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Rai RK, Bromage S. Estimated effect of age of marriage on utilisation of India's Integrated Child Development Service programme. J Epidemiol Community Health 2023:jech-2023-221325. [PMID: 38123986 DOI: 10.1136/jech-2023-221325] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Age of marriage among women is considered an important indicator of their readiness for familial integration and parenting. This study estimated the effect of age of marriage of young mothers (aged 15-24 years) on utilisation of various services for their children, provided under the Integrated Child Development Service (ICDS) programme in India. METHODS Data from the nationally representative 2019-2021 National Family Health Survey of India were analysed. Mothers' age of menarche was used as an instrumental variable to isolate the effect of age of marriage on whether their children received (1) food, (2) health check-up, (3) immunisation, (4) early childhood care or preschooling or (5) weight measurement services from ICDS. RESULTS Nationally, 67.9% (95% CI 67.6%, 68.3%) of children received food (sample: 60 578), 61.8% (95% CI 61.4%, 62.1%) received a health check-up (sample: 60 316), 60.0% (95% CI 59.6%, 60.4%) received immunisation services (sample: 60 537), 52.0% (95% CI 51.6%, 52.4%) received early childhood care or preschooling (sample: 60 458) and 62.9% (95% CI 62.5%, 63.3%) received weight measurement services (sample: 60 278). Findings from instrumental variable analysis suggest that a 1-year increase in age of marriage could yield a 9 percentage point increase (95% CI 4%-13%; p<0.001) in utilisation of immunisation services. Although postponement of marriage positively affected utilisation of each of the other four ICDS components, these effects were not statistically significant. CONCLUSION Postponing age of marriage among young women is an effective intervention for promoting uptake of child immunisation services. Our findings support the Government of India's 2021 Bill to raise legal age of marriage of women.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Institute of Nutrition, Mahidol University, Salaya, Nakhon Pathom, Thailand
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Sabri Bromage
- Institute of Nutrition, Mahidol University, Salaya, Nakhon Pathom, Thailand
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
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Rai RK, Shinde S, De Neve JW, Fawzi WW. Predictors of Incidence and Remission of Anemia among Never-Married Adolescents Aged 10-19 Years: A Population-Based Prospective Longitudinal Study in India. Curr Dev Nutr 2023; 7:100031. [PMID: 37181932 PMCID: PMC10111602 DOI: 10.1016/j.cdnut.2023.100031] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 12/16/2022] [Accepted: 01/19/2023] [Indexed: 01/29/2023] Open
Abstract
Background Dynamics of the anemia burden among Indian adolescents are poorly understood because of a lack of population-based longitudinal data. Objectives To examine the burden of anemia among never-married adolescents aged 10-19 y from the states of Bihar and Uttar Pradesh, India, and a wide range of predictors of its incidence and remission. Methods A sample of 3279 adolescents (male: 1787 and female: 1492) aged 10-19 y were included from baseline (2015-2016) and follow-up (2018-2019) surveys of the UDAYA (Understanding the Lives of Adolescents and Young Adults) project in India. In 2018-2019, all new cases of anemia were considered as incidence, whereas a return to the nonanemic status from being anemic in 2015-2016 was considered remission. Univariate and multivariable modified Poisson regression models with robust error variance were deployed to attain the study objective. Results The crude prevalence of anemia among males decreased from 33.9% (95% CI: 30.7%-37.3%) in 2015-2016 to 31.6% (95% CI: 28.6%-34.7%) in 2018-2019 but increased among females from 57.7% (95% CI: 53.5%-61.7%) in 2015-2016 to 63.8% (95% CI: 59.9%-67.5%) in 2018-2019. Anemia incidence was estimated to be 33.7% (95% CI: 30.3%-37.2%), whereas nearly 38.5% (95% CI: 35.1%-42.1%) of adolescents experienced remission of anemia. Older adolescents (aged 15-19 y) were less likely to experience anemia incidence. Consumption of eggs daily or weekly was negatively associated with anemia incidence compared with occasional or never consumption. Females had a higher risk of experiencing an incidence of anemia and decreased risk of experiencing anemia remission. The likelihood of adolescents experiencing anemia increased with an increased patient health questionnaire score. Household size was also associated with an increased risk of anemia incidence. Conclusions Interventions that are sensitive to socio-demographic factors and encouraging access to mental health services and nutritious food consumption could be helpful in further anemia mitigation.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Economics, University of Göttingen, Göttingen, Lower Saxony, Germany
- Centre for Modern Indian Studies, University of Göttingen, Göttingen, Lower Saxony, Germany
| | - Sachin Shinde
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
- Center for Inquiry into Mental Health, Pune, Maharashtra, India
| | - Jan-Walter De Neve
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
| | - Wafaie W. Fawzi
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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Rai RK, Barik A, Chowdhury A. Use of antenatal and delivery care services and their association with maternal and infant mortality in rural India. Sci Rep 2022; 12:16490. [PMID: 36192467 PMCID: PMC9529891 DOI: 10.1038/s41598-022-20951-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/21/2022] [Indexed: 11/25/2022] Open
Abstract
Optimum use of antenatal care (ANC) and delivery care services could reduce morbidity and mortality among prospective mothers and their children. However, the role of ANC and delivery services in prevention of both maternal and child mortality is poorly understood, primarily because of dearth of prospective cohort data. Using a ten-years population-based prospective cohort data, this study examined the use of ANC and delivery services and their association with maternal and infant mortality in rural India. Descriptive statistics were estimated, and multivariable logistic regression modelling was used to attain the study objective. Findings revealed that consumption of ≥ 100 iron-and-folic acid (IFA) tablet/equivalent syrup during pregnancy had a protective association with maternal and infant mortality. Lack of maternal blood group checks during pregnancy was associated with increased odds of the death of infants. Caesarean/forceps delivery and delivery conducted by untrained personnel were associated with increased odds of maternal mortality. Findings from this study reemphasizes on increasing coverage and consumption of IFA tablets/equivalent syrup. Improved ANC and delivery services and increased uptake of all types of ANC and delivery care services are equally important for improvement in maternal and child survival in rural India.
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Affiliation(s)
- Rajesh Kumar Rai
- Department of Economics, University of Göttingen, 37073, Göttingen, Germany. .,Centre for Modern Indian Studies, University of Göttingen, 37073, Göttingen, Germany. .,Society for Health and Demographic Surveillance, Suri, West Bengal, 731101, India. .,Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, 02115, USA.
| | - Anamitra Barik
- Society for Health and Demographic Surveillance, Suri, West Bengal, 731101, India.,Suri District Hospital, Suri, West Bengal, 731101, India
| | - Abhijit Chowdhury
- Society for Health and Demographic Surveillance, Suri, West Bengal, 731101, India.,School of Digestive and Liver Disease, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, 700020, India.,John C Martin Centre for Liver Research and Innovations, Indian Institute of Liver and Digestive Sciences, Liver Foundation West Bengal, Kolkata, West Bengal, 700150, India
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Gupta K BNVSG, Patnaik S, Ray BC, Rai RK, Prusty RK. Elevated temperature mechanical behavior of nano Al
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embedded interpenetrating polymer network/glass fiber composites. J Appl Polym Sci 2022. [DOI: 10.1002/app.52991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- B. N. V. S. Ganesh Gupta K
- FRP Composite Laboratory, Department of Metallurgical and Materials Engineering National Institute of Technology Rourkela India
| | - Satyaroop Patnaik
- FRP Composite Laboratory, Department of Metallurgical and Materials Engineering National Institute of Technology Rourkela India
| | - Bankim Chandra Ray
- FRP Composite Laboratory, Department of Metallurgical and Materials Engineering National Institute of Technology Rourkela India
| | - Rajesh Kumar Rai
- Department of Metallurgical & Materials Engineering Malaviya National Institute of Technology Jaipur India
| | - Rajesh Kumar Prusty
- FRP Composite Laboratory, Department of Metallurgical and Materials Engineering National Institute of Technology Rourkela India
- Centre for Nanomaterials National Institute of Technology, Rourkela Rourkela India
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Burkart K, Causey K, Cohen AJ, Wozniak SS, Salvi DD, Abbafati C, Adekanmbi V, Adsuar JC, Ahmadi K, Alahdab F, Al-Aly Z, Alipour V, Alvis-Guzman N, Amegah AK, Andrei CL, Andrei T, Ansari F, Arabloo J, Aremu O, Aripov T, Babaee E, Banach M, Barnett A, Bärnighausen TW, Bedi N, Behzadifar M, Béjot Y, Bennett DA, Bensenor IM, Bernstein RS, Bhattacharyya K, Bijani A, Biondi A, Bohlouli S, Breitner S, Brenner H, Butt ZA, Cámera LA, Cantu-Brito C, Carvalho F, Cerin E, Chattu VK, Chauhan BG, Choi JYJ, Chu DT, Dai X, Dandona L, Dandona R, Daryani A, Davletov K, de Courten B, Demeke FM, Denova-Gutiérrez E, Dharmaratne SD, Dhimal M, Diaz D, Djalalinia S, Duncan BB, El Sayed Zaki M, Eskandarieh S, Fareed M, Farzadfar F, Fattahi N, Fazlzadeh M, Fernandes E, Filip I, Fischer F, Foigt NA, Freitas M, Ghashghaee A, Gill PS, Ginawi IA, Gopalani SV, Guo Y, Gupta RD, Habtewold TD, Hamadeh RR, Hamidi S, Hankey GJ, Hasanpoor E, Hassen HY, Hay SI, Heibati B, Hole MK, Hossain N, Househ M, Irvani SSN, Jaafari J, Jakovljevic M, Jha RP, Jonas JB, Jozwiak JJ, Kasaeian A, Kaydi N, Khader YS, Khafaie MA, Khan EA, Khan J, Khan MN, Khatab K, Khater AM, Kim YJ, Kimokoti RW, Kisa A, Kivimäki M, Knibbs LD, Kosen S, Koul PA, Koyanagi A, Kuate Defo B, Kugbey N, Lauriola P, Lee PH, Leili M, Lewycka S, Li S, Lim LL, Linn S, Liu Y, Lorkowski S, Mahasha PW, Mahotra NB, Majeed A, Maleki A, Malekzadeh R, Mamun AA, Manafi N, Martini S, Meharie BG, Menezes RG, Mestrovic T, Miazgowski B, Miazgowski T, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mohajer B, Mohammed S, Mohan V, Mokdad AH, Monasta L, Moraga P, Morrison SD, Mueller UO, Mukhopadhyay S, Mustafa G, Muthupandian S, Naik G, Nangia V, Ndwandwe DE, Negoi RI, Ningrum DNA, Noubiap JJ, Ogbo FA, Olagunju AT, Onwujekwe OE, Ortiz A, Owolabi MO, P A M, Panda-Jonas S, Park EK, Pashazadeh Kan F, Pirsaheb M, Postma MJ, Pourjafar H, Radfar A, Rafiei A, Rahim F, Rahimi-Movaghar V, Rahman MA, Rai RK, Ranabhat CL, Raoofi S, Rawal L, Renzaho AMN, Rezapour A, Ribeiro D, Roever L, Ronfani L, Sabour S, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sahebkar A, Sahraian MA, Salimzadeh H, Salvi SS, Samy AM, Sanabria J, Sarmiento-Suárez R, Sathish T, Schmidt MI, Schutte AE, Sepanlou SG, Shaikh MA, Sharafi K, Sheikh A, Shigematsu M, Shiri R, Shirkoohi R, Shuval K, Soyiri IN, Tabarés-Seisdedos R, Tefera YM, Tehrani-Banihashemi A, Temsah MH, Thankappan KR, Topor-Madry R, Tudor Car L, Ullah I, Vacante M, Valdez PR, Vasankari TJ, Violante FS, Waheed Y, Wolfe CDA, Yamada T, Yonemoto N, Yu C, Zaman SB, Zhang Y, Zodpey S, Lim SS, Stanaway JD, Brauer M. Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM 2·5 air pollution, 1990-2019: an analysis of data from the Global Burden of Disease Study 2019. Lancet Planet Health 2022; 6:e586-e600. [PMID: 35809588 PMCID: PMC9278144 DOI: 10.1016/s2542-5196(22)00122-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. METHODS We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. FINDINGS In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68-4·83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49-17·5) of deaths and 13·6% (9·73-17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22-9·53) of deaths and 5·92% (3·81-8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. INTERPRETATION Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. FUNDING Bill & Melinda Gates Foundation.
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Chakraborty S, Rai RK, Biswas AK, Barik A, Gurung P, Praveen D. Health care seeking behaviour and financial protection of patients with hypertension: A cross-sectional study in rural West Bengal, India. PLoS One 2022; 17:e0264314. [PMID: 35213621 PMCID: PMC8880395 DOI: 10.1371/journal.pone.0264314] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background Elevated blood pressure or hypertension is responsible for around 10 million annual deaths globally, and people residing in low and middle-income countries are disproportionately affected by it. India is no exception, where low rate of treatment seeking for hypertension coupled with widespread out-of-pocket payments (OOPs) have been a challenge. This study assessed the pattern of health care seeking behaviour and financial protection along with the associated factors among hypertensive individuals in rural West Bengal, India. Method and findings A cross-sectional study was conducted in Birbhum district of the state of West Bengal, India, during 2017–2018, where 300 individuals were recruited randomly from a list of hypertensives in a population cohort. Healthcare seeking for hypertension and related financial protection in terms of–OOPs and expenses relative to monthly per-capita family expenditure, were analysed. Findings indicated that 47% of hypertensives were not on treatment. Among those under treatment, 80% preferred non-public facilities, and 91% of them had wide-spread OOPs. Cost of medication was a major share of expenses followed by transportation cost to access public health care facility. Multivariable logistic regression analysis indicated longer duration of disease (adjusted odds ratio (aOR): 5.68, 95% Confidence Interval (CI) 1.24–25.99) and health care seeking from non-public establishment (aOR: 34.33, CI: 4.82–244.68) were associated with more incident of OOPs. Linear regression with generalized linear model revealed presence of co-morbidities (adjusted coefficient (aCoeff)10.28, CI: 4.96,15.61) and poorer economic groups (aCoeffpoorest 11.27, CI 3.82,18.71; aCoefflower-middle 7.83, CI 0.65,15.00 and aCoeffupper-middle 7.25, CI: 0.80,13.70) had higher relative expenditure. Conclusion This study suggests that individuals with hypertension had poor health care seeking behaviour, preferred non-public health facilities and had suboptimal financial protection. Economically poorer individuals had higher burden of health expenditure for treatment of hypertension, which indicated gaps in equitable health care delivery for the control of hypertension.
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Affiliation(s)
- Sandipta Chakraborty
- Institute of Public Health, Kalyani, West Bengal, India
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, West Bengal, India
| | - Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Economics, University of Goettingen, Goettingen, Germany
- Centre for Modern Indian Studies, University of Goettingen, Goettingen, Germany
- * E-mail:
| | | | - Anamitra Barik
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Suri District Hospital, Suri, West Bengal, India
| | | | - Devarsetty Praveen
- Primary Health Care Research, The George Institute for Global Health, Hyderabad, Telangana, India
- Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
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Rai RK. Estimated effect of vitamin A supplementation on anaemia and anthropometric failure of Indian children. Pediatr Res 2022; 91:1263-1271. [PMID: 35140334 PMCID: PMC9122827 DOI: 10.1038/s41390-022-01969-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND India has an unacceptably high burden of vitamin A deficiency (VAD) among children aged 6-59 months. To mitigate VAD and its adverse effects on child health, the Indian government runs a nationwide vitamin A supplementation (VAS) programme. However, the effect of VAS in reducing child morbidity and mortality remains inconclusive and has been debated globally. In this paper, we estimate the effect of VAS on two indicators of child nutrition-anaemia (categorized into any anaemia, and mild/moderate anaemia) and anthropometric failure (categorized into stunting, wasting, and underweight) among children aged 6-59 months. METHODS Using the nationally representative 2015-2016 National Family Health Survey data set from India, we set up a quasi-experimental study design and estimated household and mother fixed-effects of VAS on select types of child anaemia and anthropometric failure. RESULTS Findings from both the household fixed-effects and mother fixed-effects analysis showed that VAS does not influence any types of childhood anaemia and anthropometric failure in India. We discussed the findings considering existing literature and possible limitations of the study. CONCLUSIONS The infirm effect of Vitamin A on anaemia and anthropometric failure is probably indicative of targeted VAS intervention, as opposed to a universal VAS programme. IMPACT Effects of vitamin A supplementation (VAS) in treating child morbidity and mortality remain inconclusive, which calls for further rigorous studies. This study set up a quasi-experimental research design and estimated the null effect of VAS on child anaemia and childhood anthropometric failure. While the cautious interpretation of findings is urged, this study reliably supports targeted intervention of VAS, instead of the universal VAS programme. The use of nationally representative data and robust research protocol are the primary strengths of this study.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, West Bengal, India. .,Department of Global Health and Population, Harvard T H Chan School of Public Health, Cambridge, MA, USA. .,Department of Economics, University of Goettingen, Göttingen, Germany. .,Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany.
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Rai RK, Bromage S, Fawzi WW. Receipt of Weekly Iron Supplementation among Indian Children, 2005-2016. Curr Dev Nutr 2021; 5:nzab020. [PMID: 34084992 PMCID: PMC8164210 DOI: 10.1093/cdn/nzab020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 02/05/2021] [Accepted: 02/24/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND In response to India's unacceptably high burden of anemia among children aged 6-59 mo, the central government introduced the National Iron Plus Initiative program which recommends an intervention of iron supplementation to mitigate anemia, especially iron deficiency anemia. OBJECTIVE The objective of this study was to examine the trend (between 2005-2006 and 2015-2016) in receiving weekly iron supplementation (WIS) among children aged 6-59 mo, and factors associated with receiving WIS during 2015-2016. METHODS Two waves of the nationally representative cross-sectional National Family Health Survey (NFHS) data collected during 2005-2006 (NFHS-3) and 2015-2016 (NFHS-4) were used. The trend was measured using both rounds of datasets, whereas factors associated with WIS receipt were assessed from NFHS-4. The trend was assessed using a sample of 35,650 children from NFHS-3 and 202,227 children from NFHS-4. After exclusion of 8978 cases, a total of 199,110 children were included to analyze the factors associated with receiving WIS. Using appropriate sample weighting, unadjusted and adjusted (multivariate) logistic regression analyses were deployed. Application of the chi-squared test and checking for multicollinearity were also part of the analysis. The possibility of sample selection bias was tested. RESULTS An increase of WIS receipt (from 4.6% in 2005-2006 to 26% in 2015-2016) was observed. Older children, children living in rural areas, children belonging to Scheduled Tribes, children of mothers with secondary education or higher, and children whose mothers had some mass media exposure had higher odds of receiving WIS. Children of fifth or higher birth order, children who were followers of Islam and Christianity, children from the richest economic group, noninstitutional birth of children, and children from high-focus group states were negatively associated with WIS receipt. CONCLUSIONS Despite improvement (between 2005-2006 and 2015-2016) in receiving WIS, coverage remains unacceptably low (in absolute terms). The suboptimum performance of WIS intervention demands further investigation.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
| | - Sabri Bromage
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
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Rai RK, Barik A, Mazumdar S, Chatterjee K, Kalkonde YV, Mathur P, Chowdhury A, Fawzi WW. Non-communicable diseases are the leading cause of mortality in rural Birbhum, West Bengal, India: a sex-stratified analysis of verbal autopsies from a prospective cohort, 2012-2017. BMJ Open 2020; 10:e036578. [PMID: 33099492 PMCID: PMC7590361 DOI: 10.1136/bmjopen-2019-036578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES There is a dearth of data on causes of death in rural India, which impedes identification of public health priorities to guide health interventions. This study aims to offer insights from verbal autopsies, to understand the pattern and distribution of causes of death in a rural area of Birbhum District, West Bengal, India. DESIGN Causes of death data were retrieved from a prospective vital event surveillance system. SETTING The Birbhum Population Project, a Health and Demographic Surveillance System, West Bengal, India. PARTICIPANTS Between January 2012 and December 2017, all deaths were recorded. MAIN OUTCOME MEASURES Trained Surveyors tracked all deaths prospectively and used a previously validated verbal autopsy (VA) tool to record causes of death. Experienced physicians reviewed completed VA forms, and assigned cause of death using the 10th version of International Classification of Diseases. In addition to cause-specific mortality fraction, cause-specific crude death rate (CDR) among males and females were estimated. RESULTS A total of 2320 deaths (1348 males and 972 females) were recorded. An estimated CDR was 708/100 000. Over half of all deaths (1176 deaths, 50.7%) were attributed to non-communicable diseases (NCDs), with nearly 30% of all deaths attributed to circulatory system disorders; whereas 24.2% and 3.9% deaths were due to cerebrovascular diseases and ischaemic heart disease, respectively. Equal percent (13%) of males died from external causes and from infectious and parasitic diseases, and 11% died from respiratory system-related diseases. Among females, 12% died from infectious and parasitic diseases. Among children aged 0-4 years, 50% of all male deaths and 45% of all female deaths were attributed to conditions in the perinatal period. CONCLUSIONS NCDs are the leading cause of death among adults in a select population of rural Birbhum, India. Health programmes for rural India should prioritise plans to mitigate deaths due to NCDs.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States
- Department of Economics, University of Göttingen, Göttingen, Germany
- Centre for Modern Indian Studies, University of Göttingen, Göttingen, Germany
| | - Anamitra Barik
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Chest Clinic, DTC District Hospital and Niramoy TB Sanatorium, Birbhum, West Bengal, India
| | - Saibal Mazumdar
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
| | - Kajal Chatterjee
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
| | - Yogeshwar V Kalkonde
- Rural NCDs and Tribal Health Programme, Society for Education Action and Research in Community Health, Gadchiroli, Maharashtra, India
| | - Prashant Mathur
- Indian Council of Medical Research-National Centre for Disease Informatics and Research, Bengaluru, Karnataka, India
| | - Abhijit Chowdhury
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
- Indian Institute of Liver and Digestive Sciences, Kolkata, West Bengal, India
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States
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Haagsma JA, James SL, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Liu Z, Lucchesi LR, Roberts NLS, Sylte DO, Adebayo OM, Ahmadi A, Ahmed MB, Aichour MTE, Alahdab F, Alghnam SA, Aljunid SM, Al-Raddadi RM, Alsharif U, Altirkawi K, Anjomshoa M, Antonio CAT, Appiah SCY, Aremu O, Arora A, Asayesh H, Assadi R, Awasthi A, Ayala Quintanilla BP, Balalla S, Banstola A, Barker-Collo SL, Bärnighausen TW, Bazargan-Hejazi S, Bedi N, Behzadifar M, Behzadifar M, Benjet C, Bennett DA, Bensenor IM, Bhaumik S, Bhutta ZA, Bijani A, Borges G, Borschmann R, Bose D, Boufous S, Brazinova A, Campuzano Rincon JC, Cárdenas R, Carrero JJ, Carvalho F, Castañeda-Orjuela CA, Catalá-López F, Choi JYJ, Christopher DJ, Crowe CS, Dalal K, Daryani A, Davitoiu DV, Degenhardt L, De Leo D, De Neve JW, Deribe K, Dessie GA, deVeber GA, Dharmaratne SD, Doan LP, Dolan KA, Driscoll TR, Dubey M, El-Khatib Z, Ellingsen CL, El Sayed Zaki M, Endries AY, Eskandarieh S, Faro A, Fereshtehnejad SM, Fernandes E, Filip I, Fischer F, Franklin RC, Fukumoto T, Gezae KE, Gill TK, Goulart AC, Grada A, Guo Y, Gupta R, Haghparast Bidgoli H, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Haro JM, Hassankhani H, Hassen HY, Havmoeller R, Hendrie D, Henok A, Híjar M, Hole MK, Homaie Rad E, Hossain N, Hostiuc S, Hu G, Igumbor EU, Ilesanmi OS, Irvani SSN, Islam SMS, Ivers RQ, Jacobsen KH, Jahanmehr N, Jakovljevic M, Jayatilleke AU, Jha RP, Jonas JB, Jorjoran Shushtari Z, Jozwiak JJ, Jürisson M, Kabir A, Kalani R, Kasaeian A, Kelbore AG, Kengne AP, Khader YS, Khafaie MA, Khalid N, Khan EA, Khoja AT, Kiadaliri AA, Kim YE, Kim D, Kisa A, Koyanagi A, Kuate Defo B, Kucuk Bicer B, Kumar M, Lalloo R, Lam H, Lami FH, Lansingh VC, Leasher JL, Li S, Linn S, Lunevicius R, Machado FR, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahotra NB, Majdan M, Majeed A, Malekzadeh R, Malik MA, Malta DC, Manda AL, Mansournia MA, Massenburg BB, Maulik PK, Meheretu HAA, Mehndiratta MM, Melese A, Mendoza W, Mengesha MM, Meretoja TJ, Meretoja A, Mestrovic T, Miazgowski T, Miller TR, Mini GK, Mirrakhimov EM, Moazen B, Mohammad Gholi Mezerji N, Mohammadibakhsh R, Mohammed S, Molokhia M, Monasta L, Mondello S, Montero-Zamora PA, Moodley Y, Moosazadeh M, Moradi G, Moradi-Lakeh M, Morawska L, Velásquez IM, Morrison SD, Moschos MM, Mousavi SM, Murthy S, Musa KI, Naik G, Najafi F, Nangia V, Nascimento BR, Ndwandwe DE, Negoi I, Nguyen TH, Nguyen SH, Nguyen LH, Nguyen HLT, Ningrum DNA, Nirayo YL, Ofori-Asenso R, Ogbo FA, Oh IH, Oladimeji O, Olagunju AT, Olagunju TO, Olivares PR, Orpana HM, Otstavnov SS, P A M, Pakhale S, Park EK, Patton GC, Pesudovs K, Phillips MR, Polinder S, Prakash S, Radfar A, Rafay A, Rafiei A, Rahimi S, Rahimi-Movaghar V, Rahman MA, Rai RK, Ramezanzadeh K, Rawaf S, Rawaf DL, Renzaho AMN, Resnikoff S, Rezaeian S, Roever L, Ronfani L, Roshandel G, Sabde YD, Saddik B, Salamati P, Salimi Y, Salz I, Samy AM, Sanabria J, Sanchez Riera L, Santric Milicevic MM, Satpathy M, Sawhney M, Sawyer SM, Saxena S, Saylan M, Schneider IJC, Schwebel DC, Seedat S, Sepanlou SG, Shaikh MA, Shams-Beyranvand M, Shamsizadeh M, Sharif-Alhoseini M, Sheikh A, Shen J, Shigematsu M, Shiri R, Shiue I, Silva JP, Singh JA, Sinha DN, Soares Filho AM, Soriano JB, Soshnikov S, Soyiri IN, Starodubov VI, Stein DJ, Stokes MA, Sufiyan MB, Sunshine JE, Sykes BL, Tabarés-Seisdedos R, Tabb KM, Tehrani-Banihashemi A, Tessema GA, Thakur JS, Tran KB, Tran BX, Tudor Car L, Uthman OA, Uzochukwu BSC, Valdez PR, Varavikova E, Vasconcelos AMN, Venketasubramanian N, Violante FS, Vlassov V, Waheed Y, Wang YP, Wijeratne T, Winkler AS, Yadav P, Yano Y, Yenesew MA, Yip P, Yisma E, Yonemoto N, Younis MZ, Yu C, Zafar S, Zaidi Z, Zaman SB, Zamani M, Zhao Y, Zodpey S, Hay SI, Lopez AD, Mokdad AH, Vos T. Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017. Inj Prev 2020; 26:i12-i26. [PMID: 31915273 PMCID: PMC7571356 DOI: 10.1136/injuryprev-2019-043296] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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: 05/03/2019] [Revised: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. METHODS Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. RESULTS For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. CONCLUSIONS The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.
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Affiliation(s)
- Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Lydia R Lucchesi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | - Alireza Ahmadi
- Department of Anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | | | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota, USA
| | - Suliman A Alghnam
- Department of Population Health Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - 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
| | - Rajaa M Al-Raddadi
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ubai Alsharif
- Department of Oral and Maxillofacial Surgery, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
| | | | - Mina Anjomshoa
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - 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
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - 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
| | | | - Reza Assadi
- Education Development Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - 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
| | - Shivanthi Balalla
- School of Public Health, Auckland University of Technology, Auckland, New Zealand
| | - 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, Massachusetts, USA
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Neeraj Bedi
- Department of Community Medicine, Gandhi Medical College Bhopal, Bhopal, India
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Meysam Behzadifar
- Department of Epidemiology and Biostatistics, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Corina Benjet
- Department of Epidemiology and Psychosocial Research, 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
| | | | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Guilherme Borges
- Department of Epidemiology and Psychosocial Research, 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
| | - Dipan Bose
- Transport & Digital Development, World Bank, Washington, District of Columbia, USA
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research Department, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Julio Cesar Campuzano Rincon
- National Institute of Public Health, Cuernavaca, Mexico
- School of Medicine, University of the Valley of Cuernavaca, Cuernavaca, Mexico
| | - Rosario Cárdenas
- Department of Population and Health, Metropolitan Autonomous University, Mexico City, Mexico
| | - Juan J Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - 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
| | - Ferrán Catalá-López
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Jee-Young J Choi
- Department of Biochemistry and Biomedical Science, Seoul National University Hospital, Seoul, South Korea
| | | | | | - Koustuv Dalal
- Institute of Public Health Kalyani, Kalyani, India
- School of Health Science, Orebro University, Orebro, Sweden
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Dragos Virgil Davitoiu
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Surgery, Clinical Emergency Hospital Sf. Pantelimon, Bucharest, Romania
| | - Louisa Degenhardt
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Mount Gravatt, Queensland, Australia
| | - Jan-Walter De Neve
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - 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
| | | | - Gabrielle Aline deVeber
- Centre for Global Child Health, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Linh Phuong Doan
- Center of Excellence in Health Service Management, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Kate A Dolan
- University of New South Wales, Sydney, New South Wales, Australia
| | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Manisha Dubey
- United Nations World Food Programme, New Delhi, India
| | - 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
| | | | | | - Aman Yesuf Endries
- Public Health Department, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Andre Faro
- Department of Psychology, Federal University of Sergipe, Sao Cristovao, Brazil
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Division of Neurology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, California, USA
- School of Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Science, James Cook University, Douglas, Queensland, Australia
| | - Takeshi Fukumoto
- Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, Pennsylvania, USA
- Department of Dermatology, Kobe University, Kobe, Japan
| | | | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University of São Paulo, Sao Paulo, Brazil
- Internal Medicine Department, University Hospital, University of São Paulo, Sao Paulo, Brazil
| | - Ayman Grada
- School of Medicine, Boston University, Boston, Massachusetts, USA
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Epidemiology and Biostatistics, Zhengzhou University, Zhengzhou, China
| | - Rahul Gupta
- March of Dimes, Arlington, Virginia, USA
- School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | | | - Arvin Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arya Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - 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
| | - 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, Teppi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Rasmus Havmoeller
- Clinical Sciences, Karolinska University Hospital, Stockholm, Sweden
| | - Delia Hendrie
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Andualem Henok
- Department of Public Health, Mizan-Tepi University, Teppi, Ethiopia
| | - Martha Híjar
- Research Coordination, AC Environments Foundation, Cuernavaca, Mexico
- CISS, National Institute of Public Health, Cuernavaca, Mexico
| | - Michael K Hole
- Department of Pediatrics, Dell Medical School, University of Texas Austin, Austin, Texas, USA
| | - Enayatollah Homaie Rad
- Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Naznin Hossain
- Department of Pharmacology and Therapeutics, Dhaka Medical College, Dhaka University, Dhaka, Bangladesh
- Department of Pharmacology, Bangladesh Industrial Gases Limited, Tangail, Bangladesh
| | - Sorin Hostiuc
- Faculty of Dentistry, 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
| | - Ehimario U Igumbor
- School of Public Health, University of the Western Cape, Bellville, Cape Town, South Africa
- Department of Public Health, Walter Sisulu University, Mthatha, South Africa
| | | | - 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, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Q Ivers
- Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Kathryn H Jacobsen
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, 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
| | - 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 Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Zahra Jorjoran Shushtari
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, 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
| | - Rizwan Kalani
- Department of Neurology, University of Washington, Seattle, Washington, USA
| | - 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
| | | | - Andre Pascal Kengne
- Non-communicable Diseases Research Unit, Medical Research Council South Africa, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Yousef Saleh Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Ramtha, 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
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Abdullah T Khoja
- Department of Public Health, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Young-Eun Kim
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Ai Koyanagi
- CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - 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
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Hilton Lam
- Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | - Van C Lansingh
- HelpMeSee, New York City, New York, USA
- International Relations Department, Mexican Institute of Ophthalmology, Queretaro, Mexico
| | - Janet L Leasher
- College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shai Linn
- School of Public Health, University of Haifa, Haifa, Israel
| | - 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
| | - Flavia R Machado
- Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, Sao Paulo, Brazil
| | | | | | | | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - 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
| | - Manzoor Ahmad Malik
- Department of Humanities and Social Sciences, Indian Institute of Technology, Roorkee, Haridwar, India
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ana-Laura Manda
- Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - 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
| | - Hailemariam Abiy Alemu Meheretu
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
- School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
| | - Man Mohan Mehndiratta
- Neurology Department, Janakpuri Super Specialty Hospital Society, New Delhi, India
- Neurology Department, Govind Ballabh Institute of Medical Education and Research, New Delhi, India
| | - Addisu Melese
- Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
| | | | - 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, Melbourne, Victoria, Australia
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - 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, Maryland, 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
| | - 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
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
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- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | - 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
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
- Department of Neurology, Oasi Research Institute, Troina, Italy
| | - Pablo A Montero-Zamora
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
| | - 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
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- 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
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- 1st Department of Ophthalmology, University of Athens, Athens, Greece
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Seyyed Meysam Mousavi
- Health Management Reserach Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran, Iran
| | - Srinivas Murthy
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kamarul Imran Musa
- School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia
| | - Gurudatta Naik
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Farid Najafi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
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- Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
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- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- General Surgery Department, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Trang Huyen Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Son Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
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- Public Health Department, Universitas Negeri Semarang, Kota Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | | | - Richard Ofori-Asenso
- Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, Australia
- Independent Consultant, Accra, Ghana
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea
| | - Olanrewaju Oladimeji
- HAST, Human Sciences Research Council, Durban, South Africa
- School of Public Health, Faculty of Health Sciences, University of Namibia, Osakhati, Namibia
| | - 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, Ontario, Canada
| | - Pedro R Olivares
- Institute of Physical Activity and Health, Autonomous University of Chile, Talca, Chile
| | - Heather M Orpana
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Stanislav S Otstavnov
- Analytical Center, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Committee for the Comprehensive Assessment of Medical Devices and Information Technology, Health Technology Assessment Association, 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, University of Ottawa, Ottawa, Ontario, Canada
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | - George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Population Health Department, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Konrad Pesudovs
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
- Department of Psychiatry, Department of Epidemiology, Columbia University, New York City, New York, USA
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Swayam Prakash
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando, Florida, USA
- College of Graduate Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Anwar Rafay
- Department of Epidemiology & Biostatistics, Contech School of Public Health, Lahore, Pakistan
| | - 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
| | - 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, Heidelberg, Victoria, Australia
- National Centre for Farmer Health, Deakin University, Waurn Ponds, Victoria, Australia
| | - Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, India
- Department of Economics, University of Göttingen, Göttingen, Germany
| | - Kiana Ramezanzadeh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Academic Public Health Department, Public Health England, London, UK
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK
- University College London Hospitals, London, UK
| | - Andre M N Renzaho
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- Organization for the Prevention of Blindness, Paris, France
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- 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
| | - Yogesh Damodar Sabde
- National Institute for Research in Environmental Health, Indian Council of Medical Research, Bhopal, India
| | - Basema Saddik
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yahya Salimi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - 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, West Virginia, USA
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, Ohio, 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
| | - Maheswar Satpathy
- UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
- Udyam-Global Association for Sustainable Development, Bhubaneswar, India
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Susan M Sawyer
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Sonia Saxena
- School of Public Health, Imperial College London, London, UK
| | - Mete Saylan
- Market Access Department, Bayer, Istanbul, Turkey
| | - Ione J C Schneider
- School of Health Sciences, Federal University of Santa Catarina, Ararangua, Brazil
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, 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
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- School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
- School of Medicine, Alborz University of Medical Sciences, Karaj, 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
| | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
- Division of General Internal Medicine and Primary Care, Harvard University, Boston, Massachusetts, USA
| | - Jiabin Shen
- Center for Pediatric Trauma Research, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
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- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ivy Shiue
- Institute of Medical Epidemiology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | | | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Medicine Service, US Department of Veteran Affairs, Birmingham, Alabama, USA
| | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Adauto Martins Soares Filho
- Department of Diseases and Noncommunicable Diseases and Health Promotion, Federal Ministry of Health, Brasilia, Brazil
| | - 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
| | - Sergey Soshnikov
- Department of Research Development, Federal Research Institute for Health Organization and Informatics of the Ministry of Health (FRIHOI), Moscow, Russia
| | - 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
| | - Vladimir I Starodubov
- Federal Research Institute for Health Organization and Informatics of the Ministry of Health (FRIHOI), Moscow, Russia
| | - Dan J Stein
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Mark A Stokes
- Department of Psychology, Deakin University, Burwood, Victoria, Australia
| | | | - Jacob E Sunshine
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington, USA
| | - Bryan L Sykes
- Department of Criminology, Law and Society, University of California Irvine, Irvine, California, 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, Illinois, USA
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Gizachew Assefa Tessema
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Jarnail Singh Thakur
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Khanh Bao Tran
- Molecular Medicine and Pathology Department, 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
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | | | - Pascual R Valdez
- Argentine Society of Medicine, Buenos Aires, Argentina
- Velez Sarsfield Hospital, Buenos Aires, Argentina
| | - Elena Varavikova
- Central Research Institute of Cytology and Genetics, Federal Research Institute for Health Organization and Informatics of the Ministry of Health (FRIHOI), Moscow, Russia
| | - Ana Maria Nogales Vasconcelos
- Department of Statistics, University of Brasília, Brasília, Brazil
- Directorate of Social Studies and Policies, Federal District Planning Company, Brasília, Brazil
| | - 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
| | - Yuan-Pang Wang
- Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Tissa Wijeratne
- Department of Psychology and Counselling, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, St Albans, Victoria, Australia
| | - Andrea Sylvia Winkler
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - Priyanka Yadav
- Centre for the Study of Regional Development, Jawahar Lal Nehru University, New Delhi, India
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
| | | | - 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
| | - Mustafa Z Younis
- Health Economics & Finance, Jackson State University, Jackson, Mississippi, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Shamsa Zafar
- Department of Obstetrics & Gynaecology, A.C.S. Medical College and Hospital, Islamabad, Pakistan
| | - 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, Monash University, Melbourne, Victoria, Australia
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Sanjay Zodpey
- Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- University of Melbourne, Melbourne, Queensland, Australia
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
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Rai RK, Kumar C, Singh PK, Singh L, Barik A, Chowdhury A. Incidence of Prehypertension and Hypertension in Rural India, 2012-2018: A Sex-Stratified Population-Based Prospective Cohort Study. Am J Hypertens 2020; 33:552-562. [PMID: 32149333 DOI: 10.1093/ajh/hpaa034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/20/2020] [Accepted: 03/04/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND India is home to the largest number of hypertensive individuals, and factors responsible for the incidence of hypertension are poorly understood. This study examines predictors of transition to different stages of hypertension-incidence of hypertension, incidence of prehypertension, and incidence of prehypertension to hypertension. METHODS Population-based survey data from the Birbhum Population Project, located in West Bengal, India were used. A cohort of 8,977 individuals (male: 3,934, female: 5,043), participated in the 2012-13 survey, and were followed up for resurvey in 2017-18. The Seventh Report of the Joint National Committee (JNC 7) guidelines were followed to define hypertension. Bivariate and multivariate Poisson regression analyses were conducted to attain the study objective. RESULTS The incidence of hypertension, prehypertension among males (7.9% and 45.3%, respectively) is higher than that among females (5.9% and 32.7%, respectively). However, the incidence of prehypertension to hypertension is lower among males (23.6%) than among females (33.6%). Among both sexes, with age, the incidence of hypertension, and incidence of prehypertension to hypertension appeared to increase, whereas incidence of prehypertension among females increased with age. Findings indicate a diverse gradient of socioeconomic, behavioral, and anthropometric characteristics influencing the incidence of different stages of hypertension. CONCLUSIONS With a focus on females and the richest individuals, this study proposes that an appropriate intervention be designed in keeping with the socioeconomic, behavioral gradient of incidence of different stages of hypertension. The role of anthropometric indicators in hypertension is proposed to be further studied for better population-based screening.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
- Department of Economics, and Centre for Modern Indian Studies, University of Göttingen, Göttingen, Germany
| | - Chandan Kumar
- Department of Policy Studies, TERI School of Advanced Studies, New Delhi, India
| | - Prashant Kumar Singh
- Division of Preventive Oncology, ICMR National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Lucky Singh
- ICMR National Institute of Medical Statistics, New Delhi, India
| | - Anamitra Barik
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Chest Clinic—Suri District Hospital, and Niramoy TB Sanatorium, Suri, West Bengal, India
| | - Abhijit Chowdhury
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Department of Hepatology—School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
- Indian Institute of Liver and Digestive Sciences, Kolkata, West Bengal, India
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12
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Troeger CE, Khalil IA, Blacker BF, Biehl MH, Albertson SB, Zimsen SRM, Rao PC, Abate D, Ahmadi A, Ahmed MLCB, Akal CG, Alahdab F, Alam N, Alene KA, Alipour V, Aljunid SM, Al-Raddadi RM, Alvis-Guzman N, Amini S, Anber NH, Anjomshoa M, Antonio CAT, Arabloo J, Aremu O, Atalay HT, Atique S, Avokpaho EFGA, Awad S, Awasthi A, Badawi A, Balakrishnan K, Banoub JAM, Barac A, Bassat Q, Bedi N, Bennett DA, Bhattacharyya K, Bhutta ZA, Bijani A, Car J, Carvalho F, Castañeda-Orjuela CA, Christopher DJ, Dandona L, Dandona R, Daryani A, Demeke FM, Deshpande A, Djalalinia S, Dubey M, Dubljanin E, Duken EE, El Sayed Zaki M, Endries AY, Fernandes E, Fischer F, Fullman N, Gardner WM, Geta B, Ghadiri K, Gorini G, Goulart AC, Guo Y, Hailu GB, Haj-Mirzaian A, Haj-Mirzaian A, Hamidi S, Hassen HY, Hoang CL, Hostiuc M, Hussain Z, Irvani SSN, James SL, Jha RP, Jonas JB, Karch A, Kasaeian A, Kassa TD, Kassebaum NJ, Kefale AT, Khader YS, Khan EA, Khan MN, Khang YH, Khoja AT, Kimokoti RW, Kisa A, Kisa S, Kissoon N, Kochhar S, Kosen S, Koyanagi A, Kuate Defo B, Kumar GA, Lal DK, Leshargie CT, Li S, Lodha R, Macarayan ERK, Majdan M, Mamun AA, Manguerra H, Melese A, Memish ZA, Mengistu DT, Meretoja TJ, Mestrovic T, Miazgowski B, Mirrakhimov EM, Moazen B, Mohammad KA, Mohammed S, Monasta L, Moore CE, Mosser JF, Mousavi SM, Murthy S, Mustafa G, Nazari J, Nguyen CT, Nguyen LH, Nisar MI, Nixon MR, Ogbo FA, Okoro A, Olagunju AT, Olagunju TO, P A M, Pakhale S, Postma MJ, Qorbani M, Quansah R, Rafiei A, Rahim F, Rahimi-Movaghar V, Rai RK, Rezai MS, Rezapour A, Rios-Blancas MJ, Ronfani L, Rosettie K, Rothenbacher D, Safari S, Saleem Z, Sambala EZ, Samy AM, Santric Milicevic MM, Sartorius B, Sawhney M, Seyedmousavi S, Shaikh MA, Sheikh A, Shigematsu M, Smith DL, Soriano JB, Sreeramareddy CT, Stanaway JD, Sufiyan MB, Teklu TGE, Temsah MH, Tessema B, Tran BX, Tran KB, Ullah I, Updike RL, Vasankari TJ, Veisani Y, Wada FW, Waheed Y, Weaver M, Wiens KE, Wiysonge CS, Yimer EM, Yonemoto N, Zaidi Z, Zar HJ, Zarghi A, Lim SS, Vos T, Mokdad AH, Murray CJL, Kyu HH, Hay SI, Reiner RC. Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years: an analysis of the Global Burden of Disease Study 2017. Lancet Infect Dis 2020; 20:37-59. [PMID: 31678029 PMCID: PMC7340495 DOI: 10.1016/s1473-3099(19)30401-3] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/13/2019] [Accepted: 07/05/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Many countries have shown marked declines in diarrhoeal disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. METHODS This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. FINDINGS Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162-593 145) among children younger than 5 years globally in 2017, a rate of 78·4 deaths (70·1-87·1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69·6% (63·1-74·6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13·3% decrease, 11·2-15·5), childhood wasting (9·9% decrease, 9·6-10·2), and low use of oral rehydration solution (6·9% decrease, 4·8-8·4). INTERPRETATION Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors-particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution-appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness. FUNDING Bill & Melinda Gates Foundation.
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Rai RK, Sudfeld CR, Barik A, Fawzi WW, Chowdhury A. Sociodemographic Determinants of Preterm Birth and Small for Gestational Age in Rural West Bengal, India. J Trop Pediatr 2019; 65:537-546. [PMID: 30753693 DOI: 10.1093/tropej/fmz002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Preterm birth and small for gestational age (SGA) are major contributors to neonatal mortality in India. However, social determinates of preterm births and SGA are poorly characterized. We use population-based data from a health and demographic surveillance system (HDSS) in rural West Bengal, India, to examine risk factors for preterm birth and SGA. HDSS pregnancy cohort data for 2430 pregnant women were used in this analysis. Of 2430 pregnancies, 16% were preterm births and 38.2% were SGA. Results from logistic regression reveal that higher maternal education (≥11 years) was associated with reduced risk of preterm births and SGA. Greater wealth quintile was also associated with decreased risk of preterm births and SGA (p-value for trend: <0.05). In light of the findings, ensuring effective coverage of preterm and SGA interventions among women of low socioeconomic status will be essential to mitigate the large burden of preterm births and SGA.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Anamitra Barik
- Society for Health and Demographic Surveillance, Suri, West Bengal, India.,Suri District Hospital, and Niramoy TB Sanatorium, Suri, West Bengal, India
| | - Wafaie W Fawzi
- Departments of Global Health and Population, Nutrition, and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Abhijit Chowdhury
- Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal, India
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14
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Roth GA, Johnson CO, Abate KH, Abd-Allah F, Ahmed M, Alam K, Alam T, Alvis-Guzman N, Ansari H, Ärnlöv J, Atey TM, Awasthi A, Awoke T, Barac A, Bärnighausen T, Bedi N, Bennett D, Bensenor I, Biadgilign S, Castañeda-Orjuela C, Catalá-López F, Davletov K, Dharmaratne S, Ding EL, Dubey M, Faraon EJA, Farid T, Farvid MS, Feigin V, Fernandes J, Frostad J, Gebru A, Geleijnse JM, Gona PN, Griswold M, Hailu GB, Hankey GJ, Hassen HY, Havmoeller R, Hay S, Heckbert SR, Irvine CMS, James SL, Jara D, Kasaeian A, Khan AR, Khera S, Khoja AT, Khubchandani J, Kim D, Kolte D, Lal D, Larsson A, Linn S, Lotufo PA, Magdy Abd El Razek H, Mazidi M, Meier T, Mendoza W, Mensah GA, Meretoja A, Mezgebe HB, Mirrakhimov E, Mohammed S, Moran AE, Nguyen G, Nguyen M, Ong KL, Owolabi M, Pletcher M, Pourmalek F, Purcell CA, Qorbani M, Rahman M, Rai RK, Ram U, Reitsma MB, Renzaho AMN, Rios-Blancas MJ, Safiri S, Salomon JA, Sartorius B, Sepanlou SG, Shaikh MA, Silva D, Stranges S, Tabarés-Seisdedos R, Tadele Atnafu N, Thakur JS, Topor-Madry R, Truelsen T, Tuzcu EM, Tyrovolas S, Ukwaja KN, Vasankari T, Vlassov V, Vollset SE, Wakayo T, Weintraub R, Wolfe C, Workicho A, Xu G, Yadgir S, Yano Y, Yip P, Yonemoto N, Younis M, Yu C, Zaidi Z, Zaki MES, Zipkin B, Afshin A, Gakidou E, Lim SS, Mokdad AH, Naghavi M, Vos T, Murray CJL. The Burden of Cardiovascular Diseases Among US States, 1990-2016. JAMA Cardiol 2019; 3:375-389. [PMID: 29641820 PMCID: PMC6145754 DOI: 10.1001/jamacardio.2018.0385] [Citation(s) in RCA: 235] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Question How does the total burden of cardiovascular diseases vary across US states? Findings In this study using the Global Burden of Disease methodology, large disparities in total burden of CVD were found between US states despite marked improvements in CVD burden. Meaning These estimates can provide a benchmark for states working to focus on key risk factors, improve health care quality, and lower health care costs. Importance Cardiovascular disease (CVD) is the leading cause of death in the United States, but regional variation within the United States is large. Comparable and consistent state-level measures of total CVD burden and risk factors have not been produced previously. Objective To quantify and describe levels and trends of lost health due to CVD within the United States from 1990 to 2016 as well as risk factors driving these changes. Design, Setting, and Participants Using the Global Burden of Disease methodology, cardiovascular disease mortality, nonfatal health outcomes, and associated risk factors were analyzed by age group, sex, and year from 1990 to 2016 for all residents in the United States using standardized approaches for data processing and statistical modeling. Burden of disease was estimated for 10 groupings of CVD, and comparative risk analysis was performed. Data were analyzed from August 2016 to July 2017. Exposures Residing in the United States. Main Outcomes and Measures Cardiovascular disease disability-adjusted life-years (DALYs). Results Between 1990 and 2016, age-standardized CVD DALYs for all states decreased. Several states had large rises in their relative rank ordering for total CVD DALYs among states, including Arkansas, Oklahoma, Alabama, Kentucky, Missouri, Indiana, Kansas, Alaska, and Iowa. The rate of decline varied widely across states, and CVD burden increased for a small number of states in the most recent years. Cardiovascular disease DALYs remained twice as large among men compared with women. Ischemic heart disease was the leading cause of CVD DALYs in all states, but the second most common varied by state. Trends were driven by 12 groups of risk factors, with the largest attributable CVD burden due to dietary risk exposures followed by high systolic blood pressure, high body mass index, high total cholesterol level, high fasting plasma glucose level, tobacco smoking, and low levels of physical activity. Increases in risk-deleted CVD DALY rates between 2006 and 2016 in 16 states suggest additional unmeasured risks beyond these traditional factors. Conclusions and Relevance Large disparities in total burden of CVD persist between US states despite marked improvements in CVD burden. Differences in CVD burden are largely attributable to modifiable risk exposures.
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Affiliation(s)
| | - Gregory A Roth
- Institute for Health Metrics and Evaluation, University of Washington, Seattle.,Division of Cardiology, Department of Medicine, University of Washington, Seattle
| | - Catherine O Johnson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Khurshid Alam
- The University of Western Australia, Perth, Western Australia, Australia
| | - Tahiya Alam
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | | | - Ashish Awasthi
- Indian Institute of Public Health Gandhinagar, Public Health Foundation of India, Gandhinagar, Gujarat, India
| | | | | | | | | | | | | | | | | | - Ferrán Catalá-López
- INCLIVA Health Research Institute, Centro de Investigación Biomédica en Red Salud Mental, University of Valencia, Valencia, Spain
| | - Kairat Davletov
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | - Eric L Ding
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Manisha Dubey
- International Institute for Population Sciences, Mumbai, India
| | | | - Talha Farid
- University of Louisville, Louisville, Kentucky
| | - Maryam S Farvid
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Valery Feigin
- Auckland University of Technology, Auckland, New Zealand
| | | | - Joseph Frostad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Max Griswold
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | | | | | - Simon Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Susan R Heckbert
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Spencer Lewis James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Dube Jara
- Debre Markos University, Debre Markos, Ethiopia
| | - Amir Kasaeian
- Hematology, Oncology, and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Abdullah T Khoja
- Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | | | - Daniel Kim
- Northeastern University, Boston, Massachusetts
| | | | - Dharmesh Lal
- Public Health Foundation of India, New Delhi, India
| | - Anders Larsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Paulo A Lotufo
- Clinical Research Center, University Hospital, University of São Paulo, São Paulo, São Paulo, Brazil
| | | | - Mohsen Mazidi
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing
| | - Toni Meier
- Martin Luther University of Halle-Wittenberg, Halle, Germany
| | | | | | - Atte Meretoja
- University of Melbourne, Melbourne, Victoria, Australia
| | | | | | | | | | - Grant Nguyen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Minh Nguyen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Kanyin Liane Ong
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Mayowa Owolabi
- Department of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Martin Pletcher
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Caroline A Purcell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Mostafa Qorbani
- Noncommunicable Diseases Research Center, Alborz University of Medical Sciences, Hassan Abad, Karaj, Iran
| | | | - Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, West Bengal, India
| | - Usha Ram
- International Institute for Population Sciences, Mumbai, India
| | | | | | | | - Saeid Safiri
- Maragheh University of Medical Sciences, East Azerbaijan Province, Iran
| | | | | | | | | | - Diego Silva
- Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Rafael Tabarés-Seisdedos
- INCLIVA Health Research Institute, Centro de Investigación Biomédica en Red Salud Mental, University of Valencia, Valencia, Spain
| | | | - J S Thakur
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | - Stefanos Tyrovolas
- Hospital Sant Joan de Déu Barcelona, Sant Joan de Déu Research Foundation, Centro de Investigación Biomédica en Red Salud Mental, Universitat de Barcelona, Barcelona, Spain
| | - Kingsley Nnanna Ukwaja
- Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Vasiliy Vlassov
- National Research University Higher School of Economics, Moscow, Russia
| | | | | | | | | | | | - Gelin Xu
- Nanjing University School of Medicine, Nanjing, China
| | - Simon Yadgir
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Yuichiro Yano
- The University of Mississippi Medical Center, Jackson
| | - Paul Yip
- University of Hong Kong, Pokfulam, Hong Kong
| | | | | | | | | | | | - Ben Zipkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Ashkan Afshin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
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15
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Reiner RC, Olsen HE, Ikeda CT, Echko MM, Ballestreros KE, Manguerra H, Martopullo I, Millear A, Shields C, Smith A, Strub B, Abebe M, Abebe Z, Adhena BM, Adhikari TB, Akibu M, Al-Raddadi RM, Alvis-Guzman N, Antonio CAT, Aremu O, Asgedom SW, Asseffa NA, Avila-Burgos L, Barac A, Bärnighausen TW, Bassat Q, Bensenor IM, Bhutta ZA, Bijani A, Bililign N, Cahuana-Hurtado L, Malta DC, Chang JC, Charlson FJ, Dharmaratne SD, Doku DT, Edessa D, El-Khatib Z, Erskine HE, Ferrari AJ, Fullman N, Gupta R, Hassen HY, Hay SI, Ilesanmi OS, Jacobsen KH, Kahsay A, Kasaeian A, Kassa TD, Kebede S, Khader YS, Khan EA, Khan MN, Khang YH, Khubchandani J, Kinfu Y, Kochhar S, Kokubo Y, Koyanagi A, Defo BK, Lal DK, Kumsa FA, Larson HJ, Leung J, Mamun AA, Mehata S, Melku M, Mendoza W, Mezgebe HB, Miller TR, Moges NA, Mohammed S, Mokdad AH, Monasta L, Neupane S, Nguyen HLT, Ningrum DNA, Nirayo YL, Nong VM, Ogbo FA, Olagunju AT, Olusanya BO, Olusanya JO, Patton GC, Pereira DM, Pourmalek F, Qorbani M, Rafay A, Rai RK, Ram U, Ranabhat CL, Renzaho AMN, Rezai MS, Ronfani L, Roth GA, Safiri S, Sartorius B, Scott JG, Shackelford KA, Sliwa K, Sreeramareddy C, Sufiyan MB, Terkawi AS, Topor-Madry R, Tran BX, Ukwaja KN, Uthman OA, Vollset SE, Weldegwergs KG, Werdecker A, Whiteford HA, Wijeratne T, Yonemoto N, Yotebieng M, Zuhlke LJ, Kyu HH, Naghavi M, Vos T, Murray CJL, Kassebaum NJ. Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study. JAMA Pediatr 2019; 173:e190337. [PMID: 31034019 PMCID: PMC6547084 DOI: 10.1001/jamapediatrics.2019.0337] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Understanding causes and correlates of health loss among children and adolescents can identify areas of success, stagnation, and emerging threats and thereby facilitate effective improvement strategies. OBJECTIVE To estimate mortality and morbidity in children and adolescents from 1990 to 2017 by age and sex in 195 countries and territories. DESIGN, SETTING, AND PARTICIPANTS This study examined levels, trends, and spatiotemporal patterns of cause-specific mortality and nonfatal health outcomes using standardized approaches to data processing and statistical analysis. It also describes epidemiologic transitions by evaluating historical associations between disease indicators and the Socio-Demographic Index (SDI), a composite indicator of income, educational attainment, and fertility. Data collected from 1990 to 2017 on children and adolescents from birth through 19 years of age in 195 countries and territories were assessed. Data analysis occurred from January 2018 to August 2018. EXPOSURES Being under the age of 20 years between 1990 and 2017. MAIN OUTCOMES AND MEASURES Death and disability. All-cause and cause-specific deaths, disability-adjusted life years, years of life lost, and years of life lived with disability. RESULTS Child and adolescent deaths decreased 51.7% from 13.77 million (95% uncertainty interval [UI], 13.60-13.93 million) in 1990 to 6.64 million (95% UI, 6.44-6.87 million) in 2017, but in 2017, aggregate disability increased 4.7% to a total of 145 million (95% UI, 107-190 million) years lived with disability globally. Progress was uneven, and inequity increased, with low-SDI and low-middle-SDI locations experiencing 82.2% (95% UI, 81.6%-82.9%) of deaths, up from 70.9% (95% UI, 70.4%-71.4%) in 1990. The leading disaggregated causes of disability-adjusted life years in 2017 in the low-SDI quintile were neonatal disorders, lower respiratory infections, diarrhea, malaria, and congenital birth defects, whereas neonatal disorders, congenital birth defects, headache, dermatitis, and anxiety were highest-ranked in the high-SDI quintile. CONCLUSIONS AND RELEVANCE Mortality reductions over this 27-year period mean that children are more likely than ever to reach their 20th birthdays. The concomitant expansion of nonfatal health loss and epidemiological transition in children and adolescents, especially in low-SDI and middle-SDI countries, has the potential to increase already overburdened health systems, will affect the human capital potential of societies, and may influence the trajectory of socioeconomic development. Continued monitoring of child and adolescent health loss is crucial to sustain the progress of the past 27 years.
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Affiliation(s)
| | - Robert C. Reiner
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Department of Health Metrics Sciences, University of Washington, Seattle
| | | | | | | | | | - Helen Manguerra
- Institute for Health Metrics and Evaluation, Seattle, Washington
| | - Ira Martopullo
- Institute for Health Metrics and Evaluation, Seattle, Washington
| | - Anoushka Millear
- Institute for Health Metrics and Evaluation, Seattle, Washington
| | - Chloe Shields
- Institute for Health Metrics and Evaluation, Seattle, Washington
| | - Alison Smith
- Institute for Health Metrics and Evaluation, Seattle, Washington
| | - Bryan Strub
- Institute for Health Metrics and Evaluation, Seattle, Washington
| | - Molla Abebe
- Department of Clinical Chemistry, University of Gondar, Gondar, Ethiopia
| | - Zegeye Abebe
- Department of Human Nutrition, University of Gondar, Gondar, Ethiopia
| | | | - Tara Ballav Adhikari
- Nepal Health Research Environment, Center for Social Science and Public Health Research Nepal, Lalitpur, Nepal
- Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
| | - Mohammed Akibu
- Department of Midwifery, Debre Berhan University, Debre Berhan, Ethiopia
| | - Rajaa M. Al-Raddadi
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nelson Alvis-Guzman
- Research Group on Health Economics, University of Cartagena, Cartagena, Colombia
- Research Group on Hospital Management and Health Policies, University of the Coast, Barranquilla, Colombia
| | - 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
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, United Kingdom
| | | | | | - Leticia Avila-Burgos
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Aleksandra Barac
- Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Till W. Bärnighausen
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Quique Bassat
- Barcelona Institute for Global Health, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies, Manhiça Health Research Center, Manhiça, Mozambique
| | | | - Zulfiqar A. Bhutta
- The Centre for Global Child Health, University of Toronto, Toronto, Canada
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | | | - Lucero Cahuana-Hurtado
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Jung-Chen Chang
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fiona J. Charlson
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Department of Global Health, University of Washington, Seattle
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - David Teye Doku
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Dumessa Edessa
- School of Pharmacy, Haramaya University, Harar, Ethiopia
| | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Holly E. Erskine
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | - Alize J. Ferrari
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | - Nancy Fullman
- Institute for Health Metrics and Evaluation, Seattle, Washington
| | - Rahul Gupta
- West Virginia Bureau for Public Health, Charleston, West Virginia
- Department of Health Policy, Management, and Leadership, West Virginia University, Morgantown
| | - Hamid Yimam Hassen
- Public Health Department, Mizan-Tepi University, Teppi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Antwerp, Belgium
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Department of Health Metrics Sciences, University of Washington, Seattle
| | | | - Kathryn H. Jacobsen
- Department of Global and Community Health, George Mason University, Fairfax, Virginia
| | - Amaha Kahsay
- Department of Nutrition and Dietetics, Mekelle University, Tigray, Ethiopia
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Seifu Kebede
- Midwifery Program, Salale University, Fiche, Ethiopia
| | - Yousef Saleh Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Ramtha, Jordan
| | - Ejaz Ahmad Khan
- Department of Epidemiology and Biostatistics, Health Services Academy, Islamabad, Pakistan
| | - Mohammed Nuruzzaman Khan
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | - Young-Ho Khang
- Department of Health Policy and Management, Seoul National University, Seoul, South Korea
- Institute of Health Policy and Management, Seoul National University, Seoul, South Korea
| | - Jagdish Khubchandani
- Department of Nutrition and Health Science, Ball State University, Muncie, Indiana
| | - Yohannes Kinfu
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Sonali Kochhar
- Department of Global Health, University of Washington, Seattle
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Ai Koyanagi
- Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Barcelona
| | - Barthelemy Kuate Defo
- Department of Demography, University of Montreal, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | | | - Fekede Asefa Kumsa
- Center for Midwifery, Child, and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia
- School of Public Health, Haramaya University, Harar, Ethiopia
| | - Heidi J. Larson
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Janni Leung
- Center for Youth Substance Abuse Research, The University of Queensland, St Lucia, Queensland, Australia
| | - Abdullah A. Mamun
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Suresh Mehata
- Research, Monitoring, and Evaluation, Ipas Nepal, Kathmandu, Nepal
| | - Mulugeta Melku
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund, Lima, Peru
| | | | - Ted R. Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | | | - Shafiu Mohammed
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | - Ali H. Mokdad
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Department of Health Metrics Sciences, University of Washington, Seattle
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Subas Neupane
- Faculty of Health Sciences, University of Tampere, Tampere, Finland
| | | | - Dina Nur Anggraini Ningrum
- Department of Public Health Science, State University of Semarang, Kota Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
| | | | - Vuong Minh Nong
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Andrew T. Olagunju
- Department of Psychiatry,University of Adelaide, Adelaide, South Australia, Australia
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | | | | | - George C. Patton
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Population Health Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - David M. Pereira
- Rede de Química e Tecnologia/Laboratório Asociado do Química Verde, University of Porto, Oporto, Portugal
- Cartagena University, Cartagena, Colombia
| | - Farshad Pourmalek
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mostafa Qorbani
- Noncommunicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Anwar Rafay
- Department of Epidemiology and Biostatistics, Contech School of Public Health, Lahore, Pakistan
| | - Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, India
- Department of Economics, University of Göttingen, Göttingen, Germany
| | - Usha Ram
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Chhabi Lal Ranabhat
- Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, South Korea
| | - Andre M. N. Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | | | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gregory A. Roth
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Division of Cardiology, University of Washington, Seattle
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Benn Sartorius
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - James G. Scott
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Child and Youth Mental Health, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | | | - Karen Sliwa
- Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
| | | | | | - Abdullah Sulieman Terkawi
- Department of Anesthesiology, University of Virginia, Charlottesville
- Syrian Expatriate Medical Association, Charlottesville, Virginia
| | - Roman Topor-Madry
- Institute for Public Health, Jagiellonian University Medical College, Krakow, Poland
- Agency for Health Technology Assessment and Tariff System, Warszawa, Poland
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | | | - Olalekan A. Uthman
- Division of Health Sciences, University of Warwick, Coventry, United Kingdom
| | - Stein Emil Vollset
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Department of Health Metrics Sciences, University of Washington, Seattle
| | | | - Andrea Werdecker
- Demographic Change and Ageing Research Area, Federal Institute for Population Research, Wiesbaden, Germany
- Independent Consultant, Staufenberg, Germany
| | - Harvey A. Whiteford
- Institute for Health Metrics and Evaluation, Seattle, Washington
- The University of Queensland, Brisbane, Queensland, Australia
| | - Tissa Wijeratne
- Department of Medicine, University of Melbourne, St Albans, Victoria, Australia
- Department of Psychology, La Trobe University, Melbourne, Victoria, Australia
| | - Naohiro Yonemoto
- Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Marcel Yotebieng
- College of Public Health, The Ohio State University, Columbus
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Liesl J. Zuhlke
- Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Hmwe Hmwe Kyu
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Department of Health Metrics Sciences, University of Washington, Seattle
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Department of Health Metrics Sciences, University of Washington, Seattle
| | - Theo Vos
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Department of Health Metrics Sciences, University of Washington, Seattle
| | - Christopher J. L. Murray
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Department of Health Metrics Sciences, University of Washington, Seattle
| | - Nicholas J. Kassebaum
- Institute for Health Metrics and Evaluation, Seattle, Washington
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle
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Stanaway JD, Reiner RC, Blacker BF, Goldberg EM, Khalil IA, Troeger CE, Andrews JR, Bhutta ZA, Crump JA, Im J, Marks F, Mintz E, Park SE, Zaidi AKM, Abebe Z, Abejie AN, Adedeji IA, Ali BA, Amare AT, Atalay HT, Avokpaho EFGA, Bacha U, Barac A, Bedi N, Berhane A, Browne AJ, Chirinos JL, Chitheer A, Dolecek C, El Sayed Zaki M, Eshrati B, Foreman KJ, Gemechu A, Gupta R, Hailu GB, Henok A, Hibstu DT, Hoang CL, Ilesanmi OS, Iyer VJ, Kahsay A, Kasaeian A, Kassa TD, Khan EA, Khang YH, Magdy Abd El Razek H, Melku M, Mengistu DT, Mohammad KA, Mohammed S, Mokdad AH, Nachega JB, Naheed A, Nguyen CT, Nguyen HLT, Nguyen LH, Nguyen NB, Nguyen TH, Nirayo YL, Pangestu T, Patton GC, Qorbani M, Rai RK, Rana SM, Ranabhat CL, Roba KT, Roberts NLS, Rubino S, Safiri S, Sartorius B, Sawhney M, Shiferaw MS, Smith DL, Sykes BL, Tran BX, Tran TT, Ukwaja KN, Vu GT, Vu LG, Weldegebreal F, Yenit MK, Murray CJL, Hay SI. The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Infect Dis 2019; 19:369-381. [PMID: 30792131 PMCID: PMC6437314 DOI: 10.1016/s1473-3099(18)30685-6] [Citation(s) in RCA: 372] [Impact Index Per Article: 74.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/17/2018] [Accepted: 11/01/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Efforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, and the approach taken to produce them. METHODS For this systematic analysis we broke down the relative contributions of typhoid and paratyphoid fevers by country, year, and age, and analysed trends in incidence and mortality. We modelled the combined incidence of typhoid and paratyphoid fevers and split these total cases proportionally between typhoid and paratyphoid fevers using aetiological proportion models. We estimated deaths using vital registration data for countries with sufficiently high data completeness and using a natural history approach for other locations. We also estimated disability-adjusted life-years (DALYs) for typhoid and paratyphoid fevers. FINDINGS Globally, 14·3 million (95% uncertainty interval [UI] 12·5-16·3) cases of typhoid and paratyphoid fevers occurred in 2017, a 44·6% (42·2-47·0) decline from 25·9 million (22·0-29·9) in 1990. Age-standardised incidence rates declined by 54·9% (53·4-56·5), from 439·2 (376·7-507·7) per 100 000 person-years in 1990, to 197·8 (172·0-226·2) per 100 000 person-years in 2017. In 2017, Salmonella enterica serotype Typhi caused 76·3% (71·8-80·5) of cases of enteric fever. We estimated a global case fatality of 0·95% (0·54-1·53) in 2017, with higher case fatality estimates among children and older adults, and among those living in lower-income countries. We therefore estimated 135·9 thousand (76·9-218·9) deaths from typhoid and paratyphoid fever globally in 2017, a 41·0% (33·6-48·3) decline from 230·5 thousand (131·2-372·6) in 1990. Overall, typhoid and paratyphoid fevers were responsible for 9·8 million (5·6-15·8) DALYs in 2017, down 43·0% (35·5-50·6) from 17·2 million (9·9-27·8) DALYs in 1990. INTERPRETATION Despite notable progress, typhoid and paratyphoid fevers remain major causes of disability and death, with billions of people likely to be exposed to the pathogens. Although improvements in water and sanitation remain essential, increased vaccine use (including with typhoid conjugate vaccines that are effective in infants and young children and protective for longer periods) and improved data and surveillance to inform vaccine rollout are likely to drive the greatest improvements in the global burden of the disease. FUNDING Bill & Melinda Gates Foundation.
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Singh L, Goel R, Rai RK, Singh PK. Socioeconomic inequality in functional deficiencies and chronic diseases among older Indian adults: a sex-stratified cross-sectional decomposition analysis. BMJ Open 2019; 9:e022787. [PMID: 30819699 PMCID: PMC6398785 DOI: 10.1136/bmjopen-2018-022787] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 01/10/2019] [Accepted: 01/31/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Older adults with adverse socioeconomic conditions suffer disproportionately from a poor quality of life. Stratified by sex, income-related inequalities have been decomposed for functional deficiencies and chronic diseases among older adults, and the degree to which social and demographic factors contribute to these inequalities was identified in this study. DESIGN Cross-sectional study. PARTICIPANTS Data used for this study were retrieved from the WHO Study on Global AGEing and Adult Health Wave 1. A total of 3753 individuals (men: 1979, and women: 1774) aged ≥60 years were found eligible for the analysis. MEASURES Instrumental Activity of Daily Living (IADL) deficiency and presence of chronic diseases. METHOD The decomposition method proposed by Adam Wagstaff and his colleagues was used. The method allows estimating how determinants of health contribute proportionally to inequality in a health variable. RESULTS Compared with men, women were disproportionately affected by both functional deficiencies and chronic diseases. The relative contribution of sociodemographic factors to IADL deficiency was highest among those with poor economic status (38.5%), followed by those who were illiterate (22.5%), which collated to 61% of the total explained inequalities. Similarly, for chronic diseases, about 93% of the relative contribution was shared by those with poor economic status (42.3%), rural residence (30.5%) and illiteracy (20.3%). Significant difference in predictors was evident between men and women in IADL deficiency and chronic illness. CONCLUSION Pro-poor intervention strategies could be designed to address functional deficiencies and chronic diseases, with special attention to women.
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Affiliation(s)
- Lucky Singh
- ICMR - National Institute of Medical Statistics, New Delhi, India
| | - Richa Goel
- Indian Council of Medical Research, New Delhi, India
| | | | - Prashant Kumar Singh
- Division of Preventive Oncology, ICMR - National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
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James SL, Theadom A, Ellenbogen RG, Bannick MS, Montjoy-Venning W, Lucchesi LR, Abbasi N, Abdulkader R, Abraha HN, Adsuar JC, Afarideh M, Agrawal S, Ahmadi A, Ahmed MB, Aichour AN, Aichour I, Aichour MTE, Akinyemi RO, Akseer N, Alahdab F, Alebel A, Alghnam SA, Ali BA, Alsharif U, Altirkawi K, Andrei CL, Anjomshoa M, Ansari H, Ansha MG, Antonio CAT, Appiah SCY, Ariani F, Asefa NG, Asgedom SW, Atique S, Awasthi A, Ayala Quintanilla BP, Ayuk TB, Azzopardi PS, Badali H, Badawi A, Balalla S, Banstola A, Barker-Collo SL, Bärnighausen TW, Bedi N, Behzadifar M, Behzadifar M, Bekele BB, Belachew AB, Belay YA, Bennett DA, Bensenor IM, Berhane A, Beuran M, Bhalla A, Bhaumik S, Bhutta ZA, Biadgo B, Biffino M, Bijani A, Bililign N, Birungi C, Boufous S, Brazinova A, Brown AW, Car M, Cárdenas R, Carrero JJ, Carvalho F, Castañeda-Orjuela CA, Catalá-López F, Chaiah Y, Champs AP, Chang JC, Choi JYJ, Christopher DJ, Cooper C, Crowe CS, Dandona L, Dandona R, Daryani A, Davitoiu DV, Degefa MG, Demoz GT, Deribe K, Djalalinia S, Do HP, Doku DT, Drake TM, Dubey M, Dubljanin E, El-Khatib Z, Ofori-Asenso R, Eskandarieh S, Esteghamati A, Esteghamati S, Faro A, Farzadfar F, Farzaei MH, Fereshtehnejad SM, Fernandes E, Feyissa GT, Filip I, Fischer F, Fukumoto T, Ganji M, Gankpe FG, Gebre AK, Gebrehiwot TT, Gezae KE, Gopalkrishna G, Goulart AC, Haagsma JA, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Haro JM, Hassankhani H, Hassen HY, Havmoeller R, Hawley C, Hay SI, Hegazy MI, Hendrie D, Henok A, Hibstu DT, Hoffman HJ, Hole MK, Homaie Rad E, Hosseini SM, Hostiuc S, Hu G, Hussen MA, Ilesanmi OS, Irvani SSN, Jakovljevic M, Jayaraman S, Jha RP, Jonas JB, Jones KM, Jorjoran Shushtari Z, Jozwiak JJ, Jürisson M, Kabir A, Kahsay A, Kahssay M, Kalani R, Karch A, Kasaeian A, Kassa GM, Kassa TD, Kassa ZY, Kengne AP, Khader YS, Khafaie MA, Khalid N, Khalil I, Khan EA, Khan MS, Khang YH, Khazaie H, Khoja AT, Khubchandani J, Kiadaliri AA, Kim D, Kim YE, Kisa A, Koyanagi A, Krohn KJ, Kuate Defo B, Kucuk Bicer B, Kumar GA, Kumar M, Lalloo R, Lami FH, Lansingh VC, Laryea DO, Latifi A, Leshargie CT, Levi M, Li S, Liben ML, Lotufo PA, Lunevicius R, Mahotra NB, Majdan M, Majeed A, Malekzadeh R, Manda AL, Mansournia MA, Massenburg BB, Mate KKV, Mehndiratta MM, Mehta V, Meles H, Melese A, Memiah PTN, Mendoza W, Mengistu G, Meretoja A, Meretoja TJ, Mestrovic T, Miazgowski T, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Moazen B, Mohammadi M, Mohammed S, Mokdad AH, Molokhia M, Monasta L, Mondello S, Moosazadeh M, Moradi G, Moradi M, Moradi-Lakeh M, Moradinazar M, Morrison SD, Moschos MM, Mousavi SM, Murthy S, Musa KI, Mustafa G, Naghavi M, Naik G, Najafi F, Nangia V, Nascimento BR, Negoi I, Nguyen TH, Nichols E, Ningrum DNA, Nirayo YL, Nyasulu PS, Ogbo FA, Oh IH, Okoro A, Olagunju AT, Olagunju TO, Olivares PR, Otstavnov SS, Owolabi MO, P A M, Pakhale S, Pandey AR, Pesudovs K, Pinilla-Monsalve GD, Polinder S, Poustchi H, Prakash S, Qorbani M, Radfar A, Rafay A, Rafiei A, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman M, Rahman MA, Rai RK, Rajati F, Ram U, Rawaf DL, Rawaf S, Reiner RC, Reis C, Renzaho AMN, Resnikoff S, Rezaei S, Rezaeian S, Roever L, Ronfani L, Roshandel G, Roy N, Ruhago GM, Saddik B, Safari H, Safiri S, Sahraian MA, Salamati P, Saldanha RDF, Samy AM, Sanabria J, Santos JV, Santric Milicevic MMM, Sartorius B, Satpathy M, Savuon K, Schneider IJC, Schwebel DC, Sepanlou SG, Shabaninejad H, Shaikh MAA, Shams-Beyranvand M, Sharif M, Sharif-Alhoseini M, Shariful Islam SM, She J, Sheikh A, Shen J, Sheth KN, Shibuya K, Shiferaw MS, Shigematsu M, Shiri R, Shiue I, Shoman H, Siabani S, Siddiqi TJ, Silva JP, Silveira DGA, Sinha DN, Smith M, Soares Filho AM, Sobhani S, Soofi M, Soriano JB, Soyiri IN, Stein DJ, Stokes MA, Sufiyan MB, Sunguya BF, Sunshine JE, Sykes BL, Szoeke CEI, Tabarés-Seisdedos R, Te Ao BJ, Tehrani-Banihashemi A, Tekle MG, Temsah MH, Temsah O, Topor-Madry R, Tortajada-Girbés M, Tran BX, Tran KB, Tudor Car L, Ukwaja KN, Ullah I, Usman MS, Uthman OA, Valdez PR, Vasankari TJ, Venketasubramanian N, Violante FS, Wagnew FWS, Waheed Y, Wang YP, Weldegwergs KG, Werdecker A, Wijeratne T, Winkler AS, Wyper GMA, Yano Y, Yaseri M, Yasin YJ, Ye P, Yimer EM, Yip P, Yisma E, Yonemoto N, Yoon SJ, Yost MG, Younis MZ, Yousefifard M, Yu C, Zaidi Z, Zaman SB, Zamani M, Zenebe ZM, Zodpey S, Feigin VL, Vos T, Murray CJL. Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18:56-87. [PMID: 30497965 PMCID: PMC6291456 DOI: 10.1016/s1474-4422(18)30415-0] [Citation(s) in RCA: 917] [Impact Index Per Article: 183.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/02/2018] [Accepted: 10/30/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. METHODS We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. FINDINGS In 2016, there were 27·08 million (95% uncertainty interval [UI] 24·30-30·30 million) new cases of TBI and 0·93 million (0·78-1·16 million) new cases of SCI, with age-standardised incidence rates of 369 (331-412) per 100 000 population for TBI and 13 (11-16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55·50 million (53·40-57·62 million) and of SCI was 27·04 million (24·98-30·15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8·4% (95% UI 7·7 to 9·2), whereas that of SCI did not change significantly (-0·2% [-2·1 to 2·7]). Age-standardised incidence rates increased by 3·6% (1·8 to 5·5) for TBI, but did not change significantly for SCI (-3·6% [-7·4 to 4·0]). TBI caused 8·1 million (95% UI 6·0-10·4 million) YLDs and SCI caused 9·5 million (6·7-12·4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82-141) per 100 000 for TBI and 130 (90-170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. INTERPRETATION TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments. FUNDING Bill & Melinda Gates Foundation.
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19
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Kyu HH, Maddison ER, Henry NJ, Ledesma JR, Wiens KE, Reiner R, Biehl MH, Shields C, Osgood-Zimmerman A, Ross JM, Carter A, Frank TD, Wang H, Srinivasan V, Agarwal SK, Alahdab F, Alene KA, Ali BA, Alvis-Guzman N, Andrews JR, Antonio CAT, Atique S, Atre SR, Awasthi A, Ayele HT, Badali H, Badawi A, Barac A, Bedi N, Behzadifar M, Behzadifar M, Bekele BB, Belay SA, Bensenor IM, Butt ZA, Carvalho F, Cercy K, Christopher DJ, Daba AK, Dandona L, Dandona R, Daryani A, Demeke FM, Deribe K, Dharmaratne SD, Doku DT, Dubey M, Edessa D, El-Khatib Z, Enany S, Fernandes E, Fischer F, Garcia-Basteiro AL, Gebre AK, Gebregergs GB, Gebremichael TG, Gelano TF, Geremew D, Gona PN, Goodridge A, Gupta R, Haghparast Bidgoli H, Hailu GB, Hassen HY, Hedayati MTT, Henok A, Hostiuc S, Hussen MA, Ilesanmi OS, Irvani SSN, Jacobsen KH, Johnson SC, Jonas JB, Kahsay A, Kant S, Kasaeian A, Kassa TD, Khader YS, Khafaie MA, Khalil I, Khan EA, Khang YH, Kim YJ, Kochhar S, Koyanagi A, Krohn KJ, Kumar GA, Lakew AM, Leshargie CT, Lodha R, Macarayan ERK, Majdzadeh R, Martins-Melo FR, Melese A, Memish ZA, Mendoza W, Mengistu DT, Mengistu G, Mestrovic T, Moazen B, Mohammad KA, Mohammed S, Mokdad AH, Moosazadeh M, Mousavi SM, Mustafa G, Nachega JB, Nguyen LH, Nguyen SH, Nguyen TH, Ningrum DNA, Nirayo YL, Nong VM, Ofori-Asenso R, Ogbo FA, Oh IH, Oladimeji O, Olagunju AT, Oren E, Pereira DM, Prakash S, Qorbani M, Rafay A, Rai RK, Ram U, Rubino S, Safiri S, Salomon JA, Samy AM, Sartorius B, Satpathy M, Seyedmousavi S, Sharif M, Silva JP, Silveira DGA, Singh JA, Sreeramareddy CT, Tran BX, Tsadik AG, Ukwaja KN, Ullah I, Uthman OA, Vlassov V, Vollset SE, Vu G, Weldegebreal F, Werdecker A, Yimer EM, Yonemoto N, Yotebieng M, Naghavi M, Vos T, Hay SI, Murray CJL. Global, regional, and national burden of tuberculosis, 1990-2016: results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study. Lancet Infect Dis 2018; 18:1329-1349. [PMID: 30507459 PMCID: PMC6250050 DOI: 10.1016/s1473-3099(18)30625-x] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and programme decision making. We assessed the levels and trends in the fatal and non-fatal burden of tuberculosis by drug resistance and HIV status for 195 countries and territories from 1990 to 2016. METHODS We analysed 15 943 site-years of vital registration data, 1710 site-years of verbal autopsy data, 764 site-years of sample-based vital registration data, and 361 site-years of mortality surveillance data to estimate mortality due to tuberculosis using the Cause of Death Ensemble model. We analysed all available data sources, including annual case notifications, prevalence surveys, population-based tuberculin surveys, and estimated tuberculosis cause-specific mortality to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how the burden of tuberculosis differed from the burden predicted by the Socio-demographic Index (SDI), a composite indicator of income per capita, average years of schooling, and total fertility rate. FINDINGS Globally in 2016, among HIV-negative individuals, the number of incident cases of tuberculosis was 9·02 million (95% uncertainty interval [UI] 8·05-10·16) and the number of tuberculosis deaths was 1·21 million (1·16-1·27). Among HIV-positive individuals, the number of incident cases was 1·40 million (1·01-1·89) and the number of tuberculosis deaths was 0·24 million (0·16-0·31). Globally, among HIV-negative individuals the age-standardised incidence of tuberculosis decreased annually at a slower rate (-1·3% [-1·5 to -1·2]) than mortality did (-4·5% [-5·0 to -4·1]) from 2006 to 2016. Among HIV-positive individuals during the same period, the rate of change in annualised age-standardised incidence was -4·0% (-4·5 to -3·7) and mortality was -8·9% (-9·5 to -8·4). Several regions had higher rates of age-standardised incidence and mortality than expected on the basis of their SDI levels in 2016. For drug-susceptible tuberculosis, the highest observed-to-expected ratios were in southern sub-Saharan Africa (13·7 for incidence and 14·9 for mortality), and the lowest ratios were in high-income North America (0·4 for incidence) and Oceania (0·3 for mortality). For multidrug-resistant tuberculosis, eastern Europe had the highest observed-to-expected ratios (67·3 for incidence and 73·0 for mortality), and high-income North America had the lowest ratios (0·4 for incidence and 0·5 for mortality). INTERPRETATION If current trends in tuberculosis incidence continue, few countries are likely to meet the SDG target to end the tuberculosis epidemic by 2030. Progress needs to be accelerated by improving the quality of and access to tuberculosis diagnosis and care, by developing new tools, scaling up interventions to prevent risk factors for tuberculosis, and integrating control programmes for tuberculosis and HIV. FUNDING Bill & Melinda Gates Foundation.
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Dicker D, Nguyen G, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, Abbastabar H, Abd-Allah F, Abdela J, Abdelalim A, Abdel-Rahman O, Abdi A, Abdollahpour I, Abdulkader RS, Abdurahman AA, Abebe HT, Abebe M, Abebe Z, Abebo TA, Aboyans V, Abraha HN, Abrham AR, Abu-Raddad LJ, Abu-Rmeileh NME, Accrombessi MMK, Acharya P, Adebayo OM, Adedeji IA, Adedoyin RA, Adekanmbi V, Adetokunboh OO, Adhena BM, Adhikari TB, Adib MG, Adou AK, Adsuar JC, Afarideh M, Afshin A, Agarwal G, Aggarwal R, Aghayan SA, Agrawal S, Agrawal A, Ahmadi M, Ahmadi A, Ahmadieh H, Ahmed MLCB, Ahmed S, Ahmed MB, Aichour AN, Aichour I, Aichour MTE, Akanda AS, Akbari ME, Akibu M, Akinyemi RO, Akinyemiju T, Akseer N, Alahdab F, Al-Aly Z, Alam K, Alebel A, Aleman AV, Alene KA, Al-Eyadhy A, Ali R, Alijanzadeh M, Alizadeh-Navaei R, Aljunid SM, Alkerwi A, Alla F, Allebeck P, Allen CA, Alonso J, Al-Raddadi RM, Alsharif U, Altirkawi K, Alvis-Guzman N, Amare AT, Amini E, Ammar W, Amoako YA, Anber NH, Andrei CL, Androudi S, Animut MD, Anjomshoa M, Anlay DZ, Ansari H, Ansariadi A, Ansha MG, Antonio CAT, Appiah SCY, Aremu O, Areri HA, Ärnlöv J, Arora M, Artaman A, Aryal KK, Asadi-Lari M, Asayesh H, Asfaw ET, Asgedom SW, Assadi R, Ataro Z, Atey TMM, Athari SS, Atique S, Atre SR, Atteraya MS, Attia EF, Ausloos M, Avila-Burgos L, Avokpaho EFGA, Awasthi A, Awuah B, Ayala Quintanilla BP, Ayele HT, Ayele Y, Ayer R, Ayuk TB, Azzopardi PS, Azzopardi-Muscat N, Badali H, Badawi A, Balakrishnan K, Bali AG, Banach M, Banstola A, Barac A, Barboza MA, Barquera S, Barrero LH, Basaleem H, Bassat Q, Basu A, Basu S, Baune BT, Bazargan-Hejazi S, Bedi N, Beghi E, Behzadifar M, Behzadifar M, Béjot Y, Bekele BB, Belachew AB, Belay AG, Belay E, Belay SA, Belay YA, Bell ML, Bello AK, Bennett DA, Bensenor IM, Berhane A, Berman AE, Bernabe E, Bernstein RS, Bertolacci GJ, Beuran M, Beyranvand T, Bhala N, Bhatia E, Bhatt S, Bhattarai S, Bhaumik S, Bhutta ZA, Biadgo B, Bijani A, Bikbov B, Bililign N, Bin Sayeed MS, Birlik SM, Birungi C, Bisanzio D, Biswas T, Bjørge T, Bleyer A, Basara BB, Bose D, Bosetti C, Boufous S, Bourne R, Brady OJ, Bragazzi NL, Brant LC, Brazinova A, Breitborde NJK, Brenner H, Britton G, Brugha T, Burke KE, Busse R, Butt ZA, Cahuana-Hurtado L, Callender CSKH, Campos-Nonato IR, Campuzano Rincon JC, Cano J, Car M, Cárdenas R, Carreras G, Carrero JJ, Carter A, Carvalho F, Castañeda-Orjuela CA, Castillo Rivas J, Castro F, Catalá-López F, Çavlin A, Cerin E, Chaiah Y, Champs AP, Chang HY, Chang JC, Chattopadhyay A, Chaturvedi P, Chen W, Chiang PPC, Chimed-Ochir O, Chin KL, Chisumpa VH, Chitheer A, Choi JYJ, Christensen H, Christopher DJ, Chung SC, Cicuttini FM, Ciobanu LG, Cirillo M, Claro RM, Cohen AJ, Collado-Mateo D, Constantin MM, Conti S, Cooper C, Cooper LT, Cortesi PA, Cortinovis M, Cousin E, Criqui MH, Cromwell EA, Crowe CS, Crump JA, Cucu A, Cunningham M, Daba AK, Dachew BA, Dadi AF, Dandona L, Dandona R, Dang AK, Dargan PI, Daryani A, Das SK, Das Gupta R, das Neves J, Dasa TT, Dash AP, 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Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1684-1735. [PMID: 30496102 PMCID: PMC6227504 DOI: 10.1016/s0140-6736(18)31891-9] [Citation(s) in RCA: 575] [Impact Index Per Article: 95.8] [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: 04/09/2018] [Revised: 07/14/2018] [Accepted: 08/08/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. METHODS The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. FINDINGS Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. INTERPRETATION This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. FUNDING Bill & Melinda Gates Foundation.
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Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1736-1788. [PMID: 30496103 PMCID: PMC6227606 DOI: 10.1016/s0140-6736%2818%2932203-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 01/19/2024]
Abstract
BACKGROUND Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. METHODS The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries-Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. FINDINGS At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5-74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9-19·6), and injuries 8·0% (7·7-8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5-23·9), representing an additional 7·61 million (7·20-8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0-8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0-24·0) and the death rate by 31·8% (30·1-33·3). Total deaths from injuries increased by 2·3% (0·5-4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2-15·1) to 57·9 deaths (55·9-59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000-289 000) globally in 2007 to 352 000 (334 000-363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8-148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2-40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2-36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990-neonatal disorders, lower respiratory infections, and diarrhoeal diseases-were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. INTERPRETATION Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. FUNDING Bill & Melinda Gates Foundation.
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Zucker I, Zuhlke LJJ, Lim SS, Murray CJL. Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:2091-2138. [PMID: 30496107 PMCID: PMC6227911 DOI: 10.1016/s0140-6736(18)32281-5] [Citation(s) in RCA: 264] [Impact Index Per Article: 44.0] [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: 06/15/2018] [Revised: 09/06/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of "leaving no one behind", it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment. METHODS We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. FINDINGS The global median health-related SDG index in 2017 was 59·4 (IQR 35·4-67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6-14·0) to a high of 84·9 (83·1-86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. INTERPRETATION The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains-curative interventions in the case of NCDs-towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions-or inaction-today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. FUNDING Bill & Melinda Gates Foundation.
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Shushtari Z, Joshi A, Jozwiak JJ, Jürisson M, Kabir Z, Kahsay A, Kalani R, Kanchan T, Kant S, Kar C, Karami M, Karami Matin B, Karch A, Karema C, Karimi N, Karimi SM, Kasaeian A, Kassa DH, Kassa GM, Kassa TD, Kassebaum NJ, Katikireddi SV, Kaul A, Kawakami N, Kazemi Z, Karyani AK, Kefale AT, Keiyoro PN, Kemp GR, Kengne AP, Keren A, Kesavachandran CN, Khader YS, Khafaei B, Khafaie MA, Khajavi A, Khalid N, Khalil IA, Khan G, Khan MS, Khan MA, Khang YH, Khater MM, Khazaei M, Khazaie H, Khoja AT, Khosravi A, Khosravi MH, Kiadaliri AA, Kiirithio DN, Kim CI, Kim D, Kim YE, Kim YJ, Kimokoti RW, Kinfu Y, Kisa A, Kissimova-Skarbek K, Kivimäki M, Knibbs LD, Knudsen AKS, Kochhar S, Kokubo Y, Kolola T, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kravchenko MA, Krishan K, Krohn KJ, Kromhout H, Kuate Defo B, Kucuk Bicer B, Kumar GA, Kumar M, Kuzin I, Kyu HH, Lachat C, Lad DP, Lad SD, Lafranconi A, Lalloo R, Lallukka T, Lami FH, Lang JJ, Lansingh VC, Larson SL, Latifi A, Lazarus JV, Lee PH, Leigh J, Leili M, Leshargie CT, Leung J, Levi M, Lewycka S, Li S, Li Y, Liang J, Liang X, Liao Y, Liben ML, Lim LL, Linn S, Liu S, Lodha R, Logroscino G, Lopez AD, Lorkowski S, Lotufo PA, Lozano R, Lucas TCD, Lunevicius R, Ma S, Macarayan ERK, Machado ÍE, Madotto F, Mai HT, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malta DC, Mamun AA, Manda AL, Manguerra H, Mansournia MA, Mantovani LG, Maravilla JC, Marcenes W, Marks A, Martin RV, Martins SCO, Martins-Melo FR, März W, Marzan MB, Massenburg BB, Mathur MR, Mathur P, Matsushita K, Maulik PK, Mazidi M, McAlinden C, McGrath JJ, McKee M, Mehrotra R, Mehta KM, Mehta V, Meier T, Mekonnen FA, Melaku YA, Melese A, Melku M, Memiah PTN, Memish ZA, Mendoza W, Mengistu DT, Mensah GA, Mensink GBM, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Mezgebe HB, Miazgowski B, Miazgowski T, Millear AI, Miller TR, Miller-Petrie MK, Mini GK, Mirarefin M, Mirica A, Mirrakhimov EM, Misganaw AT, Mitiku H, Moazen B, Mohajer B, Mohammad KA, Mohammadi M, Mohammadifard N, 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C, Zaidi Z, Zaman SB, Zamani M, Zavala-Arciniega L, Zhang AL, Zhang H, Zhang K, Zhou M, Zimsen SRM, Zodpey S, Murray CJL. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1923-1994. [PMID: 30496105 PMCID: PMC6227755 DOI: 10.1016/s0140-6736(18)32225-6] [Citation(s) in RCA: 2618] [Impact Index Per Article: 436.3] [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: 05/27/2018] [Revised: 08/31/2018] [Accepted: 09/05/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk-outcome associations. METHODS We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. FINDINGS In 2017, 34·1 million (95% uncertainty interval [UI] 33·3-35·0) deaths and 1·21 billion (1·14-1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6-62·4) of deaths and 48·3% (46·3-50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39-11·5) deaths and 218 million (198-237) DALYs, followed by smoking (7·10 million [6·83-7·37] deaths and 182 million [173-193] DALYs), high fasting plasma glucose (6·53 million [5·23-8·23] deaths and 171 million [144-201] DALYs), high body-mass index (BMI; 4·72 million [2·99-6·70] deaths and 148 million [98·6-202] DALYs), and short gestation for birthweight (1·43 million [1·36-1·51] deaths and 139 million [131-147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3-6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. INTERPRETATION By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning. FUNDING Bill & Melinda Gates Foundation.
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Esteghamati S, Fakhim H, Fallah Omrani V, Faramarzi M, Fareed M, Farhadi F, Farid TA, Farinha CSES, Farioli A, Faro A, Farvid MS, Farzadfar F, Feigin VL, Fentahun N, Fereshtehnejad SM, Fernandes E, Fernandes JC, Ferrari AJ, Feyissa GT, Filip I, Fischer F, Fitzmaurice C, Foigt NA, Foreman KJ, Fox J, Frank TD, Fukumoto T, Fullman N, Fürst T, Furtado JM, Futran ND, Gall S, Ganji M, Gankpe FG, Garcia-Basteiro AL, Gardner WM, Gebre AK, Gebremedhin AT, Gebremichael TG, Gelano TF, Geleijnse JM, Genova-Maleras R, Geramo YCD, Gething PW, Gezae KE, Ghadiri K, Ghasemi Falavarjani K, Ghasemi-Kasman M, Ghimire M, Ghosh R, Ghoshal AG, Giampaoli S, Gill PS, Gill TK, Ginawi IA, Giussani G, Gnedovskaya EV, Goldberg EM, Goli S, Gómez-Dantés H, Gona PN, Gopalani SV, Gorman TM, Goulart AC, Goulart BNG, Grada A, Grams ME, Grosso G, Gugnani HC, Guo Y, Gupta PC, Gupta R, Gupta R, Gupta T, Gyawali B, Haagsma JA, Hachinski V, Hafezi-Nejad N, Haghparast Bidgoli H, Hagos TB, Hailu GB, Haj-Mirzaian A, 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Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1789-1858. [PMID: 30496104 PMCID: PMC6227754 DOI: 10.1016/s0140-6736(18)32279-7#] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/30/2018] [Accepted: 09/12/2018] [Indexed: 08/12/2023]
Abstract
BACKGROUND The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. METHODS We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. FINDINGS Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs s1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). INTERPRETATION Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. FUNDING Bill & Melinda Gates Foundation.
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R, Mabika CM, Macarayan ERK, Mackay MT, Madotto F, Mahmood TAE, Mahotra NB, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malik MA, Mamun AA, Manamo WA, Manda AL, Mangalam S, Mansournia MA, Mantovani LG, Mapoma CC, Marami D, Maravilla JC, Marcenes W, Marina S, Martins-Melo FR, März W, Marzan MB, Mashamba-Thompson TP, Masiye F, Mason-Jones AJ, Massenburg BB, Mathur MR, Maulik PK, Mazidi M, McGrath JJ, Mehata S, Mehendale SM, Mehndiratta MM, Mehrotra R, Mehrzadi S, Mehta KM, Mehta V, Mekonnen TC, Meles HG, Meles KG, Melese A, Melku M, Memiah PTN, Memish ZA, Mendoza W, Mengesha MM, Mengistu DT, Mengistu G, Mensah GA, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Mezgebe HB, Miangotar Y, Miazgowski B, Miazgowski T, Miller TR, Miller-Petrie MK, Mini GK, Mirabi P, Mirica A, Mirrakhimov EM, Misganaw AT, Moazen B, Mohammad KA, Mohammadi M, Mohammadifard N, Mohammadi-Khanaposhtani M, Mohammed MA, Mohammed S, Mokdad AH, Mola GD, Molokhia M, Monasta L, Montañez JC, Moradi G, Moradi M, Moradi-Lakeh M, Moradinazar M, Moraga P, Morgado-Da-Costa J, Mori R, Morrison SD, Mosapour A, Moschos MM, Mousavi SM, Muche AA, Muchie KF, Mueller UO, Mukhopadhyay S, Muller K, Murphy TB, Murthy GVS, Musa J, Musa KI, Mustafa G, Muthupandian S, Nachega JB, Nagel G, Naghavi M, Naheed A, Nahvijou A, Naik G, Naik P, Najafi F, Naldi L, Nangia V, Nansseu JR, Nascimento BR, Nawaz H, Ncama BP, Neamati N, Negoi I, Negoi RI, Neupane S, Newton CRJ, Ngalesoni FN, Ngunjiri JW, Nguyen G, Nguyen LH, Nguyen TH, Ningrum DNA, Nirayo YL, Nisar MI, Nixon MR, Nomura S, Noroozi M, Noubiap JJ, Nouri HR, Shiadeh MN, Nowroozi MR, Nyandwi A, Nyasulu PS, Odell CM, Ofori-Asenso R, Ogah OS, Ogbo FA, Oh IH, Okoro A, Oladimeji O, Olagunju AT, Olagunju TO, Olivares PR, Olusanya BO, Olusanya JO, Ong SK, Ortiz A, Osgood-Zimmerman A, Ota E, Otieno BA, Otstavnov SS, Owolabi MO, Oyekale AS, P A M, Pakhale S, Pakhare AP, Pana A, Panda BK, Panda-Jonas S, Pandey AR, Park EK, Parsian H, Patel S, Patil ST, Patle A, Patton GC, Paturi VR, Paudel D, Pedroso MM, Peprah EK, Pereira DM, Perico N, Pesudovs K, Petri WA, Petzold M, Pierce M, Pigott DM, Pillay JD, Pirsaheb M, Polanczyk GV, Postma MJ, Pourmalek F, Pourshams A, Poustchi H, Prakash S, Prasad N, Purcell CA, Purwar MB, Qorbani M, Quansah R, Radfar A, Rafay A, Rafiei A, Rahim F, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman M, Rahman MS, Rahman MHU, Rahman MA, Rahman SU, Rai RK, Rajati F, Rajsic S, Ram U, Ranabhat CL, Ranjan P, Rawaf DL, Rawaf S, Ray SE, Razo-García C, Reiner RC, Reis C, Remuzzi G, Renzaho AMN, Resnikoff S, Rezaei S, Rezaeian S, Rezai MS, Riahi SM, Rios-Blancas MJ, Roba KT, Roberts NLS, Roever L, Ronfani L, Roshandel G, Rostami A, Rubagotti E, Ruhago GM, Sabde YD, Sachdev PS, Saddik B, Saeedi Moghaddam S, Safari H, Safari Y, Safari-Faramani R, Safdarian M, Safi S, Safiri S, Sagar R, Sahebkar A, Sahraian MA, Sajadi HS, Salahshoor MR, Salam N, Salama JS, Salamati P, Saldanha RDF, Saleem Z, Salimi Y, Salimzadeh H, Salomon JA, Salvi SS, Salz I, Sambala EZ, Samy AM, Sanabria J, Sanchez-Niño MD, Santos IS, Santric Milicevic MM, Sao Jose BP, Sardana M, Sarker AR, Sarmiento-Suárez R, Saroshe S, Sarrafzadegan N, Sartorius B, Sarvi S, Sathian B, Satpathy M, Sawant AR, Sawhney M, Saxena S, Schaeffner E, Schelonka K, Schneider IJC, Schwebel DC, Schwendicke F, Seedat S, Sekerija M, Sepanlou SG, Serván-Mori E, Shabaninejad H, Shackelford KA, Shafieesabet A, Shaheen AA, Shaikh MA, Shakir RA, Shams-Beyranvand M, Shamsi M, Shamsizadeh M, Sharafi H, Sharafi K, Sharif M, Sharif-Alhoseini M, Sharma J, Sharma R, She J, Sheikh A, Shi P, Shibuya K, Shigematsu M, Shiri R, Shirkoohi R, Shiue I, Shokraneh F, Shukla SR, Si S, Siabani S, Sibai AM, Siddiqi TJ, Sigfusdottir ID, Sigurvinsdottir R, Silpakit N, Silva DAS, Silva JP, Silveira DGA, Singam NSV, Singh JA, Singh NP, Singh V, Sinha DN, Sliwa K, Soares Filho AM, Sobaih BH, Sobhani S, Soofi M, Soriano JB, Soyiri IN, Sreeramareddy CT, Starodubov VI, Steiner C, Stewart LG, Stokes MA, Strong M, Subart ML, Sufiyan MB, Sulo G, Sunguya BF, Sur PJ, Sutradhar I, Sykes BL, Sylaja PN, Sylte DO, Szoeke CEI, Tabarés-Seisdedos R, Tabb KM, Tadakamadla SK, Tandon N, Tassew AA, Tassew SG, Taveira N, Tawye NY, Tehrani-Banihashemi A, Tekalign TG, Tekle MG, Temsah MH, Terkawi AS, Teshale MY, Tessema B, Teweldemedhin M, Thakur JS, Thankappan KR, Thirunavukkarasu S, Thomas N, Thomson AJ, Tilahun B, To QG, Tonelli M, Topor-Madry R, Torre AE, Tortajada-Girbés M, Tovani-Palone MR, Toyoshima H, Tran BX, Tran KB, Tripathy SP, Truelsen TC, Truong NT, Tsadik AG, Tsegay A, Tsilimparis N, Tudor Car L, Ukwaja KN, Ullah I, Usman MS, Uthman OA, Uzun SB, Vaduganathan M, Vaezi A, Vaidya G, Valdez PR, Varavikova E, Varughese S, Vasankari TJ, Vasconcelos AMN, Venketasubramanian N, Villafaina S, Violante FS, Vladimirov SK, Vlassov V, Vollset SE, Vos T, Vosoughi K, Vujcic IS, Wagnew FS, Waheed Y, Walson JL, Wang Y, Wang YP, Weiderpass E, Weintraub RG, Weldegwergs KG, Werdecker A, Westerman R, Whiteford H, Widecka J, Widecka K, Wijeratne T, Winkler AS, Wiysonge CS, Wolfe CDA, Wu S, Wyper GMA, Xu G, Yamada T, Yano Y, Yaseri M, Yasin YJ, Ye P, Yentür GK, Yeshaneh A, Yimer EM, Yip P, Yisma E, Yonemoto N, Yoon SJ, Yotebieng M, Younis MZ, Yousefifard M, Yu C, Zadnik V, Zaidi Z, Zaman SB, Zamani M, Zare Z, Zeleke MM, Zenebe ZM, Zerfu TA, Zhang X, Zhao XJ, Zhou M, Zhu J, Zimsen SRM, Zodpey S, Zoeckler L, Lopez AD, Lim SS. Population and fertility by age and sex for 195 countries and territories, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1995-2051. [PMID: 30496106 PMCID: PMC6227915 DOI: 10.1016/s0140-6736(18)32278-5] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [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: 04/08/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. METHODS We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10-54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10-14 years and 50-54 years was estimated from data on fertility in women aged 15-19 years and 45-49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. FINDINGS From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4-52·0). The TFR decreased from 4·7 livebirths (4·5-4·9) to 2·4 livebirths (2·2-2·5), and the ASFR of mothers aged 10-19 years decreased from 37 livebirths (34-40) to 22 livebirths (19-24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3-200·8) since 1950, from 2·6 billion (2·5-2·6) to 7·6 billion (7·4-7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15-64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9-1·2) in Cyprus to a high of 7·1 livebirths (6·8-7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07-0·09) in South Korea to 2·4 livebirths (2·2-2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3-0·4) in Puerto Rico to a high of 3·1 livebirths (3·0-3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. INTERPRETATION Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. FUNDING Bill & Melinda Gates Foundation.
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Troeger C, Blacker B, Khalil IA, Rao PC, Cao J, Zimsen SRM, Albertson SB, Deshpande A, Farag T, Abebe Z, Adetifa IMO, Adhikari TB, Akibu M, Al Lami FH, Al-Eyadhy A, Alvis-Guzman N, Amare AT, Amoako YA, Antonio CAT, Aremu O, Asfaw ET, Asgedom SW, Atey TM, Attia EF, Avokpaho EFGA, Ayele HT, Ayuk TB, Balakrishnan K, Barac A, Bassat Q, Behzadifar M, Behzadifar M, Bhaumik S, Bhutta ZA, Bijani A, Brauer M, Brown A, Camargos PAM, Castañeda-Orjuela CA, Colombara D, Conti S, Dadi AF, Dandona L, Dandona R, Do HP, Dubljanin E, Edessa D, Elkout H, Endries AY, Fijabi DO, Foreman KJ, Forouzanfar MH, Fullman N, Garcia-Basteiro AL, Gessner BD, Gething PW, Gupta R, Gupta T, Hailu GB, Hassen HY, Hedayati MT, Heidari M, Hibstu DT, Horita N, Ilesanmi OS, Jakovljevic MB, Jamal AA, Kahsay A, Kasaeian A, Kassa DH, Khader YS, Khan EA, Khan MN, Khang YH, Kim YJ, Kissoon N, Knibbs LD, Kochhar S, Koul PA, Kumar GA, Lodha R, Magdy Abd El Razek H, Malta DC, Mathew JL, Mengistu DT, Mezgebe HB, Mohammad KA, Mohammed MA, Momeniha F, Murthy S, Nguyen CT, Nielsen KR, Ningrum DNA, Nirayo YL, Oren E, Ortiz JR, PA M, Postma MJ, Qorbani M, Quansah R, Rai RK, Rana SM, Ranabhat CL, Ray SE, Rezai MS, Ruhago GM, Safiri S, Salomon JA, Sartorius B, Savic M, Sawhney M, She J, Sheikh A, Shiferaw MS, Shigematsu M, Singh JA, Somayaji R, Stanaway JD, Sufiyan MB, Taffere GR, Temsah MH, Thompson MJ, Tobe-Gai R, Topor-Madry R, Tran BX, Tran TT, Tuem KB, Ukwaja KN, Vollset SE, Walson JL, Weldegebreal F, Werdecker A, West TE, Yonemoto N, Zaki MES, Zhou L, Zodpey S, Vos T, Naghavi M, Lim SS, Mokdad AH, Murray CJL, Hay SI, Reiner RC. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis 2018; 18:1191-1210. [PMID: 30243584 PMCID: PMC6202443 DOI: 10.1016/s1473-3099(18)30310-4] [Citation(s) in RCA: 912] [Impact Index Per Article: 152.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/02/2018] [Accepted: 05/10/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Lower respiratory infections are a leading cause of morbidity and mortality around the world. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, provides an up-to-date analysis of the burden of lower respiratory infections in 195 countries. This study assesses cases, deaths, and aetiologies spanning the past 26 years and shows how the burden of lower respiratory infection has changed in people of all ages. METHODS We used three separate modelling strategies for lower respiratory infections in GBD 2016: a Bayesian hierarchical ensemble modelling platform (Cause of Death Ensemble model), which uses vital registration, verbal autopsy data, and surveillance system data to predict mortality due to lower respiratory infections; a compartmental meta-regression tool (DisMod-MR), which uses scientific literature, population representative surveys, and health-care data to predict incidence, prevalence, and mortality; and modelling of counterfactual estimates of the population attributable fraction of lower respiratory infection episodes due to Streptococcus pneumoniae, Haemophilus influenzae type b, influenza, and respiratory syncytial virus. We calculated each modelled estimate for each age, sex, year, and location. We modelled the exposure level in a population for a given risk factor using DisMod-MR and a spatio-temporal Gaussian process regression, and assessed the effectiveness of targeted interventions for each risk factor in children younger than 5 years. We also did a decomposition analysis of the change in LRI deaths from 2000-16 using the risk factors associated with LRI in GBD 2016. FINDINGS In 2016, lower respiratory infections caused 652 572 deaths (95% uncertainty interval [UI] 586 475-720 612) in children younger than 5 years (under-5s), 1 080 958 deaths (943 749-1 170 638) in adults older than 70 years, and 2 377 697 deaths (2 145 584-2 512 809) in people of all ages, worldwide. Streptococcus pneumoniae was the leading cause of lower respiratory infection morbidity and mortality globally, contributing to more deaths than all other aetiologies combined in 2016 (1 189 937 deaths, 95% UI 690 445-1 770 660). Childhood wasting remains the leading risk factor for lower respiratory infection mortality among children younger than 5 years, responsible for 61·4% of lower respiratory infection deaths in 2016 (95% UI 45·7-69·6). Interventions to improve wasting, household air pollution, ambient particulate matter pollution, and expanded antibiotic use could avert one under-5 death due to lower respiratory infection for every 4000 children treated in the countries with the highest lower respiratory infection burden. INTERPRETATION Our findings show substantial progress in the reduction of lower respiratory infection burden, but this progress has not been equal across locations, has been driven by decreases in several primary risk factors, and might require more effort among elderly adults. By highlighting regions and populations with the highest burden, and the risk factors that could have the greatest effect, funders, policy makers, and programme implementers can more effectively reduce lower respiratory infections among the world's most susceptible populations. FUNDING Bill & Melinda Gates Foundation.
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Rai RK, Jaacks LM, Bromage S, Barik A, Fawzi WW, Chowdhury A. Prospective cohort study of overweight and obesity among rural Indian adults: sociodemographic predictors of prevalence, incidence and remission. BMJ Open 2018; 8:e021363. [PMID: 30166296 PMCID: PMC6119421 DOI: 10.1136/bmjopen-2017-021363] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To assess sociodemographic predictors of prevalence, incidence and remission of overweight including obesity among adults (aged ≥18 years) in rural Eastern India. DESIGN Prospective cohort study. SETTING Birbhum Health and Demographic Surveillance System, West Bengal, India. PARTICIPANTS Self-weighted sample of 24 115 adults (men: 10915, women: 13200) enrolled in 2008 were followed up for body mass index (BMI) reassessment in 2017. PRIMARY AND SECONDARY OUTCOME MEASURES Measured BMI was categorised as: underweight (<18.5 kg/m2), normal weight (18.5-22.9 kg/m2) and overweight including obesity (≥23 kg/m2; hereinafter overweight). Incident overweight was defined as transition from normal weight in 2008 to overweight in 2017, whereas if overweight individuals in 2008 measured normal BMI in 2017, it was classified as remission from overweight. RESULTS In 2008, 10.1% of men and 14.6% of women were overweight, whereas 17.3% of men and 24.7% of women were overweight in 2017. At the same time, in 2017, 35.6% of men and 33.3% of women were underweight. Incident overweight was 19.0% among men and 27.2% among women, whereas remission among men was higher (15.4%) than women (11.5%). Women were more likely to be overweight in 2008 and to experience incident overweight than men. For men and women, education level and wealth were positively associated with prevalence and incidence of overweight. Remission from overweight was less likely in Sainthia, a business hub in the district, as compared with Mohammad Bazar, a more rural area. CONCLUSION A nutrition transition to higher risk of overweight is evident in this rural setting in India, especially among women and individuals with high socioeconomic status. At the same time, a high prevalence of underweight persists, resulting in a significant double burden. Culturally sensitive interventions that address both ends of the malnutrition spectrum should be prioritised.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Birbhum, West Bengal, India
| | - Lindsay M Jaacks
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sabri Bromage
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Anamitra Barik
- Society for Health and Demographic Surveillance, Birbhum, West Bengal, India
- Suri District Hospital and Niramoy TB Sanatorium, Birbhum, West Bengal, India
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Abhijit Chowdhury
- Society for Health and Demographic Surveillance, Birbhum, West Bengal, India
- Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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Naghavi M, Marczak LB, Kutz M, Shackelford KA, Arora M, Miller-Petrie M, Aichour MTE, Akseer N, Al-Raddadi RM, Alam K, Alghnam SA, Antonio CAT, Aremu O, Arora A, Asadi-Lari M, Assadi R, Atey TM, Avila-Burgos L, Awasthi A, Ayala Quintanilla BP, Barker-Collo SL, Bärnighausen TW, Bazargan-Hejazi S, Behzadifar M, Behzadifar M, Bennett JR, Bhalla A, Bhutta ZA, Bilal AI, Borges G, Borschmann R, Brazinova A, Campuzano Rincon JC, Carvalho F, Castañeda-Orjuela CA, Dandona L, Dandona R, Dargan PI, De Leo D, Dharmaratne SD, Ding EL, Phuc Do H, Doku DT, Doyle KE, Driscoll TR, Edessa D, El-Khatib Z, Endries AY, Esteghamati A, Faro A, Farzadfar F, Feigin VL, Fischer F, Foreman KJ, Franklin RC, Fullman N, Futran ND, Gebrehiwot TT, Gutiérrez RA, Hafezi-Nejad N, Haghparast Bidgoli H, Hailu GB, Haro JM, Hassen HY, Hawley C, Hendrie D, Híjar M, Hu G, Ilesanmi OS, Jakovljevic M, James SL, Jayaraman S, Jonas JB, Kahsay A, Kasaeian A, Keiyoro PN, Khader Y, Khalil IA, Khang YH, Khubchandani J, Ahmad Kiadaliri A, Kieling C, Kim YJ, Kosen S, Krohn KJ, Kumar GA, Lami FH, Lansingh VC, Larson HJ, Linn S, Lunevicius R, Magdy Abd El Razek H, Magdy Abd El Razek M, Malekzadeh R, Carvalho Malta D, Mason-Jones AJ, Matzopoulos R, Memiah PTN, Mendoza W, Meretoja TJ, Mezgebe HB, Miller TR, Mohammed S, Moradi-Lakeh M, Mori R, Nand D, Tat Nguyen C, Le Nguyen Q, Ningrum DNA, Akpojene Ogbo F, Olagunju AT, Patton GC, Phillips MR, Polinder S, Pourmalek F, Qorbani M, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman M, Rai RK, Ranabhat CL, Rawaf DL, Rawaf S, Rowhani-Rahbar A, Safdarian M, Safiri S, Sagar R, Salama JS, Sanabria J, Santric Milicevic MM, Sarmiento-Suárez R, Sartorius B, Satpathy M, Schwebel DC, Seedat S, Sepanlou SG, Shaikh MA, Sharew NT, Shiue I, Singh JA, Sisay M, Skirbekk V, Soares Filho AM, Stein DJ, Stokes MA, Sufiyan MB, Swaroop M, Sykes BL, Tabarés-Seisdedos R, Tadese F, Tran BX, Thanh Tran T, Ukwaja KN, Vasankari TJ, Vlassov V, Werdecker A, Ye P, Yip P, Yonemoto N, Younis MZ, Zaidi Z, El Sayed Zaki M, Hay SI, Lim SS, Lopez AD, Mokdad AH, Vos T, Murray CJL. Global Mortality From Firearms, 1990-2016. JAMA 2018; 320:792-814. [PMID: 30167700 PMCID: PMC6143020 DOI: 10.1001/jama.2018.10060] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 06/23/2018] [Indexed: 12/21/2022]
Abstract
Importance Understanding global variation in firearm mortality rates could guide prevention policies and interventions. Objective To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories. Design, Setting, and Participants This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths. Exposures Firearm ownership and access. Main Outcomes and Measures Cause-specific deaths by age, sex, location, and year. Results Worldwide, it was estimated that 251 000 (95% uncertainty interval [UI], 195 000-276 000) people died from firearm injuries in 2016, with 6 countries (Brazil, United States, Mexico, Colombia, Venezuela, and Guatemala) accounting for 50.5% (95% UI, 42.2%-54.8%) of those deaths. In 1990, there were an estimated 209 000 (95% UI, 172 000 to 235 000) deaths from firearm injuries. Globally, the majority of firearm injury deaths in 2016 were homicides (64.0% [95% UI, 54.2%-68.0%]; absolute value, 161 000 deaths [95% UI, 107 000-182 000]); additionally, 27% were firearm suicide deaths (67 500 [95% UI, 55 400-84 100]) and 9% were unintentional firearm deaths (23 000 [95% UI, 18 200-24 800]). From 1990 to 2016, there was no significant decrease in the estimated global age-standardized firearm homicide rate (-0.2% [95% UI, -0.8% to 0.2%]). Firearm suicide rates decreased globally at an annualized rate of 1.6% (95% UI, 1.1-2.0), but in 124 of 195 countries and territories included in this study, these levels were either constant or significant increases were estimated. There was an annualized decrease of 0.9% (95% UI, 0.5%-1.3%) in the global rate of age-standardized firearm deaths from 1990 to 2016. Aggregate firearm injury deaths in 2016 were highest among persons aged 20 to 24 years (for men, an estimated 34 700 deaths [95% UI, 24 900-39 700] and for women, an estimated 3580 deaths [95% UI, 2810-4210]). Estimates of the number of firearms by country were associated with higher rates of firearm suicide (P < .001; R2 = 0.21) and homicide (P < .001; R2 = 0.35). Conclusions and Relevance This study estimated between 195 000 and 276 000 firearm injury deaths globally in 2016, the majority of which were firearm homicides. Despite an overall decrease in rates of firearm injury death since 1990, there was variation among countries and across demographic subgroups.
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Affiliation(s)
- Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Laurie B Marczak
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Michael Kutz
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Megha Arora
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Molly Miller-Petrie
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Nadia Akseer
- Centre for Global Child Health, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Rajaa M Al-Raddadi
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khurshid Alam
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Suliman A Alghnam
- Department of Population Health, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
| | - Olatunde Aremu
- Department of Public and Community Health, Birmingham City University, Birmingham, England
| | - Amit Arora
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia
- Oral Health Services, Sydney Local Health District, Sydney, Australia
| | - Mohsen Asadi-Lari
- Department of Epidemiology and Biostatistics, Iran University of Medical Sciences, Tehran, Iran
- International Relations Department, Iranian Ministry of Health and Medical Education, Tehran, Iran
| | - Reza Assadi
- Education Development Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Leticia Avila-Burgos
- Center of Health System Research, The National Institute of Public Health, Cuernavaca, Mexico
| | - Ashish Awasthi
- Indian Institute of Public Health, Gandhinagar, India
- Public Health Foundation of India, Gurugram, India
| | - 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
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- Institute of Public Health, Heidelberg University, Heidelberg, Germany
- Department of Global Health and Population, Harvard University, Boston, Massachusetts
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, California
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorranmabad, Iran
| | - Meysam Behzadifar
- Faculty of Health and Nutrition, Lorestan University of Medical Sciences, Khorranmabad, Iran
| | - James R Bennett
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Ashish Bhalla
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Arebu Issa Bilal
- School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
| | - Guilherme Borges
- Department of Epidemiology, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - Rohan Borschmann
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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- National Institute of Health, Cuernavaca, Mexico
- Escuela de Medicina, Universidad Valle de Cuernavaca, Cuernavaca, Mexico
| | - Félix Carvalho
- Ucibio, Requimte, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Carlos A Castañeda-Orjuela
- Colombian National Health Observatory, Instituto Nacional de Salud, Bogota, Colombia
- Epidemiology and Public Health Evaluation Group, Universidad Nacional de Colombia, Bogota, Colombia
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
| | - Paul I Dargan
- Department of Clinical Toxicology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
- Department of Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Mt Gravatt, QLD, Australia
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Eric L Ding
- Harvard School of Public Health, Department of Nutrition, Harvard University, Boston, Massachusetts
| | - Huyen Phuc Do
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - David Teye Doku
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Kerrie E Doyle
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University (RMIT), Bundoora, VIC, Australia
| | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Dumessa Edessa
- School of Pharmacy, Haramaya University, Harar, Ethiopia
| | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Aman Yesuf Endries
- Department of Public Health, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - 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
| | - Valery L Feigin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Florian Fischer
- Department of Public Health Medicine, Bielefeld University, Bielefeld, Germany
| | - Kyle J Foreman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Richard Charles Franklin
- College of Public Health Medical and Veterinary Science, James Cook University, Douglas, QLD, Australia
| | - Nancy Fullman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Neal D Futran
- School of Medicine Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle
| | | | - Reyna Alma Gutiérrez
- Epidemiological and Psychosocial Investigations, National Institute of Psychiatry Ramon de la Fuente, Mexico City, Mexico
| | - Nima Hafezi-Nejad
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland
| | | | | | - Josep Maria Haro
- Research Unit, Parc Sanitari Sant Joan de Déu (CIBERSAM), Sant Boi de Llobregat, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Hamid Yimam Hassen
- Department of Public Health, Mizan-Tepi University, Mizan Teferi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Caitlin Hawley
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Delia Hendrie
- School of Public Health, Curtin University, Bentley, Perth, WA, Australia
| | - Martha Híjar
- Research Coordination, Fundación Entornos AC, Cuernavaca, Mexico
- CISS, National Institute of Public Health, Cuernavaca, Mexico
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | | | | | - Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Sudha Jayaraman
- Department of Surgery, Virginia Commonwealth University, Richmond
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- Capital Medical University, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Amaha Kahsay
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Peter Njenga Keiyoro
- School of Continuing and Distance Education, University of Nairobi, Nairobi, Kenya
| | - Yousef Khader
- Public Health and Community Medicine, Jordan University of Science and Technology, Alramtha, Jordan
| | - Ibrahim A Khalil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Young-Ho Khang
- Department of Health Policy and Management, College of Medicine, Seoul National University, Seoul, South Korea
- Institute of Health Policy and Management, SNU Medical Research Center, Seoul National University, Seoul, South Korea
| | - Jagdish Khubchandani
- Department of Nutrition and Health Science, Ball State University, Muncie, Indiana
| | | | - Christian Kieling
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Child & Adolescent Psychiatry Division, Hospital of Clinics of Porto Alegre, Porto Alegre, Brazil
| | - Yun Jin Kim
- School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | | | - Kristopher J Krohn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - G Anil Kumar
- Public Health Foundation of India, Gurugram, India
| | - Faris Hasan Lami
- Department of Community and Family Medicine, Academy of Medical Science, Baghdad, Iraq
| | - Van C Lansingh
- Helpmesee, New York, New York
- Department of International Relations, Mexican Institute of Ophthalmology, Queretaro, Mexico
| | - Heidi Jane Larson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Shai Linn
- School of Public Health, University of Haifa, Haifa, Israel
| | - Raimundas Lunevicius
- General Surgery Department, Aintree University Hospital National Health Service Foundation Trust (NHS), Liverpool, United Kingdom
- School of Medicine, University of Liverpool, Liverpool, United Kingdom
| | | | | | - 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
- Departamento Materno Infantil e Saúde Publica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Richard Matzopoulos
- Burden of Disease Research 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 T N Memiah
- Department of Public Health, University of West Florida, Pensacola
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
| | - Tuomo J Meretoja
- Comprehensive Cancer Center, Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- Department of Surgery, University of Helsinki, Helsinki, Finland
| | | | - Ted R Miller
- School of Public Health, Curtin University, Bentley, Perth, WA, Australia
- Pacific Institute for Research & Evaluation, Calverton, Maryland
| | - Shafiu Mohammed
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Rintaro Mori
- Department of Health Policy, National Center for Child Health and Development, Setagaya, Japan
| | - Devina Nand
- Health Information Unit, Ministry of Health, Suva, Fiji
- Accamargo Cancer Center, São Paulo, Brazil
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Quyen Le Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Dina Nur Anggraini Ningrum
- Public Health Department, Semarang State University, Kota Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | | | - Andrew T Olagunju
- School of Medicine, University of Adelaide, Adelaide, SA, Australia
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Department of Paediatrics, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Farshad Pourmalek
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahfuzar Rahman
- Research and Evaluation Division, BRAC (Bangladesh Rehabilitation Assistance Committee), Dhaka, Bangladesh
| | - Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, India
- Department of Economics, University of Göttingen, Göttingen, Germany
| | - Chhabi Lal Ranabhat
- Institute for Poverty Alleviation and International Development, Yonsei University, South Korea
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education & Training, Imperial College London, London, United Kingdom
- University College London Hospitals, London, United Kingdom
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
- Public Health England, London, United Kingdom
| | | | - Mahdi Safdarian
- Sina Trauma and Surgery Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Joseph S Salama
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, West Virginia
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Milena M Santric Milicevic
- Faculty of Medicine, Institute of Social Medicine, Centre School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Rodrigo Sarmiento-Suárez
- Department of Health and Society, Faculty of Medicine, Universidad Ciencias Aplicadas y Ambientales, Bogotá, Colombia
| | - Benn Sartorius
- Department of Public Health Medicine, University of Kwazulu-Natal, Durban, South Africa
| | - Maheswar Satpathy
- UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - 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
| | | | | | - Ivy Shiue
- Instituts Für Medizinische Epidemiologie, Biometrie Und Informatik, Martin Luther University Halle-Wittenberg, Haale, Germany
| | - Jasvinder A Singh
- School of Medicine, University of Alabama at Birmingham
- Department of Epidemiology, University of Alabama at Birmingham
| | - Mekonnen Sisay
- School of Pharmacy, Haramaya University, Harar, Ethiopia
| | | | - Adauto Martins Soares Filho
- Department of Diseases and Noncommunicable Diseases and Health Promotion, Federal Ministry of Health, Brasilia, Brazil
| | - Dan J Stein
- South African Medical Research Council, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | | | - Mamta Swaroop
- Department of Surgery, Northwestern University, Chicago, Illinois
| | - Bryan L Sykes
- Department of Criminology, Law, & Society, University of California Irvine
| | | | - Fentaw Tadese
- Department of Public Health, Wollo University, Dessie, Ethiopia
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Tung Thanh Tran
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | | | - Vasily Vlassov
- Department of Health Care Management and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Andrea Werdecker
- Demographic Change and Ageing, Federal Institute for Population Research, Wiesbaden, Germany
| | - Pengpeng Ye
- Division of Injury Prevention and Mental Health Improvement, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, China
| | - Paul Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong SAR, China
| | - Naohiro Yonemoto
- Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Mustafa Z Younis
- Healthcare Management-Health Economics & Finance/Global Health, Jackson State University, Jackson, Missouri
- Research Center for Public Health, Tsinghua University, Beijing, China
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
- Faculty of Medical Sciences, A.C.S. Medical College and Hospital, Algiers, Algeria
| | | | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
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Rai RK, Fawzi WW, Barik A, Chowdhury A. The burden of iron-deficiency anaemia among women in India: how have iron and folic acid interventions fared? WHO South East Asia J Public Health 2018; 7:18-23. [PMID: 29582845 DOI: 10.4103/2224-3151.228423] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Iron-deficiency anaemia (IDA) among women in India is a problem of major public health significance. Using data from three waves of the National Family Health Survey, this article discusses the burden of and trend in IDA among women in India, and discusses the level of iron and folic acid (IFA) supplementation and its potential role in reducing the burden of IDA. Between 2005-2006 and 2015-2016, IDA in India decreased by only 3.5 percentage points (from 56.5% in 2005-2006 to 53.0% in 2015-2016) for women aged 15-49 years. However, during the same period, of 27 states compared, IDA increased in eight: Delhi, Haryana, Himachal Pradesh, Kerala, Meghalaya, Tamil Nadu, Punjab and Uttar Pradesh; furthermore, some of these (e.g. Kerala) are states that rank among the highest on the state Human Development Index but had failed to contain the burden of IDA. Although there is a standard guideline for IFA supplementation in place, the IFA intervention appears to be ineffective in reducing the burden of IDA in India (nationally only 30.3 % of mothers consumed IFA for 100 days or more when they were pregnant), probably due to irregular consumption of IFA where the provision of screening under the National Iron+ Initiative scheme appears to be unsuccessful. To strengthen the IFA intervention and its uptake, a concerted effort of community-level health workers (accredited social health activists, auxiliary nurse midwives and anganwadi workers) is urgently needed. In addition, food-based strategies (dietary diversification and food fortification), food supplementation and improvement of health services are required to reduce the burden of anaemia among women in India.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
| | - Wafaie W Fawzi
- Department of Global Health and Population, Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, United States of America
| | - Anamitra Barik
- Chest Clinic, Suri District Hospital, West Bengal State Department of Health and Family Welfare, Suri, West Bengal, India
| | - Abhijit Chowdhury
- Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
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Dieleman JL, Sadat N, Chang AY, Fullman N, Abbafati C, Acharya P, Adou AK, Ahmad Kiadaliri A, Alam K, Alizadeh-Navaei R, Alkerwi A, Ammar W, Antonio CAT, Aremu O, Asgedom SW, Atey TM, Avila-Burgos L, Ayer R, Badali H, Banach M, Banstola A, Barac A, Belachew AB, Birungi C, Bragazzi NL, Breitborde NJK, Cahuana-Hurtado L, Car J, Catalá-López F, Chapin A, Chen CS, Dandona L, Dandona R, Daryani A, Dharmaratne SD, Dubey M, Edessa D, Eldrenkamp E, Eshrati B, Faro A, Feigl AB, Fenny AP, Fischer F, Foigt N, Foreman KJ, Ghimire M, Goli S, Hailu AD, Hamidi S, Harb HL, Hay SI, Hendrie D, Ikilezi G, Javanbakht M, John D, Jonas JB, Kaldjian A, Kasaeian A, Kasahun YC, Khalil IA, Khang YH, Khubchandani J, Kim YJ, Kinge JM, Kosen S, Krohn KJ, Kumar GA, Lafranconi A, Lam H, Listl S, Magdy Abd El Razek H, Magdy Abd El Razek M, Majeed A, Malekzadeh R, Malta DC, Martinez G, Mensah GA, Meretoja A, Micah A, Miller TR, Mirrakhimov EM, Mlashu FW, Mohammed E, Mohammed S, Moses M, Mousavi SM, Naghavi M, Nangia V, Ngalesoni FN, Nguyen CT, Nguyen TH, Niriayo Y, Noroozi M, Owolabi MO, Patel T, Pereira DM, Polinder S, Qorbani M, Rafay A, Rafiei A, Rahimi-Movaghar V, Rai RK, Ram U, Ranabhat CL, Ray SE, Reiner RC, Sajadi HS, Santoro R, Santos JV, Sarker AR, Sartorius B, Satpathy M, Sepanlou SG, Shaikh MA, Sharif M, She J, Sheikh A, Shrime MG, Sisay M, Soneji S, Soofi M, Sorensen RJD, Tadesse H, Tao T, Templin T, Tesema AG, Thapa S, Tobe-Gai R, Topor-Madry R, Tran BX, Tran KB, Tran TT, Undurraga EA, Vasankari T, Violante FS, Werdecker A, Wijeratne T, Xu G, Yonemoto N, Younis MZ, Yu C, Zaki MES, Zlavog B, Murray CJL. Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40. Lancet 2018; 391:1783-1798. [PMID: 29678341 PMCID: PMC5946843 DOI: 10.1016/s0140-6736(18)30697-4] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 03/09/2018] [Accepted: 03/13/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. METHODS We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country's UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios. FINDINGS In the reference scenario, global health spending was projected to increase from US$10 trillion (95% uncertainty interval 10 trillion to 10 trillion) in 2015 to $20 trillion (18 trillion to 22 trillion) in 2040. Per capita health spending was projected to increase fastest in upper-middle-income countries, at 4·2% (3·4-5·1) per year, followed by lower-middle-income countries (4·0%, 3·6-4·5) and low-income countries (2·2%, 1·7-2·8). Despite global growth, per capita health spending was projected to range from only $40 (24-65) to $413 (263-668) in 2040 in low-income countries, and from $140 (90-200) to $1699 (711-3423) in lower-middle-income countries. Globally, the share of health spending covered by pooled resources would range widely, from 19·8% (10·3-38·6) in Nigeria to 97·9% (96·4-98·5) in Seychelles. Historical performance on the UHC index was significantly associated with pooled resources per capita. Across the alternative scenarios, we estimate UHC reaching between 5·1 billion (4·9 billion to 5·3 billion) and 5·6 billion (5·3 billion to 5·8 billion) lives in 2030. INTERPRETATION We chart future scenarios for health spending and its relationship with UHC. Ensuring that all countries have sustainable pooled health resources is crucial to the achievement of UHC. FUNDING The Bill & Melinda Gates Foundation.
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Kyu HH, Maddison ER, Henry NJ, Mumford JE, Barber R, Shields C, Brown JC, Nguyen G, Carter A, Wolock TM, Wang H, Liu PY, Reitsma M, Ross JM, Abajobir AA, Abate KH, Abbas K, Abera M, Abera SF, Abera Hareri H, Ahmed M, Alene KA, Alvis-Guzman N, Amo-Adjei J, Andrews J, Ansari H, Antonio CA, Anwari P, Asayesh H, Atey TM, Atre S, Barac A, Beardsley J, Bedi N, Bensenor I, Beyene AS, Butt ZA, Cardona PJ, Christopher D, Dandona L, Dandona R, Deribe K, Deribew A, Ehrenkranz R, El Sayed Zaki M, Endries A, Feyissa TR, Fischer F, Gai R, Garcia-Basteiro AL, Gebrehiwot TT, Gesesew H, Getahun B, Gona P, Goodridge A, Gugnani H, Haghparast-Bidgoli H, Hailu GB, Hassen HY, Hilawe E, Horita N, Jacobsen KH, Jonas JB, Kasaeian A, Kedir MS, Kemmer L, Khader Y, Khan E, Khang YH, Khoja AT, Kim YJ, Koul P, Koyanagi A, Krohn KJ, Kumar GA, Kutz M, Lodha R, Magdy And El Razek H, Majdzadeh R, Manyazewal T, Memish Z, Mendoza W, Mezgebe HB, Mohammed S, Ogbo FA, Oh IH, Oren E, Osgood-Zimmerman A, Pereira D, Plass D, Pourmalek F, Qorbani M, Rafay A, Rahman M, Rai RK, Rao PC, Ray SE, Reiner R, Reinig N, Safiri S, Salomon JA, Sandar L, Sartorius B, Shamsizadeh M, Shey M, Shifti DM, Shore H, Singh J, Sreeramareddy CT, Swaminathan S, Swartz SJ, Tadese F, Tedla BA, Tegegne BS, Tessema B, Topor-Madry R, Ukwaja KN, Uthman OA, Vlassov V, Vollset SE, Wakayo T, Weldegebreal S, Westerman R, Workicho A, Yonemoto N, Yoon SJ, Yotebieng M, Naghavi M, Hay SI, Vos T, Murray CJL. The global burden of tuberculosis: results from the Global Burden of Disease Study 2015. Lancet Infect Dis 2018; 18:261-284. [PMID: 29223583 PMCID: PMC5831985 DOI: 10.1016/s1473-3099(17)30703-x] [Citation(s) in RCA: 202] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/30/2017] [Accepted: 10/02/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND An understanding of the trends in tuberculosis incidence, prevalence, and mortality is crucial to tracking of the success of tuberculosis control programmes and identification of remaining challenges. We assessed trends in the fatal and non-fatal burden of tuberculosis over the past 25 years for 195 countries and territories. METHODS We analysed 10 691 site-years of vital registration data, 768 site-years of verbal autopsy data, and 361 site-years of mortality surveillance data using the Cause of Death Ensemble model to estimate tuberculosis mortality rates. We analysed all available age-specific and sex-specific data sources, including annual case notifications, prevalence surveys, and estimated cause-specific mortality, to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how observed tuberculosis incidence, prevalence, and mortality differed from expected trends as predicted by the Socio-demographic Index (SDI), a composite indicator based on income per capita, average years of schooling, and total fertility rate. We also estimated tuberculosis mortality and disability-adjusted life-years attributable to the independent effects of risk factors including smoking, alcohol use, and diabetes. FINDINGS Globally, in 2015, the number of tuberculosis incident cases (including new and relapse cases) was 10·2 million (95% uncertainty interval 9·2 million to 11·5 million), the number of prevalent cases was 10·1 million (9·2 million to 11·1 million), and the number of deaths was 1·3 million (1·1 million to 1·6 million). Among individuals who were HIV negative, the number of incident cases was 8·8 million (8·0 million to 9·9 million), the number of prevalent cases was 8·9 million (8·1 million to 9·7 million), and the number of deaths was 1·1 million (0·9 million to 1·4 million). Annualised rates of change from 2005 to 2015 showed a faster decline in mortality (-4·1% [-5·0 to -3·4]) than in incidence (-1·6% [-1·9 to -1·2]) and prevalence (-0·7% [-1·0 to -0·5]) among HIV-negative individuals. The SDI was inversely associated with HIV-negative mortality rates but did not show a clear gradient for incidence and prevalence. Most of Asia, eastern Europe, and sub-Saharan Africa had higher rates of HIV-negative tuberculosis burden than expected given their SDI. Alcohol use accounted for 11·4% (9·3-13·0) of global tuberculosis deaths among HIV-negative individuals in 2015, diabetes accounted for 10·6% (6·8-14·8), and smoking accounted for 7·8% (3·8-12·0). INTERPRETATION Despite a concerted global effort to reduce the burden of tuberculosis, it still causes a large disease burden globally. Strengthening of health systems for early detection of tuberculosis and improvement of the quality of tuberculosis care, including prompt and accurate diagnosis, early initiation of treatment, and regular follow-up, are priorities. Countries with higher than expected tuberculosis rates for their level of sociodemographic development should investigate the reasons for lagging behind and take remedial action. Efforts to prevent smoking, alcohol use, and diabetes could also substantially reduce the burden of tuberculosis. FUNDING Bill & Melinda Gates Foundation.
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Barik A, Das K, Chowdhury A, Rai RK. Metabolic syndrome among rural Indian adults. Clin Nutr ESPEN 2018; 23:129-135. [DOI: 10.1016/j.clnesp.2017.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/24/2017] [Accepted: 11/14/2017] [Indexed: 11/30/2022]
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Abstract
India accounts for the highest number of maternal and child deaths globally. A large body of empirical research suggests that improvement in the coverage of institutional delivery is essential to reduce the burden of maternal and child death. However the dynamics of choice of place of delivery is poorly understood. Using qualitative survey data consisting of twelve focus group discussions, conducted in a rural setting of West Bengal, India, this study aims to understand the reasons behind preferring home or institution for delivery. Findings reveal that some women who underwent an institutional delivery preferred to deliver their baby at home. On the other hand, of women who delivered their baby at home, 60% wanted to deliver their babies in institutions but could not do so, primarily due to the unwillingness of family members and misreporting of the onset of true labour pain. With the help of Accredited Social Health Activists, the village level health workers, there is need for an intervention that focuses on educating household members (essentially targeting husbands and mother-in-laws) about birth preparedness, and identification of true labour pain.
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Affiliation(s)
- Ashoke Gorain
- Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, India
| | - Anamitra Barik
- Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, India
- Chest Clinic, Niramoy—District Tuberculosis Centre, District Hospital of Birbhum, Suri, Birbhum, West Bengal, India
| | - Abhijit Chowdhury
- Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, India
- Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, India
- * E-mail:
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Barik A, Sarkhel S, Basu S, Chowdhury A, Rai RK. Probable psychiatric disorder in a rural community of West Bengal, India. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1495-1500. [PMID: 29022074 DOI: 10.1007/s00127-017-1447-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/04/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE India faces multiple challenges to mitigate a high burden of psychiatric disorders. The risk of developing psychiatric disorder among the rural Indian population is poorly investigated. This study aims to understand the factors associated with probable psychiatric disorder (PPD) among a select rural Indian population. METHODS Data from the Birbhum population project of the society for health and demographic surveillance, West Bengal, India, were utilized. Cross-sectional data covering a sample of 31,135 respondents (male 15,384 and female 15,751) aged ≥ 16 years were used. The General Health Questionnaire-28 was administered and the responses were computed into three categories: psychological case, psychological caseness, and normal. Bivariate and multivariate ordered logit regression analyses were applied to attain the study objective. RESULTS Of the total population, 26% of respondents were identified with PPD. People aged ≥ 60 years, females, divorced/separated/widowed individuals, the unemployed and people with no formal education, individuals from the poorest economic group, and people with a history of selling or mortgaging assets towards their healthcare expenditure had a higher prevalence of psychiatric case within their respective group. CONCLUSIONS A high burden of PPD was estimated in the select rural community. While designing an intervention for measuring and addressing psychiatric disorders, the socioeconomic gradient of PPD could be helpful.
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Affiliation(s)
- Anamitra Barik
- Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, 731101, India
- Niramay TB Sanatorium and Chest Clinic, District Hospital of Birbhum, Suri, Birbhum, West Bengal, 731101, India
| | - Sujit Sarkhel
- Institute of Post Graduate Medical Education and Research (IPGMER), 244, AJC Bose Road, Kolkata, 700 020, India
| | - Saugata Basu
- Department of Psychology, University of Calcutta, 92 APC Road, Kolkata, West Bengal, 700 009, India
| | - Abhijit Chowdhury
- Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, 731101, India
- Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research (IPGMER), 244, AJC Bose Road, Kolkata, 700 020, India
| | - Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, 731101, India.
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Barik A, Rai RK. Catch them young: grooming a new generation of physicians in India. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-017-0817-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Vos T, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulkader RS, Abdulle AM, Abebo TA, Abera SF, Aboyans V, Abu-Raddad LJ, Ackerman IN, Adamu AA, Adetokunboh O, Afarideh M, Afshin A, Agarwal SK, Aggarwal R, Agrawal A, Agrawal S, Ahmadieh H, Ahmed MB, Aichour MTE, Aichour AN, Aichour I, Aiyar S, Akinyemi RO, Akseer N, Al Lami FH, Alahdab F, Al-Aly Z, Alam K, Alam N, Alam T, Alasfoor D, Alene KA, Ali R, Alizadeh-Navaei R, Alkerwi A, Alla F, Allebeck P, Allen C, Al-Maskari F, Al-Raddadi R, Alsharif U, Alsowaidi S, Altirkawi KA, Amare AT, Amini E, Ammar W, Amoako YA, Andersen HH, Antonio CAT, Anwari P, Ärnlöv J, Artaman A, Aryal KK, Asayesh H, Asgedom SW, Assadi R, Atey TM, Atnafu NT, Atre SR, Avila-Burgos L, Avokphako EFGA, Awasthi A, Bacha U, Badawi A, Balakrishnan K, Banerjee A, Bannick MS, Barac A, Barber RM, Barker-Collo SL, Bärnighausen T, Barquera S, Barregard L, Barrero LH, Basu S, Battista B, Battle KE, Baune BT, Bazargan-Hejazi S, Beardsley J, Bedi N, Beghi E, Béjot Y, Bekele BB, Bell ML, Bennett DA, Bensenor IM, Benson J, Berhane A, Berhe DF, Bernabé E, Betsu BD, Beuran M, Beyene AS, Bhala N, Bhansali A, Bhatt S, Bhutta ZA, Biadgilign S, Bicer BK, Bienhoff K, Bikbov B, Birungi C, Biryukov S, Bisanzio D, Bizuayehu HM, Boneya DJ, Boufous S, Bourne RRA, Brazinova A, Brugha TS, Buchbinder R, Bulto LNB, Bumgarner BR, Butt ZA, Cahuana-Hurtado L, Cameron E, Car M, Carabin H, Carapetis JR, Cárdenas R, Carpenter DO, Carrero JJ, Carter A, Carvalho F, Casey DC, Caso V, Castañeda-Orjuela CA, Castle CD, Catalá-López F, Chang HY, Chang JC, Charlson FJ, Chen H, Chibalabala M, Chibueze CE, Chisumpa VH, Chitheer AA, Christopher DJ, Ciobanu LG, Cirillo M, Colombara D, Cooper C, Cortesi PA, Criqui MH, Crump JA, Dadi AF, Dalal K, Dandona L, Dandona R, das Neves J, Davitoiu DV, de Courten B, De Leo DD, Defo BK, Degenhardt L, Deiparine S, Dellavalle RP, Deribe K, Des Jarlais DC, Dey S, Dharmaratne SD, Dhillon PK, Dicker D, Ding EL, Djalalinia S, Do HP, Dorsey ER, dos Santos KPB, Douwes-Schultz D, Doyle KE, Driscoll TR, Dubey M, Duncan BB, El-Khatib ZZ, Ellerstrand J, Enayati A, Endries AY, Ermakov SP, Erskine HE, Eshrati B, Eskandarieh S, Esteghamati A, Estep K, Fanuel FBB, Farinha CSES, Faro A, Farzadfar F, Fazeli MS, Feigin VL, Fereshtehnejad SM, Fernandes JC, Ferrari AJ, Feyissa TR, Filip I, Fischer F, Fitzmaurice C, Flaxman AD, Flor LS, Foigt N, Foreman KJ, Franklin RC, Fullman N, Fürst T, Furtado JM, Futran ND, Gakidou E, Ganji M, Garcia-Basteiro AL, Gebre T, Gebrehiwot TT, Geleto A, Gemechu BL, Gesesew HA, Gething PW, Ghajar A, Gibney KB, Gill PS, Gillum RF, Ginawi IAM, Giref AZ, Gishu MD, Giussani G, Godwin WW, Gold AL, Goldberg EM, Gona PN, Goodridge A, Gopalani SV, Goto A, Goulart AC, Griswold M, Gugnani HC, Gupta R, Gupta R, Gupta T, Gupta V, Hafezi-Nejad N, Hailu GB, Hailu AD, Hamadeh RR, Hamidi S, Handal AJ, Hankey GJ, Hanson SW, Hao Y, Harb HL, Hareri HA, Haro JM, Harvey J, Hassanvand MS, Havmoeller R, Hawley C, Hay SI, Hay RJ, Henry NJ, Heredia-Pi IB, Hernandez JM, Heydarpour P, Hoek HW, Hoffman HJ, Horita N, Hosgood HD, Hostiuc S, Hotez PJ, Hoy DG, Htet AS, Hu G, Huang H, Huynh C, Iburg KM, Igumbor EU, Ikeda C, Irvine CMS, Jacobsen KH, Jahanmehr N, Jakovljevic MB, Jassal SK, Javanbakht M, Jayaraman SP, Jeemon P, Jensen PN, Jha V, Jiang G, John D, Johnson SC, Johnson CO, Jonas JB, Jürisson M, Kabir Z, Kadel R, Kahsay A, Kamal R, Kan H, Karam NE, Karch A, Karema CK, Kasaeian A, Kassa GM, Kassaw NA, Kassebaum NJ, Kastor A, Katikireddi SV, Kaul A, Kawakami N, Keiyoro PN, Kengne AP, Keren A, Khader YS, Khalil IA, Khan EA, Khang YH, Khosravi A, Khubchandani J, Kiadaliri AA, Kieling C, Kim YJ, Kim D, Kim P, Kimokoti RW, Kinfu Y, Kisa A, Kissimova-Skarbek KA, Kivimaki M, Knudsen AK, Kokubo Y, Kolte D, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kravchenko M, Krishnaswami S, Krohn KJ, Kumar GA, Kumar P, Kumar S, Kyu HH, Lal DK, Lalloo R, Lambert N, Lan Q, Larsson A, Lavados PM, Leasher JL, Lee PH, Lee JT, Leigh J, Leshargie CT, Leung J, Leung R, Levi M, Li Y, Li Y, Li Kappe D, Liang X, Liben ML, Lim SS, Linn S, Liu PY, Liu A, Liu S, Liu Y, Lodha R, Logroscino G, London SJ, Looker KJ, Lopez AD, Lorkowski S, Lotufo PA, Low N, Lozano R, Lucas TCD, Macarayan ERK, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahdavi M, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malhotra R, Malta DC, Mamun AA, Manguerra H, Manhertz T, Mantilla A, Mantovani LG, Mapoma CC, Marczak LB, Martinez-Raga J, Martins-Melo FR, Martopullo I, März W, Mathur MR, Mazidi M, McAlinden C, McGaughey M, McGrath JJ, McKee M, McNellan C, Mehata S, Mehndiratta MM, Mekonnen TC, Memiah P, Memish ZA, Mendoza W, Mengistie MA, Mengistu DT, Mensah GA, Meretoja TJ, Meretoja A, Mezgebe HB, Micha R, Millear A, Miller TR, Mills EJ, Mirarefin M, Mirrakhimov EM, Misganaw A, Mishra SR, Mitchell PB, Mohammad KA, Mohammadi A, Mohammed KE, Mohammed S, Mohanty SK, Mokdad AH, Mollenkopf SK, Monasta L, Montico M, Moradi-Lakeh M, Moraga P, Mori R, Morozoff C, Morrison SD, Moses M, Mountjoy-Venning C, Mruts KB, Mueller UO, Muller K, Murdoch ME, Murthy GVS, Musa KI, Nachega JB, Nagel G, Naghavi M, Naheed A, Naidoo KS, Naldi L, Nangia V, Natarajan G, Negasa DE, Negoi RI, Negoi I, Newton CR, Ngunjiri JW, Nguyen TH, Nguyen QL, Nguyen CT, Nguyen G, Nguyen M, Nichols E, Ningrum DNA, Nolte S, Nong VM, Norrving B, Noubiap JJN, O'Donnell MJ, Ogbo FA, Oh IH, Okoro A, Oladimeji O, Olagunju TO, Olagunju AT, Olsen HE, Olusanya BO, Olusanya JO, Ong K, Opio JN, Oren E, Ortiz A, Osgood-Zimmerman A, Osman M, Owolabi MO, PA M, Pacella RE, Pana A, Panda BK, Papachristou C, Park EK, Parry CD, Parsaeian M, Patten SB, Patton GC, Paulson K, Pearce N, Pereira DM, Perico N, Pesudovs K, Peterson CB, Petzold M, Phillips MR, Pigott DM, Pillay JD, Pinho C, Plass D, Pletcher MA, Popova S, Poulton RG, Pourmalek F, Prabhakaran D, Prasad NM, Prasad N, Purcell C, Qorbani M, Quansah R, Quintanilla BPA, Rabiee RHS, Radfar A, Rafay A, Rahimi K, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman MHU, Rahman M, Rai RK, Rajsic S, Ram U, Ranabhat CL, Rankin Z, Rao PC, Rao PV, Rawaf S, Ray SE, Reiner RC, Reinig N, Reitsma MB, Remuzzi G, Renzaho AMN, Resnikoff S, Rezaei S, Ribeiro AL, Ronfani L, Roshandel G, Roth GA, Roy A, Rubagotti E, Ruhago GM, Saadat S, Sadat N, Safdarian M, Safi S, Safiri S, Sagar R, Sahathevan R, Salama J, Saleem HOB, Salomon JA, Salvi SS, Samy AM, Sanabria JR, Santomauro D, Santos IS, Santos JV, Santric Milicevic MM, Sartorius B, Satpathy M, Sawhney M, Saxena S, Schmidt MI, Schneider IJC, Schöttker B, Schwebel DC, Schwendicke F, Seedat S, Sepanlou SG, Servan-Mori EE, Setegn T, Shackelford KA, Shaheen A, Shaikh MA, Shamsipour M, Shariful Islam SM, Sharma J, Sharma R, She J, Shi P, Shields C, Shifa GT, Shigematsu M, Shinohara Y, Shiri R, Shirkoohi R, Shirude S, Shishani K, Shrime MG, Sibai AM, Sigfusdottir ID, Silva DAS, Silva JP, Silveira DGA, Singh JA, Singh NP, Sinha DN, Skiadaresi E, Skirbekk V, Slepak EL, Sligar A, Smith DL, Smith M, Sobaih BHA, Sobngwi E, Sorensen RJD, Sousa TCM, Sposato LA, Sreeramareddy CT, Srinivasan V, Stanaway JD, Stathopoulou V, Steel N, Stein MB, Stein DJ, Steiner TJ, Steiner C, Steinke S, Stokes MA, Stovner LJ, Strub B, Subart M, Sufiyan MB, Sunguya BF, Sur PJ, Swaminathan S, Sykes BL, Sylte DO, Tabarés-Seisdedos R, Taffere GR, Takala JS, Tandon N, Tavakkoli M, Taveira N, Taylor HR, Tehrani-Banihashemi A, Tekelab T, Terkawi AS, Tesfaye DJ, Tesssema B, Thamsuwan O, Thomas KE, Thrift AG, Tiruye TY, Tobe-Gai R, Tollanes MC, Tonelli M, Topor-Madry R, Tortajada M, Touvier M, Tran BX, Tripathi S, Troeger C, Truelsen T, Tsoi D, Tuem KB, Tuzcu EM, Tyrovolas S, Ukwaja KN, Undurraga EA, Uneke CJ, Updike R, Uthman OA, Uzochukwu BSC, van Boven JFM, Varughese S, Vasankari T, Venkatesh S, Venketasubramanian N, Vidavalur R, Violante FS, Vladimirov SK, Vlassov VV, Vollset SE, Wadilo F, Wakayo T, Wang YP, Weaver M, Weichenthal S, Weiderpass E, Weintraub RG, Werdecker A, Westerman R, Whiteford HA, Wijeratne T, Wiysonge CS, Wolfe CDA, Woodbrook R, Woolf AD, Workicho A, Xavier D, Xu G, Yadgir S, Yaghoubi M, Yakob B, Yan LL, Yano Y, Ye P, Yimam HH, Yip P, Yonemoto N, Yoon SJ, Yotebieng M, Younis MZ, Zaidi Z, Zaki MES, Zegeye EA, Zenebe ZM, Zhang X, Zhou M, Zipkin B, Zodpey S, Zuhlke LJ, Murray CJL. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390:1211-1259. [PMID: 28919117 PMCID: PMC5605509 DOI: 10.1016/s0140-6736(17)32154-2] [Citation(s) in RCA: 4400] [Impact Index Per Article: 628.6] [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: 05/08/2017] [Revised: 07/22/2017] [Accepted: 07/26/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016. METHODS We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). FINDINGS Globally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57·6 million (95% uncertainty interval [UI] 40·8-75·9 million [7·2%, 6·0-8·3]), 45·1 million (29·0-62·8 million [5·6%, 4·0-7·2]), 36·3 million (25·3-50·9 million [4·5%, 3·8-5·3]), 34·7 million (23·0-49·6 million [4·3%, 3·5-5·2]), and 34·1 million (23·5-46·0 million [4·2%, 3·2-5·3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2·7% (95% UI 2·3-3·1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from non-communicable diseases has been growing rapidly across all SDI quintiles, partly because of population growth, but also the ageing of populations. The largest absolute increases in total numbers of YLDs globally were between the ages of 40 and 69 years. Age-standardised YLD rates for all conditions combined were 10·4% (95% UI 9·0-11·8) higher in women than in men. Iron-deficiency anaemia, migraine, Alzheimer's disease and other dementias, major depressive disorder, anxiety, and all musculoskeletal disorders apart from gout were the main conditions contributing to higher YLD rates in women. Men had higher age-standardised rates of substance use disorders, diabetes, cardiovascular diseases, cancers, and all injuries apart from sexual violence. Globally, we noted much less geographical variation in disability than has been documented for premature mortality. In 2016, there was a less than two times difference in age-standardised YLD rates for all causes between the location with the lowest rate (China, 9201 YLDs per 100 000, 95% UI 6862-11943) and highest rate (Yemen, 14 774 YLDs per 100 000, 11 018-19 228). INTERPRETATION The decrease in death rates since 1990 for most causes has not been matched by a similar decline in age-standardised YLD rates. For many large causes, YLD rates have either been stagnant or have increased for some causes, such as diabetes. As populations are ageing, and the prevalence of disabling disease generally increases steeply with age, health systems will face increasing demand for services that are generally costlier than the interventions that have led to declines in mortality in childhood or for the major causes of mortality in adults. Up-to-date information about the trends of disease and how this varies between countries is essential to plan for an adequate health-system response. FUNDING Bill & Melinda Gates Foundation, and the National Institute on Aging and the National Institute of Mental Health of the National Institutes of Health.
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Wang H, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, Abraha HN, Abu-Raddad LJ, Abu-Rmeileh NME, Adedeji IA, Adedoyin RA, Adetifa IMO, Adetokunboh O, Afshin A, Aggarwal R, Agrawal A, Agrawal S, Ahmad Kiadaliri A, Ahmed MB, Aichour MTE, Aichour AN, Aichour I, Aiyar S, Akanda AS, Akinyemiju TF, Akseer N, Al Lami FH, Alabed S, Alahdab F, Al-Aly Z, Alam K, Alam N, Alasfoor D, Aldridge RW, Alene KA, Al-Eyadhy A, Alhabib S, Ali R, Alizadeh-Navaei R, Aljunid SM, Alkaabi JM, Alkerwi A, Alla F, Allam SD, Allebeck P, Al-Raddadi R, Alsharif U, Altirkawi KA, Alvis-Guzman N, Amare AT, Ameh EA, Amini E, Ammar W, Amoako YA, Anber N, Andrei CL, Androudi S, Ansari H, Ansha MG, Antonio CAT, Anwari P, Ärnlöv J, Arora M, Artaman A, Aryal KK, Asayesh H, Asgedom SW, Asghar RJ, Assadi R, Assaye AM, Atey TM, Atre SR, Avila-Burgos L, Avokpaho EFGA, Awasthi A, Babalola TK, Bacha U, Badawi A, Balakrishnan K, Balalla S, Barac A, Barber RM, Barboza MA, Barker-Collo SL, Bärnighausen T, Barquera S, Barregard L, Barrero LH, Baune BT, Bazargan-Hejazi S, Bedi N, Beghi E, Béjot Y, Bekele BB, Bell ML, Bello AK, Bennett DA, Bennett JR, Bensenor IM, Benson J, Berhane A, Berhe DF, Bernabé E, Beuran M, Beyene AS, Bhala N, Bhansali A, Bhaumik S, Bhutta ZA, Bicer BK, Bidgoli HH, Bikbov B, Birungi C, Biryukov S, Bisanzio D, Bizuayehu HM, Bjerregaard P, Blosser CD, Boneya DJ, Boufous S, Bourne RRA, Brazinova A, Breitborde NJK, Brenner H, Brugha TS, Bukhman G, Bulto LNB, Bumgarner BR, Burch M, Butt ZA, Cahill LE, Cahuana-Hurtado L, Campos-Nonato IR, Car J, Car M, Cárdenas R, Carpenter DO, Carrero JJ, Carter A, Castañeda-Orjuela CA, Castro FF, Castro RE, Catalá-López F, Chen H, Chiang PPC, Chibalabala M, Chisumpa VH, Chitheer AA, Choi JYJ, Christensen H, Christopher DJ, Ciobanu LG, Cirillo M, Cohen AJ, Colquhoun SM, Coresh J, Criqui MH, Cromwell EA, Crump JA, Dandona L, Dandona R, Dargan PI, das Neves J, Davey G, Davitoiu DV, Davletov K, de Courten B, De Leo D, Degenhardt L, Deiparine S, Dellavalle RP, Deribe K, Deribew A, Des Jarlais DC, Dey S, Dharmaratne SD, Dherani MK, Diaz-Torné C, Ding EL, Dixit P, Djalalinia S, Do HP, Doku DT, Donnelly CA, dos Santos KPB, Douwes-Schultz D, Driscoll TR, Duan L, Dubey M, Duncan BB, Dwivedi LK, Ebrahimi H, El Bcheraoui C, Ellingsen CL, Enayati A, Endries AY, Ermakov SP, Eshetie S, Eshrati B, Eskandarieh S, Esteghamati A, Estep K, Fanuel FBB, Faro A, Farvid MS, Farzadfar F, Feigin VL, Fereshtehnejad SM, Fernandes JG, Fernandes JC, Feyissa TR, Filip I, Fischer F, Foigt N, Foreman KJ, Frank T, Franklin RC, Fraser M, Friedman J, Frostad JJ, Fullman N, Fürst T, Furtado JM, Futran ND, Gakidou E, Gambashidze K, Gamkrelidze A, Gankpé FG, Garcia-Basteiro AL, Gebregergs GB, Gebrehiwot TT, Gebrekidan KG, Gebremichael MW, Gelaye AA, Geleijnse JM, Gemechu BL, Gemechu KS, Genova-Maleras R, Gesesew HA, Gething PW, Gibney KB, Gill PS, Gillum RF, Giref AZ, Girma BW, Giussani G, Goenka S, Gomez B, Gona PN, Gopalani SV, Goulart AC, Graetz N, Gugnani HC, Gupta PC, Gupta R, Gupta R, Gupta T, Gupta V, Haagsma JA, Hafezi-Nejad N, Hakuzimana A, Halasa YA, Hamadeh RR, Hambisa MT, Hamidi S, Hammami M, Hancock J, Handal AJ, Hankey GJ, Hao Y, Harb HL, Hareri HA, Harikrishnan S, Haro JM, Hassanvand MS, Havmoeller R, Hay RJ, Hay SI, He F, Heredia-Pi IB, Herteliu C, Hilawe EH, Hoek HW, Horita N, Hosgood HD, Hostiuc S, Hotez PJ, Hoy DG, Hsairi M, Htet AS, Hu G, Huang JJ, Huang H, Iburg KM, Igumbor EU, Ileanu BV, Inoue M, Irenso AA, Irvine CMS, Islam SMS, Islam N, Jacobsen KH, Jaenisch T, Jahanmehr N, Jakovljevic MB, Javanbakht M, Jayatilleke AU, Jeemon P, Jensen PN, Jha V, Jin Y, John D, John O, Johnson SC, Jonas JB, Jürisson M, Kabir Z, Kadel R, Kahsay A, Kalkonde Y, Kamal R, Kan H, Karch A, Karema CK, Karimi SM, Karthikeyan G, Kasaeian A, Kassaw NA, Kassebaum NJ, Kastor A, Katikireddi SV, Kaul A, Kawakami N, Kazanjan K, Keiyoro PN, Kelbore SG, Kemp AH, Kengne AP, Keren A, Kereselidze M, Kesavachandran CN, Ketema EB, Khader YS, Khalil IA, Khan EA, Khan G, Khang YH, Khera S, Khoja ATA, Khosravi MH, Kibret GD, Kieling C, Kim YJ, Kim CI, Kim D, Kim P, Kim S, Kimokoti RW, Kinfu Y, Kishawi S, Kissoon N, Kivimaki M, Knudsen AK, Kokubo Y, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kravchenko M, Krohn KJ, Kuate Defo B, Kuipers EJ, Kulikoff XR, Kulkarni VS, Kumar GA, Kumar P, Kumsa FA, Kutz M, Lachat C, Lagat AK, Lager ACJ, Lal DK, Lalloo R, Lambert N, Lan Q, Lansingh VC, Larson HJ, Larsson A, Laryea DO, Lavados PM, Laxmaiah A, Lee PH, Leigh J, Leung J, Leung R, Levi M, Li Y, Liao Y, Liben ML, Lim SS, Linn S, Lipshultz SE, Liu S, Lodha R, Logroscino G, Lorch SA, Lorkowski S, Lotufo PA, Lozano R, Lunevicius R, Lyons RA, Ma S, Macarayan ER, Machado IE, Mackay MT, Magdy Abd El Razek M, Magis-Rodriguez C, Mahdavi M, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malhotra R, Malta DC, Mantovani LG, Manyazewal T, Mapoma CC, Marczak LB, Marks GB, Martin EA, Martinez-Raga J, Martins-Melo FR, Massano J, Maulik PK, Mayosi BM, Mazidi M, McAlinden C, McGarvey ST, McGrath JJ, McKee M, Mehata S, Mehndiratta MM, Mehta KM, Meier T, Mekonnen TC, Meles KG, Memiah P, Memish ZA, Mendoza W, Mengesha MM, Mengistie MA, Mengistu DT, Menon GR, Menota BG, Mensah GA, Meretoja TJ, Meretoja A, Mezgebe HB, Micha R, Mikesell J, Miller TR, Mills EJ, Minnig S, Mirarefin M, Mirrakhimov EM, Misganaw A, Mishra SR, Mohammad KA, Mohammadi A, Mohammed KE, Mohammed S, Mohan MBV, Mohanty SK, Mokdad AH, Mollenkopf SK, Molokhia M, Monasta L, Montañez Hernandez JC, Montico M, Mooney MD, Moore AR, Moradi-Lakeh M, Moraga P, Morawska L, Mori R, Morrison SD, Mruts KB, Mueller UO, Mullany E, Muller K, Murthy GVS, Murthy S, Musa KI, Nachega JB, Nagata C, Nagel G, Naghavi M, Naidoo KS, Nanda L, Nangia V, Nascimento BR, Natarajan G, Negoi I, Nguyen CT, Nguyen QL, Nguyen TH, Nguyen G, Ningrum DNA, Nisar MI, Nomura M, Nong VM, Norheim OF, Norrving B, Noubiap JJN, Nyakarahuka L, O'Donnell MJ, Obermeyer CM, Ogbo FA, Oh IH, Okoro A, Oladimeji O, Olagunju AT, Olusanya BO, Olusanya JO, Oren E, Ortiz A, Osgood-Zimmerman A, Ota E, Owolabi MO, Oyekale AS, PA M, Pacella RE, Pakhale S, Pana A, Panda BK, Panda-Jonas S, Park EK, Parsaeian M, Patel T, Patten SB, Patton GC, Paudel D, Pereira DM, Perez-Padilla R, Perez-Ruiz F, Perico N, Pervaiz A, Pesudovs K, Peterson CB, Petri WA, Petzold M, Phillips MR, Piel FB, Pigott DM, Pishgar F, Plass D, Polinder S, Popova S, Postma MJ, Poulton RG, Pourmalek F, Prasad N, Purwar M, Qorbani M, Quintanilla BPA, Rabiee RHS, Radfar A, Rafay A, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman MHU, Rahman SU, Rahman M, Rai RK, Rajsic S, Ram U, Rana SM, Ranabhat CL, Rao PV, Rawaf S, Ray SE, Rego MAS, Rehm J, Reiner RC, Remuzzi G, Renzaho AMN, Resnikoff S, Rezaei S, Rezai MS, Ribeiro AL, Rivas JC, Rokni MB, Ronfani L, Roshandel G, Roth GA, Rothenbacher D, Roy A, Rubagotti E, Ruhago GM, Saadat S, Sabde YD, Sachdev PS, Sadat N, Safdarian M, Safi S, Safiri S, Sagar R, Sahathevan R, Sahebkar A, Sahraian MA, Salama J, Salamati P, Salomon JA, Salvi SS, Samy AM, Sanabria JR, Sanchez-Niño MD, Santos IS, Santric Milicevic MM, Sarmiento-Suarez R, Sartorius B, Satpathy M, Sawhney M, Saxena S, Saylan MI, Schmidt MI, Schneider IJC, Schulhofer-Wohl S, Schutte AE, Schwebel DC, Schwendicke F, Seedat S, Seid AM, Sepanlou SG, Servan-Mori EE, Shackelford KA, Shaheen A, Shahraz S, Shaikh MA, Shamsipour M, Shamsizadeh M, Sharma J, Sharma R, She J, Shen J, Shetty BP, Shi P, Shibuya K, Shifa GT, Shigematsu M, Shiri R, Shiue I, Shrime MG, Sigfusdottir ID, Silberberg DH, Silpakit N, Silva DAS, Silva JP, Silveira DGA, Sindi S, Singh JA, Singh PK, Singh A, Singh V, Sinha DN, Skarbek KAK, Skiadaresi E, Sligar A, Smith DL, Sobaih BHA, Sobngwi E, Soneji S, Soriano JB, Sreeramareddy CT, Srinivasan V, Stathopoulou V, Steel N, Stein DJ, Steiner C, Stöckl H, Stokes MA, Strong M, Sufiyan MB, Suliankatchi RA, Sunguya BF, Sur PJ, Swaminathan S, Sykes BL, Szoeke CEI, Tabarés-Seisdedos R, Tadakamadla SK, Tadese F, Tandon N, Tanne D, Tarajia M, Tavakkoli M, Taveira N, Tehrani-Banihashemi A, Tekelab T, Tekle DY, Temsah MH, Terkawi AS, Tesema CL, Tesssema B, Theis A, Thomas N, Thompson AH, Thomson AJ, Thrift AG, Tiruye TY, Tobe-Gai R, Tonelli M, Topor-Madry R, Topouzis F, Tortajada M, Tran BX, Truelsen T, Trujillo U, Tsilimparis N, Tuem KB, Tuzcu EM, Tyrovolas S, Ukwaja KN, Undurraga EA, Uthman OA, Uzochukwu BSC, van Boven JFM, Varakin YY, Varughese S, Vasankari T, Vasconcelos AMN, Velasquez IM, Venketasubramanian N, Vidavalur R, Violante FS, Vishnu A, Vladimirov SK, Vlassov VV, Vollset SE, Vos T, Waid JL, Wakayo T, Wang YP, Weichenthal S, Weiderpass E, Weintraub RG, Werdecker A, Wesana J, Wijeratne T, Wilkinson JD, Wiysonge CS, Woldeyes BG, Wolfe CDA, Workicho A, Workie SB, Xavier D, Xu G, Yaghoubi M, Yakob B, Yalew AZ, Yan LL, Yano Y, Yaseri M, Ye P, Yimam HH, Yip P, Yirsaw BD, Yonemoto N, Yoon SJ, Yotebieng M, Younis MZ, Zaidi Z, Zaki MES, Zeeb H, Zenebe ZM, Zerfu TA, Zhang AL, Zhang X, Zodpey S, Zuhlke LJ, Lopez AD, Murray CJL. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390:1084-1150. [PMID: 28919115 PMCID: PMC5605514 DOI: 10.1016/s0140-6736(17)31833-0] [Citation(s) in RCA: 488] [Impact Index Per Article: 69.7] [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: 01/17/2017] [Revised: 05/21/2017] [Accepted: 06/07/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap between male and female life expectancy increased with progression to higher levels of SDI. Some countries with exceptional health performance in 1990 in terms of the difference in observed to expected life expectancy at birth had slower progress on the same measure in 2016. INTERPRETATION Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. We found evidence that the absolute gap between countries in age-specific death rates has declined, although the relative gap for some age-sex groups increased. Countries that now lead in terms of having higher observed life expectancy than that expected on the basis of development alone, or locations that have either increased this advantage or rapidly decreased the deficit from expected levels, could provide insight into the means to accelerate progress in nations where progress has stalled. FUNDING Bill & Melinda Gates Foundation, and the National Institute on Aging and the National Institute of Mental Health of the National Institutes of Health.
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Gakidou E, Afshin A, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulle AM, Abera SF, Aboyans V, Abu-Raddad LJ, Abu-Rmeileh NME, Abyu GY, Adedeji IA, Adetokunboh O, Afarideh M, Agrawal A, Agrawal S, Ahmadieh H, Ahmed MB, Aichour MTE, Aichour AN, Aichour I, Akinyemi RO, Akseer N, Alahdab F, Al-Aly Z, Alam K, Alam N, Alam T, Alasfoor D, Alene KA, Ali K, Alizadeh-Navaei R, Alkerwi A, Alla F, Allebeck P, Al-Raddadi R, Alsharif U, Altirkawi KA, Alvis-Guzman N, Amare AT, Amini E, Ammar W, Amoako YA, Ansari H, Antó JM, Antonio CAT, Anwari P, Arian N, Ärnlöv J, Artaman A, Aryal KK, Asayesh H, Asgedom SW, Atey TM, Avila-Burgos L, Avokpaho EFGA, Awasthi A, Azzopardi P, Bacha U, Badawi A, Balakrishnan K, Ballew SH, Barac A, Barber RM, Barker-Collo SL, Bärnighausen T, Barquera S, Barregard L, Barrero LH, Batis C, Battle KE, Baumgarner BR, Baune BT, Beardsley J, Bedi N, Beghi E, Bell ML, Bennett DA, Bennett JR, Bensenor IM, Berhane A, Berhe DF, Bernabé E, Betsu BD, Beuran M, Beyene AS, Bhansali A, Bhutta ZA, Bicer BK, Bikbov B, Birungi C, Biryukov S, Blosser CD, Boneya DJ, Bou-Orm IR, Brauer M, Breitborde NJK, Brenner H, Brugha TS, Bulto LNB, Butt ZA, Cahuana-Hurtado L, Cárdenas R, Carrero JJ, Castañeda-Orjuela CA, Catalá-López F, Cercy K, Chang HY, Charlson FJ, Chimed-Ochir O, Chisumpa VH, Chitheer AA, Christensen H, Christopher DJ, Cirillo M, Cohen AJ, Comfort H, Cooper C, Coresh J, Cornaby L, Cortesi PA, Criqui MH, Crump JA, Dandona L, Dandona R, das Neves J, Davey G, Davitoiu DV, Davletov K, de Courten B, Defo BK, Degenhardt L, Deiparine S, Dellavalle RP, Deribe K, Deshpande A, Dharmaratne SD, Ding EL, Djalalinia S, Do HP, Dokova K, Doku DT, Donkelaar AV, Dorsey ER, Driscoll TR, Dubey M, Duncan BB, Duncan S, Ebrahimi H, El-Khatib ZZ, Enayati A, Endries AY, Ermakov SP, Erskine HE, Eshrati B, Eskandarieh S, Esteghamati A, Estep K, Faraon EJA, Farinha CSES, Faro A, Farzadfar F, Fay K, Feigin VL, Fereshtehnejad SM, Fernandes JC, Ferrari AJ, Feyissa TR, Filip I, Fischer F, Fitzmaurice C, Flaxman AD, Foigt N, Foreman KJ, Frostad JJ, Fullman N, Fürst T, Furtado JM, Ganji M, Garcia-Basteiro AL, Gebrehiwot TT, Geleijnse JM, Geleto A, Gemechu BL, Gesesew HA, Gething PW, Ghajar A, Gibney KB, Gill PS, Gillum RF, Giref AZ, Gishu MD, Giussani G, Godwin WW, Gona PN, Goodridge A, Gopalani SV, Goryakin Y, Goulart AC, Graetz N, Gugnani HC, Guo J, Gupta R, Gupta T, Gupta V, Gutiérrez RA, Hachinski V, Hafezi-Nejad N, Hailu GB, Hamadeh RR, Hamidi S, Hammami M, Handal AJ, Hankey GJ, Hanson SW, Harb HL, Hareri HA, Hassanvand MS, Havmoeller R, Hawley C, Hay SI, Hedayati MT, Hendrie D, Heredia-Pi IB, Hernandez JCM, Hoek HW, Horita N, Hosgood HD, Hostiuc S, Hoy DG, Hsairi M, Hu G, Huang JJ, Huang H, Ibrahim NM, Iburg KM, Ikeda C, Inoue M, Irvine CMS, Jackson MD, Jacobsen KH, Jahanmehr N, Jakovljevic MB, Jauregui A, Javanbakht M, Jeemon P, Johansson LRK, Johnson CO, Jonas JB, Jürisson M, Kabir Z, Kadel R, Kahsay A, Kamal R, Karch A, Karema CK, Kasaeian A, Kassebaum NJ, Kastor A, Katikireddi SV, Kawakami N, Keiyoro PN, Kelbore SG, Kemmer L, Kengne AP, Kesavachandran CN, Khader YS, Khalil IA, Khan EA, Khang YH, Khosravi A, Khubchandani J, Kiadaliri AA, Kieling C, Kim JY, Kim YJ, Kim D, Kimokoti RW, Kinfu Y, Kisa A, Kissimova-Skarbek KA, Kivimaki M, Knibbs LD, Knudsen AK, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kravchenko M, Krohn KJ, Kromhout H, Kumar GA, Kutz M, Kyu HH, Lal DK, Lalloo R, Lallukka T, Lan Q, Lansingh VC, Larsson A, Lee PH, Lee A, Leigh J, Leung J, Levi M, Levy TS, Li Y, Li Y, Liang X, Liben ML, Linn S, Liu P, Lodha R, Logroscino G, Looker KJ, Lopez AD, Lorkowski S, Lotufo PA, Lozano R, Lunevicius R, Macarayan ERK, Magdy Abd El Razek H, Magdy Abd El Razek M, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malhotra R, Malta DC, Mamun AA, Manguerra H, Mantovani LG, Mapoma CC, Martin RV, Martinez-Raga J, Martins-Melo FR, Mathur MR, Matsushita K, Matzopoulos R, Mazidi M, McAlinden C, McGrath JJ, Mehata S, Mehndiratta MM, Meier T, Melaku YA, Memiah P, Memish ZA, Mendoza W, Mengesha MM, Mensah GA, Mensink GBM, Mereta ST, Meretoja TJ, Meretoja A, Mezgebe HB, Micha R, Millear A, Miller TR, Minnig S, Mirarefin M, Mirrakhimov EM, Misganaw A, Mishra SR, Mohammad KA, Mohammed KE, Mohammed S, Mohan MBV, Mokdad AH, Monasta L, Montico M, Moradi-Lakeh M, Moraga P, Morawska L, Morrison SD, Mountjoy-Venning C, Mueller UO, Mullany EC, Muller K, Murthy GVS, Musa KI, Naghavi M, Naheed A, Nangia V, Natarajan G, Negoi RI, Negoi I, Nguyen CT, Nguyen QL, Nguyen TH, Nguyen G, Nguyen M, Nichols E, Ningrum DNA, Nomura M, Nong VM, Norheim OF, Norrving B, Noubiap JJN, Obermeyer CM, Ogbo FA, Oh IH, Oladimeji O, Olagunju AT, Olagunju TO, Olivares PR, Olsen HE, Olusanya BO, Olusanya JO, Opio JN, Oren E, Ortiz A, Ota E, Owolabi MO, PA M, Pacella RE, Pana A, Panda BK, Panda-Jonas S, Pandian JD, Papachristou C, Park EK, Parry CD, Patten SB, Patton GC, Pereira DM, Perico N, Pesudovs K, Petzold M, Phillips MR, Pillay JD, Piradov MA, Pishgar F, Plass D, Pletcher MA, Polinder S, Popova S, Poulton RG, Pourmalek F, Prasad N, Purcell C, Qorbani M, Radfar A, Rafay A, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman MHU, Rahman MA, Rahman M, Rai RK, Rajsic S, Ram U, Rawaf S, Rehm CD, Rehm J, Reiner RC, Reitsma MB, Remuzzi G, Renzaho AMN, Resnikoff S, Reynales-Shigematsu LM, Rezaei S, Ribeiro AL, Rivera JA, Roba KT, Rojas-Rueda D, Roman Y, Room R, Roshandel G, Roth GA, Rothenbacher D, Rubagotti E, Rushton L, Sadat N, Safdarian M, Safi S, Safiri S, Sahathevan R, Salama J, Salomon JA, Samy AM, Sanabria JR, Sanchez-Niño MD, Sánchez-Pimienta TG, Santomauro D, Santos IS, Santric Milicevic MM, Sartorius B, Satpathy M, Sawhney M, Saxena S, Schmidt MI, Schneider IJC, Schutte AE, Schwebel DC, Schwendicke F, Seedat S, Sepanlou SG, Serdar B, Servan-Mori EE, Shaddick G, Shaheen A, Shahraz S, Shaikh MA, Shamsipour M, Shamsizadeh M, Shariful Islam SM, Sharma J, Sharma R, She J, Shen J, Shi P, Shibuya K, Shields C, Shiferaw MS, Shigematsu M, Shin MJ, Shiri R, Shirkoohi R, Shishani K, Shoman H, Shrime MG, Sigfusdottir ID, Silva DAS, Silva JP, Silveira DGA, Singh JA, Singh V, Sinha DN, Skiadaresi E, Slepak EL, Smith DL, Smith M, Sobaih BHA, Sobngwi E, Soneji S, Sorensen RJD, Sposato LA, Sreeramareddy CT, Srinivasan V, Steel N, Stein DJ, Steiner C, Steinke S, Stokes MA, Strub B, Subart M, Sufiyan MB, Suliankatchi RA, Sur PJ, Swaminathan S, Sykes BL, Szoeke CEI, Tabarés-Seisdedos R, Tadakamadla SK, Takahashi K, Takala JS, Tandon N, Tanner M, Tarekegn YL, Tavakkoli M, Tegegne TK, Tehrani-Banihashemi A, Terkawi AS, Tesssema B, Thakur JS, Thamsuwan O, Thankappan KR, Theis AM, Thomas ML, Thomson AJ, Thrift AG, Tillmann T, Tobe-Gai R, Tobollik M, Tollanes MC, Tonelli M, Topor-Madry R, Torre A, Tortajada M, Touvier M, Tran BX, Truelsen T, Tuem KB, Tuzcu EM, Tyrovolas S, Ukwaja KN, Uneke CJ, Updike R, Uthman OA, van Boven JFM, Varughese S, Vasankari T, Veerman LJ, Venkateswaran V, Venketasubramanian N, Violante FS, Vladimirov SK, Vlassov VV, Vollset SE, Vos T, Wadilo F, Wakayo T, Wallin MT, Wang YP, Weichenthal S, Weiderpass E, Weintraub RG, Weiss DJ, Werdecker A, Westerman R, Whiteford HA, Wiysonge CS, Woldeyes BG, Wolfe CDA, Woodbrook R, Workicho A, Xavier D, Xu G, Yadgir S, Yakob B, Yan LL, Yaseri M, Yimam HH, Yip P, Yonemoto N, Yoon SJ, Yotebieng M, Younis MZ, Zaidi Z, Zaki MES, Zavala-Arciniega L, Zhang X, Zimsen SRM, Zipkin B, Zodpey S, Lim SS, Murray CJL. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390:1345-1422. [PMID: 28919119 PMCID: PMC5614451 DOI: 10.1016/s0140-6736(17)32366-8] [Citation(s) in RCA: 1554] [Impact Index Per Article: 222.0] [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: 05/29/2017] [Revised: 08/07/2017] [Accepted: 08/21/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. METHODS We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. FINDINGS Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9-11·6) decline in deaths and a 10·8% (8·3-13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7-17·5) of deaths and 6·2% (3·9-8·7) of DALYs, and population growth for 12·4% (10·1-14·9) of deaths and 12·4% (10·1-14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9-29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. INTERPRETATION Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. FUNDING The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.
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Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, Aboyans V, Adetokunboh O, Afshin A, Agrawal A, Ahmadi A, Ahmed MB, Aichour AN, Aichour MTE, Aichour I, Aiyar S, Alahdab F, Al-Aly Z, Alam K, Alam N, Alam T, Alene KA, Al-Eyadhy A, Ali SD, Alizadeh-Navaei R, Alkaabi JM, Alkerwi A, Alla F, Allebeck P, Allen C, Al-Raddadi R, Alsharif U, Altirkawi KA, Alvis-Guzman N, Amare AT, Amini E, Ammar W, Amoako YA, Anber N, Andersen HH, Andrei CL, Androudi S, Ansari H, Antonio CAT, Anwari P, Ärnlöv J, Arora M, Artaman A, Aryal KK, Asayesh H, Asgedom SW, Atey TM, Avila-Burgos L, Avokpaho EFG, Awasthi A, Babalola TK, Bacha U, Balakrishnan K, Barac A, Barboza MA, Barker-Collo SL, Barquera S, Barregard L, Barrero LH, Baune BT, Bedi N, Beghi E, Béjot Y, Bekele BB, Bell ML, Bennett JR, Bensenor IM, Berhane A, Bernabé E, Betsu BD, Beuran M, Bhatt S, Biadgilign S, Bienhoff K, Bikbov B, Bisanzio D, Bourne RRA, Breitborde NJK, Bulto LNB, Bumgarner BR, Butt ZA, Cahuana-Hurtado L, Cameron E, Campuzano JC, Car J, Cárdenas R, Carrero JJ, Carter A, Casey DC, Castañeda-Orjuela CA, Catalá-López F, Charlson FJ, Chibueze CE, Chimed-Ochir O, Chisumpa VH, Chitheer AA, Christopher DJ, Ciobanu LG, Cirillo M, Cohen AJ, Colombara D, Cooper C, Cowie BC, Criqui MH, Dandona L, Dandona R, Dargan PI, das Neves J, Davitoiu DV, Davletov K, de Courten B, Defo BK, Degenhardt L, Deiparine S, Deribe K, Deribew A, Dey S, Dicker D, Ding EL, Djalalinia S, Do HP, Doku DT, Douwes-Schultz D, Driscoll TR, Dubey M, Duncan BB, Echko M, El-Khatib ZZ, Ellingsen CL, Enayati A, Ermakov SP, Erskine HE, Eskandarieh S, Esteghamati A, Estep K, Farinha CSES, Faro A, Farzadfar F, Feigin VL, Fereshtehnejad SM, Fernandes JC, Ferrari AJ, Feyissa TR, Filip I, Finegold S, Fischer F, Fitzmaurice C, Flaxman AD, Foigt N, Frank T, Fraser M, Fullman N, Fürst T, Furtado JM, Gakidou E, Garcia-Basteiro AL, Gebre T, Gebregergs GB, Gebrehiwot TT, Gebremichael DY, Geleijnse JM, Genova-Maleras R, Gesesew HA, Gething PW, Gillum RF, Giref AZ, Giroud M, Giussani G, Godwin WW, Gold AL, Goldberg EM, Gona PN, Gopalani SV, Gouda HN, Goulart AC, Griswold M, Gupta R, Gupta T, Gupta V, Gupta PC, Haagsma JA, Hafezi-Nejad N, Hailu AD, Hailu GB, Hamadeh RR, Hambisa MT, Hamidi S, Hammami M, Hancock J, Handal AJ, Hankey GJ, Hao Y, Harb HL, Hareri HA, Hassanvand MS, Havmoeller R, Hay SI, He F, Hedayati MT, Henry NJ, Heredia-Pi IB, Herteliu C, Hoek HW, Horino M, Horita N, Hosgood HD, Hostiuc S, Hotez PJ, Hoy DG, Huynh C, Iburg KM, Ikeda C, Ileanu BV, Irenso AA, Irvine CMS, Islam SMS, Jacobsen KH, Jahanmehr N, Jakovljevic MB, Javanbakht M, Jayaraman SP, Jeemon P, Jha V, John D, Johnson CO, Johnson SC, Jonas JB, Jürisson M, Kabir Z, Kadel R, Kahsay A, Kamal R, Karch A, Karimi SM, Karimkhani C, Kasaeian A, Kassaw NA, Kassebaum NJ, Katikireddi SV, Kawakami N, Keiyoro PN, Kemmer L, Kesavachandran CN, Khader YS, Khan EA, Khang YH, Khoja ATA, Khosravi MH, Khosravi A, Khubchandani J, Kiadaliri AA, Kieling C, Kievlan D, Kim YJ, Kim D, Kimokoti RW, Kinfu Y, Kissoon N, Kivimaki M, Knudsen AK, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kulikoff XR, Kumar GA, Kumar P, Kutz M, Kyu HH, Lal DK, Lalloo R, Lambert TLN, Lan Q, Lansingh VC, Larsson A, Lee PH, Leigh J, Leung J, Levi M, Li Y, Li Kappe D, Liang X, Liben ML, Lim SS, Liu PY, Liu A, Liu Y, Lodha R, Logroscino G, Lorkowski S, Lotufo PA, Lozano R, Lucas TCD, Ma S, Macarayan ERK, Maddison ER, Magdy Abd El Razek M, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malhotra R, Malta DC, Manguerra H, Manyazewal T, Mapoma CC, Marczak LB, Markos D, Martinez-Raga J, Martins-Melo FR, Martopullo I, McAlinden C, McGaughey M, McGrath JJ, Mehata S, Meier T, Meles KG, Memiah P, Memish ZA, Mengesha MM, Mengistu DT, Menota BG, Mensah GA, Meretoja TJ, Meretoja A, Millear A, Miller TR, Minnig S, Mirarefin M, Mirrakhimov EM, Misganaw A, Mishra SR, Mohamed IA, Mohammad KA, Mohammadi A, Mohammed S, Mokdad AH, Mola GLD, Mollenkopf SK, Molokhia M, Monasta L, Montañez JC, Montico M, Mooney MD, Moradi-Lakeh M, Moraga P, Morawska L, Morozoff C, Morrison SD, Mountjoy-Venning C, Mruts KB, Muller K, Murthy GVS, Musa KI, Nachega JB, Naheed A, Naldi L, Nangia V, Nascimento BR, Nasher JT, Natarajan G, Negoi I, Ngunjiri JW, Nguyen CT, Nguyen QL, Nguyen TH, Nguyen G, Nguyen M, Nichols E, Ningrum DNA, Nong VM, Noubiap JJN, Ogbo FA, Oh IH, Okoro A, Olagunju AT, Olsen HE, Olusanya BO, Olusanya JO, Ong K, Opio JN, Oren E, Ortiz A, Osman M, Ota E, PA M, Pacella RE, Pakhale S, Pana A, Panda BK, Panda-Jonas S, Papachristou C, Park EK, Patten SB, Patton GC, Paudel D, Paulson K, Pereira DM, Perez-Ruiz F, Perico N, Pervaiz A, Petzold M, Phillips MR, Pigott DM, Pinho C, Plass D, Pletcher MA, Polinder S, Postma MJ, Pourmalek F, Purcell C, Qorbani M, Quintanilla BPA, Radfar A, Rafay A, Rahimi-Movaghar V, Rahman MHU, Rahman M, Rai RK, Ranabhat CL, Rankin Z, Rao PC, Rath GK, Rawaf S, Ray SE, Rehm J, Reiner RC, Reitsma MB, Remuzzi G, Rezaei S, Rezai MS, Rokni MB, Ronfani L, Roshandel G, Roth GA, Rothenbacher D, Ruhago GM, SA R, Saadat S, Sachdev PS, Sadat N, Safdarian M, Safi S, Safiri S, Sagar R, Sahathevan R, Salama J, Salamati P, Salomon JA, Samy AM, Sanabria JR, Sanchez-Niño MD, Santomauro D, Santos IS, Santric Milicevic MM, Sartorius B, Satpathy M, Schmidt MI, Schneider IJC, Schulhofer-Wohl S, Schutte AE, Schwebel DC, Schwendicke F, Sepanlou SG, Servan-Mori EE, Shackelford KA, Shahraz S, Shaikh MA, Shamsipour M, Shamsizadeh M, Sharma J, Sharma R, She J, Sheikhbahaei S, Shey M, Shi P, Shields C, Shigematsu M, Shiri R, Shirude S, Shiue I, Shoman H, Shrime MG, Sigfusdottir ID, Silpakit N, Silva JP, Singh JA, Singh A, Skiadaresi E, Sligar A, Smith DL, Smith A, Smith M, Sobaih BHA, Soneji S, Sorensen RJD, Soriano JB, Sreeramareddy CT, Srinivasan V, Stanaway JD, Stathopoulou V, Steel N, Stein DJ, Steiner C, Steinke S, Stokes MA, Strong M, Strub B, Subart M, Sufiyan MB, Sunguya BF, Sur PJ, Swaminathan S, Sykes BL, Tabarés-Seisdedos R, Tadakamadla SK, Takahashi K, Takala JS, Talongwa RT, Tarawneh MR, Tavakkoli M, Taveira N, Tegegne TK, Tehrani-Banihashemi A, Temsah MH, Terkawi AS, Thakur JS, Thamsuwan O, Thankappan KR, Thomas KE, Thompson AH, Thomson AJ, Thrift AG, Tobe-Gai R, Topor-Madry R, Torre A, Tortajada M, Towbin JA, Tran BX, Troeger C, Truelsen T, Tsoi D, Tuzcu EM, Tyrovolas S, Ukwaja KN, Undurraga EA, Updike R, Uthman OA, Uzochukwu BSC, van Boven JFM, Vasankari T, Venketasubramanian N, Violante FS, Vlassov VV, Vollset SE, Vos T, Wakayo T, Wallin MT, Wang YP, Weiderpass E, Weintraub RG, Weiss DJ, Werdecker A, Westerman R, Whetter B, Whiteford HA, Wijeratne T, Wiysonge CS, Woldeyes BG, Wolfe CDA, Woodbrook R, Workicho A, Xavier D, Xiao Q, Xu G, Yaghoubi M, Yakob B, Yano Y, Yaseri M, Yimam HH, Yonemoto N, Yoon SJ, Yotebieng M, Younis MZ, Zaidi Z, Zaki MES, Zegeye EA, Zenebe ZM, Zerfu TA, Zhang AL, Zhang X, Zipkin B, Zodpey S, Lopez AD, Murray CJL. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390:1151-1210. [PMID: 28919116 PMCID: PMC5605883 DOI: 10.1016/s0140-6736(17)32152-9] [Citation(s) in RCA: 2992] [Impact Index Per Article: 427.4] [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: 03/15/2017] [Revised: 06/30/2017] [Accepted: 07/04/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. METHODS We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year. YLLs were calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage coding; and other sources including surveys and surveillance systems for specific causes such as maternal mortality. To facilitate assessment of quality, we reported on the fraction of deaths assigned to GBD Level 1 or Level 2 causes that cannot be underlying causes of death (major garbage codes) by location and year. Based on completeness, garbage coding, cause list detail, and time periods covered, we provided an overall data quality rating for each location with scores ranging from 0 stars (worst) to 5 stars (best). We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to generate estimates for each location, year, age, and sex. We assessed observed and expected levels and trends of cause-specific deaths in relation to the Socio-demographic Index (SDI), a summary indicator derived from measures of average income per capita, educational attainment, and total fertility, with locations grouped into quintiles by SDI. Relative to GBD 2015, we expanded the GBD cause hierarchy by 18 causes of death for GBD 2016. FINDINGS The quality of available data varied by location. Data quality in 25 countries rated in the highest category (5 stars), while 48, 30, 21, and 44 countries were rated at each of the succeeding data quality levels. Vital registration or verbal autopsy data were not available in 27 countries, resulting in the assignment of a zero value for data quality. Deaths from non-communicable diseases (NCDs) represented 72·3% (95% uncertainty interval [UI] 71·2-73·2) of deaths in 2016 with 19·3% (18·5-20·4) of deaths in that year occurring from communicable, maternal, neonatal, and nutritional (CMNN) diseases and a further 8·43% (8·00-8·67) from injuries. Although age-standardised rates of death from NCDs decreased globally between 2006 and 2016, total numbers of these deaths increased; both numbers and age-standardised rates of death from CMNN causes decreased in the decade 2006-16-age-standardised rates of deaths from injuries decreased but total numbers varied little. In 2016, the three leading global causes of death in children under-5 were lower respiratory infections, neonatal preterm birth complications, and neonatal encephalopathy due to birth asphyxia and trauma, combined resulting in 1·80 million deaths (95% UI 1·59 million to 1·89 million). Between 1990 and 2016, a profound shift toward deaths at older ages occurred with a 178% (95% UI 176-181) increase in deaths in ages 90-94 years and a 210% (208-212) increase in deaths older than age 95 years. The ten leading causes by rates of age-standardised YLL significantly decreased from 2006 to 2016 (median annualised rate of change was a decrease of 2·89%); the median annualised rate of change for all other causes was lower (a decrease of 1·59%) during the same interval. Globally, the five leading causes of total YLLs in 2016 were cardiovascular diseases; diarrhoea, lower respiratory infections, and other common infectious diseases; neoplasms; neonatal disorders; and HIV/AIDS and tuberculosis. At a finer level of disaggregation within cause groupings, the ten leading causes of total YLLs in 2016 were ischaemic heart disease, cerebrovascular disease, lower respiratory infections, diarrhoeal diseases, road injuries, malaria, neonatal preterm birth complications, HIV/AIDS, chronic obstructive pulmonary disease, and neonatal encephalopathy due to birth asphyxia and trauma. Ischaemic heart disease was the leading cause of total YLLs in 113 countries for men and 97 countries for women. Comparisons of observed levels of YLLs by countries, relative to the level of YLLs expected on the basis of SDI alone, highlighted distinct regional patterns including the greater than expected level of YLLs from malaria and from HIV/AIDS across sub-Saharan Africa; diabetes mellitus, especially in Oceania; interpersonal violence, notably within Latin America and the Caribbean; and cardiomyopathy and myocarditis, particularly in eastern and central Europe. The level of YLLs from ischaemic heart disease was less than expected in 117 of 195 locations. Other leading causes of YLLs for which YLLs were notably lower than expected included neonatal preterm birth complications in many locations in both south Asia and southeast Asia, and cerebrovascular disease in western Europe. INTERPRETATION The past 37 years have featured declining rates of communicable, maternal, neonatal, and nutritional diseases across all quintiles of SDI, with faster than expected gains for many locations relative to their SDI. A global shift towards deaths at older ages suggests success in reducing many causes of early death. YLLs have increased globally for causes such as diabetes mellitus or some neoplasms, and in some locations for causes such as drug use disorders, and conflict and terrorism. Increasing levels of YLLs might reflect outcomes from conditions that required high levels of care but for which effective treatments remain elusive, potentially increasing costs to health systems. FUNDING Bill & Melinda Gates Foundation.
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Fullman N, Barber RM, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulkader RS, Abdulle AM, Abera SF, Aboyans V, Abu-Raddad LJ, Abu-Rmeileh NME, Adedeji IA, Adetokunboh O, Afshin A, Agrawal A, Agrawal S, Ahmad Kiadaliri A, Ahmadieh H, Ahmed MB, Aichour MTE, Aichour AN, Aichour I, Aiyar S, Akinyemi RO, Akseer N, Al-Aly Z, Alam K, Alam N, Alasfoor D, Alene KA, Alizadeh-Navaei R, Alkerwi A, Alla F, Allebeck P, Allen C, Al-Raddadi R, Alsharif U, Altirkawi KA, Alvis-Guzman N, Amare AT, Amini E, Ammar W, Ansari H, Antonio CAT, Anwari P, Arora M, Artaman A, Aryal KK, Asayesh H, Asgedom SW, Assadi R, Atey TM, Atre SR, Avila-Burgos L, Avokpaho EFGA, Awasthi A, Azzopardi P, Bacha U, Badawi A, Balakrishnan K, Bannick MS, Barac A, Barker-Collo SL, Bärnighausen T, Barrero LH, Basu S, Battle KE, Baune BT, Beardsley J, Bedi N, Beghi E, Béjot Y, Bell ML, Bennett DA, Bennett JR, Bensenor IM, Berhane A, Berhe DF, Bernabé E, Betsu BD, Beuran M, Beyene AS, Bhala N, Bhansali A, Bhatt S, Bhutta ZA, Bicer BK, Bidgoli HH, Bikbov B, Bilal AI, Birungi C, Biryukov S, Bizuayehu HM, Blosser CD, Boneya DJ, Bose D, Bou-Orm IR, Brauer M, Breitborde NJK, Brugha TS, Bulto LNB, Butt ZA, Cahuana-Hurtado L, Cameron E, Campuzano JC, Carabin H, Cárdenas R, Carrero JJ, Carter A, Casey DC, Castañeda-Orjuela CA, Castro RE, Catalá-López F, Cercy K, Chang HY, Chang JC, Charlson FJ, Chew A, Chisumpa VH, Chitheer AA, Christensen H, Christopher DJ, Cirillo M, Cooper C, Criqui MH, Cromwell EA, Crump JA, Dandona L, Dandona R, Dargan PI, das Neves J, Davitoiu DV, de Courten B, De Steur H, Defo BK, Degenhardt L, Deiparine S, Deribe K, deVeber GA, Ding EL, Djalalinia S, Do HP, Dokova K, Doku DT, Donkelaar AV, Dorsey ER, Driscoll TR, Dubey M, Duncan BB, Ebel BE, Ebrahimi H, El-Khatib ZZ, Enayati A, Endries AY, Ermakov SP, Erskine HE, Eshrati B, Eskandarieh S, Esteghamati A, Estep K, Faraon EJA, Farinha CSES, Faro A, Farzadfar F, Fazeli MS, Feigin VL, Feigl AB, Fereshtehnejad SM, Fernandes JC, Ferrari AJ, Feyissa TR, Filip I, Fischer F, Fitzmaurice C, Flaxman AD, Foigt N, Foreman KJ, Frank T, Franklin RC, Friedman J, Frostad JJ, Fürst T, Furtado JM, Gakidou E, Garcia-Basteiro AL, Gebrehiwot TT, Geleijnse JM, Geleto A, Gemechu BL, Gething PW, Gibney KB, Gill PS, Gillum RF, Giref AZ, Gishu MD, Giussani G, Glenn SD, Godwin WW, Goldberg EM, Gona PN, Goodridge A, Gopalani SV, Goryakin Y, Griswold M, Gugnani HC, Gupta R, Gupta T, Gupta V, Hafezi-Nejad N, Hailu GB, Hamadeh RR, Hammami M, Hankey GJ, Harb HL, Hareri HA, Hassanvand MS, Havmoeller R, Hawley C, Hay SI, He J, Hendrie D, Henry NJ, Heredia-Pi IB, Hoek HW, Holmberg M, Horita N, Hosgood HD, Hostiuc S, Hoy DG, Hsairi M, Htet AS, Huang JJ, Huang H, Huynh C, Iburg KM, Ikeda C, Inoue M, Irvine CMS, Jacobsen KH, Jahanmehr N, Jakovljevic MB, Jauregui A, Javanbakht M, Jeemon P, Jha V, John D, Johnson CO, Johnson SC, Jonas JB, Jürisson M, Kabir Z, Kadel R, Kahsay A, Kamal R, Karch A, Karema CK, Kasaeian A, Kassebaum NJ, Kastor A, Katikireddi SV, Kawakami N, Keiyoro PN, Kelbore SG, Kemmer L, Kengne AP, Kesavachandran CN, Khader YS, Khalil IA, Khan EA, Khang YH, Khosravi A, Khubchandani J, Kieling C, Kim JY, Kim YJ, Kim D, Kimokoti RW, Kinfu Y, Kisa A, Kissimova-Skarbek KA, Kivimaki M, Kokubo Y, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kravchenko M, Krohn KJ, Kulikoff XR, Kumar GA, Kumar Lal D, Kutz MJ, Kyu HH, Lalloo R, Lansingh VC, Larsson A, Lazarus JV, Lee PH, Leigh J, Leung J, Leung R, Levi M, Li Y, Liben ML, Linn S, Liu PY, Liu S, Lodha R, Looker KJ, Lopez AD, Lorkowski S, Lotufo PA, Lozano R, Lucas TCD, Lunevicius R, Mackay MT, Maddison ER, Magdy Abd El Razek H, Magdy Abd El Razek M, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malhotra R, Malta DC, Mamun AA, Manguerra H, Mantovani LG, Manyazewal T, Mapoma CC, Marks GB, Martin RV, Martinez-Raga J, Martins-Melo FR, Martopullo I, Mathur MR, Mazidi M, McAlinden C, McGaughey M, McGrath JJ, McKee M, Mehata S, Mehndiratta MM, Meier T, Meles KG, Memish ZA, Mendoza W, Mengesha MM, Mengistie MA, Mensah GA, Mensink GBM, Mereta ST, Meretoja TJ, Meretoja A, Mezgebe HB, Micha R, Millear A, Miller TR, Minnig S, Mirarefin M, Mirrakhimov EM, Misganaw A, Mishra SR, Mitchell PB, Mohammad KA, Mohammed KE, Mohammed S, Mohan MBV, Mokdad AH, Mollenkopf SK, Monasta L, Montañez Hernandez JC, Montico M, Moradi-Lakeh M, Moraga P, Morawska L, Morrison SD, Moses MW, Mountjoy-Venning C, Mueller UO, Muller K, Murthy GVS, Musa KI, Naghavi M, Naheed A, Naidoo KS, Nangia V, Natarajan G, Negoi RI, Negoi I, Nguyen CT, Nguyen QL, Nguyen TH, Nguyen G, Nguyen M, Nichols E, Ningrum DNA, Nomura M, Nong VM, Norheim OF, Noubiap JJN, Obermeyer CM, Ogbo FA, Oh IH, Oladimeji O, Olagunju AT, Olagunju TO, Olivares PR, Olsen HE, Olusanya BO, Olusanya JO, Ong K, Oren E, Ortiz A, Owolabi MO, PA M, Pana A, Panda BK, Panda-Jonas S, Papachristou C, Park EK, Patton GC, Paulson K, Pereira DM, Perico DN, Pesudovs K, Petzold M, Phillips MR, Pigott DM, Pillay JD, Pinho C, Piradov MA, Pishgar F, Poulton RG, Pourmalek F, Qorbani M, Radfar A, Rafay A, Rahimi-Movaghar V, Rahman MHU, Rahman MA, Rahman M, Rai RK, Rajsic S, Ram U, Ranabhat CL, Rao PC, Rawaf S, Reidy P, Reiner RC, Reinig N, Reitsma MB, Remuzzi G, Renzaho AMN, Resnikoff S, Rezaei S, Rios Blancas MJ, Rivas JC, Roba KT, Rojas-Rueda D, Rokni MB, Roshandel G, Roth GA, Roy A, Rubagotti E, Sadat N, Safdarian M, Safi S, Safiri S, Sagar R, Salama J, Salomon JA, Samy AM, Sanabria JR, Santomauro D, Santos IS, Santos JV, Santric Milicevic MM, Sartorius B, Satpathy M, Sawhney M, Saxena S, Saylan MI, Schmidt MI, Schneider IJC, Schneider MT, Schöttker B, Schutte AE, Schwebel DC, Schwendicke F, Seedat S, Sepanlou SG, Servan-Mori EE, Shackelford KA, Shaheen A, Shahraz S, Shaikh MA, Shamsipour M, Shamsizadeh M, Shariful Islam SM, Sharma J, Sharma R, She J, Shi P, Shibuya K, Shields C, Shifa GT, Shiferaw MS, Shigematsu M, Shin MJ, Shiri R, Shirkoohi R, Shirude S, Shishani K, Shoman H, Shrime MG, Silberberg DH, Silva DAS, Silva JP, Silveira DGA, Singh JA, Singh V, Sinha DN, Skiadaresi E, Slepak EL, Sligar A, Smith DL, Smith A, Smith M, Sobaih BHA, Sobngwi E, Soljak M, Soneji S, Sorensen RJD, Sposato LA, Sreeramareddy CT, Srinivasan V, Stanaway JD, Stein DJ, Steiner C, Steinke S, Stokes MA, Strub B, Sufiyan MB, Sunguya BF, Sur PJ, Swaminathan S, Sykes BL, Sylte DO, Szoeke CEI, Tabarés-Seisdedos R, Tadakamadla SK, Tandon N, Tao T, Tarekegn YL, Tavakkoli M, Taveira N, Tegegne TK, Terkawi AS, Tessema GA, Thakur JS, Thankappan KR, Thrift AG, Tiruye TY, Tobe-Gai R, Topor-Madry R, Torre A, Tortajada M, Tran BX, Troeger C, Truelsen T, Tsoi D, Tuem KB, Tuzcu EM, Tyrovolas S, Ukwaja KN, Uneke CJ, Updike R, Uthman OA, van Boven JFM, Varughese S, Vasankari T, Venketasubramanian N, Vidavalur R, Violante FS, Vladimirov SK, Vlassov VV, Vollset SE, Vos T, Wadilo F, Wakayo T, Wallin MT, Wang YP, Weichenthal S, Weiderpass E, Weintraub RG, Weiss DJ, Werdecker A, Westerman R, Whiteford HA, Wijeratne T, Wiysonge CS, Woldeyes BG, Wolfe CDA, Woodbrook R, Xavier D, Xu G, Yadgir S, Yakob B, Yan LL, Yano Y, Yaseri M, Ye P, Yimam HH, Yip P, Yonemoto N, Yoon SJ, Yotebieng M, Younis MZ, Zaidi Z, Zaki MES, Zavala-Arciniega L, Zhang X, Zipkin B, Zodpey S, Lim SS, Murray CJL. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016. Lancet 2017; 390:1423-1459. [PMID: 28916366 PMCID: PMC5603800 DOI: 10.1016/s0140-6736(17)32336-x] [Citation(s) in RCA: 190] [Impact Index Per Article: 27.1] [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: 06/15/2017] [Revised: 08/07/2017] [Accepted: 08/08/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of "leaving no one behind". Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990-2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030. METHODS We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0-100, with 0 as the 2·5th percentile estimated between 1990 and 2030, and 100 as the 97·5th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment. FINDINGS Globally, the median health-related SDG index was 56·7 (IQR 31·9-66·8) in 2016 and country-level performance markedly varied, with Singapore (86·8, 95% uncertainty interval 84·6-88·9), Iceland (86·0, 84·1-87·6), and Sweden (85·6, 81·8-87·8) having the highest levels in 2016 and Afghanistan (10·9, 9·6-11·9), the Central African Republic (11·0, 8·8-13·8), and Somalia (11·3, 9·5-13·1) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2-8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60% of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5% of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past. INTERPRETATION GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs' broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations. FUNDING Bill & Melinda Gates Foundation.
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Abstract
Select estimates of contraceptive use in the 2015-16 National Family Health Survey (NFHS is equivalent to the Demographic and Health Survey in India) have come under the scrutiny of researchers and policy makers globally. Using four waves (1992-93, 1998-99, 2005-06, and 2015-16) of published NFHS reports, this article aims to highlight the change in Contraceptive Prevalence Rate (CPR) and initiate a discussion to help investigate the reasons for the recent decline of CPR.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, Birbhum 731101, West Bengal, India.
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Barber RM, Fullman N, Sorensen RJD, Bollyky T, McKee M, Nolte E, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulle AM, Abdurahman AA, Abera SF, Abraham B, Abreha GF, Adane K, Adelekan AL, Adetifa IMO, Afshin A, Agarwal A, Agarwal SK, Agarwal S, Agrawal A, Kiadaliri AA, Ahmadi A, Ahmed KY, Ahmed MB, Akinyemi RO, Akinyemiju TF, Akseer N, Al-Aly Z, Alam K, Alam N, Alam SS, Alemu ZA, Alene KA, Alexander L, Ali R, Ali SD, Alizadeh-Navaei R, Alkerwi A, Alla F, Allebeck P, Allen C, Al-Raddadi R, Alsharif U, Altirkawi KA, Martin EA, Alvis-Guzman N, Amare AT, Amini E, Ammar W, Amo-Adjei J, Amoako YA, Anderson BO, Androudi S, Ansari H, Ansha MG, Antonio CAT, Ärnlöv J, Artaman A, Asayesh H, Assadi R, Astatkie A, Atey TM, Atique S, Atnafu NT, Atre SR, Avila-Burgos L, Avokpaho EFGA, Quintanilla BPA, Awasthi A, Ayele NN, Azzopardi P, Saleem HOB, Bärnighausen T, Bacha U, Badawi A, Banerjee A, Barac A, Barboza MA, Barker-Collo SL, Barrero LH, Basu S, Baune BT, Baye K, Bayou YT, Bazargan-Hejazi S, Bedi N, Beghi E, Béjot Y, Bello AK, Bennett DA, Bensenor IM, Berhane A, Bernabé E, Bernal OA, Beyene AS, Beyene TJ, Bhutta ZA, Biadgilign S, Bikbov B, Birlik SM, Birungi C, Biryukov S, Bisanzio D, Bizuayehu HM, Bose D, Brainin M, Brauer M, Brazinova A, Breitborde NJK, Brenner H, Butt ZA, Cárdenas R, Cahuana-Hurtado L, Campos-Nonato IR, Car J, Carrero JJ, Casey D, Caso V, Castañeda-Orjuela CA, Rivas JC, Catalá-López F, Cecilio P, Cercy K, Charlson FJ, Chen AZ, Chew A, Chibalabala M, Chibueze CE, Chisumpa VH, Chitheer AA, Chowdhury R, Christensen H, Christopher DJ, Ciobanu LG, Cirillo M, Coggeshall MS, Cooper LT, Cortinovis M, Crump JA, Dalal K, Danawi H, Dandona L, Dandona R, Dargan PI, das Neves J, Davey G, Davitoiu DV, Davletov K, De Leo D, Del Gobbo LC, del Pozo-Cruz B, Dellavalle RP, Deribe K, Deribew A, Des Jarlais DC, Dey S, Dharmaratne SD, Dicker D, Ding EL, Dokova K, Dorsey ER, Doyle KE, Dubey M, Ehrenkranz R, Ellingsen CL, Elyazar I, Enayati A, Ermakov SP, Eshrati B, Esteghamati A, Estep K, Fürst T, Faghmous IDA, Fanuel FBB, Faraon EJA, Farid TA, Farinha CSES, Faro A, Farvid MS, Farzadfar F, Feigin VL, Feigl AB, Fereshtehnejad SM, Fernandes JG, Fernandes JC, Feyissa TR, Fischer F, Fitzmaurice C, Fleming TD, Foigt N, Foreman KJ, Forouzanfar MH, Franklin RC, Frostad J, G/hiwot TT, Gakidou E, Gambashidze K, Gamkrelidze A, Gao W, Garcia-Basteiro AL, Gebre T, Gebremedhin AT, Gebremichael MW, Gebru AA, Gelaye AA, Geleijnse JM, Genova-Maleras R, Gibney KB, Giref AZ, Gishu MD, Giussani G, Godwin WW, Gold A, Goldberg EM, Gona PN, Goodridge A, Gopalani SV, Goto A, Graetz N, Greaves F, Griswold M, Guban PI, Gugnani HC, Gupta PC, Gupta R, Gupta R, Gupta T, Gupta V, Habtewold TD, Hafezi-Nejad N, Haile D, Hailu AD, Hailu GB, Hakuzimana A, Hamadeh RR, Hambisa MT, Hamidi S, Hammami M, Hankey GJ, Hao Y, Harb HL, Hareri HA, Haro JM, Hassanvand MS, Havmoeller R, Hay RJ, Hay SI, Hendrie D, Heredia-Pi IB, Hoek HW, Horino M, Horita N, Hosgood HD, Htet AS, Hu G, Huang H, Huang JJ, Huntley BM, Huynh C, Iburg KM, Ileanu BV, Innos K, Irenso AA, Jahanmehr N, Jakovljevic MB, James P, James SL, Javanbakht M, Jayaraman SP, Jayatilleke AU, Jeemon P, Jha V, John D, Johnson C, Johnson SC, Jonas JB, Juel K, Kabir Z, Kalkonde Y, Kamal R, Kan H, Karch A, Karema CK, Karimi SM, Kasaeian A, Kassebaum NJ, Kastor A, Katikireddi SV, Kazanjan K, Keiyoro PN, Kemmer L, Kemp AH, Kengne AP, Kerbo AA, Kereselidze M, Kesavachandran CN, Khader YS, Khalil I, Khan AR, Khan EA, Khan G, Khang YH, Khoja ATA, Khonelidze I, Khubchandani J, Kibret GD, Kim D, Kim P, Kim YJ, Kimokoti RW, Kinfu Y, Kissoon N, Kivipelto M, Kokubo Y, Kolk A, Kolte D, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kravchenko M, Krishnaswami S, Krohn KJ, Defo BK, Bicer BK, Kuipers EJ, Kulkarni VS, Kumar GA, Kumsa FA, Kutz M, Kyu HH, Lager ACJ, Lal A, Lal DK, Lalloo R, Lallukka T, Lan Q, Langan SM, Lansingh VC, Larson HJ, Larsson A, Laryea DO, Latif AA, Lawrynowicz AEB, Leasher JL, Leigh J, Leinsalu M, Leshargie CT, Leung J, Leung R, Levi M, Liang X, Lim SS, Lind M, Linn S, Lipshultz SE, Liu P, Liu Y, Lo LT, Logroscino G, Lopez AD, Lorch SA, Lotufo PA, Lozano R, Lunevicius R, Lyons RA, Macarayan ERK, Mackay MT, El Razek HMA, El Razek MMA, Mahdavi M, Majeed A, Malekzadeh R, Malta DC, Mantovani LG, Manyazewal T, Mapoma CC, Marcenes W, Marks GB, Marquez N, Martinez-Raga J, Marzan MB, Massano J, Mathur MR, Maulik PK, Mazidi M, McAlinden C, McGrath JJ, McNellan C, Meaney PA, Mehari A, Mehndiratta MM, Meier T, Mekonnen AB, Meles KG, Memish ZA, Mengesha MM, Mengiste DT, Mengistie MA, Menota BG, Mensah GA, Mereta ST, Meretoja A, Meretoja TJ, Mezgebe HB, Micha R, Millear A, Mills EJ, Minnig S, Mirarefin M, Mirrakhimov EM, Mock CN, Mohammad KA, Mohammed S, Mohanty SK, Mokdad AH, Mola GLD, Molokhia M, Monasta L, Montico M, Moradi-Lakeh M, Moraga P, Morawska L, Mori R, Moses M, Mueller UO, Murthy S, Musa KI, Nachega JB, Nagata C, Nagel G, Naghavi M, Naheed A, Naldi L, Nangia V, Nascimento BR, Negoi I, Neupane SP, Newton CR, Ng M, Ngalesoni FN, Ngunjiri JW, Nguyen G, Ningrum DNA, Nolte S, Nomura M, Norheim OF, Norrving B, Noubiap JJN, Obermeyer CM, Ogbo FA, Oh IH, Okoro A, Oladimeji O, Olagunju AT, Olivares PR, Olsen HE, Olusanya BO, Olusanya JO, Opio JN, Oren E, Ortiz A, Osborne RH, Osman M, Owolabi MO, PA M, Pain AW, Pakhale S, Castillo EP, Pana A, Papachristou C, Parsaeian M, Patel T, Patton GC, Paudel D, Paul VK, Pearce N, Pereira DM, Perez-Padilla R, Perez-Ruiz F, Perico N, Pesudovs K, Petzold M, Phillips MR, Pigott DM, Pillay JD, Pinho C, Polinder S, Pond CD, Prakash V, Purwar M, Qorbani M, Quistberg DA, Radfar A, Rafay A, Rahimi K, Rahimi-Movaghar V, Rahman M, Rahman MHU, Rai RK, Ram U, Rana SM, Rankin Z, Rao PV, Rao PC, Rawaf S, Rego MAS, Reitsma M, Remuzzi G, Renzaho AMNN, Resnikoff S, Rezaei S, Rezai MS, Ribeiro AL, Roba HS, Rokni MB, Ronfani L, Roshandel G, Roth GA, Rothenbacher D, Roy NK, Sachdev PS, Sackey BB, Saeedi MY, Safiri S, Sagar R, Sahraian MA, Saleh MM, Salomon JA, Samy AM, Sanabria JR, Sanchez-Niño MD, Sandar L, Santos IS, Santos JV, Milicevic MMS, Sarmiento-Suarez R, Sartorius B, Satpathy M, Savic M, Sawhney M, Saylan MI, Schöttker B, Schutte AE, Schwebel DC, Seedat S, Seid AM, Seifu CN, Sepanlou SG, Serdar B, Servan-Mori EE, Setegn T, Shackelford KA, Shaheen A, Shahraz S, Shaikh MA, Shakh-Nazarova M, Shamsipour M, Islam SMS, Sharma J, Sharma R, She J, Sheikhbahaei S, Shen J, Shi P, Shigematsu M, Shin MJ, Shiri R, Shoman H, Shrime MG, Sibamo ELS, Sigfusdottir ID, Silva DAS, Silveira DGA, Sindi S, Singh A, Singh JA, Singh OP, Singh PK, Singh V, Sinke AH, Sinshaw AE, Skirbekk V, Sliwa K, Smith A, Sobngwi E, Soneji S, Soriano JB, Sousa TCM, Sposato LA, Sreeramareddy CT, Stathopoulou V, Steel N, Steiner C, Steinke S, Stokes MA, Stranges S, Strong M, Stroumpoulis K, Sturua L, Sufiyan MB, Suliankatchi RA, Sun J, Sur P, Swaminathan S, Sykes BL, Tabarés-Seisdedos R, Tabb KM, Taffere GR, Talongwa RT, Tarajia M, Tavakkoli M, Taveira N, Teeple S, Tegegne TK, Tehrani-Banihashemi A, Tekelab T, Tekle DY, Shifa GT, Terkawi AS, Tesema AG, Thakur JS, Thomson AJ, Tillmann T, Tiruye TY, Tobe-Gai R, Tonelli M, Topor-Madry R, Tortajada M, Troeger C, Truelsen T, Tura AK, Uchendu US, Ukwaja KN, Undurraga EA, Uneke CJ, Uthman OA, van Boven JFM, Van Dingenen R, Varughese S, Vasankari T, Venketasubramanian N, Violante FS, Vladimirov SK, Vlassov VV, Vollset SE, Vos T, Wagner JA, Wakayo T, Waller SG, Walson JL, Wang H, Wang YP, Watkins DA, Weiderpass E, Weintraub RG, Wen CP, Werdecker A, Wesana J, Westerman R, Whiteford HA, Wilkinson JD, Wiysonge CS, Woldeyes BG, Wolfe CDA, Won S, Workicho A, Workie SB, Wubshet M, Xavier D, Xu G, Yadav AK, Yaghoubi M, Yakob B, Yan LL, Yano Y, Yaseri M, Yimam HH, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yu C, Zaidi Z, El Sayed Zaki M, Zambrana-Torrelio C, Zapata T, Zenebe ZM, Zodpey S, Zoeckler L, Zuhlke LJ, Murray CJL. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015. Lancet 2017; 390:231-266. [PMID: 28528753 PMCID: PMC5528124 DOI: 10.1016/s0140-6736(17)30818-8] [Citation(s) in RCA: 307] [Impact Index Per Article: 43.9] [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: 12/27/2016] [Revised: 02/26/2017] [Accepted: 02/28/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. METHODS We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. FINDINGS Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0-42·8) in 1990 to 53·7 (52·2-55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. INTERPRETATION This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. FUNDING Bill & Melinda Gates Foundation.
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Kassebaum N, Kyu HH, Zoeckler L, Olsen HE, Thomas K, Pinho C, Bhutta ZA, Dandona L, Ferrari A, Ghiwot TT, Hay SI, Kinfu Y, Liang X, Lopez A, Malta DC, Mokdad AH, Naghavi M, Patton GC, Salomon J, Sartorius B, Topor-Madry R, Vollset SE, Werdecker A, Whiteford HA, Abate KH, Abbas K, Damtew SA, Ahmed MB, Akseer N, Al-Raddadi R, Alemayohu MA, Altirkawi K, Abajobir AA, Amare AT, Antonio CAT, Arnlov J, Artaman A, Asayesh H, Avokpaho EFGA, Awasthi A, Ayala Quintanilla BP, Bacha U, Betsu BD, Barac A, Bärnighausen TW, Baye E, Bedi N, Bensenor IM, Berhane A, Bernabe E, Bernal OA, Beyene AS, Biadgilign S, Bikbov B, Boyce CA, Brazinova A, Hailu GB, Carter A, Castañeda-Orjuela CA, Catalá-López F, Charlson FJ, Chitheer AA, Choi JYJ, Ciobanu LG, Crump J, Dandona R, Dellavalle RP, Deribew A, deVeber G, Dicker D, Ding EL, Dubey M, Endries AY, Erskine HE, Faraon EJA, Faro A, Farzadfar F, Fernandes JC, Fijabi DO, Fitzmaurice C, Fleming TD, Flor LS, Foreman KJ, Franklin RC, Fraser MS, Frostad JJ, Fullman N, Gebregergs GB, Gebru AA, Geleijnse JM, Gibney KB, Gidey Yihdego M, Ginawi IAM, Gishu MD, Gizachew TA, Glaser E, Gold AL, Goldberg E, Gona P, Goto A, Gugnani HC, Jiang G, Gupta R, Tesfay FH, Hankey GJ, Havmoeller R, Hijar M, Horino M, Hosgood HD, Hu G, Jacobsen KH, Jakovljevic MB, Jayaraman SP, Jha V, Jibat T, Johnson CO, Jonas J, Kasaeian A, Kawakami N, Keiyoro PN, Khalil I, Khang YH, Khubchandani J, Ahmad Kiadaliri AA, Kieling C, Kim D, Kissoon N, Knibbs LD, Koyanagi A, Krohn KJ, Kuate Defo B, Kucuk Bicer B, Kulikoff R, Kumar GA, Lal DK, Lam HY, Larson HJ, Larsson A, Laryea DO, Leung J, Lim SS, Lo LT, Lo WD, Looker KJ, Lotufo PA, Magdy Abd El Razek H, Malekzadeh R, Markos Shifti D, Mazidi M, Meaney PA, Meles KG, Memiah P, Mendoza W, Abera Mengistie M, Mengistu GW, Mensah GA, Miller TR, Mock C, Mohammadi A, Mohammed S, Monasta L, Mueller U, Nagata C, Naheed A, Nguyen G, Nguyen QL, Nsoesie E, Oh IH, Okoro A, Olusanya JO, Olusanya BO, Ortiz A, Paudel D, Pereira DM, Perico N, Petzold M, Phillips MR, Polanczyk GV, Pourmalek F, Qorbani M, Rafay A, Rahimi-Movaghar V, Rahman M, Rai RK, Ram U, Rankin Z, Remuzzi G, Renzaho AMN, Roba HS, Rojas-Rueda D, Ronfani L, Sagar R, Sanabria JR, Kedir Mohammed MS, Santos IS, Satpathy M, Sawhney M, Schöttker B, Schwebel DC, Scott JG, Sepanlou SG, Shaheen A, Shaikh MA, She J, Shiri R, Shiue I, Sigfusdottir ID, Singh J, Silpakit N, Smith A, Sreeramareddy C, Stanaway JD, Stein DJ, Steiner C, Sufiyan MB, Swaminathan S, Tabarés-Seisdedos R, Tabb KM, Tadese F, Tavakkoli M, Taye B, Teeple S, Tegegne TK, Temam Shifa G, Terkawi AS, Thomas B, Thomson AJ, Tobe-Gai R, Tonelli M, Tran BX, Troeger C, Ukwaja KN, Uthman O, Vasankari T, Venketasubramanian N, Vlassov VV, Weiderpass E, Weintraub R, Gebrehiwot SW, Westerman R, Williams HC, Wolfe CDA, Woodbrook R, Yano Y, Yonemoto N, Yoon SJ, Younis MZ, Yu C, Zaki MES, Zegeye EA, Zuhlke LJ, Murray CJL, Vos T. Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study. JAMA Pediatr 2017; 171:573-592. [PMID: 28384795 PMCID: PMC5540012 DOI: 10.1001/jamapediatrics.2017.0250] [Citation(s) in RCA: 250] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/16/2017] [Indexed: 01/06/2023]
Abstract
Importance Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. Objective To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion. Evidence Review Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss. Findings Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries. Conclusions and Relevance Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.
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Affiliation(s)
- Nicholas Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hmwe Hmwe Kyu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Leo Zoeckler
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Katie Thomas
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Christine Pinho
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Zulfiqar A Bhutta
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurgaon-122002, National Capital Region, India
| | - Alize Ferrari
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | | | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
| | - Yohannes Kinfu
- Centre for Research & Action in Public Health, University of Canberra, Canberra, Australia
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alan Lopez
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - George C Patton
- Murdoch Childrens Research Institute, University of Melbourne, Victoria, Australia
| | - Joshua Salomon
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Benn Sartorius
- School of Nursing and Public Health, University of KwaZulu-Natal, South African Medical Research Council/University of KwaZulu-Natal Gastrointestinal Cancer Research Center, Durban, South Africa
| | - Roman Topor-Madry
- Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Stein Emil Vollset
- Center for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | | | - Harvey A Whiteford
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | | | - Kaja Abbas
- Department of Population Health, Virginia Tech, Blacksburg
| | | | | | - Nadia Akseer
- The Hospital for Sick Children, Centre for Child Health, Toronto, Ontario, Canada
| | | | | | | | | | | | - Carl A T Antonio
- Department of Health Policy and Administration, University of Philippines-Manila, Manila, Philippines
| | - Johan Arnlov
- Department of Medical Services, Uppsala University, Uppsala, Sweden
- Dalarna University, Uppsala, Sweden
| | - Al Artaman
- University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - Ashish Awasthi
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Umar Bacha
- School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | | | | | | | | | - Neeraj Bedi
- College of Public Health and Tropical Medicine, Jazan, Saudi Arabia
| | | | - Adugnaw Berhane
- College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | | | | | | | | | - Boris Bikbov
- Department of Nephrology Issues of Transplanted Kidney, V. I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russia
| | - Cheryl Anne Boyce
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Alexandra Brazinova
- Faculty of Health Sciences and Social Work, Department of Public Health, Trnava University, Trnava, Slovakia
| | | | - Austin Carter
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Ferrán Catalá-López
- University of Valencia, Valencia, Spain
- Health Research Institute and CIBERSAM, Valencia, Spain
| | - Fiona J Charlson
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | | | | | | | - John Crump
- Departmentà Centre for International Health, University of Otago, Dunedin, New Zealand
| | | | | | - Amare Deribew
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Gabrielle deVeber
- The Hospital for Sick Children, Centre for Child Health, Toronto, Ontario, Canada
| | - Daniel Dicker
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Eric L Ding
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Manisha Dubey
- International Institute for Population Sciences, Mumbai, India
| | | | - Holly E Erskine
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | | | - Andre Faro
- Federal University of Sergipe, Aracaju, Brazil
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Joao C Fernandes
- Center for Biotechnology and Fine Chemistry, Catholic University of Portugal, Porto, Portugal
| | - Daniel Obadare Fijabi
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | | | - Thomas D Fleming
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Luisa Sorio Flor
- Escola Nacional de Saúde Pública Sergio Arouca/Fiocruz, Rio De Janeiro, Brazil
| | - Kyle J Foreman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Maya S Fraser
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Joseph J Frostad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Nancy Fullman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Katherine B Gibney
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Mahari Gidey Yihdego
- Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, Mizan-Tepi University, Ethiopia
| | | | | | | | - Elizabeth Glaser
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Audra L Gold
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Ellen Goldberg
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | - Harish Chander Gugnani
- Department of Microbiology, Departments of Epidemiology and Biostatistics, St James School of Medicine, the Quarter, Anguilla
| | - Guohong Jiang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute, Jaipur, India
| | | | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | | | | | - Masako Horino
- Nevada Division of Public and Behavioral Health, Carson City, Nevada
| | | | - Guoqing Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China
| | - Kathryn H Jacobsen
- Department of Global and Community Health, George Mason University, Fairfax, Virginia
| | | | | | - Vivekanand Jha
- George Institute for Global Health, New Delhi, India
- University of Oxford, Oxford, United Kingdom
| | - Tariku Jibat
- Wageningen University, Wageningen, Netherlands
- Addis Ababa University, Addis Ababa, Ethiopia
| | - Catherine O Johnson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Jost Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karlas University, Heidelberg, Germany
| | - Amir Kasaeian
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Ibrahim Khalil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Christian Kieling
- Federal University of Rio Grande de Sul, Porto Alegre, Brazil
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Niranjan Kissoon
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Luke D Knibbs
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Kristopher J Krohn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | - Rachel Kulikoff
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - G Anil Kumar
- Public Health Foundation of India, New Delhi, India
| | | | - Hilton Y Lam
- Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines
| | - Heidi J Larson
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Anders Larsson
- Department of Medical Services, Uppsala University, Uppsala, Sweden
| | | | - Janni Leung
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Loon-Tzian Lo
- UnionHealth Associates LLC, St Louis, Missouri
- Alton Mental Health Center, Alton, Illinois
| | - Warren D Lo
- Department of Pediatrics, Department of Neurology, The Ohio State University, Columbus
| | | | - Paulo A Lotufo
- College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | | | - Reza Malekzadeh
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohsen Mazidi
- Institute of Genetics and Developmental Biology, Key State Laboratory of Molecular Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Peter A Meaney
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | | | | | | | | | - George A Mensah
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Ted R Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland
| | - Charles Mock
- School of Medicine, School of Global Health, University of Washington, Seattle
| | | | | | - Lorenzo Monasta
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Ulrich Mueller
- Federal Institute for Population Research, Wiesbaden, Germany
| | - Chie Nagata
- National Center for Child Health and Development, Tokyo, Japan
| | - Aliya Naheed
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Grant Nguyen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Quyen Le Nguyen
- Institute for Global Health, Duy Tan University, Da Nang, Vietnam
| | - Elaine Nsoesie
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - In-Hwan Oh
- Department of Preventive Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea
| | | | | | | | | | - Deepak Paudel
- UK Department for International Development, Lalitpur, Nepal
| | | | - Norberto Perico
- Istituto di Richerche Farmacologiche Mario Negri, Bergamo, Italy
| | - Max Petzold
- Health Metrics Unit, University of Gothenburg, Gothenburg, Sweden
| | | | | | | | - Mostafa Qorbani
- School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Anwar Rafay
- Contect International Health Consultants, Lahore, Punjab, Pakistan
| | - Vafa Rahimi-Movaghar
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahfuzar Rahman
- Research and Evaluation Division, Building Resources Access Communities, Dhaka, Bangladesh
| | | | - Usha Ram
- International Institute for Population Sciences, Mumbai, India
| | - Zane Rankin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | | | - Luca Ronfani
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Rajesh Sagar
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- Institute of Health Care and Social Sciences, FOM University, Essen, Germany
| | | | - James G Scott
- Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Sadaf G Sepanlou
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amira Shaheen
- Department of Public Health, An-Najah University, Nablus, Palestine
| | | | - June She
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Work Organizations, Disability Program, University of Helsinki, Helsinki, Finland
| | - Ivy Shiue
- Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | | | | | - Naris Silpakit
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alison Smith
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Jeffrey D Stanaway
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Dan J Stein
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Caitlyn Steiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Karen M Tabb
- University of Illinois at Urbana-Champaign, Champaign
| | | | | | - Bineyam Taye
- Department of Biology, Colgate University, Hamilton, New York
| | - Stephanie Teeple
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Bernadette Thomas
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alan J Thomson
- Adaptive Knowledge Management, Victoria, British Columbia, Canada
| | - Ruoyan Tobe-Gai
- National Center for Child Health and Development, Tokyo, Japan
| | | | | | - Christopher Troeger
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | | | | | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Insitutet, Stockholm, Sweden
- Institute of Population-based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | | | | | - Ronny Westerman
- Federal Institute for Population Research, Wiesbaden, Germany
| | | | | | - Rachel Woodbrook
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | | | - Seok-Jun Yoon
- Department of Preventive Medicine, School of Medicine, Korea University, Seoul, South Korea
| | | | | | | | | | | | | | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
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Dieleman J, Campbell M, Chapin A, Eldrenkamp E, Fan VY, Haakenstad A, Kates J, Liu Y, Matyasz T, Micah A, Reynolds A, Sadat N, Schneider MT, Sorensen R, Evans T, Evans D, Kurowski C, Tandon A, Abbas KM, Abera SF, Kiadaliri AA, Ahmed KY, Ahmed MB, Alam K, Alizadeh-Navaei R, Alkerwi A, Amini E, Ammar W, Amrock SM, Antonio CAT, Atey TM, Avila-Burgos L, Awasthi A, Barac A, Bernal OA, Beyene AS, Beyene TJ, Birungi C, Bizuayehu HM, Breitborde NJK, Cahuana-Hurtado L, Castro RE, Catalia-Lopez F, Dalal K, Dandona L, Dandona R, de Jager P, Dharmaratne SD, Dubey M, Farinha CSES, Faro A, Feigl AB, Fischer F, Fitchett JRA, Foigt N, Giref AZ, Gupta R, Hamidi S, Harb HL, Hay SI, Hendrie D, Horino M, Jürisson M, Jakovljevic MB, Javanbakht M, John D, Jonas JB, Karimi SM, Khang YH, Khubchandani J, Kim YJ, Kinge JM, Krohn KJ, Kumar GA, El Razek HMA, El Razek MMA, Majeed A, Malekzadeh R, Masiye F, Meier T, Meretoja A, Miller TR, Mirrakhimov EM, Mohammed S, Nangia V, Olgiati S, Osman AS, Owolabi MO, Patel T, Caicedo AJP, Pereira DM, Perelman J, Polinder S, Rafay A, Rahimi-Movaghar V, Rai RK, Ram U, Ranabhat CL, Roba HS, Salama J, Savic M, Sepanlou SG, Shrime MG, Talongwa RT, Ao BJT, Tediosi F, Tesema AG, Thomson AJ, Tobe-Gai R, Topor-Madry R, Undurraga EA, Vasankari T, Violante FS, Werdecker A, Wijeratne T, Xu G, Yonemoto N, Younis MZ, Yu C, Zaidi Z, El Sayed Zaki M, Murray CJL. Evolution and patterns of global health financing 1995-2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet 2017; 389:1981-2004. [PMID: 28433256 PMCID: PMC5440770 DOI: 10.1016/s0140-6736(17)30874-7] [Citation(s) in RCA: 150] [Impact Index Per Article: 21.4] [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: 01/07/2017] [Revised: 02/27/2017] [Accepted: 03/16/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we further explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends. METHODS We estimated national health spending by type of care and by source, including development assistance for health, based on a diverse set of data including programme reports, budget data, national estimates, and 964 National Health Accounts. These data represent health spending for 184 countries from 1995 through 2014. We converted these data into a common inflation-adjusted and purchasing power-adjusted currency, and used non-linear regression methods to model the relationship between health financing, time, and economic development. FINDINGS Between 1995 and 2014, economic development was positively associated with total health spending and a shift away from a reliance on development assistance and out-of-pocket (OOP) towards government spending. The largest absolute increase in spending was in high-income countries, which increased to purchasing power-adjusted $5221 per capita based on an annual growth rate of 3·0%. The largest health spending growth rates were in upper-middle-income (5·9) and lower-middle-income groups (5·0), which both increased spending at more than 5% per year, and spent $914 and $267 per capita in 2014, respectively. Spending in low-income countries grew nearly as fast, at 4·6%, and health spending increased from $51 to $120 per capita. In 2014, 59·2% of all health spending was financed by the government, although in low-income and lower-middle-income countries, 29·1% and 58·0% of spending was OOP spending and 35·7% and 3·0% of spending was development assistance. Recent growth in development assistance for health has been tepid; between 2010 and 2016, it grew annually at 1·8%, and reached US$37·6 billion in 2016. Nonetheless, there is a great deal of variation revolving around these averages. 29 countries spend at least 50% more than expected per capita, based on their level of economic development alone, whereas 11 countries spend less than 50% their expected amount. INTERPRETATION Health spending remains disparate, with low-income and lower-middle-income countries increasing spending in absolute terms the least, and relying heavily on OOP spending and development assistance. Moreover, tremendous variation shows that neither time nor economic development guarantee adequate prepaid health resources, which are vital for the pursuit of universal health coverage. FUNDING The Bill & Melinda Gates Foundation.
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Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, Ahmed M, Aksut B, Alam T, Alam K, Alla F, Alvis-Guzman N, Amrock S, Ansari H, Ärnlöv J, Asayesh H, Atey TM, Avila-Burgos L, Awasthi A, Banerjee A, Barac A, Bärnighausen T, Barregard L, Bedi N, Belay Ketema E, Bennett D, Berhe G, Bhutta Z, Bitew S, Carapetis J, Carrero JJ, Malta DC, Castañeda-Orjuela CA, Castillo-Rivas J, Catalá-López F, Choi JY, Christensen H, Cirillo M, Cooper L, Criqui M, Cundiff D, Damasceno A, Dandona L, Dandona R, Davletov K, Dharmaratne S, Dorairaj P, Dubey M, Ehrenkranz R, El Sayed Zaki M, Faraon EJA, Esteghamati A, Farid T, Farvid M, Feigin V, Ding EL, Fowkes G, Gebrehiwot T, Gillum R, Gold A, Gona P, Gupta R, Habtewold TD, Hafezi-Nejad N, Hailu T, Hailu GB, Hankey G, Hassen HY, Abate KH, Havmoeller R, Hay SI, Horino M, Hotez PJ, Jacobsen K, James S, Javanbakht M, Jeemon P, John D, Jonas J, Kalkonde Y, Karimkhani C, Kasaeian A, Khader Y, Khan A, Khang YH, Khera S, Khoja AT, Khubchandani J, Kim D, Kolte D, Kosen S, Krohn KJ, Kumar GA, Kwan GF, Lal DK, Larsson A, Linn S, Lopez A, Lotufo PA, El Razek HMA, Malekzadeh R, Mazidi M, Meier T, Meles KG, Mensah G, Meretoja A, Mezgebe H, Miller T, Mirrakhimov E, Mohammed S, Moran AE, Musa KI, Narula J, Neal B, Ngalesoni F, Nguyen G, Obermeyer CM, Owolabi M, Patton G, Pedro J, Qato D, Qorbani M, Rahimi K, Rai RK, Rawaf S, Ribeiro A, Safiri S, Salomon JA, Santos I, Santric Milicevic M, Sartorius B, Schutte A, Sepanlou S, Shaikh MA, Shin MJ, Shishehbor M, Shore H, Silva DAS, Sobngwi E, Stranges S, Swaminathan S, Tabarés-Seisdedos R, Tadele Atnafu N, Tesfay F, Thakur JS, Thrift A, Topor-Madry R, Truelsen T, Tyrovolas S, Ukwaja KN, Uthman O, Vasankari T, Vlassov V, Vollset SE, Wakayo T, Watkins D, Weintraub R, Werdecker A, Westerman R, Wiysonge CS, Wolfe C, Workicho A, Xu G, Yano Y, Yip P, Yonemoto N, Younis M, Yu C, Vos T, Naghavi M, Murray C. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol 2017; 70:1-25. [PMID: 28527533 PMCID: PMC5491406 DOI: 10.1016/j.jacc.2017.04.052] [Citation(s) in RCA: 2308] [Impact Index Per Article: 329.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 04/19/2017] [Accepted: 04/21/2017] [Indexed: 02/05/2023]
Abstract
Background The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. Objectives The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden. Methods CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Results In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75. Conclusions CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD.
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Affiliation(s)
| | | | | | | | | | - Gebre Abyu
- Mekelle University, Addis Ababa, Ethiopia
| | | | | | - Tahiya Alam
- University of Washington, Seattle, Washington
| | - Khurshid Alam
- University of Melbourne, Melbourne, Victoria, Australia
| | | | | | | | | | | | | | | | | | - Ashish Awasthi
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | | | | | | | - Neeraj Bedi
- College of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | | | | | | | | | | | - Jonathan Carapetis
- The University of Western Australia, Perth, Western Australia, Australia
| | | | | | | | | | - Ferrán Catalá-López
- University of València/INCLIVA Health Research Institute and CIBERSAM, València, Spain
| | | | | | | | | | | | | | | | - Lalit Dandona
- University of Washington, Seattle, Washington; Public Health Foundation of India, New Delhi, India
| | - Rakhi Dandona
- University of Washington, Seattle, Washington; Public Health Foundation of India, New Delhi, India
| | - Kairat Davletov
- Republican Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | | | | | - Manisha Dubey
- International Institute for Population Sciences, Mumbai, India
| | | | | | | | | | - Talha Farid
- University of Louisville, Louisville, Kentucky
| | | | - Valery Feigin
- Auckland University of Technology, Auckland, New Zealand
| | | | - Gerry Fowkes
- University of Edinburgh, Edinburgh United Kingdom
| | | | | | - Audra Gold
- University of Washington, Seattle, Washington
| | - Philimon Gona
- University of Massachusetts Boston, Boston, Massachusetts
| | - Rajeev Gupta
- Eternal Heart Care Center and Research Institute, Jaipur, India
| | | | | | | | | | - Graeme Hankey
- The University of Western Australia, Perth, Western Australia, Australia
| | | | | | | | - Simon I Hay
- University of Washington, Seattle, Washington; University of Oxford, Oxford, United Kingdom
| | - Masako Horino
- Nevada Division of Public and Behavioral Health, Carson City, Nevada
| | | | | | - Spencer James
- Denver Health/University of Colorado, Denver, Colorado
| | | | | | - Denny John
- International Center for Research on Women, New Delhi, India
| | - Jost Jonas
- Ruprecht-Karls Universitaet Heidelberg, Heidelberg, Germany
| | - Yogeshwar Kalkonde
- Society for Education, Action and Research in Community Health, Gadchiroli, India
| | | | | | - Yousef Khader
- Jordan University of Science and Technology, Irbid, Jordan
| | - Abdur Khan
- University of Louisville, Louisville, Kentucky
| | | | - Sahil Khera
- New York Medical College, Valhalla, New York
| | - Abdullah T Khoja
- Al-Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | | | - Daniel Kim
- Northeastern University, Boston, Massachusetts
| | | | - Soewarta Kosen
- Health Policy and Humanities, National Institute of Health Research and Development, Jakarta, Indonesia
| | | | - G Anil Kumar
- Public Health Foundation of India, New Delhi, India
| | - Gene F Kwan
- Boston University School of Medicine, Boston, Massachusetts
| | | | | | | | - Alan Lopez
- University of Melbourne, Melbourne, Victoria, Australia
| | | | | | | | | | - Toni Meier
- Martin Luther University Halle-Wittenberg, Halle, Germany
| | | | | | - Atte Meretoja
- University of Melbourne, Melbourne, Victoria, Australia
| | | | - Ted Miller
- Pacific Institute for Research & Evaluation, Beltsville, Maryland
| | | | | | | | | | | | - Bruce Neal
- The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Frida Ngalesoni
- Ministry of Health and Social Welfare, Dar es Salaam, Tanzania
| | | | | | - Mayowa Owolabi
- College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - George Patton
- University of Melbourne, Melbourne, Victoria, Australia
| | | | - Dima Qato
- University of Illinois at Chicago, Chicago, Illinois
| | | | | | | | | | - Antônio Ribeiro
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Saeid Safiri
- Maragheh University of Medical Sciences, Maragheh, Iran
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J S Thakur
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | | | | | | | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Vasiliy Vlassov
- National Research University Higher School of Economics, Moscow, Russia
| | | | | | | | | | | | - Ronny Westerman
- Federal Institute for Population Research, Wiesbaden, Germany
| | | | | | | | - Gelin Xu
- Nanjing University School of Medicine, Nanjing, China
| | | | - Paul Yip
- University of Hong Kong, Pokfulam, Hong Kong
| | | | | | | | - Theo Vos
- University of Washington, Seattle, Washington
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Rai RK, Singh L, Singh PK. Is maternal body mass index associated with neonatal mortality? A pooled analysis of nationally representative data from nine Asian countries. Nutrition 2017; 41:68-72. [PMID: 28760430 DOI: 10.1016/j.nut.2017.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/16/2017] [Accepted: 04/07/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Children born to mothers with abnormal body mass index (BMI) have increased risk for mortality. The aim of this study was to investigate whether maternal BMI is a risk factor for neonatal death in select Asian countries, including the nature of association between maternal BMI and the discrete timing of neonatal death. METHODS Nationally representative, the standard Demographic and Health Survey data from nine Asian countries were used. In all, 55 629 mothers reported their index birth; 840 reported neonatal mortality. Descriptive statistics and multivariate logistic regression analyses were applied to attain the study objective. RESULTS Overweight mothers had higher odds of neonatal mortality than mothers with optimum weight. No significant association was registered for obese mothers, possibly due to insufficient power. During the first 7 d (0-1 and 2-6 d) of birth, children born to overweight mothers had higher odds of dying, whereas for the remaining period (7-27 d), maternal underweight was the risk factor for neonatal mortality. CONCLUSION Interventions should target high-risk pregnancies to reduce the rate of neonatal mortality. With the help of community health workers or physicians, preconception counseling of prospective mothers with abnormal BMI should be devised. If conceived, underweight or overweight or obese women should be marked as high-risk pregnancy during their antenatal care visits, and they must be encouraged for delivery at an institution equipped with an emergency obstetric and neonatal care unit.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, West Bengal, India.
| | - Lucky Singh
- National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
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Hua D, Rai RK, Zhang Y, Chung TS. Aldehyde functionalized graphene oxide frameworks as robust membrane materials for pervaporative alcohol dehydration. Chem Eng Sci 2017. [DOI: 10.1016/j.ces.2016.12.061] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Moradi-Lakeh M, Forouzanfar MH, Vollset SE, El Bcheraoui C, Daoud F, Afshin A, Charara R, Khalil I, Higashi H, Abd El Razek MM, Kiadaliri AA, Alam K, Akseer N, Al-Hamad N, Ali R, AlMazroa MA, Alomari MA, Al-Rabeeah AA, Alsharif U, Altirkawi KA, Atique S, Badawi A, Barrero LH, Basulaiman M, Bazargan-Hejazi S, Bedi N, Bensenor IM, Buchbinder R, Danawi H, Dharmaratne SD, Zannad F, Farvid MS, Fereshtehnejad SM, Farzadfar F, Fischer F, Gupta R, Hamadeh RR, Hamidi S, Horino M, Hoy DG, Hsairi M, Husseini A, Javanbakht M, Jonas JB, Kasaeian A, Khan EA, Khubchandani J, Knudsen AK, Kopec JA, Lunevicius R, Abd El Razek HM, Majeed A, Malekzadeh R, Mate K, Mehari A, Meltzer M, Memish ZA, Mirarefin M, Mohammed S, Naheed A, Obermeyer CM, Oh IH, Park EK, Peprah EK, Pourmalek F, Qorbani M, Rafay A, Rahimi-Movaghar V, Shiri R, Rahman SU, Rai RK, Rana SM, Sepanlou SG, Shaikh MA, Shiue I, Sibai AM, Silva DAS, Singh JA, Skogen JC, Terkawi AS, Ukwaja KN, Westerman R, Yonemoto N, Yoon SJ, Younis MZ, Zaidi Z, Zaki MES, Lim SS, Wang H, Vos T, Naghavi M, Lopez AD, Murray CJL, Mokdad AH. Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990-2013: findings from the Global Burden of Disease Study 2013. Ann Rheum Dis 2017; 76:1365-1373. [PMID: 28209629 PMCID: PMC5738600 DOI: 10.1136/annrheumdis-2016-210146] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/28/2016] [Accepted: 01/19/2017] [Indexed: 12/22/2022]
Abstract
Objectives We used findings from the Global Burden of Disease Study 2013 to report the burden of musculoskeletal disorders in the Eastern Mediterranean Region (EMR). Methods The burden of musculoskeletal disorders was calculated for the EMR's 22 countries between 1990 and 2013. A systematic analysis was performed on mortality and morbidity data to estimate prevalence, death, years of live lost, years lived with disability and disability-adjusted life years (DALYs). Results For musculoskeletal disorders, the crude DALYs rate per 100 000 increased from 1297.1 (95% uncertainty interval (UI) 924.3–1703.4) in 1990 to 1606.0 (95% UI 1141.2–2130.4) in 2013. During 1990–2013, the total DALYs of musculoskeletal disorders increased by 105.2% in the EMR compared with a 58.0% increase in the rest of the world. The burden of musculoskeletal disorders as a proportion of total DALYs increased from 2.4% (95% UI 1.7–3.0) in 1990 to 4.7% (95% UI 3.6–5.8) in 2013. The range of point prevalence (per 1000) among the EMR countries was 28.2–136.0 for low back pain, 27.3–49.7 for neck pain, 9.7–37.3 for osteoarthritis (OA), 0.6–2.2 for rheumatoid arthritis and 0.1–0.8 for gout. Low back pain and neck pain had the highest burden in EMR countries. Conclusions This study shows a high burden of musculoskeletal disorders, with a faster increase in EMR compared with the rest of the world. The reasons for this faster increase need to be explored. Our findings call for incorporating prevention and control programmes that should include improving health data, addressing risk factors, providing evidence-based care and community programmes to increase awareness.
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Affiliation(s)
- Maziar Moradi-Lakeh
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Community Medicine, Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad H Forouzanfar
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Stein Emil Vollset
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Norwegian Institute of Public Health, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Charbel El Bcheraoui
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Farah Daoud
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Ashkan Afshin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Raghid Charara
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Ibrahim Khalil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | | | - Aliasghar Ahmad Kiadaliri
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden
| | - Khurshid Alam
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Nadia Akseer
- Hospital for Sick Children, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Nawal Al-Hamad
- Food and Nutrition Administration, Ministry of Health, Safat, Kuwait
| | | | | | - Mahmoud A Alomari
- Division of Physical Therapy, Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | | | | | | | - Suleman Atique
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
| | - Alaa Badawi
- Public Health Agency of Canada, Toronto, Ontario, Canada
| | - Lope H Barrero
- Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogota, Colombia
| | | | - Shahrzad Bazargan-Hejazi
- Charles R. Drew University of Medicine and Science, Los Angeles, California, USA.,David Geffen School of Medicine, University of California at Los Angeles (UCLA), California, USA
| | - Neeraj Bedi
- College of Public Health and Tropical Medicine, Jazan, Saudi Arabia
| | | | - Rachelle Buchbinder
- Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Hadi Danawi
- Walden University, Minneapolis, Minnesota, USA
| | - Samath D Dharmaratne
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Faiez Zannad
- Clinical Investigation Centre INSERM (the National Institute for Health and Medical Research), Université de Lorraine, Vandoeuvre les Nancy, France
| | - Maryam S Farvid
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrine and Metabolic Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Rahul Gupta
- West Virginia Bureau for Public Health, Charleston, West Virginia, USA
| | | | - Samer Hamidi
- Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Masako Horino
- Nevada Division of Behavior and Public Health, Carson City, Nevada, USA.,Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Damian G Hoy
- Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia
| | | | - Abdullatif Husseini
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Mehdi Javanbakht
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Ann Kristin Knudsen
- Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway
| | - Jacek A Kopec
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Raimundas Lunevicius
- Aintree University Hospital National Health Service Foundation Trust, Liverpool, UK.,School of Medicine, University of Liverpool, Liverpool, UK
| | | | | | - Reza Malekzadeh
- Digestive Disease Research Institute, Tehran Universities of Medical Sciences, Tehran, Iran
| | - Kedar Mate
- McGill University, Montreal, Quebec, Canada
| | - Alem Mehari
- College of Medicine, Howard University, Washington DC, USA
| | - Michele Meltzer
- Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ziad A Memish
- Saudi Ministry of Health, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Shafiu Mohammed
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria.,Institute of Public Health, Heidelberg University, Heidelberg, Germany
| | - Aliya Naheed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Carla Makhlouf Obermeyer
- Faculty of Health Sciences, Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, South Korea
| | | | | | - Mostafa Qorbani
- Noncommunicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Anwar Rafay
- Contech International Health Consultants, Lahore, Pakistan.,Contech School of Public Health, Lahore, Pakistan
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | | | - Saleem M Rana
- Contech International Health Consultants, Lahore, Pakistan.,Contech School of Public Health, Lahore, Pakistan
| | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ivy Shiue
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.,Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Abla Mehio Sibai
- Department of Epidemiology & Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | | | - Jasvinder A Singh
- University of Alabama at Birmingham, and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA
| | - Jens Christoffer Skogen
- Norwegian Institute of Public Health, Bergen, Norway.,Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
| | - Abdullah Sulieman Terkawi
- Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA.,Outcomes Research Consortium, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Kingsley N Ukwaja
- Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria
| | - Ronny Westerman
- Federal Institute for Population Research, Wiesbaden, Germany.,German National Cohort Consortium, Heidelberg, Germany
| | - Naohiro Yonemoto
- Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Seok-Jun Yoon
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | | | | | | | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Haidong Wang
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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49
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Forouzanfar MH, Liu P, Roth GA, Ng M, Biryukov S, Marczak L, Alexander L, Estep K, Hassen Abate K, Akinyemiju TF, Ali R, Alvis-Guzman N, Azzopardi P, Banerjee A, Bärnighausen T, Basu A, Bekele T, Bennett DA, Biadgilign S, Catalá-López F, Feigin VL, Fernandes JC, Fischer F, Gebru AA, Gona P, Gupta R, Hankey GJ, Jonas JB, Judd SE, Khang YH, Khosravi A, Kim YJ, Kimokoti RW, Kokubo Y, Kolte D, Lopez A, Lotufo PA, Malekzadeh R, Melaku YA, Mensah GA, Misganaw A, Mokdad AH, Moran AE, Nawaz H, Neal B, Ngalesoni FN, Ohkubo T, Pourmalek F, Rafay A, Rai RK, Rojas-Rueda D, Sampson UK, Santos IS, Sawhney M, Schutte AE, Sepanlou SG, Shifa GT, Shiue I, Tedla BA, Thrift AG, Tonelli M, Truelsen T, Tsilimparis N, Ukwaja KN, Uthman OA, Vasankari T, Venketasubramanian N, Vlassov VV, Vos T, Westerman R, Yan LL, Yano Y, Yonemoto N, Zaki MES, Murray CJL. Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015. JAMA 2017; 317:165-182. [PMID: 28097354 DOI: 10.1001/jama.2016.19043] [Citation(s) in RCA: 1254] [Impact Index Per Article: 179.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Elevated systolic blood (SBP) pressure is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions. OBJECTIVE To estimate the association between SBP of at least 110 to 115 mm Hg and SBP of 140 mm Hg or higher and the burden of different causes of death and disability by age and sex for 195 countries and territories, 1990-2015. DESIGN A comparative risk assessment of health loss related to SBP. Estimated distribution of SBP was based on 844 studies from 154 countries (published 1980-2015) of 8.69 million participants. Spatiotemporal Gaussian process regression was used to generate estimates of mean SBP and adjusted variance for each age, sex, country, and year. Diseases with sufficient evidence for a causal relationship with high SBP (eg, ischemic heart disease, ischemic stroke, and hemorrhagic stroke) were included in the primary analysis. MAIN OUTCOMES AND MEASURES Mean SBP level, cause-specific deaths, and health burden related to SBP (≥110-115 mm Hg and also ≥140 mm Hg) by age, sex, country, and year. RESULTS Between 1990-2015, the rate of SBP of at least 110 to 115 mm Hg increased from 73 119 (95% uncertainty interval [UI], 67 949-78 241) to 81 373 (95% UI, 76 814-85 770) per 100 000, and SBP of 140 mm Hg or higher increased from 17 307 (95% UI, 17 117-17 492) to 20 526 (95% UI, 20 283-20 746) per 100 000. The estimated annual death rate per 100 000 associated with SBP of at least 110 to 115 mm Hg increased from 135.6 (95% UI, 122.4-148.1) to 145.2 (95% UI 130.3-159.9) and the rate for SBP of 140 mm Hg or higher increased from 97.9 (95% UI, 87.5-108.1) to 106.3 (95% UI, 94.6-118.1). For loss of DALYs associated with systolic blood pressure of 140 mm Hg or higher, the loss increased from 95.9 million (95% uncertainty interval [UI], 87.0-104.9 million) to 143.0 million (95% UI, 130.2-157.0 million) [corrected], and for SBP of 140 mm Hg or higher, the loss increased from 5.2 million (95% UI, 4.6-5.7 million) to 7.8 million (95% UI, 7.0-8.7 million). The largest numbers of SBP-related deaths were caused by ischemic heart disease (4.9 million [95% UI, 4.0-5.7 million]; 54.5%), hemorrhagic stroke (2.0 million [95% UI, 1.6-2.3 million]; 58.3%), and ischemic stroke (1.5 million [95% UI, 1.2-1.8 million]; 50.0%). In 2015, China, India, Russia, Indonesia, and the United States accounted for more than half of the global DALYs related to SBP of at least 110 to 115 mm Hg. CONCLUSIONS AND RELEVANCE In international surveys, although there is uncertainty in some estimates, the rate of elevated SBP (≥110-115 and ≥140 mm Hg) increased substantially between 1990 and 2015, and DALYs and deaths associated with elevated SBP also increased. Projections based on this sample suggest that in 2015, an estimated 3.5 billion adults had SBP of at least 110 to 115 mm Hg and 874 million adults had SBP of 140 mm Hg or higher.
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Affiliation(s)
| | - Patrick Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Gregory A Roth
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Marie Ng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Stan Biryukov
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Laurie Marczak
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Lily Alexander
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Kara Estep
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | - Raghib Ali
- University of Oxford, Oxford, United Kingdom
| | | | - Peter Azzopardi
- Centre for Adolescent Health, Parkville, Victoria, Australia7South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Amitava Banerjee
- University College London, Farr Institute of Health Informatics Research, London, United Kingdom
| | - Till Bärnighausen
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts10Wellcome Trust Africa Centre for Health and Population Studies, Somkhele, Mtubatuba, KwaZulu-Natal, South Africa
| | - Arindam Basu
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | | | | | | | - Ferrán Catalá-López
- University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Department of Medicine, Valencia, Spain15Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Valery L Feigin
- Auckland University of Technology, National Institute for Stroke and Applied Neurosciences, Auckland, New Zealand
| | - Joao C Fernandes
- Pharmacology and Experimental Therapeutics, IBILI - Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Alemseged Aregay Gebru
- Mekelle University, Mekelle, Ethiopia; Kilte Awlaelo-Health and Demographic Surveillance System
| | | | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute, Jaipur, India
| | - Graeme J Hankey
- School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia23Harry Perkins Institute of Medical Research, Nedlands, Western Australia, Australia24Western Australian Neuroscience Research Institute, Nedlands, Western Australia, Australia
| | - Jost B Jonas
- Ruprecht-Karls-University Heidelberg, Department of Ophthalmology, Medical Faculty Mannheim, Mannheim, Germany
| | | | - Young-Ho Khang
- Seoul National University College of Medicine, Seoul, South Korea
| | | | - Yun Jin Kim
- Southern University College, Johor, Malaysia
| | | | - Yoshihiro Kokubo
- National Cerebral and Cardiovascular Center, Department of Preventive Cardiology, Suita, Osaka, Japan
| | - Dhaval Kolte
- Brown University/Rhode Island Hospital, Providence, Rhode Island
| | - Alan Lopez
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, QLD, Australia
| | | | - Reza Malekzadeh
- Tehran Universities of Medical Sciences, Digestive Disease Research Institute, Tehran, Iran
| | - Yohannes Adama Melaku
- Mekelle University, School of Public Health, Mekelle, Ethiopia37The University of Adelaide, School of Medicine, Adelaide, South Australia, Australia
| | - George A Mensah
- National Institutes of Health, Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Awoke Misganaw
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | - Bruce Neal
- The George Institute for Global Health, Sydney, NSW, Australia42The University of Sydney, Sydney, New South Wales, Australia43Royal Prince Alfred Hospital, Sydney, New South Wales, Australia44Imperial College London, London, United Kingdom
| | | | | | | | - Anwar Rafay
- Contech School of Public Health, Lahore, Punjab, Pakistan
| | | | - David Rojas-Rueda
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Uchechukwu K Sampson
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Itamar S Santos
- University of São Paulo, Internal Medicine Department, São Paulo, Brazil
| | | | - Aletta E Schutte
- Hypertension in Africa Research Team (HART); South African Medical Research Council, North-West University, Potchefstroom, South Africa
| | - Sadaf G Sepanlou
- Tehran Universities of Medical Sciences, Digestive Disease Research Institute, Tehran, Iran
| | - Girma Temam Shifa
- Arba Minch University, Arba Minch, SNNPR, Ethiopia56Addis Ababa University, Addis Ababa, Ethiopia
| | - Ivy Shiue
- Northumbria University, Faculty of Health and Life Sciences, Newcastle upon Tyne, United Kingdom58University of Edinburgh, Alzheimer Scotland Dementia Research Centre, Edinburgh, United Kingdom
| | - Bemnet Amare Tedla
- University of Gondar, Gondar, Ethiopia; James Cook University, Cairns, Queensland, Australia
| | - Amanda G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | | | - Thomas Truelsen
- University of Copenhagen, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | | | | | - Olalekan A Uthman
- University of Warwick, Warwick Medical School, Coventry, United Kingdom
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | | | | | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Ronny Westerman
- Federal Institute for Population Research, Wiesbaden, Germany70German National Cohort Consortium, Heidelberg, Germany
| | - Lijing L Yan
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
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50
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Khalil I, Colombara DV, Forouzanfar MH, Troeger C, Daoud F, Moradi-Lakeh M, Bcheraoui CE, Rao PC, Afshin A, Charara R, Abate KH, Razek MMAE, Abd-Allah F, Abu-Elyazeed R, Kiadaliri AA, Akanda AS, Akseer N, Alam K, Alasfoor D, Ali R, AlMazroa MA, Alomari MA, Al-Raddadi RMS, Alsharif U, Alsowaidi S, Altirkawi KA, Alvis-Guzman N, Ammar W, Antonio CAT, Asayesh H, Asghar RJ, Atique S, Awasthi A, Bacha U, Badawi A, Barac A, Bedi N, Bekele T, Bensenor IM, Betsu BD, Bhutta Z, Abdulhak AAB, Butt ZA, Danawi H, Dubey M, Endries AY, Faghmous IDA, Farid T, Farvid MS, Farzadfar F, Fereshtehnejad SM, Fischer F, Fitchett JRA, Gibney KB, Ginawi IAM, Gishu MD, Gugnani HC, Gupta R, Hailu GB, Hamadeh RR, Hamidi S, Harb HL, Hedayati MT, Hsairi M, Husseini A, Jahanmehr N, Javanbakht M, Jibat T, Jonas JB, Kasaeian A, Khader YS, Khan AR, Khan EA, Khan G, Khoja TAM, Kinfu Y, Kissoon N, Koyanagi A, Lal A, Latif AAA, Lunevicius R, Razek HMAE, Majeed A, Malekzadeh R, Mehari A, Mekonnen AB, Melaku YA, Memish ZA, Mendoza W, Misganaw A, Mohamed LAI, Nachega JB, Nguyen QL, Nisar MI, Peprah EK, Platts-Mills JA, Pourmalek F, Qorbani M, Rafay A, Rahimi-Movaghar V, Rahman SU, Rai RK, Rana SM, Ranabhat CL, Rao SR, Refaat AH, Riddle M, Roshandel G, Ruhago GM, Saleh MM, Sanabria JR, Sawhney M, Sepanlou SG, Setegn T, Sliwa K, Sreeramareddy CT, Sykes BL, Tavakkoli M, Tedla BA, Terkawi AS, Ukwaja K, Uthman OA, Westerman R, Wubshet M, Yenesew MA, Yonemoto N, Younis MZ, Zaidi Z, Zaki MES, Rabeeah AAA, Wang H, Naghavi M, Vos T, Lopez AD, Murray CJL, Mokdad AH. Burden of Diarrhea in the Eastern Mediterranean Region, 1990-2013: Findings from the Global Burden of Disease Study 2013. Am J Trop Med Hyg 2016; 95:1319-1329. [PMID: 27928080 PMCID: PMC5154365 DOI: 10.4269/ajtmh.16-0339] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 04/29/2016] [Accepted: 07/03/2016] [Indexed: 12/22/2022] Open
Abstract
Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0-1) in Bahrain and Oman to 471 (95% UI = 245-763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520-989) in Syria to 40,869 (95% UI = 21,540-65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden.
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Affiliation(s)
- Ibrahim Khalil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Danny V Colombara
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | | | - Christopher Troeger
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Farah Daoud
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Maziar Moradi-Lakeh
- Department of Community Medicine, Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Charbel El Bcheraoui
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Puja C Rao
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Ashkan Afshin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Raghid Charara
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | | | | | | | | | - Aliasghar Ahmad Kiadaliri
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | | | - Nadia Akseer
- University of Toronto, Toronto, Canada.,The Hospital for Sick Children, Toronto, Canada
| | - Khurshid Alam
- University of Sydney, Sydney, Australia.,University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Raghib Ali
- University of Oxford, Oxford, United Kingdom
| | | | - Mahmoud A Alomari
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | | | | | - Shirina Alsowaidi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | | | | | | | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, College of Public Health, University of the Philippines, Manila, Philippines
| | - Hamid Asayesh
- Department of Medical Emergency, School of Paramedic, Qom University of Medical Sciences, Qom, Iran
| | | | - Suleman Atique
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
| | - Ashish Awasthi
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Umar Bacha
- School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Alaa Badawi
- Public Health Agency of Canada, Toronto, Canada
| | | | - Neeraj Bedi
- College of Public Health and Tropical Medicine, Jazan, Saudi Arabia
| | | | | | | | - Zulfiqar Bhutta
- Medical Center, Aga Khan University, Karachi, Pakistan.,The Hospital for Sick Children, Toronto, Canada
| | | | - Zahid A Butt
- Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | | | - Manisha Dubey
- International Institute for Population Sciences, Mumbai, India
| | | | - Imad D A Faghmous
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Talha Farid
- University of Louisville, Louisville, Kentucky
| | - Maryam S Farvid
- Institute for Health Policy, Boston, Massachusetts.,University of Louisville, Louisville, Kentucky
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Katherine B Gibney
- Melbourne Health, Parkville, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Melkamu Dedefo Gishu
- Kersa Health and Demographic Surveillance System, Harar, Ethiopia.,Haramaya University, Dire Dawa, Ethiopia
| | - Harish Chander Gugnani
- Department of Epidemiology and Biostatistics, Saint James School of Medicine, Anguilla, British West Indies.,Department of Microbiology, Saint James School of Medicine, Anguilla, British West Indies
| | - Rahul Gupta
- West Virginia Bureau for Public Health, Charleston, West Virginia
| | - Gessessew Bugssa Hailu
- Kilte Awlaelo Health and Demographic Surveillance System, Ethiopia.,Mekelle University, Mekelle, Ethiopia
| | | | - Samer Hamidi
- Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | | | - Mohammad T Hedayati
- Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohamed Hsairi
- Department of Epidemiology, Salah Azaiz Institute, Tunis, Tunisia
| | | | - Nader Jahanmehr
- Department of Public Health, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Tariku Jibat
- Wageningen University, Wageningen, Netherlands.,Addis Ababa University, Debre Zeit, Ethiopia
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Gulfaraz Khan
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Yohannes Kinfu
- Centre for Research and Action in Public Health, Faculty of Health, University of Canberra, Canberra, Australia
| | | | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu (CIBERSAM), Barcelona, Spain
| | - Aparna Lal
- Australian National University, Canberra, Australia
| | | | - Raimundas Lunevicius
- School of Medicine, University of Liverpool, Liverpool, United Kingdom.,Aintree University Hospital, National Health Service Foundation Trust, Liverpool, United Kingdom
| | | | | | - Reza Malekzadeh
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alem Mehari
- Howard University College of Medicine, Washington, District of Columbia
| | | | - Yohannes Adama Melaku
- School of Medicine, University of Adelaide, Adelaide, Australia.,School of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Ziad A Memish
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,Saudi Ministry of Health, Riyadh, Saudi Arabia
| | | | - Awoke Misganaw
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | | | - Jean B Nachega
- Stellenbosch University, Cape Town, Western Cape, South Africa.,University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Quyen Le Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | | | | | | | | | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Anwar Rafay
- Contech School of Public Health, Lahore, Pakistan.,Contech International Health Consultants, Lahore, Pakistan
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Saleem M Rana
- Contech School of Public Health, Lahore, Pakistan.,Contech International Health Consultants, Lahore, Pakistan
| | - Chhabi L Ranabhat
- Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, South Korea.,Wonju College of Medicine, Yonsei University, Wonju, South Korea
| | - Sowmya R Rao
- Department of Surgery, School of Medicine, Boston University, Boston, Massachusetts
| | - Amany H Refaat
- Suez Canal University, Ismailia, Egypt.,Walden University, Minneapolis, Minnesota
| | - Mark Riddle
- Naval Medical Research Center, Silver Spring, Maryland
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.,Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Juan R Sanabria
- Case Western Reserve University, Cleveland, Ohio.,Department of Surgery and Comprehensive Cancer Center, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
| | | | - Sadaf G Sepanlou
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Karen Sliwa
- Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa
| | | | - Bryan L Sykes
- Departments of Criminology, Law and Society, Sociology, and Public Health, University of California-Irvine, Irvine, California
| | | | - Bemnet Amare Tedla
- James Cook University, Cairns, Australia.,University of Gondar, Gondar, Ethiopia
| | - Abdullah S Terkawi
- Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia.,Outcomes Research Consortium, Cleveland Clinic, Cleveland, Ohio.,Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | - Kingsley Ukwaja
- Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria
| | - Olalekan A Uthman
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Ronny Westerman
- German National Cohort Consortium, Heidelberg, Germany.,Federal Institute for Population Research, Wiesbaden, Germany
| | - Mamo Wubshet
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.,University of Gondar, Gondar, Ethiopia
| | | | - Naohiro Yonemoto
- Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
| | | | | | | | | | - Haidong Wang
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Alan D Lopez
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
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