Community incidence of pathogen-specific gastroenteritis: reconstructing the surveillance pyramid for seven pathogens in seven European Union member states

Abstract

(2013) Community incidence of pathogen-specific gastroenteritis: reconstructing the surveillance pyramid for seven pathogens in seven European Union member states. Epidemiology and infection, 141 (8 SUMMARYBy building reconstruction models for a case of gastroenteritis in the general population moving through different steps of the surveillance pyramid we estimated that millions of illnesses occur annually in the European population, leading to thousands of hospitalizations. We used data on the healthcare system in seven European Union member states in relation to pathogen characteristics that influence healthcare seeking. Data on healthcare usage were obtained by harmonized cross-sectional surveys. The degree of under-diagnosis and underreporting varied by pathogen and country. Overall, underreporting and under-diagnosis were estimated to be lowest for Germany and Sweden, followed by Denmark, The Netherlands, UK, Italy and Poland. Across all countries, the incidence rate was highest for Campylobacter spp. and Salmonella spp. Incidence estimates resulting from the pyramid reconstruction approach are adjusted for biases due to different surveillance systems and are therefore a better basis for international comparisons than reported data.

Community Incidence of Campylobacteriosis and Nontyphoidal Salmonellosis, France, 2008–2013

“…Therefore, we may have overestimated the proportion of cases that consulted, resulting in an underestimate of the true number of community cases. A similar approach has been used in other studies using a pyramid reconstruction model Haagsma et al, 2013;Thomas et al, 2013;Kirk et al, 2014). However, categories (bloody diarrhea and/or duration of illness or duration of diarrhea) and data sources (case-control studies, outbreak investigation, literature) were different between these studies.…”

A Systematic and Critical Review of Model-Based Economic Evaluations of Pharmacotherapeutics in Patients with Bipolar Disorder

“…Therefore countryspecific MFs should be used if possible [14,64,65]. The MFs estimated in this paper are the only ones available based on Swedish data, and these are therefore considered to be the most accurate estimates available.…”

“…Notably, the probability of experiencing bloody diarrhea for illness p, (J p ) was modeled by beta distributions that were fitted based on outbreak data. Most of the outbreak studies that were used were taken from a literature search made in a previous article [14]. Some further Swedish studies were then added before the distributions were fitted (see Online Resource 1 for details).…”

“…This problem prevents it from being performed in many countries [14]. An alternative, which is used in this paper, is to use stochastic modeling to obtain values of UE, UR, UA and MF.…”

“…By using stochastic simulation, the joint probability distribution that a case in the community gets reported can be obtained. This method has been used for Sweden in one previous study where the incidences of seven pathogens in seven European countries were examined [14]. However, some of the distribution parameters used in that study were based on very small samples and contradicted parameter values of all other countries.…”