The Belgian health examination survey: objectives, design and methods

Nguyen, Dung; Hautekiet, Pauline; Berete, Finaba; Braekman, Elise; Charafeddine, Rana; Demarest, Stefaan; Drieskens, Sabine; Gisle, Lydia; Hermans, Lize; Tafforeau, Jean; Heyden, Johan Van der

doi:10.1186/s13690-020-00428-9

Cited by 19 publications

(33 citation statements)

References 30 publications

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“…5692 households participated to the BHIS, resulting in a household participation rate of 57.5% and a total of 11, 611 BHIS participants. Of all eligible BHIS participants that were contacted, 1184 participated to the BELHES, indicating a participation rate of 24.1% [38]. 1.4% of those participants provided neither a blood nor a urine sample and were excluded from the HuBiHIS study, which ended up in a final subset of 1168 participants.…”

Section: Resultsmentioning

confidence: 99%

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Environmental exposures and health behavior in association with mental health: a study design

et al. 2020

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Background Air pollution, green space and smoking are known to affect human health. However, less is known about their underlying biological mechanisms. One of these mechanisms could be biological aging. In this study, we explore the mediation of biomarkers of exposure and biological aging to explain the associations between environmental exposures, health behavior and mental health. Methods The study population of this cross-sectional study (n = 1168) is a subsample of the Belgian 2018 Health Interview Survey (BHIS). Mental health indicators including psychological and severe psychological distress, life satisfaction, vitality, eating disorders, suicidal ideation, subjective health and depressive and anxiety disorders, demographics and health behavior such as smoking are derived from the BHIS. Urine and blood samples are collected to measure respectively the biomarkers of exposure (urinary black carbon (BC) and (hydroxy)cotinine) and the biomarkers of biological aging (mitochondrial DNA content (mtDNAc) and telomere length (TL)). Recent and chronic exposure (μg/m3) to nitrogen dioxide (NO2), particulate matter ≤2.5 μm (PM2.5) and ≤ 10 μm (PM10) and BC at the participants’ residence are modelled using a high resolution spatial temporal interpolation model. Residential green space is defined in buffers of different size (50 m – 5000 m) using land cover data in ArcGIS 10 software. For the statistical analysis multivariate linear and logistic regressions as well as mediation analyses are used taking into account a priori selected covariates and confounders. Results As this study combined data of BHIS and laboratory analyses, not all data is available for all participants. Therefore, data analyses will be conducted on different subsets. Data on air pollution and green space exposure is available for all BHIS participants. Questions on smoking and mental health were answered by respectively 7829 and 7213 BHIS participants. For biomarker assessment, (hydroxy) cotinine, urinary BC and the biomarkers of biological aging are measured for respectively 1130, 1120 and 985 participants. Conclusion By use of personal markers of air pollution and smoking, as well as biological aging, we will gain knowledge about the association between environmental exposures, health behavior, and the mental health status. The results of the study can provide insights on the health of the Belgian population, making it a nationwide interesting study.

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Section: Resultsmentioning

confidence: 99%

“…For the first time in 2018, a subsample was selected to participate in a supplementary Belgian Health Examination Survey (BELHES) [38]. Participants younger than 18 years, participants with a proxy respondent and people from the German community were not eligible for BELHES participation.…”

Section: Study Populationmentioning

confidence: 99%

Environmental exposures and health behavior in association with mental health: a study design

et al. 2020

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“…Selection bias may also have occurred during the recruitment for BHIS, and then secondly for BELHES. It has previously been stated that the BELHES responders were of higher education level than non-responders and suffered from underrepresentation of people in the age group of 18–24 years [ 15 ]. Moreover, urine was not collected from participants < 18 years of age in the BELHES, which hampered our direct comparison between CT1 and CT2.…”

Section: Discussionmentioning

confidence: 99%

“…The CT2 study used urine samples collected through the cross-sectional general Belgian Health Examination Survey (BELHES) in 2018, which was organized as a second stage of the Belgian Health Interview Survey (BHIS) that targeted all Belgian residents without age restriction [ 15 , 16 ]. Households and respondents within households were selected through a multistage geographically stratified clustered sampling procedure, based on entries from the national register.…”

Section: Methodsmentioning

confidence: 99%

Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies

et al. 2021

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Background Chlamydia trachomatis (chlamydia) is the most diagnosed sexually transmitted infection in Belgium. Screening programs focus on young women, due to the implications of chronic asymptomatic infections for reproductive health. Thereby, the frequency of infections in men and older adults is underestimated. This study aimed to estimate the point-prevalence of chlamydia in the broader Belgian population, to inform evidence-based prevention and control strategies. Methods We conducted two cross-sectional prevalence studies of chlamydia infection in the population of Belgium aged 16–59 years, 2018–2020. In the CT1 study 12,000 representative individuals were randomly selected from the national register and invited by letter to collect a urine sample at home. The CT2 study used urine samples collected through the Belgian Health Examination Survey. Molecular detection of chlamydia DNA was performed using Xpert® or Abbott Real-Time CT/NG assays. Weighted estimated prevalence and 95% confidence interval (CI) was calculated per gender and age groups of 16/18–29, 30–44 and 45–59 years, relative to the general Belgian population. Data collected on sociodemographic variables and sexual behavior were used to identify potential risk factors for chlamydia infection through calculation of the odds ratio (OR). Results The population-wide weighted estimated prevalence was 1.54% (95% CI 0.78–3) in CT1 and 1.76% (95% CI 0.63–4) in CT2. We observed no statistically significant difference between men and women or age groups. Civil relationship status (OR = 14.1 (95% CI 1.78–112), p < 0.01), sexual intercourse with a casual partner (OR = 6.31 (95% CI 1.66–24.1), p < 0.01) and > 3 sexual partners in the last 12 months (OR = 4.53 (95% CI 1.10–18.6), p = 0.02) were associated with higher relative risk for chlamydia infection. Conclusion Nationwide prevalence studies are relevant to assess the distribution of chlamydia and inform public health actions. The overall low prevalence and heterogeneous distribution of chlamydia in the general Belgian population needs to be considered for future strategies and potential harm of testing and treating asymptomatic individuals need to be taken into account. Effective case management should include appropriate treatment of symptomatic patients and partner notification, and prevention strategies should encourage behaviors such as condom use.

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“…Participants to the BHIS were invited to participate also in the BELHES. The study design of the BELHES is described more in detail elsewhere (Nguyen et al, 2020) and follows largely the technical protocol for hepatitis C prevalence surveys in the general population, as developed by the European Centre for Disease Prevention and Control (2020). In short, the BELHES was open to all persons who participated in the BHIS except for minors (< 18 years), BHIS participants for whom a proxy interview was conducted, and residents of the German Community.…”

Section: Methodsmentioning

confidence: 99%

Hepatitis C virus prevalence in Belgium

Baelen

Heyden

2021

Exp Results

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Reliable hepatitis C prevalence estimates are crucial for a good follow-up of the indicators to eliminate hepatitis by 2030 as set by the World Health Organization. In Belgium, no recent national population-based hepatitis C virus (HCV) seroprevalence estimate is available. The current study estimated HCV prevalence as part of the first Belgian Health Examination Survey, which was organized in 2018 as a second stage of the sixth Belgian Health Interview Survey. This national population-based cross-sectional study resulted in a weighted national HCV seroprevalence of 0.02% (95% CI 0.00–0.07%). The results show a much lower HCV seroprevalence compared to previous studies.

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The Belgian health examination survey: objectives, design and methods

Cited by 19 publications

References 30 publications

Environmental exposures and health behavior in association with mental health: a study design

Environmental exposures and health behavior in association with mental health: a study design

Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies

Hepatitis C virus prevalence in Belgium

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