PDF(Pubmed)
Abstract：
BACKGROUND: The objective of this study is to estimate the burden of selected immunization-preventable infectious diseases in Spain using the Burden of Communicable Diseases in Europe (BCoDE) methodology, as well as focusing on the national immunization programme and potential new inclusions.
METHODS: The BCoDE methodology relies on an incidence and pathogen-based approach to calculate disease burden via disability-adjusted life year (DALY) estimates. It considers short and long-term sequelae associated to an infection via outcome trees. The BCoDE toolkit was used to populate those trees with Spanish-specific incidence estimates, and de novo outcome trees were developed for four infections (herpes zoster, rotavirus, respiratory syncytial virus [RSV], and varicella) not covered by the toolkit. Age/sex specific incidences were estimated based on data from the Spanish Network of Epidemiological Surveillance; hospitalisation and mortality rates were collected from the Minimum Basic Data Set. A literature review was performed to design the de novo models and obtain the rest of the parameters. The methodology, assumptions, data inputs and results were validated by a group of experts in epidemiology and disease modelling, immunization and public health policy.
RESULTS: The total burden of disease amounted to 163.54 annual DALYs/100,000 population. Among the selected twelve diseases, respiratory infections represented around 90% of the total burden. Influenza exhibited the highest burden, with 110.00 DALYs/100,000 population, followed by invasive pneumococcal disease and RSV, with 25.20 and 10.57 DALYs/100,000 population, respectively. Herpes zoster, invasive meningococcal disease, invasive Haemophilus influenza infection and hepatitis B virus infection ranked lower with fewer than 10 DALYs/100,000 population each, while the rest of the infections had a limited burden (< 1 DALY/100,000 population). A higher burden of disease was observed in the elderly (≥ 60 years) and children < 5 years, with influenza being the main cause. In infants < 1 year, RSV represented the greatest burden.
CONCLUSIONS: Aligned with the BCoDE study, the results of this analysis show a persisting high burden of immunization-preventable respiratory infections in Spain and, for the first time, highlight a high number of DALYs due to RSV. These estimates provide a basis to guide prevention strategies and make public health decisions to prioritise interventions and allocate healthcare resources in Spain.
METHODS: The BCoDE methodology relies on an incidence and pathogen-based approach to calculate disease burden via disability-adjusted life year (DALY) estimates. It considers short and long-term sequelae associated to an infection via outcome trees. The BCoDE toolkit was used to populate those trees with Spanish-specific incidence estimates, and de novo outcome trees were developed for four infections (herpes zoster, rotavirus, respiratory syncytial virus [RSV], and varicella) not covered by the toolkit. Age/sex specific incidences were estimated based on data from the Spanish Network of Epidemiological Surveillance; hospitalisation and mortality rates were collected from the Minimum Basic Data Set. A literature review was performed to design the de novo models and obtain the rest of the parameters. The methodology, assumptions, data inputs and results were validated by a group of experts in epidemiology and disease modelling, immunization and public health policy.
RESULTS: The total burden of disease amounted to 163.54 annual DALYs/100,000 population. Among the selected twelve diseases, respiratory infections represented around 90% of the total burden. Influenza exhibited the highest burden, with 110.00 DALYs/100,000 population, followed by invasive pneumococcal disease and RSV, with 25.20 and 10.57 DALYs/100,000 population, respectively. Herpes zoster, invasive meningococcal disease, invasive Haemophilus influenza infection and hepatitis B virus infection ranked lower with fewer than 10 DALYs/100,000 population each, while the rest of the infections had a limited burden (< 1 DALY/100,000 population). A higher burden of disease was observed in the elderly (≥ 60 years) and children < 5 years, with influenza being the main cause. In infants < 1 year, RSV represented the greatest burden.
CONCLUSIONS: Aligned with the BCoDE study, the results of this analysis show a persisting high burden of immunization-preventable respiratory infections in Spain and, for the first time, highlight a high number of DALYs due to RSV. These estimates provide a basis to guide prevention strategies and make public health decisions to prioritise interventions and allocate healthcare resources in Spain.
摘要：
背景：这项研究的目的是使用欧洲传染病负担（BCoDE）方法来估计西班牙某些可免疫预防的传染病的负担，以及侧重于国家免疫计划和潜在的新纳入。
方法：BCoDE方法依赖于基于发病率和病原体的方法，通过残疾调整生命年（DALY）估算来计算疾病负担。它考虑了通过结果树与感染相关的短期和长期后遗症。BCoDE工具包被用来用西班牙特有的发病率估计来填充这些树，并为四种感染开发了从头结果树(带状疱疹，轮状病毒，呼吸道合胞病毒[RSV]，和水痘)不在工具包内。根据西班牙流行病学监测网络的数据估计年龄/性别特定发生率；从最低基本数据集收集住院率和死亡率。进行了文献综述以设计从头模型并获得其余参数。方法论,假设,数据输入和结果由一组流行病学和疾病建模专家验证，免疫接种和公共卫生政策。
结果：疾病总负担为163.54年DALYs/100,000人口。在选定的12种疾病中，呼吸道感染约占总负担的90%.流感表现出最高的负担，110.00DALYs/100,000人口，其次是侵袭性肺炎球菌病和RSV，25.20和10.57DALYs/100,000人口，分别。带状疱疹,侵袭性脑膜炎球菌病,侵袭性流感嗜血杆菌感染和乙型肝炎病毒感染排名较低，各少于10DALYs/100,000人口，而其余感染的负担有限（<1DALY/100,000人群）。在老年人（≥60岁）和<5岁的儿童中观察到更高的疾病负担，流感是主要原因。在<1岁的婴儿中，RSV是最大的负担。
结论：与BCoDE研究一致，这项分析的结果表明，在西班牙，可免疫预防的呼吸道感染的负担持续很高，第一次,突出显示由于RSV导致的大量DALY。这些估计为指导预防策略和做出公共卫生决策提供了基础，以优先考虑干预措施和分配西班牙的医疗保健资源。
方法：BCoDE方法依赖于基于发病率和病原体的方法，通过残疾调整生命年（DALY）估算来计算疾病负担。它考虑了通过结果树与感染相关的短期和长期后遗症。BCoDE工具包被用来用西班牙特有的发病率估计来填充这些树，并为四种感染开发了从头结果树(带状疱疹，轮状病毒，呼吸道合胞病毒[RSV]，和水痘)不在工具包内。根据西班牙流行病学监测网络的数据估计年龄/性别特定发生率；从最低基本数据集收集住院率和死亡率。进行了文献综述以设计从头模型并获得其余参数。方法论,假设,数据输入和结果由一组流行病学和疾病建模专家验证，免疫接种和公共卫生政策。
结果：疾病总负担为163.54年DALYs/100,000人口。在选定的12种疾病中，呼吸道感染约占总负担的90%.流感表现出最高的负担，110.00DALYs/100,000人口，其次是侵袭性肺炎球菌病和RSV，25.20和10.57DALYs/100,000人口，分别。带状疱疹,侵袭性脑膜炎球菌病,侵袭性流感嗜血杆菌感染和乙型肝炎病毒感染排名较低，各少于10DALYs/100,000人口，而其余感染的负担有限（<1DALY/100,000人群）。在老年人（≥60岁）和<5岁的儿童中观察到更高的疾病负担，流感是主要原因。在<1岁的婴儿中，RSV是最大的负担。
结论：与BCoDE研究一致，这项分析的结果表明，在西班牙，可免疫预防的呼吸道感染的负担持续很高，第一次,突出显示由于RSV导致的大量DALY。这些估计为指导预防策略和做出公共卫生决策提供了基础，以优先考虑干预措施和分配西班牙的医疗保健资源。
