The Burden of Disease due to COVID-19 (BoCO-19): A study protocol for a secondary analysis of surveillance data in Southern and Eastern Europe, and Central Asia

Introduction The COVID-19 pandemic has had an extensive impact on public health worldwide. However, in many countries burden of disease indicators for COVID-19 have not yet been calculated or used for monitoring. The present study protocol describes an approach developed in the project “The Burden of Disease due to COVID-19. Towards a harmonization of population health metrics for the surveillance of dynamic outbreaks” (BoCO-19). The process of data collection and aggregation across 14 different countries and sub-national regions in Southern and Eastern Europe and Central Asia is described, as well as the methodological approaches used. Materials and methods The study implemented in BoCO-19 is a secondary data analysis, using information from national surveillance systems as part of mandatory reporting on notifiable diseases. A customized data collection template is used to gather aggregated data on population size as well as COVID-19 cases and deaths. Years of life lost (YLL), as one component of the number of Disability Adjusted Life Years (DALY), are calculated as described in a recently proposed COVID-19 disease model (the ‘Burden-EU’ model) for the calculation of DALY. All-cause mortality data are collected for excess mortality sensitivity analyses. For the calculation of Years lived with disability (YLD), the Burden-EU model is adapted based on recent evidence. Because Covid-19 cases vary in terms of disease severity, the possibility and suitability of applying a uniform severity distribution of cases across all countries and sub-national regions will be explored. An approach recently developed for the Global Burden of Disease Study, that considers post-acute consequences of COVID-19, is likely to be adopted. Findings will be compared to explore the quality and usability of the existing data, to identify trends across age-groups and sexes and to formulate recommendations concerning potential improvements in data availability and quality. Discussion BoCO-19 serves as a collaborative platform in order to build international capacity for the calculation of burden of disease indicators, and to support national experts in the analysis and interpretation of country-specific data, including their strengths and weaknesses. Challenges include inherent differences in data collection and reporting systems between countries, as well as assumptions that have to be made during the calculation process.Peer Reviewe

Results of one year monitoring of the National telephone quitline on smoking cessation in the Kyrgyz Republic

Background and challenges to implementation In 2010-2011 Public Health Protection Foundation in collaboration with Republican Health Promotion Centre (RCHP) of the Ministry Health (MoH) has conducted pilot project on providing smoking cessation consultations by phone (quitline). The Pilot project recommended the Kyrgyz MoH to establish a national smoking cessation quitline service under the RCHP. Intervention or response The National quitline service was established in 2016. Link to the quitline website and telephone were displayed on 12 Pictorial Health Warnings (PHW) on cigarette packages, which were implemented in Kyrgyzstan since January 2016. National quitline service works from 9 a.m. till 9.p.m daily, except Sunday and national holidays. Total of 4143 smokers (93,7% men and 6,3% women) were consulted during 15 months (in 2016 - 2017). 50% of smokers had 3 rd degree of tobacco addiction (DTA), 32% - 2 nd DTA and 18% - 1 st DTA. 80% of smokers were 15-34 years old. Results and lessons learnt During January-June of 2017, quitline service consultants made proactive calls to the telephone subscribers, who received advices and information in same period of 2016 for conducting one-year monitoring of work. More than 60% of respondents were not reached by phone and 40% (580 people) were interviewed. 27,8% of people (28,5% males and 18,6% females) managed to quit tobacco use and 72,2% of them (71,5% males and 81,4% females) could not quit. Among the smokers who quit smoking during the last 12 months - 46% had 1st, 34%-2nd and 20% - 3rd DTA. 89% were 15-44 years old. 94% of respondents answered that quitline helped them to quit tobacco smoking. 37% of smokers who couldn´t quit tobacco were not ready do it, 32% indicated withdrawal symptoms as the underlying reason for their failure. Conclusions and key recommendations Results of one year monitoring indicate, that quitline is efficient population level smoking cessation intervention and should be continued and improved with the MoH support

BoCO-19 partner institutions.

IntroductionThe COVID-19 pandemic has had an extensive impact on public health worldwide. However, in many countries burden of disease indicators for COVID-19 have not yet been calculated or used for monitoring. The present study protocol describes an approach developed in the project “The Burden of Disease due to COVID-19. Towards a harmonization of population health metrics for the surveillance of dynamic outbreaks” (BoCO-19). The process of data collection and aggregation across 14 different countries and sub-national regions in Southern and Eastern Europe and Central Asia is described, as well as the methodological approaches used.Materials and methodsThe study implemented in BoCO-19 is a secondary data analysis, using information from national surveillance systems as part of mandatory reporting on notifiable diseases. A customized data collection template is used to gather aggregated data on population size as well as COVID-19 cases and deaths. Years of life lost (YLL), as one component of the number of Disability Adjusted Life Years (DALY), are calculated as described in a recently proposed COVID-19 disease model (the ‘Burden-EU’ model) for the calculation of DALY. All-cause mortality data are collected for excess mortality sensitivity analyses. For the calculation of Years lived with disability (YLD), the Burden-EU model is adapted based on recent evidence. Because Covid-19 cases vary in terms of disease severity, the possibility and suitability of applying a uniform severity distribution of cases across all countries and sub-national regions will be explored. An approach recently developed for the Global Burden of Disease Study, that considers post-acute consequences of COVID-19, is likely to be adopted. Findings will be compared to explore the quality and usability of the existing data, to identify trends across age-groups and sexes and to formulate recommendations concerning potential improvements in data availability and quality.DiscussionBoCO-19 serves as a collaborative platform in order to build international capacity for the calculation of burden of disease indicators, and to support national experts in the analysis and interpretation of country-specific data, including their strengths and weaknesses. Challenges include inherent differences in data collection and reporting systems between countries, as well as assumptions that have to be made during the calculation process.</div

Data sources, data availability and definitions—COVID-19 cases.

Data sources, data availability and definitions—COVID-19 cases.</p

Data sources, data availability and definitions—COVID-19 deaths.

Data sources, data availability and definitions—COVID-19 deaths.</p

GATHER checklist.

IntroductionThe COVID-19 pandemic has had an extensive impact on public health worldwide. However, in many countries burden of disease indicators for COVID-19 have not yet been calculated or used for monitoring. The present study protocol describes an approach developed in the project “The Burden of Disease due to COVID-19. Towards a harmonization of population health metrics for the surveillance of dynamic outbreaks” (BoCO-19). The process of data collection and aggregation across 14 different countries and sub-national regions in Southern and Eastern Europe and Central Asia is described, as well as the methodological approaches used.Materials and methodsThe study implemented in BoCO-19 is a secondary data analysis, using information from national surveillance systems as part of mandatory reporting on notifiable diseases. A customized data collection template is used to gather aggregated data on population size as well as COVID-19 cases and deaths. Years of life lost (YLL), as one component of the number of Disability Adjusted Life Years (DALY), are calculated as described in a recently proposed COVID-19 disease model (the ‘Burden-EU’ model) for the calculation of DALY. All-cause mortality data are collected for excess mortality sensitivity analyses. For the calculation of Years lived with disability (YLD), the Burden-EU model is adapted based on recent evidence. Because Covid-19 cases vary in terms of disease severity, the possibility and suitability of applying a uniform severity distribution of cases across all countries and sub-national regions will be explored. An approach recently developed for the Global Burden of Disease Study, that considers post-acute consequences of COVID-19, is likely to be adopted. Findings will be compared to explore the quality and usability of the existing data, to identify trends across age-groups and sexes and to formulate recommendations concerning potential improvements in data availability and quality.DiscussionBoCO-19 serves as a collaborative platform in order to build international capacity for the calculation of burden of disease indicators, and to support national experts in the analysis and interpretation of country-specific data, including their strengths and weaknesses. Challenges include inherent differences in data collection and reporting systems between countries, as well as assumptions that have to be made during the calculation process.</div

Basic disease model for calculating of the burden COVID-19, European Burden of Disease Network [29].

Basic disease model for calculating of the burden COVID-19, European Burden of Disease Network [29].</p

Data collection template all cause deaths.

Where appropriate for a study protocol, the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER, http://gather-statement.org/) have been considered in the preparation of this article [45]. (XLSX)</p

Data collection template COVID-19 cases and deaths.

Data collection template COVID-19 cases and deaths.</p

Study timeline and supporting activities within the BoCO-19 project.

Study timeline and supporting activities within the BoCO-19 project.</p