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

Cawley C. Gabrani J. Stevanović A. Aidaraliev R. Barsbay M.Ç. Lagarija S.C. Davletov K. Djamangulova T. Glushkova N. Heiden M.A.D. Kaçaniku-Gunga P. Kereselidze M. Kryeziu B. Lkhagvasuren K. Mehdiyev S. Oharova D. Sadikkhodjayeva D. Milicevic M.S. Stanisic M. Stojisavljevic S. Tecirli G. Terzic N. Wengler A. Rommel A.
October 2023 Public Library of Science

PLoS ONE
2023 #18 Issue 10 October

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.

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Department2: Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
National Association of Public Health, Tirana, Albania
Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Public Association “Healthy Future”, Bishkek, Kyrgyzstan
Faculty of Economics and Administrative Sciences, Department of Health Management, Ankara Hacı Bayram Veli University, Ankara, Turkey
Institute of Public Health of the Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Faculty of Medicine, Al-Farabi Kazakhs National University, Almaty, Kazakhstan
Department 3, Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
National Institute of Public Health of Kosovo, Kosovo, Pristina, Serbia
National Center for Disease Control & Public Health, Tbilisi, Georgia
Mongolian National University of Medical Sciences, School of Public Health, Ulaanbaatar, Mongolia
Public health and reforms center, Ministry of Health, Baku, Azerbaijan
Public Health Center of the Ministry of Health of Ukraine, Kyiv, Ukraine
Tashkent Institute of Postgraduate Medical Education, Tashkent, Uzbekistan
Institute of Public Health of Montenegro, Podgorica, Montenegro
Public Health Institute of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
Ministry of Health, Ankara, Turkey

Department2: Epidemiology and Health Monitoring
National Association of Public Health
Institute of Social Medicine
Public Association “Healthy Future”
Faculty of Economics and Administrative Sciences
Institute of Public Health of the Federation of Bosnia and Herzegovina
Asfendiyarov Kazakh National Medical University
Faculty of Medicine
Department 3
National Institute of Public Health of Kosovo
National Center for Disease Control & Public Health
Mongolian National University of Medical Sciences
Public health and reforms center
Public Health Center of the Ministry of Health of Ukraine
Tashkent Institute of Postgraduate Medical Education
Institute of Public Health of Montenegro
Public Health Institute of the Republic of Srpska
Ministry of Health

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