The Clinical and Economic Impact of Probiotics Consumption on Respiratory Tract Infections: Projections for Canada.
Identifieur interne : 000124 ( Main/Exploration ); précédent : 000123; suivant : 000125The Clinical and Economic Impact of Probiotics Consumption on Respiratory Tract Infections: Projections for Canada.
Auteurs : Irene Lenoir-Wijnkoop [Pays-Bas, France] ; Laetitia Gerlier [Belgique] ; Denis Roy [Canada] ; Gregor Reid [Canada]Source :
- PloS one [ 1932-6203 ] ; 2016.
Descripteurs français
- KwdFr :
- Absentéisme, Adolescent, Adulte, Adulte d'âge moyen, Antibactériens (usage thérapeutique), Antibactériens (économie), Canada (épidémiologie), Congé maladie (), Congé maladie (économie), Enfant, Enfant d'âge préscolaire, Femelle, Humains, Infections de l'appareil respiratoire (), Infections de l'appareil respiratoire (épidémiologie), Jeune adulte, Modèles économiques, Mâle, Nourrisson, Nouveau-né, Probiotiques (usage thérapeutique), Rendement, Santé publique (), Santé publique (économie), Sujet âgé, Sujet âgé de 80 ans ou plus.
- MESH :
- usage thérapeutique : Antibactériens, Probiotiques.
- économie : Antibactériens, Congé maladie, Santé publique.
- épidémiologie : Canada, Infections de l'appareil respiratoire.
- Absentéisme, Adolescent, Adulte, Adulte d'âge moyen, Congé maladie, Enfant, Enfant d'âge préscolaire, Femelle, Humains, Infections de l'appareil respiratoire, Jeune adulte, Modèles économiques, Mâle, Nourrisson, Nouveau-né, Rendement, Santé publique, Sujet âgé, Sujet âgé de 80 ans ou plus.
- Wicri :
- geographic : Canada.
English descriptors
- KwdEn :
- Absenteeism, Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents (economics), Anti-Bacterial Agents (therapeutic use), Canada (epidemiology), Child, Child, Preschool, Efficiency, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Models, Economic, Outcome Assessment, Health Care (economics), Outcome Assessment, Health Care (statistics & numerical data), Probiotics (therapeutic use), Public Health (economics), Public Health (statistics & numerical data), Respiratory Tract Infections (epidemiology), Respiratory Tract Infections (prevention & control), Sick Leave (economics), Sick Leave (statistics & numerical data), Young Adult.
- MESH :
- chemical , economics : Anti-Bacterial Agents.
- chemical , therapeutic use : Anti-Bacterial Agents.
- geographic , epidemiology : Canada.
- economics : Outcome Assessment, Health Care, Public Health, Sick Leave.
- epidemiology : Respiratory Tract Infections.
- prevention & control : Respiratory Tract Infections.
- statistics & numerical data : Outcome Assessment, Health Care, Public Health, Sick Leave.
- therapeutic use : Probiotics.
- Absenteeism, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Efficiency, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Models, Economic, Young Adult.
Abstract
INTRODUCTION
There is accumulating evidence supporting the use of probiotics, which are defined as "live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host", as a preventive measure against respiratory tract infections (RTI). Two recent meta-analyses showed probiotic consumption (daily intake of 107 to 1010 CFU in any form for up to 3 months) significantly reduced RTI duration, frequency, antibiotic use and work absenteeism.
OBJECTIVES
The aim of this study was to assess the impact of probiotic use in terms of number of RTI episodes and days averted, and the number of antibiotic prescriptions and missed workdays averted, in the general population of Canada. In addition, the corresponding economic impact from both a healthcare payer and a productivity perspective was estimated.
METHODS
A microsimulation model was developed to reproduce the Canadian population (sample rate of 1/1000 = 35 540 individuals) employing age and gender. RTI incidence was taken from FluWatch consultation rates for influenza-like illness (2013-14) and StatCan all-cause consultations statistics. The model was calibrated on a 2.1% RTI annual incidence in the general population (5.2 million RTI days) and included known risk factors (smoking status, shared living conditions and vaccination status). RTI-related antibiotic prescriptions and work absenteeism were obtained from the literature.
RESULTS
The results indicate that probiotic use saved 573 000-2.3 million RTI-days, according to the YHEC-Cochrane scenarios respectively. These reductions were associated with an avoidance of 52 000-84 000 antibiotic courses and 330 000-500 000 sick-leave days. A projection of corresponding costs reductions amounted to Can$1.3-8.9 million from the healthcare payer perspective and Can$61.2-99.7 million when adding productivity losses.
CONCLUSION
The analysis shows that the potential of probiotics to reduce RTI-related events may have a substantial clinical and economic impact in Canada.
DOI: 10.1371/journal.pone.0166232
PubMed: 27832195
Affiliations:
- Belgique, Canada, France, Pays-Bas
- Utrecht (province), Île-de-France
- Paris, Utrecht
- Université d'Utrecht
Links toward previous steps (curation, corpus...)
Le document en format XML
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type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName><orgName type="university">Université d'Utrecht</orgName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Director Public Health &Scientific Relations, Danone Company, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Director Public Health &Scientific Relations, Danone Company, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Gerlier, Laetitia" sort="Gerlier, Laetitia" uniqKey="Gerlier L" first="Laetitia" last="Gerlier">Laetitia Gerlier</name><affiliation wicri:level="1"><nlm:affiliation>QuintilesIMS Real-World Evidence, Zaventem, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>QuintilesIMS Real-World Evidence, Zaventem</wicri:regionArea><wicri:noRegion>Zaventem</wicri:noRegion></affiliation></author><author><name sortKey="Roy, Denis" sort="Roy, Denis" uniqKey="Roy D" first="Denis" last="Roy">Denis Roy</name><affiliation wicri:level="1"><nlm:affiliation>Department of Food Sciences, Laval University, Quebec, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Food Sciences, Laval University, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Reid, Gregor" sort="Reid, Gregor" uniqKey="Reid G" first="Gregor" last="Reid">Gregor Reid</name><affiliation wicri:level="1"><nlm:affiliation>Canadian Research and Development Centre for Probiotics, University of Western Ontario, London, Ontario, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Canadian Research and Development Centre for Probiotics, University of Western Ontario, London, 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use)</term><term>Public Health (economics)</term><term>Public Health (statistics & numerical data)</term><term>Respiratory Tract Infections (epidemiology)</term><term>Respiratory Tract Infections (prevention & control)</term><term>Sick Leave (economics)</term><term>Sick Leave (statistics & numerical data)</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Absentéisme</term><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Antibactériens (usage thérapeutique)</term><term>Antibactériens (économie)</term><term>Canada (épidémiologie)</term><term>Congé maladie ()</term><term>Congé maladie (économie)</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Humains</term><term>Infections de l'appareil respiratoire ()</term><term>Infections de l'appareil respiratoire (épidémiologie)</term><term>Jeune adulte</term><term>Modèles économiques</term><term>Mâle</term><term>Nourrisson</term><term>Nouveau-né</term><term>Probiotiques (usage thérapeutique)</term><term>Rendement</term><term>Santé publique ()</term><term>Santé publique (économie)</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords><keywords scheme="MESH" type="chemical" qualifier="economics" xml:lang="en"><term>Anti-Bacterial Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-Bacterial Agents</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Canada</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Outcome Assessment, Health Care</term><term>Public Health</term><term>Sick Leave</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Outcome Assessment, Health Care</term><term>Public Health</term><term>Sick Leave</term></keywords><keywords scheme="MESH" qualifier="therapeutic use" xml:lang="en"><term>Probiotics</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antibactériens</term><term>Probiotiques</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Antibactériens</term><term>Congé maladie</term><term>Santé publique</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Canada</term><term>Infections de l'appareil respiratoire</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Absenteeism</term><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Child</term><term>Child, Preschool</term><term>Efficiency</term><term>Female</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Male</term><term>Middle Aged</term><term>Models, Economic</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Absentéisme</term><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Congé maladie</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Humains</term><term>Infections de l'appareil respiratoire</term><term>Jeune adulte</term><term>Modèles économiques</term><term>Mâle</term><term>Nourrisson</term><term>Nouveau-né</term><term>Rendement</term><term>Santé publique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Canada</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION</b></p><p>There is accumulating evidence supporting the use of probiotics, which are defined as "live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host", as a preventive measure against respiratory tract infections (RTI). Two recent meta-analyses showed probiotic consumption (daily intake of 107 to 1010 CFU in any form for up to 3 months) significantly reduced RTI duration, frequency, antibiotic use and work absenteeism.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>The aim of this study was to assess the impact of probiotic use in terms of number of RTI episodes and days averted, and the number of antibiotic prescriptions and missed workdays averted, in the general population of Canada. In addition, the corresponding economic impact from both a healthcare payer and a productivity perspective was estimated.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A microsimulation model was developed to reproduce the Canadian population (sample rate of 1/1000 = 35 540 individuals) employing age and gender. RTI incidence was taken from FluWatch consultation rates for influenza-like illness (2013-14) and StatCan all-cause consultations statistics. The model was calibrated on a 2.1% RTI annual incidence in the general population (5.2 million RTI days) and included known risk factors (smoking status, shared living conditions and vaccination status). RTI-related antibiotic prescriptions and work absenteeism were obtained from the literature.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The results indicate that probiotic use saved 573 000-2.3 million RTI-days, according to the YHEC-Cochrane scenarios respectively. These reductions were associated with an avoidance of 52 000-84 000 antibiotic courses and 330 000-500 000 sick-leave days. A projection of corresponding costs reductions amounted to Can$1.3-8.9 million from the healthcare payer perspective and Can$61.2-99.7 million when adding productivity losses.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The analysis shows that the potential of probiotics to reduce RTI-related events may have a substantial clinical and economic impact in Canada.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27832195</PMID><DateCompleted><Year>2017</Year><Month>07</Month><Day>10</Day></DateCompleted><DateRevised><Year>2019</Year><Month>12</Month><Day>10</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1932-6203</ISSN><JournalIssue CitedMedium="Internet"><Volume>11</Volume><Issue>11</Issue><PubDate><Year>2016</Year></PubDate></JournalIssue><Title>PloS one</Title><ISOAbbreviation>PLoS ONE</ISOAbbreviation></Journal><ArticleTitle>The Clinical and Economic Impact of Probiotics Consumption on Respiratory Tract Infections: Projections for Canada.</ArticleTitle><Pagination><MedlinePgn>e0166232</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1371/journal.pone.0166232</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">There is accumulating evidence supporting the use of probiotics, which are defined as "live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host", as a preventive measure against respiratory tract infections (RTI). Two recent meta-analyses showed probiotic consumption (daily intake of 107 to 1010 CFU in any form for up to 3 months) significantly reduced RTI duration, frequency, antibiotic use and work absenteeism.</AbstractText><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">The aim of this study was to assess the impact of probiotic use in terms of number of RTI episodes and days averted, and the number of antibiotic prescriptions and missed workdays averted, in the general population of Canada. In addition, the corresponding economic impact from both a healthcare payer and a productivity perspective was estimated.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A microsimulation model was developed to reproduce the Canadian population (sample rate of 1/1000 = 35 540 individuals) employing age and gender. RTI incidence was taken from FluWatch consultation rates for influenza-like illness (2013-14) and StatCan all-cause consultations statistics. The model was calibrated on a 2.1% RTI annual incidence in the general population (5.2 million RTI days) and included known risk factors (smoking status, shared living conditions and vaccination status). RTI-related antibiotic prescriptions and work absenteeism were obtained from the literature.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The results indicate that probiotic use saved 573 000-2.3 million RTI-days, according to the YHEC-Cochrane scenarios respectively. These reductions were associated with an avoidance of 52 000-84 000 antibiotic courses and 330 000-500 000 sick-leave days. A projection of corresponding costs reductions amounted to Can$1.3-8.9 million from the healthcare payer perspective and Can$61.2-99.7 million when adding productivity losses.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The analysis shows that the potential of probiotics to reduce RTI-related events may have a substantial clinical and economic impact in Canada.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lenoir-Wijnkoop</LastName><ForeName>Irene</ForeName><Initials>I</Initials><Identifier Source="ORCID">http://orcid.org/0000-0001-9853-8076</Identifier><AffiliationInfo><Affiliation>Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Director Public Health &Scientific Relations, Danone Company, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gerlier</LastName><ForeName>Laetitia</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>QuintilesIMS Real-World Evidence, Zaventem, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roy</LastName><ForeName>Denis</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Food Sciences, Laval University, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Reid</LastName><ForeName>Gregor</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Canadian Research and Development Centre for Probiotics, University of Western Ontario, London, Ontario, Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>11</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>PLoS One</MedlineTA><NlmUniqueID>101285081</NlmUniqueID><ISSNLinking>1932-6203</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000900">Anti-Bacterial Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000041" MajorTopicYN="Y">Absenteeism</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000900" MajorTopicYN="N">Anti-Bacterial Agents</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002170" MajorTopicYN="N" Type="Geographic">Canada</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004526" MajorTopicYN="N">Efficiency</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007231" MajorTopicYN="N">Infant, Newborn</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018803" MajorTopicYN="N">Models, Economic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017063" MajorTopicYN="N">Outcome Assessment, Health Care</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019936" MajorTopicYN="N">Probiotics</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011634" MajorTopicYN="N">Public Health</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012141" MajorTopicYN="N">Respiratory Tract Infections</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018582" MajorTopicYN="N">Sick Leave</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><CoiStatement>ILW is employed by Danone and LG is employed by IMS RWES HEOR. Both employers were not involved in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. DR and GR do not declare any competing interest.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>06</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2016</Year><Month>10</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>11</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>11</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>7</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27832195</ArticleId><ArticleId IdType="doi">10.1371/journal.pone.0166232</ArticleId><ArticleId IdType="pii">PONE-D-16-22803</ArticleId><ArticleId 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IdType="pubmed">7713184</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Belgique</li><li>Canada</li><li>France</li><li>Pays-Bas</li></country><region><li>Utrecht (province)</li><li>Île-de-France</li></region><settlement><li>Paris</li><li>Utrecht</li></settlement><orgName><li>Université d'Utrecht</li></orgName></list><tree><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Lenoir Wijnkoop, Irene" sort="Lenoir Wijnkoop, Irene" uniqKey="Lenoir Wijnkoop I" first="Irene" last="Lenoir-Wijnkoop">Irene Lenoir-Wijnkoop</name></region></country><country name="France"><region name="Île-de-France"><name sortKey="Lenoir Wijnkoop, Irene" sort="Lenoir Wijnkoop, Irene" uniqKey="Lenoir Wijnkoop I" first="Irene" last="Lenoir-Wijnkoop">Irene Lenoir-Wijnkoop</name></region></country><country name="Belgique"><noRegion><name sortKey="Gerlier, Laetitia" sort="Gerlier, Laetitia" uniqKey="Gerlier L" first="Laetitia" last="Gerlier">Laetitia Gerlier</name></noRegion></country><country name="Canada"><noRegion><name sortKey="Roy, Denis" sort="Roy, Denis" uniqKey="Roy D" first="Denis" last="Roy">Denis Roy</name></noRegion><name sortKey="Reid, Gregor" sort="Reid, Gregor" uniqKey="Reid G" first="Gregor" last="Reid">Gregor Reid</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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