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  • 1
    In: BMC Infectious Diseases, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: The severity of an influenza infection is influenced by both host and viral characteristics. This study aims to assess the relevance of viral genomic data for the prediction of severe influenza A(H3N2) infections among patients hospitalized for severe acute respiratory infection (SARI), in view of risk assessment and patient management. Methods 160 A(H3N2) influenza positive samples from the 2016–2017 season originating from the Belgian SARI surveillance were selected for whole genome sequencing. Predictor variables for severity were selected using a penalized elastic net logistic regression model from a combined host and genomic dataset, including patient information and nucleotide mutations identified in the viral genome. The goodness-of-fit of the model combining host and genomic data was compared using a likelihood-ratio test with the model including host data only. Internal validation of model discrimination was conducted by calculating the optimism-adjusted area under the Receiver Operating Characteristic curve (AUC) for both models. Results The model including viral mutations in addition to the host characteristics had an improved fit ( $${X}^{2}$$ X 2 =12.03, df = 3, p = 0.007). The optimism-adjusted AUC increased from 0.671 to 0.732. Conclusions Adding genomic data (selected season-specific mutations in the viral genome) to the model containing host characteristics improved the prediction of severe influenza infection among hospitalized SARI patients, thereby offering the potential for translation into a prospective strategy to perform early season risk assessment or to guide individual patient management.
    Type of Medium: Online Resource
    ISSN: 1471-2334
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041550-3
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  • 2
    In: Archives of Public Health, Springer Science and Business Media LLC, Vol. 79, No. 1 ( 2021-12)
    Type of Medium: Online Resource
    ISSN: 2049-3258
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2133388-9
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  • 3
    In: Archives of Public Health, Springer Science and Business Media LLC, Vol. 78, No. 1 ( 2020-12)
    Abstract: In response to the COVID-19 epidemic, caused by a novel coronavirus, it was of great importance to rapidly collect as much accurate information as possible in order to characterize the public health threat and support the health authorities in its management. Hospital-based surveillance is paramount to monitor the severity of a disease in the population. Methods Two separate surveillance systems, a Surge Capacity survey and a Clinical survey, were set up to collect complementary data on COVID-19 from Belgium’s hospitals. The Surge Capacity survey collects aggregated data to monitor the hospital capacity through occupancy rates of beds and medical devices, and to follow a set of key epidemiological indicators over time. Participation is mandatory and the daily data collection includes prevalence and incidence figures on the number of COVID-19 patients in the hospital. The Clinical survey is strongly recommended by health authorities, focusses on specific patient characteristics and relies on individual patient data provided by the hospitals at admission and discharge. Conclusions This national double-level hospital surveillance was implemented very rapidly after the first COVID-19 patients were hospitalized and revealed to be crucial to monitor hospital capacity over time and to better understand the disease in terms of risk groups and outcomes. The two approaches are complementary and serve different needs.
    Type of Medium: Online Resource
    ISSN: 2049-3258
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2133388-9
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  • 4
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: National public health agencies are required to prioritise infectious diseases for prevention and control. We applied the prioritisation method recommended by the European Centre for Disease Prevention and Control to rank infectious diseases, according to their relative importance for surveillance and public health, to inform future public health action in Belgium. Methods We applied the multi-criteria-decision-analysis approach. A working group of epidemiologists and statisticians from Belgium ( n  = 6) designed a balanced set of prioritisation criteria. A panel of Belgian experts ( n  = 80) allocated in an online survey each criteria a weight, according to perceived relative importance. Next, experts ( n  = 37) scored each disease against each criteria in an online survey, guided by disease-specific factsheets referring the period 2010–2016 in Belgium. The weighted sum of the criteria’s scores composed the final weighted score per disease, on which the ranking was based. Sensitivity analyses quantified the impact of eight alternative analysis scenarios on the top-20 ranked diseases. We identified criteria and diseases associated with data-gaps as those with the highest number of blank answers in the scoring survey. Principle components of the final weighted score were identified. Results Working groups selected 98 diseases and 18 criteria, structured in five criteria groups. The diseases ranked highest were (in order) pertussis, human immunodeficiency virus infection, hepatitis C and hepatitis B. Among the five criteria groups, overall the highest weights were assigned to ‘impact on the patient’, followed by ‘impact on public health’, while different perceptions were identified between clinicians, microbiologists and epidemiologists. Among the 18 individual criteria, ‘spreading potential’ and ‘events requiring public health action’ were assigned the highest weights. Principle components clustered with thematic disease groups. Notable data gaps were found among hospital-related diseases. Conclusions We ranked infectious diseases using a standardised reproducible approach. The diseases ranked highest are included in current public health programs, but additional reflection for example about needs among risk groups is recommended. Cross-reference of the obtained ranking with current programs is needed to verify whether resources and activities map priority areas. We recommend to implement this method in a recurrent evaluation cycle of national public health priorities.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041338-5
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