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L’enregistrement TDI en Belgique, Rapport annuel, année d’enregistrement 2023
No full textLes données sont également accessibles sur un tableau de bord interactif : https://healthinformation.sciensano.be/shiny/TDI/
• En 2023, environ 30 000 demandes de traitement ont été débutées en 2023 en Belgique en lien avec l’utilisation d’alcool ou de drogues illicites. Ce chiffre reste stable entre 2015 et 2023.
• En Flandre, le cannabis est la seconde substance la plus fréquemment responsable des demandes de traitement, après l’alcool. Toutefois, le nombre de demandes de traitement pour le cannabis baisse de manière significative en Flandre.
• En Wallonie et à Bruxelles le crack est la seconde substance à l’origine des demandes de traitement, après l’alcool. Les demandes de traitement pour le crack augmentent de manière significative dans les trois régions du pays.
• Les demandes de traitement pour la kétamine, la méphédrone ou la méthamphétamine continuent de progresser de manière significative en Belgique. Au contraire, les demandes de traitement pour l’héroïne sont en baisse significative depuis 2015.
• Le nombre de patients en traitement pour plusieurs substances est en augmentation.
• Environ un patient sur trois est une femme et cette proportion est en augmentation.
• Les patients entrent en traitement en moyenne à l’âge de 40 ans et cet âge augmente de manière significative depuis 2015.
• Parmi les personnes en traitement pour un usage de substances, les pratiques d’injection sont de moins en moins fréquentes. Moins de 8 % des patients déclarent avoir déjà injecté une substance au cours de leur vie.
• Les patients en traitement pour le cannabis, la cocaïne, les opioïdes et les stimulants autres que la cocaïne commencent à consommer ces substances de plus en plus tard.</p
Sociodemographic inequalities in smoking cessation: a population survey from Flanders, Belgium
No full textBackground: Flanders’ decline in daily tobacco use will not reach the aim of a 5% prevalence by 2040. A faster reduction necessitates, especially among low-educated and socially vulnerable groups, as in these groups the decline goes slower. Towards future smoking cessation interventions within these specific target groups, this study examined prevalence and sociodemographic inequalities in different indicators of smoking cessation in Flanders. Methods: Data from the 2022 Prevention Barometer, a probabilitybased survey from Flanders, were used (N ¼ 4011, 18þ). Prevalence in ever smokers was calculated overall and by age, sex, educational attainment, making ends meet and employment status. Daily smokers reported their past-year quit smoking attempts, upcoming-year quit smoking intentions and intentions to use cessation aids. Former smokers reported successful cessation and use of cessation aids. Multivariate logistic regressions, including all demographic variables, aimed to uncover inequalities. Results: Quit smoking attempts in daily smokers (26.5%) were lower for low education (vs. middle and high education). Quit smoking intentions in daily smokers (41.0%) were lower for low vs. middle and low vs. high education. Daily smokers had lower intentions to use cessation aids (48.5%) when having difficulties in making ends meet. Among ever smokers, being older, having high education (vs. middle and low education), having no difficulties in making ends meet and being retired (vs. working and not working) was associated with higher odds for successful quitting (73.2%). Among former smokers, people being retired (vs. working and not working) had higher odds of using cessation aids (15.3%).
Conclusions: Low educated daily smokers are less likely to quit smoking. Former smokers limitedly use cessation aids to quit smoking and the use varies regarding one’s sociodemographic profile. Encouraging quit attempts and equitable access to cessation aids are public health priorities.
Key messages:
• Low-educated smokers in Flanders face barriers in quitting, highlighting the need for targeted cessation support.
• Socioeconomic disparities impact cessation aid utilization, underlining the importance of equitable access to aid for all demographics.</p
Susceptibility of Mammals to Highly Pathogenic Avian Influenza: A Qualitative Risk Assessment From the Belgian Perspective.
No full textAIMS: The world experienced a huge number of outbreaks of highly pathogenic avian influenza (HPAI) in birds, which could represent one of the largest registered epidemics of infectious disease in food-producing animals. Therefore, mammals, including humans, are continuously exposed to HPAI viruses leading to sporadic and sometimes unusual mammal infections. The aim of this paper is to assess the risk of crossing the avian/mammalian species barrier by the currently circulating HPAI viruses, focusing on the epidemiological situation of Belgium, a representative country for Western Europe.
METHODS AND RESULTS: Information on transmission pathways and species susceptibility, based on the experimental and epidemiological data, was reviewed and weighted to assess the risk of mammal infection with HPAI A(H5N1) viruses of the circulating clade 2.3.4.4b. This risk is defined as the likelihood of mammal infection by birds crossed by the clinical consequences of this infection for this animal. From the Belgian perspective, it is concluded that this risk remains ‘low’ to ‘moderate’ for captive/domestic mammal species. However, this risk was categorised as ‘high’ for certain species, i.e. mammals that have the opportunity to have frequent direct or indirect close contacts with infected (dead) birds, such as wild felids, wild mustelids, foxes and wild marine carnivore mammals. For some mammal species, the uncertainty associated with the assessment remains high due to an ever-changing situation.
CONCLUSIONS: The longer the virus will continue to circulate in wildlife/the environment the stronger the probability of contact between infected birds and mammals will become. This will increase the related risk of viral adaptation for efficient transmission between mammal, posing concerns for public health. Regular reassessments based on the field and experimental data are therefore necessary to implement and adapt risk-based mitigation measures. This will require continuous monitoring of avian influenza viruses in both birds and mammals as well as sharing of sequence data.</p
Health information system assessments: Opportunities for international collaboration
No full textSince the late 1990s, with the development of European Core Health Indicators (ECHI) and the European Health Interview Survey (EHIS), the EU aims to strengthen its continental database for evidence-informed public health policy and research. BRIDGE Health (2015-2017), InfAct (Information for Action 2018-2021) and PHIRI (Population Health Information Research Infrastructure 2020-2023) projects prepared for the establishment of a sustainable European health information infrastructure. Country health information system (HIS) assessments were core project activities, performed on the basis of the WHO Euro ‘Support Tool to strengthen health information systems’. To serve project objectives, the original top-down Support Tool was modified and implemented in a peer-to-peer approach among project countries. InfAct and PHIRI conducted 9 country peer-assessments each. InfAct assessments were carried out through country visits, targeting overall health information inequalities and good practices. PHIRI performed virtual country visits, focusing on COVID-19 health information flows. The WHO Tool was further adapted by the Joint Action TEHDAS (2021-2023) to assess the readiness of HIS in Europe for the European Health Data Space. Experience with these different iterations led to the revision of the Support Tool in 2021 to include a more expanded and modular approach which enables HIS assessments to opt to focus on specific aspects. To date, a sustainable European health information infrastructure has not been set up. Currently, the EU funds a joint Health Information Network with WHO Euro. Building regional infrastructures for public health and NCDI/MH monitoring and reporting depend on structures and on the political will of supranational organizations and their members. Meanwhile, HIS assessments to improve surveillance, population health and to reduce health information inequalities lend themselves to increased international collaboration and knowledge exchange.</p
COVID-19 mortality statistics: a comparative study of epidemiological surveillance data and death certificates in 2020 in Belgium
No full textThe COVID-19 pandemic necessitated the rapid establishment of the COVID-19 mortality epidemiological surveillance database (SURV) in Belgium due to a significant delay in availability of the cause of death database (COD). Understanding differences and limitations in both databases is crucial for contextualising COVID-19 mortality statistics. This study assesses SURV’s data quality, raises awareness of differences and limitations in both databases, and proposes recommendations for future pandemic mortality surveillance.
SURV and COD were linked probabilistically to explore overall coverages and discrepancies. Factors such as region and place of death, case classification, epidemic wave, age group, sex, and number of conditions, were analysed using logistic regression models.
SURV identified 90% (n=19,801) of COVID-19-related deaths from COD (n=22,015). Coverage was higher in hospitals (98%, n=11,130 in SURV, n=11,335 in COD) and long-term care facilities (90%, n=8,602 in SURV, n=9,580 in COD) compared to deaths at home (5%, n=52 in SURV, n=1,057 in COD). However, 83.9% of SURV records listed COVID-19 as the underlying cause of death in COD, and 75.4% of COVID-19 deaths in COD were identified in SURV. Reduced COVID-19 activity and diagnostic uncertainty resulted in lower agreement between databases. Variations in data quality were observed across epidemic waves, regions, and healthcare facilities.
In addition to reaching real-time objectives, SURV exhibited good data quality with limited discrepancies, but underreported COVID-19 deaths at home. Presuming neither database can be unequivocally considered as gold standard for COVID-19 mortality statistics, they provide valuable insights for policy formulation. Improving real-time mortality data collection is crucial, emphasising the need for effective collaboration among stakeholders</p
Policy implementation and recommended actions to create healthy food environments using the Healthy Food Environment Policy Index (Food-EPI): a comparative analysis in South Asia
No full textBACKGROUND: The increasing prevalence of diet-related non-communicable diseases (NCDs) in South Asia is concerning, with type 2 diabetes projected to rise to 68%, compared to the global increase of 44%. Encouraging healthy diets requires stronger policies for healthier food environments.
METHODS: This study reviewed and assessed food environment policies in Bangladesh, India, Pakistan, and Sri Lanka from 2020 to 2022 using the Healthy Food Environment Policy Index (Food-EPI) and compared them with global best practices. Seven policy domains and six infrastructure support domains were considered, employing 47 good practice indicators to prevent NCDs. Stakeholders from government and non-governmental sectors in South Asia (n = 148) were invited to assess policy and infrastructure support implementation using the Delphi method.
FINDINGS: Implementation of food environment policies and infrastructure support in these countries was predominantly weak. Labelling, monitoring, and leadership policies received a moderate rating, with a focus on food safety, hygiene, and quality rather than obesity prevention. Key policy gaps prioritized for attention included front-of-pack labelling, healthy food subsidies, unhealthy food taxation, restrictions on unhealthy food promotion, and improvements in school nutrition standards to combat NCDs.
INTERPRETATION: Urgent action is required to expand food policies beyond hygiene and food security measures. Comprehensive strategies targeting NCD prevention are crucial to combat the escalating burden of NCDs in the region.
FUNDING: This research was funded by the NIHR (16/136/68 and 132960) with aid from the UK Government for global health research. Petya Atanasova also acknowledges funding from the Economic and Social Research Council (ESRC) (ES/P000703/1). The views expressed are those of the authors and not necessarily of the NIHR, the UK government or the ESRC.</p
Persistent organic pollutants in human milk of Belgian mothers: levels, time trend and exposure assessment for nursing infants
No full textDetermination of 16 Hydroxyanthracene Derivatives in Food Supplements Using LC-MS/MS: Method Development and Application.
No full textHydroxyanthracene derivatives (HADs) are plant substances produced by a variety of plant species, including different , , and species and These plants are often used in food supplements to improve bowel function. However, recently, the European Commission prohibited a number of HADs due to toxicological concerns. These HADs included aloin (aloin A and aloin B), aloe-emodin, emodin, and danthron. Most of the currently available analytical methods are restricted to the analysis of only these compounds and do not include other HADs. In this view, a multi-analyte method could be useful for both regulatory analysis and dietary intake studies. To this end, such a method, employing liquid chromatography-tandem mass spectrometry and targeting 16 different HADs, was developed and validated in this study. Limits of quantification were in the range from 0.025 mg kg to 1 mg kg. The recovery of the method was within the acceptable range of 80% to 120%, with the exception of physcion. Repeatability varied from 0.5% to 11.6%, and the range for within-laboratory reproducibility was from 3.4% to 16.3%. The expanded measurement uncertainty was below 50% for all HADs. Subsequently, 24 commercial samples of food supplements and herbal infusions sourced in Belgium were analyzed. The results indicated that although the industry put a great effort into minimizing the amount of aloin and danthron present in food supplements, more than half of the products still exceeded the maximum tolerated levels suggested for aloe-emodin and emodin.</p
NATIONAL SURVEILLANCE OF SARS-COV-2 IN WASTEWATER - How does WBE contribute to the global epidemiologic assessment in Belgium? (September 2020 – 2024)
No full textMonitoring coronavirus (SARS-CoV-2) via wastewater analysis enables early detection of the evolution of the viral circulation in a population, since people infected by COVID-19 excrete particles of SARS-CoV-2 in wastewater. The circulation of SARS-CoV-2 in the Belgian population is monitored since September 2020 by taking 24h-representative samples at the inlet of 42 wastewater treatment plants twice a week.
The present report presents the COVID-19 wastewater-based epidemiology surveillance between February 2021 and December 2023 and how it was used to assess the global epidemiological (EPI) situation in Belgium during this period. The population covered by this program represents 42% of the Belgian population.
The results presented in this work demonstrate that satisfying correlation levels were observed at the implementation and running stages of the present surveillance, which were used as a proof of concept for validating our tool, especially at the time where the testing capacity was high. Also, a preceding character was evidenced in several areas and is discussed in a dedicated section of the present report. Finally, results show the added value of the wastewater-based surveillance to other existing systems (e.g. case-based incidence) for the detection of any significant resurgence in the viral circulation, as well as the reaching of a circulation peak. A “respiratory bulletin” is published weekly assessing the respiratory virus situation by integrating wastewater data with conventional surveillances (hospitalization, case, nursing home, etc.).</p