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Courville KJ, Bustamante NE, Nuñez-Samudio V, Pecchio M, Landires I, Viggiano C, Durán H, Novoa N, Alvarado E, Vargas F, Salado D, Manzanares J, Haughton K, Cuero C, Niedda M, Valdés R. Vaccination and mortality from COVID-19: a comparative study between hemodialysis, peritoneal dialysis, and non-dialysis adult population in Panama. Int Urol Nephrol 2023:10.1007/s11255-023-03529-w. [PMID: 36828920 PMCID: PMC9955520 DOI: 10.1007/s11255-023-03529-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/19/2023] [Indexed: 02/26/2023]
Abstract
PURPOSE Dialysis patients have a different response than the non-dialysis population to infection with COVID-19. This study evaluates the prevalence of infection and lethality in patients receiving hemodialysis or peritoneal dialysis in Panama, compared to non-dialysis adult population, and reports of adverse events of vaccination. METHODS This is a prospective, multi-center cohort study of spatients aged 18 years or older and receiving in-center hemodialysis or ambulatory peritoneal dialysis in 13 centers in Panama from March 2021 to 2022. For comparison with general population, the study used an extended period of two years. RESULTS A total of 1531 patients receiving dialysis treatment accepted to participate. PD patients represented an 18% of study patients. Lethality was higher in peritoneal dialysis patients with COVID-19 infection than in hemodialysis in the study group (p 0.02). Total deaths in dialysis patients for 2020 were 156 patients, before vaccination; 79 in 2021; and 25 for the first trimester of 2022. Lethality for the period of 2020-2022 was 9.3% for dialysis patients and 0.2% for non-dialysis population. There was no difference in symptoms in first dose, but with second dose, hemodialysis patients reported fewer symptoms than peritoneal dialysis patients (p < 0.0001). CONCLUSION Ninety one percent of people in the country received BNT162b2 Pfizer BionTech vaccine. Lethality decreased from 30 to 5% once vaccination was available. There were no severe adverse effects and symptoms reported were less frequent than in general population, probably due to low reactogenicity in dialysis patients, or better tolerance to pain.
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Affiliation(s)
- Karen J. Courville
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Nefrología/Hospital Dr. Gustavo N. Collado, Caja de Seguro Social, Chitré, Panamá ,Departamento de Investigación/Instituto de Ciencias Médicas, Las Tablas, Panamá
| | - Norman E. Bustamante
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Nefrología/Hospital Dr. Gustavo N. Collado, Caja de Seguro Social, Chitré, Panamá ,Departamento de Investigación/Instituto de Ciencias Médicas, Las Tablas, Panamá
| | | | - Maydelin Pecchio
- Departamento de Investigación/Instituto de Ciencias Médicas, Las Tablas, Panamá
| | - Iván Landires
- Departamento de Investigación/Instituto de Ciencias Médicas, Las Tablas, Panamá
| | - Carlos Viggiano
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Nefrología/Complejo Hospitalario Metropolitano, Caja de Seguro Social, Panama City, Panamá
| | - Herna Durán
- Coordinación Nacional de Hemodiálisis, Panama City, Panamá
| | - Nadji Novoa
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Nefrología/Hospital Dr. Rafael Hernández, Caja de Seguro Social, David, Panamá
| | - Ernesto Alvarado
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Nefrología/Policlínica Dr. Horacio Díaz Gómez, Santiago de Veraguas, Panamá
| | - Francisco Vargas
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Nefrología/Hospital Ezequiel Abadía, Soná, Panamá
| | - Dayan Salado
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Nefrología/Hospital Dr. Rafael Estevez, Caja de Seguro Social, Aguadulce, Panamá
| | - José Manzanares
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Nefrología/Policlínica Dr. Santiago Barraza, La Chorrera, Panamá
| | - Kelly Haughton
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Nefrología/Unidad de Hemodiálisis Metro 1, Panama City, Panamá
| | - César Cuero
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Nefrología/Unidad de Hemodiálisis Metro 2, Panama City, Panamá
| | - María Niedda
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Nefrología/Hospital Dra. Susana Jones Cano, San Miguelito, Panamá
| | - Régulo Valdés
- Sociedad Panameña de Nefrología e Hipertensión, Calle Gervasio García, Edificio Cetrersa, Piso 3, Hato Pintado, 0819 Panamá, Panamá ,Coordinación Nacional de Hemodiálisis, Panama City, Panamá
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Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, Brauer M, Burnett R, Casey D, Coates MM, Cohen A, Delwiche K, Estep K, Frostad JJ, Astha KC, Kyu HH, Moradi-Lakeh M, Ng M, Slepak EL, Thomas BA, Wagner J, Aasvang GM, Abbafati C, Abbasoglu Ozgoren A, Abd-Allah F, Abera SF, Aboyans V, Abraham B, Abraham JP, Abubakar I, Abu-Rmeileh NME, Aburto TC, Achoki T, Adelekan A, Adofo K, Adou AK, Adsuar JC, Afshin A, Agardh EE, Al Khabouri MJ, Al Lami FH, Alam SS, Alasfoor D, Albittar MI, Alegretti MA, Aleman AV, Alemu ZA, Alfonso-Cristancho R, Alhabib S, Ali R, Ali MK, Alla F, Allebeck P, Allen PJ, Alsharif U, Alvarez E, Alvis-Guzman N, Amankwaa AA, Amare AT, Ameh EA, Ameli O, Amini H, Ammar W, Anderson BO, Antonio CAT, Anwari P, Argeseanu Cunningham S, Arnlöv J, Arsenijevic VSA, Artaman A, Asghar RJ, Assadi R, Atkins LS, Atkinson C, Avila MA, Awuah B, Badawi A, Bahit MC, Bakfalouni T, Balakrishnan K, Balalla S, Balu RK, Banerjee A, Barber RM, Barker-Collo SL, Barquera S, Barregard L, Barrero LH, Barrientos-Gutierrez T, Basto-Abreu AC, Basu A, Basu S, Basulaiman MO, Batis Ruvalcaba C, Beardsley J, Bedi N, Bekele T, Bell ML, Benjet C, Bennett DA, Benzian H, Bernabé E, Beyene TJ, Bhala N, Bhalla A, Bhutta ZA, Bikbov B, Bin Abdulhak AA, Blore JD, Blyth FM, Bohensky MA, Bora Başara B, Borges G, Bornstein NM, Bose D, Boufous S, Bourne RR, Brainin M, Brazinova A, Breitborde NJ, Brenner H, Briggs ADM, Broday DM, Brooks PM, Bruce NG, Brugha TS, Brunekreef B, Buchbinder R, Bui LN, Bukhman G, Bulloch AG, Burch M, Burney PGJ, Campos-Nonato IR, Campuzano JC, Cantoral AJ, Caravanos J, Cárdenas R, Cardis E, Carpenter DO, Caso V, Castañeda-Orjuela CA, Castro RE, Catalá-López F, Cavalleri F, Çavlin A, Chadha VK, Chang JC, Charlson FJ, Chen H, Chen W, Chen Z, Chiang PP, Chimed-Ochir O, Chowdhury R, Christophi CA, Chuang TW, Chugh SS, Cirillo M, Claßen TKD, Colistro V, Colomar M, Colquhoun SM, Contreras AG, Cooper C, Cooperrider K, Cooper LT, Coresh J, Courville KJ, Criqui MH, Cuevas-Nasu L, Damsere-Derry J, Danawi H, Dandona L, Dandona R, Dargan PI, Davis A, Davitoiu DV, Dayama A, de Castro EF, De la Cruz-Góngora V, De Leo D, de Lima G, Degenhardt L, del Pozo-Cruz B, Dellavalle RP, Deribe K, Derrett S, Des Jarlais DC, Dessalegn M, deVeber GA, Devries KM, Dharmaratne SD, Dherani MK, Dicker D, Ding EL, Dokova K, Dorsey ER, Driscoll TR, Duan L, Durrani AM, Ebel BE, Ellenbogen RG, Elshrek YM, Endres M, Ermakov SP, Erskine HE, Eshrati B, Esteghamati A, Fahimi S, Faraon EJA, Farzadfar F, Fay DFJ, Feigin VL, Feigl AB, Fereshtehnejad SM, Ferrari AJ, Ferri CP, Flaxman AD, Fleming TD, Foigt N, Foreman KJ, Paleo UF, Franklin RC, Gabbe B, Gaffikin L, Gakidou E, Gamkrelidze A, Gankpé FG, Gansevoort RT, García-Guerra FA, Gasana E, Geleijnse JM, Gessner BD, Gething P, Gibney KB, Gillum RF, Ginawi IAM, Giroud M, Giussani G, Goenka S, Goginashvili K, Gomez Dantes H, Gona P, Gonzalez de Cosio T, González-Castell D, Gotay CC, Goto A, Gouda HN, Guerrant RL, Gugnani HC, Guillemin F, Gunnell D, Gupta R, Gupta R, Gutiérrez RA, Hafezi-Nejad N, Hagan H, Hagstromer M, Halasa YA, Hamadeh RR, Hammami M, Hankey GJ, Hao Y, Harb HL, Haregu TN, Haro JM, Havmoeller R, Hay SI, Hedayati MT, Heredia-Pi IB, Hernandez L, Heuton KR, Heydarpour P, Hijar M, Hoek HW, Hoffman HJ, Hornberger JC, Hosgood HD, Hoy DG, Hsairi M, Hu G, Hu H, Huang C, Huang JJ, Hubbell BJ, Huiart L, Husseini A, Iannarone ML, Iburg KM, Idrisov BT, Ikeda N, Innos K, Inoue M, Islami F, Ismayilova S, Jacobsen KH, Jansen HA, Jarvis DL, Jassal SK, Jauregui A, Jayaraman S, Jeemon P, Jensen PN, Jha V, Jiang F, Jiang G, Jiang Y, Jonas JB, Juel K, Kan H, Kany Roseline SS, Karam NE, Karch A, Karema CK, Karthikeyan G, Kaul A, Kawakami N, Kazi DS, Kemp AH, Kengne AP, Keren A, Khader YS, Khalifa SEAH, Khan EA, Khang YH, Khatibzadeh S, Khonelidze I, Kieling C, Kim D, Kim S, Kim Y, Kimokoti RW, Kinfu Y, Kinge JM, Kissela BM, Kivipelto M, Knibbs LD, Knudsen AK, Kokubo Y, Kose MR, Kosen S, Kraemer A, Kravchenko M, Krishnaswami S, Kromhout H, Ku T, Kuate Defo B, Kucuk Bicer B, Kuipers EJ, Kulkarni C, Kulkarni VS, Kumar GA, Kwan GF, Lai T, Lakshmana Balaji A, Lalloo R, Lallukka T, Lam H, Lan Q, Lansingh VC, Larson HJ, Larsson A, Laryea DO, Lavados PM, Lawrynowicz AE, Leasher JL, Lee JT, Leigh J, Leung R, Levi M, Li Y, Li Y, Liang J, Liang X, Lim SS, Lindsay MP, Lipshultz SE, Liu S, Liu Y, Lloyd BK, Logroscino G, London SJ, Lopez N, Lortet-Tieulent J, Lotufo PA, Lozano R, Lunevicius R, Ma J, Ma S, Machado VMP, MacIntyre MF, Magis-Rodriguez C, Mahdi AA, Majdan M, Malekzadeh R, Mangalam S, Mapoma CC, Marape M, Marcenes W, Margolis DJ, Margono C, Marks GB, Martin RV, Marzan MB, Mashal MT, Masiye F, Mason-Jones AJ, Matsushita K, Matzopoulos R, Mayosi BM, Mazorodze TT, McKay AC, McKee M, McLain A, Meaney PA, Medina C, Mehndiratta MM, Mejia-Rodriguez F, Mekonnen W, Melaku YA, Meltzer M, Memish ZA, Mendoza W, Mensah GA, Meretoja A, Mhimbira FA, Micha R, Miller TR, Mills EJ, Misganaw A, Mishra S, Mohamed Ibrahim N, Mohammad KA, Mokdad AH, Mola GL, Monasta L, Montañez Hernandez JC, Montico M, Moore AR, Morawska L, Mori R, Moschandreas J, Moturi WN, Mozaffarian D, Mueller UO, Mukaigawara M, Mullany EC, Murthy KS, Naghavi M, Nahas Z, Naheed A, Naidoo KS, Naldi L, Nand D, Nangia V, Narayan KMV, Nash D, Neal B, Nejjari C, Neupane SP, Newton CR, Ngalesoni FN, Ngirabega JDD, Nguyen G, Nguyen NT, Nieuwenhuijsen MJ, Nisar MI, Nogueira JR, Nolla JM, Nolte S, Norheim OF, Norman RE, Norrving B, Nyakarahuka L, Oh IH, Ohkubo T, Olusanya BO, Omer SB, Opio JN, Orozco R, Pagcatipunan RS, Pain AW, Pandian JD, Panelo CIA, Papachristou C, Park EK, Parry CD, Paternina Caicedo AJ, Patten SB, Paul VK, Pavlin BI, Pearce N, Pedraza LS, Pedroza A, Pejin Stokic L, Pekericli A, Pereira DM, Perez-Padilla R, Perez-Ruiz F, Perico N, Perry SAL, Pervaiz A, Pesudovs K, Peterson CB, Petzold M, Phillips MR, Phua HP, Plass D, Poenaru D, Polanczyk GV, Polinder S, Pond CD, Pope CA, Pope D, Popova S, Pourmalek F, Powles J, Prabhakaran D, Prasad NM, Qato DM, Quezada AD, Quistberg DAA, Racapé L, Rafay A, Rahimi K, Rahimi-Movaghar V, Rahman SU, Raju M, Rakovac I, Rana SM, Rao M, Razavi H, Reddy KS, Refaat AH, Rehm J, Remuzzi G, Ribeiro AL, Riccio PM, Richardson L, Riederer A, Robinson M, Roca A, Rodriguez A, Rojas-Rueda D, Romieu I, Ronfani L, Room R, Roy N, Ruhago GM, Rushton L, Sabin N, Sacco RL, Saha S, Sahathevan R, Sahraian MA, Salomon JA, Salvo D, Sampson UK, Sanabria JR, Sanchez LM, Sánchez-Pimienta TG, Sanchez-Riera L, Sandar L, Santos IS, Sapkota A, Satpathy M, Saunders JE, Sawhney M, Saylan MI, Scarborough P, Schmidt JC, Schneider IJC, Schöttker B, Schwebel DC, Scott JG, Seedat S, Sepanlou SG, Serdar B, Servan-Mori EE, Shaddick G, Shahraz S, Levy TS, Shangguan S, She J, Sheikhbahaei S, Shibuya K, Shin HH, Shinohara Y, Shiri R, Shishani K, Shiue I, Sigfusdottir ID, Silberberg DH, Simard EP, Sindi S, Singh A, Singh GM, Singh JA, Skirbekk V, Sliwa K, Soljak M, Soneji S, Søreide K, Soshnikov S, Sposato LA, Sreeramareddy CT, Stapelberg NJC, Stathopoulou V, Steckling N, Stein DJ, Stein MB, Stephens N, Stöckl H, Straif K, Stroumpoulis K, Sturua L, Sunguya BF, Swaminathan S, Swaroop M, Sykes BL, Tabb KM, Takahashi K, Talongwa RT, Tandon N, Tanne D, Tanner M, Tavakkoli M, Te Ao BJ, Teixeira CM, Téllez Rojo MM, Terkawi AS, Texcalac-Sangrador JL, Thackway SV, Thomson B, Thorne-Lyman AL, Thrift AG, Thurston GD, Tillmann T, Tobollik M, Tonelli M, Topouzis F, Towbin JA, Toyoshima H, Traebert J, Tran BX, Trasande L, Trillini M, Trujillo U, Dimbuene ZT, Tsilimbaris M, Tuzcu EM, Uchendu US, Ukwaja KN, Uzun SB, van de Vijver S, Van Dingenen R, van Gool CH, van Os J, Varakin YY, Vasankari TJ, Vasconcelos AMN, Vavilala MS, Veerman LJ, Velasquez-Melendez G, Venketasubramanian N, Vijayakumar L, Villalpando S, Violante FS, Vlassov VV, Vollset SE, Wagner GR, Waller SG, Wallin MT, Wan X, Wang H, Wang J, Wang L, Wang W, Wang Y, Warouw TS, Watts CH, Weichenthal S, Weiderpass E, Weintraub RG, Werdecker A, Wessells KR, Westerman R, Whiteford HA, Wilkinson JD, Williams HC, Williams TN, Woldeyohannes SM, Wolfe CDA, Wong JQ, Woolf AD, Wright JL, Wurtz B, Xu G, Yan LL, Yang G, Yano Y, Ye P, Yenesew M, Yentür GK, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Younoussi Z, Yu C, Zaki ME, Zhao Y, Zheng Y, Zhou M, Zhu J, Zhu S, Zou X, Zunt JR, Lopez AD, Vos T, Murray CJ. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 386:2287-323. [PMID: 26364544 PMCID: PMC4685753 DOI: 10.1016/s0140-6736(15)00128-2] [Citation(s) in RCA: 1719] [Impact Index Per Article: 191.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. METHODS Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. FINDINGS All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. INTERPRETATION Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks. FUNDING Bill & Melinda Gates Foundation.
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Murray CJL, Ortblad KF, Guinovart C, Lim SS, Wolock TM, Roberts DA, Dansereau EA, Graetz N, Barber RM, Brown JC, Wang H, Duber HC, Naghavi M, Dicker D, Dandona L, Salomon JA, Heuton KR, Foreman K, Phillips DE, Fleming TD, Flaxman AD, Phillips BK, Johnson EK, Coggeshall MS, Abd-Allah F, Abera SF, Abraham JP, Abubakar I, Abu-Raddad LJ, Abu-Rmeileh NM, Achoki T, Adeyemo AO, Adou AK, Adsuar JC, Agardh EE, Akena D, Al Kahbouri MJ, Alasfoor D, Albittar MI, Alcalá-Cerra G, Alegretti MA, Alemu ZA, Alfonso-Cristancho R, Alhabib S, Ali R, Alla F, Allen PJ, Alsharif U, Alvarez E, Alvis-Guzman N, Amankwaa AA, Amare AT, Amini H, Ammar W, Anderson BO, Antonio CAT, Anwari P, Arnlöv J, Arsenijevic VSA, Artaman A, Asghar RJ, Assadi R, Atkins LS, Badawi A, Balakrishnan K, Banerjee A, Basu S, Beardsley J, Bekele T, Bell ML, Bernabe E, Beyene TJ, Bhala N, Bhalla A, Bhutta ZA, Abdulhak AB, Binagwaho A, Blore JD, Basara BB, Bose D, Brainin M, Breitborde N, Castañeda-Orjuela CA, Catalá-López F, Chadha VK, Chang JC, Chiang PPC, Chuang TW, Colomar M, Cooper LT, Cooper C, Courville KJ, Cowie BC, Criqui MH, Dandona R, Dayama A, De Leo D, Degenhardt L, Del Pozo-Cruz B, Deribe K, Des Jarlais DC, Dessalegn M, Dharmaratne SD, Dilmen U, Ding EL, Driscoll TR, Durrani AM, Ellenbogen RG, Ermakov SP, Esteghamati A, Faraon EJA, Farzadfar F, Fereshtehnejad SM, Fijabi DO, Forouzanfar MH, Fra Paleo U, Gaffikin L, Gamkrelidze A, Gankpé FG, Geleijnse JM, Gessner BD, Gibney KB, Ginawi IAM, Glaser EL, Gona P, Goto A, Gouda HN, Gugnani HC, Gupta R, Gupta R, Hafezi-Nejad N, Hamadeh RR, Hammami M, Hankey GJ, Harb HL, Haro JM, Havmoeller R, Hay SI, Hedayati MT, Pi IBH, Hoek HW, Hornberger JC, Hosgood HD, Hotez PJ, Hoy DG, Huang JJ, Iburg KM, Idrisov BT, Innos K, Jacobsen KH, Jeemon P, Jensen PN, Jha V, Jiang G, Jonas JB, Juel K, Kan H, Kankindi I, Karam NE, Karch A, Karema CK, Kaul A, Kawakami N, Kazi DS, Kemp AH, Kengne AP, Keren A, Kereselidze M, Khader YS, Khalifa SEAH, Khan EA, Khang YH, Khonelidze I, Kinfu Y, Kinge JM, Knibbs L, Kokubo Y, Kosen S, Defo BK, Kulkarni VS, Kulkarni C, Kumar K, Kumar RB, Kumar GA, Kwan GF, Lai T, Balaji AL, Lam H, Lan Q, Lansingh VC, Larson HJ, Larsson A, Lee JT, Leigh J, Leinsalu M, Leung R, Li Y, Li Y, De Lima GMF, Lin HH, Lipshultz SE, Liu S, Liu Y, Lloyd BK, Lotufo PA, Machado VMP, Maclachlan JH, Magis-Rodriguez C, Majdan M, Mapoma CC, Marcenes W, Marzan MB, Masci JR, Mashal MT, Mason-Jones AJ, Mayosi BM, Mazorodze TT, Mckay AC, Meaney PA, Mehndiratta MM, Mejia-Rodriguez F, Melaku YA, Memish ZA, Mendoza W, Miller TR, Mills EJ, Mohammad KA, Mokdad AH, Mola GL, Monasta L, Montico M, Moore AR, Mori R, Moturi WN, Mukaigawara M, Murthy KS, Naheed A, Naidoo KS, Naldi L, Nangia V, Narayan KMV, Nash D, Nejjari C, Nelson RG, Neupane SP, Newton CR, Ng M, Nisar MI, Nolte S, Norheim OF, Nowaseb V, Nyakarahuka L, Oh IH, Ohkubo T, Olusanya BO, Omer SB, Opio JN, Orisakwe OE, Pandian JD, Papachristou C, Caicedo AJP, Patten SB, Paul VK, Pavlin BI, Pearce N, Pereira DM, Pervaiz A, Pesudovs K, Petzold M, Pourmalek F, Qato D, Quezada AD, Quistberg DA, Rafay A, Rahimi K, Rahimi-Movaghar V, Ur Rahman S, Raju M, Rana SM, Razavi H, Reilly RQ, Remuzzi G, Richardus JH, Ronfani L, Roy N, Sabin N, Saeedi MY, Sahraian MA, Samonte GMJ, Sawhney M, Schneider IJC, Schwebel DC, Seedat S, Sepanlou SG, Servan-Mori EE, Sheikhbahaei S, Shibuya K, Shin HH, Shiue I, Shivakoti R, Sigfusdottir ID, Silberberg DH, Silva AP, Simard EP, Singh JA, Skirbekk V, Sliwa K, Soneji S, Soshnikov SS, Sreeramareddy CT, Stathopoulou VK, Stroumpoulis K, Swaminathan S, Sykes BL, Tabb KM, Talongwa RT, Tenkorang EY, Terkawi AS, Thomson AJ, Thorne-Lyman AL, Towbin JA, Traebert J, Tran BX, Dimbuene ZT, Tsilimbaris M, Uchendu US, Ukwaja KN, Uzun SB, Vallely AJ, Vasankari TJ, Venketasubramanian N, Violante FS, Vlassov VV, Vollset SE, Waller S, Wallin MT, Wang L, Wang X, Wang Y, Weichenthal S, Weiderpass E, Weintraub RG, Westerman R, White RA, Wilkinson JD, Williams TN, Woldeyohannes SM, Wong JQ, Xu G, Yang YC, Yano Y, Yentur GK, Yip P, Yonemoto N, Yoon SJ, Younis M, Yu C, Jin KY, El Sayed Zaki M, Zhao Y, Zheng Y, Zhou M, Zhu J, Zou XN, Lopez AD, Vos T. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384:1005-70. [PMID: 25059949 PMCID: PMC4202387 DOI: 10.1016/s0140-6736(14)60844-8] [Citation(s) in RCA: 662] [Impact Index Per Article: 66.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration. METHODS To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets. FINDINGS Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990. INTERPRETATION Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
| | | | | | - Stephen S Lim
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - D Allen Roberts
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Nicholas Graetz
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Ryan M Barber
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Haidong Wang
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Herbert C Duber
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Daniel Dicker
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, Seattle, WA, USA; Public Health Foundation of India, New Delhi, India
| | | | - Kyle R Heuton
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | | | | | | | | | | | | | | | | | - Jerry P Abraham
- University of Texas School of Medicine San Antonio, San Antonio, TX, USA
| | | | | | - Niveen Me Abu-Rmeileh
- Institute of Community and Public Health-Birzeti University, Ramallah, West Bank, Occupied Palestinian Territory
| | | | | | | | | | | | | | | | | | | | - Gabriel Alcalá-Cerra
- Grupo de Investigación en Ciencias de la Salud y Neurociencias (CISNEURO), Cartagena de Indias, Colombia
| | - Miguel Angel Alegretti
- Facultad de Medicina, Departamento de Medicina Preventiva y Social, Universidad de la República, Montevideo, Uruguay
| | | | | | | | | | - Francois Alla
- School of Public Health, University of Lorraine, Nancy, France
| | | | | | | | | | | | - Azmeraw T Amare
- Department of Epidemiology, University of Groningen, Groningen, The Netherlands; College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Hassan Amini
- Kurdistan Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Kurdistan, Iran
| | | | | | | | | | | | | | | | - Rana J Asghar
- South Asian Public Health Forum, Islamabad, Pakistan
| | - Reza Assadi
- Mashhad University of Medical Sciences, Mashhad, Iran
| | - Lydia S Atkins
- Ministry of Health, Wellness, Human Services and Gender Relations, Castries, St. Lucia
| | - Alaa Badawi
- Public Health Agency of Canada, Toronto, ON, Canada
| | | | | | | | | | | | | | | | | | | | - Ashish Bhalla
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | - Jed D Blore
- University of Melbourne, Melbourne, VIC, Australia
| | | | | | | | | | | | - Ferrán Catalá-López
- Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency (AEMPS), Ministry of Health, Madrid, Spain
| | | | | | | | - Ting-Wu Chuang
- Department of Parasitology, College of Medicine, Taipei Medical University, Taipei, Taiwan; Center for International Tropical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | | | | | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | | | - Benjamin C Cowie
- Victorian Infectious Diseases Reference Laboratory, North Melbourne, VIC, Australia
| | | | | | - Anand Dayama
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | | | | | | | - Muluken Dessalegn
- Africa Medical and Research Foundation in Ethiopia, Addis Ababa, Ethiopia
| | | | | | - Eric L Ding
- Harvard School of Public Health, Cambridge, MA, USA
| | | | | | | | - Sergey Petrovich Ermakov
- The Institute of Social and Economic Studies of Population at the Russian Academy of Sciences, Moscow, Russia
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | - Lynne Gaffikin
- Stanford University School of Medicine, Stanford, CA, USA
| | | | | | | | | | | | | | | | - Philimon Gona
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Atsushi Goto
- Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hebe N Gouda
- University of Queensland, Brisbane, QLD, Australia
| | | | | | - Rahul Gupta
- Kanawha Charleston Health Department, Charleston, WV, USA
| | - Nima Hafezi-Nejad
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mouhanad Hammami
- Wayne County Department of Health and Human Services, Detroit, MI, USA
| | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | | | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, University of Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | | | | | | | | | - Hans W Hoek
- Parnassia Psychiatric Institute, The Hague, Netherlands
| | | | | | | | - Damian G Hoy
- School of Population Health, Brisbane, QLD, Australia; Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia
| | | | | | | | - Kaire Innos
- National Institute for Health Development, Tallinn, Estonia
| | | | | | | | - Vivekanand Jha
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Guohong Jiang
- Tianjin Centers for Diseases Control and Prevention, Tianjin, China
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Knud Juel
- The National Institute of Public Health, Copenhagen, Denmark
| | | | | | | | - André Karch
- Helmholtz Centre for Infection Research, Braunschweig, Germany; German Center for Infection Research (DZIF), Hannover-Braunschweig site, Germany
| | | | - Anil Kaul
- Oklahoma State University, Tulsa, OK, USA
| | | | - Dhruv S Kazi
- University of California San Francisco, San Francisco, CA, USA
| | | | - Andre Pascal Kengne
- South African Medical Research Council, Cape Town, Western Cape, South Africa
| | - Andre Keren
- Cardiology, Hadassah Ein Kerem University Hospital, Jerusalem, Israel
| | - Maia Kereselidze
- National Centre for Disease Control and Public Health, Tbilisi, Georgia
| | | | | | | | - Young-Ho Khang
- Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea
| | - Irma Khonelidze
- National Centre for Disease Control and Public Health, Tbilisi, Georgia
| | | | | | - Luke Knibbs
- University of Queensland, Brisbane, QLD, Australia
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - S Kosen
- Center for Community Empowerment, Health Policy & Humanities, NIHRD, Jakarta, Indonesia
| | | | | | - Chanda Kulkarni
- Rajrajeshwari Medical College & Hospital, Bangalore, Karnataka, India
| | - Kaushalendra Kumar
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Ravi B Kumar
- Indian Institute of Public Health, Public Health Foundation of India, Gurgaon, Haryana, India
| | - G Anil Kumar
- Public Health Foundation of India, New Delhi, India
| | | | - Taavi Lai
- Fourth View Consulting, Tallinn, Estonia
| | | | - Hilton Lam
- Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines
| | - Qing Lan
- National Cancer Institute, Rockville, MD, USA
| | | | - Heidi J Larson
- London School of Hygiene and Tropical Medicine, Bloomsbury, UK
| | | | | | - James Leigh
- University of Sydney, Sydney, NSW, Australia
| | - Mall Leinsalu
- National Institute for Health Development, Tallinn, Estonia
| | - Ricky Leung
- University at Albany, The State University of New York, Rensselaer, NY, USA
| | - Yichong Li
- Genentech, Inc, South San Francisco, CA, USA
| | - Yongmei Li
- Genentech, Inc, South San Francisco, CA, USA
| | | | - Hsien-Ho Lin
- Institute of Epidemiology and Preventive Medicine, Taipei, Taiwan
| | | | - Shiwei Liu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Liu
- Emory University, Atlanta, GA, USA
| | - Belinda K Lloyd
- Eastern Health Clinical School, VIC, Australia; Turning Point, Eastern Health, Fitzroy, VIC, Australia
| | | | | | | | | | - Marek Majdan
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
| | | | | | | | - Joseph R Masci
- Elmhurst Hospital Center, Mount Sinai Services, Elmhurst, NY, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Ted R Miller
- Pacific Institute for Research & Evaluation, Calverton MD, USA; Centre for Population Health Research, Curtin University, Perth, WA, Australia
| | | | | | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Lorenzo Monasta
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo," Trieste, Italy
| | - Marcella Montico
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo," Trieste, Italy
| | | | - Rintaro Mori
- National Center for Child Health and Development, Setagaya, Tokyo, Japan
| | | | | | | | - Aliya Naheed
- International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Kovin S Naidoo
- University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Luigi Naldi
- Azienda Ospedaliera papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Denis Nash
- School of Public Health, City University of New York, New York, NY, USA
| | | | - Robert G Nelson
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - Sudan Prasad Neupane
- Norwegian Center for Addiction Research (SERAF), University of Oslo, Oslo, Norway
| | - Charles R Newton
- Kenya Medical Research Institute Wellcome Trust Programme, Kilifi, Kenya
| | - Marie Ng
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Sandra Nolte
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | | | | | | | | | | | | | - John Nelson Opio
- Lira District Local Government, Lira Municipal Council, Northern Uganda, Uganda
| | - Orish Ebere Orisakwe
- Toxicology Unit, Faculty of Pharmacy, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | | | | | | | | | | | | | - Neil Pearce
- London School of Hygiene and Tropical Medicine, Bloomsbury, UK
| | - David M Pereira
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine and ICVS/3B's-PT Government Associate Laboratory, Braga, Portugal
| | - Aslam Pervaiz
- Postgraduate Medical Institute, Lahore, Punjab, Pakistan
| | | | - Max Petzold
- Centre for Applied Biostatistics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Dima Qato
- College of Pharmacy, University of Illinois, Chicago, IL, USA
| | - Amado D Quezada
- National Institute of Public Health of Mexico, Cuernavaca, Morelos, Mexico
| | | | | | | | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Saleem M Rana
- Department of Public Health, University of the Punjab, Lahore, Punjab, Pakistan
| | - Homie Razavi
- Center for Disease Analysis, Louisville, CO, USA
| | | | - Giuseppe Remuzzi
- IRCCS Mario Negri Institute for Pharmacological Research, Centro Anna Maria Astori, Bergamo, Italy
| | | | - Luca Ronfani
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo," Trieste, Italy
| | | | | | | | | | - Genesis May J Samonte
- National HIV/AIDS & STI Surveillance and Strategic Information Unit, National Epidemiology Center, Department of Health, Manila, National Capital Region, Philippines
| | | | | | | | - Soraya Seedat
- Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sara Sheikhbahaei
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Ivy Shiue
- Heriot-Watt University, Edinburgh, UK
| | - Rupak Shivakoti
- Center for Clinical Global Health Education, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Andrea P Silva
- Instituto Nacional de Epidemiología Dr Juan H Jara, Mar del Plata, Buenos Aires, Argentina
| | - Edgar P Simard
- Surveillance and Health Services Research Program American Cancer Society, Atlanta, GA, USA
| | | | | | - Karen Sliwa
- Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa, Cape Town, Western Cape, South Africa
| | | | - Sergey S Soshnikov
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia
| | | | | | - Konstantinos Stroumpoulis
- KEELPNO (Centre for Disease Control, Greece, dispatched to "Alexandra" General Hospital of Athens), Athens, Greece
| | - Soumya Swaminathan
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Bryan L Sykes
- Department of Criminology, Law and Society (and Sociology), University of California-Irvine, Chicago, IL, USA
| | | | | | | | - Abdullah Sulieman Terkawi
- Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA; Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | | | - Jeffrey A Towbin
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Bach X Tran
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Zacharie Tsala Dimbuene
- Department of Population Sciences and Development, Faculty of Economics and Management, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | | | - Kingsley N Ukwaja
- Department of Internal Medicine, Federal Teaching Hospital Abakaliki, Abakailiki, Ebonyi State, Nigeria
| | | | | | | | | | | | | | - Stein Emil Vollset
- Norwegian Institute of Public Health, Oslo, Norway; University of Bergen, Bergen, Norway
| | - Stephen Waller
- Uniformed Services University of Health Sciences, Bethesda, MD, USA
| | - Mitchell T Wallin
- VA Medical Center and Georgetown University Neurology Department, Washington, DC, USA
| | - Linhong Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - XiaoRong Wang
- Shandong University Affiliated Jinan Central Hospital, Jinan, China
| | - Yanping Wang
- National Office for Maternal and Child Health Surveillance, Chengdu, China
| | | | | | - Robert G Weintraub
- University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
| | | | - Richard A White
- Department of Infectious Disease Epidemiology, Division of Infectious Disease Control and Department of Health Statistics, Division of Epidemiology, Oslo, Norway
| | | | | | | | - John Q Wong
- Ateneo School of Medicine and Public Health, Pasig City, Metro Manila, Philippines
| | - Gelin Xu
- Nanjing University School of Medicine, Jinling Hospital, Nanjing, China
| | - Yang C Yang
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yuichiro Yano
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | | | - Paul Yip
- The University of Hong Kong, Hong Kong, Hong Kong
| | - Naohiro Yonemoto
- National Center of Neurology and Psychiatry, Kodira, Tokyo, Japan
| | | | | | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health and Global Health Institute, Wuhan University, Wuhan, China
| | - Kim Yun Jin
- TCM MEDICAL TK SDN BHD, Nusajaya, Johor Bahru, Malaysia
| | | | - Yong Zhao
- Chongqing Medical University, Chongqing, China
| | - Yingfeng Zheng
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jun Zhu
- National Office for Maternal and Child Health Surveillance, Chengdu, China
| | - Xiao Nong Zou
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Alan D Lopez
- University of Melbourne, Melbourne, VIC, Australia
| | - Theo Vos
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
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Wang H, Liddell CA, Coates MM, Mooney MD, Levitz CE, Schumacher AE, Apfel H, Iannarone M, Phillips B, Lofgren KT, Sandar L, Dorrington RE, Rakovac I, Jacobs TA, Liang X, Zhou M, Zhu J, Yang G, Wang Y, Liu S, Li Y, Ozgoren AA, Abera SF, Abubakar I, Achoki T, Adelekan A, Ademi Z, Alemu ZA, Allen PJ, AlMazroa MA, Alvarez E, Amankwaa AA, Amare AT, Ammar W, Anwari P, Cunningham SA, Asad MM, Assadi R, Banerjee A, Basu S, Bedi N, Bekele T, Bell ML, Bhutta Z, Blore JD, Basara BB, Boufous S, Breitborde N, Bruce NG, Bui LN, Carapetis JR, Cárdenas R, Carpenter DO, Caso V, Castro RE, Catalá-Lopéz F, Cavlin A, Che X, Chiang PPC, Chowdhury R, Christophi CA, Chuang TW, Cirillo M, da Costa Leite I, Courville KJ, Dandona L, Dandona R, Davis A, Dayama A, Deribe K, Dharmaratne SD, Dherani MK, Dilmen U, Ding EL, Edmond KM, Ermakov SP, Farzadfar F, Fereshtehnejad SM, Fijabi DO, Foigt N, Forouzanfar MH, Garcia AC, Geleijnse JM, Gessner BD, Goginashvili K, Gona P, Goto A, Gouda HN, Green MA, Greenwell KF, Gugnani HC, Gupta R, Hamadeh RR, Hammami M, Harb HL, Hay S, Hedayati MT, Hosgood HD, Hoy DG, Idrisov BT, Islami F, Ismayilova S, Jha V, Jiang G, Jonas JB, Juel K, Kabagambe EK, Kazi DS, Kengne AP, Kereselidze M, Khader YS, Khalifa SEAH, Khang YH, Kim D, Kinfu Y, Kinge JM, Kokubo Y, Kosen S, Defo BK, Kumar GA, Kumar K, Kumar RB, Lai T, Lan Q, Larsson A, Lee JT, Leinsalu M, Lim SS, Lipshultz SE, Logroscino G, Lotufo PA, Lunevicius R, Lyons RA, Ma S, Mahdi AA, Marzan MB, Mashal MT, Mazorodze TT, McGrath JJ, Memish ZA, Mendoza W, Mensah GA, Meretoja A, Miller TR, Mills EJ, Mohammad KA, Mokdad AH, Monasta L, Montico M, Moore AR, Moschandreas J, Msemburi WT, Mueller UO, Muszynska MM, Naghavi M, Naidoo KS, Narayan KMV, Nejjari C, Ng M, de Dieu Ngirabega J, Nieuwenhuijsen MJ, Nyakarahuka L, Ohkubo T, Omer SB, Caicedo AJP, Pillay-van Wyk V, Pope D, Pourmalek F, Prabhakaran D, Rahman SUR, Rana SM, Reilly RQ, Rojas-Rueda D, Ronfani L, Rushton L, Saeedi MY, Salomon JA, Sampson U, Santos IS, Sawhney M, Schmidt JC, Shakh-Nazarova M, She J, Sheikhbahaei S, Shibuya K, Shin HH, Shishani K, Shiue I, Sigfusdottir ID, Singh JA, Skirbekk V, Sliwa K, Soshnikov SS, Sposato LA, Stathopoulou VK, Stroumpoulis K, Tabb KM, Talongwa RT, Teixeira CM, Terkawi AS, Thomson AJ, Thorne-Lyman AL, Toyoshima H, Dimbuene ZT, Uwaliraye P, Uzun SB, Vasankari TJ, Vasconcelos AMN, Vlassov VV, Vollset SE, Waller S, Wan X, Weichenthal S, Weiderpass E, Weintraub RG, Westerman R, Wilkinson JD, Williams HC, Yang YC, Yentur GK, Yip P, Yonemoto N, Younis M, Yu C, Jin KY, El Sayed Zaki M, Zhu S, Vos T, Lopez AD, Murray CJL. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384:957-79. [PMID: 24797572 PMCID: PMC4165626 DOI: 10.1016/s0140-6736(14)60497-9] [Citation(s) in RCA: 512] [Impact Index Per Article: 51.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success. METHODS We generated updated estimates of child mortality in early neonatal (age 0-6 days), late neonatal (7-28 days), postneonatal (29-364 days), childhood (1-4 years), and under-5 (0-4 years) age groups for 188 countries from 1970 to 2013, with more than 29,000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030. FINDINGS We estimated that 6·3 million (95% UI 6·0-6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1-18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6-177·4) in Guinea-Bissau to 2·3 (1·8-2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from -6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000-13 than during 1990-2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only -1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone. INTERPRETATION Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030. FUNDING Bill & Melinda Gates Foundation, US Agency for International Development.
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Affiliation(s)
- Haidong Wang
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
| | - Chelsea A Liddell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Matthew M Coates
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Meghan D Mooney
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Carly E Levitz
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Austin E Schumacher
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Henry Apfel
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Marissa Iannarone
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Bryan Phillips
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Katherine T Lofgren
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Logan Sandar
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Ivo Rakovac
- WHO Regional Office for Europe, Copenhagen, Denmark
| | - Troy A Jacobs
- MCH Division, USAID - Global Health Bureau, HIDN, Washington, DC, USA
| | - Xiaofeng Liang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jun Zhu
- National Office for Maternal and Child's Health Surveillance, Chengdu, China
| | - Gonghuan Yang
- Peking Union Medical College, Beijing, China; Peking Union Medical College, Beijing, China
| | - Yanping Wang
- National Office for Maternal and Child's Health Surveillance, Chengdu, China
| | - Shiwei Liu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yichong Li
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | | | | | - Tom Achoki
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Ministry of Health, Gaborone, Botswana
| | | | | | | | | | | | | | | | - Azmeraw T Amare
- Department of Epidemiology, University of Groningen, Groningen, Netherlands
| | | | | | | | | | - Reza Assadi
- Mashhad University of Medical Sciences, Mashhad, Khorasan, Iran
| | - Amitava Banerjee
- University of Birmingham, Birmingham, West Midlands, United Kingdom
| | | | - Neeraj Bedi
- College of Public Health and Tropical Medicine, Jazan, Saudi Arabia
| | | | | | | | - Jed D Blore
- University of Melbourne, Melbourne, VIC, Australia
| | - Berrak Bora Basara
- Ministry of Health, General Directorate of Health Research, Ankara, Turkey
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research, University of New South Wales, Sydney, NSW, Australia
| | | | | | | | | | | | | | - Valeria Caso
- Stroke Unit, University of Perugia, Perugia, Italy
| | | | - Ferrán Catalá-Lopéz
- Division of Pharmacology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency (AEMPS), Ministry of Health, Madrid, Spain
| | - Alanur Cavlin
- Hacettepe University Institute of Population Studies, Ankara, Turkey
| | - Xuan Che
- National Institutes of Health, Bethesda, MD, USA
| | | | | | | | | | | | | | | | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Public Health Foundation of India, New Delhi, India
| | | | | | | | | | | | | | - Uğur Dilmen
- Ministry of Health, General Directorate of Health Research, Ankara, Turkey
| | - Eric L Ding
- Harvard School of Public Health, Harvard University, Boston, MA, USA
| | | | - Sergei Petrovich Ermakov
- The Institute of Social and Economic Studies of Population at the Russian Academy of Sciences, Moscow, Russia
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrine and Metabolic Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Nataliya Foigt
- Institute of Gerontology, Academy of Medical Sciences, Kyiv, Ukraine
| | | | - Ana C Garcia
- Public Health Unit of Primary Health Care Group of Almada-Seixal (region of Lisbon), Almada, Portugal
| | - Johanna M Geleijnse
- Wageningen University, Division of Human Nutrition, Wageningen, the Netherlands
| | | | | | - Philimon Gona
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Atsushi Goto
- Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hebe N Gouda
- University of Queensland, Brisbane, QLD, Australia
| | - Mark A Green
- University of Sheffield, Sheffield, South York, United Kingdom
| | | | | | - Rahul Gupta
- Kanawha Charleston Health Department, Charleston, WV, USA
| | | | - Mouhanad Hammami
- Wayne County Department of Health and Human Services, Detroit, MI, USA
| | | | - Simon Hay
- University of Oxford, Oxford, United Kingdom
| | | | | | - Damian G Hoy
- School of Population Health, Brisbane, QLD, Australia; Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia
| | | | | | | | - Vivekanand Jha
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Guohong Jiang
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Mannheim, Germany
| | - Knud Juel
- The National Institute of Public Health, Copenhagen, Denmark
| | | | - Dhruv S Kazi
- University of California San Francisco, San Francisco, CA, USA
| | - Andre Pascal Kengne
- South African Medical Research Council, Cape Town, Western Cape, South Africa
| | - Maia Kereselidze
- National Centre for Diseases Control and Public Health, Tbilisi, Georgia
| | | | | | - Young-Ho Khang
- Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea
| | - Daniel Kim
- Northeastern University, Boston, MA, USA
| | | | - Jonas M Kinge
- The Norwegian Institute of Public Health, Oslo, Norway
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Soewarta Kosen
- Center for Community Empowerment, Health Policy & Humanities, NIHRD, Jakarta, Indonesia
| | | | - G Anil Kumar
- Public Health Foundation of India, New Delhi, India
| | | | - Ravi B Kumar
- Public Health Foundation of India, New Delhi, India
| | - Taavi Lai
- Fourth View Consulting, Tallinn, Estonia
| | - Qing Lan
- National Cancer Institute, Bethesda, MD, USA
| | | | | | - Mall Leinsalu
- The National Institute for Health Development, Tallinn, Estonia
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | | | | | | | | | - Stefan Ma
- Ministry of Health Singapore, Singapore
| | - Abbas Ali Mahdi
- King George's Medical University, Lucknow, Uttar Pradesh, India
| | | | | | | | | | - Ziad A Memish
- Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | | | - George A Mensah
- Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | | | - Ted R Miller
- Pacific Institute for Research & Evaluation, Calverton, MD, USA
| | | | | | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Lorenzo Monasta
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo," Trieste, Italy
| | - Marcella Montico
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo," Trieste, Italy
| | | | | | - William T Msemburi
- South African Medical Research Council, Cape Town, Western Cape, South Africa
| | | | | | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kovin S Naidoo
- University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | | | - Chakib Nejjari
- Department of Epidemiology and Public Health, Faculty of Medicine and Pharmacy, University sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Marie Ng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | | | | | | | | | | | | | - Dan Pope
- University of Liverpool, Merseyside, United Kingdom
| | | | | | | | - Saleem M Rana
- Department of Public Health, University of the Punjab, Lahore, Punjab, Pakistan
| | | | - David Rojas-Rueda
- Centre of Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Luca Ronfani
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo," Trieste, Italy
| | | | | | - Joshua A Salomon
- Harvard School of Public Health, Harvard University, Boston, MA, USA
| | | | | | | | | | | | - Jun She
- Zhongshan Hospital, Fudan, University, Shanghai, China
| | - Sara Sheikhbahaei
- Non-Communicable Diseases Research Center, Endocrine and Metabolic Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Ivy Shiue
- Heriot-Watt University, Edinburgh, Scotland, United Kingdom
| | | | | | | | - Karen Sliwa
- Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa
| | - Sergey S Soshnikov
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia
| | - Luciano A Sposato
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | | | - Konstantinos Stroumpoulis
- KEELPNO (Center for Disease Control, Greece, dispatched to "Alexandra" General Hospital of Athens), Athens, Greece
| | | | | | | | - Abdullah Sulieman Terkawi
- Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA; Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | | | - Hideaki Toyoshima
- Health Care Center of Anjo Kosei Hospital, Anjo City, Aichi Prefecture, Japan
| | - Zacharie Tsala Dimbuene
- Department of Population Sciences and Development, Faculty of Economics and Management, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, Rwanda, Kigali City, Rwanda
| | | | - Selen Begüm Uzun
- Ministry of Health, General Directorate of Health Research, Ankara, Turkey
| | | | | | | | | | - Stephen Waller
- Uniformed Services University of Health Sciences, Bethesda, MD, USA
| | - Xia Wan
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | | | | | - Robert G Weintraub
- University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
| | | | | | | | - Yang C Yang
- University of North Carolina at Chapel Hill, Chapel Hill, NC. USA
| | | | - Paul Yip
- The University of Hong Kong, Hong Kong
| | - Naohiro Yonemoto
- National Center of Neurology and Psychiatry, Kodira, Tokyo, Japan
| | | | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, and Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - Kim Yun Jin
- TCM MEDICAL TK SDN BHD, Nusajaya, Johor Bahru, Malaysia
| | | | - Shankuan Zhu
- Zhejiang University School of Public Health, Hangzhou, Zhejiang, China
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Alan D Lopez
- University of Melbourne, Melbourne, VIC, Australia
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5
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Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NME, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DFJ, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SEAH, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KMV, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJC, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJL, Gakidou E. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384:766-81. [PMID: 24880830 PMCID: PMC4624264 DOI: 10.1016/s0140-6736(14)60460-8] [Citation(s) in RCA: 7551] [Impact Index Per Article: 755.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. METHODS We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). FINDINGS Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. INTERPRETATION Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Marie Ng
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Tom Fleming
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Blake Thomson
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Nicholas Graetz
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Erin C Mullany
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Stan Biryukov
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Semaw Ferede Abera
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Jerry P Abraham
- University of Texas School of Medicine, San Antonio, TX, USA
| | - Niveen M E Abu-Rmeileh
- Institute of Community and Public Health, Birzeti University, Ramallah, West Bank, Occupied Palestinian Territory
| | - Tom Achoki
- Institute for Health Metrics and Evaluation, Seattle, WA, USA; Ministry of Health, Gaborone, Botswana
| | - Fadia S AlBuhairan
- King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Simon Barquera
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | | | - Jed Blore
- University of Melbourne, Melbourne, VIC, Australia
| | | | | | | | | | | | | | | | | | - Lalit Dandona
- Institute for Health Metrics and Evaluation, Seattle, WA, USA; Public Health Foundation of India, New Delhi, India
| | | | | | | | - Eric L Ding
- Harvard School of Public Health, Boston, MA USA
| | - Adnan M Durrani
- National Institutes of Health, Bethesda and Montgomery, MD, USA
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Valery L Feigin
- National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand
| | - Abraham Flaxman
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Atsushi Goto
- Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Nima Hafezi-Nejad
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | | | | | | | - Lucia Hernandez
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | - Nayu Ikeda
- National Institute of Health and Nutrition, Tokyo, Japan
| | | | | | - Simerjot K Jassal
- VA San Diego, University of California San Diego, San Diego, CA, USA
| | - Sun Ha Jee
- Graduate School of Public Health, Yonsei University, Seoul, Korea
| | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | | | | | | | - Young-Ho Khang
- Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Daniel Kim
- Northeastern University, Boston, MA, USA
| | | | - Jonas M Kinge
- The Norwegian Institute of Public Health, Oslo, Norway
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soewarta Kosen
- Center for Community Empowerment, Health Policy & Informatics, NIHRD, Jakarta, Indonesia
| | - Gene Kwan
- Boston Medical Center, Boston, MA, USA
| | - Taavi Lai
- Fourth View Consulting, Tallinn, Estonia
| | - Mall Leinsalu
- The National Institute for Health Development, Tallinn, Estonia
| | - Yichong Li
- National Center for Chronic and Non-communicable Disease Control and Prevention, Beijing, China
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shiwei Liu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | | | | | - Yuan Lu
- Harvard School of Public Health, Boston, MA USA
| | - Jixiang Ma
- Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - George A Mensah
- Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, Bethesda and Montgomery, MD, USA
| | | | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Aliya Naheed
- International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | | | | | | | | | | | - Samuel O Oti
- African Population and Health Research Center, Nairobi, Kenya
| | - Andrea Pedroza
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | | | - Hyeyoung Seo
- Department of Public Health, Graduate School, Seoul, Korea
| | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Rahman Shiri
- Finnish institute of Occupational Health, Helsinki, Finland
| | - Ivy Shiue
- Heriot-Watt University, Edinburgh, Scotland, UK
| | | | | | | | | | - Lela Sturua
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | | | - Martin Tobias
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Bach X Tran
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | | | | | | | - Stein Emil Vollset
- The Norwegian Institute of Public Health, Oslo, Norway; University of Bergen, Bergen, Norway
| | - Theo Vos
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - XiaoRong Wang
- Shandong University affiliated Jinan Central Hospital, Jinan, China
| | | | - Andrea Werdecker
- Institute of Medical Sociology and Social Medicine, Marburg, Hessen, Germany
| | | | | | | | - Jihyun Yoon
- Department of Preventive Medicine, Seoul, Korea
| | | | - Yong Zhao
- Chongqing Medical University, Chongqing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Beijing, China
| | - Shankuan Zhu
- Zhejiang University School of Public Health, Hangzhou, China
| | - Alan D Lopez
- University of Melbourne, Melbourne, VIC, Australia
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6
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Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NME, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DFJ, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SEAH, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KMV, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJC, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJL, Gakidou E. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014. [PMID: 24880830 DOI: 10.1016/s0140-6736(14)60460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. METHODS We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). FINDINGS Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. INTERPRETATION Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Marie Ng
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Tom Fleming
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Blake Thomson
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Nicholas Graetz
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Erin C Mullany
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Stan Biryukov
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Semaw Ferede Abera
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Jerry P Abraham
- University of Texas School of Medicine, San Antonio, TX, USA
| | - Niveen M E Abu-Rmeileh
- Institute of Community and Public Health, Birzeti University, Ramallah, West Bank, Occupied Palestinian Territory
| | - Tom Achoki
- Institute for Health Metrics and Evaluation, Seattle, WA, USA; Ministry of Health, Gaborone, Botswana
| | - Fadia S AlBuhairan
- King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Simon Barquera
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | | | - Jed Blore
- University of Melbourne, Melbourne, VIC, Australia
| | | | | | | | | | | | | | | | | | - Lalit Dandona
- Institute for Health Metrics and Evaluation, Seattle, WA, USA; Public Health Foundation of India, New Delhi, India
| | | | | | | | - Eric L Ding
- Harvard School of Public Health, Boston, MA USA
| | - Adnan M Durrani
- National Institutes of Health, Bethesda and Montgomery, MD, USA
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Valery L Feigin
- National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand
| | - Abraham Flaxman
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Atsushi Goto
- Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Nima Hafezi-Nejad
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | | | | | | | - Lucia Hernandez
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | - Nayu Ikeda
- National Institute of Health and Nutrition, Tokyo, Japan
| | | | | | - Simerjot K Jassal
- VA San Diego, University of California San Diego, San Diego, CA, USA
| | - Sun Ha Jee
- Graduate School of Public Health, Yonsei University, Seoul, Korea
| | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | | | | | | | - Young-Ho Khang
- Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Daniel Kim
- Northeastern University, Boston, MA, USA
| | | | - Jonas M Kinge
- The Norwegian Institute of Public Health, Oslo, Norway
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soewarta Kosen
- Center for Community Empowerment, Health Policy & Informatics, NIHRD, Jakarta, Indonesia
| | - Gene Kwan
- Boston Medical Center, Boston, MA, USA
| | - Taavi Lai
- Fourth View Consulting, Tallinn, Estonia
| | - Mall Leinsalu
- The National Institute for Health Development, Tallinn, Estonia
| | - Yichong Li
- National Center for Chronic and Non-communicable Disease Control and Prevention, Beijing, China
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shiwei Liu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | | | | | - Yuan Lu
- Harvard School of Public Health, Boston, MA USA
| | - Jixiang Ma
- Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - George A Mensah
- Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, Bethesda and Montgomery, MD, USA
| | | | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Aliya Naheed
- International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | | | | | | | | | | | - Samuel O Oti
- African Population and Health Research Center, Nairobi, Kenya
| | - Andrea Pedroza
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | | | - Hyeyoung Seo
- Department of Public Health, Graduate School, Seoul, Korea
| | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Rahman Shiri
- Finnish institute of Occupational Health, Helsinki, Finland
| | - Ivy Shiue
- Heriot-Watt University, Edinburgh, Scotland, UK
| | | | | | | | | | - Lela Sturua
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | | | - Martin Tobias
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Bach X Tran
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | | | | | | | - Stein Emil Vollset
- The Norwegian Institute of Public Health, Oslo, Norway; University of Bergen, Bergen, Norway
| | - Theo Vos
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - XiaoRong Wang
- Shandong University affiliated Jinan Central Hospital, Jinan, China
| | | | - Andrea Werdecker
- Institute of Medical Sociology and Social Medicine, Marburg, Hessen, Germany
| | | | | | | | - Jihyun Yoon
- Department of Preventive Medicine, Seoul, Korea
| | | | - Yong Zhao
- Chongqing Medical University, Chongqing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Beijing, China
| | - Shankuan Zhu
- Zhejiang University School of Public Health, Hangzhou, China
| | - Alan D Lopez
- University of Melbourne, Melbourne, VIC, Australia
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