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Published on: May 6, 2013
The global burden of listeriosis: a systematic review and meta-analysis
Charline Maertens de Noordhout1, Brecht Devleesschauwer1, Frederick J Angulo1
1Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium (C Maertens de Noordhout MSc, B Devleesschauwer MSc, Prof N Speybroeck PhD); Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium (B Devleesschauwer); Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA (F J Angulo PhD); Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Katholieke Universiteit Leuven, Leuven, Belgium (Prof G Verbeke PhD); Department of Public Health, Erasmus MC, Rotterdam, Netherlands (J Haagsma PhD); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (M Kirk PhD); National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, Netherlands (Prof A Havelaar PhD); and Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands (Prof A Havelaar).
Background:
Listeriosis, caused by Listeria monocytogenes, is an important foodborne disease that can be difficult to control and commonly results in severe clinical outcomes. We aimed to provide the first estimates of global numbers of illnesses, deaths, and disability-adjusted life-years (DALYs) due to listeriosis, by synthesising information and knowledge through a systematic review.
Methods:
We retrieved data on listeriosis through a systematic review of peer-reviewed and grey literature (published in 1990-2012). We excluded incidence data from before 1990 from the analysis. We reviewed national surveillance data where available. We did a multilevel meta-analysis to impute missing country-specific listeriosis incidence rates. We used a meta-regression to calculate the proportions of health states, and a Monte Carlo simulation to generate DALYs by WHO subregion.
Findings:
We screened 11,722 references and identified 87 eligible studies containing listeriosis data for inclusion in the meta-analyses. We estimated that, in 2010, listeriosis resulted in 23,150 illnesses (95% credible interval 6061-91,247), 5463 deaths (1401-21,497), and 172,823 DALYs (44,079-676,465). The proportion of perinatal cases was 20·7% (SD 1·7).
Interpretation:
Our quantification of the global burden of listeriosis will enable international prioritisation exercises. The number of DALYs due to listeriosis was lower than those due to congenital toxoplasmosis but accords with those due to echinococcosis. Urgent efforts are needed to fill the missing data in developing countries. We were unable to identify incidence data for the AFRO, EMRO, and SEARO WHO regions.
Funding:
WHO Foodborne Diseases Epidemiology Reference Group and the Université catholique de Louvain.
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