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PubMed1995

[The extent of transfusion-associated HIV infections in Switzerland until 1994: an updated estimate].

OBJECTIVE: The first report on transfusion-associated HIV infections was published in the USA in 1982. The first case reports in Switzerland were published in 1986. So far there has never been a methodologically sound answer to the question of how many persons were infected with HIV by receiving transfusions in Switzerland before the introduction of universal HIV blood donor screening. METHODS: The following available data sources were analyzed simultaneously: firstly, the results of the look-back study conducted in 1993, secondly, the reports of HIV infections and AIDS cases in the national surveillance system, and, thirdly, the claims for compensation for HIV-infected transfusion recipients and hemophiliacs. Two methodologically different and independent estimates were obtained. Firstly, the coverage of the look-back study was estimated, which made it possible to calculate the total number of documentable transfusion-associated HIV infections in Switzerland. Secondly, matching was performed on the cases in the look-back study and the reports in the national surveillance system. Applying formulas of capture-recapture designs provided a second estimate of the total number of documentable transfusion-associated HIV infections. The claims for compensation were used to corroborate the estimates obtained. RESULTS: The two methods produced almost identical figures which were corroborated by the number of claims for compensation. It is therefore estimated that 80 to 100 persons in Switzerland may have been diagnosed as having HIV infection because of transfusions in Switzerland in the years after 1980. The last five known infections occurred in 1986 (four) and, after termination of the look-back study, in 1994 (one). However, the estimate of 80 to 100 does not include individuals who were infected before 1986 and died soon--within weeks or a few months--after the transfusion without diagnosis of HIV infection being possible. CONCLUSION: This estimate of the total number of transfusion-associated HIV infections in Switzerland is approximately half earlier published ones. In addition, the present study will probably reduce the remaining uncertainties about the size of these iatrogenic HIV infections in the 1980s.

Blood Component Transfusion↗
PubMed2006

No evidence of bluetongue virus in Switzerland.

We report the results of the first survey for antibody against bluetongue virus (BTV) that was conducted in Switzerland in the year 2003. In a nationwide cross-sectional study with partial verification, 2437 cattle sera collected from 507 herds were analysed using competitive enzyme-linked immunosorbent assays (c-ELISA). To adjust for misclassification, 158 sera, including 86 that were recorded equivocal in Switzerland, were sent to the Office Internationale des Epizooties designated regional reference laboratory in the UK for confirmation. No BTV antibody was detected in any of these samples, confirming the absence of BTV from Switzerland in 2003. The specificity of the c-ELISA used in Switzerland for individual Swiss cattle was calculated to be 96.5%. The mean herd sensitivity achieved in our survey ranged from 78.9% to 98.8% depending on the with-in herd prevalence and test sensitivity used for the calculations. The cumulated confidence level achieved with the survey based on a minimal expected prevalence of 2%, was 99.99% and therefore it was concluded that there was no evidence of BTV circulation in Switzerland in 2003.

Animals↗
PubMed2000

Daily consumption of (red) meat or meat products in Switzerland: results of the 1992/93 Swiss Health Survey.

OBJECTIVE: The present study aimed to examine the frequency of daily meat and meat product consumption and the preference for red meat in Switzerland. DESIGN: Cross-sectional Study. SETTINGS AND SUBJECTS: Data were taken from the 1992/1993 Swiss Health Survey, which collected data on a random sample of persons aged 15 and over, living in Switzerland. The survey, which had a response rate of 71%, included 7930 male and 7358 female respondents. Bivariate analyses and multivariate logistic regressions controlling for sociodemographic and lifestyle factors were performed. RESULTS: Daily consumption of meat or meat products (25%) and more frequent consumption of red than white meat (26% of meat eaters) were prevalent in Switzerland. Men, middle-aged persons, participants with a low level of education, persons living in the German or Francophone regions of Switzerland, those with Swiss nationality, smokers, overweight and obese people, those with daily alcohol consumption and physically inactive persons were found to consume daily meat or meat products more frequently. A preference for red meat rather than white meat was more often observed in men, young people, persons living in the German or Francophone regions of Switzerland, smokers and participants who consumed alcohol at least once daily. CONCLUSIONS: The analysis of data from the 1992/1993 Swiss Health Survey shows that in specific subgroups of the Swiss population meat and meat product consumption is still more frequent than recommended, but crude comparisons with older and more recent studies indicate a decrease in meat consumption. The observed clustering of daily meat consumption with other risk factors underscores the necessity to include dietary recommendations in health programs addressing other unhealthy lifestyles. European Journal of Clinical Nutrition (2000) 54, 136-142

Adolescent↗
PubMed2004

Costs and quality in the treatment of acute depression in primary care: a comparison between England, Germany and Switzerland.

No study has yet compared the costs and quality of depression treatment between European countries. The present study aimed to compare the costs and quality of treatment for the first manifestation of an acute major depression in England, Germany and Switzerland. Seventy-four randomly selected physician practices assessed their services for one hypothetical average patient (cost evaluation) and 73 practices reported retrospective data on one real patient (quality evaluation) for the year 2001. Reimbursement fees served as unit costs for Germany and Switzerland. Average reimbursement fees were used to measure resource utilization in all countries. Resource utilization was lowest in Switzerland. The percentage of patients receiving evidence-based treatment for major depression was insignificantly higher in Switzerland and England compared to Germany (56%, 52% and 35%, respectively; P>0.30). Switzerland was both the most effective and the most efficient country (in terms of resource utilization) in providing outpatient treatment for depression.

Acute Disease↗
PubMed1995

Measles, mumps, and rubella: monitoring in Switzerland through a sentinel network, 1986-94. Sentinella Arbeitsgemeinschaft.

STUDY OBJECTIVES: Since 1986, the national sentinel network in Switzerland (Sentinella) has collected reports of measles, mumps, and rubella cases in order to evaluate the impact of the Swiss MMR vaccination campaign (started in 1987) on disease frequency. DESIGN: Passive surveillance of clinical measles, mumps, and rubella cases through a voluntary physician based sentinel network in Switzerland. SETTING: Each year between June 1986 and May 1994, 150 to 200 general practitioners, specialists in internal medicine, and paediatricians in private practice covering the whole country have reported weekly numbers of consultations. PATIENTS: Every patient who fulfilled the case definition and consulted a physician participating in the Sentinella network was reported. MAIN RESULTS: Since 1986, the annual number of reported measles cases per physician has fallen--from 1.3 (95% confidence interval (CI) 1.11, 1.50) in 1986-87 to 0.4 (95% CI 0.30, 0.50) in 1993-94. A decreasing trend, although less pronounced, was also observed for rubella. An initial decrease in mumps cases was reported--from 1.8 (95% CI 1.57, 2.03) annually reported cases per physician in 1986-87 to 0.7 (95% CI 0.55, 0.83) in 1989-90. This was followed, however, by a net and sustained increase. In 1993-94, the mean annual number of reported mumps cases per practitioner reached 4.7 (95% CI 4.34, 5.01) which was the highest level since surveillance had started. Over the whole eight year period, reported mumps cases, in terms of the percentage of consultations, were four times more frequent in the French speaking part of Switzerland than in the rest of the country. The proportion of mumps cases in people reported to have been vaccinated also increased--from 10% in 1986-87 to 60% in 1993-94. CONCLUSIONS: Reductions in cases of measles and rubella but an appreciable increase in mumps cases have been observed in the past three years in Switzerland. This findings, combined with increasing vaccination coverage and the fact that 60% of mumps cases are reported in vaccinated people, suggests that the overall efficacy of the mumps vaccines used in Switzerland is probably below 80%. Under these conditions the goal of eliminating mumps will probably not be reached. Further studies are needed to evaluate the efficacy of the different mumps vaccines used.

Adolescent↗
PubMed2002

Use of sunscreens in families living in Switzerland.

BACKGROUND: The hazards due to sun exposure are well known. Many recent studies have emphasized the protection against the harmful effects of the sun by the use of sunscreens and, moreover, by staying in the shade and wearing long-sleeved shirts, hats and sunglasses. Switzerland has one of the highest rates of skin cancer induction in Europe and the incidence of melanoma in Switzerland is constantly increasing with an incidence of 10-12/100,000 inhabitants/year. Interestingly, some studies have evoked the possibility that sunscreen use can increase the risk of melanoma by increasing overall sun exposure. OBJECTIVE AND METHODS: In this context, the aim of our study was to estimate the amount of sun exposure of children, and their parents, living in Switzerland and to give a description of how they protect themselves against sun irradiation. Questionnaires were provided to pediatricians in every state (canton) in Switzerland and were given to families coming for consultation. RESULTS: A total of 328 forms including 1,285 individuals were returned from most of the cantons in Switzerland. The majority of the Swiss families had 2 children under 16 years of age with middle-aged parents (30-45 years) and a central European skin type (light skin of type II-III, brown or blue eyes, and brown to blond hair). An important sun exposure was noted even though the population seems to be conscious of the associated dangers. Sunscreens were the first-line defense against sun exposure with clothing and shielding oneself from the sun not being highly used. Moreover, sunscreens tended to be misused with most people applying them at the beach or swimming pool (instead of 15 min before exposure) and few applications throughout the day. CONCLUSIONS: Prevention should imperatively be emphasized for lower overall sun exposure as sunscreens are primarily used at the beach and not in routine daily exposure. In addition, it is agreed that prevention campaigns would be better directed towards children because up to 80% of detrimental sun exposure occurs during childhood.

Adolescent↗
PubMed2002

Detection of Mycobacterium avium subspecies paratuberculosis specific IS900 insertion sequences in bulk-tank milk samples obtained from different regions throughout Switzerland.

BACKGROUND: Since Mycobacterium avium subspecies paratuberculosis (MAP) was isolated from intestinal tissue of a human patient suffering Crohn's disease, a controversial discussion exists whether MAP have a role in the etiology of Crohn's disease or not. Raw milk may be a potential vehicle for the transmission of MAP to human population. In a previous paper, we have demonstrated that MAP are found in raw milk samples obtained from a defined region in Switzerland. The aim of this work is to collect data about the prevalence of MAP specific IS900 insertion sequence in bulk-tank milk samples in different regions of Switzerland. Furthermore, we examined eventual correlation between the presence of MAP and the somatic cell counts, the total colony counts and the presence of Enterobacteriaceae. RESULTS: 273 (19.7%) of the 1384 examined bulk-tank milk samples tested IS900 PCR-positive. The prevalence, however, in the different regions of Switzerland shows significant differences and ranged from 1.7% to 49.2%. Furthermore, there were no statistically significant (p >> 0.05) differences between the somatic cell counts and the total colony counts of PCR-positive and PCR-negative milk samples. Enterobacteriaceae occur as often in IS900 PCR-positive as in PCR-negative milk samples. CONCLUSION: This is the first study, which investigates the prevalence of MAP in bulk-tank milk samples all over Switzerland and infers the herd-level prevalence of MAP infection in dairy herds. The prevalence of 19.7% IS900 PCR-positive bulk-milk samples shows a wide distribution of subclinical MAP-infections in dairy stock in Switzerland. MAP can therefore often be transmitted to humans by raw milk consumption.

Animals↗
PubMed2006

Euthanasia and assisted suicide: comparison of legal aspects in Switzerland and other countries.

The purpose of this paper is to present the legal aspects associated with assisted suicide in Switzerland and compare them with those in other countries. Like euthanasia, assisted suicide is a subject that induces much discussion in many countries. While the law is very liberal in some countries, such as Belgium and the Netherlands (where both euthanasia and assisted suicide take place), these practices are very controversial in other countries, such as France, where they remain taboo subjects. In the United States of America, the laws concerning assisted suicide can differ greatly from one state to another. For example, in Oregon, assisted suicide is allowed if applied by a medical doctor; in others, this act is illegal. In Canada, it is punishable according to the Criminal Code. In Switzerland euthanasia is punishable by law. However, the penal code does not condemn assisted suicide, whether carried out by a medical doctor or another person, provided it is not carried out through selfish motives. The application of these practices has become simplified in recent years and societies for the right to die with dignity based on this principle have come into being (Exit and Dignitas). In the French- and German-speaking parts of Switzerland the association Exit assists individuals living in Switzerland with serious progressive and incurable disease in their engagement to end their life. The association Dignitas, in the German-speaking part of Switzerland, also undertakes--in the same circumstances--to assist individuals coming from foreign countries. Dignitas welcomes several such individuals every year, especially from Germany, where a similar approach does not currently exist.

Cross-Cultural Comparison↗
PubMed2002

Female genital mutilation in Switzerland: a survey among gynaecologists.

QUESTION UNDER STUDY: To evaluate the situation of Female Genital Mutilation (FGM) in Switzerland. METHODS: Through a questionnaire, Swiss gynaecologists were asked if they have been confronted to FGMs, if they have been asked to perform infibulations and FGMs. The health representatives (Kantonsärzte/médecins cantonaux) were interviewed on FGM activity at the Canton level. Swiss Medical Schools were asked if FGM was included in the pregraduate curriculum, and an estimated prevalence rate for FGMs in Switzerland was gathered. RESULTS: Among Swiss gynaecologists, 20% reported having been confronted with patients presenting with FGM and among them 40% had been asked about reinfibulation. Gynaecologists are occasionally asked about the possibility of performing FGMs in Switzerland. No activity concerning FGM is reported by health authorities in the Cantons. Teaching about FGM is not included in the curriculum of any of the Swiss medical schools. Approximately 6,700 girls at risk and women who have undergone FGM live in Switzerland. CONCLUSION: The extent to which gynaecologists are confronted to women with FGM may justify further action to try to better understand the situation in Switzerland. Improvement of care by better education of health care providers (guidelines) and prevention of new cases by women's education should also be considered.

Data Collection↗
PubMed2004

Burden of illness imposed by severe sepsis in Switzerland.

OBJECTIVE: This study aims to determine the burden of illness imposed by severe sepsis in Switzerland by evaluating the direct and indirect patient-related costs for critically ill patients with severe sepsis. METHODS: In order to estimate the direct costs a retrospective analysis was undertaken using records from 61 adult patients treated in three intensive care units (ICUs) in three different University hospitals in Switzerland, in 2001. Resource use was determined by a bottom up approach and valued using centre-specific unit costs for medication, nutrition, blood products, disposables and official tariffs for laboratory and microbiology analysis, diagnostic services, and clinical procedures. By adding centre-specific personnel and basic bed (hotel) costs total direct costs in the ICU were calculated. Indirect costs resulting from unfitness for work, early retirement, and premature death were calculated using official Swiss statistics for the years 1998-2000. RESULTS: The mean total direct costs for a severely septic patient are CHF 41,790 (+/- 33,222 CHF) or CHF 3244 (+/- 757 CHF) per day. Nonsurvivors cause significantly higher costs than survivors (CHF 45,956 vs. CHF 37,759, p <0.001). The total intensive care costs in Switzerland due to severe sepsis amount to CHF 146-355 million. Indirect costs were estimated to range from CHF 347 to 844 million (predominantly due to premature death). Consequently the burden of illness of severe sepsis can be estimated to range from CHF 493 to 1199 million per year in Switzerland (1 CHF = 0.662 Euro in 2001). CONCLUSION: Patients suffering from severe sepsis in Switzerland have a high mortality rate and spend a prolonged time in the ICU, leading to high direct and indirect costs. Particularly productivity losses due to premature death represent a considerable burden to the Swiss society.

Adolescent↗
PubMed1992

[Epidemiology of HIV infections in Switzerland and the German Federal Republic--contribution of official surveillance systems, of anonymous testing and of blood donor screening].

Official records on HIV infections are useful instruments to register and demonstrate the spread of the virus in the population observed. The data resulting from the registries allow the estimation of the means and the variabilities of age, sex and the probable path of infection in the observed population. In Switzerland as well as in the Federal Republic of Germany, the mean age of persons whose positive HIV status is detected increases in the course of time. In Switzerland, relatively more women are infected, and injecting drug users play a more important role. In the Federal Republic of Germany the homo-/bisexual men seem still to be the most important group. Nevertheless, data without any reference baseline do not enable an inference to be drawn in respect of trends and prevalence in the general population. Data on blood donations, collected in Switzerland as well as in Germany, and data on anonymous testing collected in Switzerland, are helpful in estimating trends and prevalence in the general population. Data suggest that the overall prevalence is higher in Switzerland than in the Federal Republic of Germany. Of course, comparisons between different countries must take in account the different structure of reporting systems and attitudes toward these systems.

AIDS Serodiagnosis↗
PubMed1999

[Development of mortality in Switzerland since 1950. I. International comparison and differences in sex, age and nationality].

BACKGROUND: All-cause mortality is an important criterion for assessing the health status and the living conditions of a population, thus indicating possible preventive measures. DATA AND METHODS: Descriptive analyses of Swiss mortality records and a comparison with the WHO mortality data bank for the period since 1950. RESULTS: Age-specific mortality trends in Switzerland are traced back to 1950 and compared with the situation in other European countries. At the beginning of the 1950s Swiss all-cause mortality rates were about the European average; now they are among the lowest worldwide. In most age classes, rates declined by more than one third between 1951/54 and 1990/94, in females even by more than 50%. This rather optimistic overall picture conceals less favourable partial trends. The decline in mortality rates in men aged 20-49 and women aged 20-34 years did not continue after 1970, and for males aged 20-44 and females aged 25-34 mortality risks have even increased in recent years. In both males and females, mortality rates from injury and poisoning (mainly accidents and suicide) exceed those of European low-incidence countries by 100%. On an international scale Swiss subjects aged between 15 and 44 years are at much higher risk, even when deaths from injury and poisoning, the most important cause of death in these ages, are excluded. When compared with their Swedish contemporaries, Swiss males aged 25-34 years have almost twice the risk of dying from a "natural" as well as from an "external" cause. As a rule, male/female sex ratios of mortality continued to increase, except in subjects aged 45-64 years. CONCLUSION: In spite of low overall mortality risks, international age-specific rates suggest considerable potential for preventive measures in Switzerland. There is some evidence of substantial under-registration of the mortality risks of foreigners living in Switzerland. As foreigners represent a substantial part of the total population--with a maximum of 30% of men aged 25-34 years--figures for Switzerland as a whole may be biased seriously. Therefore, for mortality analyses and comparisons with international data, we suggest the study be restricted to Swiss citizens. When assessing mortality risks for foreigners in Switzerland alternative data sources and methods should be taken into account.

Adolescent↗
PubMed1993

Hip fracture mortality and morbidity in Switzerland and Japan: a cross-cultural comparison.

Based on national mortality data, the frequency of hip fractures in elderly people was compared between Switzerland and Japan. Age-adjusted annual incidence rates per 100,000 population estimated for Swiss persons over 60 years were around 150 and 200 in males and around 450 in females, while for the Japanese they were only 132 in males and 285 in females. Age-adjusted death rates from hip fracture for the Swiss over 60 were 20.0 in males and 28.9 in females, while for the Japanese they were only 1.6 in males and 2.7 in females. The inclination of the age-dependent slope in hip fracture mortality rates was substantially the same in both countries, but there was a "lag time" of approximately 10 years in Japan. Remarkably, the proportion of deaths due to falls among all accidental deaths was several times greater in both sexes for the Swiss than for the Japanese. This differential might be an important underlying reason for the observed difference between death rates of hip fracture in Switzerland and Japan. Other known behavioral risk factors for hip fracture such as diet, exercise, estrogen use etc. are unlikely to explain the observed difference in hip fracture mortality and morbidity between Switzerland and Japan. However, given the doubts on the reliability and thus comparability of the available data on mortality and morbidity, the present findings should be regarded as preliminary. In conclusion, we believe that the unexplained and large difference in the burden of hip fracture between Switzerland and Japan merits further studies, including new aetiological hypotheses.

Aged↗
PubMed1992

Trends of HIV infections using the anonymous mandatory reporting system and other data sources in Switzerland and in the Federal Republic of Germany.

In Switzerland and in the Federal Republic of Germany the reporting of HIV infections is based on an anonymous mandatory reporting system for laboratories. In Switzerland, physicians have to complete a questionnaire on the patient's clinical status and risk behaviour. To make a rough estimate of the prevalence of HIV infections in the general population at low risk, data on blood donations are used in both countries. In Switzerland, additional data with information on positive and negative test results have been obtained since 1985 from anonymous test sites. In both countries, the data do not show evidence of an increasing incidence of HIV infection. The number of positive test results reported by the laboratories and physicians remains stable, and the rates of HIV-positive blood donations are declining. In the Federal Republic of Germany, homo-/bisexual men play the most important role in the epidemic, whilst in Switzerland, injecting drug users contribute most to the burden of HIV infection, and the proportion of persons probably heterosexually infected is increasing steadily. Possible selection biases need to be further discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Socio-economic factors and mortality in Switzerland.

This review paper is concerned with the topic of mortality differences by socio-economic group in Switzerland. After a short introduction to the topic and the pitfalls associated with it, the paper reviews work done in the course of a ten year programme investigating socio-economic mortality differentials in Switzerland. This programme was carried out by a working group at the Department of Social and Preventive Medicine of the University of Berne. The paper reviews methodological difficulties and pitfalls and relates the Swiss results to findings from other countries including England and Wales and Sweden. The disadvantages of socially isolated groups such as children of single women are shown. The relatively high mortality of groups under economic pressure, such as skilled manual workers in Switzerland, is demonstrated. The Swiss situation is interesting in that skilled manual workers have a higher mortality than the unskilled and semi-skilled groups. It is concluded that this is not an artifact but may be due to the fact that only Swiss workers were investigated and that Switzerland has a large proportion of foreign workers, especially in the less skilled groups. In addition, some results of an investigation of cancer mortality by occupation are reported too. Apart from some occupation-specific findings, there are some interesting cross-references to socio-economic differential mortality.

Adolescent↗
PubMed1988

Serological study of meningococcal isolates in Switzerland and France 1980-1986.

A study was performed of 342 disease-related strains of meningococci isolated in Switzerland and France between 1980 and 1986, including more than 50% of all strains isolated in Switzerland in 1986. Using a newly developed spot-blot enzyme-linked immunoassay and a panel of monoclonal anti-meningococcal antibodies, 96% of all strains were shown to react with at least one antibody. In both countries more than 50% of the strains were group B. In France serotype 2a was the prevalent serotype and was often associated with subtype P1.2. In Switzerland serological markers of epidemic strains recently described in Northern Europe (serotype 15 and subtype P1.16) were observed with increasing frequency in 1986. However, serotype 4 has been prevalent in Switzerland since 1980 and no clonal population was seen to emerge.

Antibodies, Monoclonal↗
PubMedDate not supplied

[Sample survey of smoking habits in the German, French and Romansch speaking parts of Switzerland in 1975].

In a survey of a representative sample of 900 persons in Switzerland (excluding the Italian speaking parts comprising some 4-5 percent of the population), the smoking habits of the adult population were studied. Smokers were defined as persons smoking at least one cigarette or an equivalent weight of pipe tobacco or cigars per day. 51.8% of men and 29.0% of women over age 15 are smokers. Among male smokers of cigarettes only (42% of all men), over three quarters (77.6%) smoke ten cigarettes or more per day, i.e., a quantity found harmful to health; over one half (55.8%) smoke twenty or more cigarettes per day. Half of all female smokers smoke ten or more cigarettes, more than one in every four female smokers (28.8%) smoke twenty or more cigarettes per day. It is calculated that almost two thirds of all cigarettes sold in Switzerland are smoked by smokers of twenty or more cigarettes per day, and that almost three quarters are smoked by smokers of ten or more cigarettes. Among men, smoking habits are independent of social status, whereas among women, those with higher family incomes show more frequent smoking, but also more widespread cessation of smoking than with lower incomes. Thirty percent of adults having been smokers have given up the habit, so that among men and women above age 15, theree are now some 20% and 14% respectively, of ex-smokers. This corresponds to at least 700,000 former smokers in all of Switzerland. The trend to give up starts already in the group aged 15-24 (over 20% of men and women having ever smoked have given up) and becomes more marked with increasing age. A large part of male and female smokers would like to free themselves of the habit. 30% of male and 34% of female smokers indicate that they had tried seriously to stop smoking during the twelve months preceding the interview. Trying to give up was not significantly associated with intensity of smoking or social status. According to this survey, a majority of the population (57.6%) is in favor of reserving certain parts of restaurants to non-smokers, following the example of non-smokers-compartments in railway trains. In a situation where a non-smoker asks a co-worker in a closed room not to smoke, 78.3% take sides with the non-smoker, either by conceding to him a right to smoke-free air, or by demanding from the smoker to show consideration for the non-smoker. Only 10.9% demand from the non-smoker understanding for the smoker, or concede to the smoker a right to smoke at work. Women show more understanding for cause of the non-smoker than men. This difference is more marked among smokers and former smokers than among non-smokers. Inasmuch as the results of this study are comparable to those of earlier surveys conducted in Switzerland, ther is good agreement. The only exception is a significant increase of the proportion of former smokers in the past years.

Adolescent↗
PubMed2004

Epidemiology and costs of gastroesophageal reflux disease in Switzerland: a population-based study.

OBJECTIVES: Assessment of the prevalence, health care resource use and cost of gastroesophageal reflux disease in Switzerland. METHODS: A population-based telephone survey was conducted in German and French speaking Switzerland. Reflux cases were defined using a questionnaire proposed by the German Gastro League and answered additional questions on their personal characteristics and resource use. RESULTS: 1,274 out of 7,222 participants were positively screened. The prevalence of reflux disease in Swiss adults was estimated at 17.6% (95% CI: 15.6%-19.7%) or 993,000 individuals. Regular treatment with medication was reported by 38.0% of the reflux positive sample. Reflux-induced general practitioner consultations during the last year were reported by 25.9%. On average, there were 0.84 general practitioner consultations, 0.19 specialist consultations, 0.08 gastroscopies and 0.01 hospitalisations annually. Mean direct medical costs, dominated by medication costs, were CHF 185 per patient-year (95% CI: CHF 140-230) or 0.5% of Switzerland's total health care expenditures. Total costs were CHF 234 (95% CI: CHF 185-284) per patient-year. CONCLUSIONS: The prevalence of reflux disease in Switzerland is similar to that in other industrialised countries. Reflux disease causes considerable costs, in the medical system and at the societal level.

Adolescent↗