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Wan S, Wang M. Population mobility : spatial spillover effect of government health expenditure in China. Glob Health Action 2024; 17:2319952. [PMID: 38465634 PMCID: PMC10930106 DOI: 10.1080/16549716.2024.2319952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/13/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Since the 20th century, pursuing Universal Health Coverage (UHC) has emerged as an important developmental objective in numerous countries and across the global health community. With the intricate ramifications of population mobility (PM), the government faces a mounting imperative to judiciously deploy health expenditure to realise UHC effectively. OBJECTIVE This study aimed to construct a comprehensive UHC index for China, assess the spatial effects of Government Health Expenditure (GHE) on UHC, and explore the moderating effects of PM on this association. METHOD A Dynamic Spatial Durbin Model (DSDM) was employed to investigate the influence of the GHE on UHC. Therefore, we tested the moderating effect of PM. RESULTS In the short-term, the GHE negatively impacted local UHC. However, it enhanced the UHC in neighbouring regions. Over the long term, GHE improved local UHC but decreased UHC in neighbouring regions. In the short-term, when the PM exceeded 1.42, the GHE increased the local UHC. Over the long term, when the PM exceeded 1.107, the GHE impeded local UHC. If the PM exceeded 0.91 in the long term, the GHE promoted UHC in neighbouring regions. The results of this study offer a partial explanation of GHE decisions and behaviours. CONCLUSIONS To enhance UHC, a viable strategy involves augmenting vertical transfer payments from the central government to local governments. Local governments should institute healthcare systems tailored to the urban scale and developmental stages, with due consideration for PM. Optimising the information disclosure mechanism is also a worthwhile endeavour.
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Affiliation(s)
- Simin Wan
- School of Public Finance & Public Administration, Jiangxi University of Finance and Economics, Nanchang, China
| | - Mengying Wang
- School of Public Finance & Public Administration, Jiangxi University of Finance and Economics, Nanchang, China
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Belon AP, Yashadhana A, Kongats K, Atkey K, Glenn NM, Jaques K, Nieuwendyk L, Harris P, de Leeuw E, Nykiforuk CI. Australian and Canadian financial wellbeing policy landscape during COVID-19: An equity-informed policy scan. HEALTH POLICY OPEN 2024; 6:100114. [PMID: 38213762 PMCID: PMC10776654 DOI: 10.1016/j.hpopen.2023.100114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 11/27/2023] [Accepted: 12/09/2023] [Indexed: 01/13/2024] Open
Abstract
Background This targeted and comprehensive policy scan examined how different levels of governments in Australia and Canada responded to the financial crisis brought on by the COVID-19 pandemic. We mapped the types of early policy responses addressing financial strain and promoting financial wellbeing. We also examined their equity considerations. Methods Through a systematic search, snowballing, and manual search, we identified Canadian and Australian policies at all government levels related to financial strain or financial wellbeing enacted or amended in 2019-2020. Using a deductive-inductive approach, policies were categorized by jurisdiction level, focal areas, and target population groups. Results In total, 213 and 97 policies in Canada and Australia, respectively, were included. Comparisons between Canadian and Australian policies indicated a more diversified and equity-targeted policy landscape in Canada. In both countries, most policies focused on individual and family finances, followed by housing and employment areas. Conclusions The policy scan identified gaps and missed opportunities in the early policies related to financial strain and financial wellbeing. While fast, temporary actions addressed individuals' immediate needs, we recommend governments develop a longer-term action plan to tackle the root causes of financial strain and poor financial wellbeing for better health and non-health crisis preparedness. Statement on Ethics and Informed Consent This research reported in this paper did not require ethical clearance or patient informed consent as the data sources were published policy documents. This study did not involve data collection with humans (or animals), nor any secondary datasets involving data provided by humans (or from animal studies).
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Affiliation(s)
- Ana Paula Belon
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
| | - Aryati Yashadhana
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, Australia
- School of Social Sciences, University of New South Wales, Sydney, Australia
| | - Krystyna Kongats
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
| | - Kayla Atkey
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
| | - Nicole M. Glenn
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
- PolicyWise for Children & Families, 1000 – 9925, 109 Street NW, Edmonton, AB T5K 2J8, Canada
| | - Karla Jaques
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Laura Nieuwendyk
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
| | - Patrick Harris
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Evelyne de Leeuw
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, Australia
- Healthy Urban Environments Collaboratory, Maridulu Budyari Gumal SPHERE, Sydney, Australia
| | - Candace I.J. Nykiforuk
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
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Chen L, Dai L, Xu J, Duan L, Hou X, Zhang L, Song L, Zhao F, Jiang Y. Chinese herbal compound preparation Qing-Xin-Jie-Yu granules for intermediate coronary lesions in patients with stable coronary artery disease: Study protocol for a multicenter, randomized, double-blind, placebo-controlled trial. PLoS One 2024; 19:e0307074. [PMID: 39012918 PMCID: PMC11251585 DOI: 10.1371/journal.pone.0307074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 06/24/2024] [Indexed: 07/18/2024] Open
Abstract
INTRODUCTION Despite the available secondary preventive treatments, the management of stable coronary artery disease (SCAD) remains challenging. Intermediate coronary lesion (ICL), defined as luminal stenosis between 50% and 70%, is a key stage of SCAD. However, existing therapeutic strategies are limitated in delaying plaque progression and associated with various adverse effects and economic burdens. Qing-Xin-Jie-Yu Granules (QXJYG) with proven anti-platelet, anti-inflammatory, and lipid-lowering effects may compensate for the drawbacks of current treatments and can be tested as a complementary therapy. Therefore, this study aims to investigate the efficacy and safety of QXJYG in treating ICL, with a particular focus on its impact on myocardial ischemia and plaque progression. MATERIALS AND METHODS This is a multicenter, randomized, double-blind, placebo-controlled trial. A total of 120 participants with ICL will be randomly assigned to two groups in a 1:1 ratio. In addition to basic medications, the intervention group will receive QXJYG, while the control group will receive a placebo for over 6 months, followed by a 12-month follow-up. The primary efficacy outcome is computed tomography-derived fractional flow reserve. The secondary outcomes include the degree of coronary stenosis, coronary artery calcification score, Gensini score, Seattle Angina Questionnaire score, high-sensitivity C-reactive protein, matrix metalloproteinase-9, blood lipids, and carotid artery ultrasound parameters. Major adverse cardiovascular events are recorded as endpoints. The safety outcomes include composite events of bleeding, laboratory test results, and adverse events. Clinical visits are scheduled at baseline, every 2 months during the treatment, and after a 12-month follow-up. DISCUSSION This trial is anticipated to yield reliable results to verify the efficacy and safety of QXJYG in the treatment of ICL, which will provide novel insights to help address the prevailing therapeutic dilemma of ICL, thereby facilitating for the management of SCAD. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR2200059262. Registered on April 27, 2022.
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Affiliation(s)
- Luying Chen
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lulu Dai
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiawei Xu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lian Duan
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaoxia Hou
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lu Zhang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Libo Song
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fangfang Zhao
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Chinese Journal of Integrated Traditional and Western Medicine Press, Beijing, China
| | - Yuerong Jiang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Chi C, Liang LL, Lee JL, Núñez A, Tuepker A. Healthcare for all - A critical review of Taiwan's national health insurance system through a social institution lens. J Formos Med Assoc 2024:S0929-6646(24)00306-1. [PMID: 38972766 DOI: 10.1016/j.jfma.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 07/09/2024] Open
Affiliation(s)
- Chunhuei Chi
- Health Management and Policy Program, Global Health Program, College of Health, Oregon State University, USA; International College of Innovation, National Chengchi University, Taipei, Taiwan; Oregon Universal Health Plan Governance Board, USA.
| | - Li-Lin Liang
- Institute of Public Health, College of Medicine, Health Innovation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Jwo-Leun Lee
- Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, Taiwan.
| | - Alicia Núñez
- Department of Management Control and Information Systems, School of Economics and Business, The University of Chile, Chile.
| | - Anaïs Tuepker
- RELATE Lab, Research Council Member, Northwest Native American Center of Excellence, VA HSR&D Center to Improve Veteran Involvement in Care, Department of Family Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, USA.
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Zhao M, Zhai H, Li H, Wei F, Ma H, Liu Y, Li W, Wei P. Age-standardized incidence, prevalence, and mortality rates of autoimmune diseases in adolescents and young adults (15-39 years): an analysis based on the global burden of disease study 2021. BMC Public Health 2024; 24:1800. [PMID: 38970015 PMCID: PMC11227207 DOI: 10.1186/s12889-024-19290-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/27/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Autoimmune diseases (ADs) present significant health challenges globally, especially among adolescents and young adults (AYAs) due to their unique developmental stages. Comprehensive analyses of their burden are limited. This study leverages the Global Burden of Disease (GBD) 2021 data to assess the global, regional, and national burden and trends of major ADs among AYAs from 1990 to 2021. METHODS Utilizing data from the Global Burden of Disease (GBD) Study 2021 for individuals aged 15-39 years, we employed a direct method for age standardization to calculate estimates along with 95% uncertainty intervals (UIs) for assessing the age-standardized incidence rates (ASIR), prevalence rates (ASPR), and mortality rates (ASMR) of ADs. The diseases analyzed included rheumatoid arthritis (RA), inflammatory bowel disease (IBD), multiple sclerosis (MS), type 1 diabetes mellitus (T1DM), Asthma, and Psoriasis. Trends from 1990 to 2021 were analyzed using Joinpoint regression, providing average annual percentage changes (AAPC) and 95% confidence intervals (CIs). RESULT In 2021, the global ASIR, ASPR, and ASMR of RA among AYAs (per 100,000 population) were 9.46 (95% UI: 5.92 to 13.54), 104.35 (77.44 to 137.84), and 0.016 (0.013 to 0.019), respectively. For IBD, the corresponding rates were 4.08 (3.07 to 5.37), 29.55 (23.00 to 37.83), and 0.10 (0.07 to 0.12). MS exhibited rates of 1.40 (0.93 to 1.93), 16.05 (12.73 to 19.75), and 0.05 (0.04 to 0.05), respectively. T1DM had rates of 6.63 (3.08 to 11.84), 245.51 (194.21 to 307.56), and 0.54 (0.47 to 0.60). Asthma demonstrated rates of 232.22 (132.11 to 361.24), 2245.51 (1671.05 to 2917.57), and 0.89 (0.77 to 1.08). Psoriasis showed rates of 55.08 (48.53 to 61.93) and 426.16 (394.12 to 460.18) for ASIR and ASPR, respectively. From 1990 to 2021, the global ASIR of RA (AAPC = 0.47, 95% CI: 0.46 to 0.49), IBD (0.22 [0.12 to 0.33]), MS (0.22 [0.19 to 0.26]), T1DM (0.83 [0.80 to 0.86]), and Psoriasis (0.33 [0.31 to 0.34]) showed increasing trends, whereas Asthma (-0.96 [-1.03 to -0.88]) showed a decreasing trend. The global ASPR of RA (0.70 [0.68 to 0.73]), MS (0.35 [0.32 to 0.37]), T1DM (0.68 [0.66 to 0.69]), and Psoriasis (0.29 [0.27 to 0.32]) also showed increasing trends, whereas IBD (-0.20 [-0.27 to -0.13]) and Asthma (-1.25 [-1.31 to -1.19]) showed decreasing trends. Notably, the estimated global ASMR of RA (-2.35 [-2.57 to -2.12]), MS (-0.63 [-0.86 to -0.41]), T1DM (-0.35 [-0.56 to -0.14]), and Asthma (-1.35 [-1.44 to -1.26]) in AYAs declined. Additionally, the burden of disease for ADs in AYAs varies considerably across continents and between 204 countries and territories. CONCLUSION ADs among AYAs present a substantial public health burden with notable regional disparities in incidence, prevalence, and mortality rates. Understanding these patterns is essential for developing targeted public health interventions and policies to mitigate the impact of ADs in this population.
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Affiliation(s)
- Meng Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Hongrui Zhai
- Department of Acute Infectious Diseases, Qingdao Municipal Center for Disease Control and Prevention, Qingdao, 266033, Shandong, China
| | - Han Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Feiran Wei
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Ministry of Education, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Hongfei Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Yangyang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Wei Li
- Department of Clinical Research Center, Children's Hospital of Nanjing Medical University, Nanjing, 210008, Jiangsu, China.
| | - Pingmin Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu, China.
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Alsakarneh S, Hassan K, Jaber F, Mintz M, Zulqarnian M, Obeid A, Ghoz H, Hashash JG, Farraye FA. The national burden of inflammatory bowel disease in the United States from 1990-2019: results from the Global Burden of Disease study database. Ann Gastroenterol 2024; 37:427-435. [PMID: 38974084 PMCID: PMC11226748 DOI: 10.20524/aog.2024.0894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/04/2024] [Indexed: 07/09/2024] Open
Abstract
Background Inflammatory bowel disease (IBD) epidemiology has changed rapidly in recent years. We aimed to provide a systematic report of the burden of IBD at a state level in the United States (US), and to study the age- and sex-specific trends of incidence, prevalence and mortality rates for the past 3 decades. Methods Using the Global Burden of Disease (GBD) 2019 Study Database, we examined the incidence, prevalence and mortality rate, and the disability-adjusted life-years from GBD 2019 at national and state level from 1990-2019. Results There was an overall decrease in incidence and prevalence rates of IBD in the US from 1990-2019, while a simultaneous increase in the overall mortality rates was identified. However, a distinct trend of increasing incidence and prevalence rates emerged starting in 2000, with incidence rates rising from 21 cases per 100,000 persons in 2000 to 23 cases per 100,000 persons in 2019. From 1990-2019, incidence and prevalence decreased in males at a higher rate than in females. However, mortality rates increased more in females than males. Incidence rates were highest in Midwestern and Eastern states, and were lowest across the northern Great Plains and Western states, with the highest incidence noted in Michigan (31 cases per 100,000 persons). California had the greatest decrease in incidence rates from 1990-2019 (-63.3%). Conclusion Our results concerning recent trends and geographic variations in IBD offer policymakers crucial insights for informed decision-making in policy, research, and investment, facilitating more effective strategies and allocation of resources.
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Affiliation(s)
- Saqr Alsakarneh
- Department of Medicine, University of Missouri–Kansas City, Kansas City, MO (Saqr Alsakarneh, Fouad Jaber)
| | - Kamal Hassan
- Department of Gastroenterology and Hepatology, Weill Cornell University, NY (Kamal Hassan, Micheal Mintz)
| | - Fouad Jaber
- Department of Medicine, University of Missouri–Kansas City, Kansas City, MO (Saqr Alsakarneh, Fouad Jaber)
| | - Micheal Mintz
- Department of Gastroenterology and Hepatology, Weill Cornell University, NY (Kamal Hassan, Micheal Mintz)
| | - Mir Zulqarnian
- Department of Gastroenterology and Hepatology, University of Missouri-Kansas City, MO (Mir Zulqarnian, Hassan Ghoz)
| | - Ayah Obeid
- Department of Medicine, St. Luke’s University Health Network, Bethlehem, Pennsylvania (Ayah Obied)
| | - Hassan Ghoz
- Department of Gastroenterology and Hepatology, University of Missouri-Kansas City, MO (Mir Zulqarnian, Hassan Ghoz)
| | - Jana G. Hashash
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL (Jana G. Hashash, Francis A. Farraye), USA
| | - Francis A. Farraye
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL (Jana G. Hashash, Francis A. Farraye), USA
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Wang Y, Wang R, Jiang M, Ying X. Provincial inequality of China's progress towards universal health coverage: An empirical analysis in 2016-21. J Glob Health 2024; 14:04122. [PMID: 38939928 PMCID: PMC11211969 DOI: 10.7189/jogh.14.04122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024] Open
Abstract
Background Achieving universal health coverage (UHC) is a crucial target shared by the Sustainable Development Goals (SDGs). As UHC levels are influenced by factors such as the regional economy and resource allocation, subnational evidence in China is urgently needed. This study aimed to monitor provincial progress from 2016 to 2021, thereby informing the development of region-specific strategies. Methods Based on the UHC monitoring framework proposed by the World Health Organization, a UHC index was constructed comprising the service coverage dimension (16 indicators) and financial protection dimension (four indicators). In this observational study, routinely collected health data from 25 provinces (autonomous regions and municipalities) in mainland China were obtained from statistical yearbooks, relevant literature, and nationally representative surveys. The indices were calculated using geometric means. Socioeconomic inequalities among provinces were quantified using the slope index of inequality (SII) and relative index of inequality (RII). Results From 2016 to 2021, China made laudable progress towards achieving UHC, with the index rising from 56.94 in 2016 to 63.03 in 2021. Most provinces demonstrated better performance in service coverage. Western provinces generally presented faster rates of progress, which were attributed to more substantial increases in financial protection. Despite significant disparities, with the UHC index ranging from 77.94 in Shanghai to 54.61 in Fujian in 2021, the overall equity of UHC has improved across the 25 provinces. SII decreased from 17.78 (95% confidence interval (CI) = 11.64, 23.93) to 12.25 (95% CI = 5.86, 18.63) and RII from 1.38 (95% CI = 1.29, 1.46) to 1.22 (95% CI = 1.16, 1.29). However, the non-communicable disease (NCD) domain experienced a drop in both index score and equity, underscoring the need for prioritised attention. Conclusions In the context of SDGs and the 'Healthy China 2030' initiative, China has made commendable progress towards UHC, and inter-provincial equity has improved. However, substantial differences persisted. The equitable realisation of UHC necessitates prioritising the enhancement of service capacity and financial protection in less developed regions, particularly by addressing shortages in the general practitioner workforce and mitigating catastrophic payments. Developed regions should focus on preventing NCDs through effective interventions targeting key risk factors. This study provides insights for other countries to adopt comprehensive monitoring frameworks, identify subnational disparities, and introduce targeted policy initiatives.
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Affiliation(s)
- Yining Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Ruixin Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Mingzhu Jiang
- School of Public Health, Fudan University, Shanghai, China
| | - Xiaohua Ying
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment (Fudan University), Ministry of Health, Shanghai, China
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Cao Y, Guo Y, Long Z, Wu Y, Pei B, Ye J, Zhang M, Yuan H, Jia Y, Liu X, Wang F, Zhao Y. The Global Burden of Gynecological Diseases from 1990 to 2019. Am J Prev Med 2024:S0749-3797(24)00222-8. [PMID: 38945179 DOI: 10.1016/j.amepre.2024.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION Gynecological diseases ranked second among new cases of noncommunicable diseases in women of reproductive age in 1990 and 2019 globally. The aim of this study was to estimate the disease burden of gynecological diseases and describe their trends in women of all ages from 1990 to 2019. METHODS Using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD 2019), authors examined the incidence, disability-adjusted life years, and deaths from gynecological diseases by age in 204 countries and territories worldwide from 1990 to 2019. Analyses were conducted in 2022. RESULTS Globally, the age-standardized incidence rate and age-standardized disability-adjusted life year rate (ASDR) of gynecological diseases decreased by -0.176% and -0.245%, respectively from 1990 to 2019. Low socioeconomic development index countries had the highest age-standardized incidence rate and ASDR in 2019. The age-specific incidence rate of gynecological diseases in women aged 15-29 years increased from 1990 to 2019, and the 20-24-year age group increased the greatest by 0.21%. Polycystic ovary syndrome and other types of benign disorders contributed to the major increase. CONCLUSIONS Although the disease burden of gynecological diseases decreased slightly between 1990 and 2019 globally, it remained highest in low socioeconomic development index countries. The disease burden in 20-24-year age group exhibited the fastest growth, with polycystic ovary syndrome and other types of benign disorders playing a significant role. Urgent and effective measures should be taken to target different age groups, types of gynecological disease, and regions with high disease burdens.
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Affiliation(s)
- Yukun Cao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yufeng Guo
- Department of Obstetrics and Gynecology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhiping Long
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yi Wu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Bing Pei
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingyu Ye
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Min Zhang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Heli Yuan
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanjie Jia
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xiao Liu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Fan Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yashuang Zhao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China.
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Weng Q, Chen Q, Jiang T, Zhang Y, Zhang W, Doherty M, Xie J, Liu K, Li J, Yang T, Wei J, Lei G, Zeng C. Global burden of early-onset osteoarthritis, 1990-2019: results from the Global Burden of Disease Study 2019. Ann Rheum Dis 2024; 83:915-925. [PMID: 38429104 DOI: 10.1136/ard-2023-225324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/21/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVES Early-onset osteoarthritis (OA) is an emerging health issue amidst the escalating prevalence of overweight and obesity. However, there are scant data on its disease, economic burden and attributable burden due to high body mass index (BMI). METHODS Using data from the Global Burden of Diseases Study 2019, we examined the numbers of incident cases, prevalent cases, years lived with disability (YLDs) and corresponding age-standardised rates for early-onset OA (diagnosis before age 55) from 1990 to 2019. The case definition was symptomatic and radiographically confirmed OA in any joint. The average annual percentage changes (AAPCs) of the age-standardised rates were calculated to quantify changes. We estimated the economic burden of early-onset OA and attributable burden to high BMI. RESULTS From 1990 to 2019, the global incident cases, prevalent cases and YLDs of early-onset OA were doubled. 52.31% of incident OA cases in 2019 were under 55 years. The age-standardised rates of incidence, prevalence and YLDs increased globally and for countries in all Sociodemographic Index (SDI) quintiles (all AAPCs>0, p<0.05), with the fastest increases in low-middle SDI countries. 98.04% of countries exhibited increasing trends in all age-standardised rates. Early-onset OA accounts for US$46.17 billion in healthcare expenditure and US$60.70 billion in productivity loss cost in 2019. The attributable proportion of high BMI for early-onset OA increased globally from 9.41% (1990) to 15.29% (2019). CONCLUSIONS Early-onset OA is a developing global health problem, causing substantial economic costs in most countries. Targeted implementation of cost-effective policies and preventive intervention is required to address the growing health challenge.
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Affiliation(s)
- Qianlin Weng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Qiu Chen
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Ting Jiang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
- Department of Ultrasonography, Xiangya Hospital, Central South University, Changsha, China
| | - Yuqing Zhang
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Weiya Zhang
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis UK, Nottingham, UK
| | - Michael Doherty
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis UK, Nottingham, UK
| | - Junqing Xie
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Ke Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Jiatian Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Tuo Yang
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Wei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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10
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Aida J, Inoue Y, Tabuchi T, Kondo N. Modifiable risk factors of inequalities in hypertension: analysis of 100 million health checkups recipients. Hypertens Res 2024; 47:1555-1566. [PMID: 38443615 DOI: 10.1038/s41440-024-01615-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 03/07/2024]
Abstract
Inequalities in health behaviors are thought to contribute to inequalities in hypertension. This study examined the extent to which modifiable mediating factors explain income inequalities in hypertension. This repeated cross-sectional study used data from National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) from 2009 to 2015. Those aged between 40 and 74 were enrollees in the Specific Health Checkups. Hypertension was defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90, or the use of antihypertensive medication. The mediating effects of exercise, obesity, smoking, and alcohol drinking on the association between income, as an indicator of SES, and hypertension were determined by the Karlson-Holm-Breen (KHB) method. The mean age of the 68,684,025 men and 59,118,221 women was 54.7 (SD = 9.6) and 56.7 (SD = 10.0) years, respectively. Prevalence of hypertension was higher in the lowest income group (48.6% for men, 40.2% for women) than in the highest income group (33.3% for men, 21.5% for women). Inequalities tended to increase over time. Inequalities were larger among those who did not use antihypertensive medication. Modifiable risks explained 10.6% of the association between income and hypertension for men and 15.1% for women. In men, drinking and obesity explained 8.8% and 5.5% of the inequalities in hypertension, respectively. In women, obesity explained 18.8%. Exercise increased the proportion mediated over time. Smoking explained 5.5% among women taking antihypertensive medication. There were health inequalities in hypertension among Japanese adults, and the modifiable risk factors partially explained the inequalities.
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Affiliation(s)
- Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Yuko Inoue
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
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11
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Akioyamen LE, Ko DT, Cram P, Landon BE. Approaches to Comparing the Impact of Socioeconomic Disadvantage on Acute Myocardial Infarction Care Within and Across Countries: A Scoping Review. Can J Cardiol 2024; 40:1135-1145. [PMID: 38548014 PMCID: PMC11162914 DOI: 10.1016/j.cjca.2024.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/15/2024] [Accepted: 03/03/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Understanding how cardiovascular disease treatment and outcomes differ for socioeconomically disadvantaged patients across countries may reveal insights into the impact of countries' policy initiatives on health equity. However, methods of undertaking these studies are poorly characterized. METHODS We performed a scoping review to identify studies describing between-country comparisons of socioeconomic inequalities in the care of acute myocardial infarction (AMI). We sought to determine the extent to which such comparisons have been conducted, the methodologies used, and outcomes assessed. We searched Medline from January 1, 2013 to September 30, 2023 for peer-reviewed English-language publications. Studies were included if they stratified patients by a measure of socioeconomic disadvantage (eg, race, ethnicity, income, education, occupation, immigrant status) and made comparisons between 2 or more countries. RESULTS Our search yielded 4861 articles focused on patients with AMI, of which 7 met our inclusion criteria. Common individual-level proxies for disadvantage were self-reported income or education. In contrast, we found no cross-country comparisons focused on other measures of disadvantage such as race and ethnicity. There was marked heterogeneity in methods and thresholds used to define socioeconomic disadvantage at the individual level. All included studies found that patients with higher income and higher educational attainment had improved AMI outcomes. CONCLUSIONS Between-country comparisons of socioeconomic disparities in AMI outcomes are scarce and heterogeneous, but all identified studies relied on metrics of disadvantage including income and education that could be uniformly measured across countries. We found no articles addressing other types of inequities, likely because of significant methodologic challenges.
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Affiliation(s)
- Leo E Akioyamen
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dennis T Ko
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Schulich Heart Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Peter Cram
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, UTMB, Galveston, Texas, USA
| | - Bruce E Landon
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA; Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
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12
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Wang P, Huang S, Shi X, Xu H, Wang R, Peng J, Chen Q, Zhang W, Shi L, Zhou X, Tang X. Global, regional, and national burdens of cancer in children aged zero to nine years from 1990 to 2019. J Glob Health 2024; 14:04104. [PMID: 38818611 PMCID: PMC11140426 DOI: 10.7189/jogh.14.04104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
Background The description of long-term trends in the cancer burden among children aged zero to nine years from 1990 to 2019 reveals significant changes in children's health. It helps in resource allocation and health policy planning. We analysed data on the incidence, mortality, and disability-adjusted life years (DALYs) by sex and age group in children aged zero to nine. Methods Estimates of DALYs for children aged zero to nine years, appeared as part of the Global Burden of Diseases, Injuries, and Risk Factor Study 2019, by age, sex, and location for 1990-2019. We also provided estimations by the sociodemographic index (SDI) quintile, a systematic measure to indicate educational attainment, income per capita, and total fertility rate for those younger than 25 years. We used age-period-cohort models to investigate paediatric cancers prevalence, incidence, mortality, and DALYs rates and auto-regressive integrated moving average models to predict cancer in children of different age groups in males and females. Results A total of 6 224 010 DALY numbers for cancer cases occurred globally in 2019 among children aged zero to nine years. Additionally, the incidence of paediatric cancers in 2019 in the middle SDI countries was the highest, including 60 662 cases, and the highest mortality and DALYs cases of paediatric cancers were in the low SDI countries (25 502 and 2 199 790). The joinpoint regression analysis revealed that the trend of total cancer burden in age-standardised mortality rates and age-standardised DALYs rates showed a significant decrease with an average annual percentage change of -2.10 and -2.03 from 1990 to 2019. Furthermore, the paediatric cancer spectrum was changing. Other malignant neoplasms and other leukaemia were the major components of cancer in all age groups of children. Conclusions The disease burden in children aged zero to nine years decreased significantly globally from 1990 to 2019. However, the overall prediction of childhood cancer increased slightly from 2020 to 2040. Our findings may help guide investments and inform policies. This highlights the necessity to improve current treatment measures and establish effective prevention strategies to reduce the cancer burden among children aged zero to nine years.
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Affiliation(s)
- Ping Wang
- Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Shu Huang
- Department of Gastroenterology, Lianshui County People’ Hospital, Huaian, China
- Department of Gastroenterology, Lianshui People’ Hospital of Kangda College Affiliated to Nanjing Medical University, Huaian, China
| | - Xiaomin Shi
- Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Huan Xu
- Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Ruiyu Wang
- Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Jieyu Peng
- Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Qi Chen
- Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Wei Zhang
- Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Lei Shi
- Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Xian Zhou
- Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Xiaowei Tang
- Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
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Jin Y, Guo C, Abbasian M, Abbasifard M, Abbott JH, Abdullahi A, Abedi A, Abidi H, Abolhassani H, Abu-Gharbieh E, Aburuz S, Abu-Zaid A, Addo IY, Adegboye OA, Adepoju AV, Adikusuma W, Adnani QES, Aghamiri S, Ahmad D, Ahmed A, Aithala JP, Akhlaghi S, Akkala S, Alalwan TA, Albashtawy M, Alemi H, Alhalaiqa FAN, Ali EA, Almustanyir S, Al-Raddadi RM, Alvis-Zakzuk NJ, Al-Worafi YM, Alzahrani H, Alzoubi KH, Amiri S, Amu H, Amzat J, Anderson DB, Anil A, Antony B, Arabloo J, Areda D, Artaman A, Artamonov AA, Aryal KK, Asghari-Jafarabadi M, Ashraf T, Athari SS, Atinafu BT, Atout MMW, Azadnajafabad S, Azhdari Tehrani H, Azzam AY, Badawi A, Baghcheghi N, Bai R, Baigi V, Banach M, Banakar M, Banik B, Bardhan M, Bärnighausen TW, Barqawi HJ, Barrow A, Bashiri A, Batra K, Bayani M, Bayileyegn NS, Begde A, Beyene KA, Bhagavathula AS, Bhardwaj P, Bhatti GK, Bhatti JS, Bhatti R, Bijani A, Bitra VR, Brazo-Sayavera J, Buchbinder R, Burkart K, Bustanji Y, Butt MH, Cámera LA, Carvalho F, Chattu VK, Chaurasia A, Chen G, Chen H, Chen L, Christensen SWM, Chu DT, Chukwu IS, Comachio J, Cruz-Martins N, Cuschieri S, Dadana S, Dadras O, Dai X, Dai Z, Das S, Dashti M, Delgado-Enciso I, Demisse B, Denova-Gutiérrez E, Desye B, Dewan SMR, Dhingra S, Diress M, Do TC, Do THP, Doan KDK, Dutta S, Dziedzic AM, Edinur HA, Ekholuenetale M, Elhadi M, Eskandarieh S, Esposito F, Fagbamigbe AF, Farokh P, Fatehizadeh A, Feizkhah A, Fekadu G, Ferreira N, Fetensa G, Fischer F, Foroutan B, Foroutan Koudehi M, Franklin RC, Fukumoto T, Gandhi AP, Ganesan B, Gau SY, Gautam RK, Gebre AK, Gebregergis MW, Ghaderi Yazdi B, Gholami A, Gill TK, Goleij P, Gomes-Neto M, Goyal A, Graham SM, Guan B, Gupta B, Gupta IR, Gupta S, Gupta VB, Gupta VK, Habibzadeh F, Hailu WB, Hajibeygi R, Halwani R, Haro JM, Hartvigsen J, Hasaballah AI, Haubold J, Hebert JJ, Hegazy MI, Heidari G, Heidari M, Hezam K, Hiraike Y, Hosseinzadeh H, Hosseinzadeh M, Hoveidaei AH, Hsu CJ, Huda MN, Huynh HH, Hwang BF, Ibitoye SE, Ikiroma AI, Ilic IM, Ilic MD, Iranmehr A, Islam SMS, Ismail NE, Iso H, Iwagami M, Iyasu AN, Jacob L, Jafarzadeh A, Jahankhani K, Jain N, Jairoun AA, Janakiraman B, Jayarajah U, Jayaram S, Jeganathan J, Jokar M, Jonas JB, Joo T, Joseph N, Joshua CE, Kabito GG, Kamal VK, Kandel H, Kantar RS, Karami J, Karaye IM, Karimi Behnagh A, Kaur N, Kazemi F, Kedir S, Khadembashiri MM, Khadembashiri MA, Khader YS, Khajuria H, Khan MJ, Khan MAB, Khan Suheb MZ, Khatatbeh H, Khatatbeh MM, Khateri S, Khayat Kashani HR, Khonji MS, Khubchandani J, Kian S, Kisa A, Kitila AT, Kolahi AA, Koohestani HR, Korzh O, Kostev K, Kotnis AL, Koyanagi A, Krishan K, Kuddus M, Kumar N, Kurniasari MD, Ladan MA, Lahariya C, Laksono T, Lallukka T, Landires I, Lasrado S, Lawal BK, Le TTT, Le TDT, Lee M, Lee WC, Lee YH, Lerango TL, Lim D, Lim SS, Lucchetti G, Ma ZF, Maghazachi AA, Maghbouli N, Malakan Rad E, Malhotra A, Malik AA, Mansournia MA, Mantovani LG, Manu E, Mathangasinghe Y, Mazzotti A, McPhail SM, Mengist B, Mesregah MK, Mestrovic T, Miller TR, Minh LHN, Mirahmadi Eraghi M, Mirrakhimov EM, Misganaw A, Mohamadian H, Mohamadkhani A, Mohamed NS, Mohammadi E, Mohammadi S, Mohammed M, Mojiri-Forushani H, Mokdad AH, Momenzadeh K, Momtazmanesh S, Monasta L, Montazeri F, Moradi Y, Morrison SD, Mostafavi E, Mousavi P, Mousavi SE, Mulita A, Murillo-Zamora E, Mustafa G, Muthu S, Naik GR, Naimzada MD, Nakhostin Ansari N, Narasimha Swamy S, Nargus S, Nascimento PR, Naseri A, Natto ZS, Naveed M, Nayak BP, Nazri-Panjaki A, Negaresh M, Negash H, Nejadghaderi SA, Nguyen DH, Nguyen HTH, Nguyen HQ, Nguyen PT, Nguyen VT, Niazi RK, Ofakunrin AO, Okati-Aliabad H, Okonji OC, Olatubi MI, Ommati MM, Ordak M, Owolabi MO, P A M, Padubidri JR, Pan F, Pantazopoulos I, Park S, Patel J, Patil S, Pawar S, Pedersini P, Peprah P, Perna S, Petcu IR, Petermann-Rocha FE, Pham HT, Pigeolet M, Prates EJS, Rahim F, Rahimi Z, Rahimi-Dehgolan S, Rahimi-Movaghar V, Rahman MHU, Rahmati M, Ramasamy SK, Ramasubramani P, Rapaka D, Rashedi S, Rashedi V, Rashidi MM, Rasouli-Saravani A, Rawaf S, Reddy MMRK, Redwan EMM, Rezaei N, Rezaei N, Rezaei N, Rezaei Z, Riad A, Roever L, Roshanzamir S, Roy P, de Andrade Ruela G, Saad AM, Saddik B, Sadeghian F, Saeed U, Safary A, Saghazadeh A, Sagoe D, Sharif-Askari FS, Sharif-Askari NS, Sahebkar A, Sakshaug JW, Salami AA, Saleh MA, Salehi S, Samadzadeh S, Samodra YL, Samuel VP, Santos DB, Santric-Milicevic MM, Saqib MAN, Saravanan A, Sawyer S, Schaarschmidt BM, Senapati S, Sethi Y, Seylani A, Shafaat A, Shafie M, Shahabi S, Shahbandi A, Shahrokhi S, Shaikh MA, Shamim MA, Shamshirgaran MA, Sharfaei S, Sharifan A, Sharifi A, Sharma R, Sharma S, Shashamo BB, Shi L, Shigematsu M, Shiri R, Shivarov V, Siddig EE, Sinaei E, Singh A, Singh JA, Singh P, Singh S, Singla S, Siraj MS, Skryabina AA, Solanki R, Solomon Y, Starodubova AV, Swain CK, Talic S, Tat NY, Temsah MH, Terefa DR, Tesler R, Thapar R, Tharwat S, Thayakaran R, Ticoalu JHV, Tovani-Palone MR, Tusa BS, Ty SS, Udoakang AJ, Vahabi SM, Valizadeh R, Van den Eynde J, Varthya SB, Vasankari TJ, Venketasubramanian N, Villafañe JH, Vlassov V, Vo AT, Vu LG, Wang YP, Wiangkham T, Wickramasinghe ND, Winkler AS, Wu AM, Yadollahpour A, Yahya G, Yonemoto N, You Y, Younis MZ, Zakham F, Zangiabadian M, Zarrintan A, Zhong C, Zhou H, Zhu Z, Zielińska M, Zikarg YT, Zitoun OA, Zoladl M, Tam LS, Wu D. Global pattern, trend, and cross-country inequality of early musculoskeletal disorders from 1990 to 2019, with projection from 2020 to 2050. MED 2024:S2666-6340(24)00179-X. [PMID: 38834074 DOI: 10.1016/j.medj.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/18/2024] [Accepted: 04/24/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND This study aims to estimate the burden, trends, forecasts, and disparities of early musculoskeletal (MSK) disorders among individuals ages 15 to 39 years. METHODS The global prevalence, years lived with disabilities (YLDs), disability-adjusted life years (DALYs), projection, and inequality were estimated for early MSK diseases, including rheumatoid arthritis (RA), osteoarthritis (OA), low back pain (LBP), neck pain (NP), gout, and other MSK diseases (OMSKDs). FINDINGS More adolescents and young adults were expected to develop MSK disorders by 2050. Across five age groups, the rates of prevalence, YLDs, and DALYs for RA, NP, LBP, gout, and OMSKDs sharply increased from ages 15-19 to 35-39; however, these were negligible for OA before age 30 but increased notably at ages 30-34, rising at least 6-fold by 35-39. The disease burden of gout, LBP, and OA attributable to high BMI and gout attributable to kidney dysfunction increased, while the contribution of smoking to LBP and RA and occupational ergonomic factors to LBP decreased. Between 1990 and 2019, the slope index of inequality increased for six MSK disorders, and the relative concentration index increased for gout, NP, OA, and OMSKDs but decreased for LBP and RA. CONCLUSIONS Multilevel interventions should be initiated to prevent disease burden related to RA, NP, LBP, gout, and OMSKDs among individuals ages 15-19 and to OA among individuals ages 30-34 to tightly control high BMI and kidney dysfunction. FUNDING The Global Burden of Disease study is funded by the Bill and Melinda Gates Foundation. The project is funded by the Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38).
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Vollset SE, Ababneh HS, Abate YH, Abbafati C, Abbasgholizadeh R, Abbasian M, Abbastabar H, Abd Al Magied AHA, Abd ElHafeez S, Abdelkader A, Abdelmasseh M, Abd-Elsalam S, Abdi P, Abdollahi M, Abdoun M, Abdullahi A, Abebe M, Abiodun O, Aboagye RG, Abolhassani H, Abouzid M, Aboye GB, Abreu LG, Absalan A, Abualruz H, Abubakar B, Abukhadijah HJJ, Addolorato G, Adekanmbi V, Adetunji CO, Adetunji JB, Adeyeoluwa TE, Adha R, Adhikary RK, Adnani QES, Adzigbli LA, Afrashteh F, Afzal MS, Afzal S, Agbozo F, Agodi A, Agrawal A, Agyemang-Duah W, Ahinkorah BO, Ahlstrom AJ, Ahmad A, Ahmad F, Ahmad MM, Ahmad S, Ahmad S, Ahmed A, Ahmed A, Ahmed H, Ahmed S, Ahmed SA, Akinosoglou K, Akkaif MA, Akrami AE, Akter E, Al Awaidy S, Al Hasan SM, Al Mosa AS, Al Ta'ani O, Al Zaabi OAM, Alahdab F, Alajlani MM, Al-Ajlouni Y, Alalalmeh SO, Al-Aly Z, Alam K, Alam N, Alam T, Alam Z, Al-amer RM, Alanezi FM, Alanzi TM, Albakri A, Aldhaleei WA, Aldridge RW, Alemohammad SY, Alemu YM, Al-Gheethi AAS, Al-Hanawi MK, Ali A, Ali A, Ali I, Ali MU, Ali R, Ali SSS, Ali VE, Ali W, Al-Ibraheem A, Alicandro G, Alif SM, Aljunid SM, Alla F, Almazan JU, Al-Mekhlafi HM, Alqutaibi AY, Alrawashdeh A, Alrousan SM, Al-Sabah SK, Alsabri MA, Altaany Z, Al-Tammemi AB, Al-Tawfiq JA, Altirkawi KA, Aluh DO, Alvis-Guzman N, Al-Wardat MS, Al-Worafi YM, Aly H, Alyahya MS, Alzoubi KH, Al-Zyoud W, Amani R, Ameyaw EK, Amin TT, Amindarolzarbi A, Amiri S, Amirzade-Iranaq MH, Amu H, Amugsi DA, Ancuceanu R, Anderlini D, Anderson DB, Andrade PP, Andrei CL, Andrei T, Andrews EA, Anil A, Anil S, Anoushiravani A, Antony CM, Antriyandarti E, Anuoluwa BS, Anvari S, Anyasodor AE, Appiah F, Aquilano M, Arab JP, Arabloo J, Arafa EA, Arafat M, Aravkin AY, Ardekani A, Areda D, Aregawi BB, Aremu A, Ariffin H, Arkew M, Armani K, Artamonov AA, Arumugam A, Asghari-Jafarabadi M, Ashbaugh C, Astell-Burt T, Athari SS, Atorkey P, Atout MMW, Aujayeb A, Ausloos M, Awad H, Awotidebe AW, Ayatollahi H, Ayuso-Mateos JL, Azadnajafabad S, Azeez FK, Azevedo RMS, Badar M, Baghdadi S, Bagheri M, Bagheri N, Bai R, Baker JL, Bako AT, Balakrishnan S, Balcha WF, Baltatu OC, Barchitta M, Bardideh E, Barker-Collo SL, Bärnighausen TW, Barqawi HJ, Barteit S, Basiru A, Basso JD, Bastan MM, Basu S, Bauckneht M, Baune BT, Bayati M, Bayileyegn NS, Behnoush AH, Behzadi P, Beiranvand M, Bello OO, Belo L, Beloukas A, Bemanalizadeh M, Bensenor IM, Benzian H, Beran A, Berezvai Z, Bernstein RS, Bettencourt PJG, Beyene KA, Beyene MG, Bhagat DS, Bhagavathula AS, Bhala N, Bhandari D, Bharadwaj R, Bhardwaj N, Bhardwaj P, Bhargava A, Bhaskar S, Bhat V, Bhattacharjee NV, Bhatti GK, Bhatti JS, Bhatti MS, Bhuiyan MA, Bisignano C, Biswas B, Bjørge T, Bodolica V, Bodunrin AO, Bonakdar Hashemi M, Bora Basara B, Borhany H, Bosoka SA, Botero Carvajal A, Bouaoud S, Boufous S, Boxe C, Boyko EJ, Brady OJ, Braithwaite D, Brauer M, Brazo-Sayavera J, Brenner H, Brown CS, Browne AJ, Brugha T, Bryazka D, Bulamu NB, Buonsenso D, Burkart K, Burns RA, Busse R, Bustanji Y, Butt ZA, Caetano dos Santos FL, Çakmak Barsbay M, Calina D, Campos LA, Cao S, Capodici A, Cárdenas R, Carreras G, Carugno A, Carvalho M, Castaldelli-Maia JM, Castelpietra G, Cattaruzza MS, Caye A, Cegolon L, Cembranel F, Cenko E, Cerin E, Chadban SJ, Chadwick J, Chakraborty C, Chakraborty S, Chalek J, Chan JSK, Chandika RM, Chandy S, Charan J, Chaudhary AA, Chaurasia A, Chen AT, Chen H, Chen MX, Chen S, Cherbuin N, Chi G, Chichagi F, Chimed-Ochir O, Chimoriya R, Ching PR, Chirinos-Caceres JL, Chitheer A, Cho DY, Cho WCS, Choi DW, Chong B, Chong CL, Chopra H, Chu DT, Chung E, Chutiyami M, Clayton JT, Cogen RM, Cohen AJ, Columbus A, Comfort H, Conde J, Connolly JT, Cooper EEK, Cortese S, Cruz-Martins N, da Silva AG, Dadras O, Dai X, Dai Z, Dalton BE, Damiani G, Dandona L, Dandona R, Das JK, Das S, Das S, Dash NR, Davletov K, De la Hoz FP, De Leo D, Debopadhaya S, Delgado-Enciso I, Denova-Gutiérrez E, Dervenis N, Desai HD, Devanbu VGC, Dewan SMR, Dhama K, Dhane AS, Dhingra S, Dias da Silva D, Diaz 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A, Yazdani Nia I, Ye P, Yesodharan R, Yesuf SA, Yezli S, Yiğit A, Yiğit V, Yigzaw ZA, Yin D, Yip P, Yonemoto N, You Y, Younis MZ, Yu C, Yu EA, Yu Y, Yuan CW, Yusuf H, Zafar U, Zafari N, Zahid MH, Zakham F, Zaki N, Zerfu TA, Zhang H, Zhang J, Zhang L, Zhang Y, Zhang Z, Zhao XJG, Zhao Y, Zhao Z, Zhong C, Zhou B, Zhou J, Zhou S, Zhu B, Zhumagaliuly A, Zielińska M, Zoghi G, Zumla A, Zyoud SH, Zyoud SH, Smith AE, Murray CJL. Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2204-2256. [PMID: 38762325 PMCID: PMC11121021 DOI: 10.1016/s0140-6736(24)00685-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. METHODS Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. FINDINGS In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8-63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0-45·0] in 2050) and south Asia (31·7% [29·2-34·1] to 15·5% [13·7-17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4-40·3) to 41·1% (33·9-48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6-25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5-43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5-17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7-11·3) in the high-income super-region to 23·9% (20·7-27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5-6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2-26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [-0·6 to 3·6]). INTERPRETATION Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions. FUNDING Bill & Melinda Gates Foundation.
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Wang C, Zheng Y, Luo Z, Xie J, Chen X, Zhao L, Cao W, Xu Y, Wang F, Dong X, Tan F, Li N, He J. Socioeconomic characteristics, cancer mortality, and universal health coverage: A global analysis. MED 2024:S2666-6340(24)00172-7. [PMID: 38761802 DOI: 10.1016/j.medj.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/23/2024] [Accepted: 04/05/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Achieving universal health coverage (UHC) involves all individuals attaining accessible health interventions at an affordable cost. We examined current patterns and temporal trends of cancer mortality and UHC across sociodemographic index (SDI) settings, and quantified these association. METHODS We used data from the Global Burden of Disease Study 2019 and Our World in Data. The UHC effective coverage index was obtained to assess the potential population health gains delivered by health systems. The estimated annual percentage change (EAPC) with a 95% confidence interval (CI) was calculated to quantify the trend of cancer age-standardized mortality rate (ASMR). A generalized linear model was applied to estimate the association between ASMR and UHC. FINDINGS The high (EAPC = -0.9% [95% CI, -1.0%, -0.9%]) and high-middle (-0.9% [-1.0%, -0.8%]) SDI regions had the fastest decline in ASMR (per 100,000) for total cancers from 1990 to 2019. The overall UHC effective coverage index increased by 27.9% in the high-SDI quintile to 62.2% in the low-SDI quintile. A negative association was observed between ASMR for all-cancer (adjusted odds ratio [OR] = 0.87 [0.76, 0.99]), stomach (0.73 [0.56, 0.95]), breast (0.64 [0.52, 0.79]), cervical (0.42 [0.30, 0.60]), lip and oral cavity (0.55 [0.40, 0.75]), and nasopharynx (0.42 [0.26, 0.68]) cancers and high UHC level (the lowest as the reference). CONCLUSIONS Our findings strengthen the evidence base for achieving UHC to improve cancer outcomes. FUNDING This work is funded by the China National Natural Science Foundation and Chinese Academy of Medical Sciences Innovation Fund for Medical Science.
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Affiliation(s)
- Chenran Wang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yadi Zheng
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zilin Luo
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiaxin Xie
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaolu Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liang Zhao
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Cao
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yongjie Xu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Wang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuesi Dong
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengwei Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Ni Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China.
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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16
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Hone T, Gonçalves J, Seferidi P, Moreno-Serra R, Rocha R, Gupta I, Bhardwaj V, Hidayat T, Cai C, Suhrcke M, Millett C. Progress towards universal health coverage and inequalities in infant mortality: an analysis of 4·1 million births from 60 low-income and middle-income countries between 2000 and 2019. Lancet Glob Health 2024; 12:e744-e755. [PMID: 38614628 DOI: 10.1016/s2214-109x(24)00040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/14/2024] [Accepted: 01/19/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Expanding universal health coverage (UHC) might not be inherently beneficial to poorer populations without the explicit targeting and prioritising of low-income populations. This study examines whether the expansion of UHC between 2000 and 2019 is associated with reduced socioeconomic inequalities in infant mortality in low-income and middle-income countries (LMICs). METHODS We did a retrospective analysis of birth data compiled from Demographic and Health Surveys (DHSs). We analysed all births between 2000 and 2019 from all DHSs available for this period. The primary outcome was infant mortality, defined as death within 1 year of birth. Logistic regression models with country and year fixed effects assessed associations between country-level progress to UHC (using WHO's UHC service coverage index) and infant mortality (overall and by wealth quintile), adjusting for infant-level, mother-level, and country-level variables. FINDINGS A total of 4 065 868 births to 1 833 011 mothers were analysed from 177 DHSs covering 60 LMICs between 2000 and 2019. A one unit increase in the UHC index was associated with a 1·2% reduction in the risk of infant death (AOR 0·988, 95% CI 0·981-0·995; absolute measure of association, 0·57 deaths per 1000 livebirths). An estimated 15·5 million infant deaths were averted between 2000 and 2019 because of increases in UHC. However, richer wealth quintiles had larger associated reductions in infant mortality from UHC (quintile 5 AOR 0·983, 95% CI 0·973-0·993) than poorer quintiles (quintile 1 0·991, 0·985-0·998). In the early stages of UHC, UHC expansion was generally beneficial to poorer populations (ie, larger reductions in infant mortality for poorer households [infant deaths per 1000 per one unit increase in UHC coverage: quintile 1 0·84 vs quintile 5 0·59]), but became less so as overall coverage increased (quintile 1 0·64 vs quintile 5 0·57). INTERPRETATION Since UHC expansion in LMICs appears to become less beneficial to poorer populations as coverage increases, UHC policies should be explicitly designed to ensure lower income groups continue to benefit as coverage expands. FUNDING UK National Institute for Health and Care Research.
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Affiliation(s)
- Thomas Hone
- Public Health Policy Evaluation Unit, Imperial College London, London, UK; Instituto de Estudos para Políticas de Saúde, São Paulo, Brazil.
| | - Judite Gonçalves
- Public Health Policy Evaluation Unit, Imperial College London, London, UK; NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
| | - Paraskevi Seferidi
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
| | | | - Rudi Rocha
- Instituto de Estudos para Políticas de Saúde, São Paulo, Brazil; São Paulo School of Business Administration, Fundação Getulio Vargas, São Paulo, Brazil
| | - Indrani Gupta
- Institute of Economic Growth, University of Delhi, Delhi, India
| | - Vinayak Bhardwaj
- South African Medical Research Council and Wits Centre for Health Economics and Decision Science, PRICELESS South Africa, Faculty of Health Sciences, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Taufik Hidayat
- Center for Health Economics and Policy Studies, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia; Department of Economics, University of Sussex, Brighton, UK
| | - Chang Cai
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
| | - Marc Suhrcke
- Centre for Health Economics, University of York, Heslington, York, UK; Luxembourg Institute of Socio-economic Research, Esch-sur-Alzette, Luxembourg
| | - Christopher Millett
- Public Health Policy Evaluation Unit, Imperial College London, London, UK; NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
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17
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Safiri S, Noori M, Nejadghaderi SA, Shamekh A, Sullman MJM, Collins GS, Kolahi AA. The burden of schizophrenia in the Middle East and North Africa region, 1990-2019. Sci Rep 2024; 14:9720. [PMID: 38678101 PMCID: PMC11055947 DOI: 10.1038/s41598-024-59905-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 04/16/2024] [Indexed: 04/29/2024] Open
Abstract
Schizophrenia ranks as the third-most common cause of disability among mental disorders globally. This study presents findings on the prevalence, incidence and years lived with disability (YLDs) as a result of schizophrenia in the Middle East and North Africa (MENA), stratified by age, sex and sociodemographic index (SDI). We collected publicly accessible data from the Global Burden of Disease (GBD) study 2019. This study reports the burden of schizophrenia, from 1990 to 2019, for the 21 countries that comprise MENA. In 2019, MENA exhibited an age-standardised point prevalence of 248.2, an incidence rate of 14.7 and an YLD rate of 158.7 per 100,000, which have not changed substantially between 1990 and 2019. In 2019, the age-standardised YLD rate was highest in Qatar and lowest in Afghanistan. No MENA countries demonstrated noteworthy changes in the burden of schizophrenia from 1990 to 2019. Furthermore, in 2019, the highest number of prevalent cases and the point prevalence were observed among those aged 35-39, with a higher prevalence among males in almost all age categories. Additionally, in 2019, the age-standardised YLD rates in MENA were below the worldwide average. Finally, there was a positive correlation between the burden of schizophrenia and the SDI from 1990 to 2019. The disease burden of schizophrenia has remained relatively stable over the past thirty years. Nevertheless, as the regional life-expectancy continues to increase, the burden of schizophrenia is also expected to rise. Therefore, early planning for the increase in the burden of the disease is urgently needed in the region.
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Affiliation(s)
- Saeid Safiri
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Aria Nejadghaderi
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Ali Shamekh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Gary S Collins
- Centre for Statistics in Medicine, NDORMS, Botnar Research Centre, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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18
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Hu B, Feng J, Wang Y, Fan Y, Hou L. Global, regional and national temporal trends in prevalence for cardiovascular diseases in women of childbearing age, from 1990 to 2019: An age-period-cohort analysis. Heliyon 2024; 10:e28526. [PMID: 38601535 PMCID: PMC11004743 DOI: 10.1016/j.heliyon.2024.e28526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/12/2024] Open
Abstract
Background Epidemiological studies on cardiovascular diseases (CVD) among women of childbearing age (WCBA) remain scarce. Our research aims to delineate the prevalence trends of CVD within this population over the past three decades, considering age, period, and birth cohort dynamics. Methods Estimates of CVD prevalence for WCBA, along with their 95% uncertainty intervals (UI), were extracted from the Global Burden of Diseases 2019 (GBD2019). An age-period-cohort (APC) model was utilized to assess the annual percentage change (net drifts) in overall prevalence, annual percentage changes in prevalence for individual age groups (local drifts), and fitted longitudinal age-specific rates adjusted for age effects and period/cohort relative risks (period/cohort effect). Results In 2019, the global prevalence of CVD among WCBA was 53.42 million (95% UI: 47.77 to 60.18). Eight countries recorded a prevalence exceeding one million, accounting for 54.17% of the global CVD prevalence in WCBA. Over the past 30 years, the annual net drift in CVD prevalence among the global WCBA was 0.27% (95% CI: 0.25 to 0.29). This value was 0.01% (95% CI: 0.04 to 0.06) in regions with a high sociodemographic index (SDI) and 0.21% (95% CI: 0.19 to 0.22) in those with a low SDI. Seventy-seven countries demonstrated an increasing trend in CVD prevalence, while 53 showed a decrease, and 74 remained relatively stable. Notably, as shown in local drift, there was a rise in CVD prevalence among adolescents aged 15-19 and adults aged 40-49 in regions categorized by five distinct SDI levels. This drift varied by SDI regions. Regions with a high SDI consistently had elevated period risks throughout the study duration, while other regions had lower period risks until 2000-2004 and displayed increased adverse period risks. The prevalence in low-middle and low SDI regions manifested detrimental trends, whereas other regions demonstrated an initial decline followed by a surge in successive birth cohorts. Conclusions Resources dedicated to CVD care for WCBA are largely insufficient, especially in low SDI regions. Thus, there is an urgent need to allocate cardiovascular healthcare resources variably across different SDI regions, aiming to diminish risks among successively younger birth cohorts. Throughout this endeavor, the formulation of targeted policies and the judicious distribution of resources are essential to reduce risks for women across all age groups.
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Affiliation(s)
- Ben Hu
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, 230000, Anhui, China
| | - Jun Feng
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Yuhui Wang
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230000, Anhui, China
| | - Linlin Hou
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, 230000, Anhui, China
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19
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Beyrer C, Kamarulzaman A, Isbell M, Amon J, Baral S, Bassett MT, Cepeda J, Deacon H, Dean L, Fan L, Giacaman R, Gomes C, Gruskin S, Goyal R, Mon SHH, Jabbour S, Kazatchkine M, Kasoka K, Lyons C, Maleche A, Martin N, McKee M, Paiva V, Platt L, Puras D, Schooley R, Smoger G, Stackpool-Moore L, Vickerman P, Walker JG, Rubenstein L. Under threat: the International AIDS Society-Lancet Commission on Health and Human Rights. Lancet 2024; 403:1374-1418. [PMID: 38522449 DOI: 10.1016/s0140-6736(24)00302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 09/26/2023] [Accepted: 02/12/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Chris Beyrer
- Duke Global Health Institute, Duke University, Durham, NC, USA; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA.
| | | | | | - Joseph Amon
- Office of Global Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Mary T Bassett
- François-Xavier Bagnoud Center for Health and Human Rights, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Javier Cepeda
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Harriet Deacon
- Treatied Spaces Research Group and Centre of Excellence in Data Science, Artificial Intelligence and Modelling, University of Hull, Hull, UK
| | - Lorraine Dean
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | | | - Rita Giacaman
- Institute of Community and Public Health, Birzeit University, Birzeit, West Bank, Palestine
| | - Carolyn Gomes
- UNAIDS HIV & Human Rights Reference Group, Kingston, Jamaica
| | - Sofia Gruskin
- Institute on Inequalities in Global Health, University of Southern California, Los Angeles, CA, USA
| | - Ravi Goyal
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, CA, USA
| | | | | | | | | | - Carrie Lyons
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Allan Maleche
- Kenya Legal & Ethical Issues Network on HIV and AIDS, Nairobi, Kenya
| | - Natasha Martin
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, CA, USA
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, UK
| | - Vera Paiva
- Institute of Psychology, University of Sao Paulo, Sao Paulo, Brazil
| | - Lucy Platt
- London School of Hygiene & Tropical Medicine, London, UK
| | - Dainius Puras
- Clinic of Psychiatry, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Robert Schooley
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, CA, USA
| | | | | | | | | | - Leonard Rubenstein
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
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20
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Hu B, Feng J, Wang Y, Hou L, Fan Y. Transnational inequities in cardiovascular diseases from 1990 to 2019: exploration based on the global burden of disease study 2019. Front Public Health 2024; 12:1322574. [PMID: 38633238 PMCID: PMC11021694 DOI: 10.3389/fpubh.2024.1322574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/20/2024] [Indexed: 04/19/2024] Open
Abstract
Background To describe the burden and examine transnational inequities in overall cardiovascular disease (CVD) and ten specific CVDs across different levels of societal development. Methods Estimates of disability-adjusted life-years (DALYs) for each disease and their 95% uncertainty intervals (UI) were extracted from the Global Burden of Diseases (GBD). Inequalities in the distribution of CVD burdens were quantified using two standard metrics recommended absolute and relative inequalities by the World Health Organization (WHO), including the Slope Index of Inequality (SII) and the relative concentration Index. Results Between 1990 and 2019, for overall CVD, the Slope Index of Inequality changed from 3760.40 (95% CI: 3758.26 to 3756.53) in 1990 to 3400.38 (95% CI: 3398.64 to 3402.13) in 2019. For ischemic heart disease, it shifted from 2833.18 (95% CI: 2831.67 to 2834.69) in 1990 to 1560.28 (95% CI: 1559.07 to 1561.48) in 2019. Regarding hypertensive heart disease, the figures changed from-82.07 (95% CI: -82.56 to-81.59) in 1990 to 108.99 (95% CI: 108.57 to 109.40) in 2019. Regarding cardiomyopathy and myocarditis, the data evolved from 273.05 (95% CI: 272.62 to 273.47) in 1990 to 250.76 (95% CI: 250.42 to 251.09) in 2019. Concerning aortic aneurysm, the index transitioned from 104.91 (95% CI: 104.65 to 105.17) in 1990 to 91.14 (95% CI: 90.94 to 91.35) in 2019. Pertaining to endocarditis, the figures shifted from-4.50 (95% CI: -4.64 to-4.36) in 1990 to 16.00 (95% CI: 15.88 to 16.12) in 2019. As for rheumatic heart disease, the data transitioned from-345.95 (95% CI: -346.47 to-345.42) in 1990 to-204.34 (95% CI: -204.67 to-204.01) in 2019. Moreover, the relative concentration Index for overall CVD and each specific type also varied from 1990 to 2019. Conclusion There's significant heterogeneity in transnational health inequality for ten specific CVDs. Countries with higher levels of societal development may bear a relatively higher CVD burden except for rheumatic heart disease, with the extent of inequality changing over time.
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Affiliation(s)
- Ben Hu
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, Anhui, China
| | - Jun Feng
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Yuhui Wang
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Linlin Hou
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, Anhui, China
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
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21
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Alattas M, Gordon S, Sabin LL, El-Jardali F, Wirtz VJ. Equity and unmet need of non-communicable diseases services in Saudi Arabia using a National Household Survey (2019). BMC Health Serv Res 2024; 24:346. [PMID: 38491481 PMCID: PMC10943914 DOI: 10.1186/s12913-024-10787-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 02/26/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Saudi Arabia is implementing a comprehensive health system transformation in health services provision, governance, and financing. Given the high burden of non-communicable diseases (NCD), a key objective of the transformation is to integrate NCD prevention and treatment into primary care. The study objectives were to assess primary care service use for treatment of NCDs, to quantify existing inequities in preventive services utilization, and to identify regional and sociodemographic factors associated with these inequities. METHODS Using the 2019 Kingdom of Saudi Arabia World Health Survey, multivariable logistic regression models were conducted to identify predictors of utilization of primary care services for NCD prevention and treatment, unmet need among those with a diagnosis of diabetes, hypertension, or dyslipidemia, and unmet need in breast and cervical cancer screening. RESULTS Among those with an NCD diagnosis, living in a high-income household was associated with a lower probability of having an unmet need compared to those in low-income households. Furthermore, rural residents were less likely to have an unmet need compared to urban residents (OR 0.58, p=0.029). Individuals without a perceived need for healthcare within the last 12 months had three times the probability of unmet need in comparison to those with such a perceived need (p<0.001). Women in all regions had a lower probability of ever having a mammogram compared to women in the central regions around Riyadh. Women with an education above a secondary level had five times the odds of undergoing cervical cancer screening and three times the likelihood of ever having a mammogram (P=0.012, p=0.02) than other women. Compared to women in low-income households, those in middle (OR 1.99, P=0.026), upper middle (OR 3.47, p<0.001), or high-income households (OR 2.59, p<0.001) had a higher probability of having had cervical cancer screening. CONCLUSIONS Inequities in NCD treatment and prevention services' utilization in Saudi Arabia are strongly associated with region of living, population density, wealth, income, education and perceived need for health care. More research is needed to better understand the extent of unmet primary care needs for NCD and how to address the underlying contributing factors to access inequities.
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Affiliation(s)
- Maha Alattas
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA.
- Department of Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Sarah Gordon
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Lora L Sabin
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | | | - Veronika J Wirtz
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
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22
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Yin J, Deng R, Meng Q, Feng Y, Zhang T. The future of universal health coverage: How can low- and middle-income countries 'break free from cocoons and transform'? J Glob Health 2024; 14:03021. [PMID: 38483437 PMCID: PMC10939111 DOI: 10.7189/jogh.14.03021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Affiliation(s)
- Jianzhong Yin
- Yunnan Provincial Key Laboratory of Public Health and Biosafety and School of Public Health, Kunming Medical University, Kunming, China
- Baoshan College of Traditional Chinese Medicine, Baoshan, China
- Healthy Yunnan Development Think Tank, Kunming, China
| | - Rui Deng
- Yunnan Provincial Key Laboratory of Public Health and Biosafety and School of Public Health, Kunming Medical University, Kunming, China
| | - Qiong Meng
- Yunnan Provincial Key Laboratory of Public Health and Biosafety and School of Public Health, Kunming Medical University, Kunming, China
| | - Yuemei Feng
- Yunnan Provincial Key Laboratory of Public Health and Biosafety and School of Public Health, Kunming Medical University, Kunming, China
| | - Teng Zhang
- Yunnan Provincial Key Laboratory of Public Health and Biosafety and School of Public Health, Kunming Medical University, Kunming, China
- Baoshan College of Traditional Chinese Medicine, Baoshan, China
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23
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Bian Y, Huang X, Lin S, Han H, Chen J, Lin J, Ye X. PM 2.5 air quality and health gains in the quest for carbon peaking: A case study of Fujian Province, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 915:170161. [PMID: 38232847 DOI: 10.1016/j.scitotenv.2024.170161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/07/2024] [Accepted: 01/12/2024] [Indexed: 01/19/2024]
Abstract
China faces a dual challenge of improving air quality and reducing greenhouse gas (GHG) emissions. Stringent clean air actions gradually narrow the end-of-pipe (EOP) pollution control potential. Meanwhile, pursuing carbon peaking will reduce air pollution and health risks. However, the impact on air quality and health gains in individual Chinese provinces has not been assessed with a specific focus on local policies. Here, typical shared socio-economic pathways (SSPs) and local policies (i.e., business as usual, BAU; end-of-pipe controls, EOP; co-control mitigation, CCM) are combined to set three scenarios (i.e., BAU-SSP3, EOP-SSP4, CCM-SSP1). Under these three scenarios, we couple the Low Emissions Analysis Platform (LEAP) model, an air quality model and health risk assessment methodology to evaluate the characteristics of carbon peaking in Fujian Province. PM2.5 air quality and impacts on public health are assessed, using the metric of the deaths attributable to PM2.5 pollution (DAPP). The results show that energy-related CO2 emissions will only peak before 2030 in the CCM-SSP1 scenario. In this context, air pollutant emission pathways reveal that mitigation is limited under the EOP-SSP4 scenario, necessitating further mitigation under the CCM-SSP1 scenario. The annual average PM2.5 level is projected to be 16.5 μg·m-3 in 2035 with a corresponding decrease in DAPP of 297 (95 % confidence intervals: 217-308) compared with that of 2020. Despite the significant improvements in PM2.5 air quality and health gains under the CCM-SSP1 scenario, reaching the 5 μg·m-3 target of the World Health Organization (WHO) remains difficult. Furthermore, population aging will require stronger PM2.5 mitigation to enhance health gains. This study provides a valuable reference for other developing regions to co-control air pollution and GHGs.
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Affiliation(s)
- Yahui Bian
- Key Lab of Urban Environment and Health, Research Center of Urban Carbon Neutrality, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xiaobo Huang
- Shenzhen Academy of Environmental Sciences, Shenzhen 518001, China
| | - Shuifa Lin
- Key Lab of Urban Environment and Health, Research Center of Urban Carbon Neutrality, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Hui Han
- Key Lab of Urban Environment and Health, Research Center of Urban Carbon Neutrality, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jinsheng Chen
- University of Chinese Academy of Sciences, Beijing 100049, China; Center for Excellence in Regional Atmospheric Environment, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Jianyi Lin
- Key Lab of Urban Environment and Health, Research Center of Urban Carbon Neutrality, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Xinxin Ye
- Key Lab of Urban Environment and Health, Research Center of Urban Carbon Neutrality, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China.
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Yang S, Wang S, Liu G, Li R, Li X, Chen S, Wang J, Zhao Y, Liu M, He Y. Association of Sleep Status With Cognitive Functions in Centenarians: Evidence From Hainan Centenarian Cohort. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad185. [PMID: 38150001 PMCID: PMC10873833 DOI: 10.1093/geronb/gbad185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVES This study aimed to analyze the association between sleep quality, sleep duration, and cognitive functions among centenarians. METHODS The baseline data of the China Hainan Centenarians Cohort Study served as the foundation for this study. Logistic regression was utilized to demonstrate the relationship between sleep status and cognitive impairment. Moreover, a canonical correlation analysis was performed to analyze the correlation between these variables. RESULTS A total of 994 centenarians were included. After adjustment, poor sleep quality centenarians had an odds ratio of 1.77 (95% confidence interval [CI]: 1.00-3.09) for cognitive impairment when compared to centenarians with normal sleep quality. Centenarians who slept for more than 9 hr had a stronger association with severe cognitive impairment, indicated by an odds ratio of 1.41 (95% CI: 1.02-1.96), compared to those who slept for 7-9 hr. Additionally, the canonical correlation analysis results revealed that the linear combination of sleep quality V1, primarily determined by sleep latency, daytime dysfunction, and subjective sleep quality, was associated with cognitive function; the linear combination of cognitive function W1, mainly determined by orientation, attention and calculation, and memory. DISCUSSION There exists a correlation between poor sleep quality and cognitive impairment in centenarians, as well as a correlation between sleep duration >9 hr at night and severe cognitive impairment. The primary cognitive domains associated with sleep quality are orientation, calculation, and memory. It is imperative to monitor and safeguard the cognitive functions linked to poor sleep quality in the older individuals, with attention to orientation, calculation, and memory.
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Affiliation(s)
- Shanshan Yang
- Department of Disease Prevention and Control, First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Shengshu Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Guangdong Liu
- Graduate School, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Rongrong Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Xuehang Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Shimin Chen
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Jianhua Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yali Zhao
- Central Laboratory of Hainan Hospital, Chinese People’s Liberation Army General Hospital, Sanya, China
| | - Miao Liu
- Department of Statistics and Epidemiology, Graduate School, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yao He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
- State Key Laboratory of Kidney Diseases, Beijing, China
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Zhou Y, Wu Q, Li C, Meng P, Ding L. Inequalities in non-communicable disease management in China and progress toward universal health coverage: an analysis of nationwide household survey data from 2004 to 2018. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 44:100989. [PMID: 38226331 PMCID: PMC10788262 DOI: 10.1016/j.lanwpc.2023.100989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/16/2023] [Accepted: 12/04/2023] [Indexed: 01/17/2024]
Abstract
Background Prevention and control of non-communicable diseases (NCDs) become a policy priority in Universal Health Coverage (UHC) in China, while NCD management has never been comprehensively estimated at national and subnational levels. We aimed to assess NCD management in China nationally and in key subpopulations, investigate inequalities from multidimensions, and further examine its association with health financing and resources. Methods Data included were from China Chronic Disease and Risk Factors Surveillance (CCDRFS) and China Health and Nutrition Survey (CHNS). Following the WHO recommended frameworks, we selected eight NCD health service and risk management indicators and used meta-analysis to construct the composite NCD index. We explored the trends in and projections of NCD management index and indicators at national and subnational levels by using Bayesian regression models with average annual percentage change (AAPC) from 2004 to 2018 and probability of reaching the UHC target by 2030. We further conducted comprehensive inequality analyses of NCD indicators from multidimensions with patterns of changes over time using absolute difference and relative ratio. Finally, we quantified the associations between NCD management performance with health financing and resources using stochastic frontier analysis. Findings In China, the NCD management index increased slowly from 62.0% (95% CI 36.0 to 84.0) in 2004 to 64.3% (95% CI 44.0 to 82.2) in 2018, with lagging performance being observed in prevention domain (AAPC -0.1%, 95% CrI -1.0 to 0.8). And all management indicators presented low probabilities of accomplishing 2030 targets in China. Notably, based on subnational analysis, diverse tendency and magnitude of inequalities in multiple NCD indicators were identified with widening gaps between genders (non-overweight, diabetes treatment), age groups (non-use of tobacco), urban-rural areas (non-use of alcohol, non-use of tobacco), regions (sufficient physical activity), and wealth quintiles (non-overweight, sufficient physical activity). Additionally, it was observed that compared with urban area, rural area had constantly lower health resources and presented 2.2% lower NCD management performance in 2018. Importantly, we found that health financing and resources especially distributed in primary health care (PHC) facilities were closely and positively associated with NCD management performance. A 1000 yuan increase of government health expenditure (GHE) per capita and a 10 increase of medical beds per 1000 capita in PHC facilities were associated with a 4.0% (95% CI 2.0 to 6.0) and 6.8% (95% CI 0.2 to 13.5) increase of NCD management index, respectively. Interpretation The progress towards NCD management is slow at national level and in key subpopulations in China, with great challenges of existing and widening inequalities between genders, age groups, urban-rural areas, regions and socioeconomic groups. Rural and old people were still vulnerable populations who were lagging behind in NCD prevention and control. Optimising resource allocation by strengthening PHC especially in rural area, developing tailor-made programmes targeting specific populations such as old individuals, simultaneously integrating gender, education, and economic interventions to reduce inequalities should be prioritised to help China tackle NCDs during the progress towards UHC. Funding National Natural Science Foundation of China.
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Affiliation(s)
- Ying Zhou
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
| | - Qi Wu
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
| | - Chenshuang Li
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
| | - Pu Meng
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Lieyun Ding
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
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Paun RA, Jurchuk S, Tabrizian M. A landscape of recent advances in lipid nanoparticles and their translational potential for the treatment of solid tumors. Bioeng Transl Med 2024; 9:e10601. [PMID: 38435821 PMCID: PMC10905562 DOI: 10.1002/btm2.10601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 03/05/2024] Open
Abstract
Lipid nanoparticles (LNPs) are biocompatible drug delivery systems that have found numerous applications in medicine. Their versatile nature enables the encapsulation and targeting of various types of medically relevant molecular cargo, including oligonucleotides, proteins, and small molecules for the treatment of diseases, such as cancer. Cancers that form solid tumors are particularly relevant for LNP-based therapeutics due to the enhanced permeation and retention effect that allows nanoparticles to accumulate within the tumor tissue. Additionally, LNPs can be formulated for both locoregional and systemic delivery depending on the tumor type and stage. To date, LNPs have been used extensively in the clinic to reduce systemic toxicity and improve outcomes in cancer patients by encapsulating chemotherapeutic drugs. Next-generation lipid nanoparticles are currently being developed to expand their use in gene therapy and immunotherapy, as well as to enable the co-encapsulation of multiple drugs in a single system. Other developments include the design of targeted LNPs to specific cells and tissues, and triggerable release systems to control cargo delivery at the tumor site. This review paper highlights recent developments in LNP drug delivery formulations and focuses on the treatment of solid tumors, while also discussing some of their current translational limitations and potential opportunities in the field.
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Affiliation(s)
- Radu A. Paun
- Department of Biomedical Engineering, Faculty of Medicine and Health SciencesMcGill UniversityMontrealQuebecCanada
| | - Sarah Jurchuk
- Department of Biomedical Engineering, Faculty of Medicine and Health SciencesMcGill UniversityMontrealQuebecCanada
| | - Maryam Tabrizian
- Department of Biomedical Engineering, Faculty of Medicine and Health SciencesMcGill UniversityMontrealQuebecCanada
- Faculty of Dentistry and Oral Health SciencesMcGill UniversityMontrealQuebecCanada
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Eun SJ. Evaluating the effects of the 2017 National Health Insurance coverage expansion on amenable mortality and its disparities between areas in South Korea using Bayesian structural time-series models. Soc Sci Med 2024; 344:116574. [PMID: 38350249 DOI: 10.1016/j.socscimed.2024.116574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/31/2023] [Accepted: 01/05/2024] [Indexed: 02/15/2024]
Abstract
To improve the low coverage rate of the National Health Insurance (NHI), South Korea implemented the NHI coverage expansion plan in 2017 to cover medically essential non-covered services and reduce copayment rates. This study aimed to estimate the effects of the 2017 NHI coverage expansion on amenable mortality and its disparities between areas in South Korea under a controlled interrupted time-series design using Bayesian structural time-series models. Age-standardized amenable mortality rates and rate differences (RDs) and rate ratios (RRs) between areas for amenable mortality were calculated monthly between July 2012 and December 2021 and used as the response series. The non-equivalent control series were monthly non-avoidable mortality rates and their regional disparities. After the coverage expansion, amenable mortality rates decreased for both males (-8.8%, 95% credible interval [CrI] -13.4% to -3.9%) and females (-8.3%, 95% CrI -13.4% to -2.4%), with the largest decline in the non-Seoul-Capital metropolitan area (-11.6%, 95% CrI -16.5% to -6.3%) rather than the Seoul Capital Area (-7.5%, 95% CrI -11.9% to -2.5%) and a non-significant reduction in the non-Seoul-Capital non-metropolitan area in females. RDs and RRs between areas for amenable mortality decreased non-significantly (-16.2%, 95% CrI -31.3% to 2.6% for RD and -1.2%, 95% CrI -3.7% to 1.5% for RR), except for a significant decrease in RD in males (-21.8%, 95% CrI -38.0% to -1.5%), and decreased less in females than in males. The coverage expansion was generally effective in reducing amenable mortality rates by area, but had limited effects in closing amenable mortality disparities between areas, favoring males and the non-Seoul-Capital metropolitan area. These results implied that additional measures are necessary to improve access to quality health care for females and underserved areas to enhance the effectiveness of the coverage expansion.
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Affiliation(s)
- Sang Jun Eun
- Department of Preventive Medicine, Chungnam National University College of Medicine, 266 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
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Odd DE, Stoianova S, Williams T, Odd D, Edi-osagie N, McClymont C, Fleming P, Luyt K. Race and Ethnicity, Deprivation, and Infant Mortality in England, 2019-2022. JAMA Netw Open 2024; 7:e2355403. [PMID: 38345821 PMCID: PMC10862146 DOI: 10.1001/jamanetworkopen.2023.55403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/18/2023] [Indexed: 02/15/2024] Open
Abstract
Importance England has one of the highest infant mortality rates in Europe. Much of the variation in infant mortality rates between races and ethnicities may be due to socioeconomic factors, but how deprivation and race and ethnicity are associated with infant mortality is unclear. Objectives To investigate the association of infant race and ethnicity with the infant mortality rate in England, adjusted for preterm birth and level of deprivation. Design, Setting, and Participants This cohort study included children who died younger than 1 year of age, born at or after 22 weeks' gestation, occurring from April 1, 2019, to March 31, 2022, in England. Characteristics of the infant were derived from death notifications. Exposures The racial and ethnic groups were derived from National Health Service data and were reported by the parents and characterized using the Office of National Statistics classification: Asian or Asian British (Bangladeshi, Chinese, Indian, Pakistani, or any other Asian background), Black or Black British (African, Caribbean, or any other Black background), multiracial (White and Asian, White and Black African, White and Black Caribbean, or any other multiracial background), White or White British (British, Irish, any other White background, or Gypsy or Irish Traveler), and other (Arab or any other racial or ethnic group). Main Outcomes and Measures Risk of death for all racial and ethnic groups and relative risk of death compared with the reference group (White) were calcuated. Analyses were repeated, adjusting for deprivation, gestational age of infants, and region of England. Results A total of 5621 infants who died younger than 1 year of age were reported to the National Child Mortality Database. A total of 2842 of 5130 infants (55.4%) were male; the median gestational age was 33 weeks (IQR, 25-38 weeks); of 5149 infants, 927 (18.0%) were Asian, 448 (8.7%) were Black, 3318 (64.4%) were White, 343 (6.7%) were multiracial, and 113 (2.2%) were from other racial and ethnic groups; and the median deprivation score was 4 (IQR, 3-5). In the unadjusted analysis, the relative risk of death compared with White infants was higher for Black (1.93 [95% CI, 1.75-2.13]) and Asian (1.67 [95% CI, 1.55-1.80]) infants. The population attributable risk fraction for all mortality rates among infants who were not White was 12.0% (95% CI, 10.3%-13.8%) (unadjusted), 9.8% (95% CI, 8.0%-11.7%) (adjusted for deprivation), 7.7% (95% CI, 5.9%-9.5%) (adjusted for gestational age at birth), and 12.8% (95% CI, 11.0%-14.5%) (adjusted for region of England). Conclusions and Relevance This cohort study suggests that the proportion of infants who died before 1 year of age is associated with race and ethnicity, with a population attributable risk fraction of 12.0%. An overconservative adjustment for deprivation did not explain the overall patterns seen. Approximately half the population attributable risk fraction may be due to increased risk of preterm birth in Asian and Black communities. Work is needed to identify what can be done to reduce this incidence of infant mortality.
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Affiliation(s)
- David E. Odd
- Division of Population Medicine, School of Medicine, University of Cardiff, Cardiff, United Kingdom
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom
| | - Sylvia Stoianova
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom
| | - Tom Williams
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom
| | - Dawn Odd
- School of Health and Social Wellbeing, University of the West of England, Blackberry Hill, Bristol, United Kingdom
| | - Ngozi Edi-osagie
- Newborn Intensive Care Unit, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | | | - Peter Fleming
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom
| | - Karen Luyt
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
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Zhao H, Li L, Zhang X, Shi J, Lai W, Wang W, Guo L, Gong J, Lu C. Global, regional, and national burden of depressive disorders among young people aged 10-24 years, 2010-2019. J Psychiatr Res 2024; 170:47-57. [PMID: 38103449 DOI: 10.1016/j.jpsychires.2023.11.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 08/19/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE To describe the latest disease burden, temporal trends, and risk factors of depressive disorders among young people. METHODS Data from the Global Burden of Disease Study 2019 was utilized to analyze depressive disorders among individuals aged 10-24 years. The study focused on describing the incidence, prevalence, disability-adjusted life years (DALYs), and their attributable risk factors across 204 countries and territories from 2010 to 2019. The estimated annual percentage change (EAPC) was calculated to quantify the temporal trends. RESULTS Globally, the incidence, prevalence, and DALYs rate of depressive disorders per 100 000 young people increased from 3003.01, 2445.69, and 448.61 in 2010 to 3035.26, 2470.67, and 452.58 in 2019, indicating a slight upward trend (EAPC = 0.11 for incidence and prevalence; EAPC = 0.09 for DALYs rate). Notably, the percentage of DALYs of depressive disorders among young people increased substantially from 3.24% in 2010 to 3.66% in 2019, an increase of 13.06% (EAPC = 1.26, 95%CI: 1.08-1.44), and the burden of depressive disorders among young people rose from fouth to second in females, and from tenth to fifth in males. Social demographic index (SDI) and other indicators were positively correlated with the percentage of DALYs of depressive disorder and negatively correlated with the EAPC of DALYs. CONCLUSION The global burden of depressive disorders among young people is on the rise. The regional differences in depressive disorders among young people suggest the need for enhanced screening efforts in low-SDI areas, along with the adoption of more effective prevention and control measures.
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Affiliation(s)
- Hao Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Li Li
- Maternity and Children Health Care Hospital of Luohu District, Shenzhen, China
| | - Xuening Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Wenjian Lai
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Jianhua Gong
- Maternity and Children Health Care Hospital of Luohu District, Shenzhen, China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.
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Nabanoba C, Zakumumpa H. Experiences of membership in munno mubulwadde (your friend indeed) - a novel community-based health insurance scheme in Luwero district in rural central Uganda. BMC Health Serv Res 2024; 24:89. [PMID: 38233909 PMCID: PMC10792776 DOI: 10.1186/s12913-023-10517-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Community-Based Health Insurance (CBHI) schemes are recognized as an important health financing pathway to achieving universal health coverage (UHC). Although previous studies have documented CBHIs in low-income countries, the majority of these have been provider-based. Non-provider based schemes have received comparatively less empirical attention. We sought to describe a novel non-provider based CBHI munno mubulwadde (your friend indeed) comprising informal sector members in rural central Uganda to understand the structure of the scheme, the experiences of scheme members in terms of the perceived benefits and barriers to retention in the scheme. METHODS We report qualitative findings from a larger mixed-methods study. We conducted in-depth interviews with insured members (n = 18) and scheme administrators (n = 12). Four focus groups were conducted with insured members (38 participants). Data were inductively analyzed by thematic approach. RESULTS Munno mubulwadde is a union of ten CBHI schemes coordinated by one administrative structure. Members were predominantly low-income rural informal sector households who pay annual premiums ranging from $17 and $50 annually and received medical care at 13 scheme-contracted private health facilities in Luwero District in Central Uganda. Insured members reported that scheme membership protected them from catastrophic health expenditure during episodes of sickness among household members, and especially so among households with children under-five who were reported to fall sick frequently, the scheme enabled members to receive perceived better quality health care at private providers in the study district relative to the nearest public facilities. The identified barriers to retention in the scheme include inconvenient dates for premium payment that are misaligned with harvest periods for cash crops (e.g. maize corn) on which members depended for their agrarian livelihoods, long distances to insurance-contracted private providers, falling prices of cash crops which diminished real incomes and affordability of insurance premiums in successive years after initial enrolment. CONCLUSION Munno mubulwadde was perceived by as a valuable financial cushion during episodes of illness by rural informal sector households. Policy interventions for promoting price stability of cash crops in central Uganda could enhance retention of members in this non-provider CBHI which is worthy of further research as an additional funding pathway for realizing UHC in Uganda and other low-income settings.
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Affiliation(s)
- Christine Nabanoba
- Department of Social Work and Social Administration, Makerere University, Kampala, Uganda
| | - Henry Zakumumpa
- School of Public Health, Makerere University, Kampala, Uganda.
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Xin J, Luo Y, Xiang W, Zhu S, Niu H, Feng J, Sun L, Zhang B, Zhou X, Yang W. Measurement of the burdens of neonatal disorders in 204 countries, 1990-2019: a global burden of disease-based study. Front Public Health 2024; 11:1282451. [PMID: 38264240 PMCID: PMC10803531 DOI: 10.3389/fpubh.2023.1282451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/08/2023] [Indexed: 01/25/2024] Open
Abstract
Background Neonatal disorders are facing serious public health challenges. Previous studies were based on limited data sources and had a narrow geographical scope. We aim to understand the trends of alteration in the burden of neonatal disorders from 1990 to 2019 in 204 countries and territories. Methods Data were investigated from the Global Burden of Disease Study 2019. First, we visualized the burden of neonatal disorders using the number of cases and the age-standardized incidence rate (ASIR), death rate (ASDR), and disability-adjusted life years (ASR-DALYs) from 1990 to 2019. Second, estimated annual percentage changes (EAPCs) were used to evaluate the temporal trends of disease burden during different periods. Finally, the sociodemographic index (SDI) and human development index (HDI) were used to determine whether there exists a correlation between socioeconomic development level, human development level, and potential burden consequences. Results Overall, in the past 30 years, the ASIR trends have remained relatively steady, whereas the ASDR and ASR-DALYs have declined. However, the burden of neonatal disorders varied greatly in various regions and countries. Among 21 regions, the ASIR trend had the largest increase in Central Latin America (EAPC = 0.42, 95%CI = 0.33-0.50). Conversely, the ASDR and ASR-DALYs experienced the largest decrease in Central Europe (EAPC = -5.10, 95%CI = -5.28 to 4.93) and East Asia (EAPC = -4.07, 95%CI = -4.41 to 3.73), respectively. Among 204 countries, the ASIR (EAPC = 3.35, 95%CI = 3.13-3.56) trend in Greece displayed the most significant increase, while the ASDR (EAPC = 1.26, 95%CI = 1.01-1.50) and ASR-DALYs (EAPC = 1.26, 95%CI = 1.03-1.49) trends in Dominica experienced the most substantial increase. Furthermore, there was a strong correlation between the EAPCs in ASIR, ASDR, ASR-DALYs, and SDI or HDI in 2019, with some exceptions. In addition, countries with elevated levels of HDI experienced a faster increase in ASDR and ASR-DALYs for neonatal disorders. Conclusion Although the burden of neonatal disorders shows a downward trend from 1990 to 2019, it is still not optimistic. It is necessary to implement a multi-pronged approach to reduce the increasing burden of neonatal disorders.
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Affiliation(s)
- Juan Xin
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Continuing Education and Training Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
| | - Yiwen Luo
- School of Public Health, Jiaotong University Health Science Center, Xi’an, China
| | - Wanwan Xiang
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- School of Public Health, Jiaotong University Health Science Center, Xi’an, China
| | - Sijing Zhu
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Hui Niu
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- School of Public Health, Jiaotong University Health Science Center, Xi’an, China
| | - Jiayuan Feng
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- School of Public Health, Jiaotong University Health Science Center, Xi’an, China
| | - Landi Sun
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- School of Public Health, Jiaotong University Health Science Center, Xi’an, China
| | - Boxing Zhang
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- School of Public Health, Jiaotong University Health Science Center, Xi’an, China
| | - Xihui Zhou
- Department of Pediatrics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, Maternal and Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Klarman MB, Chi X, Cajusma Y, Flaherty KE, Capois AC, Dofiné MDV, Exantus L, Friesen J, Beau de Rochars VM, Becker T, Baril C, Gurka MJ, Nelson EJ. Development and evaluation of a clinical guideline for a paediatric telemedicine service in a low-resource setting. BMJ Paediatr Open 2024; 8:e002164. [PMID: 38191203 PMCID: PMC10806461 DOI: 10.1136/bmjpo-2023-002164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/14/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE To develop and evaluate a guideline for a paediatric telemedicine and medication delivery service (TMDS). METHODS A clinical guideline for paediatric telemedicine was derived from the World Health (WHO) Organization Integrated Management of Childhood Illness (IMCI) Handbook. The guideline was deployed at a TMDS in Haiti and evaluated through a prospective cohort study; children ≤10 years were enrolled. For non-severe cases, paired virtual and in-person examinations were conducted at the call centre and household; severe cases were referred to the hospital. The performance of virtual examination components were evaluated by comparison with the paired in-person examination findings (reference). RESULTS A total of 391 cases were enrolled. Among the 320 cases with paired examinations, no general WHO danger signs were identified during in-person examinations; 5 cases (2%) required hospital referral due to problem-specific danger signs or other reasons for escalation. Cohen's kappa for the virtual designation of mild cases was 0.78 (95% CI: 0.69 to 0.87). The sensitivity and specificity of a virtually reported fever were 91% (95% CI: 87% to 96%) and 69% (95% CI: 62% to 76%), respectively; the sensitivity and specificity of virtually reported 'fast breathing' were 47% (95% CI: 21% to 72%) and 89% (95% CI: 85% to 94%), respectively. Kappa for 'no' and 'some' dehydration indicated moderate congruence between virtual and in-person examinations (0.69; 95% CI: 0.41 to 0.98). At 10 days, 273 (95%) of the 287 cases reached by phone were better/recovered. CONCLUSION Critical components of the virtual examination (triage, danger signs and dehydration assessment) performed well despite varied performance among the problem-specific components. The study and associated resources represents formative steps towards an evidence-based paediatric telemedicine guideline built on WHO clinical principles. In-person examinations for select cases were important to address limitations with virtual examinations and identify cases for escalation. TRIAL REGISTRATION NUMBER NCT03943654.
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Affiliation(s)
- Molly B Klarman
- Department of Pediatrics, University of Florida, Gainesville, Florida, USA
| | - Xiaofei Chi
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Youseline Cajusma
- Department of Pediatrics, University of Florida, Gainesville, Florida, USA
| | - Katelyn E Flaherty
- Departments of Emergency Medicine and Environmental and Global Health, University of Florida, Gainesville, Florida, USA
| | - Anne Carine Capois
- Department of Pediatrics, University of Florida, Gainesville, Florida, USA
| | | | - Lerby Exantus
- Faculté de Médecine et de Pharmacie, Université d'État d'Haiti, Port-au-Prince, Haiti
| | | | | | - Torben Becker
- Department of Emergency Medicine, University of Florida, Gainesville, Florida, USA
| | - Chantale Baril
- Faculté de Médecine et de Pharmacie, Université d'État d'Haiti, Port-au-Prince, Haiti
| | - Matthew J Gurka
- Departments of Pediatrics and Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Eric J Nelson
- Departments of Pediatrics and Environmental and Global Health, University of Florida, Gainesville, Florida, USA
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Huang X, He Y, Xu H, Shen Y, Pan X, Wu J, Chen K. Association between sociodemographic status and the T2DM-related risks in China: implication for reducing T2DM disease burden. Front Public Health 2024; 11:1297203. [PMID: 38259760 PMCID: PMC10801005 DOI: 10.3389/fpubh.2023.1297203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/07/2023] [Indexed: 01/24/2024] Open
Abstract
Objective Analyzing the association between sociodemographic status and the type 2 diabetes mellitus (T2DM)-related risks in China to reduce the disease burden of T2DM. Methods We downloaded data from the Global Burden of Disease Study 2019 to estimate the disease burden of T2DM in China. Secondary analyses were performed by year, age, gender, summary exposure value (SEV), and sociodemographic index (SDI). Results In China, it is estimated that 3.74 (3.44-4.10) million incidence, 90.0 (82.3-98.5) million prevalence, 168.4 (143.2-194.0) thousand deaths, and 9.6 (7.6-11.9) million DALYs occurred in 2019, showing an increase of 96.8, 156.7, 162.8, and 145.4% compared to 1990. An inverse U-shaped curve was observed for the correlations between T2DM-related burden and SDI. A heavier burden was found in males. The top four risk factors were high body mass index (HBMI), dietary risks, air pollution and tobacco. HBMI, as the key risk, accounted for half of the disease burden of T2DM in China. Lower degree of SEV and higher level of attributable T2DM-related burden could be found in main risks, meaning their critical role of them in the development and progression of T2DM. An inverse U-shaped curve could be found in the association between age-standardized incidence, mortality, DALYs rate, and SDI. Conclusion The disease burden of T2DM has rapidly increased in China. Gender disparities, different age distributions and inconsistent socioeconomic levels all played an important role in it. The key risk was HBMI. With the improvement of socioeconomic level, the main risk factors for T2DM have changed from environmental factors to lifestyle factors. Targeted control and preventative strategies to address adjustable risk factors could put an end to this soaring burden.
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Affiliation(s)
- Xin Huang
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
| | - Yinhui He
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
| | - Haiyan Xu
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
| | - Yuyan Shen
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of ZheJiang University School of Medicine, Zhejiang, China
| | - Xiaowen Pan
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of ZheJiang University School of Medicine, Zhejiang, China
| | - Junyun Wu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of ZheJiang University School of Medicine, Zhejiang, China
| | - Kai Chen
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
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Leonardi M, Martelletti P, Burstein R, Fornari A, Grazzi L, Guekht A, Lipton RB, Mitsikostas DD, Olesen J, Owolabi MO, Ruiz De la Torre E, Sacco S, Steiner TJ, Surya N, Takeshima T, Tassorelli C, Wang SJ, Wijeratne T, Yu S, Raggi A. The World Health Organization Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders and the headache revolution: from headache burden to a global action plan for headache disorders. J Headache Pain 2024; 25:4. [PMID: 38178049 PMCID: PMC10768290 DOI: 10.1186/s10194-023-01700-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 01/06/2024] Open
Abstract
The World Health Organization (WHO) Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders was developed by WHO to address the worldwide challenges and gaps in provision of care and services for people with epilepsy and other neurological disorders and to ensure a comprehensive, coordinated response across sectors to the burden of neurologic diseases and to promote brain health across life-course. Headache disorders constitute the second most burdensome of all neurological diseases after stroke, but the first if young and midlife adults are taken into account. Despite the availability of a range of treatments, disability associated with headache disorders, and with migraine, remains very high. In addition, there are inequalities between high-income and low and middle income countries in access to medical care. In line with several brain health initiatives following the WHOiGAP resolution, herein we tailor the main pillars of the action plan to headache disorders: (1) raising policy prioritization and strengthen governance; (2) providing effective, timely and responsive diagnosis, treatment and care; (3) implementing strategies for promotion and prevention; (4) fostering research and innovation and strengthen information systems. Specific targets for future policy actions are proposed. The Global Action Plan triggered a revolution in neurology, not only by increasing public awareness of brain disorders and brain health but also by boosting the number of neurologists in training, raising research funding and making neurology a public health priority for policy makers. Reducing the burden of headache disorders will not only improve the quality of life and wellbeing of people with headache but also reduce the burden of neurological disorders increasing global brain health and, thus, global population health.
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Affiliation(s)
- Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | | | - Rami Burstein
- John Hedley-Whyte Professor of Anesthesia and Neuroscience at the Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Arianna Fornari
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Licia Grazzi
- Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Richard B Lipton
- Montefiore Headache Center and the Albert Einstein College of Medicine, New York, Bronx, USA
| | - Dimos Dimitrios Mitsikostas
- 1st Neurology Department, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jes Olesen
- Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mayowa Ojo Owolabi
- Faculty of Clinical Sciences, Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway
- Department of Neurology, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
- Division of Brain Sciences, Imperial College London, London, UK
| | | | - Takao Takeshima
- Department of Neurology, Headache Center, Tominaga Hospital, Osaka, Japan
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Shuu-Jiun Wang
- College of Medicine and Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tissa Wijeratne
- Department of Neurology, Sunshine Hospital, St Albans, VIC, Australia
- Australian Institute of Migraine, Pascoe Vale South, Victoria, Australia
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
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Saleem TH, Rizk MA, Abdelhafez NF, Sabra A, Radwan E. Upregulation of BRCA1 and 2 protein expression is associated with dysregulation in amino acids profiles in breast cancer. Mol Biol Rep 2024; 51:50. [PMID: 38165507 PMCID: PMC10761515 DOI: 10.1007/s11033-023-09028-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/06/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The prevalence of breast cancer (BC) is high among cancers in Egypt, ranking it the most common cause of cancer mortality in women. BRCA1 and BRCA2 tumor suppressors proteins have a specific relationship with BC. Plasma free amino acids levels (PFAAs) have been reported to exhibit altered profiles among cancer patients. Thus, the present study aims to examine the alteration of the PFAAs profiles and investigate their association with BRCA1 and 2 circulating levels in Egyptian females diagnosed with BC and in females with family history of BC to establish potential early detection strategies for BC. METHODS AND RESULTS This study included 26 BC patients, 22 females with family history of BC (relatives) in addition to 38 healthy females as control group. Quantitative measurement of PFAAs was determined by the ion exchange separation method through high performance liquid chromatography. BRCA1 and BRCA2 concentrations were determined using ELISA. Our results showed PFAAs profiles in BC patients and in females with BC family history with significant upregulation in mean plasma levels of Alanine, Phenylalanine, Glutamate and Cysteine and downregulation of Taurine, Threonine, Serine, Glycine, Valine, Methionine and Histidine levels compared to controls. Also, a significant positive correlation was observed between plasma BRCA1 and Valine levels while a significant negative correlation was observed between BRCA2 and Lysine plasma levels. CONCLUSION PFAAs profile can potentially be used in early screening for BC patients and for susceptible females.
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Affiliation(s)
- Tahia H Saleem
- Medical Biochemistry Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohamed A Rizk
- General Surgery Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nashwa F Abdelhafez
- Anesthesia and Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed Sabra
- Medical Biochemistry Department, Faculty of Medicine, Merit University, Sohag, Egypt
| | - Eman Radwan
- Medical Biochemistry Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
- Biochemistry Department, Sphinx University, New Assiut, Assiut, Egypt.
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Azarbakhsh H, Rezaei F, Dehghani SS, Hassanzadeh J, Janfada M, Mirahmadizadeh A. Trend Analysis of Lung Cancer Mortality and Years of Life Lost (YLL) in South of Iran, 2004-2019. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:238-245. [PMID: 38694860 PMCID: PMC11058385 DOI: 10.18502/ijph.v53i1.14700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/19/2022] [Indexed: 05/04/2024]
Abstract
Background We aimed to determine the mortality rate and Years of Life Lost (YLL) due to lung cancer in Fars, Iran, during the period from 2004 to 2019. Methods All deaths due to lung cancer in Fars Province, Iran from the electronic population-based death registration system (EDRS) were obtained. Crude mortality rate, age-standardized mortality rate, YLL and YLL rate data were calculated and trends examined. Results During 2004-2019, 3346 deaths occurred due to lung cancer in Fars Province, which was 10.8% (3346/30936) of the total cancer deaths in this period. Crude mortality rate of lung cancer had increased 70% and 53% in male and female respectively from 2004 to 2019. The total YLL of lung cancer during the 16-year study period was 28,094 (0.9 per 1000) in men, 14,174 (0.5 per 1000) in women, and 42,268 (0.8 per 1000) in both sexes (sex ratio male/female=2). According to the join point regression, the 16- year trend of YLL rate due to premature mortality was increasing: APC was 2.5% (95% CI 0.9 to 4.2, P=0.005) for males, 1.4% (95% CI 0.3 to 2.6, P=0.017) for females. Conclusion The mortality rate and YLL due to lung cancer in Fars Province is increasing, although the standardized mortality has a constant trend. Tobacco control is the most effective and least expensive way to reduce the number of lung cancer patients worldwide. National and local media can also play an important role in informing people about the risk factors.
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Affiliation(s)
- Habibollah Azarbakhsh
- Department of Epidemiology, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Rezaei
- Research Center for Social Determinants of Health, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Jafar Hassanzadeh
- Department of Epidemiology, Institute of Health, Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Janfada
- Medical Records, Health Vice-Chancellor, Shiraz University of medical Sciences, Shiraz, Iran
| | - Alireza Mirahmadizadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Hong T, Sun F, Wang Q, Chen X, Han K. Global burden of diabetes mellitus from 1990 to 2019 attributable to dietary factors: An analysis of the Global Burden of Disease Study 2019. Diabetes Obes Metab 2024; 26:85-96. [PMID: 37743825 DOI: 10.1111/dom.15290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/19/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023]
Abstract
AIMS To analyse spatial and temporal changes in the global burden of diabetes mellitus (DM) attributable to dietary factors from 1990 to 2019. MATERIALS AND METHODS The burden of DM was analysed in terms of age-standardized disability-adjusted life-year (DALY) rates and age-standardized death rates (ASDRs), which were obtained from the Global Burden of Disease Study 2019, and their corresponding estimated annual percentage changes (EAPCs). RESULTS The ASDR exhibited a decreasing trend (EAPC = -0.02), while the age-standardized DALY rate exhibited an increasing trend (EAPC = 0.65). Forty-four percent of the burden of DM was attributable to dietary factors, with the three largest contributors being high intake of red meat, high intake of processed meat, and low intake of fruit. Residence in a region with a high sociodemographic index (SDI) was associated with a diet low in whole grains and high in red meat and processed meat, while residence in a low-SDI region was associated with a diet low in whole grains and fruits, and high in red meat. CONCLUSIONS The age-standardized DALYs of DM attributable to dietary factors increased between 1990 and 2019 but differed among areas. The three largest dietary contributors to the burden of DM were high intake of red meat, high intake of processed meat, and low intake of fruit.
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Affiliation(s)
- Ting Hong
- Department of Endocrinology, Beilun District People's Hospital, Ningbo, China
| | - Fangfang Sun
- Department of Endocrinology, Beilun District People's Hospital, Ningbo, China
| | - Qiwei Wang
- Department of Endocrinology, Beilun District People's Hospital, Ningbo, China
| | - Xufeng Chen
- Department of Rehabilitation Medicine, Ningbo No.2 Hospital, University of the Chinese Academy of Sciences, Ningbo, China
| | - Kun Han
- Department of Neurology, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
- Department of Geriatric and Neurology, Ningbo, Zhejiang, China
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Gao P, Cao G, Liu J, Yang F, Liu M. Global, regional, and national trends in incidence of depression among women, 1990-2019: An analysis of the global burden of disease study. Psychiatry Res 2024; 331:115668. [PMID: 38101074 DOI: 10.1016/j.psychres.2023.115668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 08/30/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
Depression is a common mental disorder and more women are affected by depression than men. In this study, we aimed to analyze the trends in the incidence of depression among women from 1990 to 2019 and their associations with sociodemographic and universal health coverage indices based on data from the Global Burden of Disease study 2019. It was observed that while the incidence rate of depression among women decreased by an average of 0.35% per year at the global level, the incidence rate increased at the regional level for the high sociodemographic index region by an average of 0.39% per year from 1990 to 2019. And the global downward trend in incidence rate from 1990 to 2019 was contributed by the downward trend from 2000 to 2009. In Spearman correlation analyzes at the level of country/territory, a negative correlation between the estimated annual percentage change in the incidence rate and the universal health coverage index was found (ρ=-0.15).
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Affiliation(s)
- Peng Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China, Address: No.38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Guiying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China, Address: No.38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China, Address: No.38, Xueyuan Road, Haidian District, Beijing 100191, China; Institute for Global Health and Development, Peking University, Beijing, China, Address: No.5, Yiheyuan Road, Haidian District, Beijing 100871, China
| | - Fude Yang
- Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China, Address: No.7 Huilongguan Nandian Road, Changping District, Beijing 100096, China.
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China, Address: No.38, Xueyuan Road, Haidian District, Beijing 100191, China.
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Safiri S, Hassanzadeh K, Janbaz Alamdary S, Mousavi SE, Nejadghaderi SA, Sullman MJM, Naghdi-Sedeh N, Kolahi AA. The burden of testicular cancer from 1990 to 2019 in the Middle East and North Africa region. Front Oncol 2023; 13:1276965. [PMID: 38188291 PMCID: PMC10767553 DOI: 10.3389/fonc.2023.1276965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024] Open
Abstract
Background The incidence rate of testicular cancer has risen in many countries during recent decades. This study aimed to outline the impact of testicular cancer on the Middle East and North Africa (MENA) region from 1990 to 2019, examining its burden by age group and according to the socio-demographic index (SDI). Methods Data on the incidence, death, and disability-adjusted life-years (DALYs) due to testicular cancer were retrieved from the Global Burden of Disease study 2019. The counts and age-standardized rates (per 100,000) were reported, and all rates were accompanied by 95% uncertainty intervals (UIs). Results In MENA, the age-standardized incidence rate of testicular cancer was 1.4 per 100,000 in 2019, showing a 244.0% increase since 1990. Similarly, the annual death rate, at 0.1, experienced a 2.6% rise during the same period. In 2019, testicular cancer accounted for 31.1 thousand DALYs, marking an age-standardized rate of 5.0, which was 2.8% higher than in 1990. The 1-4 age group exhibited the largest incidence rate in 2019. In addition, in both 1990 and 2019 the MENA/Global DALY ratio was higher than one in the 1-14 year age groups. During the period 1990 to 2019, the age-standardized DALY rate of testicular cancer steadily rose with higher SDI values, except for a decrease observed at an SDI of 0.8. Conclusion Over the last thirty years, there has been a notable rise in the burden of testicular cancer in the MENA region.
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Affiliation(s)
- Saeid Safiri
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kamaleddin Hassanzadeh
- Department of Urology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Seyed Ehsan Mousavi
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Nima Naghdi-Sedeh
- Department of Urology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Birhanu F, Yitbarek K. Wealth-based inequity in full child vaccination coverage: An experience from Mali, Bangladesh, and South Africa. A multilevel poison regression. PLoS One 2023; 18:e0293522. [PMID: 38117824 PMCID: PMC10732374 DOI: 10.1371/journal.pone.0293522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 10/15/2023] [Indexed: 12/22/2023] Open
Abstract
OBJECTIVES Every child around the globe should get routine childhood vaccination, which is mostly affected by the country's economic capacity besides the socioeconomic differences. However, how well countries with different economic capacities address equitable child vaccination remains unanswered. METHODS Cross-sectional data from the latest Demographic and Health Survey (DHS) database of Mali, Bangladesh, and South Africa was used for this study. The dependent variable was full child vaccination, and wealth-based inequality was assessed using rate-ratio, concentration curve, and concentration index. A multilevel Poisson regression analysis was used to determine the predictors of inequalities. A risk ratio (RR) with a p-value of 0.05 was used to declare statistical significance. All analysis was weighted. RESULTS Full child vaccination status was 30.15%, 62.18%, and 46.94% in Mali, Bangladesh, and South Africa respectively. Even if the disparity is higher in Mali, the full vaccination favors the better-off family both in Mali, and Bangladesh respectively [CInd: 0.05, 95% CI: 0.01, 0.09], [CInd: 0.02, 95% CI: 0.001, 0.03], wealth status did not have an effect in South Africa. The multilevel poison regression indicated maternal age, occupation, wealth of household, and frequency of watching television to positively affect full vaccination, whereas the number of children in the house negatively affected full vaccination. CONCLUSION Wealth-based inequality in child vaccination was higher in Mali followed by Bangladesh. There was no observable significant equity gap in South Africa. Wealth status, maternal occupation, maternal age, frequency of watching television, and number of children were predictors of full child vaccination.
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Affiliation(s)
- Frehiwot Birhanu
- School of Public Health, College of Health Science, Mizan-Tepi University, Mizan Aman, Southwest Ethiopia
| | - Kiddus Yitbarek
- Department of Health Policy and Management, Institute of Health, Jimma University, Jimma, Ethiopia
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Barcellona C, Mariñas YB, Tan SY, Lee G, Ko KC, Chham S, Chhorvann C, Leerapan B, Pham Tien N, Lim J. Measuring health equity in the ASEAN region: conceptual framework and assessment of data availability. Int J Equity Health 2023; 22:251. [PMID: 38053205 PMCID: PMC10696689 DOI: 10.1186/s12939-023-02059-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/13/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Existing research on health equity falls short of identifying a comprehensive set of indicators for measurement across health systems. Health systems in the ASEAN region, in particular, lack a standardised framework to assess health equity. This paper proposes a comprehensive framework to measure health equity in the ASEAN region and highlights current gaps in data availability according to its indicator components. METHODS A comprehensive literature review was undertaken to map out a core set of indicators to evaluate health equity at the health system level. Secondary data collection was subsequently conducted to assess current data availability for ASEAN states in key global health databases, national health accounts, and policy documents. RESULTS A robust framework to measure health equity was developed comprising 195 indicators across Health System Inputs and Processes, Outputs, Outcomes, and Contextual Factors. Total indicator data availability equated to 72.9% (1423/1950). Across the ASEAN region, the Inputs and Processes sub-component of Health Financing had complete data availability for all indicators (160/160, 100%), while Access to Essential Medicine had the least data available (6/30, 20%). Under Outputs and Outcomes, Coverage of Selected Interventions (161/270, 59.63%) and Population Health (350/350, 100%) respectively had the most data available, while other indicator sub-components had little to none (≤ 38%). 72.145% (384/530) of data is available for all Contextual Factors. Out of the 10 ASEAN countries, the Philippines had the highest data availability overall at 77.44% (151/195), while Brunei Darussalam and Vietnam had the lowest data availability at 67.18% (131/195). CONCLUSIONS The data availability gaps highlighted in this study underscore the need for a standardised framework to guide data collection and benchmarking of health equity in ASEAN. There is a need to prioritise regular data collection for overlooked indicator areas and in countries with low levels of data availability. The application of this indicator framework and resulting data availability analysis could be conducted beyond ASEAN to enable cross-regional benchmarking of health equity.
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Affiliation(s)
- Capucine Barcellona
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | | | - Si Ying Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Gabriel Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Savina Chham
- National Institute of Public Health Cambodia, Phnom Penh, Cambodia
| | - Chhea Chhorvann
- National Institute of Public Health Cambodia, Phnom Penh, Cambodia
| | - Borwornsom Leerapan
- Faculty of Medicine Ramathibodi Hospital, Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Jeremy Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Mansour O, Kazem A, El Wakil A. Assessment of breast cytoarchitecture and its associated axillary lymph node status under normal and pathological conditions in Egyptian women. Tissue Cell 2023; 85:102244. [PMID: 37856936 DOI: 10.1016/j.tice.2023.102244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/06/2023] [Accepted: 10/13/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Herein, we compare the features of neoplastic cancer cells in invasive ductal carcinoma (IDC) grade II and III patients to their corresponding normal cells both in breast and axillary lymph node (ALN) tissues. METHODS A retrospective cohort of 70 female breast cancer patients enrolled between 2018 and 2020 at Medical Research Institute, Alexandria University, Egypt, was analyzed for clinicopathological features presentation. Fresh tiny pieces of breast tissue and its associated ALN tissues were then processed to investigate the morphological appearance by scanning electron microscopy. Moreover, the histological architecture of tissue sections stained with hematoxylin and eosin was studied by light microscope, while the characterization of the ultrastructure features of breast and ALN tissues was analyzed by transmission electron microscopy. RESULTS Clinicopathological presentation of patients revealed that the Egyptian female breast cancer population adhered to the global trends of breast cancer disease with elevated incidence rate among postmenopausal women (61.3%), high frequency of IDC (95.7%), and increased ALN metastasis (65.7%). The percentage of estrogen receptor alpha (ERα) and human epidermal growth factor receptor 2 (HER2) expression, as key indicators for carcinogenesis and disease progression was 87.1% and 55.8%, respectively. The present study points to the observed discrepancies among the investigated variables in the diagnostic separation between IDC grade II and grade III. Ductal epithelial cells organization, nuclei size and irregularity, chromatin amount and uniformity, mitochondrial abundance and dysfunction were differentially manifested in IDC grades. Moreover, aberrations in the cellular organelles like lysosomes, endoplasmic reticulum, and lipid droplets vary according to the grade of IDC and the aggressiveness of the invasive breast cancer. CONCLUSIONS To sum up, this study emphasizes the importance of accurate specimen evaluation for treatment choice and decision.
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Affiliation(s)
- Omnia Mansour
- Department of Biological and Geological Sciences, Faculty of Education, Alexandria University, Egypt
| | - Amani Kazem
- Department of Pathology, Medical Research Institute, Alexandria University, Egypt
| | - Abeer El Wakil
- Department of Biological and Geological Sciences, Faculty of Education, Alexandria University, Egypt.
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Allen LN, Azab H, Jonga R, Gordon I, Karanja S, Thaker N, Evans J, Ramke J, Bastawrous A. Rapid methods for identifying barriers and solutions to improve access to community health services: a scoping review. BJGP Open 2023; 7:BJGPO.2023.0047. [PMID: 37474255 PMCID: PMC11176707 DOI: 10.3399/bjgpo.2023.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/15/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The advancement of universal health coverage (UHC) is largely based on identifying and addressing barriers to accessing community health services. Traditional qualitative research approaches provide excellent insights but have unfeasibly high resource requirements for most care providers. AIM To identify, categorise, and evaluate methods that have been used to identify barriers to and/or solutions for improving access to community-based health services, grounded in engagement with affected communities, excluding approaches that take >14 days. DESIGN & SETTING This was a scoping review. METHOD Following Joanna Briggs Institute (JBI) guidelines, a search was undertaken using the Cochrane Library, Ovid MEDLINE, Ovid Embase, Ovid Global Health, and Google Scholar. An information specialist designed the search, and dual independent review and data charting were used. RESULTS In total, 44 studies were included from 30 countries, reporting on 18 different clinical services. Thirty studies used self-described 'rapid' approaches; however, the majority of these did not justify what they meant by this term. Nearly half of the studies used mixed- or multi-methods and triangulation to verify early findings. All of the qualitative studies used interviews and/or focus groups, which were often supplemented with observations, document review, and mapping activities. The use of in situ snowball and convenience sampling; community members as data collectors and cultural guides; collaborative summarisation (review of findings with community members and end-users); and deductive framework analysis expedited the research processes. There were no data on costs. CONCLUSION There are a wide range of methods that can be used to deliver timely information about barriers to access. The methods employed in the articles reviewed tended to use traditional data collection approaches in innovative ways.
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Affiliation(s)
- Luke N Allen
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Hagar Azab
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Ronald Jonga
- Department of Audit and Clinical Effectiveness, Northampton Foundation trust, Northampton, UK
| | - Iris Gordon
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah Karanja
- Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Nam Thaker
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Jennifer Evans
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Jacqueline Ramke
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrew Bastawrous
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
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Xie D, Ma T, Cui H, Li J, Zhang A, Sheng Z, Xie Y. Global burden and influencing factors of chronic kidney disease due to type 2 diabetes in adults aged 20-59 years, 1990-2019. Sci Rep 2023; 13:20234. [PMID: 37981642 PMCID: PMC10658077 DOI: 10.1038/s41598-023-47091-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/09/2023] [Indexed: 11/21/2023] Open
Abstract
Population structure and lifestyles may have contributed to the epidemiological status of Chronic Kidney Disease due to Type 2 Diabetes (CKD-T2D). This study is a secondary data analysis. Using data from the Global Burden of Disease Study, we describe the changes in CKD-T2D burden and its influencing factors in the population aged 20-59 years from 1990 to 2019. Globally, the incidence, death, and Disability Adjusted Life Years (DALYs) rate of CKD-T2D showed an upward trend and increased with age, and the burden in males was higher than that in females. Population growth and aging were important driving factors for the increase of CKD-T2D DALY burden, while high systolic blood pressure and high body-mass index were the primary attributable risk factors. High body-mass index exhibited higher contributions to high Socioeconomic Development Index (SDI) countries, whereas low SDI countries were more impacted by high systolic blood pressure. The population attributable fraction of CKD-T2D DALY caused by high body-mass index was positively correlated with SDI, while high temperature and lead exposure were negatively correlated. Therefore, strengthening disease screening for people aged 20-59 years and formulating early intervention measures based on the level of socioeconomic development may effectively alleviate the burden of CKD-T2D.
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Affiliation(s)
- Dandan Xie
- College of Traditional Chinese Medicine, International Advanced Functional Omics Platform, Scientific Experiment Center, Hainan Medical University, No. 3, Xueyuan Road, Haikou, 571199, Hainan, China
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Health Management Center and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, No. 139, Renmin Road, Changsha, 410011, Hunan, China
- Department of Clinical Nutrition, The First Affiliated Hospital of Hainan Medical University, No. 31, Longhua Road, Haikou, 570102, Hainan, China
| | - Tianpeng Ma
- College of Traditional Chinese Medicine, International Advanced Functional Omics Platform, Scientific Experiment Center, Hainan Medical University, No. 3, Xueyuan Road, Haikou, 571199, Hainan, China
| | - Haoliang Cui
- School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jing Li
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Health Management Center and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, No. 139, Renmin Road, Changsha, 410011, Hunan, China
| | - Aihua Zhang
- College of Traditional Chinese Medicine, International Advanced Functional Omics Platform, Scientific Experiment Center, Hainan Medical University, No. 3, Xueyuan Road, Haikou, 571199, Hainan, China.
| | - Zhifeng Sheng
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Health Management Center and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, No. 139, Renmin Road, Changsha, 410011, Hunan, China.
| | - Yiqiang Xie
- College of Traditional Chinese Medicine, International Advanced Functional Omics Platform, Scientific Experiment Center, Hainan Medical University, No. 3, Xueyuan Road, Haikou, 571199, Hainan, China.
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Olyaeemanesh A, Takian A, Mostafavi H, Mobinizadeh M, Bakhtiari A, Yaftian F, Vosoogh-Moghaddam A, Mohamadi E. Health Equity Impact Assessment (HEIA) reporting tool: developing a checklist for policymakers. Int J Equity Health 2023; 22:241. [PMID: 37980523 PMCID: PMC10657117 DOI: 10.1186/s12939-023-02031-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/03/2023] [Indexed: 11/20/2023] Open
Abstract
INTRODUCTION Health Equity Impact Assessment (HEIA) is a decision support tool that shows users how a new program, policy, or innovation affects health equity in different population groups. Various HEIA reporting and dissemination tools are available, nevertheless, a practical standard tool to present the results of HEIA in an appropriate period to policymakers is lacking. This work reports the development of a tool (a checklist) for HEIA reporting at the decision-making level, aiming to promote the application of HEIA evidence for improving health equity. METHODS This is a mixed-method study that was carried out over four stages in 2022-2023: 1) identifying HEIA models, checklists, and reporting instruments; 2) development of the initial HEIA reporting checklist; 3) checklist validation; and 4) piloting the checklist. We also analyzed the Face, CVR, and CVI validity of the tool. RESULTS We developed the initial checklist through analysis of 53 included studies and the opinions of experts. The final checklist comprised five sections: policy introduction (eight subsections), managing the HEIA of policy (seven subsections), scope of the affected population (three subsections), HEIA results (seven subsections), and recommendations (three subsections). CONCLUSION Needs assessment, monitoring during implementation, health impact assessment, and other tools such as monitoring outcome reports, appraisals, and checklists are all methods for assessing health equity impact. Other equity-focused indicators, such as the equity lens and equity appraisal, may have slightly different goals than the HEIA. Similarly, the formats for presenting and publishing HEIA reports might vary, depending on the target population and the importance of the report.
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Affiliation(s)
- Alireza Olyaeemanesh
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
- National Institute for Health Research, TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Amirhossein Takian
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
- Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Department of Health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hakimeh Mostafavi
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Mohammadreza Mobinizadeh
- National Institute for Health Research, TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Ahad Bakhtiari
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Fateme Yaftian
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Abbass Vosoogh-Moghaddam
- Governance and Health Training and Research Department, National Institute for Health Research, TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
- Secretariat for Health and Food Security, TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Efat Mohamadi
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran.
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Chen J, Wang C, Shao B. Global, regional, and national thyroid cancer age-period-cohort modeling and Bayesian predictive modeling studies: A systematic analysis of the global burden of disease study 2019. Heliyon 2023; 9:e22490. [PMID: 38045179 PMCID: PMC10689957 DOI: 10.1016/j.heliyon.2023.e22490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 12/05/2023] Open
Abstract
Objective To analyze the changing trend of the global burden of thyroid cancer (TC) and its associated risk factors using data from the Global Burden of Disease study 2019 (GBD 2019). Methods This study utilized the GBD 2019 database to analyze the burden trend of TC in various regions and countries from 1990 to 2019, while also examining the age-period-cohort (APC) effect. Additionally, the study used Bayesian age-period-cohort (BAPC) and predictive models to forecast TC incidence up until 2030. Results According to data from 2019, there were 233,846.64 (95 % UI 211,636.89-252,806.55) cases of TC worldwide. The burden of TC varies among regions and countries, with higher incidence rates observed in moderate and above SDI regions. Age and gender also play a role, with incidence rates peaking in the >95 age group for men and the 70-74 age group for women. Additionally, women have a higher incidence than men. The APC model revealed that the impact of age was most significant among individuals aged 95 years and older, while it was lowest among those aged 0-14 years. Additionally, the period effect showed a relatively low risk of morbidity with a Period RR < 0 during 1990-2004 and a high relative risk of morbidity with a Period RR > 0 during 2005-2019. Furthermore, the cohort effect demonstrated that the relative risk of developing the disease was lower before 1950 and higher after 1950. Predicted values show an increasing trend in thyroid incidence over the next 30 years. Conclusions The findings of this study highlight the continued significance of thyroid cancer as a global public health issue. It is crucial to develop targeted interventions that address the specific risk factors associated with thyroid cancer. Furthermore, health policies should be customized and adapted to the unique needs of different regions and populations.
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Affiliation(s)
- Jingjing Chen
- Hospital Office, Shandong Second Provincial General Hospital, Jinan, 250000, China
| | - Chong Wang
- Department of Laboratory Medicine, Qingdao Municipal Hospital, Qingdao, 266000, China
| | - Beibei Shao
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250000, China
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Sachs J, Perry HB. Needed: a financing breakthrough at the UN High-level Meeting on Universal Health Coverage. Lancet 2023; 402:1403-1404. [PMID: 37734397 DOI: 10.1016/s0140-6736(23)01924-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023]
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Khatri RB, Assefa Y. Drivers of the Australian Health System towards Health Care for All: A Scoping Review and Qualitative Synthesis. BIOMED RESEARCH INTERNATIONAL 2023; 2023:6648138. [PMID: 37901893 PMCID: PMC10611547 DOI: 10.1155/2023/6648138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/03/2023] [Accepted: 10/07/2023] [Indexed: 10/31/2023]
Abstract
Background Australia has made significant progress towards universal access to primary health care (PHC) services. However, disparities in the utilisation of health services and health status remain challenges in achieving the global target of universal health coverage (UHC). This scoping review aimed at synthesizing the drivers of PHC services towards UHC in Australia. Methods We conducted a scoping review of the literature published from 1 January 2010 to 30 July 2021 in three databases: PubMed, Scopus, and Embase. Search terms were identified under four themes: health services, Australia, UHC, and successes or challenges. Data were analysed using an inductive thematic analysis approach. Drivers (facilitators and barriers) of PHC services were explained by employing a multilevel framework that included the proximal level (at the level of users and providers), intermediate level (organisational and community level), and distal level (macrosystem or distal/structural level). Results A total of 114 studies were included in the review. Australia has recorded several successes in increased utilisation of PHC services, resulting in an overall improvement in health status. However, challenges remain in poor access and high unmet needs of health services among disadvantaged/priority populations (e.g., immigrants and Indigenous groups), those with chronic illnesses (multiple chronic conditions), and those living in rural and remote areas. Several drivers have contributed in access to and utilisation of health services (especially among priority populations)operating at multilevel health systems, such as proximal level drivers (health literacy, users' language, access to health facilities, providers' behaviours, quantity and competency of health workforce, and service provision at health facilities), intermediate drivers (community engagement, health programs, planning and monitoring, and funding), and distal (structural) drivers (socioeconomic disparities and discriminations). Conclusion Australia has had several successes towards UHC. However, access to health services poses significant challenges among specific priority populations and rural residents. To achieve universality and equity of health services, health system efforts (supply- and demand-side policies, programs and service interventions) are required to be implemented in multilevel health systems. Implementation of targeted health policy and program approaches are needed to provide comprehensive PHC and address the effects of structural disparities.
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Affiliation(s)
- Resham B. Khatri
- Health Social Science and Development Research Institute, Kathmandu, Nepal
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Yibeltal Assefa
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
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左 爽, 李 景, 华 子. [Global disease burden of neonatal jaundice from 1990 to 2019]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:1008-1015. [PMID: 37905756 PMCID: PMC10621063 DOI: 10.7499/j.issn.1008-8830.2303063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/21/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVES To examine the global, regional, and national disease burden of neonatal jaundice. METHODS The 2019 Global Burden of Disease database was searched to collect incident cases/incidence and deaths/mortality of neonatal jaundice, as well as global socio-demographic index (SDI) and universal health coverage index (UHCI). The epidemiological trend of neonatal jaundice from 1990 to 2019 was analyzed. The correlations between incidence/mortality of neonatal jaundice and SDI and UHCI were evaluated. RESULTS From 601 681 in 1990 to 626 005 in 2019, with a 4.04% increase in global incident cases of neonatal jaundice. The overall age-standardized incidence rate exhibited an increase [estimated annual percent change=0.13 (95%CI: 0.03 to 0.23)] during this period. Additionally, deaths due to neonatal jaundice decreased by 58.83%, from 128 119 in 1990 to 52 742 in 2019. The overall age-standardized mortality rate showed a decrease [estimated annual percent change=-2.78 (95%CI: -3.00 to -2.57)] over the same period. Countries with lower SDI, such as India, Pakistan, and Nigeria, reported a higher proportion of neonatal morbidity and mortality. In 2019, a negative correlation was observed between estimated annual percent change in age-standardized mortality rate and SDI (ρ=-0.320, P<0.05) or UHCI (ρ=-0.252, P<0.05). CONCLUSIONS The global incidence of neonatal jaundice is on the rise, while the mortality rate is declining. The burden of neonatal jaundice is influenced by social development, economic factors, and the level of medical care.
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Xu L, Zhao J, Li Z, Sun J, Lu Y, Zhang R, Zhu Y, Ding K, Rudan I, Theodoratou E, Song P, Li X. National and subnational incidence, mortality and associated factors of colorectal cancer in China: A systematic analysis and modelling study. J Glob Health 2023; 13:04096. [PMID: 37824177 PMCID: PMC10569376 DOI: 10.7189/jogh.13.04096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
Background Due to their known variation by geography and economic development, we aimed to evaluate the incidence and mortality of colorectal cancer (CRC) in China over the past decades and identify factors associated with CRC among the Chinese population to provide targeted information on disease prevention. Methods We conducted a systemic review and meta-analysis of epidemiolocal studies on the incidence, mortality, and associated factors of CRC among the Chinese population, extracting and synthesising data from eligible studies retrieved from seven global and Chinese databases. We pooled age-standardised incidence rates (ASIRs) and mortality rates (ASMRs) for each province, subregion, and the whole of China, and applied a joinpoint regression model and annual per cent changes (APCs) to estimate the trends of CRC incidence and mortality. We conducted random-effects meta-analyses to assess the effect estimates of identified associated risk factors. Results We included 493 articles; 271 provided data on CRC incidence or mortality, and 222 on associated risk factors. Overall, the ASIR of CRC in China increased from 2.75 to 19.39 (per 100 000 person-years) between 1972 and 2019 with a slowed-down growth rate (APC1 = 5.75, APC2 = 0.42), while the ASMR of CRC decreased from 12.00 to 7.95 (per 100 000 person-years) between 1974 and 2020 with a slight downward trend (APC = -0.89). We analysed 62 risk factors with synthesized data; 16 belonging to the categories of anthropometrics factors, lifestyle factors, dietary factors, personal histories and mental health conditions were graded to be associated with CRC risk among the Chinese population in the meta-analysis limited to the high-quality studies. Conclusions We found substantial variation of CRC burden across regions and provinces of China and identified several associated risk factors for CRC, which could help to guide the formulation of targeted disease prevention and control strategies. Registration PROSPERO: CRD42022346558.
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Affiliation(s)
- Liying Xu
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianhui Zhao
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zihan Li
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jing Sun
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Lu
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Rongqi Zhang
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yingshuang Zhu
- Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kefeng Ding
- Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Igor Rudan
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- Algebra University, Zagreb, Croatia
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xue Li
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- The Key Laboratory of Intelligent Preventive Medicine of Zheijang Province, Hangzhou. China
| | - Global Health Epidemiology Research Group (GHERG)
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- Algebra University, Zagreb, Croatia
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- The Key Laboratory of Intelligent Preventive Medicine of Zheijang Province, Hangzhou. China
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