Brecht Devleesschauwer

• PhD, DVM, MVSc, MStat
• Senior Epidemiologist and Head of Service at Sciensano (Belgium)

Background Several studies have suggested a positive effect of occasional cannabis consumption on the frequency of leisure-time physical activity, possibly due to more motivation before, more enjoyment during, and better recovery after engaging in leisure-time physical exercise. While such an effect would contradict the stereotypical image of lower...

Background Campylobacteriosis is a major zoonotic and foodborne disease (FBD), posing a substantial social and health economic burden on human health. Burden of disease (BoD) studies, which increasingly use the disability-adjusted life years (DALYs) metric, provide comprehensive insights into disease effects. However, the complexity of DALY calcula...

Achieving WHO air pollution guidelines is critical to reduce the health burden of air pollution, which disproportionately affects socioeconomically disadvantaged populations and varies by sector, spatial distribution, and seasonal trends. This study explores the implications of sectorial and spatial-seasonal air pollution patterns, socio-economic d...

Introduction Sustaining declines in global infectious disease burden will increasingly require efforts targeted to specific aetiological agents and common transmission pathways, particularly in this era of global change and human interconnectivity accelerating transmission and emergence of infectious pathogens. Systematic reviews and meta-analyses...

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 almost 1.4 million adult members of Solidaris, the second largest health insurance fund in Belgium. Pre-existing health status was identified u...

Tobacco use is among the leading behavioural risk factors for morbidity and mortality. These high rates result in a high cost to society. Therefore, the aim of the current study was to provide a contemporary overview of the direct medical and indirect costs attributable to smoking tobacco in Belgium. Data from the Belgian Health Interview Survey (B...

Background and methods High body mass index (BMI) is a major risk factor for several non-communicable diseases. The increasing concern about the health and economic burden of BMI makes it essential for countries to track their progress on major modifiable risk exposures. The aim of the study is to estimate the burden attributable to high BMI in Bel...

Background The COVID‐19 pandemic disrupted global health systems, impacting cancer care and potentially increasing cancer mortality, especially among socioeconomically disadvantaged individuals. We aimed to assess changes in cancer mortality from March 1 to December 31, 2020 relative to the same period in 2019, and to examine potential shifts in ca...

Introduction: The prevalence of excess weight in Scotland is higher than other UK nations and amongst the highest when compared with European Union countries. The aim of our study was to use historic data to identify and integrate age-period-cohort (APC) effects into projected estimates of the prevalence of excess weight in Scotland. Methods: Int...

Background Premature mortality risks vary in space and time between subpopulations and are influenced by numerous factors, including levels of socioeconomic deprivation. In Belgium, socioeconomic deprivation has been recently quantified by the Belgian Indices of Multiple Deprivation but their contribution to the spatial patterns of premature mortal...

Background: This study aims to assess which population groups experienced the heaviest mortality burden during the first three COVID-19 waves in Belgium; and investigate potential changes in social differences in all-cause mortality during the epidemic and compared to the pre-COVID period. Methods: Exhaustive all-cause mortality information (201...

Background: The COVID-19 pandemic led to significant excess mortality in 2020 in Belgium. By using microlevel cause-specific mortality data for the total adult population in Belgium in 2020, three outcomes were considered in this study aiming at predicting sociodemographic (SD) and socioeconomic (SE) patterns of (1) COVID-19 specific death compare...

Background Taenia solium neurocysticercosis is a zoonotic neglected tropical disease, for which adequate diagnostic management is paramount, especially in patients with active cysts for whom improved and timely management could prove beneficial. Immunodiagnosis can potentially partially mitigate the necessity for neuroimaging, shortening the diagno...

Background: Campylobacteriosis is a major zoonotic and foodborne disease (FBD), posing a substantial social and health economic burden on human health. Burden of disease (BoD) studies, which increasingly use the disability-adjusted life years (DALYs) metric, provide comprehensive insights into disease effects. However, the complexity of DALY calcul...

Background: Specialised addiction treatment centers (SAC) and general mental health centers (GMHC) both offer care to people with substance use disorders (SUD) in Belgium, but these sectors often operate in parallel, with little collaboration. This fragmented system may lead to inefficiencies, particularly in the treatment of individuals with dual...

Despite numerous efforts worldwide to reduce the harmful effects of alcohol, its impact on health remains significant, contributing significantly to the loss of healthy life years. In Belgium, alcohol use is still a major public health concern, ranking among the highest in alcohol consumption across Europe. This study aims to use available national...

Zoonoses, diseases naturally transmitted between vertebrates and humans, represent significant global health threats. These diseases not only affect human health but also impose a considerable burden on animal populations, emphasizing the need for a One Health approach that integrates strategies across human, animal, and environmental health sector...

This study leverages a registry-based microsimulation model to analyze the non-fatal burden of cancer in Belgium from 2004 to 2019, emphasizing the methodology for severity distribution. Utilizing incidence- and prevalence-based approaches, we estimated Years Lived with Disability (YLD) through detailed national cancer registry data coupled with ta...

Background The COVID-19 pandemic led to significant excess mortality in 2020 in Belgium. By using microlevel cause-specific mortality data for the total Belgian adult population in 2020, three outcomes were considered in this study aiming at predicting sociodemographic (SD) and socioeconomic (SE) patterns of 1) COVID-19 specific death compared to s...

Tobacco use remains a challenge given its substantial role in contributing to disability and premature death globally. Understanding its impact on population health, as an attributable burden, can help monitor progress on the effectiveness of tobacco policies. In this study, we used the Comparative Risk Assessment (CRA) method to estimate the share...

Background Ambient air pollution, particularly surface ozone, is a significant global health concern, with 9 out of 10 people exposed to levels exceeding WHO guidelines. This exposure is linked to approximately 7 million premature deaths annually, a number expected to double by 2050. While the effects of short-term exposure to ozone on exacerbation...

Background The adverse health impact of air pollution on non-communicable diseases (NCDs) is well documented, yet methodological tools for assessing the potential health benefits of interventions are lacking. This study uses a parametric g-computation approach to evaluate the impact of hypothetical interventions targeting long-term air pollution ex...

Inflammatory bowel disease (IBD) comprises digestive disorders resulting from non-infectious inflammation of the colon and gastrointestinal tract. With its global prevalence on the rise, IBD poses significant challenges to healthcare systems. There is a need for more accurate disease burden estimates to guide decision-making processes within the he...

Background Arsenic (As) exposure poses significant health risks to exposed populations, with exposure occurring predominantly via diet for the general population as recently referred by the European Food Safety Authority. This study assesses the environmental burden of disease (EBD) for three cancer types related to arsenic, across Europe. Methods...

Background During the COVID-19 crisis, data linkages were set up to efficiently monitor the outbreak and identify vulnerable population groups. Yet, considerable technical, administrative and data security issues have hindered the effectiveness of data linkages as a critical instrument during public health emergencies. This workshop aims to provide...

When conducting health impact assessments (HIA), researchers often face the challenges of trying to align as closely as possible with policy scenarios. This phase concerns the translation of real-world policies into estimates usable in models. Most of the time, researchers need to address a policy-impact gap between what is needed by the policymake...

Valorization and interpretation of health data are contingent upon a robust analytical framework. This framework encompasses essential processes such as data cleaning, validation, and the critical evaluation of bias and missing data. A nuanced understanding of these factors is crucial for contextualizing data through stratification, developing comp...

One of the returning challenges faced by public health scientists is bridging the ‘evidence-policy gap’-the disparity between identifying public health issues and implementing policies to address them. Despite the extensive literature documenting the challenges of promoting evidence-informed policymaking, opportunities for researchers to exchange e...

Background Nepal has a history of regular natural hazards, including significant earthquakes and floods. Previous studies have shown that females, particularly younger females, are more likely to die due to disasters compared to males. This study aimed to explore gender differences in mortality - measured in Years of Life Lost (YLL) - caused by the...

Psoriasis is a common, chronic, inflammatory skin disease with a great impact on healthcare systems. Given the limitations of the currently available burden estimates, estimates of the Belgian national burden of disease study are necessary in order to guide decision-making processes within the health sector. According to the Global Psoriasis Atlas,...

As indicated by human biomonitoring (HBM) studies, exposure to pyrethroids is widespread in Europe with significantly higher exposure observed in children compared to adults. Epidemiological, toxicological, and mechanistic studies raise concerns about potential health effects in humans and, particularly, behavioral disorders such as attention defic...

The Belgian national burden of disease study (BeBOD) was launched in 2022, and currently provides disease burden estimates for 38 key diseases. The calculation of the non-fatal component of the disease burden, the Years Lived with Disability (YLD), follows a stepwise approach that aims to establish priority outcomes; quantify prevalence “best estim...

This study estimates the disease burden of ischemic heart disease (IHD), stroke and diabetes mellitus attributable to road traffic noise in the Flemish Region (Belgium) for the year 2020, expressed in disability-adjusted life years (DALYs). The research proposes an approach to stratify population exposure to noise according to age and sex, which al...

One of the main purposes of public health institute is to tracking the health status of its citizens and understanding its evolution over time. Given the absence of a singular, comprehensive data source, we developed a framework to select databases specific to each disease and outcome of interest. This process includes a thorough evaluation of the...

The burden of disease (BOD) approach, originating with the Global Burden of Disease (GBD) study in the 1990s, has become a cornerstone for population health monitoring. Despite the widespread use of the Disability-Adjusted Life Year (DALY) metric, variations in methodological approaches and reporting inconsistencies hinder comparability across stud...

The large volume of data generated by health information systems often remains siloed within the institutions that produce it, posing significant challenges to its reuse and interpretation. This fragmentation can result in conflicting information on critical health topics, complicating the decision-making process for policymakers. To address this i...

Background Smoking being one of most impactful risk factors for causing non-communicable diseases (NCD) and consequently attributable death, represents an enormous public health issue. New policy interventions aimed at reducing smoking prevalence are planned in the Belgian Tobacco Free Generation plan. Within the plan, it is aimed to reduce the num...

Human biomonitoring (HBM) data indicate that exposure to pyrethroids is widespread in Europe, with significantly higher exposure observed in children compared to adults. Epidemiological, toxicological, and mechanistic studies raise concerns for potential human health effects, particularly, behavioral effects such as attention deficit hyperactivity...

Background Bacterial antimicrobial resistance (AMR) is a global threat to both humans and livestock. Despite this, there is limited global consensus on data-informed, priority areas for intervention in both sectors. We compare current livestock AMR data collection efforts with other variables pertinent to human and livestock AMR to identify critica...

Background Initiatives aiming to assess the impact of rare diseases on population health might be hampered due to the complexity of disability-adjusted life years (DALYs) estimation. This study aimed to give insight into the epidemiological data sources and methodological approaches used in studies that estimated DALYs for chronic noncommunicable r...

Background The European Union (EU) faces many health-related challenges. Burden of diseases information and the resulting trends over time are essential for health planning. This paper reports estimates of disease burden in the EU and individual 27 EU countries in 2019, and compares them with those in 2010. Methods We used the Global Burden of Dise...

Background Fascioliasis, caused by Fasciola hepatica and Fasciola gigantica , is a global veterinary problem in livestock and an emerging zoonotic disease in various countries. Here we present prevalence estimates of Fasciola spp. in all hosts involved in the life cycle and identified risk factors associated with Fasciola transmission in northern V...

Background Timely and high-quality population-level health information is needed to support evidence-informed decision-making, for planning and evaluation of prevention, care and cure activities as well as for research to generate new knowledge. FAIR (Findable, Accessible, Interoperable and Reusable) principles are one of the key elements supportin...

Background Despite concerns about worsening pregnancy outcomes resulting from healthcare restrictions, economic difficulties and increased stress during the COVID-19 pandemic, preterm birth (PTB) rates declined in some countries in 2020, while stillbirth rates appeared stable. Like other shocks, the pandemic may have exacerbated existing socioecono...

[This corrects the article DOI: 10.1371/journal.pone.0288777.].

Introduction: The COVID-19 pandemic has accentuated a health-wealth gradient, reminiscent of patterns observed in previous influenza pandemics. This systematic review, employing a population-based approach, aims to delve into the etiological and prognostic roles of socio-economic factors on COVID-19 outcomes during the pandemic's initial phase. Met...

Background The European Union (EU) faces many health-related challenges. Burden of diseases information and the resulting trends over time are essential for health planning. This paper reports estimates of disease burden in the EU and individual 27 EU countries in 2019, and compares them with those in 2010. Methods We used the Global Burden of Dis...

Vaccination has played a major role in overcoming the COVID-19 pandemic. However, vaccination status can be influenced by demographic and socio-economic factors at individual and area level. In the context of the LINK-VACC project, the Belgian vaccine register for the COVID-19 vaccination campaign was linked at individual level with other registers...

This report was prepared with the support of the “Improved and routine monitoring of the burden and the cost of substance use (SUBOD)” project, funded by the Belgian Science Policy (BELSPO, DR/94/SUBOD), and aims to perform the necessary methodological developments to establish an improved and routine monitoring of the health and economic impact of...

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 Bacterial antimicrobial resistance (AMR) is a global threat to both humans and livestock. Despite this, there is limited global consensus on data-informed, priority areas for intervention in both sectors. We compare current livestock AMR data collection efforts with other variables pertinent to human and livestock AMR to identify critica...

Environmental stress represents an important burden on health and leads to a considerable number of diseases, hospitalisations, and excess mortality. Our study encompasses a representative sample size drawn from the Belgian population in 2016 (n = 11.26 million, with a focus on n = 11.15 million individuals). The analysis is conducted at the geogra...

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. We aim to investigate the association between area deprivation and all-cause and cause-specific premature mortality in Belgium over the period 1998–2019...

Background Estimating the risks and impacts of COVID-19 for different health groups at the population level is essential for orienting public health measures. Adopting a population-based approach, we conducted a systematic review to explore: (1) the etiological role of multimorbidity and frailty in developing SARS-CoV-2 infection and COVID-19-relat...

Chagas disease (ChD), caused by infection with the flagellated protozoan, Trypanosoma cruzi, has a complicated transmission cycle with many infection routes. These include vector-borne (via the triatomine (reduviid bug) vector defecating into a skin abrasion, usually following a blood meal), transplacental transmission, blood transfusion, organ tra...

Background Similar to many countries, Belgium experienced a rapid increase in 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 i...

Background Fasciolosis is an emerging public health threat in a number of regions worldwide. To date, we lack an overview of both its occurrence and distribution in Southeast Asia across all actors involved in the life cycle, which impedes the development of disease control measures. Therefore, our objective was to collect recent information on the...

Aim Research shows migrant groups have an increased risk of COVID-19 incidence, hospitalization and mortality. Much less is known about how these findings have developed throughout the different stages of the crisis. This study assesses patterns in excess mortality by migrant group during the first three COVID-19 waves in Belgium, while taking soci...

Background Recent studies have identified important social inequalities in SARS-CoV-2 infections 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 an...

[This corrects the article DOI: 10.1371/journal.pone.0288777.].

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...