Contract Notice

 Invitation to Tender

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Question 1
In section 2.1 of “land use patterns” are referred to as drivers of infectious disease and “important determinants of infectious disease”. Climate change is also characterized as a driver of infectious disease. These drivers are considered as “epidemic precursers”. Hence “land use patterns” are referred to as both determinants and precursors.

Please clarify the terms  “environmental determinants of infectious disease” and “environmental precursors of disease epidemics”.
Answer
Lot 1 pertains only to individual level, environmental exposures, such as heavy metals, pesticides, PCBs, dioxins, or other pollutants that can have an impact on infections, the immunological response, or sero-conversion to vaccines.  So temperature on transmission cycles is not considered under Lot 1. Environmental determinants in this case are environmental exposures. 

Question 2
Lot 1 concerns a systematic review of environmental determinants of infectious disease, and it shall “explore the interplay of environmental exposures and infections. Specifically how environmental exposures alter the susceptibility and severity of the infectious disease”.

Does this mean that lot 1 only deals with the impact of pollutants on human immunity and susceptibility, or does lot 1 also include other environmental determinants, such as temperature, impact on the transmission cycles?
Answer
In this case environmental precursors would be meteorological variables such as temperature or precipitation (Lot 2 focuses on an ecological level).

Question 3
Do we need to focus on all environmental factors? 
Or should we try to find out all environmental factors on health or only if they may have an impact on infectious diseases?
Answer
Yes, you do need to focus on all environmental factors as they refer to the tasks described in the tender. 
Lot 1 pertains to environmental exposures (through water, air, soil, radiation, etc) that alter the susceptibility to the infective dose, the persistence of infection, pathogen shedding, severity and sequelae of infectious disease.
Lot 2 pertains to meteorological variables, entomological data, water quality records, air quality measures, remote sensing information, geology, population density and many other information sources can be integrated with disease surveillance systems that would enable the analysis of environmental precursors to infectious disease epidemics.

Question 4
How wide should the systematic reviews be?  Do you give permission to use some limitations?
Answer
The search should be comprehensive but there will of course be inclusion and exclusion criteria that will be applied after consultation with ECDC staff.

Question 5
Do you have any expectations about number of trials taking into consideration in systematic review?
Answer
If the term "trials" refers to citations, then it is not the number but the importance of the citations that counts. If the number of references is too big to screen, then alternative search strategies can be discussed with the ECDC team.