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The health and economic impact of acute gastroenteritis in Belgium, 2010–2014

  • Theofilos Papadopoulos (a1) (a2), Sofieke Klamer (a1) (a2), Stephanie Jacquinet (a1), Boudewijn Catry (a1) (a3), Amber Litzroth (a1), Laure Mortgat (a1), Pavlos Mamouris (a4), Javiera Rebolledo (a1), Bert Vaes (a4), Dieter Van Cauteren (a1), Johan Van der Heyden (a1), Philippe Beutels (a5) and Brecht Devleesschauwer (a1) (a6)...

Acute gastroenteritis (AGE) remains a common condition in both low- and high-income countries. In Belgium, however, there is currently a lack of information on the societal health and economic impact of AGE. We conducted a retrospective study using mortality and cause-of-death data, hospital data, primary care data, health interview survey data and other published data. We estimated the burden of illness during a 5-year period (2010–2014) in Belgium in terms of deaths, patients admitted to hospitals, patients consulting their general practitioner (GP) and cases occurring in the community. We further quantified the health impact in terms of disability-adjusted life years (DALYs) and the economic impact in terms of cost-of-illness estimates. We estimated 343 deaths, 27 707 hospitalised patients, 464 222 GP consultations and 10 058 741 episodes occurring in the community (0.91 cases/person) on average per year. AGE was associated with 11 855 DALYs per year (107 DALY per 100 000 persons). The economic burden was estimated to represent direct costs of €112 million, indirect costs of €927 million (90% of the total costs) and an average total cost of €103 per case and €94 per person. AGE results in a substantial health and economic impact in Belgium, justifying continued mitigation efforts.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Author for correspondence: Brecht Devleesschauwer, E-mail:
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1.GBD 2016 Causes of Death Collaborators (2017) Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet 390, 11511210.
2.Lake, RJ et al. (2010) The disease pyramid for acute gastrointestinal illness in New Zealand. Epidemiology and Infection 138, 14681471.
3.Wheeler, JG et al. (1999) Study of infectious intestinal disease in England: rates in the community, presenting to general practice, and reported to national surveillance. The Infectious Intestinal Disease Study Executive. BMJ 318, 10461050.
4.Doorduyn, Y, Van Pelt, W and Havelaar, AH (2012) The burden of infectious intestinal disease (IID) in the community: a survey of self-reported IID in the Netherlands. Epidemiology and Infection 140, 11851192.
5.van den Brandhof, WE et al. (2004) Costs of gastroenteritis in The Netherlands. Epidemiology and Infection 132, 211221.
6.World Health Organization (2016) International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. Geneva: World Health Organization.
7.Boffin, N et al. (2017) Four sexually transmitted infections (STIs) in Belgian general practice: first results (2013–2014) of a nationwide continuing surveillance study. BMJ Open 7, e012118.
8.Truyers, C et al. (2014) The Intego database: background, methods and basic results of a Flemish general practice-based continuous morbidity registration project. BMC Medical Informatics and Decision Making 14, 48.
9.Demarest, S et al. (2017) Sample substitution can be an acceptable data-collection strategy: the case of the Belgian Health Interview Survey. International Journal of Public Health 62, 949957.
10.Graves, NS (2013) Acute gastroenteritis. Primary Care 40, 727741.
11.Standaert, B et al. (2013) Impact of rotavirus vaccination on hospitalisations in Belgium: comparing model predictions with observed data. PLoS ONE 8, e53864.
12.Sabbe, M et al. (2016) Sustained low rotavirus activity and hospitalisation rates in the post-vaccination era in Belgium, 2007 to 2014. Eurosurveillance 21(27):pii=30273. doi: 10.2807/1560-7917.ES.2016.21.27.30273.
13.Devleesschauwer, B et al. (2014) DALY calculation in practice: a stepwise approach. International Journal of Public Health 59, 571574.
14.Salomon, JA et al. (2015) Disability weights for the Global Burden of Disease 2013 study. The Lancet Global Health 3, e712e723.
15.Haagsma, JA et al. (2008) Disability adjusted life years and minimal disease: application of a preference-based relevance criterion to rank enteric pathogens. Population Health Metrics 6, 7.
16.Bilcke, J et al. (2012) The health and economic burden of chickenpox and herpes zoster in Belgium. Epidemiology and Infection 140, 20962109.
17.Bilcke, J et al. (2008) The health and economic burden of rotavirus disease in Belgium. European Journal of Pediatrics 167, 14091419.
18.Cleemput, N et al. (2012) Belgian Guidelines for Economic Evaluations and Budget Impact Analyses, 2nd Edn. Brussel, Belgium: Federal Knowledge Centre for Health Care (KCE). KCE reports 183C (D/2012/10.273/54). (accessed 13 September 2018).
19.Bilcke, J, Coenen, S and Beutels, P (2014) Influenza-like-illness and clinically diagnosed flu: disease burden, costs and quality of life for patients seeking ambulatory care or no professional care at all. PLoS ONE 9, e102634.
20.Mughini-Gras, L et al. (2016) Societal burden and correlates of acute gastroenteritis in families with preschool children. Scientific Reports 6, 22144.
21.Kuusi, M et al. (2003) Incidence of gastroenteritis in Norway – a population-based survey. Epidemiology and Infection 131, 591597.
22.Hoogenboom-Verdegaal, AM et al. (1994) Community-based study of the incidence of gastrointestinal diseases in The Netherlands. Epidemiology and Infection 112, 481487.
23.Hansdotter, FIR et al. (2015) The incidence of acute gastrointestinal illness in Sweden. Scandinavian Journal of Public Health 43, 540547.
24.Herikstad, H et al. (2002) A population-based estimate of the burden of diarrhoeal illness in the United States: FoodNet, 1996–7. Epidemiology and Infection 129, 917.
25.Roy, SL, Scallan, E and Beach, MJ (2006) The rate of acute gastrointestinal illness in developed countries. Journal of Water and Health 4(Suppl 2), 3169.
26.Van Cauteren, D et al. (2012) Burden of acute gastroenteritis and healthcare-seeking behaviour in France: a population-based study. Epidemiology and Infection 140, 697705.
27.Roberts, JA et al. (2003) The study of infectious intestinal disease in England: socio-economic impact. Epidemiology and Infection 130, 111.
28.Cassini, A et al. (2018) Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013. Eurosurveillance 23(16):pii=17-00454. doi: 10.2807/1560-7917.ES.2018.23.16.17-00454.
29.van Lier, A et al. (2016) Disease burden of 32 infectious diseases in the Netherlands, 2007–2011. PLoS ONE 11, e0153106.
30.Kirk, MD et al. (2015) World Health Organization estimates of the global and regional disease burden of 22 foodborne bacterial, protozoal, and viral diseases, 2010: a data synthesis. PLoS Medicine 12, e1001921.
31.Schmutz, C et al. (2017) Estimating healthcare costs of acute gastroenteritis and human campylobacteriosis in Switzerland. Epidemiology and Infection 145, 627641.
32.Barker, SF et al. (2018) Cost of gastroenteritis in Australia: a healthcare perspective. PLoS ONE 13, e0195759.
33.Shin, M et al. (2016) Healthcare costs of rotavirus and other types of gastroenteritis in children in Norway. The Pediatric Infectious Disease Journal 35, e97e101.
34.Sowmyanarayanan, TV et al. (2012) Direct costs of hospitalization for rotavirus gastroenteritis in different health facilities in India. The Indian Journal of Medical Research 136, 6873.
35.Tichopád, A et al. (2016) Cost burden of severe community-acquired rotavirus gastroenteritis requiring hospitalization in the Czech Republic, Slovakia, Poland, and Hungary: a retrospective patient chart review. Value in Health Regional Issues 10, 5360.
36.Scott, WG et al. (2000) Economic cost to New Zealand of foodborne infectious disease. The New Zealand Medical Journal 113, 281284.
37.Scharff, RL (2015) State estimates for the annual cost of foodborne illness. Journal of Food Protection 78, 10641071.
38.Minor, T et al. (2015) The per case and total annual costs of foodborne illness in the United States. Risk Analysis 35, 11251139.
39.Hoffmann, S, Batz, MB and Morris, JG Jr. (2012) Annual cost of illness and quality-adjusted life year losses in the United States due to 14 foodborne pathogens. Journal of Food Protection 75, 12921302.
40.Mangen, MJ et al. (2015) Cost-of-illness and disease burden of food-related pathogens in the Netherlands, 2011. International Journal of Food Microbiology 196, 8493.
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