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. 2018 Apr;23(16):17-00454.
doi: 10.2807/1560-7917.ES.2018.23.16.17-00454.

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

Alessandro Cassini  1   2 , Edoardo Colzani  1 , Alessandro Pini  1 , Marie-Josee J Mangen  2   3 , Dietrich Plass  4 , Scott A McDonald  3 , Guido Maringhini  1 , Alies van Lier  3 , Juanita A Haagsma  5 , Arie H Havelaar  3   6 , Piotr Kramarz  1 , Mirjam E Kretzschmar  2   3 ; BCoDE consortium  7
Affiliations

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

Alessandro Cassini et al. Euro Surveill. 2018 Apr.

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.

Keywords: HIV/AIDS, tuberculosis; burden of communicable diseases in Europe; disability-adjusted life years; infectious disease surveillance; influenza; prioritisation in public health; public health policy.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Median annual DALYs per 100,000 population for selected infectious diseases, EU/EEA countries, 2009–2013
Figure 2
Figure 2
Relative contribution of YLL and YLD to the total burden of selected infectious diseases, EU/EEA countries, 2009–2013
Figure 3
Figure 3
Bubble chart of the burden of selected infectious diseases in terms of mortality and incidence, EU/EEA countries, 2009–2013
Figure 4
Figure 4
Scatterplot of the burden of selected infectious diseases in DALYs per case and DALYs per 100,000 population per year, EU/EEA countries, 2009–2013
Figure 5
Figure 5
Annual total burden of selected infectious diseases by age group and sex, EU/EEA countries, 2009–2013
Figure 6
Figure 6
Annual age group-standardised burden of selected infectious diseases by age group and sex, EU/EEA countries, 2009–2013
Figure 7
Figure 7
Annual age group-specific burden of selected infectious diseases by age groups < 15 years of age, 15–64 years of age and ≥ 65 years of age, EU/EEA countries, 2009–2013
Figure 8
Figure 8
Comparison of ranking according to ECDC TESSy average annual notification rate and ranking according to estimated DALYs per 100,000 population, EU/EEA countries, 2009–2013
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