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Meta-Analysis
. 2014 Nov;14(11):1073-1082.
doi: 10.1016/S1473-3099(14)70870-9. Epub 2014 Sep 15.

The global burden of listeriosis: a systematic review and meta-analysis

Charline Maertens de Noordhout #  1 , Brecht Devleesschauwer #  1 , Frederick J Angulo  1 , Geert Verbeke  1 , Juanita Haagsma  1 , Martyn Kirk  1 , Arie Havelaar  1 , Niko Speybroeck  1
Affiliations
Meta-Analysis

The global burden of listeriosis: a systematic review and meta-analysis

Charline Maertens de Noordhout et al. Lancet Infect Dis. 2014 Nov.

Abstract

Background: Listeriosis, caused by Listeria monocytogenes, is an important foodborne disease that can be difficult to control and commonly results in severe clinical outcomes. We aimed to provide the first estimates of global numbers of illnesses, deaths, and disability-adjusted life-years (DALYs) due to listeriosis, by synthesising information and knowledge through a systematic review.

Methods: We retrieved data on listeriosis through a systematic review of peer-reviewed and grey literature (published in 1990-2012). We excluded incidence data from before 1990 from the analysis. We reviewed national surveillance data where available. We did a multilevel meta-analysis to impute missing country-specific listeriosis incidence rates. We used a meta-regression to calculate the proportions of health states, and a Monte Carlo simulation to generate DALYs by WHO subregion.

Findings: We screened 11,722 references and identified 87 eligible studies containing listeriosis data for inclusion in the meta-analyses. We estimated that, in 2010, listeriosis resulted in 23,150 illnesses (95% credible interval 6061-91,247), 5463 deaths (1401-21,497), and 172,823 DALYs (44,079-676,465). The proportion of perinatal cases was 20·7% (SD 1·7).

Interpretation: Our quantification of the global burden of listeriosis will enable international prioritisation exercises. The number of DALYs due to listeriosis was lower than those due to congenital toxoplasmosis but accords with those due to echinococcosis. Urgent efforts are needed to fill the missing data in developing countries. We were unable to identify incidence data for the AFRO, EMRO, and SEARO WHO regions.

Funding: WHO Foodborne Diseases Epidemiology Reference Group and the Université catholique de Louvain.

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Figures

Figure 1
Figure 1. Outcome tree for perinatal and non-perinatal listeriosis
Each block represents a node in the computational disease model, and arrows represent transition probabilities between nodes. Red boxes contribute years of life lost caused by premature death (YLLs), green boxes contribute years lived with disability (YLDs), and blue boxes have no contribution to the disability-adjusted life-years. In addition to this baseline model, we did a scenario analysis in which stillbirths were excluded from the burden estimates.
Figure 2
Figure 2. Study selection
The studies are referenced in the appendix.
Figure 3
Figure 3. Disability-adjusted life-years (DALYs) per 100 000 people for listeriosis (with stillbirths) by WHO subregion
DALYs (A) and SD of estimated DALYs (B). NA=not applicable.
Figure 4
Figure 4. Disability-adjusted life-years (DALYs) per 100 000 people for listeriosis (without stillbirths) by WHO subregion
DALYs (A) and SD of estimated DALYs (B). NA=not applicable.
See this image and copyright information in PMC

Comment in

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