Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013

Abstract

Background and aimsThe Burden of Communicable Diseases in Europe (BCoDE) study aimed to calculate disability-adjusted life years (DALYs) for 31 selected diseases in the European Union (EU) and European Economic Area (EEA). Methods: DALYs were estimated using an incidence-based and pathogen-based approach. Incidence was estimated through assessment of data availability and quality, and a correction was applied for under-estimation. Calculation of DALYs was performed with the BCoDE software toolkit without applying time discounting and age-weighting. Results: We estimated that one in 14 inhabitants experienced an infectious disease episode for a total burden of 1.38 million DALYs (95% uncertainty interval (UI): 1.25–1.5) between 2009 and 2013; 76% of which was related to the acute phase of the infection and its short-term complications. Influenza had the highest burden (30% of the total burden), followed by tuberculosis, human immunodeficiency virus (HIV) infection/AIDS and invasive pneumococcal disease (IPD). Men had the highest burden measured in DALYs (60% of the total), adults 65 years of age and over had 24% and children less than 5 years of age had 11%. Age group-specific burden showed that infants (less than 1 year of age) and elderly people (80 years of age and over) experienced the highest burden. Conclusions: These results provide baseline estimates for evaluating infectious disease prevention and control strategies. The study promotes an evidence-based approach to describing population health and assessing surveillance data availability and quality, and provides information for the planning and prioritisation of limited resources in infectious disease prevention and control.

The immune response to influenza in older humans: beyond immune senescence

“…Furthermore, 15% of older adults admitted with laboratory-confirmed influenza will experience catastrophic disability with a loss of independence in more than two basic self-care activities [30] and older adults are also vulnerable to diminished quality of life due to loss of independence following hospitalization with influenza [25]. In fact, influenza accounts for nearly 30% of all disability-adjusted life years lost to infectious disease [31], and influenza hospitalization is estimated to cost more than 2 billion dollars in Canada over the next decade [32]. Older adults, especially those living with chronic conditions and/or frailty, are highly susceptible to severe outcomes of influenza; however, the correlates of protection in this vulnerable population are not well investigated.…”

Disease modeling for public health: added value, challenges, and institutional constraints

“…In the health field as well as the environmental field, we use burden of disease measures, leading to the necessity of developing underlying models for exposure and disease progression [27,28]. In public health, we use estimates of disease burden in terms of disability adjusted life years (DALYs) to compare the impact of various diseases on population health and to provide guidance for policymakers on how resources should be used effectively to achieve health gains in the population [29] (Fig. 1).…”

Letter to the editor: Applying incidence-based disability-adjusted life years (DALYs) disease burden estimates to foster change in national vaccination policy, Slovenia, 2017 to 2018

“…Compared with other EU/EEA countries, notification rate of TBE in Slovenia is among the highest, ranging from eight per 100,000 population in 2009 to 15 per 100,000 population in 2013 [4]. In terms of burden, we estimated that TBE in Slovenia during 2009–2013 accounted annually for 11.0 DALYs per 100,000 population (95% uncertainty interval (UI): 10.2–11.7), much higher than the pooled results published by Cassini et al for selected EU countries (including Slovenia) in the same time period, which was 0.69 DALYs per 100,000 population (95% UI: 0.65–0.74) [1,3]…”

“…To the editor: Recently, Cassini et al presented in Eurosurveillance the results of the burden of infectious diseases in European Union and European Economic Area (EU/EEA) countries [1], using the incidence-based methodology to calculate disability-adjusted life years (DALYs) developed within the Burden of Communicable Diseases in Europe (BCoDE) project [2]. The description of the impact of diseases on the health of the population by means of a composite health measure provides clear and comprehensive information for transparent and accountable decision-making.…”