After the epidemiologic transition: a reassessment of mortality from infectious diseases among over-65s in France and Italy

Abstract

Objectives

To assess more accurately the contribution of infectious diseases (IDs) to mortality at age 65+.

Methods

We use cause-of-death data for France and Italy in 2009. In addition to chapter I of the 10th International Classification of Diseases (ICD-10), our list of IDs includes numerous diseases classified in other chapters. We compute mortality rates considering all death certificate entries (underlying and contributing causes).

Results

Mortality rates at age 65+ based on our extended list are more than three times higher than rates based solely on ICD-10 chapter I. IDs are frequently contributing causes of death. In France, the share of deaths at age 65+ involving an ID as underlying cause increases from 2.1 to 7.3 % with the extended list, and to 20.8 % when contributing causes are also considered. For Italy, these percentages are 1.4, 4.2 and 18.7 %, respectively.

Conclusions

Publicly available statistics underestimate the contribution of IDs to the over-65s’ mortality. Old age is a risk factor for IDs, and these diseases are more difficult to treat at advanced ages. Health policies should develop targeted actions for that population.

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References

  1. Angeletti C, Piselli P, Bidoli E, Bruzzone S, Puro V, Girardi E et al (2004) Analysis of infectious disease mortality in Italy. Infez Med 12(3):174–180

    CAS  PubMed  Google Scholar 

  2. Coste J, Bernardin E, Jougla E (2006) Patterns of mortality and their changes in France (1968–1999): insights into the structure of diseases leading to death and epidemiological transition in an industrialised country. J Epidemiol Community Health 60(11):945–955. doi:10.1136/jech.2005.044339

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  3. de Martel C, Ferlay J, Franceschi S et al (2012) Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol 13(6):607–615. doi:10.1016/S1470-2045(12)70137-7

    Article  PubMed  Google Scholar 

  4. Désesquelles A, Salvatore MA, Pappagallo M et al (2012) Analysing multiple causes of death: which methods for which data? An application to the cancer-related mortality in France and Italy. Eur J Popul 28(4):467–498. doi:10.1007/s10680-012-9272-3

    Article  Google Scholar 

  5. Désesquelles A, Demuru E, Egidi V et al (2014) Cause-specific mortality analysis: is the underlying cause of death sufficient? Revue Quetelet/Quetelet J 1(2):119–135. doi:10.14428/rqj2014.01.02.05

    Article  Google Scholar 

  6. Durando P, Sticchi L, Sasso L, Gasparini R (2007) Public health research literature on infectious diseases: coverage and gaps in Europe. Eur J Public Health 17(Suppl 1):19–23. doi:10.1093/eurpub/ckm066

    Article  PubMed  Google Scholar 

  7. Gavazzi G, Krause KH (2002) Ageing and infection. Lancet Infect Dis 2(11):659–666. doi:10.1016/S1473-3099(02)00437-1

    Article  PubMed  Google Scholar 

  8. Hahné SJM, Veldhuijzen IK, Wiessing L, Lim TA, Salminen M, Laar M (2013) Infection with hepatitis B and C virus in Europe: a systematic review of prevalence and cost-effectiveness of screening. BMC Infect Dis 13:181. doi:10.1186/1471-2334-13-181

    PubMed Central  Article  PubMed  Google Scholar 

  9. ISTAT (2004) Applying ACS to causes of death statistics in Italy. Some clues on implementation, bridge coding and further steps. Essays 13

  10. Mackenbach JP, Kunst AE, Lautenbach H, Bijlsma F, Oei YB (1995) Competing causes of death: an analysis using multiple-cause-of-death data from The Netherlands. Am J Epidemiol 141(5):466–475

    CAS  PubMed  Google Scholar 

  11. Manton KG, Stallard E (1982) Temporal trends in U.S. multiple cause of death mortality data: 1968 to 1977. Demography 19:527–547. doi:10.2307/2061017

    CAS  Article  PubMed  Google Scholar 

  12. Omran AR (1971) The epidemiologic transition: a theory of the epidemiology of population change. Milbank Meml Fund Q 489(4):509–538. doi:10.2307/3349375

    Article  Google Scholar 

  13. Pavillon G, Boileau J, Tenaud G, Lefèvre H, Jougla E (2005) Conséquences des changements de codage des causes médicales de décès sur les données nationales de mortalité en France, à partir de l’année 2000. Bulletin Epidémiologique Hebdomadaire 4:13–16

    Google Scholar 

  14. Pinner RW, Teutsch SM, Simonsen L et al (1996) Trends in infectious diseases mortality in the United States. JAMA 275(3):189–193. doi:10.1001/jama.1996.03530270029027

    CAS  Article  PubMed  Google Scholar 

  15. Remais JV, Zeng G, Li G, Tian L, Engelgau MM (2013) Convergence of non-communicable and infectious diseases in low- and middle-income countries. Int J Epidemiol 42(1):221–227. doi:10.1093/ije/dys135

    PubMed Central  Article  PubMed  Google Scholar 

  16. Suk JE, Semenza JC (2011) Future infectious disease threats to Europe. Am J Public Health 101(11):2068–2079. doi:10.2105/AJPH.2011.300181

    PubMed Central  Article  PubMed  Google Scholar 

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Correspondence to Aline Désesquelles.

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Appendix

Appendix

See Table 3.

Table 3 ICD-10 codes of the extended list of infectious and parasitic diseases

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Désesquelles, A., Demuru, E., Pappagallo, M. et al. After the epidemiologic transition: a reassessment of mortality from infectious diseases among over-65s in France and Italy. Int J Public Health 60, 961–967 (2015). https://doi.org/10.1007/s00038-015-0704-9

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Keywords

  • Infectious diseases
  • Mortality
  • Multiple causes of death
  • Aging
  • Public health