Exposure, resistance, and recovery: a three-dimensional framework for the study of mortality from infectious disease.
It has been suggested by several scholars that debates surrounding the study of mortality could benefit from a framework that integrates social and economic factors with the biological mechanisms of illness and death (Johannson and Mosk, Popul. Stud. 41 (1987) 207-236; Mosley, International Population Conference, Vol. 2, Florence, IUSSP, Liege, 1985. pp. 189-203; Mosley and Chen, in W. H. Mosley, L. C. Chen (Eds.), Child Survival: Strategies for Research, Population Council, New York, 1984, pp. 25-45; Murray and Chen, Soc. Sci. Med. 36(2) (1993) 143-155; Ruzicka, International Population Conference, Vol. 2, Florence, IUSSP, Liege, 1985, pp. 185-187). In this paper, I present a conceptual framework aimed at doing this for infectious disease mortality. The framework is built around three proximate processes: (1) exposure to potentially lethal pathogens, (2) resistance to disease pathogens after exposure, and (3) recovery from disease episodes after contraction. I apply this conceptual framework to morbidity and mortality from cholera across 41 less developed nations.
Kirby
J B
JB
Agency for Healthcare Research and Quality, Rockville, MD 20852, USA. jkirby@ahrq.gov
D002771:Cholera / Q000453:epidemiology / Q000276:immunology / Q000401:mortality* / Q000628:therapy; D003906:Developing Countries / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D004522:Educational Status; D004781:Environmental Exposure / Q000706:statistics & numerical data; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D006920:Hygiene; D007113:Immunity, Innate; D015994:Incidence; D015233:Models, Statistical; D011379:Prognosis; D012494:Sampling Studies; D012499:Sanitation; D012959:Socioeconomic Factors; D016896:Treatment Outcome