gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Burden of infectious diseases in Germany – preliminary results from the Burden of Communicable Diseases in Europe (BCoDE) pilot study

Meeting Abstract

  • Dietrich Plaß - Universität Bielefeld, Bielefeld
  • Paulo Pinheiro - Universität Bielefeld, Bielefeld
  • Alexander Krämer - Universität Bielefeld, Bielefeld
  • Cheryl Gibbons - University of Edinburgh, Edinburgh
  • Marie-Josée Mangen - University Medical Centre Utrecht (UMCU), Utrecht
  • John Brooke - University Medical Centre Utrecht (UMCU), Utrecht
  • Alessandro Cassini - European Centre for Disease Prevention and Control (ECDC), Stockholm
  • Piotr Kramarz - European Centre for Disease Prevention and Control (ECDC), Stockholm
  • Mirjam Kretzschmar - National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control Netherlands, Bilthoven

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds174

DOI: 10.3205/11gmds174, URN: urn:nbn:de:0183-11gmds1747

Published: September 20, 2011

© 2011 Plaß et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: To provide estimates of the communicable diseases burden in Europe, the ECDC initiated the BCoDE project in 2009. The methodology developed is currently piloted in four European countries (Estonia, Germany, Italy and the Netherlands). The main objective of the pilot study is to test and improve the feasibility of the methodology by first assessing disease burden of four selected pathogens.

Methods: The BCoDE consortium used a refined methodology based on the Global Burden of Disease approach developed by the World Health Organisation to estimate the disease burden of measles, influenza, hepatitis B and salmonellosis in Germany. A pathogen-based approach was developed to account for long-term sequelae resulting from an initial infection. Outcome-trees with pathogen-specific health-states and transition probabilities were generated based on semi-systematic literature reviews and expert opinions. Disability Adjusted Life Years (DALY) were estimated using input data collected from publicly accessible data sources provided by national health authorities (e.g. notification data from SurvStat). Multiplication factors were used to account for under-estimation. Uncertainty of multiplication factors and transition probabilities was assessed by sensitivity analysis using @Risk probability distributions.

Results: For the study period of 2005-2007, annual averages of 882 DALYs for measles, 34,690 DALYs for influenza, 6,839 DALYs for hepatitis B and 3,575 DALYs for salmonellosis were calculated for the German population. DALY rates per 100,000 were 0.99 for measles, 39.79 for influenza, 8.18 for hepatitis B and 4.34 for salmonellosis. For measles and influenza the acute burden accounted for 97.4% and 94.5% and the sequelae burden for 2.6% and 5.5% of the total burden, respectively. For hepatitis B and salmonellosis, the acute burden accounted for 2.6% and 35.0% and the sequelae burden for 97.4% and 65.0% of the total burden, respectively. Stratified by sex, male disease burden for measles, influenza, hepatitis B and salmonellosis was 1.03, 43.09, 8.04 and 4.29 DALY/100,000, respectively. The female burden of measles, influenza, hepatitis B and salmonellosis accounted for 0.95, 41.19, 8.30 and 4.39 DALY/100,000, respectively.

Conclusion: The preliminary results indicate that the BCoDE methodology allows for comprehensively estimating the impact of infectious pathogens on population health in Germany. For hepatitis B and salmonellosis, the approach highlights the impact of long-term sequelae from infectious pathogens with 97.4% and 65.0% of the total DALY burden. These estimates still exclude the burden of prevalent hepatitis B infection acquired elsewhere. Refinement of methodology is currently under way, and will provide improved results accentuating infectious diseases and their specific characteristics.


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