The burden of infectious diseases in Europe: a pilot study

Abstract

The main objectives of this pilot study were to test the potential use of the disease burden concept in the field of infectious diseases, including data quality and availability; to recommend future studies; and to stimulate a debate. The disease burden of seven infectious diseases (influenza, measles, HIV, campylobacteriosis, infection with enterohaemorrhagic Escherichia coli, salmonellosis and tuberculosis) in Europe was estimated by calculating Disability Adjusted Life Years (DALYs), a composite measure that attempts to combine mortality, incidence and sequelae, taking duration and severity into account. The results show that the relative burden of diseases as measured by DALYs differs from that only measured by incidence or mortality. Several limitations regarding data availability and quality have been identified, resulting in an underestimation of the true burden of disease in this pilot. Notwithstanding these, HIV-infection, tuberculosis (TB) and influenza are estimated to cause the highest burden in Europe among the selected diseases. The burden of foodborne diseases (campylobacteriosis, infection with enterohaemorrhagic Escherichia coli and salmonellosis) and in particular of measles is lower. A consideration of the relative comparison of burden between diseases can be useful when tackling the difficult, sensitive but necessary task of identifying priority actions. A low burden stresses the need for continued support for prevention and control whereas a high burden indicates the need for additional interventions. Following this pilot project, a generalised burden of disease study for infectious diseases in Europe is recommended. Such a study would benefit from an approach that identifies and combines several methods of investigation, including epidemiological modelling, and it should be done in collaboration with other international efforts in this field.

Stopping TB in Europe: some progress but still not there

“…Providing joint TB and HIV management for more patients in countries already burdened by drug-resistant TB will present a formidable challenge. While, with some exceptions, TB mortality rates in the EU are low, a recent study showed that TB still contributes heavily to death from infectious diseases in 12 EU countries in which the mean number of reported TB deaths in 2003-2004 was twice as high as that attributed to HIV infection [5].…”

Estimating the Global Burden of Foodborne Diseases - a collaborative effort

“…Therefore a three-month pilot study to explore the potential of the disease burden concept for seven communicable diseases was conducted [18].…”

Critical review of methodology and application of risk ranking for prioritisation of food and feed related issues, on the basis of the size of anticipated health impact

“…In addition, three reports from the National Institute for Public Health and the Environment in the Netherlands (RIVM) have been included Mangen et al, 2014;Van Lier et al, 2007).…”

“…For foodborne infections for which reporting is mandatory, modelling of underreporting is often used to estimate the 'true number' of infections in the population Mangen et al, 2014;Van Lier et al, 2007). Food attribution modelling can be used to attribute chemical hazard or pathogen specific illnesses to specific foods, food categories or major transmission pathways.…”