs (Report of the Scientific Working Group meeting on Schistosomiasis, Geneva, 14-16 November, 2005, World Health Organization on Behalf of the Special Programme for Research and Training in Tropical Disease, TDR/SWG/07; 2006). One of the subjects addressed during the SWG was the need to reassess the quantification of disease burden. On that occasion Charles H. King argued (referring to allocation of resources in order to effect overall improvements in health) that the analysis of this burden was critical to influence the decisions made about the value of the interventions, concluding that “a careful reassessment of schistosomiasis-associated disease burden, taken from multiple perspectives, becomes very appropriate”. He also argued that DALYs had limitations due to strong negative bias and the SWG recommended regular collection of information on the full morbidity as well as on the subtle morbidities. Unfortunately, as reflected in the viewpoint when highlighting the objectives for the next decade, availability on morbidity information is something that continues to be an unfulfilled promise and a neglect to those affected by the disease.
Janis K. Lazdins