1887
  1. Home
  2. Eurosurveillance
  3. Volume 29, Issue 33, 15/Aug/2024
  4. Article
Surveillance Open Access
Like 0
Download

SDG 5: Gender equality

Abstract

Background

There are differences between males and females for most diseases both for exposure and course of illness, including outcome. These differences can be related to biological sex or gender i.e. socio-cultural factors that may impact exposure and healthcare access.

Aim

We aimed to quantify differences between males and females in infectious disease notifications in Europe and identify countries with these differences significantly different from the European Union and European Economic Area (EU/EEA) average.

Methods

Notifiable infectious disease surveillance data are reported by EU/EEA countries to ECDC. We retrieved surveillance data for 2012−2021. Using a cut-off median of annual disability-adjusted life years above 1 per 100,000 population, we included 16 infectious diseases. We calculated median male proportion and interquartile range by disease, year, country and age group and used boxplots to identify outliers.

Results

For campylobacteriosis, acute hepatitis B, Legionnaires’ disease, malaria and HIV and AIDS, all countries had male proportion above 50%. Most countries had a male proportion below 50% for pertussis (25/28 countries), STEC infection (21/28 countries) and infection (16/24 countries). infection and listeriosis showed the greatest dispersion of male proportion across age groups. Most outliers were countries reporting few cases.

Conclusion

We observed important differences in male proportion across infectious disease notifications in EU/EEA countries. For some diseases with high male proportions in all countries, such as HIV and hepatitis B, behaviours play a role in disease transmission. Screening offered to specific populations may explain differences across countries for example for infection.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2024.29.33.2300655
2024-08-15
2024-08-15
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.33.2300655
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/29/33/eurosurv-29-33-2.html?itemId=/content/10.2807/1560-7917.ES.2024.29.33.2300655&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). Addressing sex and gender in epidemic-prone infectious diseases. Geneva: WHO; 2007. Available from: https://iris.who.int/bitstream/handle/10665/43644/9789241595346_eng.pdf
  2. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-22.  https://doi.org/10.1016/S0140-6736(20)30925-9  PMID: 33069326 
  3. Takahashi T, Ellingson MK, Wong P, Israelow B, Lucas C, Klein J, et al. Sex differences in immune responses that underlie COVID-19 disease outcomes. Nature. 2020;588(7837):315-20.  https://doi.org/10.1038/s41586-020-2700-3  PMID: 32846427 
  4. Colafella KMM, Denton KM. Sex-specific differences in hypertension and associated cardiovascular disease. Nat Rev Nephrol. 2018;14(3):185-201.  https://doi.org/10.1038/nrneph.2017.189  PMID: 29380817 
  5. Horton KC, MacPherson P, Houben RM, White RG, Corbett EL. Sex Differences in Tuberculosis Burden and Notifications in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis. PLoS Med. 2016;13(9):e1002119.  https://doi.org/10.1371/journal.pmed.1002119  PMID: 27598345 
  6. Spiteri G, Sudre B, Septfons A, Beauté J, European Zika surveillance Network. Surveillance of Zika virus infection in the EU/EEA, June 2015 to January 2017. Euro Surveill. 2017;22(41):17-00254.  https://doi.org/10.2807/1560-7917.ES.2017.22.41.17-00254  PMID: 29043960 
  7. Beauté J, The European Legionnaires’ Disease Surveillance Network. Legionnaires’ disease in Europe, 2011 to 2015. Euro Surveill. 2017;22(27):30566.  https://doi.org/10.2807/1560-7917.ES.2017.22.27.30566  PMID: 28703097 
  8. European Centre for Disease Prevention and Control (ECDC). Annual epidemiological report for 2022 - Chlamydia infection. Stockholm: ECDC; 2024. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/CHLAM_AER_2022_Report.pdf
  9. Beauté J, Plachouras D, Sandin S, Giesecke J, Sparén P. Healthcare-Associated Legionnaires’ Disease, Europe, 2008-2017. Emerg Infect Dis. 2020;26(10):2309-18. PMID: 32946366 
  10. Cassini A, Colzani E, Pini A, Mangen MJ, Plass D, McDonald SA, et al. 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. Euro Surveill. 2018;23(16):1700454.  https://doi.org/10.2807/1560-7917.ES.2018.23.16.17-00454  PMID: 29692315 
  11. European Commission. Commission implementing decision (EU) 2018/ 945 - of 22 June 2018 - on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions. Official Journal of the European Union. 6 Jul 2018. https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32018D0945
  12. European Centre for Disease Prevention and Control (ECDC). Surveillance systems overview for 2020. Stockholm: ECDC. [Accessed: 26 Jul 2024]. Available from: https://www.ecdc.europa.eu/en/publications-data/surveillance-systems-overview-2020
  13. McGill R, Tukey JW, Larsen WA. Variations of Box Plots. Am Stat. 1978;32(1):12-6.  https://doi.org/10.1080/00031305.1978.10479236 
  14. European Centre for Disease Prevention Control (ECDC) and World Health Organization Regional Office for Europe. HIV/AIDS surveillance in Europe 2022: 2021 data. Stockholm: ECDC; 2022. Available from: https://op.europa.eu/en/publication-detail/-/publication/f8f777bc-8277-11ed-9887-01aa75ed71a1/language-en
  15. Basten MGJ, van Wees DA, Matser A, Boyd A, Rozhnova G, den Daas C, et al. Time for change: Transitions between HIV risk levels and determinants of behavior change in men who have sex with men. PLoS One. 2021;16(12):e0259913.  https://doi.org/10.1371/journal.pone.0259913  PMID: 34882698 
  16. Brown R, Goulder P, Matthews PC. Sexual Dimorphism in Chronic Hepatitis B Virus (HBV) Infection: Evidence to Inform Elimination Efforts. Wellcome Open Res. 2022;7:32.  https://doi.org/10.12688/wellcomeopenres.17601.3  PMID: 36212217 
  17. Schlagenhauf P, Chen LH, Wilson ME, Freedman DO, Tcheng D, Schwartz E, et al. Sex and gender differences in travel-associated disease. Clin Infect Dis. 2010;50(6):826-32.  https://doi.org/10.1086/650575  PMID: 20156059 
  18. Kendjo E, Houzé S, Mouri O, Taieb A, Gay F, Jauréguiberry S, et al. Epidemiologic Trends in Malaria Incidence Among Travelers Returning to Metropolitan France, 1996-2016. JAMA Netw Open. 2019;2(4):e191691.  https://doi.org/10.1001/jamanetworkopen.2019.1691  PMID: 30951158 
  19. Rhines AS. The role of sex differences in the prevalence and transmission of tuberculosis. Tuberculosis (Edinb). 2013;93(1):104-7.  https://doi.org/10.1016/j.tube.2012.10.012  PMID: 23219235 
  20. European Centre for Disease Prevention and Control (ECDC). Annual epidemiological report for 2018 – Pertussis. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/AER_for_2018_pertussis.pdf
  21. European Centre for Disease Prevention and Control (ECDC). Annual epidemiological report for 2021 - STEC infection. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/AER%20STEC%20-%202021.pdf
  22. Heiman KE, Mody RK, Johnson SD, Griffin PM, Gould LH. Escherichia coli O157 Outbreaks in the United States, 2003-2012. Emerg Infect Dis. 2015;21(8):1293-301.  https://doi.org/10.3201/eid2108.141364  PMID: 26197993 
  23. Koopmans MM, Brouwer MC, Vázquez-Boland JA, van de Beek D. Human Listeriosis. Clin Microbiol Rev. 2023;36(1):e0006019.  https://doi.org/10.1128/cmr.00060-19  PMID: 36475874 
  24. Dielissen PW, Teunissen DA, Lagro-Janssen AL. Chlamydia prevalence in the general population: is there a sex difference? a systematic review. BMC Infect Dis. 2013;13(1):534.  https://doi.org/10.1186/1471-2334-13-534  PMID: 24215287 
  25. Veličko I, Ploner A, Sparén P, Herrmann B, Marions L, Kühlmann-Berenzon S. Changes in the Trend of Sexually Acquired Chlamydia Infections in Sweden and the Role of Testing: A Time Series Analysis. Sex Transm Dis. 2021;48(5):329-34.  https://doi.org/10.1097/OLQ.0000000000001318  PMID: 33122597 
  26. Bollerup S, Wessman M, Hansen JF, Nielsen S, Hay G, Cowan S, et al. Increasing prevalence of chronic hepatitis B virus infection and low linkage to care in Denmark on 31 December 2016 - an update based on nationwide registers. Infect Dis (Lond). 2023;55(1):17-26.  https://doi.org/10.1080/23744235.2022.2125065  PMID: 36221255 
  27. European Centre for Disease Prevention and Control (ECDC). Annual epidemiological report for 2019 - Chlamydia infection. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/chlamydia-annual-epidemiological-report-2019.pdf
  28. Beauté J, Ciancio BC, Panagiotopoulos T. Infectious disease surveillance system descriptors: proposal for a comprehensive set. Euro Surveill. 2020;25(27):1900708.  https://doi.org/10.2807/1560-7917.ES.2020.25.27.1900708  PMID: 32672148 
  29. Kaufman MR, Eschliman EL, Karver TS. Differentiating sex and gender in health research to achieve gender equity. Bull World Health Organ. 2023;101(10):666-71.  https://doi.org/10.2471/BLT.22.289310  PMID: 37772198 
Differences between males and females in infectious diseases notifications in the EU/EEA, 2012 to 2021
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Julien+Beaut%C3%A9&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Beauté Julien</a>, <a href="/search?value1=Francesco+Innocenti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Innocenti Francesco</a></span>. Differences between males and females in infectious diseases notifications in the EU/EEA, 2012 to 2021. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(33):pii=2300655. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.33.2300655" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.33.2300655</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 20 Nov 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 15 May 2024 </span> </p>
/content/10.2807/1560-7917.ES.2024.29.33.2300655
/content/10.2807/1560-7917.ES.2024.29.33.2300655
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error