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Gutema BT, Levecke B, Sorrie MB, Megersa ND, Zewdie TH, Yesera GE, De Henauw S, Abubakar A, Abbeddou S. Effectiveness of intermittent iron and high-dose vitamin A supplementation on cognitive development of school children in southern Ethiopia: a randomized placebo-controlled trial. Am J Clin Nutr 2024; 119:470-484. [PMID: 37952928 DOI: 10.1016/j.ajcnut.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Iron is an essential mineral whose deficiency results in cognitive alteration, impaired emotional behaviors, and altered myelination and neurotransmission. In animal models, it has been shown that vitamin A (VA) could affect cognition. OBJECTIVES The study aimed to evaluate the effectiveness of intermittent iron and VA supplementation on cognitive development of schoolchildren, and to assess the interaction between these supplementations. METHODS Considering a 2 × 2 factorial design, 504 children were randomly assigned to 1 of the 4 arms: placebo VA and placebo iron supplement; high-dose vitamin VA and placebo iron supplement; iron supplement and placebo VA; and iron and high-dose vitamin VA supplements. Cognitive development was assessed using Raven's Coloured Progressive Matrices, digit span, Tower of London, and visual search tasks. RESULTS The mean [± standard deviation (SD)] age of the enrolled children was 9.6 (±1.6) y. One-fifth of the children had iron deficiency or anemia, whereas 2.9%, 3.9%, and 12.1% of children had low iron stores, iron deficiency anemia, and VA deficiency, respectively. Intermittent iron supplementation did not result in any significant improvement of children's cognitive development and had a negative effect on the performance index of the visual search task compared with placebo (-0.17 SD, 95% confidence interval: -0.32, -0.02). Effects were evident among children with stunting, thinness, or children coming from understimulating home environments. High-dose VA supplementation resulted in a significant improvement of digit span z-score with a mean difference of 0.30 SD (95% confidence interval: 0.14, 0.46) compared with placebo VA. VA had a more beneficial impact for girls, children infected with helminths, and those from food secure households. CONCLUSION In a population where the prevalence of iron deficiency is low, intermittent iron supplementation did not have any or negative effect on the child's cognitive development outcomes. Conversely, VA supplementation improved the child's working memory. TRIAL REGISTRATION NUMBER The study is registered at clinicaltrials.gov as NCT04137354 (https://clinicaltrials.gov/study/NCT04137354).
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Affiliation(s)
- Befikadu Tariku Gutema
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Bruno Levecke
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Muluken Bekele Sorrie
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nega Degefa Megersa
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tadiwos Hailu Zewdie
- School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gesila Endashaw Yesera
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Amina Abubakar
- Kenya Medical Research Institute (KMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Hailu FM, Kefene SW, Sorrie MB, Mekuria MS, Guyo TG. Sick child's feeding practices and associated factors among mothers with sick children aged less than 2 years in Gamo zone, southern Ethiopia. Does the participation of fathers contribute to improving nutrition? A facility-based cross-sectional study. Front Public Health 2023; 11:1256499. [PMID: 37965506 PMCID: PMC10641438 DOI: 10.3389/fpubh.2023.1256499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/02/2023] [Indexed: 11/16/2023] Open
Abstract
Background Children's nutritional status can decline rapidly during or after a common childhood illness unless additional nutritional requirements associated with the illness are considered. Therefore, this study was aimed at assessing a sick child's feeding practices and associated factors among mothers who have sick children under 2 years of age in southern Ethiopia. Methods A facility-based cross-sectional study design was employed from 1 April 2022 to 30 April 2022. Data were collected through the questionnaire, entered into an open data kit (ODK), and exported into Statistical Packages for Social Sciences (SPSS) version 25.0 for analysis. A systematic random sampling technique was used to select study participants. Bivariable and multivariable logistic regression analyses were used to identify factors associated with sick child feeding practices. An adjusted odds ratio (AOR) with 95% confidence intervals (CIs) was used to determine the strength of the association. Statistical significance was declared at a p-value of <0.05. Results The overall magnitude of mothers' good sick child feeding practices was determined to be 45.0% (95% CI: 41.03, 48.97%). Being urban residents, being employed, having antenatal care (ANC) visits, having postnatal care (PNC) visits, counseling about child feeding, and fathers' involvement in sick child feeding increased the likelihood of sick child feeding practices by 4.4, 2.10, 2.31, 3.54, 2.11, and 2.54 times, respectively. Conclusion Sick child feeding practices were associated with having antenatal or postnatal visits, counseling about child feeding, and fathers' involvement in sick child feeding practices. Therefore, strengthening infant and young child feeding practices by showing special concern for the father's involvement is important to improve mothers' sick child feeding practices.
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Affiliation(s)
- Feven Masresha Hailu
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Simegn Wagaye Kefene
- Department of Public Health, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
| | - Muluken Bekele Sorrie
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Misgun Shewangezaw Mekuria
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tamirat Gezahegn Guyo
- Department of Public Health, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
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Gutema BT, Sorrie MB, Megersa ND, Yesera GE, Yeshitila YG, Pauwels NS, De Henauw S, Abbeddou S. Effects of iron supplementation on cognitive development in school-age children: Systematic review and meta-analysis. PLoS One 2023; 18:e0287703. [PMID: 37368919 DOI: 10.1371/journal.pone.0287703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Iron deficiency is negatively associated with children's cognitive development. Evidence showed that iron supplementation improves cognitive development. Nearly 50% of anemia is caused by iron deficiency. Anemia affects more school-age children, at an age where their brain development continues. The aim of this systematic review and meta-analysis is to review the evidence from published randomized controlled trials to evaluate the effects of iron supplementation on cognitive development and function among school-age children. METHOD Five databases including MEDLINE, EMBASE, Scopus, Web of Science and CENTRAL were used to search for articles on April 20th, 2021. The search was reconducted on October 13th, 2022 to retrieve new records. Studies were eligible if they included school children 6-12 years of age, were randomized controlled trials, and if they tested iron supplementation and measured cognitive development. RESULT Thirteen articles were included in the systematic review. Overall, iron supplementation significantly improved intelligence (standardized mean difference, 95% confidence interval) (SMD 0.46, 95%CI: 0.19, 0.73, P<0.001), attention and concentration (SMD 0.44, 95%CI: 0.07, 0.81, P = 0.02) and memory (SMD 0.44, 95%CI: 0.21, 0.67, P <0.001) of school-age children. There was no significant effect of iron supplementation on school achievement of school-age children (SMD 0.06, 95%CI: -0.15, 0.26, P = 0.56). In a subgroup analysis, iron-supplemented children who were anemic at baseline had had better outcomes of intelligence (SMD 0.79, 95%CI: 0.41, 1.16, P = 0.001) and memory (SMD 0.47, 95%CI: 0.13, 0.81; P = 0.006). CONCLUSION Iron supplementation has a significant positive effect on the intelligence, attention and concentration, and the memory of school-age children but there was no evidence on the effect of iron supplementation on their school achievement.
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Affiliation(s)
- Befikadu Tariku Gutema
- School of Public Health, Arba Minch University, Arba Minch, Ethiopia
- Public Health Nutrition Unit, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | | | | | | | | | - Nele S Pauwels
- Knowledge Centre for Health Ghent, Ghent University Hospital, Ghent, Belgium
| | - Stefaan De Henauw
- Public Health Nutrition Unit, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Souheila Abbeddou
- Public Health Nutrition Unit, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Frostad JJ, Nguyen QP, Baumann MM, Blacker BF, Marczak LB, Deshpande A, Wiens KE, LeGrand KE, Johnson KB, Abbasi-Kangevari M, Abdoli A, Abolhassani H, Abreu LG, Abrigo MRM, Abu-Rmeileh NME, Adekanmbi V, Agrawal A, Ahmed MB, Al-Aly Z, Alanezi FM, Alcalde-Rabanal JE, Alipour V, Altirkawi KA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amegah AK, Amini S, Amiri F, Amugsi DA, Ancuceanu R, Andrei CL, Andrei T, Antriyandarti E, Anvari D, Arabloo J, Arab-Zozani M, Athari SS, Ausloos M, Ayano G, Aynalem YA, Azari S, Badiye AD, Baig AA, Balakrishnan K, Banach M, Basu S, Bedi N, Bell ML, Bennett DA, Bhattacharyya K, Bhutta ZA, Bibi S, Bohlouli S, Boufous S, Bragazzi NL, Braithwaite D, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Car J, Cárdenas R, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Cerin E, Chattu SK, Chattu VK, Chaturvedi P, Chaturvedi S, Chen S, Chu DT, Chung SC, Dahlawi SMA, Damiani G, Dandona L, Dandona R, Darwesh AM, Das JK, Dash AP, Dávila-Cervantes CA, De Leo D, De Neve JW, Demissie GD, Denova-Gutiérrez E, Dey S, Dharmaratne SD, Dhimal M, Dhungana GP, Diaz D, Dipeolu IO, Dorostkar F, Doshmangir L, Duraes AR, Edinur HA, Efendi F, El Tantawi M, Eskandarieh S, Fadhil I, Fattahi N, Fauk NK, Fereshtehnejad SM, Folayan MO, Foroutan M, Fukumoto T, Gaidhane AM, Ghafourifard M, Ghashghaee A, Gilani SA, Gill TK, Goulart AC, Goulart BNG, Grada A, Gubari MIM, Guido D, Guo Y, Gupta RD, Gupta R, Gutiérrez RA, Hafezi-Nejad N, Hamadeh RR, Hasaballah AI, Hassanipour S, Hayat K, Heibati B, Heidari-Soureshjani R, Henry NJ, Herteliu C, Hosseinzadeh M, Hsairi M, Hu G, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Irvani SSN, Islam SMS, Iwu CCD, Jaafari J, Jakovljevic M, Javaheri T, Jha RP, Ji JS, Jonas JB, Kabir A, Kabir Z, Kalhor R, Kamyari N, Kanchan T, Kapil U, Kapoor N, Kayode GA, Keiyoro PN, Khader YS, Khalid N, Khan EA, Khan M, Khan MN, Khatab K, Khater MM, Khatib MN, Khayamzadeh M, Khubchandani J, Kim GR, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Knibbs LD, Koul PA, Koyanagi A, Krishan K, Kumar GA, Kumar M, Kusuma D, La Vecchia C, Lacey B, Lami FH, Lan Q, Lasrado S, Lauriola P, Lee PH, Lewycka S, Li S, Machado DB, Mahasha PW, Maheri M, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mansouri B, Mansournia MA, Martinez NM, Martini S, Martins-Melo FR, Mayala BK, Mehndiratta MM, Mendoza W, Menezes RG, Mengesha EW, Meretoja TJ, Mestrovic T, Michalek IM, Mirrakhimov EM, Mirzaei M, Mirzaei R, Moazen B, Mohammad Y, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Monasta L, Moradi-Lakeh M, Moraga P, Morawska L, Mosapour A, Mouodi S, Mousavi Khaneghah A, Mukhopadhyay S, Munro SB, Murray CJL, Nagarajan AJ, Naghavi M, Nair S, Nangia V, Nascimento BR, Nazari J, Negoi I, Netsere HB, Ngunjiri JW, Nguyen HLT, Noubiap JJ, Oancea B, Ogbo FA, Oh IH, Olagunju AT, Olusanya BO, Olusanya JO, Omar Bali A, Onwujekwe OE, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Pandey A, Park EC, Park EK, Patel SK, Pham HQ, Pilgrim T, Pirsaheb M, Pokhrel KN, Postma MJ, Quazi Syed Z, Rabiee N, Radfar A, Rahim F, Rahman MHU, Rahman MA, Rahmani AM, Ranabhat CL, Rao SJ, Rasella D, Rastogi P, Rath GK, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Renzaho AMN, Reshmi B, Rezaei N, Rezaei N, Rezapour A, Rickard J, Roever L, Ronfani L, Rostamian M, Rubagotti E, Rwegerera GM, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sagar R, Sahebkar A, Sahiledengle B, Salem MR, Samy AM, Santric-Milicevic MM, Saraswathy SYI, Sathian B, Sathish T, Schwebel DC, Sepanlou SG, Shahabi S, Shaheen AA, Shahid I, Shaikh MA, Shalash AS, Shams-Beyranvand M, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shetty RS, Shiferaw WS, Shigematsu M, Shin JI, Shivakumar KM, Siabani S, Siddiqi TJ, Singh BB, Singh JA, Sintayehu Y, Sorrie MB, Soyiri IN, Spurlock EE, Sreeramareddy CT, Stockfelt L, Sufiyan MB, Suliankatchi Abdulkader R, Tabarés-Seisdedos R, Tabuchi T, Taherkhani A, Temsah MH, Thankappan KR, Tovani-Palone MR, Traini E, Ullah S, Unnikrishnan B, Upadhyay E, Valadan Tahbaz S, Varughese S, Violante FS, Vo B, Vu GT, Waheed Y, Wang YP, Welgan CA, Werdecker A, Yahyazadeh Jabbari SH, Yaya S, Yazdi-Feyzabadi V, Yilma MT, Yonemoto N, Younis MZ, Yousefinezhadi T, Yu C, Yu Y, Zaman SB, Zhang Y, Zhang ZJ, Brauer M, Hay SI, Reiner RC. Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000-18: a geospatial modelling study. Lancet Glob Health 2022; 10:e1395-e1411. [PMID: 36113526 PMCID: PMC9638039 DOI: 10.1016/s2214-109x(22)00332-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/17/2022] [Accepted: 07/21/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. METHODS We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. FINDINGS Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000-257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. INTERPRETATION Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. FUNDING Bill & Melinda Gates Foundation.
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Misganaw A, Naghavi M, Walker A, Mirkuzie AH, Giref AZ, Berheto TM, Waktola EA, Kempen JH, Eticha GT, Wolde TK, Deguma D, Abate KH, Abegaz KH, Ahmed MB, Akalu Y, Aklilu A, Alemu BW, Asemahagn MA, Awedew AF, Balakrishnan S, Bekuma TT, Beyene AS, Beyene MG, Bezabih YM, Birhanu BT, Chichiabellu TY, Dachew BA, Dagnew AB, Demeke FM, Demissie GD, Derbew Molla M, Dereje N, Deribe K, Desta AA, Eshetu MK, Ferede TY, Gebreyohannes EA, Geremew A, Gesesew HA, Getacher L, Glenn SD, Hafebo AS, Hashi A, Hassen HY, Hay SI, Hordofa DF, Huluko DH, Kasa AS, Kassahun Azene G, Kebede EM, Kebede HK, Kelkay B, Kidane SZ, Legesse SM, Manamo WA, Melaku YAA, Mengesha EW, Mengesha SD, Merie HE, Mersha AM, Mersha AG, Mirutse MK, Mohammed AS, Mohammed H, Mohammed S, Netsere HB, Nigatu D, Obsa MS, Odo DB, Omer M, Regassa LD, Sahiledengle B, Shaka MF, Shiferaw WS, Sidemo NB, Sinke AH, Sintayehu Y, Sorrie MB, Tadesse BT, Tadesse EG, Tamir Z, Tamiru AT, Tareke AA, Tefera YG, Tekalegn Y, Tesema AK, Tesema TT, Tesfay FH, Tessema ZT, Tilahun T, Tsegaye GW, Tusa BS, Weledesemayat GT, Yazie TS, Yeshitila YG, Yirdaw BW, Zegeye DT, Murray CJL, Gebremedhin LT. Progress in health among regions of Ethiopia, 1990-2019: a subnational country analysis for the Global Burden of Disease Study 2019. Lancet 2022; 399:1322-1335. [PMID: 35294898 PMCID: PMC8987934 DOI: 10.1016/s0140-6736(21)02868-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 12/07/2021] [Accepted: 12/17/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Previous Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) studies have reported national health estimates for Ethiopia. Substantial regional variations in socioeconomic status, population, demography, and access to health care within Ethiopia require comparable estimates at the subnational level. The GBD 2019 Ethiopia subnational analysis aimed to measure the progress and disparities in health across nine regions and two chartered cities. METHODS We gathered 1057 distinct data sources for Ethiopia and all regions and cities that included census, demographic surveillance, household surveys, disease registry, health service use, disease notifications, and other data for this analysis. Using all available data sources, we estimated the Socio-demographic Index (SDI), total fertility rate (TFR), life expectancy, years of life lost, years lived with disability, disability-adjusted life-years, and risk-factor-attributable health loss with 95% uncertainty intervals (UIs) for Ethiopia's nine regions and two chartered cities from 1990 to 2019. Spatiotemporal Gaussian process regression, cause of death ensemble model, Bayesian meta-regression tool, DisMod-MR 2.1, and other models were used to generate fertility, mortality, cause of death, and disability rates. The risk factor attribution estimations followed the general framework established for comparative risk assessment. FINDINGS The SDI steadily improved in all regions and cities from 1990 to 2019, yet the disparity between the highest and lowest SDI increased by 54% during that period. The TFR declined from 6·91 (95% UI 6·59-7·20) in 1990 to 4·43 (4·01-4·92) in 2019, but the magnitude of decline also varied substantially among regions and cities. In 2019, TFR ranged from 6·41 (5·96-6·86) in Somali to 1·50 (1·26-1·80) in Addis Ababa. Life expectancy improved in Ethiopia by 21·93 years (21·79-22·07), from 46·91 years (45·71-48·11) in 1990 to 68·84 years (67·51-70·18) in 2019. Addis Ababa had the highest life expectancy at 70·86 years (68·91-72·65) in 2019; Afar and Benishangul-Gumuz had the lowest at 63·74 years (61·53-66·01) for Afar and 64.28 (61.99-66.63) for Benishangul-Gumuz. The overall increases in life expectancy were driven by declines in under-5 mortality and mortality from common infectious diseases, nutritional deficiency, and war and conflict. In 2019, the age-standardised all-cause death rate was the highest in Afar at 1353·38 per 100 000 population (1195·69-1526·19). The leading causes of premature mortality for all sexes in Ethiopia in 2019 were neonatal disorders, diarrhoeal diseases, lower respiratory infections, tuberculosis, stroke, HIV/AIDS, ischaemic heart disease, cirrhosis, congenital defects, and diabetes. With high SDIs and life expectancy for all sexes, Addis Ababa, Dire Dawa, and Harari had low rates of premature mortality from the five leading causes, whereas regions with low SDIs and life expectancy for all sexes (Afar and Somali) had high rates of premature mortality from the leading causes. In 2019, child and maternal malnutrition; unsafe water, sanitation, and handwashing; air pollution; high systolic blood pressure; alcohol use; and high fasting plasma glucose were the leading risk factors for health loss across regions and cities. INTERPRETATION There were substantial improvements in health over the past three decades across regions and chartered cities in Ethiopia. However, the progress, measured in SDI, life expectancy, TFR, premature mortality, disability, and risk factors, was not uniform. Federal and regional health policy makers should match strategies, resources, and interventions to disease burden and risk factors across regions and cities to achieve national and regional plans, Sustainable Development Goals, and universal health coverage targets. FUNDING Bill & Melinda Gates Foundation.
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Ward JL, Azzopardi PS, Francis KL, Santelli JS, Skirbekk V, Sawyer SM, Kassebaum NJ, Mokdad AH, Hay SI, Abd-Allah F, Abdoli A, Abdollahi M, Abedi A, Abolhassani H, Abreu LG, Abrigo MRM, Abu-Gharbieh E, Abushouk AI, Adebayo OM, Adekanmbi V, Adham D, Advani SM, Afshari K, Agrawal A, Ahmad T, Ahmadi K, Ahmed AE, Aji B, Akombi-Inyang B, Alahdab F, Al-Aly Z, Alam K, Alanezi FM, Alanzi TM, Alcalde-Rabanal JE, Alemu BW, Al-Hajj S, Alhassan RK, Ali S, Alicandro G, Alijanzadeh M, Aljunid SM, Almasi-Hashiani A, Almasri NA, Al-Mekhlafi HM, Alonso J, Al-Raddadi RM, Altirkawi KA, Alvis-Guzman N, Amare AT, Amini S, Aminorroaya A, Amit AML, Amugsi DA, Ancuceanu R, Anderlini D, Andrei CL, Androudi S, Ansari F, Ansari I, Antonio CAT, Anvari D, Anwer R, Appiah SCY, Arabloo J, Arab-Zozani M, Ärnlöv J, Asaad M, Asadi-Aliabadi M, Asadi-Pooya AA, Atout MMW, Ausloos M, Avenyo EK, Avila-Burgos L, Ayala Quintanilla BP, Ayano G, Aynalem YA, Azari S, Azene ZN, Bakhshaei MH, Bakkannavar SM, Banach M, Banik PC, Barboza MA, Barker-Collo SL, Bärnighausen TW, Basu S, Baune BT, Bayati M, Bedi N, Beghi E, Bekuma TT, Bell AW, Bell ML, Benjet C, Bensenor IM, Berhe AK, Berhe K, Berman AE, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhattarai S, Bhutta ZA, Bijani A, Bikbov B, Biondi A, Birhanu TTM, Biswas RK, Bohlouli S, Bolla SR, Boloor A, Borschmann R, Boufous S, Bragazzi NL, Braithwaite D, Breitborde NJK, Brenner H, Britton GB, Burns RA, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Cámera LA, Campos-Nonato IR, Campuzano Rincon JC, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Cerin E, Chandan JS, Chang HY, Chang JC, Charan J, Chattu VK, Chaturvedi S, Choi JYJ, Chowdhury MAK, Christopher DJ, Chu DT, Chung MT, Chung SC, Cicuttini FM, Constantin TV, Costa VM, Dahlawi SMA, Dai H, Dai X, Damiani G, Dandona L, Dandona R, Daneshpajouhnejad P, Darwesh AM, Dávila-Cervantes CA, Davletov K, De la Hoz FP, De Leo D, Dervenis N, Desai R, Desalew A, Deuba K, Dharmaratne SD, Dhungana GP, Dianatinasab M, Dias da Silva D, Diaz D, Didarloo A, Djalalinia S, Dorostkar F, Doshi CP, Doshmangir L, Doyle KE, Duraes AR, Ebrahimi Kalan M, Ebtehaj S, Edvardsson D, El Tantawi M, Elgendy IY, El-Jaafary SI, Elsharkawy A, Eshrati B, Eskandarieh S, Esmaeilnejad S, Esmaeilzadeh F, Esteghamati S, Faro A, Farzadfar F, Fattahi N, Feigin VL, Ferede TY, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fischer F, Fisher JL, Foigt NA, Folayan MO, Fomenkov AA, Foroutan M, Fukumoto T, Gad MM, Gaidhane AM, Gallus S, Gebre T, Gebremedhin KB, Gebremeskel GG, Gebremeskel L, Gebreslassie AA, Gesesew HA, Ghadiri K, Ghafourifard M, Ghamari F, Ghashghaee A, Gilani SA, Gnedovskaya EV, Godinho MA, Golechha M, Goli S, Gona PN, Gopalani SV, Gorini G, Grivna M, Gubari MIM, Gugnani HC, Guimarães RA, Guo Y, Gupta R, Haagsma JA, Hafezi-Nejad N, Haile TG, Haj-Mirzaian A, Haj-Mirzaian A, Hall BJ, Hamadeh RR, Hamagharib Abdullah K, Hamidi S, Handiso DW, Hanif A, Hankey GJ, Haririan H, Haro JM, Hasaballah AI, Hashi A, Hassan A, Hassanipour S, Hassankhani H, Hayat K, Heidari-Soureshjani R, Herteliu C, Heydarpour F, Ho HC, Hole MK, Holla R, Hoogar P, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huda TM, Humayun A, Hussain R, Hwang BF, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Intarut N, Iqbal U, Irvani SSN, Islam MM, Islam SMS, Iso H, Ivers RQ, Jahani MA, Jakovljevic M, Jalali A, Janodia MD, Javaheri T, Jeemon P, Jenabi E, Jha RP, Jha V, Ji JS, Jonas JB, Jones KM, Joukar F, Jozwiak JJ, Juliusson PB, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kalhor R, Kamyari N, Kanchan T, Karch A, Karimi SE, Kaur S, Kayode GA, Keiyoro PN, Khalid N, Khammarnia M, Khan M, Khan MN, Khatab K, Khater MM, Khatib MN, Khayamzadeh M, Khazaie H, Khoja AT, Kieling C, Kim YE, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kivimäki M, Koolivand A, Kosen S, Koyanagi A, Krishan K, Kugbey N, Kumar GA, Kumar M, Kumar N, Kurmi OP, Kusuma D, La Vecchia C, Lacey B, Lal DK, Lalloo R, Lan Q, Landires I, Lansingh VC, Larsson AO, Lasrado S, Lassi ZS, Lauriola P, Lee PH, Lee SWH, Leigh J, Leonardi M, Leung J, Levi M, Lewycka S, Li B, Li MC, Li S, Lim LL, Lim SS, Liu X, Lorkowski S, Lotufo PA, Lunevicius R, Maddison R, Mahasha PW, Mahdavi MM, Mahmoudi M, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mamun AA, Mansouri B, Mansournia MA, Martinez G, Martinez-Raga J, Martins-Melo FR, Mason-Jones AJ, Masoumi SZ, Mathur MR, Maulik PK, McGrath JJ, Mehndiratta MM, Mehri F, Memiah PTN, Mendoza W, Menezes RG, Mengesha EW, Meretoja A, Meretoja TJ, Mestrovic T, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mirzaei H, Mirzaei M, Moazen B, Mohammad DK, Mohammadi S, Mohammadian-Hafshejani A, Mohammadifard N, Mohammadpourhodki R, Mohammed S, Monasta L, Moradi G, Moradi-Lakeh M, Moradzadeh R, Moraga P, Morrison SD, Mosapour A, Mousavi Khaneghah A, Mueller UO, Muriithi MK, Murray CJL, Muthupandian S, Naderi M, Nagarajan AJ, Naghavi M, Naimzada MD, Nangia V, Nayak VC, Nazari J, Ndejjo R, Negoi I, Negoi RI, Netsere HB, Nguefack-Tsague G, Nguyen DN, Nguyen HLT, Nie J, Ningrum DNA, Nnaji CA, Nomura S, Noubiap JJ, Nowak C, Nuñez-Samudio V, Ogbo FA, Oghenetega OB, Oh IH, Oladnabi M, Olagunju AT, Olusanya BO, Olusanya JO, Omar Bali A, Omer MO, Onwujekwe OE, Ortiz A, Otoiu A, Otstavnov N, Otstavnov SS, Øverland S, Owolabi MO, P A M, Padubidri JR, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Pandey A, Panelo CIA, Park EK, Patten SB, Peden AE, Pepito VCF, Peprah EK, Pereira J, Pesudovs K, Pham HQ, Phillips MR, Piradov MA, Pirsaheb M, Postma MJ, Pottoo FH, Pourjafar H, Pourshams A, Prada SI, Pupillo E, Quazi Syed Z, Rabiee MH, Rabiee N, Radfar A, Rafiee A, Raggi A, Rahim F, Rahimi-Movaghar V, Rahman MHU, Rahman MA, Ramezanzadeh K, Ranabhat CL, Rao SJ, Rashedi V, Rastogi P, Rathi P, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Renzaho AMN, Rezaei N, Rezaei N, Rezai MS, Riahi SM, Rickard J, Roever L, Ronfani L, Roth GA, Rubagotti E, Rumisha SF, Rwegerera GM, Sabour S, Sachdev PS, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sagar R, Sahebkar A, Sahraian MA, Sajadi SM, Salem MR, Salimzadeh H, Samy AM, Sanabria J, Santric-Milicevic MM, Saraswathy SYI, Sarrafzadegan N, Sarveazad A, Sathish T, Sattin D, Saxena D, Saxena S, Schiavolin S, Schwebel DC, Schwendicke F, Senthilkumaran S, Sepanlou SG, Sha F, Shafaat O, Shahabi S, Shaheen AA, Shaikh MA, Shakiba S, Shamsi M, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shetty BSK, Shi P, Shigematsu M, Shin JI, Shiri R, Shuval K, Siabani S, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Silva JP, Simonetti B, Singh JA, Singh V, Sinke AH, Skryabin VY, Slater H, Smith EUR, Sobhiyeh MR, Sobngwi E, Soheili A, Somefun OD, Sorrie MB, Soyiri IN, Sreeramareddy CT, Stein DJ, Stokes MA, Sudaryanto A, Sultan I, Tabarés-Seisdedos R, Tabuchi T, Tadakamadla SK, Taherkhani A, Tamiru AT, Tareque MI, Thankappan KR, Thapar R, Thomas N, Titova MV, Tonelli M, Tovani-Palone MR, Tran BX, Travillian RS, Tsai AC, Tsatsakis A, Tudor Car L, Uddin R, Unim B, Unnikrishnan B, Upadhyay E, Vacante M, Valadan Tahbaz S, Valdez PR, Varughese S, Vasankari TJ, Venketasubramanian N, Villeneuve PJ, Violante FS, Vlassov V, Vos T, Vu GT, Waheed Y, Wamai RG, Wang Y, Wang Y, Wang YP, Westerman R, Wickramasinghe ND, Wu AM, Wu C, Yahyazadeh Jabbari SH, Yamagishi K, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yeshitila YG, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yousefinezhadi T, Yu C, Yu Y, Yuce D, Zaidi SS, Zaman SB, Zamani M, Zamanian M, Zarafshan H, Zarei A, Zastrozhin MS, Zhang Y, Zhang ZJ, Zhao XJG, Zhu C, Patton GC, Viner RM. Global, regional, and national mortality among young people aged 10-24 years, 1950-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2021; 398:1593-1618. [PMID: 34755628 PMCID: PMC8576274 DOI: 10.1016/s0140-6736(21)01546-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/07/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10-24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10-24 years by age group (10-14 years, 15-19 years, and 20-24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10-24 years with that in children aged 0-9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10-24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). FINDINGS In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39-1·59) worldwide in people aged 10-24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10-14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15-19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1-4 years (2·4%), and around a third less than in females aged 1-4 years (2·5%). The proportion of global deaths in people aged 0-24 years that occurred in people aged 10-24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. INTERPRETATION Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10-24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. FUNDING Bill & Melinda Gates Foundation.
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Sartorius B, VanderHeide JD, Yang M, Goosmann EA, Hon J, Haeuser E, Cork MA, Perkins S, Jahagirdar D, Schaeffer LE, Serfes AL, LeGrand KE, Abbastabar H, Abebo ZH, Abosetugn AE, Abu-Gharbieh E, Accrombessi MMK, Adebayo OM, Adegbosin AE, Adekanmbi V, Adetokunboh OO, Adeyinka DA, Ahinkorah BO, Ahmadi K, Ahmed MB, Akalu Y, Akinyemi OO, Akinyemi RO, Aklilu A, Akunna CJ, Alahdab F, Al-Aly Z, Alam N, Alamneh AA, Alanzi TM, Alemu BW, Alhassan RK, Ali T, Alipour V, Amini S, Ancuceanu R, Ansari F, Anteneh ZA, Anvari D, Anwer R, Appiah SCY, Arabloo J, Asemahagn MA, Asghari Jafarabadi M, Asmare WN, Atnafu DD, Atout MMW, Atreya A, Ausloos M, Awedew AF, Ayala Quintanilla BP, Ayanore MA, Aynalem YA, Ayza MA, Azari S, Azene ZN, Babar ZUD, Baig AA, Balakrishnan S, Banach M, Bärnighausen TW, Basu S, Bayati M, Bedi N, Bekuma TT, Bezabhe WMM, Bhagavathula AS, Bhardwaj P, Bhattacharyya K, Bhutta ZA, Bibi S, Bikbov B, Birhan TA, Bitew ZW, Bockarie MJ, Boloor A, Brady OJ, Bragazzi NL, Briko AN, Briko NI, Burugina Nagaraja S, Butt ZA, Cárdenas R, Carvalho F, Charan J, Chatterjee S, Chattu SK, Chattu VK, Chowdhury MAK, Chu DT, Cook AJ, Cormier NM, Cowden RG, Culquichicon C, Dagnew B, Dahlawi SMA, Damiani G, Daneshpajouhnejad P, Daoud F, Daryani A, das Neves J, Davis Weaver N, Derbew Molla M, Deribe K, Desta AA, Deuba K, Dharmaratne SD, Dhungana GP, Diaz D, Djalalinia S, Doku PN, Dubljanin E, Duko B, Eagan AW, Earl L, Eaton JW, Effiong A, El Sayed Zaki M, El Tantawi M, Elayedath R, El-Jaafary SI, Elsharkawy A, Eskandarieh S, Eyawo O, Ezzikouri S, Fasanmi AO, Fasil A, Fauk NK, Feigin VL, Ferede TY, Fernandes E, Fischer F, Foigt NA, Folayan MO, Foroutan M, Francis JM, Fukumoto T, Gad MM, Geberemariyam BS, Gebregiorgis BG, Gebremichael B, Gesesew HA, Getacher L, Ghadiri K, Ghashghaee A, Gilani SA, Ginindza TG, Glagn M, Golechha M, Gona PN, Gubari MIM, Gugnani HC, Guido D, Guled RA, Hall BJ, Hamidi S, Handiso DW, Hargono A, Hashi A, Hassanipour S, Hassankhani H, Hayat K, Herteliu C, Hidru HDD, Holla R, Hosgood HD, Hossain N, Hosseini M, Hosseinzadeh M, Househ M, Hwang BF, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Irvani SSN, Iwu CCD, Iwu CJ, Iyamu IO, Jain V, Jakovljevic M, Jalilian F, Jha RP, Johnson KB, Joshua V, Joukar F, Jozwiak JJ, Kabir A, Kalankesh LR, Kalhor R, Kamath A, Kamyari N, Kanchan T, Karami Matin B, Karch A, Karimi SE, Kasa AS, Kassahun G, Kayode GA, Kazemi Karyani A, Keiyoro PN, Kelkay B, Khalid N, Khan G, Khan J, Khan MN, Khatab K, Khazaei S, Kim YJ, Kisa A, Kisa S, Kochhar S, Kopec JA, Kosen S, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kuate Defo B, Kugbey N, Kulkarni V, Kumar M, Kumar N, Kurmi OP, Kusuma D, Kuupiel D, Kyu HH, La Vecchia C, Lal DK, Lam JO, Landires I, Lasrado S, Lazarus JV, Lazzar-Atwood A, Lee PH, Leshargie CT, Li B, Liu X, Lopukhov PD, M. Amin HI, Madi D, Mahasha PW, Majeed A, Maleki A, Maleki S, Mamun AA, Manafi N, Mansournia MA, Martins-Melo FR, Masoumi SZ, Mayala BK, Meharie BG, Meheretu HAA, Meles HG, Melku M, Mendoza W, Mengesha EW, Meretoja TJ, Mersha AM, Mestrovic T, Miller TR, Mirica A, Mirzaei-Alavijeh M, Mohamad O, Mohammad Y, Mohammadian-Hafshejani A, Mohammed JA, Mohammed S, Mohammed S, Mokdad AH, Mokonnon TM, Molokhia M, Moradi M, Moradi Y, Moradzadeh R, Moraga P, Mosser JF, Munro SB, Mustafa G, Muthupandian S, Naderi M, Nagarajan AJ, Naghavi M, Naveed M, Nayak VC, Nazari J, Ndejjo R, Nepal S, Netsere HB, Ngalesoni FN, Nguefack-Tsague G, Ngunjiri JW, Nigatu YT, Nigussie SN, Nnaji CA, Noubiap JJ, Nuñez-Samudio V, Oancea B, Odukoya OO, Ogbo FA, Oladimeji O, Olagunju AT, Olusanya BO, Olusanya JO, Omer MO, Omonisi AEE, Onwujekwe OE, Orisakwe OE, Otstavnov N, Owolabi MO, P A M, Padubidri JR, Pakhale S, Pana A, Pandi-Perumal SR, Patel UK, Pathak M, Patton GC, Pawar S, Peprah EK, Pokhrel KN, Postma MJ, Pottoo FH, Pourjafar H, Pribadi DRA, Quazi Syed Z, Rafiei A, Rahim F, Rahman MHU, Rahmani AM, Ram P, Rana J, Ranabhat CL, Rao S, Rao SJ, Rathi P, Rawaf DL, Rawaf S, Rawassizadeh R, Renjith V, Reta MA, Rezaei N, Rezapour A, Ribeiro AI, Ross JM, Rumisha SF, Sagar R, Sahu M, Sajadi SM, Salem MR, Samy AM, Sathian B, Schutte AE, Seidu AA, Sha F, Shafaat O, Shahbaz M, Shaikh MA, Shaka MF, Sheikh A, Shibuya K, Shin JI, Shivakumar KM, Sidemo NB, Singh JA, Skryabin VY, Skryabina AA, Soheili A, Soltani S, Somefun OD, Sorrie MB, Spurlock EE, Sufiyan MB, Taddele BW, Tadesse EG, Tamir Z, Tamiru AT, Tanser FC, Taveira N, Tehrani-Banihashemi A, Tekalegn Y, Tesfay FH, Tessema B, Tessema ZT, Thakur B, Tolani MA, Topor-Madry R, Torrado M, Tovani-Palone MR, Traini E, Tsai AC, Tsegaye GW, Ullah I, Ullah S, Umeokonkwo CD, Unnikrishnan B, Vardavas C, Violante FS, Vo B, Wado YD, Waheed Y, Wamai RG, Wang Y, Ward P, Werdecker A, Wickramasinghe ND, Wijeratne T, Wiysonge CS, Wondmeneh TG, Yamada T, Yaya S, Yeshaw Y, Yeshitila YG, Yilma MT, Yip P, Yonemoto N, Yosef T, Yusefzadeh H, Zaidi SS, Zaki L, Zamanian M, Zastrozhin MS, Zastrozhina A, Zewdie DT, Zhang Y, Zhang ZJ, Ziapour A, Hay SI, Dwyer-Lindgren L. Subnational mapping of HIV incidence and mortality among individuals aged 15-49 years in sub-Saharan Africa, 2000-18: a modelling study. Lancet HIV 2021; 8:e363-e375. [PMID: 34087097 PMCID: PMC8187986 DOI: 10.1016/s2352-3018(21)00051-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND High-resolution estimates of HIV burden across space and time provide an important tool for tracking and monitoring the progress of prevention and control efforts and assist with improving the precision and efficiency of targeting efforts. We aimed to assess HIV incidence and HIV mortality for all second-level administrative units across sub-Saharan Africa. METHODS In this modelling study, we developed a framework that used the geographically specific HIV prevalence data collected in seroprevalence surveys and antenatal care clinics to train a model that estimates HIV incidence and mortality among individuals aged 15-49 years. We used a model-based geostatistical framework to estimate HIV prevalence at the second administrative level in 44 countries in sub-Saharan Africa for 2000-18 and sought data on the number of individuals on antiretroviral therapy (ART) by second-level administrative unit. We then modified the Estimation and Projection Package (EPP) to use these HIV prevalence and treatment estimates to estimate HIV incidence and mortality by second-level administrative unit. FINDINGS The estimates suggest substantial variation in HIV incidence and mortality rates both between and within countries in sub-Saharan Africa, with 15 countries having a ten-times or greater difference in estimated HIV incidence between the second-level administrative units with the lowest and highest estimated incidence levels. Across all 44 countries in 2018, HIV incidence ranged from 2·8 (95% uncertainty interval 2·1-3·8) in Mauritania to 1585·9 (1369·4-1824·8) cases per 100 000 people in Lesotho and HIV mortality ranged from 0·8 (0·7-0·9) in Mauritania to 676·5 (513·6-888·0) deaths per 100 000 people in Lesotho. Variation in both incidence and mortality was substantially greater at the subnational level than at the national level and the highest estimated rates were accordingly higher. Among second-level administrative units, Guijá District, Gaza Province, Mozambique, had the highest estimated HIV incidence (4661·7 [2544·8-8120·3]) cases per 100 000 people in 2018 and Inhassunge District, Zambezia Province, Mozambique, had the highest estimated HIV mortality rate (1163·0 [679·0-1866·8]) deaths per 100 000 people. Further, the rate of reduction in HIV incidence and mortality from 2000 to 2018, as well as the ratio of new infections to the number of people living with HIV was highly variable. Although most second-level administrative units had declines in the number of new cases (3316 [81·1%] of 4087 units) and number of deaths (3325 [81·4%]), nearly all appeared well short of the targeted 75% reduction in new cases and deaths between 2010 and 2020. INTERPRETATION Our estimates suggest that most second-level administrative units in sub-Saharan Africa are falling short of the targeted 75% reduction in new cases and deaths by 2020, which is further compounded by substantial within-country variability. These estimates will help decision makers and programme implementers expand access to ART and better target health resources to higher burden subnational areas. FUNDING Bill & Melinda Gates Foundation.
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Lozano R, Fullman N, Mumford JE, Knight M, Barthelemy CM, Abbafati C, Abbastabar H, Abd-Allah F, Abdollahi M, Abedi A, Abolhassani H, Abosetugn AE, Abreu LG, Abrigo MRM, Abu Haimed AK, Abushouk AI, Adabi M, Adebayo OM, Adekanmbi V, Adelson J, Adetokunboh OO, Adham D, Advani SM, Afshin A, Agarwal G, Agasthi P, Aghamir SMK, Agrawal A, Ahmad T, Akinyemi RO, Alahdab F, Al-Aly Z, Alam K, Albertson SB, Alemu YM, Alhassan RK, Ali M, Ali S, Alipour V, Aljunid SM, Alla F, Almadi MAH, Almasi A, Almasi-Hashiani A, Almasri NA, Al-Mekhlafi HM, Almulhim AM, Alonso J, Al-Raddadi RM, Altirkawi KA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amini S, Amini-Rarani M, Amiri F, Amit AML, Amugsi DA, Ancuceanu R, Anderlini D, Andrei CL, Androudi S, Ansari F, Ansari-Moghaddam A, Antonio CAT, Antony CM, Antriyandarti E, Anvari D, Anwer R, Arabloo J, Arab-Zozani M, Aravkin AY, Aremu O, Ärnlöv J, Asaad M, Asadi-Aliabadi M, Asadi-Pooya AA, Ashbaugh C, Athari SS, Atout MMW, Ausloos M, Avila-Burgos L, Ayala Quintanilla BP, 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J, Chattu VK, Chaturvedi S, Chin KL, Cho DY, Choi JYJ, Christensen H, Chu DT, Chung MT, Ciobanu LG, Cirillo M, Comfort H, Compton K, Cortesi PA, Costa VM, Cousin E, Dahlawi SMA, Damiani G, Dandona L, Dandona R, Darega Gela J, Darwesh AM, Daryani A, Dash AP, Davey G, Dávila-Cervantes CA, Davletov K, De Neve JW, Denova-Gutiérrez E, Deribe K, Dervenis N, Desai R, Dharmaratne SD, Dhungana GP, Dianatinasab M, Dias da Silva D, Diaz D, Dippenaar IN, Do HT, Dorostkar F, Doshmangir L, Duncan BB, Duraes AR, Eagan AW, Edvardsson D, El Sayed I, El Tantawi M, Elgendy IY, Elyazar IRF, Eskandari K, Eskandarieh S, Esmaeilnejad S, Esteghamati A, Ezekannagha O, Farag T, Farahmand M, Faraon EJA, Farinha CSES, Farioli A, Faris PS, Faro A, Fazlzadeh M, Feigin VL, Fernandes E, Ferrara P, Feyissa GT, Filip I, Fischer F, Fisher JL, Flor LS, Foigt NA, Folayan MO, Fomenkov AA, Foroutan M, Francis JM, Fu W, Fukumoto T, Furtado JM, Gad MM, Gaidhane AM, Gakidou E, Galles NC, Gallus S, Gardner WM, Geberemariyam BS, Gebrehiwot AM, Gebremeskel LG, Gebremeskel GG, Gesesew HA, Ghadiri K, Ghafourifard M, Ghashghaee A, Ghith N, Gholamian A, Gilani SA, Gill PS, Gill TK, Ginindza TG, Gitimoghaddam M, Giussani G, Glagn M, Gnedovskaya EV, Godinho MA, Goharinezhad S, Gopalani SV, Goudarzian AH, Goulart BNG, Gubari MIM, Guimarães RA, Guled RA, Gultie T, Guo Y, Gupta R, Gupta R, Hafezi-Nejad N, Hafiz A, Haile TG, Hamadeh RR, Hameed S, Hamidi S, Han C, Han H, Handiso DW, Hanif A, Hankey GJ, Haro JM, Hasaballah AI, Hasan MM, Hashi A, Hassan S, Hassan A, Hassanipour S, Hassankhani H, Havmoeller RJ, Hay SI, Hayat K, Heidari G, Heidari-Soureshjani R, Hendrie D, Herteliu C, Hird TR, Ho HC, Hole MK, Holla R, Hollingsworth B, Hoogar P, Hopf KP, Horita N, Hossain N, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsieh VCR, Hu G, Huda TM, Humayun A, Hwang BF, Iavicoli I, Ibitoye SE, Ikeda N, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Iqbal U, Irvani SSN, Irvine CMS, Islam MM, Islam SMS, Islami F, Iso H, 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Sigurvinsdottir R, Silva DAS, Silva JP, Simonetti B, Simpson KE, Singh JA, Singh P, Sinha DN, Skryabin VY, Smith EUR, Soheili A, Soltani S, Soofi M, Sorensen RJ, Soriano JB, Sorrie MB, Soyiri IN, Spurlock EE, Sreeramareddy CT, Stanaway JD, Steel N, Stein C, Stokes MA, Sufiyan MB, Suleria HAR, Sultan I, Szumowski Ł, Tabarés-Seisdedos R, Tabuchi T, Tadakamadla SK, Taddele BW, Tadesse DB, Taherkhani A, Tamiru AT, Tanser FC, Tareque MI, Tarigan IU, Teagle WL, Tediosi F, Tefera YGG, Tela FG, Tessema ZT, Thakur B, Titova MV, Tonelli M, Topor-Madry R, Topouzis F, Tovani-Palone MRR, Tran BX, Travillian R, Troeger CE, Tudor Car L, Uddin R, Ullah I, Umeokonkwo CD, Unnikrishnan B, Upadhyay E, Uthman OA, Vacante M, Valdez PR, Varughese S, Vasankari TJ, Vasseghian Y, Venketasubramanian N, Violante FS, Vlassov V, Vollset SE, Vongpradith A, Vos T, Waheed Y, Walters MK, Wamai RG, Wang H, Wang YP, Weintraub RG, Weiss J, Werdecker A, Westerman R, Wilner LB, Woldu G, Wolfe CDA, Wu AM, Wulf Hanson S, Xie Y, Xu R, Yahyazadeh Jabbari SH, Yamagishi K, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yearwood JA, Yeshitila YG, Yip P, Yonemoto N, Younis MZ, Yousefi Z, Yousefinezhadi T, Yusefzadeh H, Zadey S, Zahirian Moghadam T, Zaidi SS, Zaki L, Zaman SB, Zamani M, Zamanian M, Zandian H, Zastrozhin MS, Zewdie KA, Zhang Y, Zhao XJG, Zhao Y, Zheng P, Zhu C, Ziapour A, Zlavog BS, Zodpey S, Murray CJL. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1250-1284. [PMID: 32861314 PMCID: PMC7562819 DOI: 10.1016/s0140-6736(20)30750-9] [Citation(s) in RCA: 251] [Impact Index Per Article: 62.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/05/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. METHODS Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. FINDINGS Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2-47·5) in 1990 to 60·3 (58·7-61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9-3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6-421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0-3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5-1040·3]) residing in south Asia. INTERPRETATION The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC. FUNDING Bill & Melinda Gates Foundation.
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Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1204-1222. [PMID: 33069326 PMCID: PMC7567026 DOI: 10.1016/s0140-6736(20)30925-9] [Citation(s) in RCA: 6299] [Impact Index Per Article: 1574.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/27/2020] [Accepted: 04/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. METHODS GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. FINDINGS Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. INTERPRETATION As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. FUNDING Bill & Melinda Gates Foundation.
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Zandian H, Zastrozhin MS, Zhang Y, Zhang ZJ, Zhao JT, Zhao XJG, Zhao Y, Zhou M, Ziapour A, Zimsen SRM, Brauer M, Afshin A, Lim SS. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1223-1249. [PMID: 33069327 PMCID: PMC7566194 DOI: 10.1016/s0140-6736(20)30752-2] [Citation(s) in RCA: 3208] [Impact Index Per Article: 802.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. METHODS GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. FINDINGS The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51-12·1) deaths (19·2% [16·9-21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12-9·31) deaths (15·4% [14·6-16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11·6% [10·3-13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. INTERPRETATION Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. FUNDING Bill & Melinda Gates Foundation.
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Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1160-1203. [PMID: 33069325 PMCID: PMC7566045 DOI: 10.1016/s0140-6736(20)30977-6] [Citation(s) in RCA: 701] [Impact Index Per Article: 175.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/10/2020] [Accepted: 04/20/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. METHODS 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10-14 and 50-54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. FINDINGS The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66-2·79) in 2000 to 2·31 (2·17-2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5-137·8) in 2000 to a peak of 139·6 million (133·0-146·9) in 2016. Global livebirths then declined to 135·3 million (127·2-144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4-27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8-67·6) in 2000 to 73·5 years (72·8-74·3) in 2019. The total number of deaths increased from 50·7 million (49·5-51·9) in 2000 to 56·5 million (53·7-59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1-10·3) in 2000 to 5·0 million (4·3-6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0-6·3) in 2000 to 7·7 billion (7·5-8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1-60·8) in 2000 to 63·5 years (60·8-66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. INTERPRETATION Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. FUNDING Bill & Melinda Gates Foundation.
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James SL, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Liu Z, Roberts NLS, Sylte DO, Bertolacci GJ, Cunningham M, Henry NJ, LeGrand KE, Abdelalim A, Abdollahpour I, Abdulkader RS, Abedi A, Abegaz KH, Abosetugn AE, Abushouk AI, Adebayo OM, Adsuar JC, Advani SM, Agudelo-Botero M, Ahmad T, Ahmed MB, Ahmed R, Eddine Aichour MT, Alahdab F, Alanezi FM, Alema NM, Alemu BW, Alghnam SA, Ali BA, Ali S, Alinia C, Alipour V, Aljunid SM, Almasi-Hashiani A, Almasri NA, Altirkawi K, Abdeldayem Amer YS, Andrei CL, Ansari-Moghaddam A, T Antonio CA, Anvari D, Yaw Appiah SC, Arabloo J, Arab-Zozani M, Arefi Z, Aremu O, Ariani F, Arora A, Asaad M, Ayala Quintanilla BP, Ayano G, Ayanore MA, Azarian G, Badawi A, Badiye AD, Baig AA, Bairwa M, Bakhtiari A, Balachandran A, Banach M, Banerjee SK, Banik PC, Banstola A, Barker-Collo SL, Bärnighausen TW, Barzegar A, Bayati M, Bazargan-Hejazi S, Bedi N, Behzadifar M, Belete H, Bennett DA, Bensenor IM, Berhe K, Bhagavathula AS, Bhardwaj P, Bhat AG, Bhattacharyya K, Bhutta ZA, Bibi S, Bijani A, Boloor A, Borges G, Borschmann R, Borzì AM, Boufous S, Braithwaite D, Briko NI, Brugha T, Budhathoki SS, Car J, Cárdenas R, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Cerin E, Chandan JS, Chapman JR, Chattu VK, Chattu SK, Chatziralli I, Chaudhary N, Cho DY, Choi JYJ, Kabir Chowdhury MA, Christopher DJ, Chu DT, Cicuttini FM, Coelho JM, Costa VM, Dahlawi SMA, Daryani A, Dávila-Cervantes CA, Leo DD, Demeke FM, Demoz GT, Demsie DG, Deribe K, Desai R, Nasab MD, Silva DDD, Dibaji Forooshani ZS, Do HT, Doyle KE, Driscoll TR, Dubljanin E, Adema BD, Eagan AW, Elemineh DA, El-Jaafary SI, El-Khatib Z, Ellingsen CL, Zaki MES, Eskandarieh S, Eyawo O, Faris PS, Faro A, Farzadfar F, Fereshtehnejad SM, Fernandes E, Ferrara P, Fischer F, Folayan MO, Fomenkov AA, Foroutan M, Francis JM, Franklin RC, Fukumoto T, Geberemariyam BS, Gebremariam H, Gebremedhin KB, Gebremeskel LG, Gebremeskel GG, Gebremichael B, Gedefaw GA, Geta B, Getenet AB, Ghafourifard M, Ghamari F, Gheshlagh RG, Gholamian A, Gilani SA, Gill TK, Goudarzian AH, Goulart AC, Grada A, Grivna M, Guimarães RA, Guo Y, Gupta G, Haagsma JA, Hall BJ, Hamadeh RR, Hamidi S, Handiso DW, Haro JM, Hasanzadeh A, Hassan S, Hassanipour S, Hassankhani H, Hassen HY, Havmoeller R, Hendrie D, Heydarpour F, Híjar M, Ho HC, Hoang CL, Hole MK, Holla R, Hossain N, Hosseinzadeh M, Hostiuc S, Hu G, Ibitoye SE, Ilesanmi OS, Inbaraj LR, Naghibi Irvani SS, Mofizul Islam M, Shariful Islam SM, Ivers RQ, Jahani MA, Jakovljevic M, Jalilian F, Jayaraman S, Jayatilleke AU, Jha RP, John-Akinola YO, Jonas JB, Jones KM, Joseph N, Joukar F, Jozwiak JJ, Jungari SB, Jürisson M, Kabir A, Kahsay A, Kalankesh LR, Kalhor R, Kamil TA, Kanchan T, Kapoor N, Karami M, Kasaeian A, Kassaye HG, Kavetskyy T, Kayode GA, Keiyoro PN, Kelbore AG, Khader YS, Khafaie MA, Khalid N, Khalil IA, Khalilov R, Khan M, Khan EA, Khan J, Khanna T, Khazaei S, Khazaie H, Khundkar R, Kiirithio DN, Kim YE, Kim YJ, Kim D, Kisa S, Kisa A, Komaki H, Kondlahalli SKM, Koolivand A, Korshunov VA, Koyanagi A, Kraemer MUG, Krishan K, Defo BK, Bicer BK, Kugbey N, Kumar N, Kumar M, Kumar V, Kumar N, Kumaresh G, Lami FH, Lansingh VC, Lasrado S, Latifi A, Lauriola P, Vecchia CL, Leasher JL, Huey Lee SW, Li S, Liu X, Lopez AD, Lotufo PA, Lyons RA, Machado DB, Madadin M, Abd El Razek MM, Mahotra NB, Majdan M, Majeed A, Maled V, Malta DC, Manafi N, Manafi A, Manda AL, Manjunatha N, Mansour-Ghanaei F, Mansournia MA, Maravilla JC, Mason-Jones AJ, Masoumi SZ, Massenburg BB, Maulik PK, Mehndiratta MM, Melketsedik ZA, Memiah PTN, Mendoza W, Menezes RG, Mengesha MM, Meretoja TJ, Meretoja A, Merie HE, Mestrovic T, Miazgowski B, Miazgowski T, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mirzaei-Alavijeh M, Mithra P, Moazen B, Moghadaszadeh M, Mohamadi E, Mohammad Y, Darwesh AM, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed S, Mohammed JA, Mohebi F, Mohseni Bandpei MA, Molokhia M, Monasta L, Moodley Y, Moradi M, Moradi G, Moradi-Lakeh M, Moradzadeh R, Morawska L, Velásquez IM, Morrison SD, Mossie TB, Muluneh AG, Musa KI, Mustafa G, Naderi M, Nagarajan AJ, Naik G, Naimzada MD, Najafi F, Nangia V, Nascimento BR, Naserbakht M, Nayak V, Nazari J, Ndwandwe DE, Negoi I, Ngunjiri JW, Nguyen TH, Nguyen CT, Nguyen DN, Thi Nguyen HL, Nikbakhsh R, Anggraini Ningrum DN, Nnaji CA, Ofori-Asenso R, Ogbo FA, Oghenetega OB, Oh IH, Olagunju AT, Olagunju TO, Bali AO, Onwujekwe OE, Orpana HM, Ota E, Otstavnov N, Otstavnov SS, P A M, Padubidri JR, Pakhale S, Pakshir K, Panda-Jonas S, Park EK, Patel SK, Pathak A, Pati S, Paulos K, Peden AE, Filipino Pepito VC, Pereira J, Phillips MR, Polibin RV, Polinder S, Pourmalek F, Pourshams A, Poustchi H, Prakash S, Angga Pribadi DR, Puri P, Syed ZQ, Rabiee N, Rabiee M, Radfar A, Rafay A, Rafiee A, Rafiei A, Rahim F, Rahimi S, Rahman MA, Rajabpour-Sanati A, Rajati F, Rakovac I, Rao SJ, Rashedi V, Rastogi P, Rathi P, Rawaf S, Rawal L, Rawassizadeh R, Renjith V, Resnikoff S, Rezapour A, Ribeiro AI, Rickard J, Rios González CM, Roever L, Ronfani L, Roshandel G, Saddik B, Safarpour H, Safdarian M, Mohammad Sajadi S, Salamati P, Rashad Salem MR, Salem H, Salz I, Samy AM, Sanabria J, Riera LS, Santric Milicevic MM, Sarker AR, Sarveazad A, Sathian B, Sawhney M, Sayyah M, Schwebel DC, Seedat S, Senthilkumaran S, Seyedmousavi S, Sha F, Shaahmadi F, Shahabi S, Shaikh MA, Shams-Beyranvand M, Sheikh A, Shigematsu M, Shin JI, Shiri R, Siabani S, Sigfusdottir ID, Singh JA, Singh PK, Sinha DN, Soheili A, Soriano JB, Sorrie MB, Soyiri IN, Stokes MA, Sufiyan MB, Sykes BL, Tabarés-Seisdedos R, Tabb KM, Taddele BW, Tefera YM, Tehrani-Banihashemi A, Tekulu GH, Tesema Tesema AK, Tesfay BE, Thapar R, Titova MV, Tlaye KG, Tohidinik HR, Topor-Madry R, Tran KB, Tran BX, Tripathy JP, Tsai AC, Tsatsakis A, Car LT, Ullah I, Ullah S, Unnikrishnan B, Upadhyay E, Uthman OA, Valdez PR, Vasankari TJ, Veisani Y, Venketasubramanian N, Violante FS, Vlassov V, Waheed Y, Wang YP, Wiangkham T, Wolde HF, Woldeyes DH, Wondmeneh TG, Wondmieneh AB, Wu AM, Wyper GMA, Yadav R, Yadollahpour A, Yano Y, Yaya S, Yazdi-Feyzabadi V, Ye P, Yip P, Yisma E, Yonemoto N, Yoon SJ, Youm Y, Younis MZ, Yousefi Z, Yu C, Yu Y, Moghadam TZ, Zaidi Z, Zaman SB, Zamani M, Zandian H, Zarei F, Zhang ZJ, Zhang Y, Ziapour A, Zodpey S, Dandona R, Dharmaratne SD, Hay SI, Mokdad AH, Pigott DM, Reiner RC, Vos T. Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study. Inj Prev 2020; 26:i125-i153. [PMID: 32839249 PMCID: PMC7571362 DOI: 10.1136/injuryprev-2019-043531] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/29/2019] [Accepted: 12/06/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. METHODS In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. RESULTS GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. CONCLUSIONS GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
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Affiliation(s)
- Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Gregory J Bertolacci
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Matthew Cunningham
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nathaniel J Henry
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kate E LeGrand
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Ibrahim Abdollahpour
- Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Aidin Abedi
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA
| | - Kedir Hussein Abegaz
- Biostatistics and Health Informatics, Madda Walabu University, Bale Robe, Ethiopia
- Radiotherapy Center, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | | | - Jose C Adsuar
- Sport Science Department, University of Extremadura, Badajoz, Spain
| | - Shailesh M Advani
- Social Behavioral Research Branch, National Institute of Health, Bethesda, MD, USA
- Cancer Prevention and Control, Georgetown University, Washington, DC, USA
| | - Marcela Agudelo-Botero
- School of Medicine, Center for Politics, Population and Health Research, National Autonomous University of Mexico, Mexico City, Mexico
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, Southeast University Nanjing, Nanjing, China
- Microbiology Department, Hazara University, Mansehra, Pakistan
| | | | - Rushdia Ahmed
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA
| | - Fahad Mashhour Alanezi
- Department of Computer Sciences, Imam Abdulrehman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Biresaw Wassihun Alemu
- Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- Midwifery Department, Arba Minch University, Injbara, Ethiopia
| | - Suliman A Alghnam
- Department of Population Health Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | - Saqib Ali
- Department of Information Systems, College of Economics and Political Science, Sultan Qaboos University, Muscat, Oman
| | - Cyrus Alinia
- Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | - Nihad A Almasri
- Physiotherapy Department, The University of Jordan, Amman, Jordan
| | | | - Yasser Sami Abdeldayem Amer
- Clinical Practice Guidelines Unit, King Saud University, Riyadh, Saudi Arabia
- Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt
| | | | | | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Davood Anvari
- Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Microbiology and Immunology, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for International Health, Ludwig Maximilians University, Munich, Germany
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Zohreh Arefi
- Department of Health Promotion and Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Filippo Ariani
- Regional Centre for the Analysis of Data on Occupational and Work-related Injuries and Diseases, Local Health Unit Tuscany Centre, Florence, Italy
| | - Amit Arora
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
- Oral Health Services, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Malke Asaad
- Plastic Surgery Department, University of Texas, Houston, TX, USA
| | - Beatriz Paulina Ayala Quintanilla
- The Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, Peru
| | - Getinet Ayano
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Martin Amogre Ayanore
- Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana
| | - Ghasem Azarian
- Department of Environmental Health Engineering, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ashish D Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Atif Amin Baig
- Biochemistry Unit, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
- School of Health Sciences, Univeristi Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Mohan Bairwa
- Institute of Health Management Research, Indian Institute of Health Management Research University, Jaipur, India
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Ahad Bakhtiari
- Health Policy and Management Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Arun Balachandran
- Department of Demography, University of Groningen, Groningen, Netherlands
- Population Research Centre, Institute for Social and Economic Change, Bengaluru, India
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | | | - Palash Chandra Banik
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Amrit Banstola
- Department of Research, Public Health Perspective Nepal, Pokhara-Lekhnath Metropolitan City, Nepal
| | | | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Akbar Barzegar
- Occupational Health Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Neeraj Bedi
- Department of Community Medicine, Gandhi Medical College Bhopal, Bhopal, India
- Jazan University, Jazan, Saudi Arabia
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Habte Belete
- Psychiatry Department, Bahir Dar University, Bhair Dar, Ethiopia
| | - Derrick A Bennett
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Isabela M Bensenor
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
| | - Kidanemaryam Berhe
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Akshaya Srikanth Bhagavathula
- Department of Internal Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
- Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
| | - Pankaj Bhardwaj
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Anusha Ganapati Bhat
- Internal Medicine Department, University of Massachusetts Medical School, Springfield, MA, USA
| | - Krittika Bhattacharyya
- Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
- Department of Statistics, University of Calcutta, Kolkata, India
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, University of Toronto, Toronto, Ontario, Canada
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sadia Bibi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Archith Boloor
- Department of Internal Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Guilherme Borges
- Department of Epidemiology and Psychosocial Reseach, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Rohan Borschmann
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Antonio Maria Borzì
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research Department, University of New South Wales, Sydney, New South Wales, Australia
| | - Dejana Braithwaite
- Division of Hematology and Oncology, Georgetown University, Washington DC, USA
| | - Nikolay Ivanovich Briko
- Department of Epidemiology and Evidence Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Traolach Brugha
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Josip Car
- Centre for Population Health Sciences, Nanyang Technological University, Singapore, Singapore
- Global eHealth Unit, Imperial College London, London, UK
| | - Rosario Cárdenas
- Department of Population and Health, Metropolitan Autonomous University, Mexico City, Mexico
| | - Félix Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | | | - Carlos A Castañeda-Orjuela
- Colombian National Health Observatory, National Institute of Health, Bogota, Colombia
- Epidemiology and Public Health Evaluation Group, National University of Colombia, Bogota, Colombia
| | - Giulio Castelpietra
- Primary Care Services Area, Central Health Directorate, Region Friuli Venezia Giulia, Trieste, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Ferrán Catalá-López
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Joht S Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jens Robert Chapman
- Swedish Neuroscience Institute, Swedish Brain and Spine Specialists, Seattle, WA, USA
| | | | | | - Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Haidari, Greece
- Ophthalmology Independent Consultant, Athens, Greece
| | - Neha Chaudhary
- Pediatrics Department, Harvard University, Boston, MA, USA
- Neonatology Department, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Daniel Youngwhan Cho
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Jee-Young J Choi
- Department of Biochemistry and Biomedical Science, Seoul National University Hospital, Seoul, South Korea
| | - Mohiuddin Ahsanul Kabir Chowdhury
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | | | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - João M Coelho
- Centro Hospitalar Universitário do Porto - Serviço de Oftalmologia, University of Porto, Porto, Portugal
| | - Vera M Costa
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Saad M A Dahlawi
- Department of Environmental Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Mount Gravatt, Queensland, Australia
| | | | - Gebre Teklemariam Demoz
- School of Pharmacy, Aksum University, Aksum, Ethiopia
- Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rupak Desai
- Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | | | | | | | - Hoa Thi Do
- Center of Excellence in Public Health Nutrition, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Kerrie E Doyle
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Bundoora, Victoria, Australia
| | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Bereket Duko Adema
- Public Health Department, Hawassa University, Hawassa, Ethiopia
- Curtin University, Perth, Western Australia, Australia
| | - Arielle Wilder Eagan
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
- Department of Social Services, Tufts Medical Center, Boston, MA, USA
| | | | | | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | - Christian Lycke Ellingsen
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Oghenowede Eyawo
- Epidemiology and Population Health, York University, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Pawan Sirwan Faris
- Biology Department, Salahaddin University-Erbil, Erbil, Iraq
- Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy
| | - Andre Faro
- Department of Psychology, Federal University of Sergipe, Sao Cristovao, Brazil
| | - Farshad Farzadfar
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurobiology, Karolinska Institutet, Stockholm, Sweden
- Division of Neurology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Pietro Ferrara
- Research Centre on Public Health (CESP), University of Milan Bicocca, Monza, Italy
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | | | | | - Masoud Foroutan
- Abadan School of Medical Sciences, Abadan University of Medical Sciences, Abadan, Iran
| | - Joel Msafiri Francis
- Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Science, James Cook University, Douglas, Queensland, Australia
- Royal Life Saving Society, Sydney, New South Wales, Australia
| | - Takeshi Fukumoto
- Department of Dermatology, Kobe University, Kobe, Japan
- Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, PA, USA
| | | | - Hadush Gebremariam
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | | | - Leake G Gebremeskel
- School of Pharmacy, Aksum University, Aksum, Ethiopia
- Pharmacy Department, Mekelle University, Mekelle, Ethiopia
| | | | | | - Getnet Azeze Gedefaw
- Bahir Dar University, Bahir Dar, Ethiopia
- Haramaya University, Dire Dawa, Ethiopia
| | - Birhanu Geta
- Department of Pharmacy, Wollo University, Dessie, Ethiopia
| | | | - Mansour Ghafourifard
- Department of Medical Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Ghamari
- Occupational Health Department, Arak University of Medical Sciences, Arak, Iran
| | - Reza Ghanei Gheshlagh
- Department of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Asadollah Gholamian
- Science and Research Branch, Islamic Azad University, Tehran, Iran
- Young Researchers and Elite Club, Islamic Azad University, Rasht, Iran
| | - Syed Amir Gilani
- Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
- Chairman BOG, Afro-Asian Institute, Lahore, Pakistan
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | | | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University of São Paulo, Sao Paulo, Brazil
- Internal Medicine Department, University of São Paulo, Sao Paulo, Brazil
| | - Ayman Grada
- Department of Dermatology, Boston University, Boston, MA, USA
| | - Michal Grivna
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rafael Alves Guimarães
- Instituto de Patologia Tropical e Saúde Pública, Federal University of Goias, Goiânia, Brazil
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Epidemiology and Biostatistics, Zhengzhou University, Zhengzhou, China
| | - Gaurav Gupta
- Non-Communicable Diseases (NCD), World Health Organization (WHO), New Delhi, India
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Brian James Hall
- Global and Community Mental Health Research Group, University of Macau, Macao, China
| | - Randah R Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | | | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
- Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - Amir Hasanzadeh
- Department of Microbiology, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Microbiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Shoaib Hassan
- Centre for International Health and Section for Ethics and Health Economics, University of Bergen, Bergen, Norway
| | - Soheil Hassanipour
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Guilan University of Medical Sciences, Rasht, Iran
| | - Hadi Hassankhani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Independent Consultant, Tabriz, Iran
| | - Hamid Yimam Hassen
- Department of Public Health, Mizan-Tepi University, Tepi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Rasmus Havmoeller
- Department of Clinical Sciences, Karolinska University Hospital, Stockholm, Sweden
| | - Delia Hendrie
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Fatemeh Heydarpour
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Martha Híjar
- Research Coordination, AC Environments Foundation, Cuernavaca, Mexico
- CISS, National Institute of Public Health, Cuernavaca. Mexico
| | - Hung Chak Ho
- Department of Urban Planning and Design, University of Hong Kong, Hong Kong, China
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Michael K Hole
- Department of Pediatrics, Dell Medical School, University of Texas Austin, Austin, TX, USA
| | - Ramesh Holla
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Naznin Hossain
- Department of Pharmacology and Therapeutics, Dhaka Medical College, Dhaka, Bangladesh
- Department of Pharmacology, Bangladesh Industrial Gases Limited, Tangail, Bangladesh
| | - Mehdi Hosseinzadeh
- Department of Computer Engineering, Islamic Azad University, Tehran, Iran
- Computer Science Department, University of Human Development, Sulaymaniyah, Iraq
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Central South University, Changsha, China
| | | | | | | | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Mofizul Islam
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, Victoria, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Mihajlo Jakovljevic
- Department for Health Care and Public Health, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Farzad Jalilian
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sudha Jayaraman
- Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Achala Upendra Jayatilleke
- Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Graduate Studies, University of Colombo, Colombo, Sri Lanka
| | - Ravi Prakash Jha
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Beijing Ophthalmology & Visual Science Key Laboratory, Beijing Tongren Hospital, Beijing, China
| | - Kelly M Jones
- Auckland University of Technology, Auckland, New Zealand
| | - Nitin Joseph
- Community Medicine Department, Manipal Academy of Higher Education, Mangalore, India
| | - Farahnaz Joukar
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | | | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amaha Kahsay
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Leila R Kalankesh
- Department of Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Kalhor
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Teshome Abegaz Kamil
- School of Public Health, Department of Health informatics and Health Innovation, A.C.S. Medical College and Hospital, Mekelle, Ethiopia
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Manoochehr Karami
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Taras Kavetskyy
- Department of Applied Physics, The John Paul II Catholic University of Lublin, Lublin Voivodeship, Poland
- Department of Biology and Chemistry, Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
| | - Gbenga A Kayode
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, Netherlands
| | | | | | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Morteza Abdullatif Khafaie
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nauman Khalid
- School of Food and Agricultural Sciences, University of Management and Technology, Lahore, Pakistan
| | - Ibrahim A Khalil
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Rovshan Khalilov
- Department of Physiology, Baku State University, Baku, Azerbaijan
| | - Maseer Khan
- Epidemiology, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Junaid Khan
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Tripti Khanna
- Department of Health Research, Indian Council of Medical Research, New Delhi, India
- Centre for Ethics, Jawahar Lal Nehru University, New Delhi, India
| | - Salman Khazaei
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Habibolah Khazaie
- Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roba Khundkar
- Nuffield Department of Surgical Sciences, Oxford University Global Surgery Group, University of Oxford, Oxford, UK
| | | | - Young-Eun Kim
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Yun Jin Kim
- School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, MA, USA
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Hamidreza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Brain Engineering Research Center, Institute for Research in Fundamental Sciences, Tehran, Iran
| | - Shivakumar K M Kondlahalli
- Public Health Dentistry Department, Krishna Institute of Medical Sciences Deemed to be University, Karad, India
| | - Ali Koolivand
- Environmental Health Engineering, Arak University of Medical Sciences, Arak, Iran
| | - Vladimir Andreevich Korshunov
- Department of Epidemiology and Evidence Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ai Koyanagi
- CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Kewal Krishan
- Department of Anthropology, Panjab University, Chandigarh, India
| | - Barthelemy Kuate Defo
- Department of Demography, University of Montreal, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Burcu Kucuk Bicer
- Department of Public Health, Yuksek Ihtisas University, Ankara, Turkey
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Nuworza Kugbey
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
- Department of Psychology and Health Promotion, University of KwaZulu-Natal, Durban, South Africa
| | - Nithin Kumar
- Community Medicine Department, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Vivek Kumar
- Department of Medicine Brigham and Women's Hospital, Harvard University, Boston, MA, USA
| | - Narinder Kumar
- Orthopaedics Department, Base Hospital Lucknow Cantt, Lucknow, India
| | - Girikumar Kumaresh
- Mechanical and Industrial Engineering, Indian Institute of Technology, Roorkee, India
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | - Van C Lansingh
- HelpMeSee, New York, NY, USA
- International Relations, Mexican Institute of Ophthalmology, Queretaro, Mexico
| | - Savita Lasrado
- Department of Otorhinolaryngology (ENT), Father Muller Medical College, Mangalore, India
| | - Arman Latifi
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Paolo Lauriola
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Carlo La Vecchia
- Clinical Medicine and Community Health, University of Milan, Milano, Italy
| | - Janet L Leasher
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Xuefeng Liu
- Department of Systems, Populations and Leadership, University of Michigan, Ann Arbor, MI, USA
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Paulo A Lotufo
- Department of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Ronan A Lyons
- Health Data Research UK, Swansea University, Swansea, UK
| | - Daiane Borges Machado
- Center for Integration of Data and Health Knowledge, FIOCRUZ: Cidacs Center for Integration of Data and Health Knowledge, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, England
| | - Mohammed Madadin
- Pathology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Venkatesh Maled
- Health Education and Research Department, SDM College of Medical Sciences & Hospital, Dharwad, India
- Health University, Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Navid Manafi
- Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran
- Ophthalmology Department, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amir Manafi
- Department of Surgery, University of Virginia, Charlottesville, VA, USA
| | - Ana-Laura Manda
- Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Narayana Manjunatha
- Psychiatry Department, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Joemer C Maravilla
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Seyedeh Zahra Masoumi
- Department of Midwifery-Reproductive Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Benjamin Ballard Massenburg
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Pallab K Maulik
- Research Department, The George Institute for Global Health, New Delhi, India
- School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Man Mohan Mehndiratta
- Neurology Department, Janakpuri Super Specialty Hospital Society, New Delhi, India
- Department of Neurology, Govind Ballabh Institute of Medical Education and Research, New Delhi, India
| | | | - Peter T N Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Baltimore, MD, USA
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
| | - Ritesh G Menezes
- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Atte Meretoja
- Neurocenter, Helsinki University Hospital, Helsinki, Finland
- School of Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | | | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
- Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Ted R Miller
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- Pacific Institute for Research & Evaluation, Calverton, MD, USA
| | - G K Mini
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Global Institute of Public Health (GIPH), Ananthapuri Hospitals and Research Centre, Trivandrum, India
| | - Andreea Mirica
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- President's Office, National Institute of Statistics, Bucharest, Romania
| | - Erkin M Mirrakhimov
- Faculty of Internal Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
- Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
| | - Mehdi Mirzaei-Alavijeh
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Prasanna Mithra
- Community Medicine Department, Manipal Academy of Higher Education, Mangalore, India
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Masoud Moghadaszadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Efat Mohamadi
- Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | | | | | - Shafiu Mohammed
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | | | - Farnam Mohebi
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Iran National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad A Mohseni Bandpei
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Yoshan Moodley
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Masoud Moradi
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Shane Douglas Morrison
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | | | - Atalay Goshu Muluneh
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Kamarul Imran Musa
- School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia
| | - Ghulam Mustafa
- Department of Pediatric Medicine, Nishtar Medical University, Multan, Pakistan
- Department of Pediatrics & Pediatric Pulmonology, Institute of Mother & Child Care, Multan, Pakistan
| | - Mehdi Naderi
- Clinical Research Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ahamarshan Jayaraman Nagarajan
- Research and Analytics, Initiative for Financing Health and Human Development, Chennai, India
- Research and Analytics, Bioinsilico Technologies, Chennai, India
| | - Gurudatta Naik
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russia
| | - Farid Najafi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Bruno Ramos Nascimento
- Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Morteza Naserbakht
- Mental Health Research Center, IUMS, Tehran, Iran
- Preventive Medicine and Public Health Research Center, IUMS, Tehran, Iran
| | - Vinod Nayak
- Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Manipal, India
| | - Javad Nazari
- Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran
- Iranian Ministry of Health and Medical Education, Tehran, Iran
| | | | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | | | - Trang Huyen Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Diep Ngoc Nguyen
- Project of ADB, National Institute of Nutrition, Hanoi, Vietnam
- Industrial Management Department, Hanoi University of Science and Technology, Hanoi, Vietnam
| | | | - Rajan Nikbakhsh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Heidelberg University Hospital, Heidelberg, Germany
| | - Dina Nur Anggraini Ningrum
- Public Health Department, Universitas Negeri Semarang, Kota Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | - Chukwudi A Nnaji
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Richard Ofori-Asenso
- Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, Australia
- Independent Consultant, Accra, Ghana
| | | | - Onome Bright Oghenetega
- Reproductive Health Sciences, Department Obstetrics and Gynecology, University of Ibadan, Ibadan, Nigeria
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaimaniyah, Iraq
| | - Obinna E Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
| | - Heather M Orpana
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Erika Ota
- Department of Global Health Nursing, St. Luke's International University, Chuo-ku, Japan
| | - Nikita Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Academic Department, Unium Ltd, Moscow, Russia
| | - Stanislav S Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | | | - Smita Pakhale
- Department of Medicine, Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, Ontario, Canada
| | - Keyvan Pakshir
- Parasitology and Mycology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | - Sangram Kishor Patel
- Research and Evaluation Department, Population Council, New Delhi, India
- Indian Institute of Health Management Research University, Jaipur, India
| | - Ashish Pathak
- Department of Pediatircs, RD Gardi Medical College, Ujjain, India
- Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Sanghamitra Pati
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India
| | - Kebreab Paulos
- Department of Midwifery, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amy E Peden
- Royal Life Saving Society, Sydney, New South Wales, Australia
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Jeevan Pereira
- Department of Orthopedics, Yenepoya Medical College, Mangalore, India
| | - Michael R Phillips
- Department of Psychiatry, Department of Epidemiology, Columbia University, New York, NY, USA
- Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
| | - Roman V Polibin
- Department of Epidemiology and Evidence-Based Medicine, Sechenon University, Moscow, Russia
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Farshad Pourmalek
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Akram Pourshams
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Swayam Prakash
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Parul Puri
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Zahiruddin Quazi Syed
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando, FL, USA
- College of Graduate Health Sciences, A.T. Still University, Mesa, AZ, USA
| | - Anwar Rafay
- Department of Epidemiology & Biostatistics, Contech School of Public Health, Lahore, Pakistan
| | - Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Alireza Rafiei
- Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fakher Rahim
- Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Siavash Rahimi
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Victoria, Australia
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | | | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ivo Rakovac
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization (WHO), Moscow, Russia
| | - Sowmya J Rao
- Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran
| | - Prateek Rastogi
- Department of Forensic Medicine, Manipal Academy of Higher Education, Manipal, India
| | - Priya Rathi
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Academic Public Health Department, Public Health England, London, UK
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, CQ University, Sydney, New South Wales, Australia
| | - Reza Rawassizadeh
- Department of Computer Science, Metropolitan College, Boston University, Boston, USA
| | - Vishnu Renjith
- Neurology Department, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- Organization for the Prevention of Blindness, Paris, France
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ana Isabel Ribeiro
- EPIUnit - Public Health Institute University Porto (ISPUP), University of Porto, Porto, Portugal
| | - Jennifer Rickard
- Surgery Department, University of Minnesota, Minneapolis, MN, USA
- Surgery Department, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Carlos Miguel Rios González
- Research Directorate, Nihon Gakko University, Fernando de la Mora, Paraguay
- Research Direction, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay
| | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Basema Saddik
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hamid Safarpour
- Department of Health in Disasters and Emergencies, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Safdarian
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hosni Salem
- Urology Department, Cairo University, Giza, Egypt
| | - Inbal Salz
- Health and Disability Intelligence Group, Ministry of Health, Wellington, New Zealand
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, WV, USA
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Lidia Sanchez Riera
- Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Institute of Bone and Joint Research, University of Sydney, Syndey, New South Wales, Australia
| | - Milena M Santric Milicevic
- Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
- Centre-School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Abdur Razzaque Sarker
- Health Economics, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Brijesh Sathian
- Surgery Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Mehdi Sayyah
- Education Development Center, Faculty Member of Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | | | - Feng Sha
- Center for Biomedical Information Technology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Faramarz Shaahmadi
- Department of Health Promotion and Education, Alborz University of Medical Sciences, Karaj, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
- Division of General Internal Medicine, Harvard University, Boston, MA, USA
| | | | - Jae Il Shin
- College of Medicine, Yonsei University, Seodaemun-gu, South Korea
- Division of Cardiology, Emory University, Atlanta, GA, USA
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Soraya Siabani
- Department of Health Education & Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
- School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Health and Behavior Studies, Columbia University, New York, NY, USA
| | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Medicine Service, US Department of Veterans Affairs (VA), Birmingham, AL, USA
| | | | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Amin Soheili
- Medical Surgical Nursing Department, Urmia University of Medical Science, Urmia, Iran
- Emergency Nursing Department, Semnan University of Medical Sciences, Semnan, Iran
| | - Joan B Soriano
- Hospital Universitario de la Princesa, Autonomous University of Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | | | - Ireneous N Soyiri
- Hull York Medical School, University of Hull, Hull City, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Mark A Stokes
- Department of Psychology, Deakin University, Melbourne, Victoria, Australia
| | | | - Bryan L Sykes
- Department of Criminology, Law and Society, University of California Irvine, Irvine, CA, USA
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Karen M Tabb
- School of Social Work, University of Illinois, Urbana, IL, USA
| | | | - Yonatal Mesfin Tefera
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Rekha Thapar
- Community Medicine Department, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Mariya Vladimirovna Titova
- Timiryazev Institute of Plant Physiology, Russian Academy of Sciences, Moscow, Russia
- Biology Department, Moscow State University, Moscow, Russia
| | | | - Hamid Reza Tohidinik
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Kerman University of Medical Sciences, Kerman, Iran
| | - Roman Topor-Madry
- Institute of Public Health, Krakow, Poland
- The Agency for Health Technology Assessment and Tariff System, Warszawa, Poland
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Military Medical University, Hanoi, Vietnam
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Alexander C Tsai
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Irfan Ullah
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
- TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan
| | - Saif Ullah
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Pakistan
| | | | - Era Upadhyay
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | | | - Pascual R Valdez
- Argentine Society of Medicine, Buenos Aires, Argentina
- Velez Sarsfield Hospital, Buenos Aires, Argentina
| | | | - Yousef Veisani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Narayanaswamy Venketasubramanian
- Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yasir Waheed
- Foundation University Medical College, Foundation University, Islamabad, Pakistan
| | - Yuan-Pang Wang
- Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Taweewat Wiangkham
- Department of Physical Therapy, Naresuan University, Meung District, Thailand
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Dawit Habte Woldeyes
- Department of Human Anatomy, Histology, and Embryology, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Adam Belay Wondmieneh
- Department of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Nursing, Wollo University, Dessie, Ethiopia
| | - Ai-Min Wu
- Department of Orthopaedics, Wenzhou Medical University, Wenzhou, China
| | - Grant M A Wyper
- Public Health Science Directorate, NHS Health Scotland, Glasgow, Scotland
| | - Rajaram Yadav
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Ali Yadollahpour
- Medical Physics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
| | - Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Health Management, Policy and Economics, Kerman University of Medical Sciences, Kerman, Iran
| | - Pengpeng Ye
- Division of Injury Prevention and Mental Health Improvement, National Center for Chronic and Noncommunicable Disease Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Paul Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Engida Yisma
- School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Naohiro Yonemoto
- Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, South Korea
| | - Mustafa Z Younis
- Department of Health Policy & Management, Jackson State University, Jackson, MS, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Zabihollah Yousefi
- Department of Environmental Health, Mazandaran University of Medical Sciences, Sari, Iran
- Environmental Health, Academy of Medical Science, Sari, Iran
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, China
| | - Telma Zahirian Moghadam
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
| | - Sojib Bin Zaman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
- Department of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran
| | - Fatemeh Zarei
- Faculty of Medical Sciences, Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, Wuhan University, Wuhan, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Arash Ziapour
- Department of Health Education & Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sanjay Zodpey
- Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Public Health Foundation of India, Gurugram, India
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Gebremedhin KB, Gebremeskel GG, Gebremichael B, Gedefaw GA, Geta B, Ghafourifard M, Ghamari F, Ghashghaee A, Gholamian A, Gill TK, Goulart AC, Grada A, Grivna M, Mohialdeen Gubari MI, Guimarães RA, Guo Y, Gupta G, Haagsma JA, Hafezi-Nejad N, Bidgoli HH, Hall BJ, Hamadeh RR, Hamidi S, Haro JM, Hasan MM, Hasanzadeh A, Hassanipour S, Hassankhani H, Hassen HY, Havmoeller R, Hayat K, Hendrie D, Heydarpour F, Híjar M, Ho HC, Hoang CL, Hole MK, Holla R, Hossain N, Hosseinzadeh M, Hostiuc S, Hu G, Ibitoye SE, Ilesanmi OS, Ilic I, Ilic MD, Inbaraj LR, Indriasih E, Naghibi Irvani SS, Shariful Islam SM, Islam MM, Ivers RQ, Jacobsen KH, Jahani MA, Jahanmehr N, Jakovljevic M, Jalilian F, Jayaraman S, Jayatilleke AU, Jha RP, John-Akinola YO, Jonas JB, Joseph N, Joukar F, Jozwiak JJ, Jungari SB, Jürisson M, Kabir A, Kadel R, Kahsay A, Kalankesh LR, Kalhor R, Kamil TA, Kanchan T, Kapoor N, Karami M, Kasaeian A, Kassaye HG, Kavetskyy T, Kebede HK, Keiyoro PN, Kelbore AG, Kelkay B, Khader YS, Khafaie 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Y, Zodpey S, Dandona L, Dandona R, Degenhardt L, Dharmaratne SD, Hay SI, Mokdad AH, Reiner RC, Sartorius B, Vos T. Global injury morbidity and mortality from 1990 to 2017: results from the Global Burden of Disease Study 2017. Inj Prev 2020; 26:i96-i114. [PMID: 32332142 PMCID: PMC7571366 DOI: 10.1136/injuryprev-2019-043494] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/29/2019] [Accepted: 12/06/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. METHODS We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). FINDINGS In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). INTERPRETATION Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
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Affiliation(s)
- Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nathaniel J Henry
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kate E LeGrand
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Amir Abdoli
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ibrahim Abdollahpour
- Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Aidin Abedi
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA
| | | | | | - Oladimeji M Adebayo
- Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Marcela Agudelo-Botero
- School of Medicine Center for Politics, Population and Health Research, National Autonomous University of Mexico, Mexico City, Mexico
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, Southeast University Nanjing, Nanjing, China
- Department of Microbiology, Hazara University Mansehra, Mansehra, Pakistan
| | - Rushdia Ahmed
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | | | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA
| | | | - Fahad Mashhour Alanezi
- Department of Computer Sciences, Imam Abdulrehman Bin Faisal University, Dammam, Saudi Arabia
| | - Animut Alebel
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
| | | | - Suliman A Alghnam
- Department of Population Health Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Samar Al-Hajj
- Faculty of Health Sciences - Health Management and Policy, American University of Beirut, Beirut, Lebanon
- British Columbia Injury Research Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Beriwan Abdulqadir Ali
- Medical Technical Institute, Erbil Polytechnic University, Erbil, Iraq
- Faculty of Pharmacy, Ishik University, Erbil, Iraq
| | - Saqib Ali
- Department of Information Systems, College of Economics and Political Science, Sultan Qaboos University, Muscat, Oman
| | - Mahtab Alikhani
- School of Health Management and Information Sciences, Department of Health Services Management, Iran University of Medical Sciences, Tehran, Iran
| | - Cyrus Alinia
- Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | - Nihad A Almasri
- Physiotherapy Department, The University of Jordan, Amman, Jordan
| | | | - Yasser Sami Abdeldayem Amer
- Clinical Practice Guidelines Unit, King Saud University, Riyadh, Saudi Arabia
- Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt
| | - Saeed Amini
- Health Services Management Department, Arak University of Medical Sciences, Arak, Iran
| | - Arianna Maever Loreche Amit
- Department of Epidemiology and Biostatistics, University of the Philippines Manila, Manila, Philippines
- Online Programs for Applied Learning, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for International Health, Ludwig Maximilians University, Munich, Germany
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Zohreh Arefi
- Department of Health Promotion and Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Filippo Ariani
- Regional Centre for the Analysis of Data on Occupational and Work-related Injuries and Diseases, Local Health Unit Tuscany Centre, Florence, Italy
| | - Amit Arora
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
- Oral Health Services, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Malke Asaad
- Department of Plastic Surgery, University of Texas, Houston, TX, USA
| | - Babak Asghari
- Department of Microbiology, Hamedan University of Medical Sciences, Azad Tabriz University, Iran
| | - Nefsu Awoke
- Department of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Beatriz Paulina Ayala Quintanilla
- The Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
- General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, Peru
| | - Getinet Ayano
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Martin Amogre Ayanore
- Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana
| | - Samad Azari
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ghasem Azarian
- Department of Environmental Health Engineering, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ashish D Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Eleni Bagli
- Department of Ophthalmology, University Hospital of Ioannina, Ioannina, Greece
- Institute of Molecular Biology & Biotechnology, Foundation for Research & Technology, Ioannina, Greece
| | - Atif Amin Baig
- Biochemistry Unit, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
- School of Health Sciences, Univeristi Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Mohan Bairwa
- Institute of Health Management Research, Indian Institute of Health Management Research University, Jaipur, India
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Ahad Bakhtiari
- Health Policy And Management Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Arun Balachandran
- Department of Demography, University of Groningen, Groningen, Netherlands
- Population Research Centre, Institute for Social and Economic Change, Bengaluru, India
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | | | - Palash Chandra Banik
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Amrit Banstola
- Department of Research, Public Health Perspective Nepal, Pokhara-Lekhnath Metropolitan City, Nepal
| | | | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Lope H Barrero
- Department of Industrial Engineering, Pontifical Javeriana University, Bogota, Colombia
| | - Akbar Barzegar
- Occupational Health Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Neeraj Bedi
- Department of Community Medicine, Gandhi Medical College Bhopal, Bhopal, India
- Jazan University, Jazan, Saudi Arabia
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Tariku Tesfaye Bekuma
- Institute of Health Sciences, School of Public Health, Wollega University, Nekemte, Ethiopia
| | - Habte Belete
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia
| | - Corina Benjet
- Department of Epidemiology and Psychosocial Reseach, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Derrick A Bennett
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Isabela M Bensenor
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
| | - Kidanemaryam Berhe
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Anusha Ganapati Bhat
- Department of Internal Medicine, University of Massachusetts Medical School, Springfield, MA, USA
| | - Krittika Bhattacharyya
- Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
- Department of Statistics, University of Calcutta, Kolkata, India
| | - Sadia Bibi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Muhammad Shahdaat Bin Sayeed
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
- Department of Clinical Pharmacy and Pharmacology, University of Dhaka, Dhaka, Bangladesh
| | - Guilherme Borges
- Department of Epidemiology and Psychosocial Reseach, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Antonio Maria Borzì
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research Department, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Nikolay Ivanovich Briko
- Department of Epidemiology and Evidence Based Medicine, I M Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Josip Car
- Centre for Population Health Sciences, Nanyang Technological University, Singapore
- Global eHealth Unit, Imperial College London, London, UK
| | - Rosario Cárdenas
- Department of Population and Health, Metropolitan Autonomous University, Mexico City, Mexico
| | - Félix Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | | | - Carlos A Castañeda-Orjuela
- Colombian National Health Observatory, National Institute of Health, Bogota, Colombia
- Epidemiology and Public Health Evaluation Group, National University of Colombia, Bogota, Colombia
| | - Giulio Castelpietra
- Primary Care Services Area, Central Health Directorate, Region Friuli Venezia Giulia, Trieste, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Ferrán Catalá-López
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Joht S Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | | | | | - Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Haidari, Greece
- Ophthalmology Private Practice Office, Independent Consultant, Athens, Greece
| | - Neha Chaudhary
- Department of Pediatrics, Harvard University, Boston, MA, USA
- Department of Neonatology, Beth Israel Deaconess Medical center, Boston, MA, USA
| | - Daniel Youngwhan Cho
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Mohiuddin Ahsanul Kabir Chowdhury
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
| | - Samantha M Colquhoun
- Research School of Population Health, Australian National University, Action, ACT, Australia
| | - Maria-Magdalena Constantin
- Department of Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 2nd Department of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
| | - Vera M Costa
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Giovanni Damiani
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
- Department of Dermatology, University of Milan, Milan, Italy
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | | | - Asmamaw Bizuneh Demis
- Department of Nursing, Woldia University, Woldia, Ethiopia
- School of Nursing, Jimma University, Jimma, Ethiopia
| | - Gebre Teklemariam Demoz
- School of Pharmacy, Aksum University, Aksum, Ethiopia
- Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rupak Desai
- Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | | | | | | | - Kerrie E Doyle
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Bundoora, VIC, Australia
| | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | | | - Bereket Duko Adema
- Public Health Department, Hawassa University, Hawassa, Ethiopia
- Curtin University, Perth, WA, Australia
| | - Arielle Wilder Eagan
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
- Department of Social Services, Tufts Medical Center, Boston, MA, USA
| | - Aziz Eftekhari
- Department of Pharmacology and Toxicology, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Pharmacology and Toxicology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Ehsani-Chimeh
- National Institute for Health Researches, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
| | - Christian Lycke Ellingsen
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Pawan Sirwan Faris
- Biology Department, Salahaddin University-Erbil, Erbil, Iraq
- Biology and Biotechnolaniogy"L Spallanzani", University of Pavia, Pavia, Italy
| | - Andre Faro
- Department of Psychology, Federal University of Sergipe, Sao Cristovao, Brazil
| | - Farshad Farzadfar
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Fatahi
- Pharmaceutical Nanotechnology, Tehran University of Medical Sciences, Tehran, Iran
| | - Wubalem Fekadu
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tomas Y Ferede
- Nursing Department, Hawassa University, Hawassa, Ethiopia
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurobiology, Karolinska Institutet, Stockholm, Sweden
- Division of Neurology, University of Ottawa, Ottawa, ON, Canada
| | | | - Pietro Ferrara
- Research Centre on Public Health (CESP), University of Milan Bicocca, Monza, Italy
| | - Garumma Tolu Feyissa
- Department of Health Education & Behavioral Sciences, Jimma University, Jimma, Ethiopia
| | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, CA, USA
- School of Health Sciences, A T Still University, Mesa, AZ, USA
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | | | - Masoud Foroutan
- Abadan School of Medical Sciences, Abadan University of Medical Sciences, Abadan, Iran
| | - Joel Msafiri Francis
- Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Science, James Cook University, Douglas, QLD, Australia
- Royal Life Saving Society, Sydney, NSW, Australia
| | - Takeshi Fukumoto
- Department of Dermatology, Kobe University, Kobe, Japan
- Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, PA, USA
| | | | | | | | | | | | - Getnet Azeze Gedefaw
- Bahir Dar University, Bahir Dar, Ethiopia
- Haramaya University, Dire Dawa, Ethiopia
| | - Birhanu Geta
- Department of Pharmacy, Wollo University, Dessie, Ethiopia
| | - Mansour Ghafourifard
- Department of Medical Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Ghamari
- Occupational Health Department, Arak University of Medical Sciences, Arak, Iran
| | - Ahmad Ghashghaee
- Department of Health Services Management, Iran University of Medical Sciences, Tehran, Iran
| | - Asadollah Gholamian
- Science and Research Branch, Islamic Azad University, Tehran, Iran
- Young Researchers and Elite Club, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Alessandra C Goulart
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
- Center for Clinical and Epidemiological Research, University of São Paulo, Sao Paulo, Brazil
| | - Ayman Grada
- Department of Dermatology, Boston University, Boston, MA, USA
| | - Michal Grivna
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Rafael Alves Guimarães
- Instituto de Patologia Tropical e Saúde Pública, Federal University of Goias, Goiânia, Brazil
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Epidemiology and Biostatistics, Zhengzhou University, Zhengzhou, China
| | - Gaurav Gupta
- Non-Communicable Diseases (NCD), World Health Organization (WHO), New Delhi, India
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Nima Hafezi-Nejad
- Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, USA
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Brian James Hall
- Global and Community Mental Health Research Group, University of Macau, Macao, China
| | - Randah R Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
- Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - Md Mehedi Hasan
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD, Australia
| | - Amir Hasanzadeh
- Department of Microbiology, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Microbiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hadi Hassankhani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Independent Consultant, Tabriz, Iran
| | - Hamid Yimam Hassen
- Department of Public Health, Mizan-Tepi University, Tepi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Rasmus Havmoeller
- Department of Clinical Sciences, Karolinska University Hospital, Stockholm, Sweden
| | - Khezar Hayat
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
| | - Delia Hendrie
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Fatemeh Heydarpour
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Martha Híjar
- Research Coordination, AC Environments Foundation, Cuernavaca, Mexico
- CISS, National Institute of Public Health, Cuernavaca, Mexico
| | - Hung Chak Ho
- Department of Urban Planning and Design, University of Hong Kong, Hong Kong, China
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Michael K Hole
- Department of Pediatrics, Dell Medical School, University of Texas Austin, Austin, TX, USA
| | - Ramesh Holla
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Naznin Hossain
- Department of Pharmacology and Therapeutics, Dhaka Medical College, Dhaka, Bangladesh
- Department of Pharmacology, Bangladesh Industrial Gases Limited, Tangail, Bangladesh
| | - Mehdi Hosseinzadeh
- Department of Computer Engineering, Islamic Azad University, Tehran, Iran
- Computer Science Department, University of Human Development, Sulaymaniyah, Iraq
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Central South University, Changsha, China
| | | | | | - Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena D Ilic
- Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | | | - Endang Indriasih
- Center for Health Resource and Services Research and Development, National Institute of Health Research & Development, Jakarta, Indonesia
| | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - M Mofizul Islam
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC, Australia
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Kathryn H Jacobsen
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA
| | | | - Nader Jahanmehr
- School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mihajlo Jakovljevic
- Department for Health Care and Public Health, I M Sechenov First Moscow State Medical University, Moscow, Russia
| | - Farzad Jalilian
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sudha Jayaraman
- Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Achala Upendra Jayatilleke
- Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Graduate Studies, University of Colombo, Colombo, Sri Lanka
| | - Ravi Prakash Jha
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Beijing Ophthalmology & Visual Science Key Laboratory, Beijing Tongren Hospital, Beijing, China
| | - Nitin Joseph
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Farahnaz Joukar
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | | | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Rajendra Kadel
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Amaha Kahsay
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Leila R Kalankesh
- Department of Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Kalhor
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Teshome Abegaz Kamil
- School of Public Health, Department of Health Informatics and Health Innovation, A C S Medical College and Hospital, Mekelle, Ethiopia
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Manoochehr Karami
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Taras Kavetskyy
- Department of Applied Physics, The John Paul II Catholic University of Lublin, Lublin Voivodeship, Poland
- Department of Biology and Chemistry, Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
| | | | | | | | - Bayew Kelkay
- Department of Midwifery, University of Gondar, Gondar, Ethiopia
| | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Morteza Abdullatif Khafaie
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nauman Khalid
- School of Food and Agricultural Sciences, University of Management and Technology, Lahore, Pakistan
| | - Ibrahim A Khalil
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Rovshan Khalilov
- Department of Physiology, Baku State University, Baku, Azerbaijan
| | - Mohammad Khammarnia
- Health Care Management, Zahedan University of Medical Sciences, zahedan, Iran
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Maseer Khan
- Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Tripti Khanna
- Department of Health Research, Indian Council of Medical Research, New Delhi, India
- Centre for Ethics, Jawahar Lal Nehru University, New Delhi, India
| | - Habibolah Khazaie
- Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Roba Khundkar
- Nuffield Department of Surgical Sciences, Oxford University Global Surgery Group, University of Oxford, Oxford, UK
| | | | - Young-Eun Kim
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, MA, USA
| | - Yun Jin Kim
- School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Hamidreza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Brain Engineering Research Center, Institute for Research in Fundamental Sciences, Tehran, Iran
| | | | - Vladimir Andreevich Korshunov
- Department of Epidemiology and Evidence Based Medicine, I M Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ai Koyanagi
- CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Kewal Krishan
- Department of Anthropology, Panjab University, Chandigarh, India
| | - Burcu Kucuk Bicer
- Department of Public Health, Yuksek Ihtisas University, Ankara, Turkey
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Nuworza Kugbey
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
- Department of Psychology and Health Promotion, University of KwaZulu-Natal, Durban, South Africa
| | - Vivek Kumar
- Department of Medicine, Brigham and Women's Hospital, Harvard University, Boston, MA, USA
| | - Nithin Kumar
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - G Anil Kumar
- Public Health Foundation of India, Gurugram, India
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
| | - Girikumar Kumaresh
- Mechanical and Industrial Engineering, Indian Institute of Technology, Roorkee, Roorkee, India
| | - Om P Kurmi
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Oluwatosin Kuti
- Health and Nutrition Section, United Nations Childrens' Fund (UNICEF), Accra, Ghana
| | - Carlo La Vecchia
- Department of Clinical Medicine and Community Health, University of Milan, Milano, Italy
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | | | - Justin J Lang
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Van C Lansingh
- HelpMeSee, New York, NY, USA
- International Relations, Mexican Institute of Ophthalmology, Queretaro, Mexico
| | | | - Savita Lasrado
- Department of Otorhinolaryngology (ENT), Father Muller Medical College, Mangalore, India
| | - Arman Latifi
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Paolo Lauriola
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
| | - Janet L Leasher
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | | | - Miriam Levi
- Regional Centre for the Analysis of Data on Occupational and Work-related Injuries and Diseases, Local Health Unit Tuscany Centre, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shai Linn
- School of Public Health, University of Haifa, Haifa, Israel
| | - Xuefeng Liu
- Department of Systems, Populations and Leadership, University of Michigan, Ann Arbor, MI, USA
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Paulo A Lotufo
- Department of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Raimundas Lunevicius
- Department of General Surgery, Aintree University Hospital National Health Service (NHS) Foundation Trust, Liverpool, UK
- Department of Surgery, University of Liverpool, Liverpool, UK
| | - Ronan A Lyons
- Health Data Research UK, Swansea University, Swansea, UK
| | - Mohammed Madadin
- College of Medicine, Pathology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Jeadran N Malagon-Rojas
- Public Health Research Department, National Health Institute Colombia, Bogota, Colombia
- Faculty of Medicine, El Bosque University, Bogota, Colombia
| | - Venkatesh Maled
- Health Education and Research Department, SDM College of Medical Sciences & Hospital, Dharwad, India
- Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Navid Manafi
- Department of Ophthalmology, Iran University of Medical Sciences, Tehran, Iran
- Ophthalmology Department, University of Manitoba, Winnipeg, MB, Canada
| | - Amir Manafi
- Department of Surgery, University of Virginia, Charlottesville, VA, USA
| | - Ana-Laura Manda
- Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Borhan Mansouri
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Joemer C Maravilla
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
| | - Lyn M March
- Institute of Bone and Joint Research, University of Sydney, St Leonards, NSW, Australia
| | | | - Seyedeh Zahra Masoumi
- Department of Midwifery-Reproductive Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Benjamin Ballard Massenburg
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Pallab K Maulik
- Research Department, The George Institute for Global Health, New Delhi, India
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Addisu Melese
- Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Peter T N Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Baltimore, MD, USA
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
| | - Ritesh G Menezes
- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Meresa Berwo Mengesha
- College of Health Science, Department of Midwifery, Adigrat University, Adigrat, Ethiopia
| | | | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Atte Meretoja
- Neurocenter, Helsinki University Hospital, Helsinki, Finland
- School of Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | | | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, ZoraProfozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Ted R Miller
- School of Public Health, Curtin University, Perth, WA, Australia
- Pacific Institute for Research & Evaluation, Calverton, MD, USA
| | - G K Mini
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Global Institute of Public Health (GIPH), Ananthapuri Hospitals and Research Centre, Trivandrum, India
| | - Andreea Mirica
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- President's Office, National Institute of Statistics Romania, Bucharest, Romania
| | - Erkin M Mirrakhimov
- Faculty of Internal Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
- Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
| | - Mehdi Mirzaei-Alavijeh
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Masoud Moghadaszadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Efat Mohamadi
- Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | | | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | | | | | - Milad Mohammadoo-Khorasani
- Department of Clinical Biochemistry, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | | | - Shafiu Mohammed
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | | | - Farnam Mohebi
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Iran National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Yoshan Moodley
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Moradi
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Setagaya, Japan
| | - Shane Douglas Morrison
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | | | - Atalay Goshu Muluneh
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Srinivas Murthy
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Kamarul Imran Musa
- School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia
| | - Ghulam Mustafa
- Department of Pediatric Medicine, Nishtar Medical University, Multan, Pakistan
- Department of Pediatrics & Pediatric Pulmonology, Institute of Mother & Child Care, Multan, Pakistan
| | - Ashraf F Nabhan
- Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt
- Knowledge Translation and Utilization, Egyptian Center for Evidence Based Medicine, Egypt
| | - Ahamarshan Jayaraman Nagarajan
- Research and Analytics, Initiative for Financing Health and Human Development, Chennai, India
- Research and Analytics, Bioinsilico Technologies, Chennai, India
| | - Gurudatta Naik
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russia
| | - Farid Najafi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Bruno Ramos Nascimento
- Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Morteza Naserbakht
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Vinod Nayak
- Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Manipal, India
| | | | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | - Rajan Nikbakhsh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Heidelberg University Hospital, Heidelberg, Germany
| | - Dina Nur Anggraini Ningrum
- Public Health Department, Universitas Negeri Semarang, Kota Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | - Chukwudi A Nnaji
- Cochrane Unit, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Peter S Nyasulu
- Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Felix Akpojene Ogbo
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Onome Bright Oghenetega
- Reproductive Health Sciences, Department Obstetrics and Gynecology, University of Ibadan, Ibadan, Nigeria
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea
| | | | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaimaniyah, Iraq
| | - Obinna E Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
| | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Accra, Ghana
- Discipline of Psychology, University of KwaZulu-Natal, Durban, South Africa
| | - Heather M Orpana
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Erika Ota
- Department of Global Health Nursing, St Luke's International University, Chuo-ku, Japan
| | - Nikita Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Academic department, Unium Ltd, Moscow, Russia
| | - Stanislav S Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | | | - Smita Pakhale
- Department of Medicine, Ottawa Hospital Research Institute, Ottawa ON, Canada
| | - Keyvan Pakshir
- Parasitology and Mycology, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | - Sangram Kishor Patel
- Research and Evaluation, Population Council, New Delhi, India
- Indian Institute of Health Management Research University Delhi, Jaipur, India
| | - Ashish Pathak
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatircs, RD Gardi Medical College, Ujjain, India
| | - Sanghamitra Pati
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India
| | - George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Population Health Theme, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - Kebreab Paulos
- Department of Midwifery, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amy E Peden
- Royal Life Saving Society, Sydney, NSW, Australia
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Jeevan Pereira
- Department of Orthopedics, Yenepoya Medical College, Mangalore, India
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
- Department of Psychiatry, Department of Epidemiology, Columbia University, New York City, NY, USA
| | - Marina Pinheiro
- Department of Chemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Roman V Polibin
- Department of Epidemiology and Evidence-Based Medicine, Sechenon University, Moscow, Russia
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Hossein Poustchi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Swayam Prakash
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Parul Puri
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Zahiruddin Quazi Syed
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando, FL, USA
- College of Graduate Health Sciences, A T Still University, Mesa, AZ, USA
| | - Anwar Rafay
- Department of Epidemiology & Biostatistics, Contech School of Public Health, Lahore, Pakistan
| | - Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Alireza Rafiei
- Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fakher Rahim
- Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Siavash Rahimi
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, VIC, Australia
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
| | | | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ivo Rakovac
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization (WHO), Moscow, Russia
| | | | - Sowmya J Rao
- Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran
| | - Prateek Rastogi
- Forensic Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Priya Rathi
- Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Academic Public Health Department, Public Health England, London, UK
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, CQ University, Sydney, NSW, Australia
| | - Reza Rawassizadeh
- Department of Computer Science, Metropolitan College, Boston University, Boston, USA
| | - Vishnu Renjith
- Neurology Department, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Andre M N Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | | | - Aziz Rezapour
- Organization for the Prevention of Blindness, Paris, France
| | - Ana Isabel Ribeiro
- EPIUnit - Public Health Institute University Porto (ISPUP), University of Porto, Porto, Portugal
| | - Jennifer Rickard
- Surgery Department, University of Minnesota, Minneapolis, MN, USA
- Surgery Department, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Carlos Miguel Rios González
- Research Directorate, Nihon Gakko University, Fernando de la Mora, Paraguay
- Research Direction, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Anas M Saad
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Yogesh Damodar Sabde
- National Institute for Research in Environmental Health, Indian Council of Medical Research, Bhopal, India
| | - Siamak Sabour
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Basema Saddik
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Saeed Safari
- Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Safari-Faramani
- Faculty of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Safarpour
- Department of Health in Disasters and Emergencies, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Safdarian
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
| | | | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farkhonde Salehi
- Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saleh Salehi Zahabi
- Radiology and Nuclear Medicine Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Research Deputy, Taleghani Hospital, Kermanshah, Iran
| | | | - Hosni Salem
- Department of Urology, Cairo University, Cairo, Egypt
| | - Omar Salman
- Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Inbal Salz
- Health and Disability Intelligence Group, Ministry of Health, Wellington, New Zealand
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, WV, USA
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Lidia Sanchez Riera
- Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Institute of Bone and Joint Research, University of Sydney, Syndey, NSW, Australia
| | - Milena M Santric Milicevic
- Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
- Centre-School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Abdur Razzaque Sarker
- Health Economics, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Brijesh Sathian
- Surgery Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Susan M Sawyer
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia
| | - Sonia Saxena
- School of Public Health, Imperial College London, London, UK
| | - Mehdi Sayyah
- Faculty member of Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Feng Sha
- Center for Biomedical Information Technology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Faramarz Shaahmadi
- Department of Health Promotion and Education, Alborz University of Medical Sciences, Karaj, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Morteza Shamsizadeh
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
- Division of General Internal Medicine, Harvard University, Boston, MA, USA
| | | | - Jae Il Shin
- College of Medicine, Yonsei University, Seodaemun-gu, South Korea
- Division of Cardiology, Emory University, Atlanta, GA, USA
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Soraya Siabani
- Department of Health Education & Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
- School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Health and Behavior Studies, Columbia University, New York, NY, USA
| | | | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Medicine Service, US Department of Veterans Affairs (VA), Birmingham, AL, USA
| | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Catalin-Gabriel Smarandache
- 2nd Department of Surgery-SUUB, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 2nd Surgery Department, Bucharest Emergency Hospital, Bucharest, Romania
| | - Emma U R Smith
- Pain Management Research Institute (PMRI), Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
- Michael J Cousins Pain Management & Research Centre, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Amin Soheili
- Department of Medical Surgical Nursing, Urmia University of Medical Science, Urmia, Iran
- Emergency Nursing Department, Semnan University of Medical Sciences, Semnan, Iran
| | - Bija Soleymani
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Reza Soltanian
- Department of Biostatistics, Hamedan University of Medical Sciences, Hamadan, Iran
| | - Joan B Soriano
- Hospital Universitario de la Princesa, Autonomous University of Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | | | - Ireneous N Soyiri
- Hull York Medical School, University of Hull, Hull City, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council, Cape Town, South Africa
| | - Mark A Stokes
- Department of Psychology, Deakin University, Burwood, VIC, Australia
| | | | | | - Bryan L Sykes
- Department of Criminology, Law and Society, University of California Irvine, Irvine, CA, USA
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Karen M Tabb
- School of Social Work, University of Illinois, Urbana, IL, USA
| | - Biruk Wogayehu Taddele
- Department of Public Health, Arbaminch College of Health Sciences, Arbaminch town sikela, Ethiopia
| | - Degena Bahrey Tadesse
- Department of Nursing, Aksum University, Aksum, Ethiopia
- Axum College of Health Science, mekelle, Ethiopia
| | | | - Ingan Ukur Tarigan
- Center for Health Resource and Services Research and Development, National Institute of Health Research & Development, Jakarta, Indonesia
| | - Yonatal Mesfin Tefera
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | - Rekha Thapar
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | | | | | - Hamid Reza Tohidinik
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Roman Topor-Madry
- Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
- The Agency for Health Technology Assessment and Tariff System, Warszawa, Poland
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Military Medical University, Hanoi, Vietnam
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Alexander C Tsai
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Saif Ullah
- Institute of Soil and Environmental Sciences, A T Still University, Faisalabad, Pakistan
| | - Irfan Ullah
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
- TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan
| | - Maida Umar
- Research Department, National Institute of Population Studies (NIPS), Islamabad, Pakistan
| | - Bhaskaran Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Era Upadhyay
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | | | - Pascual R Valdez
- Argentine Society of Medicine, Buenos Aires, Argentina
- Velez Sarsfield Hospital, Buenos Aires, Argentina
| | | | - Narayanaswamy Venketasubramanian
- Raffles Neuroscience Centre, Raffles Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yasir Waheed
- Foundation University Medical College, Foundation University, Islamabad, Pakistan
| | | | - Andrea Werdecker
- Demographic Change and Ageing Research Area, Federal Institute for Population Research, Wiesbaden, Germany
- Center of Population and Health, Wiesbaden, Germany
| | - Taweewat Wiangkham
- Department of Physical Therapy, Naresuan University, Meung District, Thailand
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Dawit Habte Woldeyes
- Department of Human Anatomy, Histology, Embryology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Dawit Zewdu Wondafrash
- Department of Pharmacology and Toxicology, Mekelle University, Mekelle, Ethiopia
- Department of Pharmacology, Addis Ababa University, Addis ababa, Ethiopia
| | | | - Adam Belay Wondmieneh
- Department of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Nursing, Wollo University, Dessie, Ethiopia
| | - Ai-Min Wu
- Department of Orthopaedics, Wenzhou Medical University, Wenzhou, China
| | - Rajaram Yadav
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Ali Yadollahpour
- Medical Physics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa ON, Canada
| | - Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Health Management, Policy and Economics, Kerman University of Medical Sciences, Kerman, Iran
| | - Paul Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Engida Yisma
- School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Naohiro Yonemoto
- Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, South Korea
| | - Mustafa Z Younis
- Department of Health Policy & Management, Jackson State University, Jackson, MS, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Zabihollah Yousefi
- Department of Environmental Health, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Environmental Health, Academy of Medical Science, Sari, Iran
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Hasan Yusefzadeh
- Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
| | - Telma Zahirian Moghadam
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
| | - Sojib Bin Zaman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Zamanian
- Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
- Department of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran
| | - Ahmad Zarei
- Department of Environment Health Engineering, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Fatemeh Zare
- Faculty of Medical Sciences, Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, Wuhan University, Wuhan, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Sanjay Zodpey
- Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Public Health Foundation of India, Gurugram, India
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Public Health Foundation of India, Gurugram, India
| | - Louisa Degenhardt
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Benn Sartorius
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Aserese AD, Atenafu A, Sisay M, Sorrie MB, Yirdaw BW, Zegeye MK. Adequate vitamin A rich food consumption and associated factors among lactating mothers visiting child immunization and post-natal clinic at health institutions in Gondar Town, Northwest Ethiopia. PLoS One 2020; 15:e0239308. [PMID: 32956396 PMCID: PMC7508326 DOI: 10.1371/journal.pone.0239308] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 09/03/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Vitamin A deficiency is highly prevalent in low-income countries and is a major public health problem worldwide. Lactating mothers are the most vulnerable population group to vitamin A deficiency. Despite this, there is limited study on vitamin A-rich food consumption by lactating mothers in Ethiopia. Therefore, this study aimed to assess adequate vitamin A rich food consumption and associated factors among lactating mothers visiting child immunization and postnatal care centers in health institutions of Gondar Town. METHODS An Institution-based cross-sectional study design was employed at a health institution in Gondar Town from February to March 2019, and included 631 study participants. Simple random sampling followed by a systematic sampling technique was used to select participants. The data were collected using the Helen Keller International Food Frequency Questionnaire, entered using Epi-Info 7 statistical software and exported to STATA version 14 for analysis. A multivariable logistic regression analysis was used to identify factors associated with the outcome variable and variables with p-value <0.05 were considered as statistically significant. RESULT A total of 624 lactating mothers participated in the study giving a response rate of 98.89%. The study shows adequate consumption of vitamin A-rich food was 38.94% (95% CI: 35%- 43%). Predictors such as attending college diploma and above (AOR = 2.26, 95% CI; 1.02-4.99), having household family size ≤ 3 (AOR = 4.04, 95% CI; 1.60-10.17), being in higher economic class (AOR = 1.93, 95% CI; 1.18-3.14), having dietary diversity score of ≥ 5 (AOR = 1.59, 95% CI; 1.09-2.32) and meal frequency of ≥ 4 (AOR = 1.64, 95% CI; 1.09-2.32) were statistically significant. CONCLUSION AND RECOMMENDATION The majority of respondents had inadequate consumption of foods rich in vitamin A. Educational status, family size, wealth index, dietary diversity, and meal frequency were found to be factors that affect adequate consumption of vitamin A-rich foods. Encouraging and educating lactating mothers to consume foods rich in vitamin A is crucial.
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Deshpande A, Miller-Petrie MK, Lindstedt PA, Baumann MM, Johnson KB, Blacker BF, Abbastabar H, Abd-Allah F, Abdelalim A, Abdollahpour I, Abegaz KH, Abejie AN, Abreu LG, Abrigo MR, Abualhasan A, Accrombessi MMK, Adamu AA, Adebayo OM, Adedeji IA, Adedoyin RA, Adekanmbi V, Adetokunboh OO, Adhikari TB, Afarideh M, Agudelo-Botero M, Ahmadi M, Ahmadi K, Ahmed MB, Ahmed AE, Akalu TY, Akanda AS, Alahdab F, Al-Aly Z, Alam S, Alam N, Alamene GM, Alanzi TM, Albright J, Albujeer A, Alcalde-Rabanal JE, Alebel A, Alemu ZA, Ali M, Alijanzadeh M, Alipour V, Aljunid SM, Almasi A, Almasi-Hashiani A, Al-Mekhlafi HM, Altirkawi KA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amini S, Amit AML, Amul GGH, Andrei CL, Anjomshoa M, Ansariadi A, Antonio CAT, Antony B, Antriyandarti E, Arabloo J, Aref HMA, Aremu O, Armoon B, Arora A, Aryal KK, Arzani A, Asadi-Aliabadi M, Asmelash D, Atalay HT, Athari SM, Athari SS, Atre SR, Ausloos M, Awasthi S, Awoke N, Ayala Quintanilla BP, Ayano G, Ayanore MA, Aynalem YA, Azari S, Azman 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M, Dhungana GP, Diaz D, Dipeolu IO, Do HT, Dolecek C, Doyle KE, Dubljanin E, Duraes AR, Edinur HA, Effiong A, Eftekhari A, El Nahas N, El Sayed Zaki M, El Tantawi M, Elhabashy HR, El-Jaafary SI, El-Khatib Z, Elkout H, Elsharkawy A, Enany S, Endalew DA, Eshrati B, Eskandarieh S, Etemadi A, Ezekannagha O, Faraon EJA, Fareed M, Faro A, Farzadfar F, Fasil AF, Fazlzadeh M, Feigin VL, Fekadu W, Fentahun N, Fereshtehnejad SM, Fernandes E, Filip I, Fischer F, Flohr C, Foigt NA, Folayan MO, Foroutan M, Franklin RC, Frostad JJ, Fukumoto T, Gad MM, Garcia GM, Gatotoh AM, Gayesa RT, Gebremedhin KB, Geramo YCD, Gesesew HA, Gezae KE, Ghashghaee A, Ghazi Sherbaf F, Gill TK, Gill PS, Ginindza TG, Girmay A, Gizaw Z, Goodridge A, Gopalani SV, Goulart BNG, Goulart AC, Grada A, Green MS, Gubari MIM, Gugnani HC, Guido D, Guimarães RA, Guo Y, Gupta R, Gupta R, Ha GH, Haagsma JA, Hafezi-Nejad N, Haile DH, Haile MT, Hall BJ, Hamidi S, Handiso DW, Haririan H, Hariyani N, Hasaballah AI, Hasan MM, Hasanzadeh A, Hassen HY, Hayelom DH, Hegazy MI, Heibati B, Heidari B, Hendrie D, Henok A, Herteliu C, Heydarpour F, Hidru HDD, Hird TR, Hoang CL, Hollerich GI, Hoogar P, Hossain N, Hosseinzadeh M, Househ M, Hu G, Humayun A, Hussain SA, Hussen MAA, Ibitoye SE, Ilesanmi OS, Ilic MD, Imani-Nasab MH, Iqbal U, Irvani SSN, Islam SMS, Ivers RQ, Iwu CJ, Jahanmehr N, Jakovljevic M, Jalali A, Jayatilleke AU, Jenabi E, Jha RP, Jha V, Ji JS, Jonas JB, Jozwiak JJ, Kabir A, Kabir Z, Kanchan T, Karch A, Karki S, Kasaeian A, Kasahun GG, Kasaye HK, Kassa GG, Kassa GM, Kayode GA, Kebede MM, Keiyoro PN, Ketema DB, Khader YS, Khafaie MA, Khalid N, Khalilov R, Khan EA, Khan J, Khan MN, Khatab K, Khater MM, Khater AM, Khayamzadeh M, Khazaei M, Khosravi MH, Khubchandani J, Kiadaliri A, Kim YJ, Kimokoti RW, Kisa S, Kisa A, Kochhar S, Kolola T, Komaki H, Kosen S, Koul PA, Koyanagi A, Krishan K, Kuate Defo B, Kugbey N, Kumar P, Kumar GA, Kumar M, Kusuma D, La Vecchia C, Lacey B, Lal A, Lal DK, Lam H, Lami FH, Lansingh VC, Lasrado S, Lebedev G, Lee PH, LeGrand KE, Leili M, Lenjebo TL, Leshargie CT, Levine AJ, Lewycka S, Li S, Linn S, Liu S, Lopez JCF, Lopukhov PD, Magdy Abd El Razek M, Mahadeshwara Prasad D, Mahasha PW, Mahotra NB, Majeed A, Malekzadeh R, Malta DC, Mamun AA, Manafi N, Mansournia MA, Mapoma CC, Martinez G, Martini S, Martins-Melo FR, Mathur MR, Mayala BK, Mazidi M, McAlinden C, Meharie BG, Mehndiratta MM, Mehrabi Nasab E, Mehta KM, Mekonnen T, Mekonnen TC, Meles GG, Meles HG, Memiah PTN, Memish ZA, Mendoza W, Menezes RG, Mereta ST, Meretoja TJ, Mestrovic T, Metekiya WM, Metekiya WM, Miazgowski B, Miller TR, Mini GK, Mirrakhimov EM, Moazen B, Mohajer B, Mohammad Y, Mohammad DK, Mohammad Gholi Mezerji N, Mohammadibakhsh R, Mohammed S, Mohammed JA, Mohammed H, Mohebi F, Mokdad AH, Moodley Y, Moradi M, Moradi G, Moradi-Joo M, Moraga P, Morales L, Mosapour A, Mosser JF, Mouodi S, Mousavi SM, Mozaffor M, Munro SB, Muriithi MK, Murray CJL, Musa KI, Mustafa G, Muthupandian S, Naderi M, Nagarajan AJ, Naghavi M, Naik G, Nangia V, Nascimento BR, Nazari J, Ndwandwe DE, Negoi I, Netsere HB, Ngunjiri JW, Nguyen CT, Nguyen HLT, Nguyen QP, Nigatu SG, Ningrum DNA, Nnaji CA, Nojomi M, Norheim OF, Noubiap JJ, Oancea B, Ogbo FA, Oh IH, Olagunju AT, Olusanya JO, Olusanya BO, Onwujekwe OE, Ortega-Altamirano DV, Osarenotor O, Osei FB, Owolabi MO, P A M, Padubidri JR, Pakhale S, Pana A, Park EK, Patel SK, Pathak A, Patle A, Paulos K, Pepito VCF, Perico N, Pervaiz A, Pescarini JM, Pesudovs K, Pham HQ, Pigott DM, Pilgrim T, Pirsaheb M, Poljak M, Pollock I, Postma MJ, Pourmalek F, Pourshams A, Prada SI, Preotescu L, Quintana H, Rabiee N, Rabiee M, Radfar A, Rafiei A, Rahim F, Rahimi S, Rahimi-Movaghar V, Rahman MA, Rahman MHU, Rajati F, Ranabhat CL, Rao PC, Rasella D, Rath GK, Rawaf S, Rawal L, Rawasia WF, Remuzzi G, Renjith V, Renzaho AM, Resnikoff S, Riahi SM, Ribeiro AI, Rickard J, Roever L, Ronfani L, Rubagotti E, Rubino S, Saad AM, Sabour S, Sadeghi E, Saeedi Moghaddam S, Safari Y, Sagar R, Sahraian MA, Sajadi SM, Salahshoor MR, Salam N, Saleem A, Salem H, Salem MR, Salimi Y, Salimzadeh H, Samy AM, Sanabria J, Santos IS, Santric-Milicevic MM, Sao Jose BP, Saraswathy SYI, Sarrafzadegan N, Sartorius B, Sathian B, Sathish T, Satpathy M, Sawhney M, Sayyah M, Sbarra AN, Schaeffer LE, Schwebel DC, Senbeta AM, Senthilkumaran S, Sepanlou SG, Serván-Mori E, Shafieesabet A, Shaheen AA, Shahid I, Shaikh MA, Shalash AS, Shams-Beyranvand M, Shamsi M, Shamsizadeh M, Shannawaz M, Sharafi K, Sharma R, Sheikh A, Shetty BSK, Shiferaw WS, Shigematsu M, Shin JI, Shiri R, Shirkoohi R, Shivakumar KM, Si S, Siabani S, Siddiqi TJ, Silva DAS, Singh V, Singh NP, Singh BBS, Singh JA, Singh A, Sinha DN, Sisay MM, Skiadaresi E, Smith DL, Soares Filho AM, Sobhiyeh MR, Sokhan A, Soriano JB, Sorrie MB, Soyiri IN, Spurlock EE, Sreeramareddy CT, Sudaryanto A, Sufiyan MB, Suleria HAR, Sykes BL, Tabarés-Seisdedos R, Tabuchi T, Tadesse DB, Tarigan IU, Taye B, Tefera YM, Tehrani-Banihashemi A, Tekelemedhin SW, Tekle MG, Temsah MH, Tesfay BE, Tesfay FH, Tessema ZT, Thankappan KR, ThekkePurakkal AS, Thomas N, Thompson RL, Thomson AJ, Topor-Madry R, Tovani-Palone MR, Traini E, Tran BX, Tran KB, Ullah I, Unnikrishnan B, Usman MS, Uthman OA, Uzochukwu BSC, Valdez PR, Varughese S, Veisani Y, Violante FS, Vollmer S, W/hawariat FG, Waheed Y, Wallin MT, Wang YP, Wang Y, Wangdi K, Weiss DJ, Weldesamuel GT, Werkneh AA, Westerman R, Wiangkham T, Wiens KE, Wijeratne T, Wiysonge CS, Wolde HF, Wondafrash DZ, Wonde TE, Worku GT, Yadollahpour A, Yahyazadeh Jabbari SH, Yamada T, Yaseri M, Yatsuya H, Yeshaneh A, Yilma MT, Yip P, Yisma E, Yonemoto N, Younis MZ, Yousof HASA, Yu C, Yusefzadeh H, Zadey S, Zahirian Moghadam T, Zaidi Z, Zaman SB, Zamani M, Zandian H, Zar HJ, Zerfu TA, Zhang Y, Ziapour A, Zodpey S, Zuniga YMH, Hay SI, Reiner RC. Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17. Lancet Glob Health 2020; 8:e1162-e1185. [PMID: 32827479 PMCID: PMC7443708 DOI: 10.1016/s2214-109x(20)30278-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/01/2020] [Accepted: 06/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. METHODS We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. FINDINGS Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4-40·7) to 50·3% (50·0-50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1-46·5) in 2017, compared with 28·7% (28·5-29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2-89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664-711) of the 1830 (1797-1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6-80·7) of countries from 2000 to 2017, and in 53·9% (50·6-59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. INTERPRETATION Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. FUNDING Bill & Melinda Gates Foundation.
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Reiner RC, Wiens KE, Deshpande A, Baumann MM, Lindstedt PA, Blacker BF, Troeger CE, Earl L, Munro SB, Abate D, Abbastabar H, Abd-Allah F, Abdelalim A, Abdollahpour I, Abdulkader RS, Abebe G, Abegaz KH, Abreu LG, Abrigo MRM, Accrombessi MMK, Acharya D, Adabi M, Adebayo OM, Adedoyin RA, Adekanmbi V, Adetokunboh OO, Adhena BM, Afarideh M, Ahmadi K, Ahmadi M, Ahmed AE, Ahmed MB, Ahmed R, Ajumobi O, Akal CG, Akalu TY, Akanda AS, Alamene GM, Alanzi TM, Albright JR, Alcalde Rabanal JE, Alemnew BT, Alemu ZA, Ali BA, Ali M, Alijanzadeh M, Alipour V, Aljunid SM, Almasi A, Almasi-Hashiani A, Al-Mekhlafi HM, Altirkawi K, Alvis-Guzman N, Alvis-Zakzuk NJ, Amare AT, Amini S, Amit AML, Andrei CL, Anegago MT, Anjomshoa M, Ansari F, Antonio CAT, Antriyandarti E, Appiah SCY, Arabloo J, Aremu O, Armoon B, Aryal KK, Arzani A, Asadi-Lari M, Ashagre AF, Atalay HT, Atique S, Atre SR, Ausloos M, Avila-Burgos L, Awasthi A, Awoke N, Ayala Quintanilla BP, Ayano G, Ayanore MA, Ayele AA, Aynalem YAA, Azari S, Babaee E, Badawi A, Bakkannavar SM, Balakrishnan S, Bali AG, Banach M, Barac A, Bärnighausen TW, Basaleem H, Bassat Q, Bayati M, Bedi N, Behzadifar M, Behzadifar M, Bekele YA, Bell ML, Bennett DA, Berbada DA, Beyranvand T, Bhat AG, Bhattacharyya K, Bhattarai S, Bhaumik S, Bijani A, Bikbov B, Biswas RK, Bogale KA, Bohlouli S, Brady OJ, Bragazzi NL, Briko NI, Briko AN, Burugina Nagaraja S, Butt ZA, Campos-Nonato IR, Campuzano Rincon JC, Cárdenas R, Carvalho F, Castro F, Chansa C, Chatterjee P, Chattu VK, Chauhan BG, Chin KL, Christopher DJ, Chu DT, Claro RM, Cormier NM, Costa VM, Damiani G, Daoud F, Dandona L, Dandona R, Darwish AH, Daryani A, Das JK, Das Gupta R, Dasa TT, Davila CA, Davis Weaver N, Davitoiu DV, De Neve JW, Demeke FM, Demis AB, Demoz GT, Denova-Gutiérrez E, Deribe K, Desalew A, Dessie GA, Dharmaratne SD, Dhillon P, Dhimal M, Dhungana GP, Diaz D, Ding EL, Diro HD, Djalalinia S, Do HP, Doku DT, Dolecek C, Dubey M, Dubljanin E, Duko Adema B, Dunachie SJ, Durães AR, Duraisamy S, Effiong A, Eftekhari A, El Sayed I, El Sayed Zaki M, El Tantawi M, Elemineh DA, El-Jaafary SI, Elkout H, Elsharkawy A, Enany S, Endalamfaw A, Endalew DA, Eskandarieh S, Esteghamati A, Etemadi A, Farag TH, Faraon EJA, Fareed M, Faridnia R, Farioli A, Faro A, Farzam H, Fazaeli AA, Fazlzadeh M, Fentahun N, Fereshtehnejad SM, Fernandes E, Filip I, Fischer F, Foroutan M, Francis JM, Franklin RC, Frostad JJ, Fukumoto T, Gayesa RT, Gebremariam KT, Gebremedhin KBB, Gebremeskel GG, Gedefaw GA, Geramo YCD, Geta B, Gezae KE, Ghashghaee A, Ghassemi F, Gill PS, Ginawi IA, Goli S, Gomes NGM, Gopalani SV, Goulart BNG, Grada A, Gugnani HC, Guido D, Guimares RA, Guo Y, Gupta R, Gupta R, Hafezi-Nejad N, Haile MT, Hailu GB, Haj-Mirzaian A, Haj-Mirzaian A, Hall BJ, Handiso DW, Haririan H, Hariyani N, Hasaballah AI, Hasan MM, Hasanzadeh A, Hassankhani H, Hassen HY, Hayelom DH, Heidari B, Henry NJ, Herteliu C, Heydarpour F, Hidru HDD, Hoang CL, Hoogar P, Hoseini-Ghahfarokhi M, Hossain N, Hosseini M, Hosseinzadeh M, Househ M, Hu G, Humayun A, Hussain SA, Ibitoye SE, Ilesanmi OS, Ilic MD, Inbaraj LR, Irvani SSN, Islam SMS, Iwu CJ, Jaca A, Jafari Balalami N, Jahanmehr N, Jakovljevic M, Jalali A, Jayatilleke AU, Jenabi E, Jha RP, Jha V, Ji JS, Jia P, Johnson KB, Jonas JB, Jozwiak JJ, Kabir A, Kabir Z, Kahsay A, Kalani H, Kanchan T, Karami Matin B, Karch A, Karki S, Kasaeian A, Kasahun GG, Kayode GA, Kazemi Karyani A, Keiyoro PN, Ketema DB, Khader YS, Khafaie MA, Khalid N, Khalil AT, Khalil I, Khalilov R, Khan MN, Khan EA, Khan G, Khan J, Khatab K, Khater A, Khater MM, Khatony A, Khayamzadeh M, Khazaei M, Khazaei S, Khodamoradi E, Khosravi MH, Khubchandani J, Kiadaliri AA, Kim YJ, Kimokoti RW, Kisa S, Kisa A, Kissoon N, Kondlahalli SKMKMM, Kosek MN, Koyanagi A, Kraemer MUG, Krishan K, Kugbey N, Kumar GA, Kumar M, Kumar P, Kusuma D, La Vecchia C, Lacey B, Lal A, Lal DK, Lami FH, Lansingh VC, Lasrado S, Lee PH, Leili M, Lenjebo TTLL, Levine AJ, Lewycka S, Li S, Linn S, Lodha R, Longbottom J, Lopukhov PD, Magdeldin S, Mahasha PW, Mahotra NB, Malta DC, Mamun AA, Manafi N, Manafi F, Manda AL, Mansournia MA, Mapoma CC, Marami D, Marczak LB, Martins-Melo FR, März W, Masaka A, Mathur MR, Maulik PK, Mayala BK, McAlinden C, Mehndiratta MM, Mehrotra R, Mehta KM, Meles GG, Melese A, Memish ZA, Mena AT, Menezes RG, Mengesha MM, Mengistu DT, Mengistu G, Meretoja TJ, Miazgowski B, Mihretie KMM, Miller-Petrie MK, Mills EJ, Mir SM, Mirabi P, Mirrakhimov EM, Mohamadi-Bolbanabad A, Mohammad KA, Mohammad Y, Mohammad DK, Mohammad Darwesh A, Mohammad Gholi Mezerji N, Mohammadifard N, Mohammed AS, Mohammed S, Mohammed JA, Mohebi F, Mokdad AH, Monasta L, Moodley Y, Moradi M, Moradi G, Moradi-Joo M, Moradi-Lakeh M, Moraga P, Mosapour A, Mouodi S, Mousavi SM, Mozaffor MMM, Muluneh AG, Muriithi MK, Murray CJL, Murthy GVS, Musa KI, Mustafa G, Muthupandian S, Naderi M, Nagarajan AJ, Naghavi M, Najafi F, Nangia V, Nazari J, Ndwandwe DE, Negoi I, Ngunjiri JW, Nguyen QP, Nguyen TH, Nguyen CT, Nigatu D, Ningrum DNA, Nnaji CA, Nojomi M, Noubiap JJ, Oh IH, Okpala O, Olagunju AT, Omar Bali A, Onwujekwe OE, Ortega-Altamirano DDV, Osarenotor O, Osei FB, Owolabi MO, P A M, Padubidri JR, Pana A, Pashaei T, Pati S, Patle A, Patton GC, Paulos K, Pepito VCF, Pereira A, Perico N, Pesudovs K, Pigott DM, Piroozi B, Platts-Mills JA, Poljak M, Postma MJ, Pourjafar H, Pourmalek F, Pourshams A, Poustchi H, Prada SI, Preotescu L, Quintana H, Rabiee N, Rabiee M, Radfar A, Rafiei A, Rahim F, Rahimi-Movaghar V, Rahman MA, Rajati F, Ramezanzadeh K, Rana SM, Ranabhat CL, Rasella D, Rawaf S, Rawaf DL, Rawal L, Remuzzi G, Renjith V, Renzaho AMN, Reta MA, Rezaei S, Ribeiro AI, Rickard J, Rios González CM, Rios-Blancas MJ, Roever L, Ronfani L, Roro EM, Rostami A, Rothenbacher D, Rubagotti E, Rubino S, Saad AM, Sabour S, Sadeghi E, Safari S, Safdarian M, Sagar R, Sahraian MA, Sajadi SM, Salahshoor MR, Salam N, Salehi F, Salehi Zahabi S, Salem MRR, Salem H, Salimi Y, Salimzadeh H, Sambala EZ, Samy AM, Sanabria J, Santos IS, Saraswathy SYI, Sarker AR, Sartorius B, Sathian B, Satpathy M, Sbarra AN, Schaeffer LE, Schwebel DC, Senbeta AM, Senthilkumaran S, Shabaninejad H, Shaheen AA, Shaikh MA, Shalash AS, Shallo SA, Shams-Beyranvand M, Shamsi M, Shamsizadeh M, Sharif M, Shey MS, Shibuya K, Shiferaw WSS, Shigematsu M, Shil A, Shin JI, Shiri R, Shirkoohi R, Si S, Siabani S, Singh JA, Singh NP, Sinha DN, Sisay MM, Skiadaresi E, Smith DL, Sobhiyeh MR, Sokhan A, Soofi M, Soriano JB, Sorrie MB, Soyiri IN, Sreeramareddy CT, Sudaryanto A, Sufiyan MB, Suleria HAR, Sykes BL, Tamirat KS, Tassew AA, Taveira N, Taye B, Tehrani-Banihashemi A, Temsah MH, Tesfay BE, Tesfay FH, Tessema ZT, Thankappan KR, Thirunavukkarasu S, Thomas N, Tlaye KG, Tlou B, Tovani-Palone MR, Traini E, Tran KB, Trihandini I, Ullah I, Unnikrishnan B, Valadan Tahbaz S, Valdez PR, Varughese S, Veisani Y, Violante FS, Vollmer S, Vos T, Wada FW, Waheed Y, Wang Y, Wang YP, Weldesamuel GT, Welgan CA, Westerman R, Wiangkham T, Wijeratne T, Wiysonge CSS, Wolde HF, Wondafrash DZ, Wonde TE, Wu AM, Xu G, Yadollahpour A, Yahyazadeh Jabbari SH, Yamada T, Yaseri M, Yenesew MA, Yeshaneh A, Yilma MT, Yimer EM, Yip P, Yirsaw BD, Yisma E, Yonemoto N, Younis MZ, Yousof HASA, Yu C, Yusefzadeh H, Zamani M, Zambrana-Torrelio C, Zandian H, Zeleke AJ, Zepro NB, Zewale TA, Zhang D, Zhang Y, Zhao XJ, Ziapour A, Zodpey S, Hay SI. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395:1779-1801. [PMID: 32513411 PMCID: PMC7314599 DOI: 10.1016/s0140-6736(20)30114-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/24/2019] [Accepted: 01/10/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. METHODS We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. FINDINGS The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. INTERPRETATION By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. FUNDING Bill & Melinda Gates Foundation.
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Tariku EZ, Abebe GA, Melketsedik ZA, Gutema BT, Megersa ND, Sorrie MB, Weldehawariat FG, Getahun EA. Anemia and its associated factors among school-age children living in different climatic zones of Arba Minch Zuria District, Southern Ethiopia. BMC Hematol 2019; 19:6. [PMID: 31049206 PMCID: PMC6480865 DOI: 10.1186/s12878-019-0137-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/04/2019] [Indexed: 11/10/2022]
Abstract
Background Anemia, defined as a low blood hemoglobin concentration, has been shown to be a major public health concern in low-income countries like Ethiopia. School-age children are the most vulnerable population groups for anemia. The aim of this study was to assess the prevalence of anemia, with consideration of altitudinal variations, and to identify factors associated with anemia among school-age children. Methods A community-based cross-sectional study was conducted from April to May 2017 among randomly selected 391 school-age children (6 to 14 years) in Arba Minch Health and Demographic Surveillance Site, Southern Ethiopia. Hemoglobin concentration was measured on the spot using portable hemoglobinometer (HemoCue Hb 201). The hemoglobin cut off values, adjusted for child age and altitude, were used to define anemia. Stool microscopic examination was done for investigation of intestinal parasites. A binary logistic regression model was used to assess the possible association of independent and outcome variables. Results The overall prevalence of anemia was 37.3% (146); (95% CI: 32.5, 42.2). Among those who were anemic, 110 (28.1%) and 35 (9%) had mild (Hb 11-11.4 g/dl for children age from 6 to 11 years and 11-11.9 g/dl for children age from 12 to 14 years) and moderate (Hb 8-10.9 g/dl) anemia respectively. A single case of severe (Hb < 8 g/dl) anemia was identified. Fifty-seven (46.3%) of children living in an altitude ≥ 2500 m above sea level were anemic. Anemia was higher among children who were positive for intestinal parasitic infections (AOR = 3.30, 95% CI: 2.04, 5.35) and children not-enrolled to schools (AOR = 2.05, 95%CI: 1.26, 3.32). Anemia was less common among children who had no habit of eating vegetables in the last week prior to the survey (AOR = 0.35, 95%CI: 0.14, 0.84). Conclusions More than one-third of school-age children were suffering from anemia. Intestinal parasitic infections and school non-enrollment were among the major factors associated with anemia among school-age children in the study area. Interventions, focusing on identified contributing factors need to be implemented by integrating with other school or community-based health programs.
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Affiliation(s)
| | - Getaneh Alemu Abebe
- 2Department of Medical Laboratory Science, Bahir Dar University, Bahir Dar, Ethiopia
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Debalkie Animut M, Sorrie MB, Birhanu YW, Teshale MY. High prevalence of neurocognitive disorders observed among adult people living with HIV/AIDS in Southern Ethiopia: A cross-sectional study. PLoS One 2019; 14:e0204636. [PMID: 30883557 PMCID: PMC6422272 DOI: 10.1371/journal.pone.0204636] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 02/28/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Comprehensive care given to people living with HIV/AIDS is improving over time; however, their concurrent cognitive illness is still ignored, under screened and treated particularly in developing countries. And this problem is also striking in Ethiopia. Therefore, the objective of this study was to assess HIV-associated neurocognitive disorders and associated factors among adult people living with HIV/AIDS. METHODS An institution based cross sectional study was conducted from April to May, 2017 at Gamo Gofa zone public Hospitals. International HIV Dementia Scale was used to screen HIV associated neurocognitive disorders. Logistic regression analysis was used to assess predictors of neurocognitive disorders. RESULT A total of 684 study participants were included in this study with a response rate of 98%. Among them, 56% were females while 44% were males. The mean (±SD) age of the participants was 38.8±8.8years. The screening prevalence of HIV-associated neurocognitive disorder was 67.1% (95% CI; 63.6, 70.5). Body mass index 16 kg/m2 (AOR 4.389 (1.603-12.016)), being married (AOR 0.377 (0.213-0.666), unemployment status (AOR 3.181 (1.752-5.777) and being in WHO clinical stage T3 category/advancing stages of the disease (AOR 3.558 (1.406-9.006) were the key predictors of HIV-associated neurocognitive disorders among people living with HIV/AIDS. CONCLUSION In this study the screening prevalence of HIV-associated neurocognitive disorder is higher than the earlier reports in Ethiopia and Africa. This indicates that early screening strategies and policies for cognitive health in people living with HIV/AIDS should be given a top priority.
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Affiliation(s)
- Megbaru Debalkie Animut
- Arbaminch University College of Medicine and Health Sciences Department of Nursing, Arbaminch, Ethiopia
| | - Muluken Bekele Sorrie
- Arbaminch University College of Medicine and Health Sciences Department of Public Health, Arbaminch, Ethiopia
| | - Yinager Workineh Birhanu
- Bahir Dar University Colleges of Medicine and Health Sciences School of Nursing, Bahir Dar Ethiopia
| | - Manaye Yihune Teshale
- Arbaminch University College of Medicine and Health Sciences Department of Public Health, Arbaminch, Ethiopia
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Sorrie MB, Yesuf ME, GebreMichael TG. Overweight/Obesity and associated factors among preschool children in Gondar City, Northwest Ethiopia: A cross-sectional study. PLoS One 2017; 12:e0182511. [PMID: 28787013 PMCID: PMC5546603 DOI: 10.1371/journal.pone.0182511] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/12/2017] [Indexed: 11/25/2022] Open
Abstract
Background Overweight and obesity among children has emerged as one of the most serious public health concerns in the 21st century, which is a predictor of adulthood obesity, morbidity and mortality. The objective of this study was to assess the prevalence of overweight /obesity and associated factors among preschool children. Methods A community based cross-sectional study was conducted in Gondar City from February 14 to March 4, 2016. Multi stage sampling technique was used to select a total of 504 preschool children. Data were collected using structured interviewer administered questionnaire and anthropometric measurements. Data were entered using Epidata version 3.1 and analyzed using SPSS version 20 and WHO 2007 Anthro version 2.0.4 software. Both bivariate and multivariate logistic regression analysis were performed to identify associated factors. P values <0.05 with 95% confidence level were used to declare statistical significance. Results A total of 500 study participants were included with 99.2% response rate and 51.6% were girls while 48.4% were boys. The mean (±SD) age of participants was 47.68 ±7.19 months. The combined prevalence of overweight /obesity was 13.8% (95%CI; 10.6, 17.2) the specific being 9.6% for overweight and 4.2% for obesity. The multivariable analysis indicated that the age group between 36–47 months [AOR = 2.38 (95%CI; 1.27,4.46)],high dietary diversity[AOR = 3.73(95%CI;1.15,12.54),consumption of sweet food[AOR = 2.69 (95%CI,1.21, 5.98)],time spent in watching television>2hr/day [AOR = 4.01 (95%CI;2.22, 7.26)] and mother’s education at secondary level [AOR = 0.35 (95% CI; 0.12, 0.96)] were associated with overweight/obesity among preschool children. Conclusions Once considered a high income country problem, result of this study in urban city like Gondar reveals that overweight/obesity is on the rise in urban Ethiopia, which indicates the need for formulating preventive programs and policies during a child’s early years.
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Affiliation(s)
- Muluken Bekele Sorrie
- Arbaminch University College of Medicine and Health Sciences Department of Midwifery, Arbaminch, Ethiopia
| | - Melkie Edris Yesuf
- University of Gondar College of Medicine and Health Sciences Institute of Public Health, Gondar, Ethiopia
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