Within the European Union (EU), documenting the burden of invasive pneumococcal disease (IPD) in infants and children is important for coordinating effective pneumococcal immunization policies. Our objective was to document the burden of IPD in countries of the EU plus Switzerland and Norway. European affiliates of Wyeth Vaccines made available recent epidemiological data on IPD from local disease surveillance programmes, including unpublished sources. Recent literature and websites were also searched to provide as wide a representation as possible. This included OVID and abstracts from a number of international meetings, dating from the year 2000. The reported rates of paediatric IPD per 100 000 (age) ranged from a low of 1·7 (<2 years) to 4·2 (2–15 years) in Sweden to a high of 93·5 to 174 (<2 years) to 56·2 (<5 years) in Spain. The percentage of circulating serotypes causing IPD that are covered by 7-valent pneumococcal conjugate vaccine (PCV) IPD serotype coverage ranged from 60% to 80% for European children aged <2 years. Under reporting, differences in reporting methods, antibiotic prescribing and disparities in blood-culturing practices may explain the differences in reported disease incidence. Because of the excellent clinical efficacy of the PCV against IPD, national pneumococcal vaccination programmes in Europe have the potential to prevent much morbidity and mortality.
BACKGROUND: The incidence of invasive pneumococcal disease (IPD) varies depending on a number of factors, including vaccine uptake, in both children and adults, the geographic location, and local serotype prevalence. There are limited data about the burden of Streptococcus pneumoniae (Spn), serotype distribution, and clinical characteristics of adults hospitalized due to IPD in Colombia. The objectives of this study included assessment of Spn serotype distribution, clinical characteristics, mortality, ICU admission, and the need for mechanical ventilation. METHODS: This was an observational, retrospective, a citywide study conducted between 2012 and 2019 in Bogotá, Colombia. We analyzed reported positive cases of IPD from 55 hospitals in a governmental pneumococcal surveillance program. Pneumococcal strains were isolated in each hospital and typified in a centralized laboratory. This is a descriptive study stratified by age and subtypes of IPD obtained through the analysis of medical records. RESULTS: A total of 310 patients with IPD were included, of whom 45.5% were female. The leading cause of IPD was pneumonia (60%, 186/310), followed by meningitis. The most frequent serotypes isolated were 19A (13.87%, 43/310) and 3 (11.94%, 37/310). The overall hospital mortality rate was 30.3% (94/310). Moreover, 52.6% (163/310 patients) were admitted to the ICU, 45.5% (141/310) required invasive mechanical ventilation and 5.1% (16/310) non-invasive mechanical ventilation. CONCLUSION: Pneumococcal pneumonia is the most prevalent cause of IPD, with serotypes 19A and 3 being the leading cause of IPD in Colombian adults. Mortality due to IPD in adults continues to be very high. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06769-2.
Risk factors for invasive pneumococcal disease (IPD) include young and old age, comorbidities (such as splenic dysfunction, immunodeficiencies, chronic renal disease, chronic heart or lung disease or cerebral spinal fluid leak), crowded environments or poor socioeconomic conditions. Universal use of the 7-valent pneumococcal conjugate (7vPncCRM) vaccine for infants and young children has led to significant decreases in IPD in the vaccinated population (direct protection), and there has also been a decrease in the incidence of IPD among the nonvaccinated population (indirect immunity; herd protection). While 7vPncCRM vaccine is administered universally to children in USA, many countries of the European Union have chosen to target children with comorbidities. This review aims to highlight individual risk factors for IPD, describe studies that evaluated pneumococcal conjugate vaccines in at-risk groups and estimate the proportion of at-risk children who may have been vaccinated in the European Union since the 7vPncCRM vaccine was introduced, using UK as an example. Although immunisation targeting only children with comorbidities may achieve satisfactory results for a few, many otherwise healthy children at risk simply because of their age will be neglected, and herd protection might not be established.
Abstract Background In Japan, the clinical characteristics and recent serotype distribution among adult patients of invasive pneumococcal disease (IPD) have not been fully investigated since the introduction of the pneumococcal conjugate vaccine (PCV) in children. From November 2010, PCV7 was encouraged by an official program, funded by government, subsequently included in the routine schedule in April 2013, and replaced with a PCV13 in November 2013. Methods Between April 2013 and March 2015, patients with IPD older than 15 years were evaluated based on the enhanced national surveillance in ten prefectures of Japan. The serotype distribution of the isolates was analyzed in these patients. Results The analysis included 291 patients: 107 patients (37%) were female and the median age was 70 years. Of 281 patients with available data, 202 (72%) had underlying diseases, including 107 patients (38%) with immunocompromised status. The case fatality proportion for all case was 20%. In subgroup analysis, the case fatality proportion (29%) in immunocompromised patients was much higher than that (0–16%) in each age group of nonimmunocompromised patients (15–39 years, 40–64 years, and ≥ 65 years). While the proportion of bacteremia without any focus (27%) was higher than that (8–10%) in nonimmunocompromised patients, the proportions of vaccine types (PCV13, 32%; PPSV23, 51%) of the causative isolates were lower than those in each age group of nonimmunocompromised patients. Among 291 isolates, the most frequent serotypes were 3 (17%), 19A (13%), and 22F (10%). Twelve percent of the isolates were PCV7 serotypes, 46% were PCV13 serotypes, and 66% were PPSV23 serotypes. Conclusions The majority of adult patients of IPD had underlying diseases, including immunocompromised conditions. A low proportion (12%) of PCV7-type IPD was observed in this population where PCV7 for children had been included in the routine immunization schedule.
Background: In 2012, Fiji introduced the 10-valent pneumococcal conjugate vaccine (PCV10). We assessed the impact of PCV10 on invasive pneumococcal disease (IPD), probable bacterial or pneumococcal meningitis (PBPM), meningitis and sepsis 3-5 years post-introduction. Methods: Laboratory-confirmed IPD and PBPM cases were extracted from national laboratory records. ICD-10-AM coded all-cause meningitis and sepsis cases were extracted from national hospitalisation records. Incidence rate ratios were used to compare outcomes pre/post-PCV10, stratified by age groups: 1-23m, 2-4y, 5-9y, 10-19y, 20-54y, ≥55y. To account for different detection and serotyping methods in the pre-and post-PCV10 period, a Bayesian inference model estimated serotype-specific changes in IPD, using pneumococcal carriage and surveillance data. Findings: There were 423 IPD, 1,029 PBPM, 1,391 all-cause meningitis and 7,611 all-cause sepsis cases. Five years post-PCV10 introduction, IPD declined by 60% (95%CI: 37%, 76%) in children 1-23m months old, and in age groups 2-4y, 5-9y, 10-19y although confidence intervals spanned zero. PBPM declined by 36% (95%CI: 21%, 48%) among children 1-23 months old, and in all other age groups, although some confidence intervals spanned zero. Among children <5y of age, PCV10-type IPD declined by 83% (95%CI; 70%, 90%) and with no evidence of change in non-PCV10-type IPD (9%, 95%CI; -69, 43%). There was no change in all-cause meningitis or sepsis. Post-PCV10, the most common serotypes in vaccine age-eligible and non-age eligible people were serotypes 8 and 23B, and 3 and 7F, respectively. Interpretations: Our study demonstrates the effectiveness of PCV10 against IPD in a country in the Asia-Pacific of which there is a paucity of data. Funding: This study was support by the Department of Foreign Affairs and Trade of the Australian Government and Fiji Health Sector Support Program (FHSSP). FHSSP is implemented by Abt JTA on behalf of the Australian Government.
BACKGROUND: In 2012, Fiji introduced the 10-valent pneumococcal conjugate vaccine (PCV10). We assessed the impact of PCV10 on invasive pneumococcal disease (IPD), probable bacterial or pneumococcal meningitis (PBPM), meningitis and sepsis 3-5 years post-introduction. METHODS: Laboratory-confirmed IPD and PBPM cases were extracted from national laboratory records. ICD-10-AM coded all-cause meningitis and sepsis cases were extracted from national hospitalisation records. Incidence rate ratios were used to compare outcomes pre/post-PCV10, stratified by age groups: 1-23m, 2-4y, 5-9y, 10-19y, 20-54y, ≥55y. To account for different detection and serotyping methods in the pre-and post-PCV10 period, a Bayesian inference model estimated serotype-specific changes in IPD, using pneumococcal carriage and surveillance data. FINDINGS: There were 423 IPD, 1,029 PBPM, 1,391 all-cause meningitis and 7,611 all-cause sepsis cases. Five years post-PCV10 introduction, IPD declined by 60% (95%CI: 37%, 76%) in children 1-23m months old, and in age groups 2-4y, 5-9y, 10-19y although confidence intervals spanned zero. PBPM declined by 36% (95%CI: 21%, 48%) among children 1-23 months old, and in all other age groups, although some confidence intervals spanned zero. Among children <5y of age, PCV10-type IPD declined by 83% (95%CI; 70%, 90%) and with no evidence of change in non-PCV10-type IPD (9%, 95%CI; -69, 43%). There was no change in all-cause meningitis or sepsis. Post-PCV10, the most common serotypes in vaccine age-eligible and non-age eligible people were serotypes 8 and 23B, and 3 and 7F, respectively. INTERPRETATIONS: Our study demonstrates the effectiveness of PCV10 against IPD in a country in the Asia-Pacific of which there is a paucity of data. FUNDING: This study was support by the Department of Foreign Affairs and Trade of the Australian Government and Fiji Health Sector Support Program (FHSSP). FHSSP is implemented by Abt JTA on behalf of the Australian Government.
Background: Invasive Pneumococcal Disease (IPD) is a major public health concern. The effectiveness of 23-valent polysaccharide pneumococcal vaccine (PPV23) against IPD in older age-groups is not fully understood. We measured PPV23 effectiveness against IPD and interpreted changes in IPD incidence between 2000 and 2017. Methods: Public Health England conducts enhanced national IPD surveillance in England and Wales. The indirect cohort method was used to estimate PPV23 effectiveness against IPD in individuals aged ≥ 65 years eligible for PPV23 vaccination during 2012-2016. IPD incidence in 2016/17 was compared to rates during 2000-2003, when neither PPV23 nor pneumococcal conjugate vaccines (PCVs) were routinely used in England and Wales. Findings: PPV23 effectiveness, irrespective of time since vaccination, was 27% (95% CI, 17-35) after adjusting for age, co-morbidity and year of infection. Vaccine effectiveness reduced non-significantly (p = 0.13) with time since vaccination, from 41% (95% CI, 23-54) for those vaccinated within two years, to 34% (95% CI, 16-48) for those vaccinated 2-4 years previously, and 23% (95% CI, 12-32) for those vaccinated ≥ 5 years previously. Vaccine effectiveness did not vary significantly by age but was highest in previously healthy individuals (45%; 95%CI, 27-59). IPD incidence for PPV23 serotypes not included in the PCVs did not decrease after routine PPV23 use but increased significantly since PCV introduction in 2006. Interpretation: PPV23 offers moderate short-term protection against IPD in older adults. PPV23 serotypes comprise an increasing proportion of IPD cases in older adults because of serotype replacement following routine PCV use in children. Funding: European Union's Horizon 2020.
BACKGROUND: Invasive Pneumococcal Disease (IPD) is a major public health concern. The effectiveness of 23-valent polysaccharide pneumococcal vaccine (PPV23) against IPD in older age-groups is not fully understood. We measured PPV23 effectiveness against IPD and interpreted changes in IPD incidence between 2000 and 2017. METHODS: Public Health England conducts enhanced national IPD surveillance in England and Wales. The indirect cohort method was used to estimate PPV23 effectiveness against IPD in individuals aged ≥ 65 years eligible for PPV23 vaccination during 2012–2016. IPD incidence in 2016/17 was compared to rates during 2000–2003, when neither PPV23 nor pneumococcal conjugate vaccines (PCVs) were routinely used in England and Wales. FINDINGS: PPV23 effectiveness, irrespective of time since vaccination, was 27% (95% CI, 17–35) after adjusting for age, co-morbidity and year of infection. Vaccine effectiveness reduced non-significantly (p = 0.13) with time since vaccination, from 41% (95% CI, 23–54) for those vaccinated within two years, to 34% (95% CI, 16–48) for those vaccinated 2–4 years previously, and 23% (95% CI, 12–32) for those vaccinated ≥ 5 years previously. Vaccine effectiveness did not vary significantly by age but was highest in previously healthy individuals (45%; 95%CI, 27–59). IPD incidence for PPV23 serotypes not included in the PCVs did not decrease after routine PPV23 use but increased significantly since PCV introduction in 2006. INTERPRETATION: PPV23 offers moderate short-term protection against IPD in older adults. PPV23 serotypes comprise an increasing proportion of IPD cases in older adults because of serotype replacement following routine PCV use in children. FUNDING: European Union's Horizon 2020.
Background: Pneumococcal conjugate vaccine, 7 valent (PCV7) is the most costly vaccine yet considered for publicly funded programs. In mid 2001, Australia funded PCV7 for high-risk groups only (indigenous children and children with certain underlying medical conditions). World wide, non-industry-funded studies and studies using cost-utility measures are sparse. We undertook an independent economic analysis of PCV7 compared with no vaccination in the non high-risk Australian childhood population using cost-utility and cost-effectiveness measures. Methods: The incidence of invasive pneumococcal disease (IPD), non-bacteraemic pneumonia and otitis media was estimated using representative urban Australian data, or by extrapolation from comparable industrialised countries. A decision-analytic model was developed for a hypothetical birth cohort using the age-specific vaccine coverage from the Californian randomised controlled trial of PCV7. Health outcomes were measured by life-years saved and deaths and disability-adjusted life-years (DALYs) averted. In line with government guidelines, only direct costs were considered in 1997-1998 Australian dollars. Results: For a birth cohort of 250,000, the gross cost of vaccination is $ 78.6 million. Subtracting treatment cost savings, the net cost (discounted) is $ 61.7 million. In undiscounted terms, vaccination prevents 13.7 deaths, 11.2 (82%) from IPD and the remainder from non-bacteraemic pneumonia. The discounted cost per death avoided is $ 5.0 million, per life-year saved $ 230,130 and per DALY averted $ 121,100, giving a break-even vaccine price of $ 15.40 per dose. These estimates are most sensitive to the unit cost per dose of vaccine, estimates of incidence and vaccine efficacy against non-bacteraemic pneumonia and the discount rate. The cost per DALY reduced to $ 81,000 with a discount rate of 3% rather than 5% and to $ 90, 000 with the most favourable assumptions concerning pneumonia reduction. Discussion: With a vaccine price of $ 90 per dose, mid-range estimates of impact against non-bacteraemic pneumonia, and discount rate of 5%, a PCV7 program for infants not at high risk of IPD is at the upper limit of cost per DALY previously approved under Australian pharmaceutical funding guidelines. The impact of PCV7 against non-bacteraemic pneumonia is poorly defined, but its importance to cost-effectiveness in resource rich and resource poor settings warrants further studies or analysis to give greater precision to this outcome.
Background: Pneumococcal conjugate vaccine, 7 valent (PCV7) is the most costly vaccine yet considered for publicly funded programs. In mid 2001, Australia funded PCV7 for high-risk groups only (indigenous children and children with certain underlying medical conditions). World wide, non-industry-funded studies and studies using cost-utility measures are sparse. We undertook an independent economic analysis of PCV7 compared with no vaccination in the non high-risk Australian childhood population using cost-utility and cost-effectiveness measures. Methods: The incidence of invasive pneumococcal disease (IPD), non-bacteraemic pneumonia and otitis media was estimated using representative urban Australian data, or by extrapolation from comparable industrialised countries. A decision-analytic model was developed for a hypothetical birth cohort using the age-specific vaccine coverage from the Californian randomised controlled trial of PCV7. Health outcomes were measured by life-years saved and deaths and disability-adjusted life-years (DALYs) averted. In line with government guidelines, only direct costs were considered in 1997-1998 Australian dollars. Results: For a birth cohort of 250,000, the gross cost of vaccination is $ 78.6 million. Subtracting treatment cost savings, the net cost (discounted) is $ 61.7 million. In undiscounted terms, vaccination prevents 13.7 deaths, 11.2 (82%) from IPD and the remainder from non-bacteraemic pneumonia. The discounted cost per death avoided is $ 5.0 million, per life-year saved $ 230,130 and per DALY averted $ 121,100, giving a break-even vaccine price of $ 15.40 per dose. These estimates are most sensitive to the unit cost per dose of vaccine, estimates of incidence and vaccine efficacy against non-bacteraemic pneumonia and the discount rate. The cost per DALY reduced to $ 81,000 with a discount rate of 3% rather than 5% and to $ 90, 000 with the most favourable assumptions concerning pneumonia reduction. Discussion: With a vaccine price of $ 90 per dose, mid-range estimates of impact against non-bacteraemic pneumonia, and discount rate of 5%, a PCV7 program for infants not at high risk of IPD is at the upper limit of cost per DALY previously approved under Australian pharmaceutical funding guidelines. The impact of PCV7 against non-bacteraemic pneumonia is poorly defined, but its importance to cost-effectiveness in resource rich and resource poor settings warrants further studies or analysis to give greater precision to this outcome.
Routine use of pneumococcal conjugate vaccines (PCVs) in developing countries is expected to lead to a significant reduction in childhood deaths. However, PCVs have been associated with replacement disease with non-vaccine serotypes. We established a population-based surveillance system to document the direct and indirect impact of PCVs on the incidence of invasive pneumococcal disease (IPD) and radiological pneumonia in those aged 2 months and older in The Gambia, and to monitor changes in serotype-specific IPD. Here we describe how this surveillance system was set up and is being operated as a partnership between the Medical Research Council Unit and the Gambian Government. This surveillance system is expected to provide crucial information for immunisation policy and serves as a potential model for those introducing routine PCV vaccination in diverse settings.
Objectives: Pneumococcal conjugate vaccines (PCVs) are effective in reducing pneumococcal disease. We measured 13-valent PCV (PCV13) effect on different pneumococcal outcomes using diverse studies in Lao People's Democratic Republic. Methods: Studies included: pre-PCV13 population-based record review of hospitalized childhood pneumonia cases; acute respiratory infection (ARI) study post-PCV13 to demonstrate effectiveness (VE) against hypoxic pneumonia; invasive pneumococcal disease (IPD) surveillance in all ages (2004–2018); carriage studies in children hospitalized with ARI (2013–2019); community carriage surveys pre- and post-PCV13. Results: Annual pneumonia incidence rate in children pre-PCV13 was 1,530 (95% confidence interval [CI] 1,477–1,584) per 100,000. Adjusted VE against hypoxic pneumonia was 37% (95% CI 6–57%). For IPD, 85% (11/13) of cases were due to vaccine-types pre-PCV13, and 43% (3/7) post-PCV13 in children aged <5 years; for ≥5 years, 61% (27/44) and 42% (17/40), respectively. For ARI cases, adjusted VE for vaccine-type carriage was 39% (95% CI 4–60) in <5 year olds; slightly higher than community surveys (23% [95% CI 4–39%] in 12–23 month olds). Conclusions: Despite limited baseline data, we found evidence of PCV13 impact on disease and carriage. Our approach could be used in similar settings to augment existing WHO PCV evaluation guidelines.
Pneumonia is one of the top causes of deaths in children younger than 5 years of age. According to WHO estimation, globally there are nearly 2 millions young children who die from pneumonia every year, and more than 70% of these deaths occurred in Africa and Southeast Asia. Pneumonia caused by Streptococcus pneumoniae (also called pneumococcus) is a vaccine preventable disease, accounting for 39% of community-acquired pneumonia. There are two types of pneumococcal vaccines that are pneumococcal polysaccharide vaccine (PPV) and pneumococcal conjugate vaccines (PCV). The latter one is routinely advised for children younger than five years. The aims of this paper are to review the global disease burden caused by Streptococcus pneumoniae in children younger than 5 years and to gather vaccine program information globally. For narrative review and policy analysis, WHO websites, other websites of health organizations or institutions, and literatures from Pubmed were reviewed, using key words "children pneumonia", "Streptococcus pneumoniae", "pneumonia vaccine", "pneumococcal conjugate vaccine ", "PCV-7", "7-valent PCV", "PCV-13", "13-valent PCV". Numerous literatures have reported that obvious incidence decrease of invasive pneumococcal diseases (IPD) in young children after PCV vaccination. In July 2000 PCV-7 ("7-valent pneumococcal conjugate vaccine") was incorporated into National Immunization Program (NIP) in United States. Although since then the incidence of IPD caused by vaccine-covered serotypes markedly decreased, those caused by non-vaccine-covered serotypes were found substantially increased. In February 2010, PCV-13 ("13-valent pneumococcal conjugate vaccine") replaced PCV-7 in NIP in United States. With a wider range of serotypes, PCV-13 was expected to be more effective than PCV-7 in children under 5. Using modeling method, many scholars estimated that PCV-13 was likely to be more cost-effective in reported settings when herd immunity was taken into consideration. Schedule of vaccine was another issue that needs to be investigated. There are three schedules commonly adopted by health authorities: 2 primary doses with 1 booster dose (2p+1), and 3 primary doses with 1 booster (3p+1) or without 1 booster dose (3p+0). In individual report, it seems three schedules were all effective. From result of systematic review, more evidence supported to use 3p+0 schedule (and 3p+1 schedule). However, emerging evidences are in support of 2p+1 schedule tool. WHO recommended both 3p+0 and 2p+1 schedule. If the country with high incidence rate in young infant (less than 32 weeks) 2p+1 schedule may not provide adequate protection for special individual serotype. In addition 2p+1 schedule may also lead to lower antibody level between the second primary dose and the booster dose, but the booster dose could induce higher antibody level, which is important for protecting certain serotypes. Countries should consider local factors and choose suitable vaccine schedule accordingly. In terms of global PCV programs, around 80 countries have already added PCV into their NIP, 58 countries (30%) were planning to introduce the program; nevertheless remaining 51 countries (26%) of countries have no schedule to introduce it yet. Most countries that have implemented PCV programs were western industrialized countries. With support from Global Alliance for Vaccines and Immunization (GAVI), 15 eligible African countries have had routine PCV programs. Comparatively, in Asia, India and China, two countries with the largest population and largest number of IPD cases in the world, have no PCV program to the children. Even industrialized economies like Japan and Taiwan have not implemented yet. Asia was lagging behind for decades. PCV program needs to be prioritized in Asian countries. Asian governments should consider investing more in PCV programs (high-income countries) and/or cooperating with other organizations such as GAVI (low-income countries) to increase the coverage of PCVs in children under 5 and to protect them from pneumococcal diseases. ; published_or_final_version ; Public Health ; Master ; Master of Public Health
BACKGROUND: Despite the current recommendation by the Centre for Health Protection (CHP)of Hong Kong for adults aged 65 years or above to receive 23-valent pneumococcal polysaccharide vaccine (PPV23), pneumococcal disease(PD) has become the second leading causes of death in Hong Kong. A relatively new pneumococcal vaccine –13-valent pneumococcal conjugate vaccine (PCV13) was approved by the US Food and Drug Administration (FDA) in December 2011 and the European Medicines Agency (EMA) in July 2013 for the prevention of invasive disease caused by S. pneumoniae for older adults aged 50 years or above. It was shown to overcome some of the limitations of PPV23and potentially confer benefits to older adults in the prevention of PD. OBJECTIVES: To systematically review available literatures to examine whether PCV13 is superior to PPV23 or no vaccination in terms of the cost-effectiveness in the prevention of PD in older adults aged 50 years or above. METHODS: Two databases, PubMed and ISI Web of Science, were used to search for published journals. The year range of search in these databases was confined to10 years. RESULTS: A total of 318studies were identified initially and 10studies were included in this systematic review. Studies were conducted in the US, Colombia and European Union (EU) countries e.g. Italy, Germany, Netherlands and Spain. Different perspectives including societal, payer and health system were considered. The use of PCV13 was compared to either PPV23 or no vaccination in older adults aged 50 years or above. The coverage of PCV13 ranged from 42.4% to 70%, conferring an efficacy between 58% and 93.9%. The cost-effectiveness of PCV13 was expressed through the number of avoided cases/deaths for PD including invasive pneumococcal disease(IPD), inpatient and outpatient community-acquired pneumonia (CAP) as well as the incremental cost-effectiveness ratios (ICERs),either in cost per quality-adjusted life-year (QALY) gained or cost per life-year gained (LYG).Overall, PCV13 is shown to avoid more pneumococcal cases compared to PPV23 or no vaccination and is cost-effective in older adults aged 50 years of above. CONCLUSION: PCV13 is considered to be more cost-effective in older adults compared to PPV23 or no vaccination based on the current systematic review. Randomized controlled trials and cost-effectiveness evaluations are suggested to be conducted in Hong Kong and Asia-specific regions in order to obtain clinical and economic data of PCV13 in the Asian population. Policy-makers should also consider the effects of serotype replacement on the change in serotype distribution in local setting from time to time so that vaccines with appropriate serotype formulations could be researched. ; published_or_final_version ; Public Health ; Master ; Master of Public Health
Background and aims: The 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 groupspecific 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.
