CSU 55/2008: DISEASE ERADICATION AND HAPPINESS

Thursday, 18th of December 2008

CSU 55/2008: DISEASE ERADICATION AND HAPPINESS

This is the last update of 2008; the present writer and his family are off to Cape Town to drench in the South Africa sun; back in early January. Our sympathies go to those freezing in more northern climes.

To end the year, I am bringing to your attention three citations that deal with either happiness or disease eradication and elimination. The third citation is of most general interest. From the authors' conclusions: 'People's happiness depends on the happiness of others with whom they are connected.' Few would believe, before this article, that the BMJ would publish views similar to those of Perry Como, who sang 'Make someone happy/Make just one someone happy/And you will be happy, too.'

To those working on disease eradication, the subject of the first citation, the linkage between their work and happiness is self-evident. To those working over the holidays on global polio eradication and, less conspicuously, global guinea worm eradication, bon courage.

Good reading.

Bob Davis

1) Disease Eradication

This article from the online encyclopedia Wikipedia summarizes current thinking on the eradication of infectious diseases. Readers who would like to add to this rather brief article can log in to Wikipedia and supply additional text.

http://en.wikipedia.org/wiki/Eradication_of_infectious_diseases

2) Elimination of Lymphatic Filariasis

The Global Programme to Eliminate Lymphatic Filariasis, GPELF, with homepage at

http://www.who.int/lymphatic_filariasis/disease/en/, has made great strides in its first eight years of operations.

In this article from PLOS/Neglected Tropical Diseases, available on the Web at

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=18841205

Ottesen and colleagues review those experiences. From their abstract:

Background

In its first 8 years, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) achieved an unprecedentedly rapid scale-up: >1.9 billion treatments with anti-filarial drugs (albendazole, ivermectin, and diethylcarbamazine) were provided via yearly mass drug administration (MDA) to a minimum of 570 million individuals living in 48 of the 83 initially identified LF-endemic countries.

Methodology

To assess the health impact that this massive global effort has had, we analyzed the benefits accrued first from preventing or stopping the progression of LF disease, and then from the broader anti-parasite effects ('beyond-LF' benefits) attributable to the use of albendazole and ivermectin. Projections were based on demographic and disease prevalence data from publications of the Population Reference Bureau, The World Bank, and the World Health Organization.

Result

Between 2000 and 2007, the GPELF prevented LF disease in an estimated 6.6 million newborns who would otherwise have acquired LF, thus averting in their lifetimes nearly 1.4 million cases of hydrocele, 800,000 cases of lymphedema and 4.4 million cases of subclinical disease. Similarly, 9.5 million individuals—previously infected but without overt manifestations of disease—were protected from developing hydrocele (6.0 million) or lymphedema (3.5 million). These LF-related benefits, by themselves, translate into 32 million DALYs (Disability Adjusted Life Years) averted. Ancillary, 'beyond-LF' benefits from the >1.9 billion treatments delivered by the GPELF were also enormous, especially because of the >310 million treatments to the children and women of childbearing age who received albendazole with/without ivermectin (effectively treating intestinal helminths, onchocerciasis, lice, scabies, and other conditions). These benefits can be described but remain difficult to quantify, largely because of the poorly defined epidemiology of these latter infections.

Conclusion

The GPELF has earlier been described as a 'best buy' in global health; this present tally of attributable health benefits from its first 8 years strengthens this notion considerably.

3) Dynamic Spread of Happiness

The Framingham Study is best known for its analysis of risk factors for heart disease. In this study, just published in the BMJ, Fowler and Christakis look at how happiness spreads within a social network. They conclude that ' People's happiness depends on the happiness of others with whom they are connected. This provides further justification for seeing happiness, like health, as a collective phenomenon.' Full text at www.bmj.com, search Christakis, or go to http://www.ncbi.nlm.nih.gov/pubmed/19056788?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study.

Fowler JH, Christakis NA.

Department of Political Science, University of California, San Diego, CA, USA.

OBJECTIVES: To evaluate whether happiness can spread from person to person and whether niches of happiness form within social networks. DESIGN: Longitudinal social network analysis.

SETTING: Framingham Heart Study social network.

PARTICIPANTS: 4739 individuals followed from 1983 to 2003.

MAIN OUTCOME MEASURES: Happiness measured with validated four item scale; broad array of attributes of social networks and diverse social ties.

RESULTS: Clusters of happy and unhappy people are visible in the network, and the relationship between people's happiness extends up to three degrees of separation (for example, to the friends of one's friends' friends). People who are surrounded by many happy people and those who are central in the network are more likely to become happy in the future. Longitudinal statistical models suggest that clusters of happiness result from the spread of happiness and not just a tendency for people to associate with similar individuals. A friend who lives within a mile (about 1.6 km) and who becomes happy increases the probability that a person is happy by 25% (95% confidence interval 1% to 57%). Similar effects are seen in coresident spouses (8%, 0.2% to 16%), siblings who live within a mile (14%, 1% to 28%), and next door neighbours (34%, 7% to 70%). Effects are not seen between coworkers. The effect decays with time and with geographical separation.

CONCLUSIONS: People's happiness depends on the happiness of others with whom they are connected. This provides further justification for seeing happiness, like health, as a collective phenomenon.