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INITIATIVE POUR LA PROMOTION DE LA QUALITÉ ET L'ÉPIDÉMIOLOGIE CHEZ LES ENFANTS ET LES ADOLESCENTS ATTEINTS DU DIABÈTE SUCRÉ (IPQE-EAD) Résultats 2021
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Le présent rapport décrit les résultats du huitème audit auquel ont participé les centres de diabétologie pédiatrique (dénommés ci-après CDP) agréés. Cet audit a permis de collecter les données de 3 619 patients atteints de diabète de type 1 âgés de moins de 19 ans et traités dans 16 CDP. Les données se rapportaient aux soins prodigués en 2021. Ce rapport explore les tendances concernant la qualité des soins et étudie les caractéristiques de la population au cours de la période 2008-2021. L’audit n’a pas permis de collecter de données de patients atteints d’un diabète de type 2.
Voici les principaux résultats :
Certains aspects de la qualité des soins, mesurés par une large série d’indicateurs de processus et de résultats, se sont améliorés entre 2008 et 2021 : le nombre de déterminations de la tension artérielle et la proportion de patients ayant atteint l’objectif thérapeutique de l’HbA1c de 7,0, 7,5 et 9,0 % ont augmenté, tandis que le nombre de déterminations de l’HbA1c (une ou trois) et du dépistage de la coeliaquie et de l’auto-immunité thyroïdienne se sont maintenus à un niveau élevé (> 80 %) pour tous les audits.
L’amélioration de l’HbA1c a été constatée dans 13 CDP sur 16, en grande partie indépendamment des caractéristiques des patients (sexe, statut de famille nucléaire, etc.). Notez que parmi les 3 CDP où l’amélioration n’a pas été constatée présentaient une valeur HbA1c des plus faibles en 2008.
Le dépistage annuel de la rétinopathie continue de baisser tant dans la population générale que dans la population cible au cours de la période 2008-2021.
Les résultats ont montré que la proportion de patients en surpoids augmente depuis 2008. Toutefois, cette tendance a également été observée dans la population générale selon le rapport 2019 de l’OCDE et les deux tendances augmentent de la même façon. Autrement dit, l’augmentation de la proportion de jeunes avec le diabète en surpoids évolue au même rythme que celui de la population de jeunes sans diabète (tendances des deux populations ne sont pas significativement différentes).
Les taux de complications aiguës et chroniques et les niveaux de facteurs de risque cardiovasculaire (à l’exception de l’IMC) sont restés stables au cours de la période 2008-2021.
En conclusion, malgré les limites inhérentes à la nature transversale de l’étude et son suivi limité, le huitième audit du projet IPQE-EAD a mis en lumière la poursuite de l’évolution favorable de l’HbA1c, l’un des indicateurs essentiels de la qualité des soins. Grâce à la collecte de données supplémentaires depuis 2013 (obtenues par l’échantillonnage de tous les patients éligibles au lieu de seulement 50 %), il sera désormais possible d’analyser l’évolution de l’HbA1c de chaque patient individuellement et ses déterminants, et ainsi de repérer les facteurs auxquels nous devons apporter une attention accrue afin d’améliorer la qualité des soins de diabétologie pédiatrique.</p
The prevalence of pathogens in ticks collected from humans in Belgium, 2021, versus 2017.
No full textBACKGROUND: Ticks carry a variety of microorganisms, some of which are pathogenic to humans. The human risk of tick-borne diseases depends on, among others, the prevalence of pathogens in ticks biting humans. To follow-up on this prevalence over time, a Belgian study from 2017 was repeated in 2021.
METHODS: During the tick season 2021, citizens were invited to have ticks removed from their skin, send them and fill in a short questionnaire on an existing citizen science platform for the notification of tick bites (TekenNet). Ticks were morphologically identified to species and life stage level and screened using multiplex qPCR targeting, among others, Borrelia burgdorferi (sensu lato), Anaplasma phagocytophilum, Borrelia miyamotoi, Neoehrlichia mikurensis, Babesia spp., Rickettsia helvetica and tick-borne encephalitis virus (TBEV). The same methodology as in 2017 was used.
RESULTS: In 2021, the same tick species as in 2017 were identified in similar proportions; of 1094 ticks, 98.7% were Ixodes ricinus, 0.8% Ixodes hexagonus and 0.5% Dermacentor reticulatus. A total of 928 nymphs and adults could be screened for the presence of pathogens. Borrelia burgdorferi (s.l.) was detected in 9.9% (95% CI 8.2-12.0%), which is significantly lower than the prevalence of 13.9% (95% CI 12.2-15.7%) in 2017 (P = 0.004). The prevalences of A. phagocytophilum (4.7%; 95% CI 3.5-6.3%) and R. helvetica (13.3%; 95% CI 11.2-15.6%) in 2021 were significantly higher compared to 2017 (1.8%; 95% CI 1.3-2.7% and 6.8%; 95% CI 5.6-8.2% respectively) (P < 0.001 for both). For the other pathogens tested, no statistical differences compared to 2017 were found, with prevalences ranging between 1.5 and 2.9% in 2021. Rickettsia raoultii was again found in D. reticulatus ticks (n = ⅗ in 2021). Similar to 2017, no TBEV was detected in the ticks. Co-infections were found in 5.1% of ticks. When combining co-infection occurrence in 2017 and 2021, a positive correlation was observed between B. burgdorferi (s.l.) and N. mikurensis and B. burgdorferi (s.l.) and B. miyamotoi (P < 0.001 for both).
CONCLUSIONS: Although the 2021 prevalences fell within expectations, differences were found compared to 2017. Further research to understand the explanations behind these differences is needed.</p
Nutri-Score 2023 update
No full textIn 2023, the algorithm underlying the Nutri-Score front-of-pack label was updated to better align with food-based dietary guidelines (FBDGs) across countries engaged in the system. On the basis of a comparison of FBDGs and literature reviews with the current Nutri-Score classification, modification scenarios were developed and tested in nutritional composition databases of branded products in four countries. The updated Nutri-Score nutrient profile model allows a better discrimination between products, in closer alignment with FBDGs, while the updated algorithm adopts a stricter approach for products that are high in components of concern (including non-nutritive sweeteners) and low in favourable dietary components. The updated Nutri-Score algorithm increases the alignment between the front-of-pack label system and FBDGs, strengthening its potential as a complementary public health tool in an international perspective.</p
Food environment in Burkina Faso: priority actions recommended to the government using Food-EPI tool.
No full textINTRODUCTION: The food environment is an important factor in the efforts of countries worldwide to achieve a transition to sustainable food systems. The objective of this study is to formulate and prioritize actions to be addressed to the government of Burkina Faso for the creation of a healthy food environment, which will contribute to reducing malnutrition in all its forms and non-communicable diseases.
METHODS: National experts were brought together to identify and prioritize actions to fill the gaps identified through a multi-step assessment process following the methodology of the Healthy Food and Environment Policy Index (Food-EPI).
RESULTS: Up to 20 priority policy actions were recommended to the Burkina Faso government. Actions in the policy component focused mainly on regulation of food promotion and marketing, particularly to children, and others in the infrastructure support component focused largely on political leadership, i.e., strong and visible political support from the government to improve the food environment, population nutrition, diet-related non-communicable diseases and their inequalities.
CONCLUSION: The priority actions to be recommended to the government will strengthen advocacy for government decisions to create a healthier food environment in the country.</p
Determinants of food insecurity among adults residing in peri-urban municipal settings in Flanders, Belgium
No full textExperimental accumulation and depuration kinetics and natural occurrence of microcystin-LR in basil (Ocimum basilicum L.).
No full textMicrocystin-LR (MC-LR) is a hepatotoxic metabolite that naturally occurs during some cyanobacterial blooms in eutrophic waterbodies, and irrigation of edible plants with MC-LR-contaminated water causes bioaccumulation of the toxin. However, sufficient information about accumulation and depuration mechanics in hydroculture-grown herb plants is still lacking. This work aimed at 1) investigating bioaccumulation and depuration of MC-LR in basil, 2) verifying the possible MC-LR detoxification mechanisms in the plant, and 3) detecting the natural occurrence of MC-LR in basil (n = 50) collected from the Belgian market. Basil plants grown in a hydroculture were exposed to MC-LR (5, 20, and 50 μg L) spiked in a Hoagland solution for seven days. MC-LR depuration was also studied by transferring the plants to a non-contaminated Hoagland solution after exposure to MC-LR for another seven days. MC-LR concentrations in Hoagland solution, basil leaves, and roots were quantified using a validated UHPLC-MS/MS method. In addition, ELISA and LC-HRMS (only basil leaves) were used for confirmation. The results showed an increase in the accumulated levels of MC-LR at higher exposure doses, with higher MC-LR levels in roots than in leaves for all the treatment conditions. For MC-LR depuration, significant reductions were observed in all the treatment conditions for roots only. No MC-LR conjugates, potentially related to metabolism, were detected by LC-HRMS. Finally, MC-LR was detected in one store-bought basil sample, representing the first occurrence of cyanotoxins in an edible crop from Belgium.</p
