Correspondence
these, 600 would have lost both 4 Deacon H, Stephney I. HIV/AIDS, stigma and
parents. These numbers might be an
underestimate due to—for example—
under-reporting of mortality or
variation in spousal infection rates,
but they provide a likely order
of magnitude.
Will this increase in orphans
overwhelm the capacity of extended
family networks, the traditional care
provider to orphans in the region? It is
unlikely. Orphans from Ebola represent
a small proportion of the total orphan
burden. Across the three countries
analysed, they represent only 1·35% of
the total 711 600 orphans (figure). A
related concern is that stigma might lead
to rejection of orphans by households
that would traditionally have fostered
them. This is reminiscent of a similar
narrative around HIV/AIDS orphans in
Published Online the early 2000s, but a systematic review
December 8, 2014 finds no evidence of HIV/AIDS stigma on
http://dx.doi.org/10.1016/
S0140-6736(14)62345-X fostering arrangements.4
Every child who loses a parent
experiences a tragedy. But many
non-orphan children are experiencing
significant income shocks due to the
Ebola crisis, and income differences can
dwarf the differences between orphans
and non-orphans.5 Thus, while it will
be crucial to be mindful of the needs
of orphans, broader attention to the
needs of children in the wake of the
Ebola crisis will be just as important for
the long-term health and welfare of
the affected countries.
We declare no competing interests.
*David K Evans, Anna Popova
devans2@worldbank.org
World Bank, Washington, DC, USA
1 WHO. Ebola situation report. February 11, 2015.
http://apps.who.int/ebola/en/ebola-situation-
report/situation-reports/ebola-situation-report-
11-february-2015 (accessed Feb 11, 2015).
2 Beegle K, De Weerdt J, Dercon S. Orphanhood
and human capital destruction: is there
persistence into adulthood? Demography 2010;
47: 163–80.
3 Evans DK, Popova A. Orphans and Ebola:
estimating the secondary impact of a public
health crisis. World Bank Policy Research
Working Paper 7196; 2015. http://
documents.worldbank.org/curated/
en/2015/02/24016886/orphans-ebola-
estimating-secondary-impact-public-health-
crisis (accessed Feb 18, 2015).
946
harmonious relationships between
children: a literature review. Cape Town:
Human Sciences Research Council; 2007.
5 Ainsworth M, Filmer D. Inequalities in
children’s schooling: AIDS, orphanhood,
poverty, and gender. World Development 2006;
34: 1099–128.
Humanism and
medicine in China
We read with interest the recent Lancet
Editorial on literature and medicine
(Jan 10, p 90), 1 and the related
Perspective by Gabriel Weston (Jan 10,
p 108).2 We enjoyed the two essays,
and they led us to think about medical
humanism in China.
Traditionally, Chinese scholars
continually integrated knowledge
from various disciplines, especially
humanities, into traditional medicine.
Literature was essential for doctors.
Moreover, to serve patients better,
doctors would often read philosophers
such as Confucius to become more
considerate people. Traditional Chinese
medicine survives, and the strong
sense of humanity contained within it
should remain an important factor.
However, this tradition of emphasis
on medical humanism seems to be
fading with time. The absence of a
strong reading culture in China3 could
explain this situation. Colleges should
be more responsible for encouraging
reading. At present, they do not
focus enough on humanities and the
literary development of students,
instead colleges concentrate on
medical knowledge and technology.
Health-care professionals nowadays
are mostly responsible for their own
self-improvement with respect to
literature knowledge, which allows
them to develop communication
skills and explore human nature, a
substantial part of medical practice.
Although great advances have
been made in medical science,
tradition such as the influence of
literature and humanities needs
to be carried forward. This could
certainly contribute to establish more
doctors and patients.
We declare no competing interests.
Wenjuan Tao, Liangbiao Gu,
Yanqing Zhao, *Kejian Li
Kejian_Li@yeah.net
Shandong University of Traditional Chinese Medicine,
Jinan 250355, China (WT, YZ, KL); and School of
Medicine, Shandong University, Jinan, China (LG)
1 The Lancet. Literature and medicine: why do
we care? Lancet 2015; 385: 90.
2 Gabriel W. The art of medicine: Developing
judgment, not being judgmental. Lancet 2015;
385: 108–09.
3 2014. http://www.chinadaily.com.cn/
culture/2014-03/18/content_17354545.htm
(accessed Jan 20, 2015).
Department of Error
Allemani C, Weir HK, Carreira H, et al, and the
CONCORD Working Group. Global surveillance of
cancer survival 1995–2009: analysis of individual
data for 25 676 887 patients from 279
population-based registries in 67 countries
(CONCORD-2). Lancet 2015; 385: 977–1010—In
Table 3 of this Article, in the Population
covered column, the worldwide total should be
“896 210 297”. In the Results (8th paragraph),
“male patients” should be “males”. In Figure 4,
the title should end “...in 228 cancer registries”.
In Table 4, in the line for Tunisia (central),
2005–09, the value for Stomach should be
“49·0§”; in the line for Indonesia (Jakarta),
2005–09, the value for Cervix should be
“65·1§”. In the Discussion (23rd paragraph),
“per 1000 population” should be “per
1000 livebirths”. These corrections have been
made to the online version as of Dec 8, 2014,
and the printed Article is correct.
Neuschwander-Tetri BA, Loomba R, Sanyal AJ, et al.
Farnesoid X nuclear receptor ligand obeticholic acid
for non-cirrhotic, non-alcoholic steatohepatitis
(FLINT): a multicentre, randomised, placebo-
controlled trial. Lancet 2015; 385: 956–65—The
appendix for this Article has been corrected. In
table S2, the fibrosis at baseline groups should
have read “stage 0–1” and “stage 2–4”. In table
S4, part F, in the OCA group, at baseline NAS=7
and week 72 NAS=6 the number of biopsies
should be 4. This correction has been made to
the appendix as of March 13, 2015.
Molyneux AJ, Birks J, Clarke A, Sneade M, Kerr RS.
The durability of endovascular coiling versus
neurosurgical clipping of ruptured cerebral
aneurysms: 18 year follow-up of the UK cohort of
the International Subarachnoid Aneurysm Trial
(ISAT) Lancet 2015; 385: 691–97—In the
seventh paragraph of the Results section of
this Article (Feb 21), the number of deaths in
the 18·5 year follow-up period should be 388.
This correction has been made to the online
version as of March 13, 2015.
www.thelancet.com Vol 385 March 14, 2015