Brecht Devleesschauwer

Sciensano · Epidemiology and public health

Context The Democratic Republic of Congo (DRC), one of the most malaria-affected countries worldwide, is a potential hub for global drug-resistant malaria. This study aimed at summarizing and mapping surveys of malaria parasites carrying molecular markers of drug-resistance across the country. Methods A systematic mapping review was carried out be...

Background While many studies on the determinants of post-COVID-19 conditions (PCC) have been conducted, little is known about the relationship between SARS-CoV-2 variants and PCC. This study aimed to assess the association between different SARS-CoV-2 variants and the probability of having PCC three months after the infection. Methods This study...

Knowledge about the extent of the COVID-19 mortality burden is important to inform policy-making decisions. To gain greater insights into the population health impact of COVID-19 mortality, Years of Life Lost (YLL) can be estimated. We aimed to determine YLL linked to COVID-19 over the first two years (March 2020–March 2022) of the pandemic in Cypr...

Previous efforts to estimate the burden of fatigue-related symptoms due to long COVID have a very high threshold for inclusion of cases, relative to the proposed definition from the World Health Organization. In practice this means that milder cases, that may be occurring very frequently, are not included in estimates of the burden of long COVID wh...

Background: Accurate comparable prevalence proportions are required to better understand the epidemiology of frailty. Estimates in many countries are missing or incomparable. The Global Burden of Disease Frailty Index (GBD-FI) applies the deficit accumulation model to generate frailty scores from items available in the Global Burden of Disease stu...

Introduction Cancer causes a substantial burden to our society, both from a health and an economic perspective. To improve cancer patient outcomes and lower society expenses, early diagnosis and timely treatment are essential. The recent COVID-19 crisis has disrupted the care trajectory of cancer patients, which may affect their prognosis in a pote...

Non-communicable diseases (NCDs) are responsible for a significant proportion of global morbidity and mortality, placing a substantial burden on individuals, communities, and healthcare systems. To effectively plan and allocate resources for prevention and treatment, it is crucial to understand the future burden of NCDs. Projections of prevalence o...

Background Life Expectancy (LE) at birth, the average number of years a person is expected to live from birth, with constant age-specific mortality, is an essential indicator of a country or region's well-being, highlighting progress and gaps in societal health, including at the sub-national level. In this study, our goal was to analyse sub-nationa...

Background In Serbia, premature mortality due to COVID-19 usually has been assessed using aggregated mortality data, thus overlooking the impact of sociodemographic factors. Within the European Burden of Disease Network (COST Action CA18218), we examined the association between several sociodemographic factors and COVID-19 years of life lost (YLL)...

Introduction Breast cancer (BC) is a preventable non-communicable disease and the most common cancer among women of reproductive age. Although largely associated with non-modifiable risk factors, the prevention of modifiable risk factors for BC (smoking, alcohol use, physical inactivity, and dietary risks) can help decrease society's burden. The ai...

Background Stroke is one of the leading causes of disability worldwide and there are many reports that the higher risk of ischemic stroke is associated with air pollution. It is noted that the adverse effects of air pollution on health are still invisible and not enough communicated to patients and health professionals. Methods Within the European...

Background Severe cases of COVID-19 require hospital treatment due to the risk of developing a life-threatening condition. Monitoring and reporting indicators of severe forms of COVID-19 in the population can warn health authorities of its increasing presence and the growing demand for hospital treatment and measures to protect persons at risk. By...

Background Tobacco use in Belgium remains a key public health concern with an estimated 15% of adults reporting daily tobacco use in 2018. In 2022, the Belgian government launched the “Interfederal Strategy 2022-2028 for a Smoke-free Generation.” The strategy outlines a number of targets for reducing daily tobacco use among adults 15+ years and you...

Background Life Expectancy (LE) at birth, the average number of years a person is expected to live from birth, supposing constant age-specific mortality, is an essential indicator of a country or region's well-being, reflecting policy options at the regional level and highlighting progress and gaps in societal health, including at the sub-national...

Background The adverse health impact of air pollution exposure on stroke is already well documented but there is a lack of methodological tools to provide actionable evidence on the potential health benefits of realistic interventions. This study demonstrates the use of a parametric g-computation approach to evaluate the impact of hypothetical inte...

Background Evidence suggests that people from lower socioeconomic status are at higher risk of infectious disease impact, owed to virus exposure, susceptibility and incomplete or delayed vaccination. However, It is unknown whether COVID-19 incidence disparities is due to social inequalities or social vaccination inequalities. The aim of this resear...

Comparative risk assessment is commonly applied to derive the share of the burden of disease attributable to specific risk factors, including air pollution. This method is usually conducted at national level, meaning areas and population groups within the country cannot be compared. We propose a novel approach, where the burden attributable to air...

Background Sustainability and health concerns are driving dietary shifts globally, including changes in consumption of dairy products. Dairy provides essential micronutrients e.g., calcium, iodine, and B12 vitamin, and are a source of high-quality protein. They have also been associated with increased risk of diseases. We estimated the health risk-...

What are the most relevant diseases in a country? As the need for prioritising the use of available resources constantly increases, a timely, sound and comprehensive answer to this question is more than ever needed to inform public health decision making. The burden of disease metrics such as the Disability-adjusted Life Years (DALY) are important...

Background Valid estimates of the national disease burden often lack during crises. They need to be improved to help assess the effectiveness and efficiency of the national public health system. To determine the magnitude of acute COVID-19 in Belgrade in 2020 and 2021, we estimated the total, age and sex-disaggregated Years Lived with Disability (Y...

Issue/Problem Motorised road traffic is a major contributor to Nitrogen Dioxide (NO2) emissions, contributing to the development and worsening of asthma. With a substantial and escalating prevalence of asthma in urban areas worldwide, this is an issue of public health significance. Description of the problem Deploying methods such as Random Forest...

By being the leading risk factor for most of the leading causes of death worldwide, tobacco use represents an important public health issue that causes a significant health and economic burden. Despite policy regulations, the prevalence of the use remains substantial in many countries, such as Belgium. A comprehensive framework for the quantificati...

Introduction Tobacco use is one of largest contributors to preventable disease burden in the world. In Belgium, tobacco use is a public health concern and prominent on the policy agenda. To monitor tobacco use and understand the impact on associated outcomes, we estimated the population attributable fraction (PAF) to tobacco use in Belgium and used...

Background This study aims to investigate how pre-existing health status and social background contribute to excess mortality during the COVID-19 crisis in Belgium. Methods The study population consists of 1.4 million adult members of Solidaris, the second largest health insurance fund in Belgium. Pre-existing health status was identified using he...

Objectives Since the onset of the COVID-19 pandemic, most research has focused on its acute pathophysiology, yet some people tend to experience persisting symptoms beyond the acute phase of infection, referred to as post COVID-19 condition (PCC). However, evidence on PCC is still scarce. This study aimed to assess the distribution, classification o...

In a previous study in Belgian nursing homes (NH) during the first wave of the COVID-19 pandemic, we found a SARS-CoV-2 seroprevalence of 17% with a large variability (0–45%) between NH. The current exploratory study aimed to identify nursing home-specific risk factors for high SARS-CoV-2 seroprevalence. Between October 19 th , 2020 and November 13...

The European Health Data Space (EHDS) aims to make the primary use of health data for healthcare provision more continuous, effective, and (cost) efficient. Moreover, it pursues to facilitate the secondary use of health data for purposes such as research, innovation, and policy making. In the context of secondary use, the EHDS legislative proposal...

Background Burden of disease estimates have become important population health metrics over the past decade to measure losses in health. In Belgium, the disease burden caused by COVID-19 has not yet been estimated, although COVID-19 has emerged as one of the most important diseases. Therefore, the current study aims to estimate the direct COVID-19...

Aims: Cardiovascular diseases (CVD) are the leading cause of death worldwide. The COVID-19 pandemic has disrupted healthcare systems, causing delays in essential medical services, and potentially impacting CVD treatment. This study aims to estimate the impact of the pandemic on delayed CVD care in Europe by providing a systematic overview of the a...

Introduction Information on years of life lost (YLL) due to premature mortality is instrumental to assess the fatal impact of disease and necessary for the calculation of Belgian disability-adjusted life years (DALYs). This study presents a novel method to reallocate causes of death data. Materials and methods Causes of death data are provided by...

Background Despite effective prevention and control strategies, in countries of the Balkan region, cancers are the second leading cause of mortality, closely following circulatory system diseases. Objective To describe trends in the burden of breast, cervical, and colon and rectum cancer in the Balkan region and per country between 1990 and 2019,...

Bacterial antimicrobial resistance (AMR) is among the leading global health challenges of the century. Animals and their products are known contributors to the human AMR burden, but the extent of this contribution is not clear. This systematic literature review aimed to identify studies investigating the direct impact of animal sources, defined as...

A global transformation of food systems is needed, given their impact on the three interconnected pandemics of undernutrition, obesity and climate change. A scoping review was conducted to synthesise the effectiveness of food system policies/interventions to improve nutrition, nutrition inequalities and environmental sustainability, and to identify...

Background Although overall health status in the last decades improved, health inequalities due to non-communicable diseases (NCDs) persist between and within European countries. There is a lack of studies giving insights into health inequalities related to NCDs in the European Economic Area (EEA) countries. Therefore, the aim of the present study...

Background Since the onset of the COVID-19 pandemic, most research has focused on the acute phase of COVID-19, yet some people experience symptoms beyond, referred to as post COVID-19 conditions (PCC). However, evidence on PCC and its impacts on health-related quality of life (HRQoL) is still scarce. This study aimed to assess the impact of COVID-1...

Background Higher levels of socioeconomic deprivation have been consistently associated with increased risk of premature mortality, but a detailed analysis by causes of death is lacking in Belgium. Our aim is to investigate the association between area deprivation and all-cause and cause-specific premature mortality in Belgium over the period 1998–...

Background Overweight is a major risk factor for non-communicable diseases (NCDs) in Europe, affecting almost 60% of all adults. Tackling obesity is therefore a key long-term health challenge and is vital to reduce premature mortality from NCDs. Methodological challenges remain however, to provide actionable evidence on the potential health benefit...

Background Similar to many countries, Belgium experienced a rapid increase of cancer diagnoses in the last years. Considering that a large part of cancer types could be prevented, our study aimed to estimate the annual healthcare burden of cancer per site, and to compare cost with burden of disease estimates to have a better understanding of the im...

Objectives: Within the framework of the burden of disease (BoD) approach, disease and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature re...

The current rise in the prevalence of allergies to aeroallergens is incompletely understood and attributed to interactions with environmental changes and lifestyle changes. Environmental nitrogen pollution might be a potential driver of this increasing prevalence. While the ecological impact of excessive nitrogen pollution has been widely studied a...

The majority of emerging infectious diseases are zoonoses, most of which are classified as "neglected". By affecting both humans and animals, zoonoses pose a dual burden. The disability-adjusted life year (DALY) metric quantifies human health burden since it combines mortality and morbidity. This review aims to describe and analyze the current stat...

Objectives: To describe and assess the risk of bias of the primary input studies that underpinned the Global Burden of Disease Study (GBD) 2019 modelled prevalence estimates of low back pain (LBP), neck pain (NP), and knee osteoarthritis (OA), from Australia, Brazil, Canada, Spain, and Switzerland. To evaluate the certainty of the GBD modelled prev...

Introduction Data linkage systems have proven to be a powerful tool in support of combating and managing the COVID-19 pandemic. However, the interoperability and the reuse of different data sources may pose a number of technical, administrative and data security challenges. Methods and analysis This protocol aims to provide a case study for linkin...

Introduction Information on years of life lost (YLL) due to premature mortality is instrumental to assess the fatal impact of disease and necessary for the calculation of Belgian disability-adjusted life years (DALYs). This study presents a novel method to reallocate causes of death data. Materials and methods Causes of death data are provided by S...

Introduction Low back pain (LBP), neck pain (NKP), osteoarthritis (OST) and rheumatoid arthritis (RHE) are among the musculoskeletal (MSK) disorders causing the greatest disability in terms of Years Lived with Disability. The current study aims to analyze the health and economic impact of these MSK disorders in Belgium, providing a summary of morbi...

Background Bacterial vaginosis (BV) is a condition that, if symptomatic, is characterized by discharge and odor, with high recurrence rates even when treated. This study aims to review what literature exists on the association between BV and the emotional, sexual, and social health of women. Methods MEDLINE, Embase and Web of Science databases wer...

Background: While many studies on the determinants of post-COVID-19 conditions (PCC) have been conducted, little is known about the relationship between SARS-CoV-2 variants and PCC. This study aimed to assess the association between different SARS-CoV-2 variants and the probability of having PCC three months after the infection. Methods: This study...

Background: In the past, deprivation has been mostly captured through simple and univariate measures such as low income or poor educational attainment in research on health and social inequalities in Belgium. This paper presents a shift towards a more complex, multidimensional measure of deprivation at the aggregate level and describes the develop...

Background In many countries, the prevalence of non-communicable diseases risk factors is commonly assessed through self-reported information from health interview surveys. It has been shown, however, that self-reported instead of objective data lead to an underestimation of the prevalence of obesity, hypertension and hypercholesterolemia. This stu...

Background Recent studies have identified important social inequalities in SARS-CoV-2 infection and related COVID-19 outcomes in the Belgian population. The aim of our study was to investigate the sociodemographic and socioeconomic characteristics associated with the uptake of COVID-19 vaccine in Belgium. Methods We conducted a cross-sectional ana...

Background: The World Health Organization declared a pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on March 11, 2020. The standardized approach of disability-adjusted life years (DALYs) allows for quantifying the combined impact of morbidity and mortality of diseases and in...

This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and...

This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and...

Foods can be an important source of exposure to chemicals harmful to humans. To identify and prioritize effective food safety strategies, and allocate resources to the interventions with maximum public health benefit, policy makers need evidence on which hazards cause the highest burden of disease in the population. The Disability Adjusted Life Yea...

Previous efforts to estimate the burden of fatigue-related symptoms due to long COVID have a very high threshold for inclusion of cases, relative to the proposed definition from the World Health Organization. In practice, this means that milder cases, that may be occurring very frequently, are not included in estimates of the burden of long COVID,...

Background Poor housing conditions have been associated with increased mortality. Our objective is to investigate the association between housing inequality and increased mortality in Belgium and to estimate the number of deaths that could be prevented if the population of the whole country faced the mortality rates experienced in areas that are le...

Background Foodborne and zoonotic diseases such as brucellosis present many challenges to public health and economic welfare. Increasingly, researchers and public health institutes use disability-adjusted life years (DALYs) to generate a comprehensive comparison of the population health impact of these conditions. DALYs calculations, however, entai...

Background In Belgium, the first COVID-19 death was reported on 10 March 2020. Nursing home (NH) residents are particularly vulnerable for COVID-19, making it essential to follow-up the spread of COVID-19 in this setting. This manuscript describes the methodology of surveillance and epidemiology of COVID-19 cases, hospitalizations and deaths in Bel...

Background Belgium monitors the burden of healthcare-associated infections (HAIs) and antimicrobial use in nursing homes (NHs) by participating in the European point prevalence surveys (PPSs) organised in long-term care facilities (HALT surveys). We present the main findings of the three national PPSs conducted in NHs participating in at least one...

Background In Belgium, current research on socio-economic inequalities in the coronavirus disease 2019 (COVID-19) crisis has mainly focused on excess mortality and data from the first epidemiological wave. The current study adds onto this by examining the association between COVID-19 incidence and area deprivation during the first five wave and int...

Background Burden of disease analyses quantify population health and provide comprehensive overviews of the health status of countries or specific population groups. The comparative risk assessment (CRA) methodology is commonly used to estimate the share of the burden attributable to risk factors. The aim of this paper is to identify and address so...

Introduction No information is available in Belgium on life expectancy adjusted for health-related quality of life (HRQoL). Quality-adjusted life expectancy (QALE) captures the multidimensionality of health by accounting for losses in mortality and HRQoL linked to physical, mental, and social impairments. The objective of this study is to estimate...

Background Lyme borreliosis (LB) is the most common tick-borne disease in Europe and North America, yet its economic burden remains largely unknown. This study aimed to estimate the economic cost associated with the different clinical manifestations of LB in Belgium. Methods An incidence approach and societal perspective were used to estimate the...

Background It is important to understand the effects of population ageing on disease burden and explore conditions that drive poor health in later life to prevent or manage these. We examined the development of disease burden and its components for major disease groups among older adults in Europe over the last 30 years. Methods Using data from th...

Introduction There is growing evidence that the impact of COVID-19 crisis may be stronger for individuals with multimorbidity, frailty and lower socioeconomic status. Existing reviews focus on few, mainly short-term effects of COVID-19 illness and patients with single chronic disease. Information is also largely missing for population representativ...