Browsing by Author "Antunes, Leonor Fonseca"
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- Burden of disease estimation using dose-response models based on E.coli quantification in ready-to-eat meals of institutional canteensPublication . Antunes, Leonor Fonseca; Henriques, Ana Rita Barroso Cunha de Sá; Nunes, Telmo Renato Landeiro Raposo Pina (Tutor)ABSTRACT - In 2015 the World Health Organization launched an initiative to estimate the global burden of foodborne disease, through the release of the Estimates of the Global Burden of Foodborne Diseases. According to the most recent estimate, in 2010, Shiga toxin-producing E.coli (STEC) was responsible for 12,953 disability adjusted life years (DALYs), enterotoxigenic E.coli (ETEC) for 2,084,229 DALYs and enteropathogenic E.coli (EPEC) for 2,938,407 DALYs. These E.coli groups are associated with the onset of gastroenteritis with different severities, however, STEC can be associated with other sequelae such as hemolytic uremic syndrome and end stage renal disease. This work aimed to estimate the annual foodborne burden of disease associated with STEC, ETEC and EPEC infection based on results of E.coli quantification in ready-to-eat meals of institutional canteens from 2018 to 2019. Results were compiled and organized in a database, and the number of expected cases of disease resulted from the application of dose-response models for risk assessment using quantitative microbial risk assessment methodology which also allowed DALYs calculation. Two different scenarios were built based on the ingested meal portion and also based on the occurrence of E.coli STEC, ETEC and EPEC. A sensitivity analysis was performed for each model using Sobol method. Assuming a scenario in which a whole meal portion (450 grams) was consumed daily, the calculated burden was 4.99 x 10-3 DALYs/person/year for STEC infection, 2.82 x 10-4 DALYs/person/year for ETEC infection and 7.91 x 10-6 DALYs/person/year for EPEC infection. Regarding the sensitivity analysis, the factors that most contributed to the overall output variability were the occurrence of the E.coli group for the STEC model, the number of people exposed to the hazard for the ETEC model and the E.coli concentrations for the EPEC model.