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.
Highlights
Countries of the European Union (EU) and European Economic Area (EEA) increasingly face the challenge of how best to allocate limited resources for infectious disease prevention and control
EU/EEA: European Union/European Economic Area; HAV: Hepatitis A virus; hepatitis B virus (HBV): Hepatitis B virus; human immunodeficiency virus (HIV)/AIDS: Human immunodeficiency virus infection; invasive Haemophilus influenzae disease (IHID): Invasive Haemophilus influenzae disease; invasive meningococcal disease (IMD): Invasive meningococcal disease; invasive pneumococcal disease (IPD): Invasive pneumococcal disease; STEC/ VTEC: Shiga toxin/verocytotoxin-producing Escherichia coli; TBE: Tick-borne encephalitis; vCJD: variant Creutzfeldt–Jakob disease; YLD: years lived with disability; YLL: years of life lost due to premature mortality
This methodology uses an incidence-based approach with a disease progression pathway to estimate disability-adjusted life years (DALYs), an outcome measure that describes the impact of years lived with disability (YLD) following the onset of a disease and of years of life lost due to premature mortality (YLL) compared with a standardised life expectancy [22]
Summary
Countries of the European Union (EU) and European Economic Area (EEA) increasingly face the challenge of how best to allocate limited resources for infectious disease prevention and control. EU/EEA: European Union/European Economic Area; HAV: Hepatitis A virus; HBV: Hepatitis B virus; HIV/AIDS: Human immunodeficiency virus infection; IHID: Invasive Haemophilus influenzae disease; IMD: Invasive meningococcal disease; IPD: Invasive pneumococcal disease; STEC/ VTEC: Shiga toxin/verocytotoxin-producing Escherichia coli; TBE: Tick-borne encephalitis; vCJD: variant Creutzfeldt–Jakob disease; YLD: years lived with disability; YLL: years of life lost due to premature mortality. 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. Conclusions: These results provide baseline estimates for evaluating infectious disease prevention and control strategies
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