Disease Burden of 32 Infectious Diseases in the Netherlands 2007-2011.

Thursday, 22nd of September 2016 Print

PLoS One. 2016 Apr 20;11(4):e0153106. doi: 10.1371/journal.pone.0153106. eCollection 2016.

Disease Burden of 32 Infectious Diseases in the Netherlands 2007-2011.

van Lier A1 McDonald SA1 Bouwknegt M1EPI group Kretzschmar ME12 Havelaar AH3 Mangen MJ12 Wallinga J1 de Melker HE1.

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Infectious disease burden estimates provided by a composite health measure give a balanced view of the true impact of a disease on a population allowing the relative impact of diseases that differ in severity and mortality to be monitored over time. This article presents the first national disease burden estimates for a comprehensive set of 32 infectious diseases in the Netherlands.


The average annual disease burden was computed for the period 2007-2011 for selected infectious diseases in the Netherlands using the disability-adjusted life years (DALY) measure. The pathogen- and incidence-based approach was adopted to quantify the burden due to both morbidity and premature mortality associated with all short and long-term consequences of infection. Natural history models disease progression probabilities disability weights and other parameters were adapted from previous research. Annual incidence was obtained from statutory notification and other surveillance systems which was corrected for under-ascertainment and under-reporting. The highest average annual disease burden was estimated for invasive pneumococcal disease (9444 DALYs/year; 95% uncertainty interval [UI]: 8911-9961) and influenza (8670 DALYs/year; 95% UI: 8468-8874) which represents 16% and 15% of the total burden of all 32 diseases respectively. The remaining 30 diseases ranked by number of DALYs/year from high to low were: HIV infection legionellosis toxoplasmosis chlamydia campylobacteriosis pertussis tuberculosis hepatitis C infection Q fever norovirus infection salmonellosis gonorrhoea invasive meningococcal disease hepatitis B infection invasive Haemophilus influenzae infection shigellosis listeriosis giardiasis hepatitis A infection infection with STEC O157 measles cryptosporidiosis syphilis rabies variant Creutzfeldt-Jakob disease tetanus mumps rubella diphtheria and poliomyelitis. The very low burden for the latter five diseases can be attributed to the National Immunisation Programme. The average disease burden per individual varied from 0.2 (95% UI: 0.1-0.4) DALYs per 100 infections for giardiasis to 5081 and 3581 (95% UI: 3540-3611) DALYs per 100 infections for rabies and variant Creutzfeldt-Jakob disease respectively.


For guiding and supporting public health policy decisions regarding the prioritisation of interventions and preventive measures estimates of disease burden and the comparison of burden between diseases can be informative. Although the collection of disease-specific parameters and estimation of incidence is a process subject to continuous improvement the current study established a baseline for assessing the impact of future public health initiatives.


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