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Zafari P, Zarifian A, Alizadeh-Navaei R, Taghadosi M, Rafiei A. Association between polymorphisms of cytokine genes and brucellosis: A comprehensive systematic review and meta-analysis. Cytokine 2020; 127:154949. [PMID: 31816580 DOI: 10.1016/j.cyto.2019.154949] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 11/27/2019] [Accepted: 12/02/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Owing to involvement of host genetic factors in susceptibility to brucellosis infection and its outcome, this study aimed to carry out a comprehensive systematic review and meta-analysis to derive a precise evaluation of the association between the risk of brucellosis and its focal complication and all cytokines examined in case-control studies, including Interferon gamma (IFN-γ), Tumor Necrosis Factor (TNF)-α, TNF-β, Transforming Growth Factor(TGF)-β, IL-2, IL-4, IL-6, IL-10, IL-12B, IL-15, and IL-18 polymorphisms. METHODS A systematic literature search in PubMed, Web of Science, Google Scholar, and Scopus was performed to identify the relevant studies, and related information was extracted. The effect size (ES) and corresponding 95% confidence intervals (CIs) were calculated to estimate the association. RESULTS From 158 initial results, twenty-five eligible studies were included in the meta-analysis. Overall, the pooled results showed that the dominant models of IFN-γ UTR5644, TGF-β rs1800470 and rs1800471, TNF-α rs1800629, and IL-10 rs1800872 were significantly less frequent in brucellosis patients than the controls. Also, the pooled analysis of the mutant allele vs. wild allele of TGF-β rs1800471 and IL-10 rs1800872 showed negative association with brucellosis risk. On the other hand, our pooled analysis demonstrated that the mutant allele of IL-4 rs2243250 and IL-18 rs1946519 were associated with increased susceptibility to brucellosis. In addition, the IFN-γ UTR5644 and TGF-β rs1800470 were more frequent in the patients without focal forms. CONCLUSIONS IL-4 rs2243250 and IL-18 rs1946519 have a positive correlation with brucellosis whereas the IFN-γ UTR5644, TGF-β rs1800470 and rs1800471, TNF-α rs1800629, and IL-10 rs1800872 showed a negative association with this disease. The association between the other single nucleotide polymorphisms (SNP) and brucellosis risk was not confirmed in the current meta-analysis. PROSPERO Registration: CRD42018117203.
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Affiliation(s)
- Parisa Zafari
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmadreza Zarifian
- Center for Excellence in Clinical Research, Mashhad University of Medical Sciences, Mashhad, Iran; Infection Control and Hand Hygiene Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Taghadosi
- Department of Immunology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Rafiei
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
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Mardanshahi Z, Tayebi M, Shafiee S, Barzin M, Shafizad M, Alizadeh-Navaei R, Gholinataj A. Evaluation of subacute subarachnoid haemorrhage detection using a magnetic resonance imaging sequence: Double inversion recovery. Biomedicine (Taipei) 2020; 10:29-35. [PMID: 33854932 PMCID: PMC7735974 DOI: 10.37796/2211-8039.1058] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 11/03/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The diagnosis of subarachnoid hemorrhage (SAH) especially at the subacute stage is still a challenging issue using the conventional imaging modalities. Here we evaluated the role of double inversion recovery (DIR) sequence of MRI compared with the conventional gradient-recalled echo (GRE)-T2*-W and susceptibility-weighted imaging (SWI) sequences in the diagnosis of subacute SAH. MATERIALS AND METHODS This prospective study was conducted on 21 patients with SAH, which were diagnosed using CT scan at the initial step. In the third week after the injury (14-20 days), all patients underwent a brain MRI exam that included T2*-W, SWI, and DIR imaging sequences. All images were independently read by two radiologists, who were blinded to the clinical history of the patients. The presence or absence of SAH was reviewed and assessed in 6 anatomical regions. RESULTS On the DIR images, 20 patients were found to have at least one subarachnoid signal abnormality, while the SWI and T2*-W images identified SAH areas on 17 and 15 patients, respectively. The highest rate of inter-observer consensus by the DIR sequence was found in the interhemispheric fissure and perimesencephalic area (k = 1). Also, a highest rate of inter-observer consensus using SWI was found in the interhemispheric fissure and posterior fossa cistern area (k = 1). A weak agreement was found in frontal-parietal convexity using SWI (k = 0.447), and in posterior fossa cistern by the T2* sequence (k = 0.447). CONCLUSION In conclusion, the DIR sequence was more reliable at identifying signal abnormalities in subacute SAH patients than the T2*-W and SWI sequence, and is suggested as a promising imaging technique for detecting hemorrhagic areas without considering the anatomical distribution of SAH.
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Affiliation(s)
- Zahra Mardanshahi
- Department of Radiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Tayebi
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Sajad Shafiee
- Department of Neurosurgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Misagh Shafizad
- Department of Neurosurgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdolmajid Gholinataj
- Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Corresponding author at: E-mail address: (A. Gholinataj)
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Shamshirian A, Alizadeh-Navaei R, Abedi S, Jafarpour H, Fazli H, Hosseini S, Hessami A, Karimifar K, Yosefi S, Zahedi M, Motamen S, Ghorbanpour A, Zarandi B, Esfahani A, Rostamian-Moghaddam Y, Mehdipour S, Heydari K, Aghajanian S, Mehdi SP, Azad A, Azizi S. Levels of Blood Biomarkers among Patients with Myocardial Infarction in Comparison to Control Group. Ethiop J Health Sci 2020; 30:5-12. [PMID: 32116427 PMCID: PMC7036464 DOI: 10.4314/ejhs.v30i1.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 07/24/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Myocardial infarction (MI) as a term for a heart attack happens due to reduced blood flow to heart myocardium and lack of oxygen supply caused by plaques in the interior walls of coronary arteries. With respect to the importance of MI etiology, we aimed to study the relationship of MI and blood examination variables. METHODS This study was conducted in Mazandaran Heart Center as a hospital-based case-control Comprising 894 participants including 465 cases and 429 controls, individually matched by sex and age. Considered blood markers were analyzed using routine laboratory methods and equipment. RESULTS Of all participants, 64.3% of the cases and 51.0% of the controls were males with a mean age of 61.2 (±13.8) in cases and 62.4 (±14.) in controls. We could not find any differences between cases and controls for total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and alkaline-phosphatase (ALP) (P>0.05). However, levels of creatine-kinase-muscle/brain (CK-MB) (P<0.0001), fasting-blood-sugar (FBS) (P<0.0001), aspartate-aminotransferase (AST) (P<0.0001), alanine-transferase (ALT) (P<0.0001) and erythrocyte sedimentation rate (ESR) (P=0.001) were significantly higher in cases compared to the controls (P<0.05). Multivariable analyses revealed that the risk of MI was associated with high levels of AST (adjusted OR=24.3, 95%CI=3.5±165.6, P=0.001) and LDL (adjusted OR=7.4, 95%CI=1.0±51.8, P=0.001). CONCLUSION Our investigation indicated that the levels of CK-MB, FBS, AST, ALT and ESR were significantly higher in patients with MI. Besides, our findings showed that the risk of MI in cases with high levels of AST and LDL was about 24 and 7 times more than the control group respectively.
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Affiliation(s)
- Amir Shamshirian
- Department of Medical Laboratory Sciences, School of Allied Medical sciences, Mazandaran University of Medical Sciences, Iran
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Iran
- Mazandaran Heart Center, Mazandaran University of Medical Sciences, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Iran
| | - Samira Abedi
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Iran
| | - Hamed Jafarpour
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Iran
| | - Hanieh Fazli
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Iran
| | - Samira Hosseini
- Department of Medical Laboratory Sciences, School of Allied Medical sciences, Mazandaran University of Medical Sciences, Iran
| | - Amirhossein Hessami
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Iran
| | - Keyvan Karimifar
- Student Research committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sedighe Yosefi
- Department of Biochemistry, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohammad Zahedi
- Department of Medical Laboratory Sciences, School of Allied Medical sciences, Mazandaran University of Medical Sciences, Iran
| | - Sepideh Motamen
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Iran
| | - Atiyeh Ghorbanpour
- Department of Hematology, Student Research Committee, Iran University of Medical Sciences, Iran
| | - Bahman Zarandi
- Department of Hematology, Student Research Committee, Iran University of Medical Sciences, Iran
| | - Aliakbar Esfahani
- Student Research committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Shirin Mehdipour
- Mazandaran Heart Center, Mazandaran University of Medical Sciences, Iran
| | - Keyvan Heydari
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Iran
| | - Sedigheh Aghajanian
- Department of Medical Laboratory Sciences, School of Allied Medical sciences, Mazandaran University of Medical Sciences, Iran
| | - Somayeh Pour Mehdi
- Mazandaran Heart Center, Mazandaran University of Medical Sciences, Iran
| | - Alireza Azad
- Mazandaran Heart Center, Mazandaran University of Medical Sciences, Iran
| | - Soheil Azizi
- Department of Medical Laboratory Sciences, School of Allied Medical sciences, Mazandaran University of Medical Sciences, Iran
- Mazandaran Heart Center, Mazandaran University of Medical Sciences, Iran
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HEDAYATIZADEH-OMRAN A. Epidemiology of Gastrointestinal Cancers in the North of Iran: Results of Mazandaran Population-Based Cancer Registry. TJ Oncol 2020. [DOI: 10.5505/tjo.2020.2365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Zafari P, Zarifian A, Alizadeh-Navaei R, Taghadosi M, Rafiei A, Samimi Z, Niksolat F. Asymmetric and symmetric dimethylarginine concentration as an indicator of cardiovascular diseases in rheumatoid arthritis patients: a systematic review and meta-analysis of case-control studies. Clin Rheumatol 2020; 39:127-134. [PMID: 31376089 DOI: 10.1007/s10067-019-04713-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 02/08/2023]
Abstract
Rheumatoid arthritis (RA) is the most common type of inflammatory arthritis leading to joint damage and physical disability. Cardiovascular diseases (CVDs) are considered a common comorbidity in patients with RA. However, the mechanism underlying its pathogenesis is not definitively explained. Endothelial dysfunction caused by impaired nitric oxide synthesis is an early indicator of cardiovascular disease. Asymmetric and symmetric dimethylarginine (ADMA and SDMA, respectively) the inhibitors of endothelial nitric oxide synthase (NOS) have emerged as novel CVD risk factor determiners. Concerning the unmet need to identify a salutary biomarker for CVD prediction, the purpose of this meta-analysis was to assess the serum/plasma ADMA and SDMA levels in RA patients compared with the healthy controls. A thorough literature search was performed in PubMed, Scopus, Web of Science, and Google Scholar to identify all studies reporting ADMA and/or SDMA levels in RA patients compared with healthy controls. The quality of studies was evaluated using the Newcastle-Ottawa scale (NOS). Pooled standard mean difference (SMD) with 95% confidence interval (CI) was used as the effect size in this study. We also conducted stratified analysis based on assay methods and median age of the participants. Fourteen articles were included. The pooled serum/plasma levels of ADMA were higher in RA patients compared with those of healthy controls (SMD = 1.02, 95% CI = 0.49 to 1.55); However, no statistical differences between RA patients and healthy controls in serum/plasma SDMA levels was seen (SMD = 0.57, 95% CI = -0.21 to 1.36). Subgroup analyses suggested that participants aged > 50 years had higher levels of ADMA rather than controls and the measurement method was a source of heterogeneity for ADMA. According to the results of this meta-analysis, ADMA measurement but not SDMA, can be useful for assessment of endothelial dysfunction as a predictor of CVD risk in RA patients. Prospero registration number: CRD42019121126.
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Affiliation(s)
- Parisa Zafari
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmadreza Zarifian
- Center for Excellence in Clinical Research, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Taghadosi
- Department of Immunology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Rafiei
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Samimi
- Department of Immunology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Niksolat
- Department of Internal Medicine, Orthopaedic Research Center, Faculty of Medicine, Sari, Iran.
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Eslamijouybari M, Heydari K, Maleki I, Moosazadeh M, Hedayatizadeh-Omran A, Vahedi L, Ghasemian R, Sharifpour A, Alizadeh-Navaei R. Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in COVID-19 Patients and Control Group and Relationship with Disease Prognosis. Caspian J Intern Med 2020; 11:531-535. [PMID: 33425271 PMCID: PMC7780872 DOI: 10.22088/cjim.11.0.531] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/25/2020] [Accepted: 09/07/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The present study aimed to compare the complete blood count (CBC) indices between COVID-19 patients and the control group, and assess the relationship of these indices with COVID-19 prognosis. METHODS COVID-19 patients (confirmed by PCR or CT-Scan) who visited Imam Hospital in Sari were selected in this case-control study. The control group was selected from Tabari cohort population matched with the case group in terms of gender and age. CBC, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and outcome of the disease (in the case group) were assessed in this study. RESULTS The number of participants were 527 in both case and control groups, of which, 232 (44%) were females in each arms. Platelet count, lymphocyte count, and hemoglobin concentration were also higher in the control group (P=0.000). NLR and PLR were significantly higher in COVID-19 patients compared to the control group (P=0.000). NLR had a significant relationship with the severity of the disease. NLR was two times higher in the patients who died of COVID-19 than those who recovered (P=0.000). ROC curve analysis for diagnostic values of NLR and PLR showed that the areas under the ROC curves for NLR and PLR were 0.703 (95% CI: 0.64-0.76) and 0.535 (95% CI: 0.46-06), respectively. CONCLUSION NLR can be used as a prognostic marker for COVID-19 given the significant difference of NLR between those who died and recovered from COVID-19.
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Affiliation(s)
- Mohammad Eslamijouybari
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Keyvan Heydari
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iradj Maleki
- Gut and Liver Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Akbar Hedayatizadeh-Omran
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Lale Vahedi
- Department of Pathology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Sharifpour
- Department of Pulmonary and Critical Care, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Bozorgi F, Hedayatizadeh-Omran A, Alizadeh-Navaei R, Goli Khatir I, Amjadi O, Khademloo M, Banihashemi AA. Diagnostic value of serum lactate as a predictor and early outcome in multiple trauma patients. Chirurgia (Bucur) 2019. [DOI: 10.23736/s0394-9508.18.04916-1] [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: 02/05/2023]
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Tabrizi N, Zarvani A, Rezaei P, Cheraghmakani H, Alizadeh-Navaei R. Levetiracetam in genetic generalized epilepsy: A prospective unblinded active-controlled trial. Epilepsy Res 2019; 157:106214. [PMID: 31627041 DOI: 10.1016/j.eplepsyres.2019.106214] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/29/2019] [Accepted: 10/02/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To compare the efficacy and tolerability of levetiracetam (LEV) versus valproate (VPA) monotherapy in adults with genetic generalized tonic-clonic seizures alone (GTCS) and juvenile myoclonic epilepsy (JME). METHODS This study was an open-label, active-controlled trial with a two-parallel-group design. Outcome measures including withdrawal rate and seizure freedom rate at 26th weeks and time to withdrawal, and time to first seizure were compared between LEV and VPA groups. Furthermore, tolerability and development of adverse events (AEs) were investigated and analyzed. RESULTS One hundred and three patients enrolled the study. 71.1% of patients in LEV group and 29.3% in VPA group were female. By the end of 26th week, seizure freedom rate and withdrawal rate were 88.9% and 8.9% in LEV group and 86.2% and 10.3% in VPA group with no significant difference. Time to first seizure was longer in VPA group (p = 0.32) and time to withdrawal favored LEV (p = 0.51). At least one AE was reported in 37.7% of patients in LEV group and 55.1% in VPA group. The most common AEs were psychiatric symptoms and dizziness in those on LEV and weight gain and dyspepsia in VPA group. CONCLUSION LEV has similar efficacy and acceptable safety in comparison to VPA in short-term treatment of patients with genetic GTCS and JME, and it could be considered as an alternative to VPA particularly in women of reproductive age.
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Affiliation(s)
- Nasim Tabrizi
- Neurology department, Mazandaran University of medical sciences, Sari, Iran.
| | - Ashraf Zarvani
- Neurology department, Mazandaran University of medical sciences, Sari, Iran
| | - Parisa Rezaei
- Neurology department, Mazandaran University of medical sciences, Sari, Iran
| | | | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Moosazadeh M, Sadough A, Afshari M, Barzegari S, Janbabaee G, Tabrizi R, Akbari M, Alizadeh-Navaei R, Hedayatizadeh-Omran A, Rostami-Maskopaee F. Prevalence of BRAF gene mutation in samples of primary and metastatic colorectal cancer: A meta-analysis. Eur J Cancer Care (Engl) 2019; 28:e13160. [PMID: 31482595 DOI: 10.1111/ecc.13160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 06/23/2019] [Accepted: 08/01/2019] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Understanding the prevalence and biology of BRAF gene can improve the treatment methods of cancerous patients. This study aims to estimate the prevalence of BRAF gene mutation in samples of primary and metastatic colorectal cancer using meta-analysis method. METHODS We searched PubMed, Scopus, ScienceDirect, Ovid and Google Scholar motor engine using MeSH terms of relevant keywords. During the screening phase, titles, abstracts and full texts were reviewed and risk of bias was assessed for all selected papers based on Newcastle-Ottawa Scale (NOS) checklist. The results of the primary studies were combined using meta-analysis. RESULTS Of 95 eligible studies entered into the meta-analysis, prevalence of BRAF gene mutation had been assessed among 19,484 primary tumour samples as well as 12,256 metastatic samples. The total prevalence of BRAF gene mutation among primary tumour samples was estimated as of 10.16% (8.09-12.22) in the world, 0.41% (0-1.89) in EMRO region, 10.06% (7.54-12.59) in EURO region, 10.33% (7.24-13.43) in SEARO region and 11.33% (7.29-15.37) in WPRO region. The pooled estimates for BRAF gene mutation in metastatic samples were 6.53% (5.09-7.96), 8.07% (5.57-10.56), 5.38% (3.75-7.02) and 5.55% (1.72-9.38) for all regions, EURO, WPRO and PAHO regions respectively. CONCLUSION Our results showed evidences of BRAF gene mutation in one-tenth of primary colorectal tumour samples in EURO, PAHO, SEARO and WPRO regions which was considerably higher than that of the EMRO region.
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Affiliation(s)
- Mahmood Moosazadeh
- Health Sciences Research center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Azita Sadough
- Traditional Medicine and History of Medical science Research center, Faculty of Iranian medicine, Babol University of Medical Science, Babol, Iran
| | - Mahdi Afshari
- Department of Community Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Saeed Barzegari
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghasem Janbabaee
- Gastrointestinal Cancer Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Tabrizi
- Health Policy Research Center, Student Research Committee, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Akbari
- Health Policy Research Center, Student Research Committee, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal cancer research center, Mazandaran University of Medical Sciences, Sari, Iran
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Kheradmand M, Moosazadeh M, Saeedi M, Poustchi H, Eghtesad S, Esmaeili R, Alizadeh-Navaei R, Hedayatizadeh-Omran A, Nikaeein R, Rafiei A, Janbabaee G, Kashi Z, Sohrab M, Shirzad AhooDashti M, Afshari M, Golpour B, Aarabi M, Maleki I, Tirgar Fakheri H, Ghaemian A, Zarghami M, Ghaemi A. Tabari Cohort Profile and Preliminary Results in Urban Areas and Mountainous Regions of Mazandaran, Iran. Arch Iran Med 2019; 22:279-285. [PMID: 31356093 DOI: pmid/31356093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 03/17/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND The Tabari cohort study (TCS), part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN), is a large longitudinal prospective cohort designed to better understand the risk factors associated with major non-communicable diseases (NCDs) across two urban and mountainous regions in north of Iran. METHODS The enrollment phase of TCS started in June 2015 and ended in November 2017. During this phase, individuals aged 35-70 years from urban and mountainous regions of Sari township (Mazandaran province) were invited to the cohort center by health volunteers (urban regions) and Behvarz (mountainous areas) using census information. Data was collected based on the PERSIAN cohort study protocols. Hypertension was defind as systolic blood pressure ≥140 mm Hg or a diastolic blood pressure ≥90 mm Hg or history of diagnosis with hypertension or taking antihypertensive medications among participants free from cardiovascular diseases. Diabetes was defined as fasting blood sugar ≥126 mg/dL or a history of diagnosis or taking glucoselowering medications among all participants. RESULTS A total of 10,255 participants were enrolled in TCS, 59.5% of whom were female. Among the total population, 7,012 participants were urban residents (68.4%). The prevalence of daily smoking in the total population was 9.1%. Body mass index in 75.9% of participants was ≥25 kg/m2. The prevalence of hypertension, diabetes, and thyroid disorders were 22.2%, 17.2%, and 10.5%, respectively. CONCLUSION The Tabari cohort is different from other cohorts in terms of levels of risk factors associated with NCDs. This study has certain important strengths including its population-based design and large sample size that provides a valid platform for conducting future investigations and trials. A biobank that has been designed to store blood, nail, hair and urine samples for future research is another strength of this study. Researchers who are interested in using the information can refer to the following web page: http://persiancohort.com.
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Affiliation(s)
- Motahareh Kheradmand
- Health Sciences Research center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Saeedi
- Department of Pharmaceutics, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sareh Eghtesad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ravanbakhsh Esmaeili
- Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Roja Nikaeein
- Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Rafiei
- Department of Immunology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ghasem Janbabaee
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Kashi
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehrnoush Sohrab
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mahdi Afshari
- Department of Community Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | | | - Mohsen Aarabi
- Department of Family Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iradj Maleki
- Gut and Liver Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hafez Tirgar Fakheri
- Gut and Liver Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Ghaemian
- Department of Cardiology, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehran Zarghami
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Ghaemi
- Department of Basic Science and Nutrition, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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Shamshirian A, Alizadeh-Navaei R, Pourfathollah AA, Alipoor R, Mohseni AR. Seroprevalence and geographical distribution of hepatitis C virus in Iranian patients with thalassemia: a systematic review and meta-analysis. J LAB MED 2019. [DOI: 10.1515/labmed-2018-0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Abstract
Background
Thalassemia as a hereditary hemoglobinopathy is the most common monogenic disease worldwide. Patients with thalassemia require regular blood transfusion, which provides the risk for the transmission of hepatitis C virus (HCV) as the most common post-transfusion infection in such patients, and this rate is very diverse in different parts of the world. We aimed to determine the prevalence of HCV among patients with thalassemia in Iran.
Methods
In this study, we searched for articles on the prevalence of HCV among Iranian thalassemia patients in English and Persian databases up to 2017. Heterogeneities were assessed by using an I-square (I2) test. Prevalence and 95% confidence interval (CI) were calculated using the random effects model.
Results
In total, 37 studies with 9185 patients were included in the meta-analysis. The prevalence of HCV among Iranian thalassemia patients was 17.0% (95% CI: 14.5–19.8). The rate of prevalence among male and female subjects was 17.4% (95% CI: 13.8–21.9) and 16.8% (95% CI: 13.2–21.1), respectively.
Conclusions
We found that the prevalence of HCV among Iranian thalassemia patients declined over time and the Iranian Blood Transfusion Organization has had a reasonable performance in HCV screening.
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Abedi S, Janbabaei G, Afshari M, Moosazadeh M, Rashidi Alashti M, Hedayatizadeh-Omran A, Alizadeh-Navaei R, Abedini E. Estimating the Survival of Patients With Lung Cancer: What Is the Best Statistical Model? J Prev Med Public Health 2019; 52:140-144. [PMID: 30971081 PMCID: PMC6459760 DOI: 10.3961/jpmph.17.090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 01/21/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Investigating the survival of patients with cancer is vitally necessary for controlling the disease and for assessing treatment methods. This study aimed to compare various statistical models of survival and to determine the survival rate and its related factors among patients suffering from lung cancer. METHODS In this retrospective cohort, the cumulative survival rate, median survival time, and factors associated with the survival of lung cancer patients were estimated using Cox, Weibull, exponential, and Gompertz regression models. Kaplan-Meier tables and the log-rank test were also used to analyze the survival of patients in different subgroups. RESULTS Of 102 patients with lung cancer, 74.5% were male. During the follow-up period, 80.4% died. The incidence rate of death among patients was estimated as 3.9 (95% confidence [CI], 3.1 to 4.8) per 100 person-months. The 5-year survival rate for all patients, males, females, patients with non-small cell lung carcinoma (NSCLC), and patients with small cell lung carcinoma (SCLC) was 17%, 13%, 29%, 21%, and 0%, respectively. The median survival time for all patients, males, females, those with NSCLC, and those with SCLC was 12.7 months, 12.0 months, 16.0 months, 16.0 months, and 6.0 months, respectively. Multivariate analyses indicated that the hazard ratios (95% CIs) for male sex, age, and SCLC were 0.56 (0.33 to 0.93), 1.03 (1.01 to 1.05), and 2.91 (1.71 to 4.95), respectively. CONCLUSIONS Our results showed that the exponential model was the most precise. This model identified age, sex, and type of cancer as factors that predicted survival in patients with lung cancer.
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Affiliation(s)
- Siavosh Abedi
- Department of Internal Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ghasem Janbabaei
- Gastrointestinal Cancer Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Afshari
- Department of Community Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Corresponding author: Mahmood Moosazadeh, PhD Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Khazarabad Road, Sari 4815733971, Iran E-mail:
| | | | | | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ehsan Abedini
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Azizi S, Shamshirian A, Alizadeh-Navaei R, Jafarpour H, Asemi Z, Tamtaji OR, Vaziri MS, Homayounfar R, Rezaei Shahmirzadi A, Alipoor R. A Genetic Association Study of MTHFR C677T Polymorphism with Risk of Metabolic Syndrome: A Systematic Review and Meta-Analysis. Galen Med J 2019; 8:e1472. [PMID: 34466514 PMCID: PMC8343661 DOI: 10.31661/gmj.v8i0.1472] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 01/23/2019] [Accepted: 02/08/2019] [Indexed: 02/05/2023] Open
Abstract
Methylenetetrahydrofolate reductase (MTHFR) is an enzyme that plays a crucial role as a methyl-group donor in demethylation of homocysteine. The aim of this systematic review and meta-analysis was to study the relationship between MTHFR gene polymorphism and metabolic syndrome (MS). We used search engines and databases such as Science Direct, Google Scholar, Embase, Cochrane Library, and PubMed to identify eligible studies up to 2018. The articles were studied based on keywords including MTHFR, mutation, variant, and polymorphism in combination with MS. Data was analyzed using Comprehensive Meta-Analysis version 2.2.064 software. After extracting the data from seven articles, the total number of subjects was 1280 in the patient group and 1374 in the control group. The odds ratio was estimated to be 1.078 for the allele model of T vs. C (95% confidence interval [CI]: 1.626-0.715), 1.157 for the allele model of CC vs. CT (95% CI: 0.829-1.615), 1.020 for the allele model of CT + TT vs. CC (95% CI: 1.611-0.646) and 0.799 for the allele model of TT vs. CC + CT (95% CI: 1.185- 0.539). As well, the results showed no statistically significant correlation between polymorphism genotypes of the MTHFR gene and MS (P<0.05). In general, this study showed that the presence of C677T polymorphism in the MTHFR gene has no effect on the incidence of MS.
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Affiliation(s)
- Soheil Azizi
- Department of Laboratory Sciences, Faculty of Paramedicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Shamshirian
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Jafarpour
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Omid Reza Tamtaji
- Physiology Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Sadegh Vaziri
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Reza Homayounfar
- Non-Communicable Disease Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Reza Alipoor
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Non-Communicable Disease Research Center, Fasa University of Medical Sciences, Fasa, Iran
- Correspondence to: Reza Alipoor, Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran Telephone Number: +989174462124 Email Address:
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Moosazadeh M, Maleki I, Alizadeh-Navaei R, Kheradmand M, Hedayatizadeh-Omran A, Shamshirian A, Barzegar A. Normal values of neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio among Iranian population: Results of Tabari cohort. Caspian J Intern Med 2019; 10:320-325. [PMID: 31558995 PMCID: PMC6729162 DOI: 10.22088/cjim.10.3.320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and platelet-lymphocyte ratio (PLR) have a prognostic value in several types of diseases such as cancers and they vary in different races. So, we aimed to evaluate the normal range of these markers among healthy people to determine the normal value in Iranian population. METHODS In the present study, cross-sectional data of population-based cohort study named "Tabari cohort study" was utilized. In the first phase of Tabari cohort, 10255 participants aged 35-70 years from urban and rural areas of Sari, Mazandaran, Iran entered into the study. The study included a questionnaire survey and blood collection. Blood samples were collected after 12 hours fasting from all participants during the study. Hematological indices were measured for all samples using Celltac Alpha MEK-6510 K (Tokyo, Japan). RESULTS After sample exclusion, 2212 healthy subjects of Tabari's normal cohort population were investigated. The mean age of the samples was 47.9±9.29 years. The mean of NLR, LMR, PLR were 1.70±0.70, 11.15±3.14 and 117.05±47.73, respectively. CONCLUSION Our investigation provides preliminary reference values for NLR, LMR, and PMR among Iranian population that can be used for disease progress in various clinical procedures.
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Affiliation(s)
- Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iradj Maleki
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Motahareh Kheradmand
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Amir Shamshirian
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Agil Barzegar
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Shekarriz R, Montazer F, Alizadeh-Navaei R. Overexpression of cancer stem cell marker Lgr5 in colorectal cancer patients and association with clinicopathological findings. Caspian J Intern Med 2019; 10:412-416. [PMID: 31814939 PMCID: PMC6856925 DOI: 10.22088/cjim.10.4.411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND To determine the expression of cancer stem cell marker Leucine-rich repeat-containing G-protein coupled receptor 5 (Lgr5) in colorectal carcinoma samples compared to normal adjacent tissue and any possible association with clinicopathological findings. METHODS This study was performed on forty samples of cancerous colorectal tissues (case group) and their adjacent normal mucosa (control group) in Imam Khomeini Hospital (Sari, Mazandaran, Iran). Expression of Lgr5 in tissue sections was done by immunohistochemistry. Statistical analysis was carried out using SPSS software. RESULTS Forty colorectal cancer patients including 21 males (57.8±11.6 years) and 19 females (58.4±12.77 years) were enrolled. Lgr5 was overexpressed in tumoral samples than normal adjacent tissues (77.5% vs 27.5%, p<0.001). Also, no association was found between primary tumor, regional lymph nodes, invasion, histological type, grade, distant metastasis and IHC results. Patients with low Lgr5 expression had a better survival rate than patients with high expression but this was not statistically significant (p=0.121). CONCLUSION The higher immunoreactivity of Lgr5 in colorectal cancer tissues may indicate its role as a cancer stem cell marker in tumor carcinogenesis and patient's survival however; Lgr5 is not associated with pathological prognostic variables.
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Affiliation(s)
- Ramin Shekarriz
- Department of Hematology and Oncology, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Science, Sari, Iran
| | - Fatemeh Montazer
- Department of Pathology, Iran University of Medical Sciences, Tehran, Iran
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Science, Sari, Iran
- Correspondence: Fatemeh Montazer, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Science, Sari, Iran. E-mail: , Tel: 0098 2151048, Fax: 0098 2155900243
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Science, Sari, Iran
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Montazer F. Expression of GLUT1 in Neoplastic Cells of Papillary Thyroid Cancer. TJ Oncol 2019. [DOI: 10.5505/tjo.2019.1994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Mohammadzadeh I, Haghshenas M, Asefi S, Alizadeh-Navaei R. IgE level in newborn umbilical cord and its relationship with some maternal factors. Clin Mol Allergy 2019; 17:11. [PMID: 31372096 PMCID: PMC6659304 DOI: 10.1186/s12948-019-0115-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 07/16/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Allergic diseases are among major pediatric issues as they are highly prevalent and chronic. Therefore, identification of factors contributing to allergic disease could play a significant role in prevention of these conditions. This study aimed at investigating the IgE level in newborn's umbilical cord blood and its relationship with some maternal factors. METHODS A cross-sectional study was conducted in 101 mothers and their newborns in Babol, Iran 2016. The samples were selected using non-probability convenience sampling. Information including newborn sex, gravidity, history of allergy before and during pregnancy (asthma, allergic rhinitis, eczema, hives, food allergy, and drug allergy), family history of allergy among mothers, history of exposure to secondhand smoke and pets, and delivery techniques was recorded. The IgE levels in newborn umbilical cord blood and maternal serum were measured using an IgE kit and ELISA technique. RESULTS The newborns included 53 females (52.5%) and 29 mothers had vaginal birth (28.7%). History of exposure to secondhand smoke was found in 15 samples (14.9%), and 18 participants reported exposure to pets (17.8%). The median IgE levels in newborns and their mothers were 0.41 and 98.6, respectively. In general, IgE level in all newborns was within the normal range, but, it was higher than normal in 15 mothers (14.9%). The IgE level was significantly higher in male newborns than that of the female newborns (p = 0.011). There were no significant differences in the IgE levels of mothers and their newborns on the basis of delivery technique and history of exposure to pets (p > 0.05). CONCLUSION In this study, the IgE level in all newborns was within the normal range, and sex was found to be an effective factor in IgE levels.
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Affiliation(s)
- Iraj Mohammadzadeh
- 0000 0004 0421 4102grid.411495.cNon-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Imam Khomeini Street, Babol, 4731-741151 Iran
| | - Mohsen Haghshenas
- 0000 0004 0421 4102grid.411495.cNon-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Imam Khomeini Street, Babol, 4731-741151 Iran
| | - Samaneh Asefi
- 0000 0004 0421 4102grid.411495.cNon-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Imam Khomeini Street, Babol, 4731-741151 Iran
| | - Reza Alizadeh-Navaei
- 0000 0001 2227 0923grid.411623.3Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, 48166-33131 Iran
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Abstract
[This corrects the article DOI: 10.1016/S0140-6736(18)32203-7.].
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GBD 2017 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1859-922. [PMID: 30415748 DOI: 10.1016/S0140-6736(18)32335-3] [Citation(s) in RCA: 1801] [Impact Index Per Article: 300.2] [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: 05/13/2018] [Revised: 08/31/2018] [Accepted: 09/18/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life-years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. METHODS We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Socio-demographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. FINDINGS Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2). INTERPRETATION With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health. 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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EFGA, Awasthi A, Quintanilla BPA, Ayele Y, Ayer R, Azzopardi PS, Babazadeh A, Bacha U, Badali H, Badawi A, Bali AG, Ballesteros KE, Banach M, Banerjee K, Bannick MS, Banoub JAM, Barboza MA, Barker-Collo SL, Bärnighausen TW, Barquera S, Barrero LH, Bassat Q, Basu S, Baune BT, Baynes HW, Bazargan-Hejazi S, Bedi N, Beghi E, Behzadifar M, Behzadifar M, Béjot Y, Bekele BB, Belachew AB, Belay E, Belay YA, Bell ML, Bello AK, Bennett DA, Bensenor IM, Berman AE, Bernabe E, Bernstein RS, Bertolacci GJ, Beuran M, Beyranvand T, Bhalla A, Bhattarai S, Bhaumik S, Bhutta ZA, Biadgo B, Biehl MH, Bijani A, Bikbov B, Bilano V, Bililign N, Bin Sayeed MS, Bisanzio D, Biswas T, Blacker BF, Basara BB, Borschmann R, Bosetti C, Bozorgmehr K, Brady OJ, Brant LC, Brayne C, Brazinova A, Breitborde NJK, Brenner H, Briant PS, Britton G, Brugha T, Busse R, Butt ZA, 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, 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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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R, Malta DC, Mamun AA, Manda AL, Manguerra H, Manhertz T, Mansournia MA, Mantovani LG, Mapoma CC, Maravilla JC, Marcenes W, Marks A, Martins-Melo FR, Martopullo I, März W, Marzan MB, Mashamba-Thompson TP, Massenburg BB, Mathur MR, Matsushita K, Maulik PK, Mazidi M, McAlinden C, McGrath JJ, McKee M, Mehndiratta MM, Mehrotra R, Mehta KM, Mehta V, Mejia-Rodriguez F, Mekonen T, Melese A, Melku M, Meltzer M, Memiah PTN, Memish ZA, Mendoza W, Mengistu DT, Mengistu G, Mensah GA, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Mezerji NMG, Miazgowski B, Miazgowski T, Millear AI, Miller TR, Miltz B, Mini GK, Mirarefin M, Mirrakhimov EM, Misganaw AT, Mitchell PB, Mitiku H, Moazen B, Mohajer B, Mohammad KA, Mohammadifard N, Mohammadnia-Afrouzi M, Mohammed MA, Mohammed S, Mohebi F, Moitra M, Mokdad AH, Molokhia M, Monasta L, Moodley Y, Moosazadeh M, Moradi G, Moradi-Lakeh M, Moradinazar M, Moraga P, Morawska L, Moreno Velásquez I, Morgado-Da-Costa J, Morrison SD, Moschos MM, Mountjoy-Venning WC, 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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: 7041] [Impact Index Per Article: 1173.5] [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: 05/09/2018] [Revised: 08/30/2018] [Accepted: 09/12/2018] [Indexed: 02/06/2023]
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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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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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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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, 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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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Fitzmaurice C, Akinyemiju TF, Al Lami FH, Alam T, Alizadeh-Navaei R, Allen C, Alsharif U, Alvis-Guzman N, Amini E, Anderson BO, Aremu O, Artaman A, Asgedom SW, Assadi R, Atey TM, Avila-Burgos L, Awasthi A, Ba Saleem HO, Barac A, Bennett JR, Bensenor IM, Bhakta N, Brenner H, Cahuana-Hurtado L, Castañeda-Orjuela CA, Catalá-López F, Choi JYJ, Christopher DJ, Chung SC, Curado MP, Dandona L, Dandona R, das Neves J, Dey S, Dharmaratne SD, Doku DT, Driscoll TR, Dubey M, Ebrahimi H, Edessa D, El-Khatib Z, Endries AY, Fischer F, Force LM, Foreman KJ, Gebrehiwot SW, Gopalani SV, Grosso G, Gupta R, Gyawali B, Hamadeh RR, Hamidi S, Harvey J, Hassen HY, Hay RJ, Hay SI, Heibati B, Hiluf MK, Horita N, Hosgood HD, Ilesanmi OS, Innos K, Islami F, Jakovljevic MB, Johnson SC, Jonas JB, Kasaeian A, Kassa TD, Khader YS, Khan EA, Khan G, Khang YH, Khosravi MH, Khubchandani J, Kopec JA, Kumar GA, Kutz M, Lad DP, Lafranconi A, Lan Q, Legesse Y, Leigh J, Linn S, Lunevicius R, Majeed A, Malekzadeh R, Malta DC, Mantovani LG, McMahon BJ, Meier T, Melaku YA, Melku M, Memiah P, Mendoza W, Meretoja TJ, Mezgebe HB, Miller TR, Mohammed S, Mokdad AH, Moosazadeh M, Moraga P, Mousavi SM, Nangia V, Nguyen CT, Nong VM, Ogbo FA, Olagunju AT, Pa M, Park EK, Patel T, Pereira DM, Pishgar F, Postma MJ, Pourmalek F, Qorbani M, Rafay A, Rawaf S, Rawaf DL, Roshandel G, Safiri S, Salimzadeh H, Sanabria JR, Santric Milicevic MM, Sartorius B, Satpathy M, Sepanlou SG, Shackelford KA, Shaikh MA, Sharif-Alhoseini M, She J, Shin MJ, Shiue I, Shrime MG, Sinke AH, Sisay M, Sligar A, Sufiyan MB, Sykes BL, Tabarés-Seisdedos R, Tessema GA, Topor-Madry R, Tran TT, Tran BX, Ukwaja KN, Vlassov VV, Vollset SE, Weiderpass E, Williams HC, Yimer NB, Yonemoto N, Younis MZ, Murray CJL, Naghavi M. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol 2018; 4:1553-1568. [PMID: 29860482 PMCID: PMC6248091 DOI: 10.1001/jamaoncol.2018.2706] [Citation(s) in RCA: 1054] [Impact Index Per Article: 175.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
IMPORTANCE The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. OBJECTIVE To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus. EVIDENCE REVIEW Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition. FINDINGS In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, -1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535 000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined. Between 2006 and 2016, the average annual age-standardized incidence rates for all cancers combined increased in 130 of 195 countries or territories, and the average annual age-standardized death rates decreased within that timeframe in 143 of 195 countries or territories. CONCLUSIONS AND RELEVANCE Large disparities exist between countries in cancer incidence, deaths, and associated disability. Scaling up cancer prevention and ensuring universal access to cancer care are required for health equity and to fulfill the global commitments for noncommunicable disease and cancer control.
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Affiliation(s)
| | - Christina Fitzmaurice
- Division of Hematology, Department of Medicine, University of Washington, Seattle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | | | - Tahiya Alam
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Christine Allen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Ubai Alsharif
- Charite University Medicine Berlin, Charité Universitätsmedizin, Berlin, Berlin, Germany
| | - Nelson Alvis-Guzman
- ALZAK Foundation-Universidad de la Costa, Universidad de Cartagena, Universidad de Cartagena, Cartagena de Indias, Colombia
| | - Erfan Amini
- Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Olatunde Aremu
- Birmingham City, University Department of Public Health and Therapies, Birmingham, England
| | - Al Artaman
- University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Reza Assadi
- Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Ashish Awasthi
- Indian Institute of Public Health, Gandhinagar, Gujarat, India
| | | | - Aleksandra Barac
- Faculty of Medicine, University of Belgrade, Belgrade, Belgrade, Serbia
| | - James R Bennett
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | | | - Carlos A Castañeda-Orjuela
- Colombian National Health Observatory, Instituto Nacional de Salud, Bogota, Bogota, DC, Colombia
- Epidemiology and Public Health Evaluation Group, Public Health Department, Universidad Nacional de Colombia, Bogota, Colombia
| | - Ferrán Catalá-López
- Department of Medicine, University of Valencia, INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Jee-Young Jasmine Choi
- Seoul National University Hospital, Seoul, South Korea
- Seoul National University Medical Library, Seoul, South Korea
| | | | - Sheng-Chia Chung
- The Farr Institute of Health Informatics Research, Institute of Health Informatics, University College London, London, England
| | - Maria Paula Curado
- Accamargo Cancer Center, Sao Paulo, Sao Paulo, Brazil
- International Prevention Research Institute, Ecully, France
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, National Capital Region, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, National Capital Region, India
| | - José das Neves
- INEB-Instituto de Engenharia Biomédica, University of Porto, Porto, Portugal
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
| | | | - Samath D Dharmaratne
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - David Teye Doku
- University of Cape Coast, Cape Coast, Ghana
- University of Tampere, Tampere, Finland
| | - Tim R Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Manisha Dubey
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Hedyeh Ebrahimi
- Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ziad El-Khatib
- Department of Global Health and Social Medicine, Harvard Medical School, Kigali, Rwanda
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Florian Fischer
- School of Public Health, Bielefeld University, Bielefeld, North Rhine-Westphalia, Germany
| | - Lisa M Force
- St Jude Children's Research Hospital, Memphis, Tennessee
| | - Kyle J Foreman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Imperial College London, London, England
| | | | - Sameer Vali Gopalani
- Department of Health and Social Affairs, Government of the Federated States of Micronesia, Palikir, Pohnpei, Federated States of Micronesia
| | - Giuseppe Grosso
- University Hospital Policlinico "Vittorio Emanuele," Catania, Italy
- NNEdPro Global Centre for Nutrition and Health, Cambridge, England
| | - Rahul Gupta
- West Virginia Bureau for Public Health, Charleston
| | | | | | - Samer Hamidi
- Haan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - James Harvey
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Roderick J Hay
- International Foundation for Dermatology, London, England
- King's College London, London, England
| | - 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, England
| | - Behzad Heibati
- Air Pollution Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Nobuyuki Horita
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - H Dean Hosgood
- Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Kaire Innos
- National Institute for Health Development, Tallinn, Estonia
| | - Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Mihajlo B Jakovljevic
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Central Serbia, Serbia
- Center for Health Trends and Forecasts, University of Washington, Seattle
| | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Amir Kasaeian
- Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Yousef Saleh Khader
- Department of Community Medicine, Public Health and Family Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Gulfaraz Khan
- Department of Microbiology and Immunology, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Young-Ho Khang
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea
- Institute of Health Policy and Management, Seoul National University Medical Center, Seoul, South Korea
| | - Mohammad Hossein Khosravi
- Baqiyatallah University of Medical Sciences, Tehran, Iran
- International Otorhinolaryngology Research Association (IORA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Jagdish Khubchandani
- Department of Nutrition and Health Science, Ball State University, Muncie, Indiana
| | - Jacek A Kopec
- University of British Columbia, Vancouver, British Columbia, Canada
| | - G Anil Kumar
- Public Health Foundation of India, Gurugram, National Capital Region, India
| | - Michael Kutz
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | - Qing Lan
- National Cancer Institute, Rockville, Maryland
| | | | - James Leigh
- University of Sydney, Sydney, New South Wales, Australia
| | | | - Raimundas Lunevicius
- Aintree University Hospital National Health Service Foundation Trust, Liverpool, England
- School of Medicine, University of Liverpool, Liverpool, England
| | - Azeem Majeed
- Department of Primary Care & Public Health, Imperial College London, London, England
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Toni Meier
- Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Martin Luther University Halle-Wittenberg, Saale, Germany
| | - Yohannes Adama Melaku
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- School of Public Health, Mekelle University, Mekelle, Ethiopia
| | | | | | | | - Tuomo J Meretoja
- Comprehensive Cancer Center, Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | | | - Ted R Miller
- Pacific Institute for Research & Evaluation, Calverton, Maryland
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Shafiu Mohammed
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
- Institute of Public Health, Heidelberg University, Heidelberg, Baden Wuettemberg, Germany
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Mahmood Moosazadeh
- Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Paula Moraga
- Lancaster Medical School, Lancaster University, Lancaster, England
| | - Seyyed Meysam Mousavi
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Vuong Minh Nong
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Felix Akpojene Ogbo
- Centre for Health Research, Western Sydney University, Sydney, New South Wales, Australia
| | - Andrew Toyin Olagunju
- Department of Psychiatry, College of Medicine, University of Lagos, Lagos, Lagos State, Nigeria
- Department of Psychiatry, Lagos University Teaching Hospital, Lagos, Nigeria
- Discipline of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia
| | - Mahesh Pa
- JSS Medical College (PA), JSS University, Mysore, Karnataka, India
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, South Korea
| | - Tejas Patel
- White Plains Hospital, White Plains, New York
| | - David M Pereira
- REQUIMTE/LAQV, Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Farhad Pishgar
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maarten J Postma
- University Medical Center Groningen, Groningen, the Netherlands
- University of Groningen, Groningen, the Netherlands
| | | | - Mostafa Qorbani
- Non-Communicable 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
| | | | - David Laith Rawaf
- North Hampshire Hospitals, Basingstroke, England
- University College London Hospitals, London, England
- WHO Collaborating Centre, Imperial College of London, London, England
| | - 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
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | | | - Juan Ramon Sanabria
- Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
- Case Western Reserve University, Cleveland, Ohio
| | - Milena M Santric Milicevic
- Centre School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, Belgrade, Belgrade, Serbia
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Belgrade, Serbia
| | - Benn Sartorius
- Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- UKZN Gastrointestinal Cancer Research Centre, South African Medical Research Council, Durban, South Africa
| | - Maheswar Satpathy
- Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
| | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Jun She
- Department of Pulmonary Medicine, Zhongshan Hospital (She), Fudan University, Shanghai, China
| | - Min-Jeong Shin
- Department of Public Health Sciences, Korea University, Seoul, South Korea
| | - Ivy Shiue
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, Scotland
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin Luther University Halle-Wittenberg, Saale, Germany
| | | | | | | | - Amber Sligar
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Bryan L Sykes
- Departments of Criminology, Law & Society, Sociology, and Public Health, University of California, Irvine
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
| | - Gizachew Assefa Tessema
- University of Gondar, Gondar, Ethiopia
- University of Adelaide, Adelaide, South Australia, Australia
| | - Roman Topor-Madry
- Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
- Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Tung Thanh Tran
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Bach Xuan Tran
- Johns Hopkins University, Baltimore, Maryland
- Hanoi Medical University, Hanoi, Vietnam
| | - Kingsley Nnanna Ukwaja
- Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | | | - Stein Emil Vollset
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Hywel C Williams
- Centre of Evidence-Based Dermatology, University of Nottingham, Nottingham, England
| | | | - Naohiro Yonemoto
- Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
| | | | | | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
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Omrani-Nava V, Hedayatizadeh-Omran A, Alizadeh-Navaei R, Mokhberi V, Jalalian R, Janbabaei G, Amjadi O, Rahmatpour G, Mozaffari A. TP53 single nucleotide polymorphism (rs1042522) in Iranian patients with coronary artery disease. Biomed Rep 2018; 9:259-265. [PMID: 30271603 PMCID: PMC6158393 DOI: 10.3892/br.2018.1121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 03/02/2018] [Accepted: 06/22/2018] [Indexed: 02/05/2023] Open
Abstract
Chronic diseases including coronary artery disease (CAD) impose a high burden in terms of mortality and disability particularly in developing countries. Both genetic and environmental risk factors confer susceptibility to CAD. Meanwhile, a functional polymorphism in the tumor protein p53 (TP53) gene (codon 72, exon 4) has been reported to be associated with a wide range of cancers and inflammatory disorders. There are controversies regarding CAD and involvement of the TP53 codon 72 single nucleotide polymorphism; therefore, the present case-control study was conducted to evaluate the potential association between this TP53 polymorphism and CAD in an Iranian population. A total of 153 subjects (including 70 patients diagnosed with CAD and 83 subjects with normal coronary parameters, determined by angiography) were genotyped for the TP53 (rs1042522) polymorphism by the polymerase chain reaction-restriction fragment length polymorphism technique. Clinical and laboratory findings were also evaluated. The χ2 test and unpaired Student's t-test were applied to compare genotype and allele distributions and clinical characteristics between the two groups. Significant associations of the Pro72 allele [odds ratio (OR)=1.66, P=0.027] and Pro/Pro genotype (OR=2.91, P=0.022) with CAD were identified. No associations between patients' clinical findings and genotypes were apparent. Therefore, according to present findings, the TP53 Pro72 allele may be involved in the development of CAD along with conventional risk factors in patients from Northern Iran.
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Affiliation(s)
- Versa Omrani-Nava
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
| | - Akbar Hedayatizadeh-Omran
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
- Correspondence to: Dr Akbar Hedayatizadeh-Omran, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, 70 Razi Street, Sari, Mazandaran 48166-33131, Iran, E-mail:
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
| | - Vahid Mokhberi
- Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48471-91971, Iran
| | - Rozita Jalalian
- Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48471-91971, Iran
| | - Ghasem Janbabaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
| | - Omolbanin Amjadi
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
| | - Ghasem Rahmatpour
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
| | - Amir Mozaffari
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
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Gohardehi S, Sharif M, Sarvi S, Moosazadeh M, Alizadeh-Navaei R, Hosseini SA, Amouei A, Pagheh A, Sadeghi M, Daryani A. The potential risk of toxoplasmosis for traffic accidents: A systematic review and meta-analysis. Exp Parasitol 2018; 191:19-24. [PMID: 29906469 DOI: 10.1016/j.exppara.2018.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/01/2018] [Accepted: 06/12/2018] [Indexed: 02/05/2023]
Abstract
Toxoplasmosis is a prevalent infectious disease. Although most people infected by Toxoplasma gondii are asymptomatic, evidence has suggested that this disease might affect some aspects of a host's behavior and associate with schizophrenia, suicide attempt, changes in various aspects of personality, and poor neurocognitive performance. These associations may play roles in increasing the risk of a number of incidents, such as traffic accidents, among infected people. In this regard, this study aimed to provide summary estimates for the available data on the potential risk of toxoplasmosis for traffic accidents. To this end, using a number of search terms, i.e. toxoplasmosis, Toxoplasma gondii, traffic accident, road accident, car accident, crash, and prevalence, literature searches (up to October 1, 2017) were carried out via 6 databases. The meta-analysis was conducted using the StatsDirect statistical software and a P-value less than 0.05 was regarded as significant in all statistical analyses. Out of 1841 identified studies, 9 studies were finally considered eligible for carrying out this systematic review. Reviewing results of these studies indicated that 5 out of 9 studies reported a significant relationship between Toxoplasma gondii and traffic accidents. Additionally, data related to gender showed significant differences between infected and control men and women. Considering age, reviewing the results of these studies revealed a significant difference between the infected people and the Toxoplasma-negative subjects under 45 years of age. However, no significant difference was found between the two groups aged 45 or older. Given these results, it can be concluded that Toxoplasma gondii significantly increases the risk of having traffic accidents.
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Affiliation(s)
- Shaban Gohardehi
- Toxoplasmosis Research Center (TRC), Mazandaran University of Medical Sciences, Sari, Iran; Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Sharif
- Department of Parasitology and Mycology, School of Medicine, Sari, Iran
| | - Shahabeddin Sarvi
- Toxoplasmosis Research Center (TRC), Mazandaran University of Medical Sciences, Sari, Iran; Department of Parasitology and Mycology, School of Medicine, Sari, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Abdollah Hosseini
- Toxoplasmosis Research Center (TRC), Mazandaran University of Medical Sciences, Sari, Iran; Department of Parasitology and Mycology, School of Medicine, Sari, Iran
| | - Afsaneh Amouei
- Toxoplasmosis Research Center (TRC), Mazandaran University of Medical Sciences, Sari, Iran; Department of Parasitology and Mycology, School of Medicine, Sari, Iran
| | - Abdolsattar Pagheh
- Toxoplasmosis Research Center (TRC), Mazandaran University of Medical Sciences, Sari, Iran; Department of Parasitology and Mycology, School of Medicine, Sari, Iran
| | - Mitra Sadeghi
- Toxoplasmosis Research Center (TRC), Mazandaran University of Medical Sciences, Sari, Iran; Department of Parasitology and Mycology, School of Medicine, Sari, Iran
| | - Ahmad Daryani
- Toxoplasmosis Research Center (TRC), Mazandaran University of Medical Sciences, Sari, Iran; Department of Parasitology and Mycology, School of Medicine, Sari, Iran.
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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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Global Burden of Disease Health Financing Collaborator Network. Spending on health and HIV/AIDS: domestic health spending and development assistance in 188 countries, 1995-2015. Lancet 2018; 391:1799-829. [PMID: 29678342 DOI: 10.1016/S0140-6736(18)30698-6] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [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: 03/10/2018] [Accepted: 03/13/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Comparable estimates of health spending are crucial for the assessment of health systems and to optimally deploy health resources. The methods used to track health spending continue to evolve, but little is known about the distribution of spending across diseases. We developed improved estimates of health spending by source, including development assistance for health, and, for the first time, estimated HIV/AIDS spending on prevention and treatment and by source of funding, for 188 countries. METHODS We collected published data on domestic health spending, from 1995 to 2015, from a diverse set of international agencies. We tracked development assistance for health from 1990 to 2017. We also extracted 5385 datapoints about HIV/AIDS spending, between 2000 and 2015, from online databases, country reports, and proposals submitted to multilateral organisations. We used spatiotemporal Gaussian process regression to generate complete and comparable estimates for health and HIV/AIDS spending. We report most estimates in 2017 purchasing-power parity-adjusted dollars and adjust all estimates for the effect of inflation. FINDINGS Between 1995 and 2015, global health spending per capita grew at an annualised rate of 3·1% (95% uncertainty interval [UI] 3·1 to 3·2), with growth being largest in upper-middle-income countries (5·4% per capita [UI 5·3-5·5]) and lower-middle-income countries (4·2% per capita [4·2-4·3]). In 2015, $9·7 trillion (9·7 trillion to 9·8 trillion) was spent on health worldwide. High-income countries spent $6·5 trillion (6·4 trillion to 6·5 trillion) or 66·3% (66·0 to 66·5) of the total in 2015, whereas low-income countries spent $70·3 billion (69·3 billion to 71·3 billion) or 0·7% (0·7 to 0·7). Between 1990 and 2017, development assistance for health increased by 394·7% ($29·9 billion), with an estimated $37·4 billion of development assistance being disbursed for health in 2017, of which $9·1 billion (24·2%) targeted HIV/AIDS. Between 2000 and 2015, $562·6 billion (531·1 billion to 621·9 billion) was spent on HIV/AIDS worldwide. Governments financed 57·6% (52·0 to 60·8) of that total. Global HIV/AIDS spending peaked at 49·7 billion (46·2-54·7) in 2013, decreasing to $48·9 billion (45·2 billion to 54·2 billion) in 2015. That year, low-income and lower-middle-income countries represented 74·6% of all HIV/AIDS disability-adjusted life-years, but just 36·6% (34·4 to 38·7) of total HIV/AIDS spending. In 2015, $9·3 billion (8·5 billion to 10·4 billion) or 19·0% (17·6 to 20·6) of HIV/AIDS financing was spent on prevention, and $27·3 billion (24·5 billion to 31·1 billion) or 55·8% (53·3 to 57·9) was dedicated to care and treatment. INTERPRETATION From 1995 to 2015, total health spending increased worldwide, with the fastest per capita growth in middle-income countries. While these national disparities are relatively well known, low-income countries spent less per person on health and HIV/AIDS than did high-income and middle-income countries. Furthermore, declines in development assistance for health continue, including for HIV/AIDS. Additional cuts to development assistance could hasten this decline, and risk slowing progress towards global and national goals. FUNDING The Bill & Melinda Gates Foundation.
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Maternal mortality and morbidity burden in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study. Int J Public Health 2018; 63:47-61. [PMID: 28776252 PMCID: PMC5973988 DOI: 10.1007/s00038-017-1004-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/15/2017] [Accepted: 06/21/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Assessing the burden of maternal mortality is important for tracking progress and identifying public health gaps. This paper provides an overview of the burden of maternal mortality in the Eastern Mediterranean Region (EMR) by underlying cause and age from 1990 to 2015. METHODS We used the results of the Global Burden of Disease 2015 study to explore maternal mortality in the EMR countries. RESULTS The maternal mortality ratio in the EMR decreased 16.3% from 283 (241-328) maternal deaths per 100,000 live births in 1990 to 237 (188-293) in 2015. Maternal mortality ratio was strongly correlated with socio-demographic status, where the lowest-income countries contributed the most to the burden of maternal mortality in the region. CONCLUSION Progress in reducing maternal mortality in the EMR has accelerated in the past 15 years, but the burden remains high. Coordinated and rigorous efforts are needed to make sure that adequate and timely services and interventions are available for women at each stage of reproductive life.
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Intentional injuries in the Eastern Mediterranean Region, 1990-2015: findings from the Global Burden of Disease 2015 study. Int J Public Health 2018; 63:39-46. [PMID: 28776251 PMCID: PMC5973968 DOI: 10.1007/s00038-017-1005-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/06/2017] [Accepted: 06/21/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES We used GBD 2015 findings to measure the burden of intentional injuries in the Eastern Mediterranean Region (EMR) between 1990 and 2015. METHODS The Global Burden of Disease (GBD) study defines intentional injuries as a combination of self-harm (including suicide), interpersonal violence, collective violence (war), and legal intervention. We estimated number of deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) for each type of intentional injuries. RESULTS In 2015, 28,695 individuals (95% UI: 25,474-37,832) died from self-harm, 35,626 (95% UI: 20,947-41,857) from interpersonal violence, and 143,858 (95% UI: 63,554-223,092) from collective violence and legal interventions. In 2015, collective violence and legal intervention was the fifth-leading cause of DALYs in the EMR and the leading cause in Syria, Yemen, Iraq, Afghanistan, and Libya; they account for 49.7% of total DALYs in Syria. CONCLUSIONS Our findings call for increased efforts to stabilize the region and assist in rebuilding the health systems, as well as increasing transparency and employing preventive strategies to reduce self-harm and interpersonal injuries.
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Adolescent health in the Eastern Mediterranean Region: findings from the global burden of disease 2015 study. Int J Public Health 2018; 63:79-96. [PMID: 28776253 PMCID: PMC5701730 DOI: 10.1007/s00038-017-1003-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/15/2017] [Accepted: 06/21/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The 22 countries of the East Mediterranean Region (EMR) have large populations of adolescents aged 10-24 years. These adolescents are central to assuring the health, development, and peace of this region. We described their health needs. METHODS Using data from the Global Burden of Disease Study 2015 (GBD 2015), we report the leading causes of mortality and morbidity for adolescents in the EMR from 1990 to 2015. We also report the prevalence of key health risk behaviors and determinants. RESULTS Communicable diseases and the health consequences of natural disasters reduced substantially between 1990 and 2015. However, these gains have largely been offset by the health impacts of war and the emergence of non-communicable diseases (including mental health disorders), unintentional injury, and self-harm. Tobacco smoking and high body mass were common health risks amongst adolescents. Additionally, many EMR countries had high rates of adolescent pregnancy and unmet need for contraception. CONCLUSIONS Even with the return of peace and security, adolescents will have a persisting poor health profile that will pose a barrier to socioeconomic growth and development of the EMR.
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Neonatal, infant, and under-5 mortality and morbidity burden in the Eastern Mediterranean region: findings from the Global Burden of Disease 2015 study. Int J Public Health 2018; 63:63-77. [PMID: 28776242 PMCID: PMC5702263 DOI: 10.1007/s00038-017-0998-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 05/01/2017] [Revised: 06/15/2017] [Accepted: 06/21/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES Although substantial reductions in under-5 mortality have been observed during the past 35 years, progress in the Eastern Mediterranean Region (EMR) has been uneven. This paper provides an overview of child mortality and morbidity in the EMR based on the Global Burden of Disease (GBD) study. METHODS We used GBD 2015 study results to explore under-5 mortality and morbidity in EMR countries. RESULTS In 2015, 755,844 (95% uncertainty interval (UI) 712,064-801,565) children under 5 died in the EMR. In the early neonatal category, deaths in the EMR decreased by 22.4%, compared to 42.4% globally. The rate of years of life lost per 100,000 population under 5 decreased 54.38% from 177,537 (173,812-181,463) in 1990 to 80,985 (76,308-85,876) in 2015; the rate of years lived with disability decreased by 0.57% in the EMR compared to 9.97% globally. CONCLUSIONS Our findings call for accelerated action to decrease child morbidity and mortality in the EMR. Governments and organizations should coordinate efforts to address this burden. Political commitment is needed to ensure that child health receives the resources needed to end preventable deaths.
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The burden of mental disorders in the Eastern Mediterranean region, 1990-2015: findings from the global burden of disease 2015 study. Int J Public Health 2018; 63:25-37. [PMID: 28776247 PMCID: PMC5973970 DOI: 10.1007/s00038-017-1006-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES Mental disorders are among the leading causes of nonfatal burden of disease globally. METHODS We used the global burden of diseases, injuries, and risk factors study 2015 to examine the burden of mental disorders in the Eastern Mediterranean region (EMR). We defined mental disorders according to criteria proposed in the diagnostic and statistical manual of mental disorders IV and the 10th International Classification of Diseases. RESULTS Mental disorders contributed to 4.7% (95% uncertainty interval (UI) 3.7-5.6%) of total disability-adjusted life-years (DALYs), ranking as the ninth leading cause of disease burden. Depressive disorders and anxiety disorders were the third and ninth leading causes of nonfatal burden, respectively. Almost all countries in the EMR had higher age-standardized mental disorder DALYs rates compared to the global level, and in half of the EMR countries, observed mental disorder rates exceeded the expected values. CONCLUSIONS The burden of mental disorders in the EMR is higher than global levels, particularly for women. To properly address this burden, EMR governments should implement nationwide quality epidemiological surveillance of mental disorders and provide adequate prevention and treatment services.
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Diabetes mellitus and chronic kidney disease in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study. Int J Public Health 2018; 63:177-186. [PMID: 28776240 PMCID: PMC5973961 DOI: 10.1007/s00038-017-1014-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 05/01/2017] [Revised: 06/30/2017] [Accepted: 07/01/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES We used findings from the Global Burden of Disease 2015 study to update our previous publication on the burden of diabetes and chronic kidney disease due to diabetes (CKD-DM) during 1990-2015. METHODS We extracted GBD 2015 estimates for prevalence, mortality, and disability-adjusted life years (DALYs) of diabetes (including burden of low vision due to diabetes, neuropathy, and amputations and CKD-DM for 22 countries of the EMR from the GBD visualization tools. RESULTS In 2015, 135,230 (95% UI 123,034-148,184) individuals died from diabetes and 16,470 (95% UI 13,977-18,961) from CKD-DM, 216 and 179% increases, respectively, compared to 1990. The total number of people with diabetes was 42.3 million (95% UI 38.6-46.4 million) in 2015. DALY rates of diabetes in 2015 were significantly higher than the expected rates based on Socio-demographic Index (SDI). CONCLUSIONS Our study showed a large and increasing burden of diabetes in the region. There is an urgency in dealing with diabetes and its consequences, and these efforts should be at the forefront of health prevention and promotion.
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Danger ahead: the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region, 1990-2015. Int J Public Health 2018; 63:11-23. [PMID: 28776238 PMCID: PMC5973982 DOI: 10.1007/s00038-017-1017-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/30/2017] [Accepted: 07/07/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The Eastern Mediterranean Region faces several health challenges at a difficult time with wars, unrest, and economic change. METHODS We used the Global Burden of Disease 2015 study to present the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region from 1990 to 2015. RESULTS Ischemic heart disease was the leading cause of death in the region in 2015, followed by cerebrovascular disease. Changes in total deaths ranged from a reduction of 25% for diarrheal diseases to an increase of about 42% for diabetes and tracheal, bronchus, and lung cancer. Collective violence and legal intervention increased by 850% during the time period. Diet was the leading risk factor for disability-adjusted life years (DALYs) for men compared to maternal malnutrition for females. Childhood undernutrition was the leading risk factor for DALYs in 1990 and 2005, but the second in 2015 after high blood pressure. CONCLUSIONS Our study shows that the region is facing several health challenges and calls for global efforts to stabilise the region and to address the current and future burden of disease.
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Burden of vision loss in the Eastern Mediterranean region, 1990-2015: findings from the Global Burden of Disease 2015 study. Int J Public Health 2018; 63:199-210. [PMID: 28776250 PMCID: PMC5973987 DOI: 10.1007/s00038-017-1000-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/22/2017] [Accepted: 06/23/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES To report the estimated trend in prevalence and years lived with disability (YLDs) due to vision loss (VL) in the Eastern Mediterranean region (EMR) from 1990 to 2015. METHODS The estimated trends in age-standardized prevalence and the YLDs rate due to VL in 22 EMR countries were extracted from the Global Burden of Disease (GBD) 2015 study. The association of Socio-demographic Index (SDI) with changes in prevalence and YLDs of VL was evaluated using a multilevel mixed model. RESULTS The age-standardized prevalence of VL in the EMR was 18.2% in 1990 and 15.5% in 2015. The total age-standardized YLDs rate attributed to all-cause VL in EMR was 536.9 per 100,000 population in 1990 and 482.3 per 100,000 population in 2015. For each 0.1 unit increase in SDI, the age-standardized prevalence and YLDs rate of VL showed a reduction of 1.5% (p < 0.001) and 23.9 per 100,000 population (p < 0.001), respectively. CONCLUSIONS The burden of VL is high in the EMR; however, it shows a descending trend over the past 25 years. EMR countries need to establish comprehensive eye care programs in their health care systems.
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Transport injuries and deaths in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 Study. Int J Public Health 2018; 63:187-198. [PMID: 28776255 PMCID: PMC5973983 DOI: 10.1007/s00038-017-0987-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 05/02/2017] [Revised: 05/23/2017] [Accepted: 05/29/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Transport injuries (TI) are ranked as one of the leading causes of death, disability, and property loss worldwide. This paper provides an overview of the burden of TI in the Eastern Mediterranean Region (EMR) by age and sex from 1990 to 2015. METHODS Transport injuries mortality in the EMR was estimated using the Global Burden of Disease mortality database, with corrections for ill-defined causes of death, using the cause of death ensemble modeling tool. Morbidity estimation was based on inpatient and outpatient datasets, 26 cause-of-injury and 47 nature-of-injury categories. RESULTS In 2015, 152,855 (95% uncertainty interval: 137,900-168,100) people died from TI in the EMR countries. Between 1990 and 2015, the years of life lost (YLL) rate per 100,000 due to TI decreased by 15.5%, while the years lived with disability (YLD) rate decreased by 10%, and the age-standardized disability-adjusted life years (DALYs) rate decreased by 16%. CONCLUSIONS Although the burden of TI mortality and morbidity decreased over the last two decades, there is still a considerable burden that needs to be addressed by increasing awareness, enforcing laws, and improving road conditions.
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Hedayatizadeh-Omran A, Alizadeh-Navaei R, Janbabaei G, Omrani-Nava V, Hasheminasab Y, Amjadi O, Tehrani M. Association of P53 gene polymorphism with gastric cancer in Northern Iran as a high-risk region. Biomed Rep 2018; 8:433-438. [PMID: 29616139 PMCID: PMC5876468 DOI: 10.3892/br.2018.1070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/30/2017] [Indexed: 02/06/2023] Open
Abstract
Gastric cancer has the fourth highest morbidity rate of all cancers worldwide. Genetic factors including alterations in oncogenes and tumor suppressor genes serve an important role in gastric cancer development and progression. The P53 gene acts as a tumor suppressor gene by regulating the cell cycle, DNA transcription and repair, apoptosis, senescence and genome stability. In addition to somatic P53 mutations in cancer development, germline polymorphisms are also involved in different malignancies. The polymorphism of P53 at codon 72 (Arg72Pro) is established as a common variant that increases susceptibility to various cancers. The present case-control study was conducted to evaluate the possible association between this P53 polymorphism and gastric cancer in the Iranian population. A total of 59 patients with gastric cancer and 59 healthy controls were enrolled in the present study. Genomic DNA was extracted from peripheral blood mononuclear cells and genotype analysis was performed using a polymerase chain reaction-based restriction fragment length polymorphism assay. Genotype frequencies did not differ significantly between the patients and controls (P=0.4); the frequencies of the three genotypes Arg/Arg, Arg/Pro and Pro/Pro in gastric cancer patients were 28.8, 49.2 and 22.0%, and in controls were 37.3, 49.2 and 13.6%. Additionally, there were no differences in genotype frequencies based on tumor location, histological differentiation or tumor stage. Based on these findings, it may be concluded that the P53 codon 72 polymorphism does not contribute to gastric cancer susceptibility in Northern Iran.
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Affiliation(s)
- Akbar Hedayatizadeh-Omran
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
- Correspondence to: Dr Reza Alizadeh-Navaei, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran, E-mail:
| | - Ghasem Janbabaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
| | - Versa Omrani-Nava
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
| | - Yahya Hasheminasab
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
| | - Omolbanin Amjadi
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
| | - Mohsen Tehrani
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166-33131, Iran
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Burden of diarrhea in the Eastern Mediterranean Region, 1990-2015: Findings from the Global Burden of Disease 2015 study. Int J Public Health 2018; 63:109-121. [PMID: 28776239 PMCID: PMC5973974 DOI: 10.1007/s00038-017-1008-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 04/30/2017] [Revised: 06/20/2017] [Accepted: 06/28/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES Diarrheal diseases (DD) are an important cause of disease burden, especially in children in low-income settings. DD can also impact children's potential livelihood through growth faltering, cognitive impairment, and other sequelae. METHODS As part of the Global Burden of Disease study, we estimated DD burden, and the burden attributable to specific risk factors and etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2015. We calculated disability-adjusted life-years (DALYs)-the sum of years of life lost and years lived with disability-for both sexes and all ages. RESULTS We estimate that over 103,692 diarrhea deaths occurred in the EMR in 2015 (95% uncertainty interval: 87,018-124,692), and the mortality rate was 16.0 deaths per 100,000 persons (95% UI: 13.4-19.2). The majority of these deaths occurred in children under 5 (63.3%) (65,670 deaths, 95% UI: 53,640-79,486). DALYs per 100,000 ranged from 304 (95% UI 228-400) in Kuwait to 38,900 (95% UI 25,900-54,300) in Somalia. CONCLUSIONS Our findings will guide evidence-based health policy decisions for interventions to achieve the ultimate goal of reducing the DD burden.
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Burden of cancer in the Eastern Mediterranean Region, 2005-2015: findings from the Global Burden of Disease 2015 Study. Int J Public Health 2018; 63:151-164. [PMID: 28776254 PMCID: PMC5973975 DOI: 10.1007/s00038-017-0999-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/02/2017] [Accepted: 06/13/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To estimate incidence, mortality, and disability-adjusted life years (DALYs) caused by cancer in the Eastern Mediterranean Region (EMR) between 2005 and 2015. METHODS Vital registration system and cancer registry data from the EMR region were analyzed for 29 cancer groups in 22 EMR countries using the Global Burden of Disease Study 2015 methodology. RESULTS In 2015, cancer was responsible for 9.4% of all deaths and 5.1% of all DALYs. It accounted for 722,646 new cases, 379,093 deaths, and 11.7 million DALYs. Between 2005 and 2015, incident cases increased by 46%, deaths by 33%, and DALYs by 31%. The increase in cancer incidence was largely driven by population growth and population aging. Breast cancer, lung cancer, and leukemia were the most common cancers, while lung, breast, and stomach cancers caused most cancer deaths. CONCLUSIONS Cancer is responsible for a substantial disease burden in the EMR, which is increasing. There is an urgent need to expand cancer prevention, screening, and awareness programs in EMR countries as well as to improve diagnosis, treatment, and palliative care services.
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Burden of lower respiratory infections in the Eastern Mediterranean Region between 1990 and 2015: findings from the Global Burden of Disease 2015 study. Int J Public Health 2018; 63:97-108. [PMID: 28776246 PMCID: PMC5973986 DOI: 10.1007/s00038-017-1007-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/08/2017] [Accepted: 06/28/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES We used data from the Global Burden of Disease 2015 study (GBD) to calculate the burden of lower respiratory infections (LRIs) in the 22 countries of the Eastern Mediterranean Region (EMR) from 1990 to 2015. METHODS We conducted a systematic analysis of mortality and morbidity data for LRI and its specific etiologic factors, including pneumococcus, Haemophilus influenzae type b, Respiratory syncytial virus, and influenza virus. We used modeling methods to estimate incidence, deaths, and disability-adjusted life-years (DALYs). We calculated burden attributable to known risk factors for LRI. RESULTS In 2015, LRIs were the fourth-leading cause of DALYs, causing 11,098,243 (95% UI 9,857,095-12,396,566) DALYs and 191,114 (95% UI 170,934-210,705) deaths. The LRI DALY rates were higher than global estimates in 2015. The highest and lowest age-standardized rates of DALYs were observed in Somalia and Lebanon, respectively. Undernutrition in childhood and ambient particulate matter air pollution in the elderly were the main risk factors. CONCLUSIONS Our findings call for public health strategies to reduce the level of risk factors in each age group, especially vulnerable child and elderly populations.
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Trends in HIV/AIDS morbidity and mortality in Eastern Mediterranean countries, 1990-2015: findings from the Global Burden of Disease 2015 study. Int J Public Health 2018; 63:123-136. [PMID: 28776249 PMCID: PMC5702264 DOI: 10.1007/s00038-017-1023-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/19/2017] [Accepted: 07/21/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES We used the results of the Global Burden of Disease 2015 study to estimate trends of HIV/AIDS burden in Eastern Mediterranean Region (EMR) countries between 1990 and 2015. METHODS Tailored estimation methods were used to produce final estimates of mortality. Years of life lost (YLLs) were calculated by multiplying the mortality rate by population by age-specific life expectancy. Years lived with disability (YLDs) were computed as the prevalence of a sequela multiplied by its disability weight. RESULTS In 2015, the rate of HIV/AIDS deaths in the EMR was 1.8 (1.4-2.5) per 100,000 population, a 43% increase from 1990 (0.3; 0.2-0.8). Consequently, the rate of YLLs due to HIV/AIDS increased from 15.3 (7.6-36.2) per 100,000 in 1990 to 81.9 (65.3-114.4) in 2015. The rate of YLDs increased from 1.3 (0.6-3.1) in 1990 to 4.4 (2.7-6.6) in 2015. CONCLUSIONS HIV/AIDS morbidity and mortality increased in the EMR since 1990. To reverse this trend and achieve epidemic control, EMR countries should strengthen HIV surveillance, and scale up HIV antiretroviral therapy and comprehensive prevention services.
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Burden of cardiovascular diseases in the Eastern Mediterranean Region, 1990-2015: findings from the Global Burden of Disease 2015 study. Int J Public Health 2018; 63:137-149. [PMID: 28776245 PMCID: PMC5973984 DOI: 10.1007/s00038-017-1012-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [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: 05/01/2017] [Revised: 06/20/2017] [Accepted: 06/28/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES To report the burden of cardiovascular diseases (CVD) in the Eastern Mediterranean Region (EMR) during 1990-2015. METHODS We used the 2015 Global Burden of Disease study for estimates of mortality and disability-adjusted life years (DALYs) of different CVD in 22 countries of EMR. RESULTS A total of 1.4 million CVD deaths (95% UI: 1.3-1.5) occurred in 2015 in the EMR, with the highest number of deaths in Pakistan (465,116) and the lowest number of deaths in Qatar (723). The age-standardized DALY rate per 100,000 decreased from 10,080 in 1990 to 8606 in 2015 (14.6% decrease). Afghanistan had the highest age-standardized DALY rate of CVD in both 1990 and 2015. Kuwait and Qatar had the lowest age-standardized DALY rates of CVD in 1990 and 2015, respectively. High blood pressure, high total cholesterol, and high body mass index were the leading risk factors for CVD. CONCLUSIONS The age-standardized DALY rates in the EMR are considerably higher than the global average. These findings call for a comprehensive approach to prevent and control the burden of CVD in the region.
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Burden of obesity in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study. Int J Public Health 2018; 63:165-176. [PMID: 28776243 PMCID: PMC5973977 DOI: 10.1007/s00038-017-1002-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [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: 05/01/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES We used the Global Burden of Disease (GBD) 2015 study results to explore the burden of high body mass index (BMI) in the Eastern Mediterranean Region (EMR). METHODS We estimated the prevalence of overweight and obesity among children (2-19 years) and adults (≥20 years) in 1980 and 2015. The burden of disease related to high BMI was calculated using the GBD comparative risk assessment approach. RESULTS The prevalence of obesity increased for adults from 15.1% (95% UI 13.4-16.9) in 1980 to 20.7% (95% UI 18.8-22.8) in 2015. It increased from 4.1% (95% UI 2.9-5.5) to 4.9% (95% UI 3.6-6.4) for the same period among children. In 2015, there were 417,115 deaths and 14,448,548 disability-adjusted life years (DALYs) attributable to high BMI in EMR, which constitute about 10 and 6.3% of total deaths and DALYs, respectively, for all ages. CONCLUSIONS This is the first study to estimate trends in obesity burden for the EMR from 1980 to 2015. We call for EMR countries to invest more resources in prevention and health promotion efforts to reduce this burden.
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Zamani M, Ebrahimtabar F, Zamani V, Miller WH, Alizadeh-Navaei R, Shokri-Shirvani J, Derakhshan MH. Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther 2018; 47:868-876. [PMID: 29430669 DOI: 10.1111/apt.14561] [Citation(s) in RCA: 401] [Impact Index Per Article: 66.8] [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: 11/29/2017] [Revised: 01/01/2018] [Accepted: 01/22/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND The epidemiology of Helicobacter pylori infection is poorly understood. AIM To establish the reported regional and national prevalence of H. pylori infection, stratified by age and gender. METHODS All relevant English publications from 2000 to 2017 cited by PubMed and Scopus were retrieved using comprehensive combinations of keywords. The overall prevalence of H. pylori was estimated using both random effect and fixed effect meta-analyses, and presented as prevalence rate (% and 95% CI). The analyses were extended by separation into gender and age groups. RESULTS A total of 14 056 records were obtained initially. After applying exclusion criteria in several steps, 183 studies were selected. Analysis of 410 879 participants from 73 countries in six continents revealed an overall prevalence of 44.3% (95% CI: 40.9-47.7) worldwide. This rate ranged from 50.8% (95% CI: 46.8-54.7) in developing countries compared with 34.7% (95% CI: 30.2-39.3) in developed countries. The global H. pylori infection rate was 42.7% (95% CI: 39-46.5) in females compared to 46.3% (95% CI: 42.1-50.5) in males. The prevalence in adults (≥18 years) was significantly higher than in children (48.6% [95% CI: 43.8-53.5] vs 32.6% [95% CI: 28.4-36.8], respectively). There was a statistically nonsignificant decrease in the prevalence in 2009-2016 compared with the 2000-2009 period. CONCLUSIONS The observed differences between countries appear to be due to economic and social conditions. H. pylori infection can be a benchmark for the socioeconomic and health status of a country. Further studies are suggested to investigate the natural history of the acquisition of H. pylori infection from childhood into adult life.
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Affiliation(s)
- M Zamani
- Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - F Ebrahimtabar
- Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - V Zamani
- Vice-Chancellery for Health, Babol University of Medical Sciences, Babol, Iran
| | - W H Miller
- Faculty of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - R Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - J Shokri-Shirvani
- Department of Internal Medicine, Rohani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - M H Derakhshan
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
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Zamani M, Alizadeh-Navaei R, Zahed Pasha Y. Reply to: Improving the Quality of the Reporting of Systematic Reviews and Meta-analyses. Arch Iran Med 2018; 21:184. [PMID: 29693411 DOI: pmid/29693411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 02/05/2018] [Indexed: 02/08/2023]
Affiliation(s)
- Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Yadollah Zahed Pasha
- Permanent Member of the Academy of Medical Sciences of Islamic Republic of Iran, Babol University of Medical Sciences, Babol, Iran
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