Effects of an ageing population and the replacement of immune birth cohorts on the burden of hepatitis A in the Netherlands

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• 作者：Scott A McDonald (1)
  Marie-Josée J Mangen (2)
  Anita Suijkerbuijk (3)
  Edoardo Colzani (4)
  Mirjam EE Kretzschmar (1) (2)
  
• 关键词：Hepatitis A virus ; Dynamic transmission model ; Disability ; adjusted life ; years ; Natural immunity ; Population ageing
• 刊名：BMC Infectious Diseases
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：13
• 期：1
• 全文大小：316KB
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  32. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2334/13/120/prepub
  
• 作者单位：Scott A McDonald (1)
  Marie-Josée J Mangen (2)
  Anita Suijkerbuijk (3)
  Edoardo Colzani (4)
  Mirjam EE Kretzschmar (1) (2)
  
  1. Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  2. Julius Centre for Health Sciences & Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
  3. Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  4. European Centre for Disease Prevention and Control, Stockholm, Sweden
  

文摘

Background In populations in which the incidence of hepatitis A virus (HAV) infection has declined due to socio-economic improvements, better sanitation and hygiene, and vaccination, birth cohorts who have long-term immunity through exposure early in life are now being replaced by non-immune cohorts, meaning that more cases in the elderly may occur in future. Our goal was to qualitatively investigate the interaction of this cohort effect and demographic change (population ageing) on the estimated disease burden of HAV infection in the Netherlands. Methods We used dynamic MSIR (maternal immunity–susceptible–infectious–recovered) transmission and demographic models to simulate annual HAV incidence over the period 2000-030, and estimated disease burden using the disability-adjusted life years (DALY) measure and a pre-defined disease progression model. Five scenarios representing different force of infection situations were simulated. Results The overall disease burden was projected to decrease over the simulation period in the baseline scenario (310 DALYs in 2000 compared with 67 in 2030). This decreasing trend was absent for the 55+ years age group; 23.5% of all new infections were predicted to occur in the 55+ group in 2030, compared with 5.5% in the 55+ group in 2000. Conclusions In the absence of further public health interventions and under the assumption of a continued steady decline in the force of infection, the HAV disease burden in the Netherlands is predicted to decrease over the coming decades, but with proportionally more of the burden occurring within the increasingly larger segment of the population represented by elderly persons who are no longer naturally immune.