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Pu L, Wang L, Zhang R, Zhao T, Jiang Y, Han L. Projected Global Trends in Ischemic Stroke Incidence, Deaths and Disability-Adjusted Life Years From 2020 to 2030. Stroke 2023; 54:1330-1339. [PMID: 37094034 DOI: 10.1161/strokeaha.122.040073] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 01/25/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND We projected global trends in ischemic stroke from 2020 to 2030 according to age, sex, and socio-demographic index (SDI) quintile. METHODS Estimated annual percentage changes (EAPCs) were used to project trends in the incidence of deaths from and disability-adjusted life years (DALYs) due to ischemic stroke between 2020 and 2030. EAPCs were computed using generalized additive models and data from the Global Burden of Disease study during the 1990 to 2019 period. RESULTS The global age-standardized incidence rate of ischemic stroke was projected to increase to 89.32 per 100 000 population in 2030 (EAPC=0.89), whereas the associated global age-standardized death and DALY rates were projected to decrease to 18.28 (EAPC, -3.58) and 500.37 per 100 000 (EAPC=-1.75), respectively, in 2030. The projections indicated a higher age-standardized incidence rate of ischemic stroke among women than among men in 2030 (90.70 versus 87.64 per 100 000). The incidence rate of ischemic stroke was projected to increase across all age groups and SDI quintiles between 2020 and 2030. At the national level, the greatest increase in the age-standardized incidence rate of ischemic stroke between 2020 and 2030 was projected to occur in Cyprus (EAPC=4.16), followed by Palestine (EAPC=3.50) and South Africa (EAPC=2.64). Additionally, the projections suggested increases in the age-standardized death and DALY rates due to ischemic stroke for countries in low-SDI quintiles (EAPC=3.68 and EAPC=5.30, respectively). CONCLUSIONS The projections indicated that the incidence rate of ischemic stroke will increase both sexes, all age groups, and all SDI quintiles and in some countries between 2020 and 2030. Furthermore, countries with a low SDI should be aware of potential increases in the age-standardized death and DALY due to ischemic stroke.
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Affiliation(s)
- Liyuan Pu
- Hwa Mei Hospital, Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province (L.P., R.Z., T.Z., Y.J., L.H.), University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China
- Department of Global Health, Ningbo Institute of Life and Health Industry (L.P., R.Z., T.Z., Y.J., L.H.), University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China
| | - Li Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, PR China (L.W.)
| | - Ruijie Zhang
- Hwa Mei Hospital, Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province (L.P., R.Z., T.Z., Y.J., L.H.), University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China
- Department of Global Health, Ningbo Institute of Life and Health Industry (L.P., R.Z., T.Z., Y.J., L.H.), University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China
| | - Tian Zhao
- Hwa Mei Hospital, Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province (L.P., R.Z., T.Z., Y.J., L.H.), University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China
- Department of Global Health, Ningbo Institute of Life and Health Industry (L.P., R.Z., T.Z., Y.J., L.H.), University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China
| | - Yannan Jiang
- Hwa Mei Hospital, Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province (L.P., R.Z., T.Z., Y.J., L.H.), University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China
- Department of Global Health, Ningbo Institute of Life and Health Industry (L.P., R.Z., T.Z., Y.J., L.H.), University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China
| | - Liyuan Han
- Hwa Mei Hospital, Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province (L.P., R.Z., T.Z., Y.J., L.H.), University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China
- Department of Global Health, Ningbo Institute of Life and Health Industry (L.P., R.Z., T.Z., Y.J., L.H.), University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China
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Cuschieri S, Alkerwi A, Economou M, Idavain J, Lai T, Lesnik T, Meyers C, Samouda H, Sigfúsdóttir ID, Terzic N, Tzivian L, Pallari E. Conducting national burden of disease studies and knowledge translation in eight small European states: challenges and opportunities. Health Res Policy Syst 2022; 20:113. [PMID: 36271370 PMCID: PMC9587663 DOI: 10.1186/s12961-022-00923-1] [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: 05/11/2022] [Accepted: 09/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several countries across Europe are engaging in burden of disease (BoD) studies. This article aims to understand the experiences of eight small European states in relation to their research opportunities and challenges in conducting national BoD studies and in knowledge translation of research outputs to policy-making. METHODS Countries participating in the study were those outlined by the WHO/Europe Small Countries Initiative and members of the Cooperation in Science and Technology (COST) Action CA18218 European Burden of Disease Network. A set of key questions targeting the research landscape were distributed to these members. WHO's framework approach for research development capacities was applied to gain a comprehensive understanding of shortages in relation to national BoD studies in order to help strengthen health research capacities in the small states of Europe. RESULTS Most small states lack the resources and expertise to conduct BoD studies, but nationally representative data are relatively accessible. Public health officials and researchers tend to have a close-knit relationship with the governing body and policy-makers. The major challenge faced by small states is in knowledge generation and transfer rather than knowledge translation. Nevertheless, some policy-makers fail to make adequate use of knowledge translation. CONCLUSIONS Small states, if equipped with adequate resources, may have the capacity to conduct national BoD studies. This work can serve as a model for identifying current gaps and opportunities in each of the eight small European countries, as well as a guide for translating country BoD study results into health policy.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, RM 425 Biomedical Building, Msida, Malta.
| | - Ala'a Alkerwi
- Ministry of Health, Directorate of Health, Service Epidemiology and Statistics, Luxembourg, Luxembourg
| | - Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Jane Idavain
- National Institute for Health Development, Tallinn, Estonia
| | - Taavi Lai
- Fourth View Consulting, Tallinn, Estonia
| | - Tina Lesnik
- National Institute of Public Health, Ljubljana, Slovenia
| | - Caine Meyers
- Icelandic Centre for Social Research and Analysis, Reykjavik, Iceland
| | - Hanen Samouda
- Precision Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - Natasa Terzic
- Institute of Public Health of Montenegro, Podgorica, Montenegro
| | | | - Elena Pallari
- Health Innovation Network, Minerva House, 5 Montague Cl, London, SE1 9BB, United Kingdom
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Cuschieri S, Hatziyianni A, Karayiannis P, Haagsma JA, Wyper GMA, Kantaris M, Theodorou M, Pallari E. Re-engineering the Cypriot General Healthcare System for Syndemics. Front Public Health 2022; 10:734796. [PMID: 35899154 PMCID: PMC9309491 DOI: 10.3389/fpubh.2022.734796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
To date in Cyprus, there is no dedicated “Quality Improvement” body or Public Health authority. The long-awaited general healthcare system (known as GeSy or GHS) has been completed, mid-stream of the COVID-19 pandemic. A recently proposed resilience plan in response to the lessons learnt from the pandemic was put forward by the Government of the Republic of Cyprus to strengthen the capacity of the GHS and support public health defense. The negotiator of GeSy and Health Minister 2015–2018 also provided his view that the health system needs a holistic transformation of service provision. Recognizing failures and thinking from a syndemogenesis perspective how the envisioned patient-centric healthcare delivery can be achieved, we propose that the public health response could also be linked to a politico-economic one in shielding GeSy. We make such case for a syndemic strategy (simultaneous management of COVID-19 and pre-existing epidemics on the island) and the development of the five-district model where each main district hospital is to complement the activities of the GHS through developing: 1. A training Center for training and sharing of best practices for COVID-19 and other public emergencies. 2. A public health body. 3. A quality improvement institute. 4. A commissioning center on planning and streamlining healthcare services. 5. A clinical trial platform. The rationale is based on the management literature and use of existing resources and capabilities for transforming the GeSy and generating value.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | | | | | - Juanita A. Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Grant M. A. Wyper
- European Burden of Disease Network, European Cooperation in Science and Technology, Scotland, United Kingdom
| | | | | | - Elena Pallari
- Health Innovation Network, London, United Kingdom
- *Correspondence: Elena Pallari
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