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De TDI-registratie in België - Jaarlijks rapport, registratiejaar 2023
No full textDe gegevens zijn ook beschikbaar op een interactief dashboard : https://healthinformation.sciensano.be/shiny/TDI/
• In 2023 werden in België ongeveer 30.000 aanvragen voor behandeling gestart in verband met het gebruik van alcohol of illegale drugs. Dit aantal is stabiel tussen 2015 en 2023.
• In Vlaanderen is cannabis na alcohol de meest voorkomende substantie waarvoor behandeling wordt gevraagd. Het aantal aanvragen om behandeling voor cannabis daalt aanzienlijk in Vlaanderen.
• In Wallonië en Brussel is crack na alcohol de meest behandelde substantie. De vraag naar behandeling voor crack neemt aanzienlijk toe in alle drie de gewesten van het land.
• De vraag naar behandeling voor ketamine, mephedrone en methamfetamine blijft aanzienlijk stijgen in België. Daarentegen is de vraag naar behandeling voor heroïne sinds 2015 aanzienlijk gedaald.
• Het aantal patiënten in behandeling voor verschillende substanties lijkt toe te nemen.
• Ongeveer een op de drie patiënten is vrouw en dit aandeel neemt toe.
• De gemiddelde leeftijd waarop patiënten in behandeling gaan is 40 jaar en deze leeftijd is sinds 2015 aanzienlijk gestegen.
• Injecteren komt steeds minder voor bij mensen die in behandeling zijn voor middelengebruik. Minder dan 8% van de patiënten geeft aan ooit een substantie te
hebben geïnjecteerd.
• Patiënten die onder behandeling zijn voor cannabis, cocaïne, opioïden en andere stimulerende substanties dan cocaïne gebruiken op steeds latere leeftijd deze substantie voor het eerst.</p
Could a ring treatment approach be proposed to control Taenia solium transmission in a post elimination setting? A pilot study in Zambia.
No full textBACKGROUND: Geographically targeted Taenia solium ring approaches consisting of treating individuals within a radius of 100-meter of a cysticercosis positive pig have been trialled in Peru. This study explored if a similar approach could be proposed to control T. solium transmission in a post elimination setting in Zambia, focussing on community members’ willingness to be sampled and treated.
METHODOLOGY AND PRINCIPAL FINDINGS: The study was conducted in a community where elimination of active T. solium transmission was achieved. All eligible pigs and people were sampled, at 4- to 6-monthly intervals, followed by implementation of the ring treatment approach. This implied that whenever a pig was seropositive for cysticercosis during sampling, every human and pig residing in a radius of 50-meters of the seropositive pig would be treated. The results of the positive human stool samples were used to create the rings, whenever no pigs were positive. From June 2018 to October 2019, four samplings, followed by ring treatments were conducted. Between 84% and 91% of the willing people provided a stool sample, covering 46% to 59% of the total population living in the study area. Between 78% and 100% of the eligible pigs got sampled. Three ring treatments were based on porcine seropositivity and one on taeniosis results. Two to four rings were opened per sampling. During the ring treatments, between 89% and 100% of the eligible human and pig population living within a ring was treated.
CONCLUSIONS: Participants were willing to participate and get treatment, once the rings were opened. However, the utility of ring treatment approaches in a post elimination setting needs further evaluation, given the lack of highly accurate diagnostic tools for porcine cysticercosis and the challenges in obtaining stool samples. The ring treatment approach adopted should be further improved before recommendations to public health authorities can be given.</p
Report of the WP6 workshop on cross-sectoral collaboration Zagreb (CROATIA), 29-30 November 2023
No full textJA TERROR has organised a two days’ workshop on cross-sectoral collaboration in the response to a biological or chemical terror attack. The workshop took place in Zagreb (Croatia), on 29 and 30 November 2023, with the participation of 45 experts from 13 European JA partners’ countries, from the three relevant sectors: Health, Security-Law Enforcement, and Civil Protection. During the workshop, participants followed an itinerary through different working sessions on strategic preparedness and response components to identify and analyse key issues related to five selected topics with focus on cross-sectoral collaboration: 1. Surveillance systems, shared threat detection and joint risk assessment 2. Cross-sectoral emergency planning (including strategic stockpiling) & governance 3. Cross-sectoral information sharing and flow in preparedness and response 4. Cross-sectoral capacity building, human resources, training and exercise 5. Post-incident joint evaluation, recovery and corrective measures</p
Personal characteristics and transmission dynamics associated with SARS-CoV-2 semi-quantitative PCR test results: an observational study from Belgium, 2021-2022.
No full textINTRODUCTION: Following harmonization efforts by the Belgian National Reference Center for SARS-CoV-2, semi-quantitative PCR test (SQ-PCR) results, used as a proxy for viral load, were routinely collected after performing RT-qPCR tests.
METHODS: We investigated both the personal characteristics associated with SQ-PCR results and the transmission dynamics involving these results. We used person-level laboratory test data and contact tracing data collected in Belgium from March 2021 to February 2022. Personal characteristics (age, sex, vaccination, and laboratory-confirmed prior infection) and disease stage by date of symptom onset were analyzed in relation to SQ-PCR results using logistic regression. Vaccine effectiveness (VE) against a high viral load (≥10 copies/mL) was estimated from the adjusted probabilities. Contact tracing involves the mandatory testing of high-risk exposure contacts (HREC) after contact with an index case. Odds ratios for test positivity and high viral load in HREC were calculated based on the SQ-PCR result of the index case using logistic regression models adjusted for age, sex, immunity status (vaccination, laboratory-confirmed prior infection), variant (Alpha, Delta, Omicron), calendar time, and contact tracing covariates.
RESULTS: We included 909,157 SQ-PCR results of COVID-19 cases, 379,640 PCR results from index cases, and 72,052 SQ-PCR results of HREC. High viral load was observed more frequently among recent cases, symptomatic cases, cases over 25 years of age, and those not recently vaccinated (>90 days). The vaccine effectiveness (VE) of the primary schedule in the first 30 days after vaccination was estimated at 47.3% (95%CI 40.8-53.2) during the Delta variant period. A high viral load in index cases was associated with an increased test positivity in HREC (OR 2.7, 95%CI 2.62-2.79) and, among those testing positive, an increased likelihood of a high viral load (OR 2.84, 95%CI 2.53-3.19).</p
EU-HIP – Country visit report – Croatia
No full textThis report has been developed within the remit of the project “EU interoperability with HERA’s IT Platform (EU-HIP)”. EU-HIP is a consortium of 15 European countries, coordinated by Statens Serum Institute (SSI), Denmark. The scope of the project is to support countries to enhance and improve national IT systems in an efficient and coordinated manner, with the objective of obtaining interoperability with the centralised IT platform of the EU Health Emergency Preparedness and Response Authority (HERA). HERA’s IT platform (ATHINA) is currently under development and seeks to gather intelligence on public health surveillance and medical countermeasures (MCM) to support threat assessment and crisis management across Europe. The priority areas are pathogens with high pandemic potential (PHPP), antimicrobial resistance (AMR), and chemical, biological, radiological and nuclear (CBRN) threats, as well as appropriate medical countermeasures, such as medicinal products, medical devices and personal protective equipment (PPE). A baseline activity of the EU-HIP project is to perform a landscape assessment of countries’ IT systems, in relation to the above-mentioned priorities, across all countries involved in the consortium. In addition, in-depth country visits are being performed in a selected number of countries, to gain detailed insights on the countries’ IT systems for health threat detection and assessment. This report presents the findings from the landscape assessment and in-depth country visit in Croatia.</p
Detection and Serological Evidence of European Bat Lyssavirus 1 in Belgian Bats between 2016 and 2018.
No full textLyssaviruses are neurotropic viruses capable of inducing fatal encephalitis. While rabies virus has been successfully eradicated in Belgium, the prevalence of other lyssaviruses remains uncertain. In this study, we conducted a survey on live animals and passive surveillance to investigate the presence of lyssaviruses in Belgium. In 2018, a total of 113 saliva samples and 87 blood samples were collected from bats. Saliva was subjected to RT-qPCR to identify lyssavirus infections. Additionally, an adapted lyssavirus neutralisation assay was set up for the detection of antibodies neutralising EBLV-1 in blood samples. Furthermore, we examined 124 brain tissue samples obtained from deceased bats during passive surveillance between 2016 and 2018. All saliva samples tested negative for lyssaviruses. Analysis of the blood samples uncovered the presence of lyssavirus-neutralising antibodies in five bat species and 32% of samples with a wide range depending on bat species, suggesting past exposure to a lyssavirus. Notably, EBLV-1 was detected in brain tissue samples from two specimens collected in 2016 near Bertrix and 2017 near Étalle, confirming for the first time the presence of EBLV-1 in Belgium and raising awareness of the potential risks associated with this species of bats as reservoirs of the virus.</p
Establishing disease models for the Belgian national burden of disease study: challenges and perspectives
No full textAbstract
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 estimates”; establish disease models; and perform expert evaluation of methods and results. The disease models visualize the relationship between the different health states associated with a given outcome. Health states include the different acute and chronic stages of the outcome (including complications), which may be stratified in different severity levels (e.g., mild, moderate, severe). Disease models used in burden of disease studies primarily aim to document the considered health states, and do not aim at a representation of the complete clinical picture of the condition. The disease models instead help in understanding how the number of cases for each health state is calculated. Models typically start with one “parent node”, which contains all cases. This parent node then gives rise to multiple “child nodes”, with the terminal child nodes representing the individual health states. In BeBOD, disease models and severity distributions are adapted from the Global Burden of Disease (GBD) study, and complemented with local data where possible. This process ensures consistency with available disability weights, while still allowing for local data to feed into the calculations. In this presentation, we will demonstrate the BeBOD process for establishing disease models based on a number of archetypical examples, which represent varying challenges linked to disease model complexity, clarity and completeness of the GBD disease model documentation, and availability of local data. Future perspectives will be discussed, including the improved leveraging of local clinical data, and the implementation of tailored active data collection.</p
The knowledge layer: the role of key messages for translating data into meaning
No full textThe 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 issue, Belgium has initiated the ‘Health Status Report’ website, hosted at healthybelgium.be. This website aims to synthesize and present health data in a manner that supports evidence-based policy formulation. The website adopts a structured approach to data integration and interpretation: initially, we identify and prioritize key health topics based on their relevance and the quality of available data. Subsequently, we merge and analyze data from diverse sources to discern patterns and trends that are crucial for public health monitoring. The insights gained are then presented through both narrative texts and interactive visualizations, facilitating access and understanding for a broad audience. Crucial to this process is ongoing communication with experts and stakeholders, ensuring that the data is not only accurately interpreted but also aligns with the needs and expectations of its users. We also aim to translate the raw data into meaningful key messages by consulting with internal and external experts. This interactive platform thus serves as a critical tool for translating complex health data into actionable knowledge, enabling informed public health strategies and interventions.</p