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Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00757-8. [PMID: 38642570 DOI: 10.1016/s0140-6736(24)00757-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/07/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING Bill & Melinda Gates Foundation.
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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00367-2. [PMID: 38582094 DOI: 10.1016/s0140-6736(24)00367-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation.
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Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 2024; 23:344-381. [PMID: 38493795 PMCID: PMC10949203 DOI: 10.1016/s1474-4422(24)00038-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378-521), affecting 3·40 billion (3·20-3·62) individuals (43·1%, 40·5-45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7-26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6-38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5-32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7-2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. FUNDING Bill & Melinda Gates Foundation.
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Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00476-8. [PMID: 38484753 DOI: 10.1016/s0140-6736(24)00476-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period. METHODS 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5-65·1] decline), and increased during the COVID-19 pandemic period (2020-21; 5·1% [0·9-9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98-5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50-6·01) in 2019. An estimated 131 million (126-137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7-17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8-24·8), from 49·0 years (46·7-51·3) to 71·7 years (70·9-72·5). Global life expectancy at birth declined by 1·6 years (1·0-2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67-8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4-52·7]) and south Asia (26·3% [9·0-44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING Bill & Melinda Gates Foundation.
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Renedo D, Acosta JN, Leasure AC, Sharma R, Krumholz HM, de Havenon A, Alahdab F, Aravkin AY, Aryan Z, Bärnighausen TW, Basu S, Burkart K, Coberly K, Criqui MH, Dai X, Desai R, Dharmaratne SD, Doshi R, Elgendy IY, Feigin VL, Filip I, Gad MM, Ghozy S, Hafezi-Nejad N, Kalani R, Karaye IM, Kisa A, Krishnamoorthy V, Lo W, Mestrovic T, Miller TR, Misganaw A, Mokdad AH, Murray CJL, Natto ZS, Radfar A, Ram P, Roth GA, Seylani A, Shah NS, Sharma P, Sheikh A, Singh JA, Song S, Sotoudeh H, Vervoort D, Wang C, Xiao H, Xu S, Zand R, Falcone GJ, Sheth KN. Burden of Ischemic and Hemorrhagic Stroke Across the US From 1990 to 2019. JAMA Neurol 2024; 81:2815830. [PMID: 38436973 PMCID: PMC10913004 DOI: 10.1001/jamaneurol.2024.0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/18/2024] [Indexed: 03/05/2024]
Abstract
Importance Stroke is a leading cause of death and disability in the US. Accurate and updated measures of stroke burden are needed to guide public health policies. Objective To present burden estimates of ischemic and hemorrhagic stroke in the US in 2019 and describe trends from 1990 to 2019 by age, sex, and geographic location. Design, Setting, and Participants An in-depth cross-sectional analysis of the 2019 Global Burden of Disease study was conducted. The setting included the time period of 1990 to 2019 in the US. The study encompassed estimates for various types of strokes, including all strokes, ischemic strokes, intracerebral hemorrhages (ICHs), and subarachnoid hemorrhages (SAHs). The 2019 Global Burden of Disease results were released on October 20, 2020. Exposures In this study, no particular exposure was specifically targeted. Main Outcomes and Measures The primary focus of this analysis centered on both overall and age-standardized estimates, stroke incidence, prevalence, mortality, and DALYs per 100 000 individuals. Results In 2019, the US recorded 7.09 million prevalent strokes (4.07 million women [57.4%]; 3.02 million men [42.6%]), with 5.87 million being ischemic strokes (82.7%). Prevalence also included 0.66 million ICHs and 0.85 million SAHs. Although the absolute numbers of stroke cases, mortality, and DALYs surged from 1990 to 2019, the age-standardized rates either declined or remained steady. Notably, hemorrhagic strokes manifested a substantial increase, especially in mortality, compared with ischemic strokes (incidence of ischemic stroke increased by 13% [95% uncertainty interval (UI), 14.2%-11.9%]; incidence of ICH increased by 39.8% [95% UI, 38.9%-39.7%]; incidence of SAH increased by 50.9% [95% UI, 49.2%-52.6%]). The downturn in stroke mortality plateaued in the recent decade. There was a discernible heterogeneity in stroke burden trends, with older adults (50-74 years) experiencing a decrease in incidence in coastal areas (decreases up to 3.9% in Vermont), in contrast to an uptick observed in younger demographics (15-49 years) in the South and Midwest US (with increases up to 8.4% in Minnesota). Conclusions and Relevance In this cross-sectional study, the declining age-standardized stroke rates over the past 3 decades suggest progress in managing stroke-related outcomes. However, the increasing absolute burden of stroke, coupled with a notable rise in hemorrhagic stroke, suggests an evolving and substantial public health challenge in the US. Moreover, the significant disparities in stroke burden trends across different age groups and geographic locations underscore the necessity for region- and demography-specific interventions and policies to effectively mitigate the multifaceted and escalating burden of stroke in the country.
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Affiliation(s)
- Daniela Renedo
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
- Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut
| | - Julian N. Acosta
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Audrey C. Leasure
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Richa Sharma
- Yale Center for Brain & Mind Health, Yale School of Medicine, New Haven, Connecticut
| | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
| | - Adam de Havenon
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Fares Alahdab
- Evidence-Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota
| | - Aleksandr Y. Aravkin
- Department of Applied Mathematics, University of Washington, Seattle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Zahra Aryan
- Brigham and Women’s Hospital, Harvard University, Boston, Massachusetts
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Sanjay Basu
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of General Internal Medicine, San Francisco General Hospital, San Francisco, California
| | - Katrin Burkart
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Kaleb Coberly
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Michael H. Criqui
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Rupak Desai
- Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Rajkumar Doshi
- Department of Cardiology, St. Joseph’s University Medical Center, Paterson, New Jersey
| | - Islam Y. Elgendy
- Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Valery L. Feigin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
- Research Center of Neurology, Moscow, Russia
| | - Irina Filip
- Avicenna Medical and Clinical Research Institute, Oak Lawn, Illinois
| | - Mohamed M. Gad
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
- Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill
| | - Sherief Ghozy
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Nima Hafezi-Nejad
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
| | - Rizwan Kalani
- Department of Neurology, University of Washington, Seattle
| | - Ibraheem M. Karaye
- School of Health Professions and Human Services, Hofstra University, Hempstead, New York
- Department of Anesthesiology, Montefiore Medical Center, Bronx, New York
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of International Health and Sustainability, Tulane University, New Orleans, Louisiana
| | - Vijay Krishnamoorthy
- Department of Anesthesiology, Duke University, Durham, North Carolina
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle
| | - Warren Lo
- Department of Pediatrics, Ohio State University, Columbus
- Department of Neurology, Nationwide Children’s Hospital, Columbus, Ohio
| | - Tomislav Mestrovic
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Ted R. Miller
- Pacific Institute for Research & Evaluation, Calverton, Maryland
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Awoke Misganaw
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- School of Public Health, College of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ali H. Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Christopher J. L. Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Zuhair S. Natto
- Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Health Policy and Oral Epidemiology, Harvard University, Boston, Massachusetts
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando
| | - Pradhum Ram
- Division of Cardiology, UPMC Western Maryland, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Gregory A. Roth
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Division of Cardiology, University of Washington, Seattle
| | - Allen Seylani
- National Heart, Lung, and Blood Institute, National Institute of Health, Rockville, Maryland
| | - Nilay S. Shah
- Department of Medicine (Cardiology), Northwestern University, Chicago, Illinois
| | - Purva Sharma
- Department of Medical Oncology, Kent Hospital, Warwick, Rhode Island
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, United Kingdom
| | - Jasvinder A. Singh
- School of Medicine, University of Alabama at Birmingham, Birmingham
- Medicine Service, US Department of Veterans Affairs (VA), Birmingham, Alabama
| | - Suhang Song
- Department of Health Policy and Management, University of Georgia College of Public Health, Athens
| | - Houman Sotoudeh
- Department of Radiology, University of Alabama at Birmingham, Birmingham
| | - Dominique Vervoort
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland
| | - Cong Wang
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Hong Xiao
- Department of Public Health Science, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Suowen Xu
- Department of Endocrinology, University of Science and Technology of China, Hefei, China
- Max-Planck-Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Ramin Zand
- Department of Neurology, Pennsylvania State University College of Medicine, Hershey
| | - Guido J. Falcone
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
- Yale Center for Brain & Mind Health, Yale School of Medicine, New Haven, Connecticut
| | - Kevin N. Sheth
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
- Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut
- Yale Center for Brain & Mind Health, Yale School of Medicine, New Haven, Connecticut
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Wu AM, Cross M, Elliott JM, Culbreth GT, Haile LM, Steinmetz JD, Hagins H, Kopec JA, Brooks PM, Woolf AD, Kopansky-Giles DR, Walton DM, Treleaven JM, Dreinhoefer KE, Betteridge N, Abbasifard M, Abbasi-Kangevari Z, Addo IY, Adesina MA, Adnani QES, Aithala JP, Alhalaiqa FAN, Alimohamadi Y, Amiri S, Amu H, Antony B, Arabloo J, Aravkin AY, Asghari-Jafarabadi M, Atomsa GH, Azadnajafabad S, Azzam AY, Baghdadi S, Balogun SA, Balta AB, Banach M, Banakar M, Barrow A, Bashiri A, Bekele A, Bensenor IM, Bhardwaj P, Bhat AN, Bilchut AH, Briggs AM, Buchbinder R, Cao C, Chaurasia A, Chirinos-Caceres JL, Christensen SWM, Coberly K, Cousin E, Dadras O, Dai X, de Luca K, Dehghan A, Dong HJ, Ekholuenetale M, Elhadi M, Eshetu HB, Eskandarieh S, Etaee F, Fagbamigbe AF, Fares J, Fatehizadeh A, Feizkhah A, Ferreira ML, Ferreira N, Fischer F, Franklin RC, Ganesan B, Gebremichael MA, Gerema U, Gholami A, Ghozy S, Gill TK, Golechha M, Goleij P, Golinelli D, Graham SM, Haj-Mirzaian A, Harlianto NI, Hartvigsen J, Hasanian M, Hassen MB, Hay SI, Hebert JJ, Heidari G, Hoveidaei AH, Hsiao AK, Ibitoye SE, Iwu CCD, Jacob L, Janodia MD, Jin Y, Jonas JB, Joshua CE, Kandel H, Khader YS, Khajuria H, Khan EA, Khan MAB, Khatatbeh MM, Khateri S, Khayat Kashani HR, Khonji MS, Khubchandani J, Kim YJ, Kisa A, Kolahi AA, Koohestani HR, Krishan K, Kuddus M, Kuttikkattu A, Lasrado S, Lee YH, Legesse SM, Lim SS, Liu X, Lo J, Malih N, Manandhar SP, Mathews E, Mesregah MK, Mestrovic T, Miller TR, Mirghaderi SP, Misganaw A, Mohammadi E, Mohammed S, Mokdad AH, Momtazmanesh S, Moni MA, Mostafavi E, Murray CJL, Nair TS, Nejadghaderi SA, Nzoputam OJ, Oh IH, Okonji OC, Owolabi MO, Pacheco-Barrios K, Pahlevan Fallahy MT, Park S, Patel J, Pawar S, Pedersini P, Peres MFP, Petcu IR, Pourahmadi M, Qattea I, Ram P, Rashidi MM, Rawaf S, Rezaei N, Rezaei N, Saeed U, Saheb Sharif-Askari F, Salahi S, Sawhney M, Schumacher AE, Shafie M, Shahabi S, Shahbandi A, Shamekh A, Sharma S, Shiri R, Shobeiri P, Sinaei E, Singh A, Singh JA, Singh P, Skryabina AA, Smith AE, Tabish M, Tan KK, Tegegne MD, Tharwat S, Vahabi SM, Valadan Tahbaz S, Vasankari TJ, Venketasubramanian N, Vollset SE, Wang YP, Wiangkham T, Yonemoto N, Zangiabadian M, Zare I, Zemedikun DT, Zheng P, Ong KL, Vos T, March LM. Global, regional, and national burden of neck pain, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol 2024; 6:e142-e155. [PMID: 38383088 PMCID: PMC10897950 DOI: 10.1016/s2665-9913(23)00321-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND Neck pain is a highly prevalent condition that leads to considerable pain, disability, and economic cost. We present the most current estimates of neck pain prevalence and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) by age, sex, and location, with forecasted prevalence to 2050. METHODS Systematic reviews identified population-representative surveys used to estimate the prevalence of and YLDs from neck pain in 204 countries and territories, spanning from 1990 to 2020, with additional data from opportunistic review. Medical claims data from Taiwan (province of China) were also included. Input data were pooled using DisMod-MR 2.1, a Bayesian meta-regression tool. Prevalence was forecast to 2050 using a mixed-effects model using Socio-demographic Index as a predictor and multiplying by projected population estimates. We present 95% UIs for every metric based on the 2·5th and 97·5th percentiles of 100 draws of the posterior distribution. FINDINGS Globally, in 2020, neck pain affected 203 million (95% uncertainty interval [UI] 163-253) people. The global age-standardised prevalence rate of neck pain was estimated to be 2450 (1960-3040) per 100 000 population and global age-standardised YLD rate was estimated to be 244 (165-346) per 100 000. The age-standardised prevalence rate remained stable between 1990 and 2020 (percentage change 0·2% [-1·3 to 1·7]). Globally, females had a higher age-standardised prevalence rate (2890 [2330-3620] per 100 000) than males (2000 [1600-2480] per 100 000), with the prevalence peaking between 45 years and 74 years in male and female sexes. By 2050, the estimated global number of neck pain cases is projected to be 269 million (219-322), with an increase of 32·5% (23·9-42·3) from 2020 to 2050. Decomposition analysis of the projections showed population growth was the primary contributing factor, followed by population ageing. INTERPRETATION Although age-standardised rates of neck pain have remained stable over the past three decades, by 2050 the projected case numbers are expected to rise. With the highest prevalence in older adults (higher in females than males), a larger effect expected in low-income and middle-income countries, and a rapidly ageing global population, neck pain continues to pose a challenge in terms of disability burden worldwide. For future planning, it is essential we improve our mechanistic understanding of the different causes and risk factors for neck pain and prioritise the consistent collection of global neck pain data and increase the number of countries with data on neck pain. FUNDING Bill & Melinda Gates Foundation and Global Alliance for Musculoskeletal Health.
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Moberg ME, Hamilton EB, Zeng SM, Bryazka D, Zhao JT, Feldman R, Abate YH, Abbasi-Kangevari M, Abdurehman AM, Abedi A, Abu-Gharbieh E, Addo IY, Adepoju AV, Adnani QES, Afzal S, Ahinkorah BO, Ahmad S, Ahmed D, Ahmed H, Alem DT, Al-Gheethi AAS, Alimohamadi Y, Ameyaw EK, Amrollahi-Sharifabadi M, Anagaw TF, Anyasodor AE, Arabloo J, Aravkin AY, Athari SS, Atreya A, Azari Jafari A, Badiye AD, Baghcheghi N, Bagherieh S, Bansal H, Barrow A, Bashiri A, Bayileyegn NS, Berhie AY, Bhagavathula AS, Bhardwaj P, Boloor A, Cámera LA, Carvalho F, Carvalho M, Chandrasekar EK, Chang JC, Chattu VK, Chu DT, Coberly K, Cruz-Martins N, Dadras O, Dai X, Darvishi Cheshmeh Soltani R, Das S, Das S, Debela SA, Demessa BH, Deng X, Desta AA, Desye B, Dhimal M, Dibas M, Dsouza HL, Ekholuenetale M, El Sayed I, El-Huneidi W, Enyew DB, Fagbamigbe AF, Fatehizadeh A, Fatima SAF, Fischer F, Franklin RC, Garg T, Gebi TG, Gerema U, Getachew M, Getachew ME, Ghamari F, Golechha M, Goleij P, Gupta S, Gupta VB, Gupta VK, Harorani M, Hasani H, Hassan AM, Hassanian-Moghaddam H, Hassen MB, Hay SI, Hayat K, Heidari M, Heidari-Foroozan M, Heyi DZ, Holla R, Hoogar P, Hossain MS, Hosseini MS, Hostiuc S, Hoveidamanesh S, Ilesanmi OS, Ilic IM, Immurana M, Iwu CCD, Jayarajah U, Joseph N, Joshua CE, Kadashetti V, Kanchan T, Kandel H, Kantar RS, Kapoor N, Karaye IM, Katoto PDMC, Khajuria H, Khan EA, Khateri S, Khodamoradi F, Khormali M, Khubchandani J, Kim G, Kisa A, Koohestani HR, Krishan K, Kumar N, Laflamme L, Landires I, Larijani B, Lauriola P, Le TTT, Ledda C, Lee SW, Lim SS, Lobo SW, Lunevicius R, Maharaj SB, Menezes RG, Mentis AFA, Mestrovic T, Miller TR, Mirmoeeni S, Misganaw A, Mishra M, Misra S, Mittal C, Mohammadi E, Mokdad AH, Moni MA, Mostafavi E, Mubarik S, Mulita F, Mulualem JA, Mulugeta T, Murray CJL, Myers I, Nayak BP, Nayak VC, Nejadghaderi SA, Nguyen HLT, Nguyen VT, Nouraei H, Nzoputam OJ, Okati-Aliabad H, Olufadewa II, Ordak M, Padron-Monedero A, Padubidri JR, Pandey A, Pant S, Parekh U, Pawar S, Peden AE, Petcu IR, Piel FB, Piracha ZZ, Pourali G, Qattea I, Qureshi MF, Raghav PR, Rahman M, Rahmani S, Ramasubramani P, Ramazanu S, Rawaf S, Rezaei N, Rezaei N, Rezaeian M, Saddik B, Sadeghi M, Sadeghian F, Saeed U, Sahebkar A, Saif Z, Sakshaug JW, Salahi S, Salamati P, Samy AM, Sarmiento-Suárez R, Schwebel DC, Senthilkumaran S, Seylani A, Shaikh MA, Sham S, Shashamo BB, Sheikhi RA, Shetty BSK, Shetty PH, Sibhat MM, Singh H, Singh P, Sisay EA, Solomon Y, Taheri M, Ullah I, Ullah S, Violante FS, Vu LG, Wickramasinghe ND, Yigit A, Yonemoto N, Yousefi Z, Zaman M, Zastrozhin MS, Zhang ZJ, Zheng P, Zoladl M, Steinmetz JD, Vos T, Naghavi M, Ong KL. Global, regional, and national mortality due to unintentional carbon monoxide poisoning, 2000-2021: results from the Global Burden of Disease Study 2021. Lancet Public Health 2023; 8:e839-e849. [PMID: 37813118 PMCID: PMC10602911 DOI: 10.1016/s2468-2667(23)00185-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Unintentional carbon monoxide poisoning is a largely preventable cause of death that has received insufficient attention. We aimed to conduct a comprehensive global analysis of the demographic, temporal, and geographical patterns of fatal unintentional carbon monoxide poisoning from 2000 to 2021. METHODS As part of the latest Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), unintentional carbon monoxide poisoning mortality was quantified using the GBD cause of death ensemble modelling strategy. Vital registration data and covariates with an epidemiological link to unintentional carbon monoxide poisoning informed the estimates of death counts and mortality rates for all locations, sexes, ages, and years included in the GBD. Years of life lost (YLLs) were estimated by multiplying deaths by remaining standard life expectancy at age of death. Population attributable fractions (PAFs) for unintentional carbon monoxide poisoning deaths due to occupational injuries and high alcohol use were estimated. FINDINGS In 2021, the global mortality rate due to unintentional carbon monoxide poisoning was 0·366 per 100 000 (95% uncertainty interval 0·276-0·415), with 28 900 deaths (21 700-32 800) and 1·18 million YLLs (0·886-1·35) across all ages. Nearly 70% of deaths occurred in males (20 100 [15 800-24 000]), and the 50-54-year age group had the largest number of deaths (2210 [1660-2590]). The highest mortality rate was in those aged 85 years or older with 1·96 deaths (1·38-2·32) per 100 000. Eastern Europe had the highest age-standardised mortality rate at 2·12 deaths (1·98-2·30) per 100 000. Globally, there was a 53·5% (46·2-63·7) decrease in the age-standardised mortality rate from 2000 to 2021, although this decline was not uniform across regions. The overall PAFs for occupational injuries and high alcohol use were 13·6% (11·9-16·0) and 3·5% (1·4-6·2), respectively. INTERPRETATION Improvements in unintentional carbon monoxide poisoning mortality rates have been inconsistent across regions and over time since 2000. Given that unintentional carbon monoxide poisoning is almost entirely preventable, policy-level interventions that lower the risk of carbon monoxide poisoning events should be prioritised, such as those that increase access to improved heating and cooking devices, reduce carbon monoxide emissions from generators, and mandate use of carbon monoxide alarms. FUNDING Bill & Melinda Gates Foundation.
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Gill TK, Mittinty MM, March LM, Steinmetz JD, Culbreth GT, Cross M, Kopec JA, Woolf AD, Haile LM, Hagins H, Ong KL, Kopansky-Giles DR, Dreinhoefer KE, Betteridge N, Abbasian M, Abbasifard M, Abedi K, Adesina MA, Aithala JP, Akbarzadeh-Khiavi M, Al Thaher Y, Alalwan TA, Alzahrani H, Amiri S, Antony B, Arabloo J, Aravkin AY, Arumugam A, Aryal KK, Athari SS, Atreya A, Baghdadi S, Bardhan M, Barrero LH, Bearne LM, Bekele AB, Bensenor IM, Bhardwaj P, Bhatti R, Bijani A, Bordianu T, Bouaoud S, Briggs AM, Cheema HA, Christensen SWM, Chukwu IS, Clarsen B, Dai X, de Luca K, Desye B, Dhimal M, Do TC, Fagbamigbe AF, Farokh Forghani S, Ferreira N, Ganesan B, Gebrehiwot M, Ghashghaee A, Graham SM, Harlianto NI, Hartvigsen J, Hasaballah AI, Hasanian M, Hassen MB, Hay SI, Heidari M, Hsiao AK, Ilic IM, Jokar M, Khajuria H, Khan MJ, Khanal P, Khateri S, Kiadaliri A, Kim MS, Kisa A, Kolahi AA, Krishan K, Krishnamoorthy V, Landires I, Larijani B, Le TTT, Lee YH, Lim SS, Lo J, Madani SP, Malagón-Rojas JN, Malik I, Marateb HR, Mathew AJ, Meretoja TJ, Mesregah MK, Mestrovic T, Mirahmadi A, Misganaw A, Mohaghegh S, Mokdad AH, Momenzadeh K, Momtazmanesh S, Monasta L, Moni MA, Moradi Y, Mostafavi E, Muhammad JS, Murray CJL, Muthu S, Nargus S, Nassereldine H, Neupane S, Niazi RK, Oh IH, Okati-Aliabad H, Oulhaj A, Pacheco-Barrios K, Park S, Patel J, Pawar S, Pedersini P, Peres MFP, Petcu IR, Petermann-Rocha FE, Poursadeqiyan M, Qattea I, Qureshi MF, Rafferty Q, Rahimi-Dehgolan S, Rahman M, Ramasamy SK, Rashedi V, Redwan EMM, Ribeiro DC, Roever L, Safary A, Sagoe D, Saheb Sharif-Askari F, Sahebkar A, Salehi S, Shafaat A, Shahabi S, Sharma S, Shashamo BB, Shiri R, Singh A, Slater H, Smith AE, Sunuwar DR, Tabish M, Tharwat S, Ullah I, Valadan Tahbaz S, Vasankari TJ, Villafañe JH, Vollset SE, Wiangkham T, Yonemoto N, You Y, Zare I, Zheng P, Vos T, Brooks PM. Global, regional, and national burden of other musculoskeletal disorders, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol 2023; 5:e670-e682. [PMID: 37927903 PMCID: PMC10620749 DOI: 10.1016/s2665-9913(23)00232-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Background Musculoskeletal disorders include more than 150 different conditions affecting joints, muscles, bones, ligaments, tendons, and the spine. To capture all health loss from death and disability due to musculoskeletal disorders, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) includes a residual musculoskeletal category for conditions other than osteoarthritis, rheumatoid arthritis, gout, low back pain, and neck pain. This category is called other musculoskeletal disorders and includes, for example, systemic lupus erythematosus and spondylopathies. We provide updated estimates of the prevalence, mortality, and disability attributable to other musculoskeletal disorders and forecasted prevalence to 2050. Methods Prevalence of other musculoskeletal disorders was estimated in 204 countries and territories from 1990 to 2020 using data from 68 sources across 23 countries from which subtraction of cases of rheumatoid arthritis, osteoarthritis, low back pain, neck pain, and gout from the total number of cases of musculoskeletal disorders was possible. Data were analysed with Bayesian meta-regression models to estimate prevalence by year, age, sex, and location. Years lived with disability (YLDs) were estimated from prevalence and disability weights. Mortality attributed to other musculoskeletal disorders was estimated using vital registration data. Prevalence was forecast to 2050 by regressing prevalence estimates from 1990 to 2020 with Socio-demographic Index as a predictor, then multiplying by population forecasts. Findings Globally, 494 million (95% uncertainty interval 431-564) people had other musculoskeletal disorders in 2020, an increase of 123·4% (116·9-129·3) in total cases from 221 million (192-253) in 1990. Cases of other musculoskeletal disorders are projected to increase by 115% (107-124) from 2020 to 2050, to an estimated 1060 million (95% UI 964-1170) prevalent cases in 2050; most regions were projected to have at least a 50% increase in cases between 2020 and 2050. The global age-standardised prevalence of other musculoskeletal disorders was 47·4% (44·9-49·4) higher in females than in males and increased with age to a peak at 65-69 years in male and female sexes. In 2020, other musculoskeletal disorders was the sixth ranked cause of YLDs globally (42·7 million [29·4-60·0]) and was associated with 83 100 deaths (73 600-91 600). Interpretation Other musculoskeletal disorders were responsible for a large number of global YLDs in 2020. Until individual conditions and risk factors are more explicitly quantified, policy responses to this burden remain a challenge. Temporal trends and geographical differences in estimates of non-fatal disease burden should not be overinterpreted as they are based on sparse, low-quality data. Funding Bill & Melinda Gates Foundation.
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Wu D, Jin Y, Xing Y, Abate MD, Abbasian M, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abd-Allah F, Abdelmasseh M, Abdollahifar MA, Abdulah DM, Abedi A, Abedi V, Abidi H, Aboagye RG, Abolhassani H, Abuabara K, Abyadeh M, Addo IY, Adeniji KN, Adepoju AV, Adesina MA, Sakilah Adnani QE, Afarideh M, Aghamiri S, Agodi A, Agrawal A, Aguilera Arriagada CE, Ahmad A, Ahmad D, Ahmad S, Ahmad S, Ahmadi A, Ahmed A, Ahmed A, Aithala JP, Ajadi AA, Ajami M, Akbarzadeh-Khiavi M, Alahdab F, AlBataineh MT, Alemi S, Saeed Al-Gheethi AA, Ali L, Alif SM, Almazan JU, Almustanyir S, Alqahtani JS, Alqasmi I, Khan Altaf IU, Alvis-Guzman N, Alvis-Zakzuk NJ, Al-Worafi YM, Aly H, Amani R, Amu H, Amusa GA, Andrei CL, Ansar A, Ansariniya H, Anyasodor AE, Arabloo J, Arefnezhad R, Arulappan J, Asghari-Jafarabadi M, Ashraf T, Atata JA, Athari SS, Atlaw D, Wahbi Atout MM, Aujayeb A, Awan AT, Ayatollahi H, Azadnajafabad S, Azzam AY, Badawi A, Badiye AD, Bagherieh S, Baig AA, Bantie BB, Barchitta M, Bardhan M, Barker-Collo SL, Barone-Adesi F, Batra K, Bayileyegn NS, Behnoush AH, Belgaumi UI, Bemanalizadeh M, Bensenor IM, Beyene KA, Bhagavathula AS, Bhardwaj P, Bhaskar S, Bhat AN, Bitaraf S, Bitra VR, Boloor A, Bora K, Botelho JS, Buchbinder R, Calina D, Cámera LA, Carvalho AF, Kai Chan JS, Chattu VK, Abebe EC, Chichagi F, Choi S, Chou TC, Chu DT, Coberly K, Costa VM, Couto RA, Cruz-Martins N, Dadras O, Dai X, Damiani G, Dascalu AM, Dashti M, Debela SA, Dellavalle RP, Demetriades AK, Demlash AA, Deng X, Desai HD, Desai R, Rahman Dewan SM, Dey S, Dharmaratne SD, Diaz D, Dibas M, Dinis-Oliveira RJ, Diress M, Do TC, Doan DK, Dodangeh M, Dodangeh M, Dongarwar D, Dube J, Dziedzic AM, Ed-Dra A, Edinur HA, Eissazade N, Ekholuenetale M, Ekundayo TC, Elemam NM, Elhadi M, Elmehrath AO, Abdou Elmeligy OA, Emamverdi M, Emeto TI, Esayas HL, Eshetu HB, Etaee F, Fagbamigbe AF, Faghani S, Fakhradiyev IR, Fatehizadeh A, Fathi M, Feizkhah A, Fekadu G, Fereidouni M, Fereshtehnejad SM, Fernandes JC, Ferrara P, Fetensa G, Filip I, Fischer F, Foroutan B, Foroutan M, Fukumoto T, Ganesan B, Belete Gemeda BN, Ghamari SH, Ghasemi M, Gholamalizadeh M, Gill TK, Gillum RF, Goldust M, Golechha M, Goleij P, Golinelli D, Goudarzi H, Guan SY, Guo Y, Gupta B, Gupta VB, Gupta VK, Haddadi R, Hadi NR, Halwani R, Haque S, Hasan I, Hashempour R, Hassan A, Hassan TS, Hassanzadeh S, Hassen MB, Haubold J, Hayat K, Heidari G, Heidari M, Heidari-Soureshjani R, Herteliu C, Hessami K, Hezam K, Hiraike Y, Holla R, Hosseini MS, Huynh HH, Hwang BF, Ibitoye SE, Ilic IM, Ilic MD, Iranmehr A, Iravanpour F, Ismail NE, Iwagami M, Iwu CC, Jacob L, Jafarinia M, Jafarzadeh A, Jahankhani K, Jahrami H, Jakovljevic M, Jamshidi E, Jani CT, Janodia MD, Jayapal SK, Jayaram S, Jeganathan J, Jonas JB, Joseph A, Joseph N, Joshua CE, Vaishali K, Kaambwa B, Kabir A, Kabir Z, Kadashetti V, Kaliyadan F, Kalroozi F, Kamal VK, Kandel A, Kandel H, Kanungo S, Karami J, Karaye IM, Karimi H, Kasraei H, Kazemian S, Kebede SA, Keikavoosi-Arani L, Keykhaei M, Khader YS, Khajuria H, Khamesipour F, Khan EA, Khan IA, Khan M, Khan MJ, Khan MA, Khan MA, Khatatbeh H, Khatatbeh MM, Khateri S, Khayat Kashani HR, Kim MS, Kisa A, Kisa S, Koh HY, Kolkhir P, Korzh O, Kotnis AL, Koul PA, Koyanagi A, Krishan K, Kuddus M, Kulkarni VV, Kumar N, Kundu S, Kurmi OP, La Vecchia C, Lahariya C, Laksono T, Lám J, Latief K, Lauriola P, Lawal BK, Thu Le TT, Bich Le TT, Lee M, Lee SW, Lee WC, Lee YH, Lenzi J, Levi M, Li W, Ligade VS, Lim SS, Liu G, Liu X, Llanaj E, Lo CH, Machado VS, Maghazachi AA, Mahmoud MA, Mai TA, Majeed A, Sanaye PM, Makram OM, Rad EM, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, Mansournia MA, Mantovani LG, Martorell M, Masoudi S, Masoumi SZ, Mathangasinghe Y, Mathews E, Mathioudakis AG, Maugeri A, Mayeli M, Carabeo Medina JR, Meles GG, Mendes JJ, Menezes RG, Mestrovic T, Michalek IM, Micheletti Gomide Nogueira de Sá AC, Mihretie ET, Nhat Minh LH, Mirfakhraie R, Mirrakhimov EM, Misganaw A, Mohamadkhani A, Mohamed NS, Mohammadi F, Mohammadi S, Mohammed S, Mohammed S, Mohan S, Mohseni A, Mokdad AH, Momtazmanesh S, Monasta L, Moni MA, Moniruzzaman M, Moradi Y, Morovatdar N, Mostafavi E, Mousavi P, Mukoro GD, Mulita A, Mulu GB, Murillo-Zamora E, Musaigwa F, Mustafa G, Muthu S, Nainu F, Nangia V, Swamy SN, Natto ZS, Navaraj P, Nayak BP, Nazri-Panjaki A, Negash H, Nematollahi MH, Nguyen DH, Hien Nguyen HT, Nguyen HQ, Nguyen PT, Nguyen VT, Niazi RK, Nikolouzakis TK, Nnyanzi LA, Noreen M, Nzoputam CI, Nzoputam OJ, Oancea B, Oh IH, Okati-Aliabad H, Okonji OC, Okwute PG, Olagunju AT, Olatubi MI, Olufadewa II, Ordak M, Otstavnov N, Owolabi MO, Mahesh P, Padubidri JR, Pak A, Pakzad R, Palladino R, Pana A, Pantazopoulos I, Papadopoulou P, Pardhan S, Parthasarathi A, Pashaei A, Patel J, Pathan AR, Patil S, Paudel U, Pawar S, Pedersini P, Pensato U, Pereira DM, Pereira J, Pereira MO, Pereira RB, Peres MF, Perianayagam A, Perna S, Petcu IR, Pezeshki PS, Pham HT, Philip AK, Piradov MA, Podder I, Podder V, Poddighe D, Sady Prates EJ, Qattea I, Radfar A, Raee P, Rafiei A, Raggi A, Rahim F, Rahimi M, Rahimifard M, Rahimi-Movaghar V, Rahman MO, Ur Rahman MH, Rahman M, Rahman MA, Rahmani AM, Rahmani M, Rahmani S, Rahmanian V, Ramasubramani P, Rancic N, Rao IR, Rashedi S, Rashid AM, Ravikumar N, Rawaf S, Mohamed Redwan EM, Rezaei N, Rezaei N, Rezaei N, Rezaeian M, Ribeiro D, Rodrigues M, Buendia Rodriguez JA, Roever L, Romero-Rodríguez E, Saad AM, Saddik B, Sadeghian S, Saeed U, Safary A, Safdarian M, Safi SZ, Saghazadeh A, Sagoe D, Sharif-Askari FS, Sharif-Askari NS, Sahebkar A, Sahoo H, Sahraian MA, Sajid MR, Sakhamuri S, Sakshaug JW, Saleh MA, Salehi L, Salehi S, Farrokhi AS, Samadzadeh S, Samargandy S, Samieefar N, Samy AM, Sanadgol N, Sanjeev RK, Sawhney M, Saya GK, Schuermans A, Senthilkumaran S, Sepanlou SG, Sethi Y, Shafie M, Shah H, Shahid I, Shahid S, Shaikh MA, Sharfaei S, Sharma M, Shayan M, Shehata HS, Sheikh A, Shetty JK, Shin JI, Shirkoohi R, Shitaye NA, Shivakumar K, Shivarov V, Shobeiri P, Siabani S, Sibhat MM, Siddig EE, Simpson CR, Sinaei E, Singh H, Singh I, Singh JA, Singh P, Singh S, Siraj MS, Al Mamun Sohag A, Solanki R, Solikhah S, Solomon Y, Soltani-Zangbar MS, Sun J, Szeto MD, Tabarés-Seisdedos R, Tabatabaei SM, Tabish M, Taheri E, Tahvildari A, Talaat IM, Lukenze Tamuzi JJ, Tan KK, Tat NY, Oliaee RT, Tavasol A, Temsah MH, Thangaraju P, Tharwat S, Tibebu NS, Vera Ticoalu JH, Tillawi T, Tiruye TY, Tiyuri A, Tovani-Palone MR, Tripathi M, Tsegay GM, Tualeka AR, Ty SS, Ubah CS, Ullah S, Ullah S, Umair M, Umakanthan S, Upadhyay E, Vahabi SM, Vaithinathan AG, Tahbaz SV, Valizadeh R, Varthya SB, Vasankari TJ, Venketasubramanian N, Verras GI, Villafañe JH, Vlassov V, Vo DC, Waheed Y, Waris A, Welegebrial BG, Westerman R, Wickramasinghe DP, Wickramasinghe ND, Willekens B, Woldegeorgis BZ, Woldemariam M, Xiao H, Yada DY, Yahya G, Yang L, Yazdanpanah F, Yon DK, Yonemoto N, You Y, Zahir M, Zaidi SS, Zangiabadian M, Zare I, Zeineddine MA, Zemedikun DT, Zeru NG, Zhang C, Zhao H, Zhong C, Zielińska M, Zoladl M, Zumla A, Guo C, Tam LS. Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019. EClinicalMedicine 2023; 64:102193. [PMID: 37731935 PMCID: PMC10507198 DOI: 10.1016/j.eclinm.2023.102193] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023] Open
Abstract
Background The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of -0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = -0.41), inflammatory bowel disease (AAPC = -0.72), multiple sclerosis (AAPC = -0.26), psoriasis (AAPC = -0.77), and atopic dermatitis (AAPC = -0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38).
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Black RJ, Cross M, Haile LM, Culbreth GT, Steinmetz JD, Hagins H, Kopec JA, Brooks PM, Woolf AD, Ong KL, Kopansky-Giles DR, Dreinhoefer KE, Betteridge N, Aali A, Abbasifard M, Abbasi-Kangevari M, Abdurehman AM, Abedi A, Abidi H, Aboagye RG, Abolhassani H, Abu-Gharbieh E, Abu-Zaid A, Adamu K, Addo IY, Adesina MA, Adnani QES, Afzal MS, Ahmed A, Aithala JP, Akhlaghdoust M, Alemayehu A, Alvand S, Alvis-Zakzuk NJ, Amu H, Antony B, Arabloo J, Aravkin AY, Arulappan J, Ashraf T, Athari SS, Azadnajafabad S, Badawi A, Baghcheghi N, Baig AA, Balta AB, Banach M, Banik PC, Barrow A, Bashiri A, Bearne LM, Bekele A, Bensenor IM, Berhie AY, Bhagavathula AS, Bhardwaj P, Bhat AN, Bhojaraja VS, Bitaraf S, Bodicha BBA, Botelho JS, Briggs AM, Buchbinder R, Castañeda-Orjuela CA, Charalampous P, Chattu VK, Coberly K, Cruz-Martins N, Dadras O, Dai X, de Luca K, Dessalegn FN, Dessie G, Dhimal M, Digesa LE, Diress M, Doku PN, Edinur HA, Ekholuenetale M, Elhadi M, El-Sherbiny YM, Etaee F, Ezzeddini R, Faghani S, Filip I, Fischer F, Fukumoto T, Ganesan B, Gebremichael MA, Gerema U, Getachew ME, Ghashghaee A, Gill TK, Gupta B, Gupta S, Gupta VB, Gupta VK, Halwani R, Hannan MA, Haque S, Harlianto NI, Harorani M, Hasaballah AI, Hassen MB, Hay SI, Hayat K, Heidari G, Hezam K, Hill CL, Hiraike Y, Horita N, Hoveidaei AH, Hsiao AK, Hsieh E, Hussain S, Iavicoli I, Ilic IM, Islam SMS, Ismail NE, Iwagami M, Jakovljevic M, Jani CT, Jeganathan J, Joseph N, Kadashetti V, Kandel H, Kanko TK, Karaye IM, Khajuria H, Khan MJ, Khan MAB, Khanali J, Khatatbeh MM, Khubchandani J, Kim YJ, Kisa A, Kolahi AA, Kompani F, Koohestani HR, Koyanagi A, Krishan K, Kuddus M, Kumar N, Kuttikkattu A, Larijani B, Lim SS, Lo J, Machado VS, Mahajan PB, Majeed A, Malakan Rad E, Malik AA, Mansournia MA, Mathews E, Mendes JJ, Mentis AFA, Mesregah MK, Mestrovic T, Mirghaderi SP, Mirrakhimov EM, Misganaw A, Mohamadkhani A, Mohammed S, Mokdad AH, Moniruzzaman M, Montasir AA, Mulu GB, Murillo-Zamora E, Murray CJL, Mustafa G, Naghavi M, Nair TS, Naqvi AA, Natto ZS, Nayak BP, Neupane S, Nguyen CT, Niazi RK, Nzoputam OJ, Oh IH, Okati-Aliabad H, Okonji OC, Olufadewa II, Owolabi MO, Pacheco-Barrios K, Padubidri JR, Patel J, Pathan AR, Pawar S, Pedersini P, Perianayagam A, Petcu IR, Qattea I, Radfar A, Rafiei A, Rahman MHU, Rahmanian V, Rashedi V, Rashidi MM, Ratan ZA, Rawaf S, Razeghinia MS, Redwan EMM, Renzaho AMN, Rezaei N, Rezaei N, Riad A, Saad AMA, Saddik B, Saeed U, Safary A, Sahebazzamani M, Sahebkar A, Sahoo H, Salek Farrokhi A, Saqib MAN, Seylani A, Shahabi S, Shaikh MA, Shashamo BB, Shetty A, Shetty JK, Shigematsu M, Shivarov V, Shobeiri P, Sibhat MM, Sinaei E, Singh A, Singh JA, Singh P, Singh S, Siraj MS, Skryabina AA, Slater H, Smith AE, Solomon Y, Soltani-Zangbar MS, Tabish M, Tan KK, Tat NY, Tehrani-Banihashemi A, Tharwat S, Tovani-Palone MR, Tusa BS, Valadan Tahbaz S, Valdez PR, Valizadeh R, Vaziri S, Vollset SE, Wu AM, Yada DY, Yehualashet SS, Yonemoto N, You Y, Yunusa I, Zangiabadian M, Zare I, Zarrintan A, Zhang ZJ, Zhong C, Zoladl M, Vos T, March LM. Global, regional, and national burden of rheumatoid arthritis, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol 2023; 5:e594-e610. [PMID: 37795020 PMCID: PMC10546867 DOI: 10.1016/s2665-9913(23)00211-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background Rheumatoid arthritis is a chronic autoimmune inflammatory disease associated with disability and premature death. Up-to-date estimates of the burden of rheumatoid arthritis are required for health-care planning, resource allocation, and prevention. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we provide updated estimates of the prevalence of rheumatoid arthritis and its associated deaths and disability-adjusted life-years (DALYs) by age, sex, year, and location, with forecasted prevalence to 2050. Methods Rheumatoid arthritis prevalence was estimated in 204 countries and territories from 1990 to 2020 using Bayesian meta-regression models and data from population-based studies and medical claims data (98 prevalence and 25 incidence studies). Mortality was estimated from vital registration data with the Cause of Death Ensemble model (CODEm). Years of life lost (YLL) were calculated with use of standard GBD lifetables, and years lived with disability (YLDs) were estimated from prevalence, a meta-analysed distribution of rheumatoid arthritis severity, and disability weights. DALYs were calculated by summing YLLs and YLDs. Smoking was the only risk factor analysed. Rheumatoid arthritis prevalence was forecast to 2050 by logistic regression with Socio-Demographic Index as a predictor, then multiplying by projected population estimates. Findings In 2020, an estimated 17·6 million (95% uncertainty interval 15·8-20·3) people had rheumatoid arthritis worldwide. The age-standardised global prevalence rate was 208·8 cases (186·8-241·1) per 100 000 population, representing a 14·1% (12·7-15·4) increase since 1990. Prevalence was higher in females (age-standardised female-to-male prevalence ratio 2·45 [2·40-2·47]). The age-standardised death rate was 0·47 (0·41-0·54) per 100 000 population (38 300 global deaths [33 500-44 000]), a 23·8% (17·5-29·3) decrease from 1990 to 2020. The 2020 DALY count was 3 060 000 (2 320 000-3 860 000), with an age-standardised DALY rate of 36·4 (27·6-45·9) per 100 000 population. YLDs accounted for 76·4% (68·3-81·0) of DALYs. Smoking risk attribution for rheumatoid arthritis DALYs was 7·1% (3·6-10·3). We forecast that 31·7 million (25·8-39·0) individuals will be living with rheumatoid arthritis worldwide by 2050. Interpretation Rheumatoid arthritis mortality has decreased globally over the past three decades. Global age-standardised prevalence rate and YLDs have increased over the same period, and the number of cases is projected to continue to increase to the year 2050. Improved access to early diagnosis and treatment of rheumatoid arthritis globally is required to reduce the future burden of the disease. Funding Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.
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Aguilar GR, Swetschinski LR, Weaver ND, Ikuta KS, Mestrovic T, Gray AP, Chung E, Wool EE, Han C, Hayoon AG, Araki DT, Abdollahi A, Abu-Zaid A, Adnan M, Agarwal R, Dehkordi JA, Aravkin AY, Areda D, Azzam AY, Berezin EN, Bhagavathula AS, Bhutta ZA, Bhuyan SS, Browne AJ, Castañeda-Orjuela CA, Chandrasekar EK, Ching PR, Dai X, Darmstadt GL, De la Hoz FP, Diao N, Diaz D, Mombaque dos Santos W, Eyre D, Garcia C, Haines-Woodhouse G, Hassen MB, Henry NJ, Hopkins S, Hossain MM, Iregbu KC, Iwu CC, Jacobs JA, Janko MM, Jones R, Karaye IM, Khalil IA, Khan IA, Khan T, Khubchandani J, Khusuwan S, Kisa A, Koyaweda GW, Krapp F, Kumaran EA, Kyu HH, Lim SS, Liu X, Luby S, Maharaj SB, Maronga C, Martorell M, May J, McManigal B, Mokdad AH, Moore CE, Mostafavi E, Murillo-Zamora E, Mussi-Pinhata MM, Nanavati R, Nassereldine H, Natto ZS, Qamar FN, Nuñez-Samudio V, Ochoa TJ, Ojo-Akosile TR, Olagunju AT, Olivas-Martinez A, Ortiz-Brizuela E, Ounchanum P, Paredes JL, Patthipati VS, Pawar S, Pereira M, Pollard A, Ponce-De-Leon A, Sady Prates EJ, Qattea I, Reyes LF, Roilides E, Rosenthal VD, Rudd KE, Sangchan W, Seekaew S, Seylani A, Shababi N, Sham S, Sifuentes-Osornio J, Singh H, Stergachis A, Tasak N, Tat NY, Thaiprakong A, Valdez PR, Yada DY, Yunusa I, Zastrozhin MS, Hay SI, Dolecek C, Sartorius B, Murray CJ, Naghavi M. The burden of antimicrobial resistance in the Americas in 2019: a cross-country systematic analysis. Lancet Reg Health Am 2023; 25:100561. [PMID: 37727594 PMCID: PMC10505822 DOI: 10.1016/j.lana.2023.100561] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/22/2023] [Accepted: 07/10/2023] [Indexed: 09/21/2023]
Abstract
Background Antimicrobial resistance (AMR) is an urgent global health challenge and a critical threat to modern health care. Quantifying its burden in the WHO Region of the Americas has been elusive-despite the region's long history of resistance surveillance. This study provides comprehensive estimates of AMR burden in the Americas to assess this growing health threat. Methods We estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen-drug combinations for countries in the WHO Region of the Americas in 2019. We obtained data from mortality registries, surveillance systems, hospital systems, systematic literature reviews, and other sources, and applied predictive statistical modelling to produce estimates of AMR burden for all countries in the Americas. Five broad components were the backbone of our approach: the number of deaths where infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of pathogens resistant to an antibiotic class, and the excess risk of mortality (or duration of an infection) associated with this resistance. We then used these components to estimate the disease burden by applying two counterfactual scenarios: deaths attributable to AMR (compared to an alternative scenario where resistant infections are replaced with susceptible ones), and deaths associated with AMR (compared to an alternative scenario where resistant infections would not occur at all). We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity. Findings We estimated 569,000 deaths (95% UI 406,000-771,000) associated with bacterial AMR and 141,000 deaths (99,900-196,000) attributable to bacterial AMR among the 35 countries in the WHO Region of the Americas in 2019. Lower respiratory and thorax infections, as a syndrome, were responsible for the largest fatal burden of AMR in the region, with 189,000 deaths (149,000-241,000) associated with resistance, followed by bloodstream infections (169,000 deaths [94,200-278,000]) and peritoneal/intra-abdominal infections (118,000 deaths [78,600-168,000]). The six leading pathogens (by order of number of deaths associated with resistance) were Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Together, these pathogens were responsible for 452,000 deaths (326,000-608,000) associated with AMR. Methicillin-resistant S. aureus predominated as the leading pathogen-drug combination in 34 countries for deaths attributable to AMR, while aminopenicillin-resistant E. coli was the leading pathogen-drug combination in 15 countries for deaths associated with AMR. Interpretation Given the burden across different countries, infectious syndromes, and pathogen-drug combinations, AMR represents a substantial health threat in the Americas. Countries with low access to antibiotics and basic health-care services often face the largest age-standardised mortality rates associated with and attributable to AMR in the region, implicating specific policy interventions. Evidence from this study can guide mitigation efforts that are tailored to the needs of each country in the region while informing decisions regarding funding and resource allocation. Multisectoral and joint cooperative efforts among countries will be a key to success in tackling AMR in the Americas. Funding Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund.
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Wunrow HY, Bender RG, Vongpradith A, Sirota SB, Swetschinski LR, Novotney A, Gray AP, Ikuta KS, Sharara F, Wool EE, Aali A, Abd-Elsalam S, Abdollahi A, Abdul Aziz JM, Abidi H, Aboagye RG, Abolhassani H, Abu-Gharbieh E, Adamu LH, Adane TD, Addo IY, Adegboye OA, Adekiya TA, Adnan M, Adnani QES, Afzal S, Aghamiri S, Aghdam ZB, Agodi A, Ahinkorah BO, Ahmad A, Ahmad S, Ahmadzade M, Ahmed A, Ahmed A, Ahmed JQ, Ahmed MS, Akinosoglou K, Aklilu A, Akonde M, Alahdab F, AL-Ahdal TMA, Alanezi FM, Albelbeisi AH, Alemayehu TBB, Alene KA, Al-Eyadhy A, Al-Gheethi AAS, Ali A, Ali BA, Ali L, Ali SS, Alimohamadi Y, Alipour V, Aljunid SM, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Al-Worafi YM, Aly H, Ameyaw EK, Ancuceanu R, Ansar A, Ansari G, Anyasodor AE, Arabloo J, Aravkin AY, Areda D, Artamonov AA, Arulappan J, Aruleba RT, Asaduzzaman M, Atalell KA, Athari SS, Atlaw D, Atout MMW, Attia S, Awoke T, Ayalew MK, Ayana TM, Ayele AD, Azadnajafabad S, Azizian K, Badar M, Badiye AD, Baghcheghi N, Bagheri M, Bagherieh S, Bahadory S, Baig AA, Barac A, Barati S, Bardhan M, Basharat Z, Bashiri A, Basnyat B, Bassat Q, Basu S, Bayileyegn NS, Bedi N, Behnoush AH, Bekel AA, Belete MA, Bello OO, Bhagavathula AS, Bhandari D, Bhardwaj P, Bhaskar S, Bhat AN, Bijani A, Bineshfar N, Boloor A, Bouaoud S, Buonsenso D, Burkart K, Cámera LA, Castañeda-Orjuela CA, Cernigliaro A, Charan J, Chattu VK, Ching PR, Chopra H, Choudhari SG, Christopher DJ, Chu DT, Couto RAS, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Das S, Dash NR, Dashti M, De la Hoz FP, Debela SA, Dejen D, Dejene H, Demeke D, Demeke FM, Demessa BH, Demetriades AK, Demissie S, Dereje D, Dervišević E, Desai HD, Dessie AM, Desta F, Dhama K, Djalalinia S, Do TC, Dodangeh M, Dodangeh M, Dominguez RMV, Dongarwar D, Dsouza HL, Durojaiye OC, Dziedzic AM, Ekat MH, Ekholuenetale M, Ekundayo TC, El Sayed Zaki M, El-Abid H, Elhadi M, El-Hajj VG, El-Huneidi W, El-Sakka AA, Esayas HL, Fagbamigbe AF, Falahi S, Fares J, Fatehizadeh A, Fatima SAF, Feasey NA, Fekadu G, Fetensa G, Feyissa D, Fischer F, Foroutan B, Gaal PA, Gadanya MA, Gaipov A, Ganesan B, Gebrehiwot M, Gebrekidan KG, Gebremeskel TG, Gedef GM, Gela YY, Gerema U, Gessner BD, Getachew ME, Ghadiri K, Ghaffari K, Ghamari SH, Ghanbari R, Ghazy RMM, Ghozali G, Gizaw ABAB, Glushkova EV, Goldust M, Golechha M, Guadie HA, Guled RA, Gupta M, Gupta S, Gupta VB, Gupta VK, Gupta VK, Hadi NR, Haj-Mirzaian A, Haller S, Hamidi S, Haque S, Harapan H, Hasaballah AI, Hasan I, Hasani H, Hasanian M, Hassankhani H, Hassen MB, Hayat K, Heidari M, Heidari-Foroozan M, Heidari-Soureshjani R, Hezam K, Holla R, Horita N, Hossain MM, Hosseini MS, Hosseinzadeh M, Hostiuc S, Hussain S, Hussein NR, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Imam MT, Iregbu KC, Ismail NE, Iwu CCD, Jaja C, Jakovljevic M, Jamshidi E, Javadi Mamaghani A, Javidnia J, Jokar M, Jomehzadeh N, Joseph N, Joshua CE, Jozwiak JJ, Kabir Z, Kalankesh LR, Kalhor R, Kamal VK, Kandel H, Karaye IM, Karch A, Karimi H, Kaur H, Kaur N, Keykhaei M, Khajuria H, Khalaji A, Khan A, Khan IA, Khan M, Khan T, Khatab K, Khatatbeh MM, Khayat Kashani HR, Khubchandani J, Kim MS, Kisa A, Kisa S, Kompani F, Koohestani HR, Kothari N, Krishan K, Krishnamoorthy Y, Kulimbet M, Kumar M, Kumaran SD, Kuttikkattu A, Kwarteng A, Laksono T, Landires I, Laryea DO, Lawal BK, Le TTT, Ledda C, Lee SW, Lee S, Lema GK, Levi M, Lim SS, Liu X, Lopes G, Lutzky Saute R, Machado Teixeira PH, Mahmoodpoor A, Mahmoud MA, Malakan Rad E, Malhotra K, Malik AA, Martinez-Guerra BA, Martorell M, Mathur V, Mayeli M, Medina JRC, Melese A, Memish ZA, Mentis AFA, Merza MA, Mestrovic T, Michalek IM, Minh LHN, Mirahmadi A, Mirmosayyeb O, Misganaw A, Misra AK, Moghadasi J, Mohamed NS, Mohammad Y, Mohammadi E, Mohammed S, Mojarrad Sani M, Mojiri-forushani H, Mokdad AH, Momtazmanesh S, Monasta L, Moni MA, Mossialos E, Mostafavi E, Motaghinejad M, Mousavi Khaneghah A, Mubarik S, Muccioli L, Muhammad JS, Mulita F, Mulugeta T, Murillo-Zamora E, Mustafa G, Muthupandian S, Nagarajan AJ, Nainu F, Nair TS, Nargus S, Nassereldine H, Natto ZS, Nayak BP, Negoi I, Negoi RI, Nejadghaderi SA, Nguyen HQ, Nguyen PT, Nguyen VT, Niazi RK, Noroozi N, Nouraei H, Nuñez-Samudio V, Nuruzzaman KM, Nwatah VE, Nzoputam CI, Nzoputam OJ, Oancea B, Obaidur RM, Odetokun IA, Ogunsakin RE, Okonji OC, Olagunju AT, Olana LT, Olufadewa II, Oluwafemi YD, Oumer KS, Ouyahia A, P A M, Pakshir K, Palange PN, Pardhan S, Parikh RR, Patel J, Patel UK, Patil S, Paudel U, Pawar S, Pensato U, Perdigão J, Pereira M, Peres MFP, Petcu IR, Pinheiro M, Piracha ZZ, Pokhrel N, Postma MJ, Prates EJS, Qattea I, Raghav PR, Rahbarnia L, Rahimi-Movaghar V, Rahman M, Rahman MA, Rahmanian V, Rahnavard N, Ramadan H, Ramasubramani P, Rani U, Rao IR, Rapaka D, Ratan ZA, Rawaf S, Redwan EMM, Reiner Jr RC, Rezaei N, Riad A, Ribeiro da Silva TM, Roberts T, Robles Aguilar G, Rodriguez JAB, Rosenthal VD, Saddik B, Sadeghian S, Saeed U, Safary A, Saheb Sharif-Askari F, Saheb Sharif-Askari N, Sahebkar A, Sahu M, Sajedi SA, Saki M, Salahi S, Salahi S, Saleh MA, Sallam M, Samadzadeh S, Samy AM, Sanjeev RK, Satpathy M, Seylani A, Sha'aban A, Shafie M, Shah PA, Shahrokhi S, Shahzamani K, Shaikh MA, Sham S, Shannawaz M, Sheikh A, Shenoy SM, Shetty PH, Shin JI, Shokri F, Shorofi SA, Shrestha S, Sibhat MM, Siddig EE, Silva LMLR, Singh H, Singh JA, Singh P, Singh S, Sinto R, Skryabina AA, Socea B, Sokhan A, Solanki R, Solomon Y, Sood P, Soshnikov S, Stergachis A, Sufiyan MB, Suliankatchi Abdulkader R, Sultana A, T Y SS, Taheri E, Taki E, Tamuzi JJLL, Tan KK, Tat NY, Temsah MH, Terefa DR, Thangaraju P, Tibebu NS, Ticoalu JHV, Tillawi T, Tincho MB, Tleyjeh II, Toghroli R, Tovani-Palone MR, Tufa DG, Turner P, Ullah I, Umeokonkwo CD, Unnikrishnan B, Vahabi SM, Vaithinathan AG, Valizadeh R, Varthya SB, Vos T, Waheed Y, Walde MT, Wang C, Weerakoon KG, Wickramasinghe ND, Winkler AS, Woldemariam M, Worku NA, Wright C, Yada DY, Yaghoubi S, Yahya GATY, Yenew CYY, Yesiltepe M, Yi S, Yiğit V, You Y, Yusuf H, Zakham F, Zaman M, Zaman SB, Zare I, Zareshahrabadi Z, Zarrintan A, Zastrozhin MS, Zhang H, Zhang J, Zhang ZJ, Zheng P, Zoladl M, Zumla A, Hay SI, Murray CJL, Naghavi M, Kyu HH. Global, regional, and national burden of meningitis and its aetiologies, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2023; 22:685-711. [PMID: 37479374 PMCID: PMC10356620 DOI: 10.1016/s1474-4422(23)00195-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. METHODS We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. FINDINGS In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000-277 000) and 2·51 million (2·11-2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400-145 000) and 1·28 million incident cases (0·947-1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6-8·4) per 100 000 population in 1990 to 3·3 (2·8-3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1-19·2]), followed by N meningitidis (13·6% [12·7-14·4]) and K pneumoniae (12·2% [10·2-14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5-81·8]), followed by N meningitidis (72·3% [64·4-78·5]) and viruses (58·2% [47·1-67·3]). INTERPRETATION Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment. FUNDING Bill & Melinda Gates Foundation.
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Ong KL, Stafford LK, McLaughlin SA, Boyko EJ, Vollset SE, Smith AE, Dalton BE, Duprey J, Cruz JA, Hagins H, Lindstedt PA, Aali A, Abate YH, Abate MD, Abbasian M, Abbasi-Kangevari Z, Abbasi-Kangevari M, Abd ElHafeez S, Abd-Rabu R, Abdulah DM, Abdullah AYM, Abedi V, Abidi H, Aboagye RG, Abolhassani H, Abu-Gharbieh E, Abu-Zaid A, Adane TD, Adane DE, Addo IY, Adegboye OA, Adekanmbi V, Adepoju AV, Adnani QES, Afolabi RF, Agarwal G, Aghdam ZB, Agudelo-Botero M, Aguilera Arriagada CE, Agyemang-Duah W, Ahinkorah BO, Ahmad D, Ahmad R, Ahmad S, Ahmad A, Ahmadi A, Ahmadi K, Ahmed A, Ahmed A, Ahmed LA, Ahmed SA, Ajami M, Akinyemi RO, Al Hamad H, Al Hasan SM, AL-Ahdal TMA, Alalwan TA, Al-Aly Z, AlBataineh MT, Alcalde-Rabanal JE, Alemi S, Ali H, Alinia T, Aljunid SM, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Amare F, Ameyaw EK, Amiri S, Amusa GA, Andrei CL, Anjana RM, Ansar A, Ansari G, Ansari-Moghaddam A, Anyasodor AE, Arabloo J, Aravkin AY, Areda D, Arifin H, Arkew M, Armocida B, Ärnlöv J, Artamonov AA, Arulappan J, Aruleba RT, Arumugam A, Aryan Z, Asemu MT, Asghari-Jafarabadi M, Askari E, Asmelash D, Astell-Burt T, Athar M, Athari SS, Atout MMW, Avila-Burgos L, Awaisu A, Azadnajafabad S, B DB, Babamohamadi H, Badar M, Badawi A, Badiye AD, Baghcheghi N, Bagheri N, Bagherieh S, Bah S, Bahadory S, Bai R, Baig AA, Baltatu OC, Baradaran HR, Barchitta M, Bardhan M, Barengo NC, Bärnighausen TW, Barone MTU, Barone-Adesi F, Barrow A, Bashiri H, Basiru A, Basu S, Basu S, Batiha AMM, Batra K, Bayih MT, Bayileyegn NS, Behnoush AH, Bekele AB, Belete MA, Belgaumi UI, Belo L, Bennett DA, Bensenor IM, Berhe K, Berhie AY, Bhaskar S, Bhat AN, Bhatti JS, Bikbov B, Bilal F, Bintoro BS, Bitaraf S, Bitra VR, Bjegovic-Mikanovic V, Bodolica V, Boloor A, Brauer M, Brazo-Sayavera J, Brenner H, Butt ZA, Calina D, Campos LA, Campos-Nonato IR, Cao Y, Cao C, Car J, Carvalho M, Castañeda-Orjuela CA, Catalá-López F, Cerin E, Chadwick J, Chandrasekar EK, Chanie GS, Charan J, Chattu VK, Chauhan K, Cheema HA, Chekol Abebe E, Chen S, Cherbuin N, Chichagi F, Chidambaram SB, Cho WCS, Choudhari SG, Chowdhury R, Chowdhury EK, Chu DT, Chukwu IS, Chung SC, Coberly K, Columbus A, Contreras D, Cousin E, Criqui MH, Cruz-Martins N, Cuschieri S, Dabo B, Dadras O, Dai X, Damasceno AAM, Dandona R, Dandona L, Das S, Dascalu AM, Dash NR, Dashti M, Dávila-Cervantes CA, De la Cruz-Góngora V, Debele GR, Delpasand K, Demisse FW, Demissie GD, Deng X, Denova-Gutiérrez E, Deo SV, Dervišević E, Desai HD, Desale AT, Dessie AM, Desta F, Dewan SMR, Dey S, Dhama K, Dhimal M, Diao N, Diaz D, Dinu M, Diress M, Djalalinia S, Doan LP, Dongarwar D, dos Santos Figueiredo FW, Duncan BB, Dutta S, Dziedzic AM, Edinur HA, Ekholuenetale M, Ekundayo TC, Elgendy IY, Elhadi M, El-Huneidi W, Elmeligy OAA, Elmonem MA, Endeshaw D, Esayas HL, Eshetu HB, Etaee F, Fadhil I, Fagbamigbe AF, Fahim A, Falahi S, Faris MEM, Farrokhpour H, Farzadfar F, Fatehizadeh A, Fazli G, Feng X, Ferede TY, Fischer F, Flood D, Forouhari A, Foroumadi R, Foroutan Koudehi M, Gaidhane AM, Gaihre S, Gaipov A, Galali Y, Ganesan B, Garcia-Gordillo MA, Gautam RK, Gebrehiwot M, Gebrekidan KG, Gebremeskel TG, Getacher L, Ghadirian F, Ghamari SH, Ghasemi Nour M, Ghassemi F, Golechha M, Goleij P, Golinelli D, Gopalani SV, Guadie HA, Guan SY, Gudayu TW, Guimarães RA, Guled RA, Gupta R, Gupta K, Gupta VB, Gupta VK, Gyawali B, Haddadi R, Hadi NR, Haile TG, Hajibeygi R, Haj-Mirzaian A, Halwani R, Hamidi S, Hankey GJ, Hannan MA, Haque S, Harandi H, Harlianto NI, Hasan SMM, Hasan SS, Hasani H, Hassanipour S, Hassen MB, Haubold J, Hayat K, Heidari G, Heidari M, Hessami K, Hiraike Y, Holla R, Hossain S, Hossain MS, Hosseini MS, Hosseinzadeh M, Hosseinzadeh H, Huang J, Huda MN, Hussain S, Huynh HH, Hwang BF, Ibitoye SE, Ikeda N, Ilic IM, Ilic MD, Inbaraj LR, Iqbal A, Islam SMS, Islam RM, Ismail NE, Iso H, Isola G, Itumalla R, Iwagami M, Iwu CCD, Iyamu IO, Iyasu AN, Jacob L, Jafarzadeh A, Jahrami H, Jain R, Jaja C, Jamalpoor Z, Jamshidi E, Janakiraman B, Jayanna K, Jayapal SK, Jayaram S, Jayawardena R, Jebai R, Jeong W, Jin Y, Jokar M, Jonas JB, Joseph N, Joseph A, Joshua CE, Joukar F, Jozwiak JJ, Kaambwa B, Kabir A, Kabthymer RH, Kadashetti V, Kahe F, Kalhor R, Kandel H, Karanth SD, Karaye IM, Karkhah S, Katoto PDMC, Kaur N, Kazemian S, Kebede SA, Khader YS, Khajuria H, Khalaji A, Khan MAB, Khan M, Khan A, Khanal S, Khatatbeh MM, Khater AM, Khateri S, khorashadizadeh F, Khubchandani J, Kibret BG, Kim MS, Kimokoti RW, Kisa A, Kivimäki M, Kolahi AA, Komaki S, Kompani F, Koohestani HR, Korzh O, Kostev K, Kothari N, Koyanagi A, Krishan K, Krishnamoorthy Y, Kuate Defo B, Kuddus M, Kuddus MA, Kumar R, Kumar H, Kundu S, Kurniasari MD, Kuttikkattu A, La Vecchia C, Lallukka T, Larijani B, Larsson AO, Latief K, Lawal BK, Le TTT, Le TTB, Lee SWH, Lee M, Lee WC, Lee PH, Lee SW, Lee SW, Legesse SM, Lenzi J, Li Y, Li MC, Lim SS, Lim LL, Liu X, Liu C, Lo CH, Lopes G, Lorkowski S, Lozano R, Lucchetti G, Maghazachi AA, Mahasha PW, Mahjoub S, Mahmoud MA, Mahmoudi R, Mahmoudimanesh M, Mai AT, Majeed A, Majma Sanaye P, Makris KC, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, Mamun AA, Mansouri B, Marateb HR, Mardi P, Martini S, Martorell M, Marzo RR, Masoudi R, Masoudi S, Mathews E, Maugeri A, Mazzaglia G, Mekonnen T, Meshkat M, Mestrovic T, Miao Jonasson J, Miazgowski T, Michalek IM, Minh LHN, Mini GK, Miranda JJ, Mirfakhraie R, Mirrakhimov EM, Mirza-Aghazadeh-Attari M, Misganaw A, Misgina KH, Mishra M, Moazen B, Mohamed NS, Mohammadi E, Mohammadi M, Mohammadian-Hafshejani A, Mohammadshahi M, Mohseni A, Mojiri-forushani H, Mokdad AH, Momtazmanesh S, Monasta L, Moniruzzaman M, Mons U, Montazeri F, Moodi Ghalibaf A, Moradi Y, Moradi M, Moradi Sarabi M, Morovatdar N, Morrison SD, Morze J, Mossialos E, Mostafavi E, Mueller UO, Mulita F, Mulita A, Murillo-Zamora E, Musa KI, Mwita JC, Nagaraju SP, Naghavi M, Nainu F, Nair TS, Najmuldeen HHR, Nangia V, Nargus S, Naser AY, Nassereldine H, Natto ZS, Nauman J, Nayak BP, Ndejjo R, Negash H, Negoi RI, Nguyen HTH, Nguyen DH, Nguyen PT, Nguyen VT, Nguyen HQ, Niazi RK, Nigatu YT, Ningrum DNA, Nizam MA, Nnyanzi LA, Noreen M, Noubiap JJ, Nzoputam OJ, Nzoputam CI, Oancea B, Odogwu NM, Odukoya OO, Ojha VA, Okati-Aliabad H, Okekunle AP, Okonji OC, Okwute PG, Olufadewa II, Onwujekwe OE, Ordak M, Ortiz A, Osuagwu UL, Oulhaj A, Owolabi MO, Padron-Monedero A, Padubidri JR, Palladino R, Panagiotakos D, Panda-Jonas S, Pandey A, Pandey A, Pandi-Perumal SR, Pantea Stoian AM, Pardhan S, Parekh T, Parekh U, Pasovic M, Patel J, Patel JR, Paudel U, Pepito VCF, Pereira M, Perico N, Perna S, Petcu IR, Petermann-Rocha FE, Podder V, Postma MJ, Pourali G, Pourtaheri N, Prates EJS, Qadir MMF, Qattea I, Raee P, Rafique I, Rahimi M, Rahimifard M, Rahimi-Movaghar V, Rahman MO, Rahman MA, Rahman MHU, Rahman M, Rahman MM, Rahmani M, Rahmani S, Rahmanian V, Rahmawaty S, Rahnavard N, Rajbhandari B, Ram P, Ramazanu S, Rana J, Rancic N, Ranjha MMAN, Rao CR, Rapaka D, Rasali DP, Rashedi S, Rashedi V, Rashid AM, Rashidi MM, Ratan ZA, Rawaf S, Rawal L, Redwan EMM, Remuzzi G, Rengasamy KRR, Renzaho AMN, Reyes LF, Rezaei N, Rezaei N, Rezaeian M, Rezazadeh H, Riahi SM, Rias YA, Riaz M, Ribeiro D, Rodrigues M, Rodriguez JAB, Roever L, Rohloff P, Roshandel G, Roustazadeh A, Rwegerera GM, Saad AMA, Saber-Ayad MM, Sabour S, Sabzmakan L, Saddik B, Sadeghi E, Saeed U, Saeedi Moghaddam S, Safi S, Safi SZ, Saghazadeh A, Saheb Sharif-Askari N, Saheb Sharif-Askari F, Sahebkar A, Sahoo SS, Sahoo H, Saif-Ur-Rahman KM, Sajid MR, Salahi S, Salahi S, Saleh MA, Salehi MA, Salomon JA, Sanabria J, Sanjeev RK, Sanmarchi F, Santric-Milicevic MM, Sarasmita MA, Sargazi S, Sathian B, Sathish T, Sawhney M, Schlaich MP, Schmidt MI, Schuermans A, Seidu AA, Senthil Kumar N, Sepanlou SG, Sethi Y, Seylani A, Shabany M, Shafaghat T, Shafeghat M, Shafie M, Shah NS, Shahid S, Shaikh MA, Shanawaz M, Shannawaz M, Sharfaei S, Shashamo BB, Shiri R, Shittu A, Shivakumar KM, Shivalli S, Shobeiri P, Shokri F, Shuval K, Sibhat MM, Silva LMLR, Simpson CR, Singh JA, Singh P, Singh S, Siraj MS, Skryabina AA, Sohag AAM, Soleimani H, Solikhah S, Soltani-Zangbar MS, Somayaji R, Sorensen RJD, Starodubova AV, Sujata S, Suleman M, Sun J, Sundström J, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabaeizadeh SA, Tabish M, Taheri M, Taheri E, Taki E, Tamuzi JJLL, Tan KK, Tat NY, Taye BT, Temesgen WA, Temsah MH, Tesler R, Thangaraju P, Thankappan KR, Thapa R, Tharwat S, Thomas N, Ticoalu JHV, Tiyuri A, Tonelli M, Tovani-Palone MR, Trico D, Trihandini I, Tripathy JP, Tromans SJ, Tsegay GM, Tualeka AR, Tufa DG, Tyrovolas S, Ullah S, Upadhyay E, Vahabi SM, Vaithinathan AG, Valizadeh R, van Daalen KR, Vart P, Varthya SB, Vasankari TJ, Vaziri S, Verma MV, Verras GI, Vo DC, Wagaye B, Waheed Y, Wang Z, Wang Y, Wang C, Wang F, Wassie GT, Wei MYW, Weldemariam AH, Westerman R, Wickramasinghe ND, Wu Y, Wulandari RDWI, Xia J, Xiao H, Xu S, Xu X, Yada DY, Yang L, Yatsuya H, Yesiltepe M, Yi S, Yohannis HK, Yonemoto N, You Y, Zaman SB, Zamora N, Zare I, Zarea K, Zarrintan A, Zastrozhin MS, Zeru NG, Zhang ZJ, Zhong C, Zhou J, Zielińska M, Zikarg YT, Zodpey S, Zoladl M, Zou Z, Zumla A, Zuniga YMH, Magliano DJ, Murray CJL, Hay SI, Vos T. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2023; 402:203-234. [PMID: 37356446 PMCID: PMC10364581 DOI: 10.1016/s0140-6736(23)01301-6] [Citation(s) in RCA: 240] [Impact Index Per Article: 240.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
BACKGROUND Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. METHODS Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. FINDINGS In 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8-6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7-9·9]) and, at the regional level, in Oceania (12·3% [11·5-13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1-79·5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1-96·8) of diabetes cases and 95·4% (94·9-95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5-71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5-30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22-1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1-17·6) in north Africa and the Middle East and 11·3% (10·8-11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. INTERPRETATION Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. FUNDING Bill & Melinda Gates Foundation.
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Thomson AM, McHugh TA, Oron AP, Teply C, Lonberg N, Vilchis Tella V, Wilner LB, Fuller K, Hagins H, Aboagye RG, Aboye MB, Abu-Gharbieh E, Abu-Zaid A, Addo IY, Ahinkorah BO, Ahmad A, AlRyalat SAS, Amu H, Aravkin AY, Arulappan J, Atout MMW, Badiye AD, Bagherieh S, Banach M, Banakar M, Bardhan M, Barrow A, Bedane DA, Bensenor IM, Bhagavathula AS, Bhardwaj P, Bhardwaj PV, Bhat AN, Bhutta ZA, Bilalaga MM, Bishai JD, Bitaraf S, Boloor A, Butt MH, Chattu VK, Chu DT, Dadras O, Dai X, Danaei B, Dang AK, Demisse FW, Dhimal M, Diaz D, Djalalinia S, Dongarwar D, Elhadi M, Elmonem MA, Esezobor CI, Etaee F, Eyawo O, Fagbamigbe AF, Fatehizadeh A, Force LM, Gardner WM, Ghaffari K, Gill PS, Golechha M, Goleij P, Gupta VK, Hasani H, Hassan TS, Hassen MB, Ibitoye SE, Ikiroma AI, Iwu CCD, James PB, Jayaram S, Jebai R, Jha RP, Joseph N, Kalantar F, Kandel H, Karaye IM, Kassahun WD, Khan IA, Khanmohammadi S, Kisa A, Kompani F, Krishan K, Landires I, Lim SS, Mahajan PB, Mahjoub S, Majeed A, Marasini BP, Meresa HA, Mestrovic T, Minhas S, Misganaw A, Mokdad AH, Monasta L, Mustafa G, Nair TS, Narasimha Swamy S, Nassereldine H, Natto ZS, Naveed M, Nayak BP, Noubiap JJ, Noyes T, Nri-ezedi CA, Nwatah VE, Nzoputam CI, Nzoputam OJ, Okonji OC, Onikan AO, Owolabi MO, Patel J, Pati S, Pawar S, Petcu IR, Piel FB, Qattea I, Rahimi M, Rahman M, Rawaf S, Redwan EMM, Rezaei N, Saddik B, Saeed U, Saheb Sharif-Askari F, Samy AM, Schumacher AE, Shaker E, Shetty A, Sibhat MM, Singh JA, Suleman M, Sunuwar DR, Szeto MD, Tamuzi JJLL, Tat NY, Taye BT, Temsah MH, Umair M, Valadan Tahbaz S, Wang C, Wickramasinghe ND, Yigit A, Yiğit V, Yunusa I, Zaman BA, Zangiabadian M, Zheng P, Hay SI, Naghavi M, Murray CJL, Kassebaum NJ. Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000-2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Haematol 2023:S2352-3026(23)00118-7. [PMID: 37331373 PMCID: PMC10390339 DOI: 10.1016/s2352-3026(23)00118-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Previous global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population health effect of sickle cell disease. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study delivers a comprehensive global assessment of prevalence of sickle cell disease and mortality burden by age and sex for 204 countries and territories from 2000 to 2021. METHODS We estimated cause-specific sickle cell disease mortality using standardised GBD approaches, in which each death is assigned to a single underlying cause, to estimate mortality rates from the International Classification of Diseases (ICD)-coded vital registration, surveillance, and verbal autopsy data. In parallel, our goal was to estimate a more accurate account of sickle cell disease health burden using four types of epidemiological data on sickle cell disease: birth incidence, age-specific prevalence, with-condition mortality (total deaths), and excess mortality (excess deaths). Systematic reviews, supplemented with ICD-coded hospital discharge and insurance claims data, informed this modelling approach. We employed DisMod-MR 2.1 to triangulate between these measures-borrowing strength from predictive covariates and across age, time, and geography-and generated internally consistent estimates of incidence, prevalence, and mortality for three distinct genotypes of sickle cell disease: homozygous sickle cell disease and severe sickle cell β-thalassaemia, sickle-haemoglobin C disease, and mild sickle cell β-thalassaemia. Summing the three models yielded final estimates of incidence at birth, prevalence by age and sex, and total sickle cell disease mortality, the latter of which was compared directly against cause-specific mortality estimates to evaluate differences in mortality burden assessment and implications for the Sustainable Development Goals (SDGs). FINDINGS Between 2000 and 2021, national incidence rates of sickle cell disease were relatively stable, but total births of babies with sickle cell disease increased globally by 13·7% (95% uncertainty interval 11·1-16·5), to 515 000 (425 000-614 000), primarily due to population growth in the Caribbean and western and central sub-Saharan Africa. The number of people living with sickle cell disease globally increased by 41·4% (38·3-44·9), from 5·46 million (4·62-6·45) in 2000 to 7·74 million (6·51-9·2) in 2021. We estimated 34 400 (25 000-45 200) cause-specific all-age deaths globally in 2021, but total sickle cell disease mortality burden was nearly 11-times higher at 376 000 (303 000-467 000). In children younger than 5 years, there were 81 100 (58 800-108 000) deaths, ranking total sickle cell disease mortality as 12th (compared to 40th for cause-specific sickle cell disease mortality) across all causes estimated by the GBD in 2021. INTERPRETATION Our findings show a strikingly high contribution of sickle cell disease to all-cause mortality that is not apparent when each death is assigned to only a single cause. Sickle cell disease mortality burden is highest in children, especially in countries with the greatest under-5 mortality rates. Without comprehensive strategies to address morbidity and mortality associated with sickle cell disease, attainment of SDG 3.1, 3.2, and 3.4 is uncertain. Widespread data gaps and correspondingly high uncertainty in the estimates highlight the urgent need for routine and sustained surveillance efforts, further research to assess the contribution of conditions associated with sickle cell disease, and widespread deployment of evidence-based prevention and treatment for those with sickle cell disease. FUNDING Bill & Melinda Gates Foundation.
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Abstract
This scoping review aimed to identify the scope of the current literature on the prevalence, consequences, and risk factors of domestic violence (DV) against women by their husbands or male partners in North African and Middle Eastern countries. The methodology for this scoping review was based on the framework outlined by Arksey and O'Malley. Studies published on DV against women over the age of 15 by partner or husband and published in peer-reviewed scientific journals between January 1970 and April 2018 were included in the review. The databases MEDLINE, PsychINFO, CINAHL, HealthSTAR, EMBASE, Scopus, African Journals Online, Turkish Journal Database, and gray literature sources were searched. On completion of the review process, 151 full-text articles were identified for charting. This review demonstrated that women's age, women's education level, duration of marriage, history of childhood abuse/witnessing family violence, living in the rural region, and family income level were negatively associated with DV, indicating that younger women, women with lower education, a longer marriage duration, and a lower income level had a higher risk of exposure to DV in this region. Anxiety, depression/insomnia, and physical injury were the most common health problems reported by victims in the region. The highest proportion of women with no response to violence was reported in Jordan, Saudi Arabia, and Turkey. The findings of this scoping review represent the first attempt to summarize the literature from North African and Middle Eastern countries and demonstrate the similarity in DV-related behaviors among women despite the cultural and regional diversity of the studies.
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Affiliation(s)
- Sezer Kisa
- Faculty of Health Sciences, Department of Nursing and Health
Promotion, Oslo Metropolitan University, Norway
- Sezer, Kisa, Department of Nursing and
Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University,
Oslo, Norway.
| | | | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo,
Norway
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Amundsen PA, Underwood M, Burton K, Grotle M, Malmberg-Heimonen I, Kisa A, Småstuen MC, Holmgard TE, Martinsen A, Lothe J, Irgens PMS, Højen M, Monsen SS, Froud R. Individual supported work placements (ReISE) for improving sustained return to work in unemployed people with persistent pain: study protocol for a cohort randomised controlled trial with embedded economic and process evaluations. Trials 2023; 24:179. [PMID: 36906593 PMCID: PMC10006572 DOI: 10.1186/s13063-023-07211-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/01/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Around one-third of workdays lost in Norway are due to musculoskeletal conditions, with persistent (chronic) pain being the most frequent cause of sick leave and work disability. Increasing work participation for people with persistent pain improves their health, quality of life, and well-being and reduces poverty; however, it is not clear how to best help unemployed people who have persistent pain to return to work. The aim of this study is to examine if a matched work placement intervention featuring case manager support and work-focused healthcare improves return to work rates and quality of life for unemployed people in Norway with persistent pain who want to work. METHODS We will use a cohort randomised controlled approach to test the effectiveness and cost-effectiveness of a matched work placement intervention featuring case manager support and work-focused healthcare compared to those receiving usual care in the cohort alone. We will recruit people aged 18-64, who have been out of work for at least 1 month, had pain for more than 3 months, and want to work. Initially, all (n = 228) will be recruited to an observational cohort study on the impact of being unemployed with persistent pain. We will then randomly select one in three to be offered the intervention. The primary outcome of sustained return to work will be measured using registry and self-reported data, while secondary outcomes include self-reported levels of health-related quality of life and physical and mental health. Outcomes will be measured at baseline and 3, 6, and 12 months post-randomisation. We will run a process evaluation parallel to the intervention exploring implementation, continuity of the intervention, reasons for participating, declining participation, and mechanisms behind cases of sustained return to work. An economic evaluation of the trial process will also be conducted. DISCUSSION The ReISE intervention is designed to increase work participation for people with persistent pain. The intervention has the potential to improve work ability by collaboratively navigating obstacles to working. If successful, the intervention may be a viable option for helping people in this population. TRIAL REGISTRATION ISRCTN Registry 85,437,524 Registered on 30 March 2022.
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Affiliation(s)
- Pål André Amundsen
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway.
| | - Martin Underwood
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Kim Burton
- Professor of Occupational Healthcare, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - Margreth Grotle
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Ira Malmberg-Heimonen
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Adnan Kisa
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Thor Einar Holmgard
- User representative from the Norwegian Back Pain Association, Fjellhagen, P.O. Box 9612, 3065, Drammen, Norway
| | - Amy Martinsen
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Ullevål, Building 37B, P.O. Box 4956 Nydalen, 0424, Oslo, Norway
| | - Jakob Lothe
- Co/FORMI, The Norwegian Council for Musculoskeletal Health, Oslo Universitetssykehus, Nydalen, P.O. Box 4956, 0424, Oslo, Norway
| | | | - Magnus Højen
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway
| | | | - Robert Froud
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway.,Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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Almunawar MN, Anshari M, Rosdi NBDM, Kisa A, Younis M. Reconsidering Patient Value to Create Better Healthcare. Journal of Health Management 2023. [DOI: 10.1177/09720634231153721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Healthcare can be seen as a value shop, in which solutions to health problems are offered in exchange for valuable contributions. However, the full value exchange between the healthcare provider and the patient is not always apparent. The value shop concept runs the risk of considering only what the patient pays (i.e., money, either paid by the patient or reimbursed by the government) while ignoring another important value, data. Yet without this data, the patient’s problem cannot be solved. This article offers a new paradigm in which a health provider can deliver better value by integrating all dimensions of the provider’s and patient’s value.
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Affiliation(s)
| | - Muhammad Anshari
- UBD School of Business and Economics, Universiti Brunei Darussalam, Brunei
| | | | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Mustafa Younis
- School of Public Health, Jackson State University, Jackson, MS, USA
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Haeuser E, Serfes AL, Cork MA, Yang M, Abbastabar H, Abhilash ES, Adabi M, Adebayo OM, Adekanmbi V, Adeyinka DA, Afzal S, Ahinkorah BO, Ahmadi K, Ahmed MB, Akalu Y, Akinyemi RO, Akunna CJ, Alahdab F, Alanezi FM, Alanzi TM, Alene KA, Alhassan RK, Alipour V, Almasi-Hashiani A, Alvis-Guzman N, Ameyaw EK, Amini S, Amugsi DA, Ancuceanu R, Anvari D, Appiah SCY, Arabloo J, Aremu O, Asemahagn MA, Jafarabadi MA, Awedew AF, Quintanilla BPA, Ayanore MA, Aynalem YA, Azari S, Azene ZN, Darshan BB, Babalola TK, Baig AA, Banach M, Bärnighausen TW, Bell AW, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bijani A, Bitew ZW, Bohlouli S, Bolarinwa OA, Boloor A, Bozicevic I, Butt ZA, Cárdenas R, Carvalho F, Charan J, Chattu VK, Chowdhury MAK, Chu DT, Cowden RG, Dahlawi SMA, Damiani G, Darteh EKM, Darwesh AM, das Neves J, Weaver ND, De Leo D, De Neve JW, Deribe K, Deuba K, Dharmaratne S, Dianatinasab M, Diaz D, Didarloo A, Djalalinia S, Dorostkar F, Dubljanin E, Duko B, El Tantawi M, El-Jaafary SI, Eshrati B, Eskandarieh S, Eyawo O, Ezeonwumelu IJ, Ezzikouri S, Farzadfar F, Fattahi N, Fauk NK, Fernandes E, Filip I, Fischer F, Foigt NA, Foroutan M, Fukumoto T, Gad MM, Gaidhane AM, Gebregiorgis BG, Gebremedhin KB, Getacher L, Ghadiri K, Ghashghaee A, Golechha M, Gubari MIM, Gugnani HC, Guimarães RA, Haider MR, Haj-Mirzaian A, Hamidi S, Hashi A, Hassanipour S, Hassankhani H, Hayat K, Herteliu C, Ho HC, Holla R, Hosseini M, Hosseinzadeh M, Hwang BF, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Islam RM, Iwu CCD, Jakovljevic M, Jha RP, Ji JS, Johnson KB, Joseph N, Joshua V, Joukar F, Jozwiak JJ, Kalankesh LR, Kalhor R, Kamyari N, Kanchan T, Matin BK, Karimi SE, Kayode GA, Karyani AK, Keramati M, Khan EA, Khan G, Khan MN, Khatab K, Khubchandani J, Kim YJ, Kisa A, Kisa S, Kopec JA, Kosen S, Laxminarayana SLK, Koyanagi A, Krishan K, Defo BK, Kugbey N, Kulkarni V, Kumar M, Kumar N, Kusuma D, La Vecchia C, Lal DK, Landires I, Larson HJ, Lasrado S, Lee PH, Li S, Liu X, Maleki A, Malik P, Mansournia MA, Martins-Melo FR, Mendoza W, Menezes RG, Mengesha EW, Meretoja TJ, Mestrovic T, Mirica A, Moazen B, Mohamad O, Mohammad Y, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed S, Mohammed S, Mokdad AH, Moradi M, Moraga P, Mubarik S, Mulu GBB, Mwanri L, Nagarajan AJ, Naimzada MD, Naveed M, Nazari J, Ndejjo R, Negoi I, Ngalesoni FN, Nguefack-Tsague G, Ngunjiri JW, Nguyen CT, Nguyen HLT, Nnaji CA, Noubiap JJ, Nuñez-Samudio V, Nwatah VE, Oancea B, Odukoya OO, Olagunju AT, Olakunde BO, Olusanya BO, Olusanya JO, Bali AO, Onwujekwe OE, Orisakwe OE, Otstavnov N, Otstavnov SS, Owolabi MO, Mahesh PA, Padubidri JR, Pana A, Pandey A, Pandi-Perumal SR, Kan FP, Patton GC, Pawar S, Peprah EK, Postma MJ, Preotescu L, Syed ZQ, Rabiee N, Radfar A, Rafiei A, Rahim F, Rahimi-Movaghar V, Rahmani AM, Ramezanzadeh K, Rana J, Ranabhat CL, Rao SJ, Rawaf DL, Rawaf S, Rawassizadeh R, Regassa LD, Rezaei N, Rezapour A, Riaz MA, Ribeiro AI, Ross JM, Rubagotti E, Rumisha SF, Rwegerera GM, Moghaddam SS, Sagar R, Sahiledengle B, Sahu M, Salem MR, Kafil HS, Samy AM, Sartorius B, Sathian B, Seidu AA, Shaheen AA, Shaikh MA, Shamsizadeh M, Shiferaw WS, Shin JI, Shrestha R, Singh JA, Skryabin VY, Skryabina AA, Soltani S, Sufiyan MB, Tabuchi T, Tadesse EG, Taveira N, Tesfay FH, Thapar R, Tovani-Palone MR, Tsegaye GW, Umeokonkwo CD, Unnikrishnan B, Villafañe JH, Violante FS, Vo B, Vu GT, Wado YD, Waheed Y, Wamai RG, Wang Y, Ward P, Wickramasinghe ND, Wilson K, Yaya S, Yip P, Yonemoto N, Yu C, Zastrozhin MS, Zhang Y, Zhang ZJ, Hay SI, Dwyer-Lindgren L. Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000-2018. BMC Med 2022; 20:488. [PMID: 36529768 PMCID: PMC9760541 DOI: 10.1186/s12916-022-02639-z] [Citation(s) in RCA: 4] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/26/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15-59 years across SSA. METHODS We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. RESULTS We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. CONCLUSIONS As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.
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Affiliation(s)
- Emily Haeuser
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
| | - Audrey L Serfes
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Michael A Cork
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Mingyou Yang
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Hedayat Abbastabar
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - E S Abhilash
- Department of Botany, Sree Narayana Guru College Chelannur, Kozhikode, India
| | - Maryam Adabi
- Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Victor Adekanmbi
- Department of Population Medicine, Cardiff University, Cardiff, UK
| | - Daniel Adedayo Adeyinka
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | - Saira Afzal
- Department of Community Medicine, King Edward Memorial Hospital, Lahore, Pakistan
- Department of Public Health, Public Health Institute, Lahore, Pakistan
| | - Bright Opoku Ahinkorah
- The Australian Centre for Public and Population Health Research (ACPPHR), University of Technology Sydney, Sydney, NSW, Australia
| | - Keivan Ahmadi
- School of Public Health, Imperial College London, London, UK
| | - Muktar Beshir Ahmed
- Department of Epidemiology, Jimma University, Jimma, Ethiopia
- Australian Center for Precision Health, University of South Australia, Adelaide, SA, Australia
| | - Yonas Akalu
- Department of Medical Physiology, University of Gondar, Gondar, Ethiopia
| | - Rufus Olusola Akinyemi
- Institute for Advanced Medical Research and Training, University of Ibadan, Ibadan, Nigeria
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Chisom Joyqueenet Akunna
- Department of Public Health, The Intercountry Centre for Oral Health (ICOH) for Africa, Jos, Nigeria
- Department of Public Health, Federal Ministry of Health, Garki, Nigeria
| | - Fares Alahdab
- Mayo Evidence-based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA
| | | | - Turki M Alanzi
- Health Information Management and Technology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Kefyalew Addis Alene
- Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Robert Kaba Alhassan
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
| | | | - Nelson Alvis-Guzman
- Research Group in Hospital Management and Health Policies, Universidad de la Costa (University of the Coast), Barranquilla, Colombia
- Research Group in Health Economics, University of Cartagena, Cartagena, Colombia
| | - Edward Kwabena Ameyaw
- The Australian Centre for Public and Population Health Research (ACPPHR), University of Technology Sydney, Sydney, NSW, Australia
| | - Saeed Amini
- Department of Health Services Management, Khomein University of Medical Sciences, Khomein, Iran
| | - Dickson A Amugsi
- Department of Maternal and Child Wellbeing, African Population and Health Research Center, Nairobi, Kenya
| | - Robert Ancuceanu
- Pharmacy Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Davood Anvari
- Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for International Health, Ludwig Maximilians University, Munich, Germany
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Olatunde Aremu
- Department of Public Health, Birmingham City University, Birmingham, UK
| | | | - Mohammad Asghari Jafarabadi
- Department of Biostatistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Biostatistics and Epidemiology, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | | | - Martin Amogre Ayanore
- Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana
- Department of Health Economics, Centre for Health Policy Advocacy Innovation & Research in Africa (CHPAIR-Africa), Accra, Ghana
| | | | - Samad Azari
- Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - B B Darshan
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Tesleem Kayode Babalola
- Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Community Health and Primary Care, University of Lagos, Lagos, Nigeria
| | - Atif Amin Baig
- Unit of Biochemistry, Universiti Sultan Zainal Abidin (Sultan Zainal Abidin University), Kuala Terengganu, Malaysia
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Arielle Wilder Bell
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
- Department of Social Services, Tufts Medical Center, Boston, MA, USA
| | - Akshaya Srikanth Bhagavathula
- Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nikha Bhardwaj
- Department of Anatomy, All India Institute of Medical Sciences, Jodhpur, India
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, India
| | - Krittika Bhattacharyya
- Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
- Department of Statistics, University of Calcutta, Kolkata, India
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Zebenay Workneh Bitew
- Nutrition Department, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Somayeh Bohlouli
- Department of Veterinary Medicine, Islamic Azad University, Kermanshah, Iran
| | | | - Archith Boloor
- Department of Internal Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Ivana Bozicevic
- WHO Collaborating Centre for HIV Strategic Information, University of Zagreb, Zagreb, Croatia
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Zahid A Butt
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
- Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | - Rosario Cárdenas
- Department of Health Care, Metropolitan Autonomous University, Mexico City, Mexico
| | - Felix Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Jaykaran Charan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
| | - Vijay Kumar Chattu
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Sawangi, India
- Saveetha Medical College, Saveetha University, Chennai, India
| | - Mohiuddin Ahsanul Kabir Chowdhury
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Dinh-Toi Chu
- Center for Biomedicine and Community Health, VNU-International School, Hanoi, Vietnam
| | - Richard G Cowden
- Department of Psychology, University of the Free State, Park West, South Africa
| | - Saad M A Dahlawi
- Environmental Health Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Giovanni Damiani
- IRCCS Istituto Ortopedico Galeazzi (Galeazzi Orthopedic Institute IRCCS), University of Milan, Milan, Italy
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | | | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | - José das Neves
- Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
- Institute of Biomedical Engineering (INEB), University of Porto, Porto, Portugal
| | - Nicole Davis Weaver
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Mount Gravatt, QLD, Australia
| | - Jan-Walter De Neve
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Kebede Deribe
- Wellcome Trust Brighton and Sussex Centre for Global Health Research, Brighton and Sussex Medical School, Brighton, UK
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Keshab Deuba
- National Centre for AIDS and STD Control, Save the Children, Kathmandu, Nepal
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Samath Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Mostafa Dianatinasab
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands
- Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Daniel Diaz
- Center of Complexity Sciences, National Autonomous University of Mexico, Mexico City, Mexico
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Rosales, Culiacán, Mexico
| | - Alireza Didarloo
- Department of Community Medicine and Public Health, Urmia University of Medical Science, Urmia, Iran
| | - Shirin Djalalinia
- Development of Research and Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Fariba Dorostkar
- Department of Medical Laboratory Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Eleonora Dubljanin
- Institute of Microbiology and Immunology, University of Belgrade, Belgrade, Serbia
| | - Bereket Duko
- School of Public Health, Hawassa University, Hawassa, Ethiopia
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Maha El Tantawi
- Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt
| | | | - Babak Eshrati
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ifeanyi Jude Ezeonwumelu
- Institute for Health Science Research Germans Trias i Pujol, Autonomous University of Barcelona, Badalona, Spain
- IrsiCaixa AIDS Research Institute, Badalona, Spain
| | - Sayeh Ezzikouri
- Department of Virology, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Farshad Farzadfar
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazir Fattahi
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nelsensius Klau Fauk
- Torrens University Australia, Adelaide, SA, Australia
- Institute of Resource Governance and Social Change, Kupang, Indonesia
| | - Eduarda Fernandes
- Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
| | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, CA, USA
- School of Health Sciences, A.T. Still University, Mesa, AZ, USA
| | - Florian Fischer
- Institute of Public Health, Charité Universitätsmedizin Berlin (Charité Medical University Berlin), Berlin, Germany
| | - Nataliya A Foigt
- Institute of Gerontology, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - Masoud Foroutan
- Department of Medical Parasitology, Abadan University of Medical Sciences, Abadan, Iran
- Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
| | | | - Mohamed M Gad
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA
- Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | - Lemma Getacher
- Department of Public Health, Debre Berhan University, Debre Berhan, Ethiopia
| | - Keyghobad Ghadiri
- Infectious Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Pediatric Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ahmad Ghashghaee
- School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mahaveer Golechha
- Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India
| | | | - Harish Chander Gugnani
- Department of Microbiology, Saint James School of Medicine, The Valley, Anguilla
- Department of Epidemiology, Saint James School of Medicine, The Valley, Anguilla
| | | | | | - Arvin Haj-Mirzaian
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Abdiwahab Hashi
- Department of Public Health, Jigjiga University, Jijiga, Ethiopia
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hadi Hassankhani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Independent Consultant, Tabriz, Iran
| | - Khezar Hayat
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
| | - Claudiu Herteliu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- School of Business, London South Bank University, London, UK
| | - Hung Chak Ho
- Department of Urban Planning and Design, University of Hong Kong, Hong Kong, China
| | - Ramesh Holla
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hosseinzadeh
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Department of Computer Science, University of Human Development, Sulaymaniyah, Iraq
| | - Bing-Fang Hwang
- Department of Occupational Safety and Health, China Medical University, Taichung, Taiwan
| | | | - Olayinka Stephen Ilesanmi
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Irena M Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena D Ilic
- Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | - Rakibul M Islam
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Chidozie C D Iwu
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Mihajlo Jakovljevic
- Institute of Advanced Manufacturing Technologies, Peter the Great St. Petersburg Polytechnic University, St. Petersburg, Russia
- Institute of Comparative Economic Studies, Hosei University, Tokyo, Japan
| | - Ravi Prakash Jha
- Department of Community Medicine, Dr. Baba Saheb Ambedkar Medical College & Hospital, Delhi, India
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kimberly B Johnson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nitin Joseph
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Vasna Joshua
- National Institute of Epidemiology, Indian Council of Medical Research, Chennai, India
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | - Leila R Kalankesh
- School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Kalhor
- Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Naser Kamyari
- Department of Biostatistics, Abadan University of Medical Sciences, Abadan, Iran
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Salah Eddin Karimi
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Gbenga A Kayode
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, Netherlands
| | - Ali Kazemi Karyani
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Ejaz Ahmad Khan
- Department of Epidemiology and Biostatistics, Health Services Academy, Islamabad, Pakistan
| | - Gulfaraz Khan
- Department of Medical Microbiology & Immunology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | - Khaled Khatab
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
- College of Arts and Sciences, Ohio University, Zanesville, OH, USA
| | | | - Yun Jin Kim
- School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Jacek A Kopec
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Richmond, Canada
| | | | | | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Kewal Krishan
- Department of Anthropology, Panjab University, Chandigarh, India
| | - Barthelemy Kuate Defo
- Department of Demography, University of Montreal, Montreal, QC, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
| | - Nuworza Kugbey
- University of Environment and Sustainable Development, Somanya, Ghana
| | - Vaman Kulkarni
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Nithin Kumar
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Dian Kusuma
- Imperial College Business School, Imperial College London, London, UK
- Faculty of Public Health, University of Indonesia, Depok, Indonesia
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Iván Landires
- Unit of Genetics and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Ministry of Health, Herrera, Panama
| | - Heidi Jane Larson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Savita Lasrado
- Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
| | - Paul H Lee
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Xuefeng Liu
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Quantitative Health Science, Case Western Reserve University, Cleveland, OH, USA
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- Department of Environmental Health Engineering, Tehran University of Medical Sciences, Tehran, Iran
- Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
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- Department of Pediatrics, Montefiore Medical Center, New York, NY, USA
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
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- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
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- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
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- Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
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- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
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- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
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- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
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- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
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- Department of Biomolecular Sciences, University of Mississippi, Oxford, MS, USA
- Department of Pharmacy, Mizan-Tepi University, Mizan, Ethiopia
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- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
- Department of Health Care Management, Technical University of Berlin, Berlin, Germany
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- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Paula Moraga
- Computer, Electrical, and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Getaneh Baye B Mulu
- Department of Pediatrics and Child Health, Debre Berhan University, Debre Berhan, Ethiopia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Adeaide, SA, Australia
| | - Ahamarshan Jayaraman Nagarajan
- Research and Analytics Department, Initiative for Financing Health and Human Development, Chennai, India
- Department of Research and Analytics, Bioinsilico Technologies, Chennai, India
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- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russia
| | - Muhammad Naveed
- Department of Biotechnology, University of Central Punjab, Lahore, Pakistan
| | - Javad Nazari
- Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Frida N Ngalesoni
- Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
| | | | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | - Chukwudi A Nnaji
- South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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- Centre for Heart Rhythm Disorders, University of Adelaide, Adelaide, SA, Australia
| | - Virginia Nuñez-Samudio
- Unit of Microbiology and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Department of Public Health, Ministry of Health, Herrera, Panama
| | - Vincent Ebuka Nwatah
- Department of Pediatrics, National Hospital, Abuja, Nigeria
- Department of International Public Health, University of Liverpool, Liverpool, UK
| | - Bogdan Oancea
- Administrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania
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- Department of Community Health and Primary Care, University of Lagos, Idi Araba, Nigeria
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
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- Diplomacy and Public Relations Department, University of Human Development, Sulaymaniyah, Iraq
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- Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
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- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - Stanislav S Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
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- Department of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
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- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
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- Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Manipal, India
| | - Adrian Pana
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- Department of Health Metrics, Center for Health Outcomes & Evaluation, Bucharest, Romania
| | - Ashok Pandey
- Research Department, Nepal Health Research Council, Kathmandu, Nepal
- Research Department, Public Health Research Society Nepal, Kathmandu, Nepal
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- Department of Pediatrics, University of Melbourne, Melbourne, VIC, Australia
- Population Health Theme, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Shrikant Pawar
- Department of Genetics, Yale University, New Haven, CT, USA
| | - Emmanuel K Peprah
- School of Global Public Health, New York University, New York, NY, USA
| | - Maarten J Postma
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- School of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Liliana Preotescu
- National Institute of Infectious Diseases, Bucuresti, Romania
- Department of Infectious Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Zahiruddin Quazi Syed
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Navid Rabiee
- School of Engineering, Macquarie University, Sydney, NSW, Australia
- Pohang University of Science and Technology, Pohang, South Korea
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Alireza Rafiei
- Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fakher Rahim
- Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Rahmani
- Future Technology Research Center, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Kiana Ramezanzadeh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Juwel Rana
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Research and Innovation Division, South Asian Institute for Social Transformation (SAIST), Dhaka, Bangladesh
| | - Chhabi Lal Ranabhat
- Research Department, Policy Research Institute, Kathmandu, Nepal
- Health and Public Policy Department, Global Center for Research and Development, Kathmandu, Nepal
| | - Sowmya J Rao
- Department of Oral Pathology, Sharavathi Dental College and Hospital, Shimogga, India
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK
- University College London Hospitals, London, UK
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Academic Public Health England, Public Health England, London, UK
| | | | | | - Nima Rezaei
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mavra A Riaz
- Faculty of Business and Management, Universiti Sultan Zainal Abidin (Sultan Zainal Abidin University), Kuala Terengganu, Malaysia
| | - Ana Isabel Ribeiro
- Epidemiology Research Unit (EPIUnit), University of Porto, Porto, Portugal
| | - Jennifer M Ross
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Enrico Rubagotti
- African Genome Center, Mohammed VI Polytechnic University (UM6P), Ben Guerir, Morocco
- Centro de Investigaciones en Anomalías Congénitas y Enfermedades Raras (Center for Research in Congenital Anomalies and Rare Diseases), Universidad ICESI (ICESI University), Cali, Colombia
| | - Susan Fred Rumisha
- Malaria Atlas Project, Telethon Kids Institute, Perth, Australia
- Department of Health Statistics, National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | - Sahar Saeedi Moghaddam
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | | | - Maitreyi Sahu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Marwa Rashad Salem
- Public Health and Community Medicine Department, Cairo University, Giza, Egypt
| | - Hossein Samadi Kafil
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Benn Sartorius
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Brijesh Sathian
- Geriatric and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, QLD, Townsville, Australia
| | - Amira A Shaheen
- Public Health Division, An-Najah National University, Nablus, Palestine
| | | | - Morteza Shamsizadeh
- Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Borås, Sweden
| | | | - Jae Il Shin
- College of Medicine, Yonsei University, Seoul, South Korea
| | - Roman Shrestha
- Department of Internal Medicine, Yale University, New Haven, CT, USA
| | - Jasvinder A Singh
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Medicine Service, US Department of Veterans Affairs (VA), Birmingham, AL, USA
| | | | - Anna Aleksandrovna Skryabina
- Department of Infectious Diseases and Epidemiology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Shahin Soltani
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | | | - Nuno Taveira
- University Institute "Egas Moniz", Monte da Caparica, Portugal
- Research Institute for Medicines, University of Lisbon, Lisbon, Portugal
| | - Fisaha Haile Tesfay
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Southgate Institute for Health and Society, Flinders University, Adelaide, SA, Australia
| | - Rekha Thapar
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Marcos Roberto Tovani-Palone
- Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
- Modestum LTD, London, UK
| | | | - Chukwuma David Umeokonkwo
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Nigeria
| | | | | | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Bay Vo
- Faculty of Information Technology, HUTECH University, Ho Chi Minh City, Vietnam
| | - Giang Thu Vu
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Yohannes Dibaba Wado
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Nairobi, Kenya
| | - Yasir Waheed
- Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan
| | - Richard G Wamai
- Department of Cultures, Societies and Global Studies, Northeastern University, Boston, MA, USA
- School of Public Health, University of Nairobi, Nairobi, Kenya
| | - Yanzhong Wang
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Paul Ward
- Centre for Health Policy Research, Torrens University Australia, Adelaide, SA, Australia
| | | | - Katherine Wilson
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
- The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Paul Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Public Health, Juntendo University, Tokyo, Japan
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Mikhail Sergeevich Zastrozhin
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA
- Addictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | | | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Laura Dwyer-Lindgren
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Haakenstad A, Yearwood JA, Fullman N, Bintz C, Bienhoff K, Weaver MR, Nandakumar V, LeGrand KE, Knight M, Abbafati C, Abbasi-Kangevari M, Abdoli A, Abeldaño Zuñiga RA, Adedeji IA, Adekanmbi V, Adetokunboh OO, Afzal MS, Afzal S, Agudelo-Botero M, Ahinkorah BO, Ahmad S, Ahmadi A, Ahmadi S, Ahmed A, Ahmed Rashid T, Aji B, Akande-Sholabi W, Alam K, Al Hamad H, Alhassan RK, Ali L, Alipour V, Aljunid SM, Ameyaw EK, Amin TT, Amu H, Amugsi DA, Ancuceanu R, Andrade PP, Anjum A, Arabloo J, Arab-Zozani M, Ariffin H, Arulappan J, Aryan Z, Ashraf T, Atnafu DD, Atreya A, Ausloos M, Avila-Burgos L, Ayano G, Ayanore MA, Azari S, Badiye AD, Baig AA, Bairwa M, Bakkannavar SM, Baliga S, Banik PC, Bärnighausen TW, Barra F, Barrow A, Basu S, Bayati M, Belete R, Bell AW, Bhagat DS, Bhagavathula AS, Bhardwaj P, Bhardwaj N, Bhaskar S, Bhattacharyya K, Bhurtyal A, Bhutta ZA, Bibi S, Bijani A, Bikbov B, Biondi A, Bolarinwa OA, Bonny A, Brenner H, Buonsenso D, Burkart K, Busse R, Butt ZA, Butt NS, Caetano dos Santos FL, Cahuana-Hurtado L, Cámera LA, Cárdenas R, Carneiro VLA, Catalá-López F, Chandan JS, Charan J, Chavan PP, Chen S, Chen S, Choudhari SG, Chowdhury EK, Chowdhury MAK, Cirillo M, Corso B, Dadras O, Dahlawi SMA, Dai X, Dandona L, Dandona R, Dangel WJ, Dávila-Cervantes CA, Davletov K, Deuba K, Dhimal M, Dhimal ML, Djalalinia S, Do HP, Doshmangir L, Duncan BB, Effiong A, Ehsani-Chimeh E, Elgendy IY, Elhadi M, El Sayed I, El Tantawi M, Erku DA, Eskandarieh S, Fares J, Farzadfar F, Ferrero S, Ferro Desideri L, Fischer F, Foigt NA, Foroutan M, Fukumoto T, Gaal PA, Gaihre S, Gardner WM, Garg T, Getachew Obsa A, Ghafourifard M, Ghashghaee A, Ghith N, Gilani SA, Gill PS, Goharinezhad S, Golechha M, Guadamuz JS, Guo Y, Gupta RD, Gupta R, Gupta VK, Gupta VB, Hamiduzzaman M, Hanif A, Haro JM, Hasaballah AI, Hasan MM, Hasan MT, Hashi A, Hay SI, Hayat K, Heidari M, Heidari G, Henry NJ, Herteliu C, Holla R, Hossain S, Hossain SJ, Hossain MBH, Hosseinzadeh M, Hostiuc S, Hoveidamanesh S, Hsieh VCR, Hu G, Huang J, Huda MM, Ifeagwu SC, Ikuta KS, Ilesanmi OS, Irvani SSN, Islam RM, Islam SMS, Ismail NE, Iso H, Isola G, Itumalla R, Iwagami M, Jahani MA, Jahanmehr N, Jain R, Jakovljevic M, Janodia MD, Jayapal SK, Jayaram S, Jha RP, Jonas JB, Joo T, Joseph N, Jürisson M, Kabir A, Kalankesh LR, Kalhor R, Kamath AM, Kamenov K, Kandel H, Kantar RS, Kapoor N, Karanikolos M, Katikireddi SV, Kavetskyy T, Kawakami N, Kayode GA, Keikavoosi-Arani L, Keykhaei M, Khader YS, Khajuria H, Khalilov R, Khammarnia M, Khan MN, Khan MAB, Khan M, Khezeli M, Kim MS, Kim YJ, Kisa S, Kisa A, Klymchuk V, Koly KN, Korzh O, Kosen S, Koul PA, Kuate Defo B, Kumar GA, Kusuma D, Kyu HH, Larsson AO, Lasrado S, Lee WC, Lee YH, Lee CB, Li S, Lucchetti G, Mahajan PB, Majeed A, Makki A, Malekzadeh R, Malik AA, Malta DC, Mansournia MA, Mantovani LG, Martinez-Valle A, Martins-Melo FR, Masoumi SZ, Mathur MR, Maude RJ, Maulik PK, McKee M, Mendoza W, Menezes RG, Mensah GA, Meretoja A, Meretoja TJ, Mestrovic T, Michalek IM, Mirrakhimov EM, Misganaw A, Misra S, Moazen B, Mohammadi M, Mohammed S, Moitra M, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moradi G, Moreira RS, Mosser JF, Mostafavi E, Mouodi S, Nagarajan AJ, Nagata C, Naghavi M, Nangia V, Narasimha Swamy S, Narayana AI, Nascimento BR, Nassereldine H, Nayak BP, Nazari J, Negoi I, Nepal S, Neupane Kandel S, Ngunjiri JW, Nguyen HLT, Nguyen CT, Ningrum DNA, Noubiap JJ, Oancea B, Oghenetega OB, Oh IH, Olagunju AT, Olakunde BO, Omar Bali A, Omer E, Onwujekwe OE, Otoiu A, Padubidri JR, Palladino R, Pana A, Panda-Jonas S, Pandi-Perumal SR, Pardhan S, Pasupula DK, Pathak PK, Patton GC, Pawar S, Pereira J, Pilania M, Piroozi B, Podder V, Pokhrel KN, Postma MJ, Prada SI, Quazi Syed Z, Rabiee N, Radhakrishnan RA, Rahman MM, Rahman M, Rahman M, Rahman MHU, Rahmani AM, Ranabhat CL, Rao CR, Rao SJ, Rasella D, Rawaf S, Rawaf DL, Rawal L, Renzaho AM, Reshmi B, Resnikoff S, Rezapour A, Riahi SM, Ripon RK, Sacco S, Sadeghi M, Saeed U, Sahebkar A, Sahiledengle B, Sahoo H, Sahu M, Salama JS, Salamati P, Samy AM, Sanabria J, Santric-Milicevic MM, Sathian B, Sawhney M, Schmidt MI, Seidu AA, Sepanlou SG, Seylani A, Shaikh MA, Sheikh A, Shetty A, Shigematsu M, Shiri R, Shivakumar KM, Shokri A, Singh JA, Sinha DN, Skryabin VY, Skryabina AA, Sofi-Mahmudi A, Sousa RARC, Stephens JH, Sun J, Szócska M, Tabarés-Seisdedos R, Tadbiri H, Tamiru AT, Thankappan KR, Topor-Madry R, Tovani-Palone MR, Tran MTN, Tran BX, Tripathi N, Tripathy JP, Troeger CE, Uezono DR, Ullah S, Ullah A, Unnikrishnan B, Vacante M, Valadan Tahbaz S, Valdez PR, Vasic M, Veroux M, Vervoort D, Violante FS, Vladimirov SK, Vlassov V, Vo B, Waheed Y, Wamai RG, Wang YP, Wang Y, Ward P, Wiangkham T, Yadav L, Yahyazadeh Jabbari SH, Yamagishi K, Yaya S, Yazdi-Feyzabadi V, Yi S, Yiğit V, Yonemoto N, Younis MZ, Yu C, Yunusa I, Zaman SB, Zastrozhin MS, Zhang ZJ, Zhong C, Zuniga YMH, Lim SS, Murray CJL, Lozano R. Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Glob Health 2022; 10:e1715-e1743. [PMID: 36209761 PMCID: PMC9666426 DOI: 10.1016/s2214-109x(22)00429-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/13/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. METHODS We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. FINDINGS Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9-21·3), as well as among the young (22·5, 19·9-24·7), working (17·2, 15·2-19·1), and post-working (15·1, 13·2-17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6-33·0) on average in low-SDI countries to 83·4 (82·4-84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4-89·0), working (33·8-82·8), and post-working (30·4-79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. INTERPRETATION Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. FUNDING Bill & Melinda Gates Foundation.
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Kyu HH, Vongpradith A, Sirota SB, Novotney A, Troeger CE, Doxey MC, Bender RG, Ledesma JR, Biehl MH, Albertson SB, Frostad JJ, Burkart K, Bennitt FB, Zhao JT, Gardner WM, Hagins H, Bryazka D, Dominguez RMV, Abate SM, Abdelmasseh M, Abdoli A, Abdoli G, Abedi A, Abedi V, Abegaz TM, Abidi H, Aboagye RG, Abolhassani H, Abtew YD, Abubaker Ali H, Abu-Gharbieh E, Abu-Zaid A, Adamu K, Addo IY, Adegboye OA, Adnan M, Adnani QES, Afzal MS, Afzal S, Ahinkorah BO, Ahmad A, Ahmad AR, Ahmad S, Ahmadi A, Ahmadi S, Ahmed H, Ahmed JQ, Ahmed Rashid T, Akbarzadeh-Khiavi M, Al Hamad H, Albano L, Aldeyab MA, Alemu BM, Alene KA, Algammal AM, Alhalaiqa FAN, Alhassan RK, Ali BA, Ali L, Ali MM, Ali SS, Alimohamadi Y, Alipour V, Al-Jumaily A, Aljunid SM, Almustanyir S, Al-Raddadi RM, Al-Rifai RHH, AlRyalat SAS, Alvis-Guzman N, Alvis-Zakzuk NJ, Ameyaw EK, Aminian Dehkordi JJ, Amuasi JH, Amugsi DA, Anbesu EW, Ansar A, Anyasodor AE, Arabloo J, Areda D, Argaw AM, Argaw ZG, Arulappan J, Aruleba RT, Asemahagn MA, Athari SS, Atlaw D, Attia EF, Attia S, Aujayeb A, Awoke T, Ayana TM, Ayanore MA, Azadnajafabad S, Azangou-Khyavy M, Azari S, Azari Jafari A, Badar M, Badiye AD, Baghcheghi N, Bagherieh S, Baig AA, Banach M, Banerjee I, Bardhan M, Barone-Adesi F, Barqawi HJ, Barrow A, Bashiri A, Bassat Q, Batiha AMM, Belachew AB, Belete MA, Belgaumi UI, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhatt P, Bhojaraja VS, Bhutta ZA, Bhuyan SS, Bijani A, Bitaraf S, Bodicha BBA, Briko NI, Buonsenso D, Butt MH, Cai J, Camargos P, Cámera LA, Chakraborty PA, Chanie MG, Charan J, Chattu VK, Ching PR, Choi S, Chong YY, Choudhari SG, Chowdhury EK, Christopher DJ, Chu DT, Cobb NL, Cohen AJ, Cruz-Martins N, Dadras O, Dagnaw FT, Dai X, Dandona L, Dandona R, Dao ATM, Debela SA, Demisse B, Demisse FW, Demissie S, Dereje D, Desai HD, Desta AA, Desye B, Dhingra S, Diao N, Diaz D, Digesa LE, Doan LP, Dodangeh M, Dongarwar D, Dorostkar F, dos Santos WM, Dsouza HL, Dubljanin E, Durojaiye OC, Edinur HA, Ehsani-Chimeh E, Eini E, Ekholuenetale M, Ekundayo TC, El Desouky ED, El Sayed I, El Sayed Zaki M, Elhadi M, Elkhapery AMR, Emami A, Engelbert Bain L, Erkhembayar R, Etaee F, Ezati Asar M, Fagbamigbe AF, Falahi S, Fallahzadeh A, Faraj A, Faraon EJA, Fatehizadeh A, Ferrara P, Ferrari AA, Fetensa G, Fischer F, Flavel J, Foroutan M, Gaal PA, Gaidhane AM, Gaihre S, Galehdar N, Garcia-Basteiro AL, Garg T, Gebrehiwot MD, Gebremichael MA, Gela YY, Gemeda BNB, Gessner BD, Getachew M, Getie A, Ghamari SH, Ghasemi Nour M, Ghashghaee A, Gholamrezanezhad A, Gholizadeh A, Ghosh R, Ghozy S, Goleij P, Golitaleb M, Gorini G, Goulart AC, Goyomsa GG, Guadie HA, Gudisa Z, Guled RA, Gupta S, Gupta VB, Gupta VK, Guta A, Habibzadeh P, Haj-Mirzaian A, Halwani R, Hamidi S, Hannan MA, Harorani M, Hasaballah AI, Hasani H, Hassan AM, Hassani S, Hassanian-Moghaddam H, Hassankhani H, Hayat K, Heibati B, Heidari M, Heyi DZ, Hezam K, Holla R, Hong SH, Horita N, Hosseini MS, Hosseinzadeh M, Hostiuc M, Househ M, Hoveidamanesh S, Huang J, Hussein NR, Iavicoli I, Ibitoye SE, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Immurana M, Ismail NE, Iwagami M, Jaafari J, Jamshidi E, Jang SI, Javadi Mamaghani A, Javaheri T, Javanmardi F, Javidnia J, Jayapal SK, Jayarajah U, Jayaram S, Jema AT, Jeong W, Jonas JB, Joseph N, Joukar F, Jozwiak JJ, K V, Kabir Z, Kacimi SEO, Kadashetti V, Kalankesh LR, Kalhor R, Kamath A, Kamble BD, Kandel H, Kanko TK, Karaye IM, Karch A, Karkhah S, Kassa BG, Katoto PDMC, Kaur H, Kaur RJ, Keikavoosi-Arani L, Keykhaei M, Khader YS, Khajuria H, Khan EA, Khan G, Khan IA, Khan M, Khan MN, Khan MAB, Khan YH, Khatatbeh MM, Khosravifar M, Khubchandani J, Kim MS, Kimokoti RW, Kisa A, Kisa S, Kissoon N, Knibbs LD, Kochhar S, Kompani F, Koohestani HR, Korshunov VA, Kosen S, Koul PA, Koyanagi A, Krishan K, Kuate Defo B, Kumar GA, Kurmi OP, Kuttikkattu A, Lal DK, Lám J, Landires I, Ledda C, Lee SW, Levi M, Lewycka S, Liu G, Liu W, Lodha R, Lorenzovici L, Lotfi M, Loureiro JA, Madadizadeh F, Mahmoodpoor A, Mahmoudi R, Mahmoudimanesh M, Majidpoor J, Makki A, Malakan Rad E, Malik AA, Mallhi TH, Manla Y, Matei CN, Mathioudakis AG, Maude RJ, Mehrabi Nasab E, Melese A, Memish ZA, Mendoza-Cano O, Mentis AFA, Meretoja TJ, Merid MW, Mestrovic T, Micheletti Gomide Nogueira de Sá AC, Mijena GFW, Minh LHN, Mir SA, Mirfakhraie R, Mirmoeeni S, Mirza AZ, Mirza M, Mirza-Aghazadeh-Attari M, Misganaw AS, Misganaw AT, Mohammadi E, Mohammadi M, Mohammed A, Mohammed S, Mohan S, Mohseni M, Moka N, Mokdad AH, Momtazmanesh S, Monasta L, Moniruzzaman M, Montazeri F, Moore CE, Moradi A, Morawska L, Mosser JF, Mostafavi E, Motaghinejad M, Mousavi Isfahani H, Mousavi-Aghdas SA, Mubarik S, Murillo-Zamora E, Mustafa G, Nair S, Nair TS, Najafi H, Naqvi AA, Narasimha Swamy S, Natto ZS, Nayak BP, Nejadghaderi SA, Nguyen HVN, Niazi RK, Nogueira de Sá AT, Nouraei H, Nowroozi A, Nuñez-Samudio V, Nzoputam CI, Nzoputam OJ, Oancea B, Ochir C, Odukoya OO, Okati-Aliabad H, Okekunle AP, Okonji OC, Olagunju AT, Olufadewa II, Omar Bali A, Omer E, Oren E, Ota E, Otstavnov N, Oulhaj A, P A M, Padubidri JR, Pakshir K, Pakzad R, Palicz T, Pandey A, Pant S, Pardhan S, Park EC, Park EK, Pashazadeh Kan F, Paudel R, Pawar S, Peng M, Pereira G, Perna S, Perumalsamy N, Petcu IR, Pigott DM, Piracha ZZ, Podder V, Polibin RV, Postma MJ, Pourasghari H, Pourtaheri N, Qadir MMF, Raad M, Rabiee M, Rabiee N, Raeghi S, Rafiei A, Rahim F, Rahimi M, Rahimi-Movaghar V, Rahman A, Rahman MO, Rahman M, Rahman MA, Rahmani AM, Rahmanian V, Ram P, Ramezanzadeh K, Rana J, Ranasinghe P, Rani U, Rao SJ, Rashedi S, Rashidi MM, Rasul A, Ratan ZA, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghinia MS, Redwan EMM, Reitsma MB, Renzaho AMN, Rezaeian M, Riad A, Rikhtegar R, Rodriguez JAB, Rogowski ELB, Ronfani L, Rudd KE, Saddik B, Sadeghi E, Saeed U, Safary A, Safi SZ, Sahebazzamani M, Sahebkar A, Sakhamuri S, Salehi S, Salman M, Samadi Kafil H, Samy AM, Santric-Milicevic MM, Sao Jose BP, Sarkhosh M, Sathian B, Sawhney M, Saya GK, Seidu AA, Seylani A, Shaheen AA, Shaikh MA, Shaker E, Shamshad H, Sharew MM, Sharhani A, Sharifi A, Sharma P, Sheidaei A, Shenoy SM, Shetty JK, Shiferaw DS, Shigematsu M, Shin JI, Shirzad-Aski H, Shivakumar KM, Shivalli S, Shobeiri P, Simegn W, Simpson CR, Singh H, Singh JA, Singh P, Siwal SS, Skryabin VY, Skryabina AA, Soltani-Zangbar MS, Song S, Song Y, Sood P, Sreeramareddy CT, Steiropoulos P, Suleman M, Tabatabaeizadeh SA, Tahamtan A, Taheri M, Taheri Soodejani M, Taki E, Talaat IM, Tampa M, Tandukar S, Tat NY, Tat VY, Tefera YM, Temesgen G, Temsah MH, Tesfaye A, Tesfaye DG, Tessema B, Thapar R, Ticoalu JHV, Tiyuri A, Tleyjeh II, Togtmol M, Tovani-Palone MR, Tufa DG, Ullah I, Upadhyay E, Valadan Tahbaz S, Valdez PR, Valizadeh R, Vardavas C, Vasankari TJ, Vo B, Vu LG, Wagaye B, Waheed Y, Wang Y, Waris A, West TE, Wickramasinghe ND, Xu X, Yaghoubi S, Yahya GAT, Yahyazadeh Jabbari SH, Yon DK, Yonemoto N, Zaman BA, Zandifar A, Zangiabadian M, Zar HJ, Zare I, Zareshahrabadi Z, Zarrintan A, Zastrozhin MS, Zeng W, Zhang M, Zhang ZJ, Zhong C, Zoladl M, Zumla A, Lim SS, Vos T, Naghavi M, Brauer M, Hay SI, Murray CJL. Age-sex differences in the global burden of lower respiratory infections and risk factors, 1990-2019: results from the Global Burden of Disease Study 2019. Lancet Infect Dis 2022; 22:1626-1647. [PMID: 35964613 PMCID: PMC9605880 DOI: 10.1016/s1473-3099(22)00510-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/18/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. METHODS In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466-469, 470.0, 480-482.8, 483.0-483.9, 484.1-484.2, 484.6-484.7, and 487-489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4-B97.6, J09-J15.8, J16-J16.9, J20-J21.9, J91.0, P23.0-P23.4, and U04-U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age-sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age-sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. FINDINGS Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240-275) LRI incident episodes in males and 232 million (217-248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18-1·42) male deaths and 1·20 million (1·07-1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16-1·18) and 1·31 times (95% UI 1·23-1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4-131·1]) and deaths (100·0% [83·4-115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (-70·7% [-77·2 to -61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7-61·8] in males and 56·4% [40·7-65·1] in females), and more than a quarter of LRI deaths among those aged 5-14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6-35·5] for males and PAF 25·8% [16·3-35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4-25·2) in those aged 15-49 years, 30·5% (24·1-36·9) in those aged 50-69 years, and 21·9% (16·8-27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5-27·9) in those aged 15-49 years and 18·2% (12·5-24·5) in those aged 50-69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2-15·8) of LRI deaths. INTERPRETATION The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities. FUNDING Bill & Melinda Gates Foundation.
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Mestrovic T, Robles Aguilar G, Swetschinski LR, Ikuta KS, Gray AP, Davis Weaver N, Han C, Wool EE, Gershberg Hayoon A, Hay SI, Dolecek C, Sartorius B, Murray CJL, Addo IY, Ahinkorah BO, Ahmed A, Aldeyab MA, Allel K, Ancuceanu R, Anyasodor AE, Ausloos M, Barra F, Bhagavathula AS, Bhandari D, Bhaskar S, Cruz-Martins N, Dastiridou A, Dokova K, Dubljanin E, Durojaiye OC, Fagbamigbe AF, Ferrero S, Gaal PA, Gupta VB, Gupta VK, Gupta VK, Herteliu C, Hussain S, Ilic IM, Ilic MD, Jamshidi E, Joo T, Karch A, Kisa A, Kisa S, Kostyanev T, Kyu HH, Lám J, Lopes G, Mathioudakis AG, Mentis AFA, Michalek IM, Moni MA, Moore CE, Mulita F, Negoi I, Negoi RI, Palicz T, Pana A, Perdigão J, Petcu IR, Rabiee N, Rawaf DL, Rawaf S, Shakhmardanov MZ, Sheikh A, Silva LMLR, Skryabin VY, Skryabina AA, Socea B, Stergachis A, Stoeva TZ, Sumi CD, Thiyagarajan A, Tovani-Palone MR, Yesiltepe M, Zaman SB, Naghavi M. The burden of bacterial antimicrobial resistance in the WHO European region in 2019: a cross-country systematic analysis. Lancet Public Health 2022; 7:e897-e913. [PMID: 36244350 PMCID: PMC9630253 DOI: 10.1016/s2468-2667(22)00225-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Antimicrobial resistance (AMR) represents one of the most crucial threats to public health and modern health care. Previous studies have identified challenges with estimating the magnitude of the problem and its downstream effect on human health and mortality. To our knowledge, this study presents the most comprehensive set of regional and country-level estimates of AMR burden in the WHO European region to date. METHODS We estimated deaths and disability-adjusted life-years attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen-drug combinations for the WHO European region and its countries in 2019. Our methodological approach consisted of five broad components: the number of deaths in which infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antimicrobial drug of interest, and the excess risk of mortality (or duration of an infection) associated with this resistance. These components were then used to estimate the disease burden by using two counterfactual scenarios: deaths attributable to AMR (considering an alternative scenario where infections with resistant pathogens are replaced with susceptible ones) and deaths associated with AMR (considering an alternative scenario where drug-resistant infections would not occur at all). Data were solicited from a wide array of international stakeholders; these included research hospitals, surveillance networks, and infection databases maintained by private laboratories and medical technology companies. We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity. FINDINGS We estimated 541 000 deaths (95% UI 370 000-763 000) associated with bacterial AMR and 133 000 deaths (90 100-188 000) attributable to bacterial AMR in the whole WHO European region in 2019. The largest fatal burden of AMR in the region came from bloodstream infections, with 195 000 deaths (104 000-333 000) associated with resistance, followed by intra-abdominal infections (127 000 deaths [81 900-185 000]) and respiratory infections (120 000 deaths [94 500-154 000]). Seven leading pathogens were responsible for about 457 000 deaths associated with resistance in 53 countries of this region; these pathogens were, in descending order of mortality, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium, Streptococcus pneumoniae, and Acinetobacter baumannii. Methicillin-resistant S aureus was shown to be the leading pathogen-drug combination in 27 countries for deaths attributable to AMR, while aminopenicillin-resistant E coli predominated in 47 countries for deaths associated with AMR. INTERPRETATION The high levels of resistance for several important bacterial pathogens and pathogen-drug combinations, together with the high mortality rates associated with these pathogens, show that AMR is a serious threat to public health in the WHO European region. Our regional and cross-country analyses open the door for strategies that can be tailored to leading pathogen-drug combinations and the available resources in a specific location. These results underscore that the most effective way to tackle AMR in this region will require targeted efforts and investments in conjunction with continuous outcome-based research endeavours. FUNDING Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund.
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Frostad JJ, Nguyen QP, Baumann MM, Blacker BF, Marczak LB, Deshpande A, Wiens KE, LeGrand KE, Johnson KB, Abbasi-Kangevari M, Abdoli A, Abolhassani H, Abreu LG, Abrigo MRM, Abu-Rmeileh NME, Adekanmbi V, Agrawal A, Ahmed MB, Al-Aly Z, Alanezi FM, Alcalde-Rabanal JE, Alipour V, Altirkawi KA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amegah AK, Amini S, Amiri F, Amugsi DA, Ancuceanu R, Andrei CL, Andrei T, Antriyandarti E, Anvari D, Arabloo J, Arab-Zozani M, Athari SS, Ausloos M, Ayano G, Aynalem YA, Azari S, Badiye AD, Baig AA, Balakrishnan K, Banach M, Basu S, Bedi N, Bell ML, Bennett DA, Bhattacharyya K, Bhutta ZA, Bibi S, Bohlouli S, Boufous S, Bragazzi NL, Braithwaite D, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Car J, Cárdenas R, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Cerin E, Chattu SK, Chattu VK, Chaturvedi P, Chaturvedi S, Chen S, Chu DT, Chung SC, Dahlawi SMA, Damiani G, Dandona L, Dandona R, Darwesh AM, Das JK, Dash AP, Dávila-Cervantes CA, De Leo D, De Neve JW, Demissie GD, Denova-Gutiérrez E, Dey S, Dharmaratne SD, Dhimal M, Dhungana GP, Diaz D, Dipeolu IO, Dorostkar F, Doshmangir L, Duraes AR, Edinur HA, Efendi F, El Tantawi M, Eskandarieh S, Fadhil I, Fattahi N, Fauk NK, Fereshtehnejad SM, Folayan MO, Foroutan M, Fukumoto T, Gaidhane AM, Ghafourifard M, Ghashghaee A, Gilani SA, Gill TK, Goulart AC, Goulart BNG, Grada A, Gubari MIM, Guido D, Guo Y, Gupta RD, Gupta R, Gutiérrez RA, Hafezi-Nejad N, Hamadeh RR, Hasaballah AI, Hassanipour S, Hayat K, Heibati B, Heidari-Soureshjani R, Henry NJ, Herteliu C, Hosseinzadeh M, Hsairi M, Hu G, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Irvani SSN, Islam SMS, Iwu CCD, Jaafari J, Jakovljevic M, Javaheri T, Jha RP, Ji JS, Jonas JB, Kabir A, Kabir Z, Kalhor R, Kamyari N, Kanchan T, Kapil U, Kapoor N, Kayode GA, Keiyoro PN, Khader YS, Khalid N, Khan EA, Khan M, Khan MN, Khatab K, Khater MM, Khatib MN, Khayamzadeh M, Khubchandani J, Kim GR, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Knibbs LD, Koul PA, Koyanagi A, Krishan K, Kumar GA, Kumar M, Kusuma D, La Vecchia C, Lacey B, Lami FH, Lan Q, Lasrado S, Lauriola P, Lee PH, Lewycka S, Li S, Machado DB, Mahasha PW, Maheri M, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mansouri B, Mansournia MA, Martinez NM, Martini S, Martins-Melo FR, Mayala BK, Mehndiratta MM, Mendoza W, Menezes RG, Mengesha EW, Meretoja TJ, Mestrovic T, Michalek IM, Mirrakhimov EM, Mirzaei M, Mirzaei R, Moazen B, Mohammad Y, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Monasta L, Moradi-Lakeh M, Moraga P, Morawska L, Mosapour A, Mouodi S, Mousavi Khaneghah A, Mukhopadhyay S, Munro SB, Murray CJL, Nagarajan AJ, Naghavi M, Nair S, Nangia V, Nascimento BR, Nazari J, Negoi I, Netsere HB, Ngunjiri JW, Nguyen HLT, Noubiap JJ, Oancea B, Ogbo FA, Oh IH, Olagunju AT, Olusanya BO, Olusanya JO, Omar Bali A, Onwujekwe OE, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Pandey A, Park EC, Park EK, Patel SK, Pham HQ, Pilgrim T, Pirsaheb M, Pokhrel KN, Postma MJ, Quazi Syed Z, Rabiee N, Radfar A, Rahim F, Rahman MHU, Rahman MA, Rahmani AM, Ranabhat CL, Rao SJ, Rasella D, Rastogi P, Rath GK, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Renzaho AMN, Reshmi B, Rezaei N, Rezaei N, Rezapour A, Rickard J, Roever L, Ronfani L, Rostamian M, Rubagotti E, Rwegerera GM, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sagar R, Sahebkar A, Sahiledengle B, Salem MR, Samy AM, Santric-Milicevic MM, Saraswathy SYI, Sathian B, Sathish T, Schwebel DC, Sepanlou SG, Shahabi S, Shaheen AA, Shahid I, Shaikh MA, Shalash AS, Shams-Beyranvand M, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shetty RS, Shiferaw WS, Shigematsu M, Shin JI, Shivakumar KM, Siabani S, Siddiqi TJ, Singh BB, Singh JA, Sintayehu Y, Sorrie MB, Soyiri IN, Spurlock EE, Sreeramareddy CT, Stockfelt L, Sufiyan MB, Suliankatchi Abdulkader R, Tabarés-Seisdedos R, Tabuchi T, Taherkhani A, Temsah MH, Thankappan KR, Tovani-Palone MR, Traini E, Ullah S, Unnikrishnan B, Upadhyay E, Valadan Tahbaz S, Varughese S, Violante FS, Vo B, Vu GT, Waheed Y, Wang YP, Welgan CA, Werdecker A, Yahyazadeh Jabbari SH, Yaya S, Yazdi-Feyzabadi V, Yilma MT, Yonemoto N, Younis MZ, Yousefinezhadi T, Yu C, Yu Y, Zaman SB, Zhang Y, Zhang ZJ, Brauer M, Hay SI, Reiner RC. Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000-18: a geospatial modelling study. Lancet Glob Health 2022; 10:e1395-e1411. [PMID: 36113526 PMCID: PMC9638039 DOI: 10.1016/s2214-109x(22)00332-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/17/2022] [Accepted: 07/21/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. METHODS We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. FINDINGS Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000-257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. INTERPRETATION Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. FUNDING Bill & Melinda Gates Foundation.
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The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2022; 400:563-591. [PMID: 35988567 PMCID: PMC9395583 DOI: 10.1016/s0140-6736(22)01438-6] [Citation(s) in RCA: 189] [Impact Index Per Article: 94.5] [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: 01/14/2022] [Revised: 05/13/2022] [Accepted: 07/28/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01-4·94) deaths and 105 million (95·0-116) DALYs for both sexes combined, representing 44·4% (41·3-48·4) of all cancer deaths and 42·0% (39·1-45·6) of all DALYs. There were 2·88 million (2·60-3·18) risk-attributable cancer deaths in males (50·6% [47·8-54·1] of all male cancer deaths) and 1·58 million (1·36-1·84) risk-attributable cancer deaths in females (36·3% [32·5-41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6-28·4) and DALYs by 16·8% (8·8-25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9-42·8] and 33·3% [25·8-42·0]). INTERPRETATION The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. FUNDING Bill & Melinda Gates Foundation.
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Sharma R, Abbasi-Kangevari M, Abd-Rabu R, Abidi H, Abu-Gharbieh E, Acuna JM, Adhikari S, Advani SM, Afzal MS, Aghaie Meybodi M, Ahinkorah BO, Ahmad S, Ahmadi A, Ahmadi S, Ahmed H, Ahmed LA, Ahmed MB, Al Hamad H, Alahdab F, Alanezi FM, Alanzi TM, Alhalaiqa FAN, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Almustanyir S, Al-Raddadi RM, Alvand S, Alvis-Guzman N, Amini S, Ancuceanu R, Anoushiravani A, Anoushirvani AA, Ansari-Moghaddam A, Arabloo J, Aryannejad A, Asghari Jafarabadi M, Athari SS, Ausloos F, Ausloos M, Awedew AF, Awoke MA, Ayana TM, Azadnajafabad S, Azami H, Azangou-Khyavy M, Azari Jafari A, Badiye AD, Bagherieh S, Bahadory S, Baig AA, Baker JL, Banach M, Barrow A, Berhie AY, Besharat S, Bhagat DS, Bhagavathula AS, Bhala N, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Bjørge T, Bodicha BBA, Braithwaite D, Brenner H, Calina D, Cao C, Cao Y, Carreras G, Carvalho F, Cerin E, Chakinala RC, Cho WCS, Chu DT, Conde J, Costa VM, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Danielewicz A, Demeke FM, Demissie GD, Desai R, Dhamnetiya D, Dianatinasab M, Diaz D, Didehdar M, Doaei S, Doan LP, Dodangeh M, Eghbalian F, Ejeta DD, Ekholuenetale M, Ekundayo TC, El Sayed I, Elhadi M, Enyew DB, Eyayu T, Ezzeddini R, Fakhradiyev IR, Farooque U, Farrokhpour H, Farzadfar F, Fatehizadeh A, Fattahi H, Fattahi N, Fereidoonnezhad M, Fernandes E, Fetensa G, Filip I, Fischer F, Foroutan M, Gaal PA, Gad MM, Gallus S, Garg T, Getachew T, Ghamari SH, Ghashghaee A, Ghith N, Gholamalizadeh M, Gholizadeh Navashenaq J, Gizaw AT, Glasbey JC, Golechha M, Goleij P, Gonfa KB, Gorini G, Guha A, Gupta S, Gupta VB, Gupta VK, Haddadi R, Hafezi-Nejad N, Haj-Mirzaian A, Halwani R, Haque S, Hariri S, Hasaballah AI, Hassanipour S, Hay SI, Herteliu C, Holla R, Hosseini MS, Hosseinzadeh M, Hostiuc M, Househ M, Huang J, Humayun A, Iavicoli I, Ilesanmi OS, Ilic IM, Ilic MD, Islami F, Iwagami M, Jahani MA, Jakovljevic M, Javaheri T, Jayawardena R, Jebai R, Jha RP, Joo T, Joseph N, Joukar F, Jozwiak JJ, Kabir A, Kalhor R, Kamath A, Kapoor N, Karaye IM, Karimi A, Kauppila JH, Kazemi A, Keykhaei M, Khader YS, Khajuria H, Khalilov R, Khanali J, Khayamzadeh M, Khodadost M, Kim H, Kim MS, Kisa A, Kisa S, Kolahi AA, Koohestani HR, Kopec JA, Koteeswaran R, Koyanagi A, Krishnamoorthy Y, Kumar GA, Kumar M, Kumar V, La Vecchia C, Lami FH, Landires I, Ledda C, Lee SW, Lee WC, Lee YY, Leong E, Li B, Lim SS, Lobo SW, Loureiro JA, Lunevicius R, Madadizadeh F, Mahmoodpoor A, Majeed A, Malekpour MR, Malekzadeh R, Malik AA, Mansour-Ghanaei F, Mantovani LG, Martorell M, Masoudi S, Mathur P, Meena JK, Mehrabi Nasab E, Mendoza W, Mentis AFA, Mestrovic T, Miao Jonasson J, Miazgowski B, Miazgowski T, Mijena GFW, Mirmoeeni S, Mirza-Aghazadeh-Attari M, Mirzaei H, Misra S, Mohammad KA, Mohammadi E, Mohammadi S, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Mohammed TA, Moka N, Mokdad AH, Mokhtari Z, Molokhia M, Momtazmanesh S, Monasta L, Moradi G, Moradzadeh R, Moraga P, Morgado-da-Costa J, Mubarik S, Mulita F, Naghavi M, Naimzada MD, Nam HS, Natto ZS, Nayak BP, Nazari J, Nazemalhosseini-Mojarad E, Negoi I, Nguyen CT, Nguyen SH, Noor NM, Noori M, Noori SMA, Nuñez-Samudio V, Nzoputam CI, Oancea B, Odukoya OO, Oguntade AS, Okati-Aliabad H, Olagunju AT, Olagunju TO, Ong S, Ostroff SM, Padron-Monedero A, Pakzad R, Pana A, Pandey A, Pashazadeh Kan F, Patel UK, Paudel U, Pereira RB, Perumalsamy N, Pestell RG, Piracha ZZ, Pollok RCG, Pourshams A, Pourtaheri N, Prashant A, Rabiee M, Rabiee N, Radfar A, Rafiei S, Rahman M, Rahmani AM, Rahmanian V, Rajai N, Rajesh A, Ramezani-Doroh V, Ramezanzadeh K, Ranabhat K, Rashedi S, Rashidi A, Rashidi M, Rashidi MM, Rastegar M, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghinia MS, Renzaho AMN, Rezaei N, Rezaei N, Rezaei S, Rezaeian M, Rezazadeh-Khadem S, Roshandel G, Saber-Ayad MM, Saberzadeh-Ardestani B, Saddik B, Sadeghi H, Saeed U, Sahebazzamani M, Sahebkar A, Salek Farrokhi A, Salimi A, Salimzadeh H, Samadi P, Samaei M, Samy AM, Sanabria J, Santric-Milicevic MM, Saqib MAN, Sarveazad A, Sathian B, Satpathy M, Schneider IJC, Šekerija M, Sepanlou SG, Seylani A, Sha F, Shafiee SM, Shaghaghi Z, Shahabi S, Shaker E, Sharifian M, Sharifi-Rad J, Sheikhbahaei S, Shetty JK, Shirkoohi R, Shobeiri P, Siddappa Malleshappa SK, Silva DAS, Silva Julian G, Singh AD, Singh JA, Siraj MS, Sivandzadeh GR, Skryabin VY, Skryabina AA, Socea B, Solmi M, Soltani-Zangbar MS, Song S, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Tabibian E, Taheri M, TaheriAbkenar Y, Taherkhani A, Talaat IM, Tan KK, Tbakhi A, Tesfaye B, Tiyuri A, Tollosa DN, Touvier M, Tran BX, Tusa BS, Ullah I, Ullah S, Vacante M, Valadan Tahbaz S, Veroux M, Vo B, Vos T, Wang C, Westerman R, Woldemariam M, Yahyazadeh Jabbari SH, Yang L, Yazdanpanah F, Yu C, Yuce D, Yunusa I, Zadnik V, Zahir M, Zare I, Zhang ZJ, Zoladl M. Global, regional, and national burden of colorectal cancer and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol 2022; 7:627-647. [PMID: 35397795 PMCID: PMC9192760 DOI: 10.1016/s2468-1253(22)00044-9] [Citation(s) in RCA: 154] [Impact Index Per Article: 77.0] [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: 09/25/2021] [Revised: 01/30/2022] [Accepted: 02/04/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. METHODS Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. FINDINGS Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408-868 574) to 2·17 million (2·00-2·34), and deaths increased from 518 126 (493 682-537 877) to 1·09 million (1·02-1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3-23·0) per 100 000 to 26·7 (24·6-28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5-14·9) per 100 000 to 13·7 (12·6-14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7-320·7) per 100 000 to 295·5 (275·2-313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9-80·0] per 100 000), Monaco (60·7 [48·5-73·6] per 100 000), and Andorra (56·6 [42·8-71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0-37·1] per 100 000), Brunei (30·3 [26·6-34·1] per 100 000), and Hungary (28·6 [23·6-34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15·6%), smoking (13·3%), a diet low in calcium (12·9%), and alcohol use (9·9%) were the main contributors to colorectal cancer DALYs in 2019. INTERPRETATION The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions. FUNDING Bill & Melinda Gates Foundation.
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Clarsen B, Nylenna M, Klitkou ST, Vollset SE, Baravelli CM, Bølling AK, Aasvang GM, Sulo G, Naghavi M, Pasovic M, Asaduzzaman M, Bjørge T, Eggen AE, Eikemo TA, Ellingsen CL, Haaland ØA, Hailu A, Hassan S, Hay SI, Juliusson PB, Kisa A, Kisa S, Månsson J, Mekonnen T, Murray CJL, Norheim OF, Ottersen T, Sagoe D, Sripada K, Winkler AS, Knudsen AKS. Changes in life expectancy and disease burden in Norway, 1990–2019: an analysis of the Global Burden of Disease Study 2019. The Lancet Public Health 2022; 7:e593-e605. [PMID: 35779543 PMCID: PMC9253891 DOI: 10.1016/s2468-2667(22)00092-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 01/04/2023] Open
Abstract
Background Methods Findings Interpretation Funding
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Burkart K, Causey K, Cohen AJ, Wozniak SS, Salvi DD, Abbafati C, Adekanmbi V, Adsuar JC, Ahmadi K, Alahdab F, Al-Aly Z, Alipour V, Alvis-Guzman N, Amegah AK, Andrei CL, Andrei T, Ansari F, Arabloo J, Aremu O, Aripov T, Babaee E, Banach M, Barnett A, Bärnighausen TW, Bedi N, Behzadifar M, Béjot Y, Bennett DA, Bensenor IM, Bernstein RS, Bhattacharyya K, Bijani A, Biondi A, Bohlouli S, Breitner S, Brenner H, Butt ZA, Cámera LA, Cantu-Brito C, Carvalho F, Cerin E, Chattu VK, Chauhan BG, Choi JYJ, Chu DT, Dai X, Dandona L, Dandona R, Daryani A, Davletov K, de Courten B, Demeke FM, Denova-Gutiérrez E, Dharmaratne SD, Dhimal M, Diaz D, Djalalinia S, Duncan BB, El Sayed Zaki M, Eskandarieh S, Fareed M, Farzadfar F, Fattahi N, Fazlzadeh M, Fernandes E, Filip I, Fischer F, Foigt NA, Freitas M, Ghashghaee A, Gill PS, Ginawi IA, Gopalani SV, Guo Y, Gupta RD, Habtewold TD, Hamadeh RR, Hamidi S, Hankey GJ, Hasanpoor E, Hassen HY, Hay SI, Heibati B, Hole MK, Hossain N, Househ M, Irvani SSN, Jaafari J, Jakovljevic M, Jha RP, Jonas JB, Jozwiak JJ, Kasaeian A, Kaydi N, Khader YS, Khafaie MA, Khan EA, Khan J, Khan MN, Khatab K, Khater AM, Kim YJ, Kimokoti RW, Kisa A, Kivimäki M, Knibbs LD, Kosen S, Koul PA, Koyanagi A, Kuate Defo B, Kugbey N, Lauriola P, Lee PH, Leili M, Lewycka S, Li S, Lim LL, Linn S, Liu Y, Lorkowski S, Mahasha PW, Mahotra NB, Majeed A, Maleki A, Malekzadeh R, Mamun AA, Manafi N, Martini S, Meharie BG, Menezes RG, Mestrovic T, Miazgowski B, Miazgowski T, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mohajer B, Mohammed S, Mohan V, Mokdad AH, Monasta L, Moraga P, Morrison SD, Mueller UO, Mukhopadhyay S, Mustafa G, Muthupandian S, Naik G, Nangia V, Ndwandwe DE, Negoi RI, Ningrum DNA, Noubiap JJ, Ogbo FA, Olagunju AT, Onwujekwe OE, Ortiz A, Owolabi MO, P A M, Panda-Jonas S, Park EK, Pashazadeh Kan F, Pirsaheb M, Postma MJ, Pourjafar H, Radfar A, Rafiei A, Rahim F, Rahimi-Movaghar V, Rahman MA, Rai RK, Ranabhat CL, Raoofi S, Rawal L, Renzaho AMN, Rezapour A, Ribeiro D, Roever L, Ronfani L, Sabour S, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sahebkar A, Sahraian MA, Salimzadeh H, Salvi SS, Samy AM, Sanabria J, Sarmiento-Suárez R, Sathish T, Schmidt MI, Schutte AE, Sepanlou SG, Shaikh MA, Sharafi K, Sheikh A, Shigematsu M, Shiri R, Shirkoohi R, Shuval K, Soyiri IN, Tabarés-Seisdedos R, Tefera YM, Tehrani-Banihashemi A, Temsah MH, Thankappan KR, Topor-Madry R, Tudor Car L, Ullah I, Vacante M, Valdez PR, Vasankari TJ, Violante FS, Waheed Y, Wolfe CDA, Yamada T, Yonemoto N, Yu C, Zaman SB, Zhang Y, Zodpey S, Lim SS, Stanaway JD, Brauer M. Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM 2·5 air pollution, 1990-2019: an analysis of data from the Global Burden of Disease Study 2019. Lancet Planet Health 2022; 6:e586-e600. [PMID: 35809588 PMCID: PMC9278144 DOI: 10.1016/s2542-5196(22)00122-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. METHODS We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. FINDINGS In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68-4·83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49-17·5) of deaths and 13·6% (9·73-17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22-9·53) of deaths and 5·92% (3·81-8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. INTERPRETATION Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. FUNDING Bill & Melinda Gates Foundation.
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Haagsma JA, Charalampous P, Ariani F, Gallay A, Moesgaard Iburg K, Nena E, Ngwa CH, Rommel A, Zelviene A, Abegaz KH, Al Hamad H, Albano L, Liliana Andrei C, Andrei T, Antonazzo IC, Aremu O, Arumugam A, Atreya A, Aujayeb A, Ayuso-Mateos JL, Engelbert Bain L, Banach M, Winfried Bärnighausen T, Barone-Adesi F, Beghi M, Bennett DA, Bhagavathula AS, Carvalho F, Castelpietra G, Caterina L, Chandan JS, Couto RAS, Cruz-Martins N, Damiani G, Dastiridou A, Demetriades AK, Dias-da-Silva D, Francis Fagbamigbe A, Fereshtehnejad SM, Fernandes E, Ferrara P, Fischer F, Fra.Paleo U, Ghirini S, Glasbey JC, Glavan IR, Gomes NGM, Grivna M, Harlianto NI, Haro JM, Hasan MT, Hostiuc S, Iavicoli I, Ilic MD, Ilic IM, Jakovljevic M, Jonas JB, Jerzy Jozwiak J, Jürisson M, Kauppila JH, Kayode GA, Khan MAB, Kisa A, Kisa S, Koyanagi A, Kumar M, Kurmi OP, La-Vecchia C, Lamnisos D, Lasrado S, Lauriola P, Linn S, Loureiro JA, Lunevicius R, Madureira-Carvalho A, Mechili EA, Majeed A, Menezes RG, Mentis AFA, Meretoja A, Mestrovic T, Miazgowski T, Miazgowski B, Mirica A, Molokhia M, Mohammed S, Monasta L, Mulita F, David Naimzada M, Negoi I, Neupane S, Oancea B, Orru H, Otoiu A, Otstavnov N, Otstavnov SS, Padron-Monedero A, Panda-Jonas S, Pardhan S, Patel J, Pedersini P, Pinheiro M, Rakovac I, Rao CR, Rawaf S, Rawaf DL, Rodrigues V, Ronfani L, Sagoe D, Sanmarchi F, Santric-Milicevic MM, Sathian B, Sheikh A, Shiri R, Shivalli S, Dora Sigfusdottir I, Sigurvinsdottir R, Yurievich Skryabin V, Aleksandrovna Skryabina A, Smarandache CG, Socea B, Sousa RARC, Steiropoulos P, Tabarés-Seisdedos R, Roberto Tovani-Palone M, Tozija F, Van de Velde S, Juhani Vasankari T, Veroux M, Violante FS, Vlassov V, Wang Y, Yadollahpour A, Yaya S, Sergeevich Zastrozhin M, Zastrozhina A, Polinder S, Majdan M. The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study. Arch Public Health 2022; 80:142. [PMID: 35590340 PMCID: PMC9121595 DOI: 10.1186/s13690-022-00891-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 01/27/2022] [Accepted: 05/02/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries. METHODS We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year. RESULTS In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019. CONCLUSIONS Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries.
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Affiliation(s)
- Juanita A. Haagsma
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Periklis Charalampous
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Filippo Ariani
- Epidemiology Unit, Central Tuscany Local Health Authority, Florence, Italy
| | - Anne Gallay
- grid.493975.50000 0004 5948 8741Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Kim Moesgaard Iburg
- grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Evangelia Nena
- grid.12284.3d0000 0001 2170 8022Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Che Henry Ngwa
- grid.8761.80000 0000 9919 9582School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ,grid.22903.3a0000 0004 1936 9801Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Alexander Rommel
- grid.13652.330000 0001 0940 3744Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ausra Zelviene
- Institute of Hygiene, Health Information Center, Kaunas, Lithuania
| | - Kedir Hussein Abegaz
- grid.412132.70000 0004 0596 0713Department of Biostatistics, Near East University, Nicosia, Cyprus ,Department of Biostatistics and Health Informatics, Madda Walabu University, Bale Robe, Ethiopia
| | - Hanadi Al Hamad
- grid.413548.f0000 0004 0571 546XGeriatrics and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
| | - Luciana Albano
- grid.9841.40000 0001 2200 8888Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Catalina Liliana Andrei
- grid.8194.40000 0000 9828 7548Cardiology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Tudorel Andrei
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Ippazio Cosimo Antonazzo
- grid.7563.70000 0001 2174 1754Research Center On Public Health, University of Milan-Bicocca, Monza, Italy
| | - Olatunde Aremu
- grid.19822.300000 0001 2180 2449Department of Public Health, Birmingham City University, Birmingham, UK
| | - Ashokan Arumugam
- grid.412789.10000 0004 4686 5317Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Alok Atreya
- grid.429382.60000 0001 0680 7778Department of Forensic Medicine, Lumbini Medical College, Palpa, Nepal
| | - Avinash Aujayeb
- grid.451090.90000 0001 0642 1330Northumbria Healthcare NHS Foundation Trust, Cramlington, UK
| | - Jose Luis Ayuso-Mateos
- grid.411251.20000 0004 1767 647XHospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain ,grid.413448.e0000 0000 9314 1427Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Luchuo Engelbert Bain
- grid.36511.300000 0004 0420 4262Lincoln International Institute for Rural Health (LIIRH), University of Lincoln, Lincoln, UK ,Global South Health Services and Research, GSHS, Amsterdam, The Netherlands
| | - Maciej Banach
- grid.8267.b0000 0001 2165 3025Department of Hypertension, Medical University of Lodz, Lodz, Poland ,grid.415071.60000 0004 0575 4012Polish Mothers’ Memorial Hospital Research Institute, Lodz, Poland
| | - Till Winfried Bärnighausen
- grid.7700.00000 0001 2190 4373Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany ,grid.38142.3c000000041936754XT.H. Chan School of Public Health, Harvard University, Boston, MA USA
| | - Francesco Barone-Adesi
- grid.16563.370000000121663741Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - Derrick A. Bennett
- grid.4991.50000 0004 1936 8948Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Akshaya S. Bhagavathula
- grid.43519.3a0000 0001 2193 6666Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates ,grid.4491.80000 0004 1937 116XDepartment of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Prague, Czech Republic
| | - Félix Carvalho
- grid.5808.50000 0001 1503 7226Research Unit On Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Giulio Castelpietra
- Outpatient and Inpatient Care Service, Central Health Directorate, Friuli Venezia Giulia Region, Trieste, Italy
| | - Ledda Caterina
- grid.8158.40000 0004 1757 1969Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Joht Singh Chandan
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Rosa A. S. Couto
- grid.5808.50000 0001 1503 7226Department of Chemical Sciences, University of Porto, Porto, Portugal
| | - Natália Cruz-Martins
- grid.5808.50000 0001 1503 7226Faculty of Medicine, University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Institute for Research & Innovation in Health (i3S), University of Porto, Porto, Portugal ,Institute of Research and Advanced, Training in Health Sciences and Technologies (INFACTS), Gandra, Portugal
| | - Giovanni Damiani
- grid.4708.b0000 0004 1757 2822Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, University of Milan, Milan, Italy ,grid.67105.350000 0001 2164 3847Department of Dermatology, Case Western Reserve University, Cleveland, OH USA
| | - Anna Dastiridou
- grid.411299.6Department of Ophthalmology, University Hospital of Larissa, Larissa, Greece
| | - Andreas K. Demetriades
- grid.418716.d0000 0001 0709 1919Edinburgh Spinal Surgery Outcome Studies Group, Department of Neurosurgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Diana Dias-da-Silva
- grid.5808.50000 0001 1503 7226Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Adeniyi Francis Fagbamigbe
- grid.9582.60000 0004 1794 5983Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Seyed-Mohammad Fereshtehnejad
- grid.28046.380000 0001 2182 2255Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, ON Canada ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Department of Neurobiology, Karolinska Institute, Stockholm, Sweden
| | - Eduarda Fernandes
- grid.5808.50000 0001 1503 7226Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
| | - Pietro Ferrara
- grid.7563.70000 0001 2174 1754Research Center On Public Health, University of Milan-Bicocca, Monza, Italy
| | - Florian Fischer
- grid.6363.00000 0001 2218 4662Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Urbano Fra.Paleo
- grid.8393.10000000119412521Research Institute for Sustainable Land Development (Interra), University of Extremadura, Caceres, Spain
| | - Silvia Ghirini
- grid.416651.10000 0000 9120 6856National Center On Addictions and Doping, Istituto Superiore Di Sanità, Rome, Italy
| | - James C. Glasbey
- grid.6572.60000 0004 1936 7486NIHR Global Health Research Unit On Global Surgery, University of Birmingham, Birmingham, UK
| | - Ionela-Roxana Glavan
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Nelson G. M. Gomes
- grid.5808.50000 0001 1503 7226Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Department of Chemistry, University of Porto, Porto, Portugal
| | - Michal Grivna
- grid.43519.3a0000 0001 2193 6666Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Netanja I. Harlianto
- grid.7692.a0000000090126352Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain ,Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - M. Tasdik Hasan
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh ,grid.10025.360000 0004 1936 8470Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Sorin Hostiuc
- grid.8194.40000 0000 9828 7548Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania ,Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Ivo Iavicoli
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, University of Naples Federico II, Naples, Italy
| | - Milena D. Ilic
- grid.413004.20000 0000 8615 0106Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | - Irena M. Ilic
- grid.7149.b0000 0001 2166 9385Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mihajlo Jakovljevic
- grid.448878.f0000 0001 2288 8774N. A. Semashko Department of Public Health and Healthcare, I. M. Sechenov First Moscow State Medical University, Moscow, Russia ,grid.413004.20000 0000 8615 0106Department of Global Health, Economics and Policy, University of Kragujevac, Kragujevac, Serbia
| | - Jost B. Jonas
- grid.7700.00000 0001 2190 4373Department of Ophthalmology, Heidelberg University, Mannheim, Germany ,grid.414373.60000 0004 1758 1243Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Jacek Jerzy Jozwiak
- grid.107891.60000 0001 1010 7301Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | - Mikk Jürisson
- grid.10939.320000 0001 0943 7661Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Joonas H. Kauppila
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden ,grid.10858.340000 0001 0941 4873Surgery Research Unit, University of Oulu, Oulu, Finland
| | - Gbenga A. Kayode
- grid.421160.0International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria ,grid.5477.10000000120346234Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
| | - Moien A. B. Khan
- grid.43519.3a0000 0001 2193 6666Department of Family Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates ,grid.451052.70000 0004 0581 2008Primary Care Department, NHS North West London, London, England
| | - Adnan Kisa
- grid.457625.70000 0004 0383 3497School of Health Sciences, Kristiania University College, Oslo, Norway ,grid.265219.b0000 0001 2217 8588Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA USA
| | - Sezer Kisa
- grid.412414.60000 0000 9151 4445Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain ,grid.425902.80000 0000 9601 989XCatalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Manasi Kumar
- grid.10604.330000 0001 2019 0495Department of Psychiatry, University of Nairobi, Nairobi, Kenya ,grid.83440.3b0000000121901201Division of Psychology and Language Sciences, University College London, London, UK
| | - Om P. Kurmi
- grid.25073.330000 0004 1936 8227Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada ,grid.8096.70000000106754565Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Carlo La-Vecchia
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Demetris Lamnisos
- grid.440838.30000 0001 0642 7601Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Savita Lasrado
- grid.414767.70000 0004 1765 9143Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
| | - Paolo Lauriola
- grid.5326.20000 0001 1940 4177Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Shai Linn
- grid.18098.380000 0004 1937 0562School of Public Health, University of Haifa, Haifa, Israel
| | - Joana A. Loureiro
- grid.5808.50000 0001 1503 7226Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), University of Porto, Porto, Portugal
| | - Raimundas Lunevicius
- grid.10025.360000 0004 1936 8470Department of General Surgery, School of Medicine, Liverpool University Hospitals NHS Foundation Trust, University of Liverpool, Liverpool, UK
| | - Aurea Madureira-Carvalho
- Institute of Research and Advanced, Training in Health Sciences and Technologies (INFACTS), Gandra, Portugal ,grid.5808.50000 0001 1503 7226Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade Do Porto, Porto, Portugal
| | - Enkeleint A. Mechili
- grid.8127.c0000 0004 0576 3437Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece ,Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania
| | - Azeem Majeed
- grid.7445.20000 0001 2113 8111Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Ritesh G. Menezes
- grid.411975.f0000 0004 0607 035XForensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Alexios-Fotios A. Mentis
- grid.418497.7Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece ,grid.411299.6Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Atte Meretoja
- grid.1008.90000 0001 2179 088XSchool of Health Sciences, University of Melbourne, Melbourne, VIC Australia ,grid.15485.3d0000 0000 9950 5666Neurology Unit, Helsinki University Hospital, Helsinki, Finland
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Dr Zora Profozic Polyclinic, Zagreb, Croatia ,grid.502995.20000 0004 4651 2415University Centre Varazdin, University North, Varazdin, Croatia
| | - Tomasz Miazgowski
- grid.107950.a0000 0001 1411 4349Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Bartosz Miazgowski
- grid.107950.a0000 0001 1411 4349Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
| | - Andreea Mirica
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Mariam Molokhia
- grid.13097.3c0000 0001 2322 6764Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Shafiu Mohammed
- grid.7700.00000 0001 2190 4373Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany ,grid.411225.10000 0004 1937 1493Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Francesk Mulita
- grid.412458.eDepartment of General Surgery, University General Hospital of Patras, Patras, Greece
| | - Mukhammad David Naimzada
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia ,grid.411191.d0000 0000 9146 0440Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russia
| | - Ionut Negoi
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania ,Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Subas Neupane
- grid.502801.e0000 0001 2314 6254Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland ,grid.502801.e0000 0001 2314 6254Gerontology Research Center, Tampere University, Tampere, Finland
| | - Bogdan Oancea
- grid.5100.40000 0001 2322 497XAdministrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania
| | - Hans Orru
- grid.10939.320000 0001 0943 7661Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia ,grid.12650.300000 0001 1034 3451Department of Public Health and Clinical Medicine, Sustainable Health, Umea University, Umea, Sweden
| | - Adrian Otoiu
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Nikita Otstavnov
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - Stanislav S. Otstavnov
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia ,grid.410682.90000 0004 0578 2005Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Alicia Padron-Monedero
- grid.512889.f0000 0004 1768 0241National School of Public Health, Institute of Health Carlos III, Madrid, Spain
| | - Songhomitra Panda-Jonas
- grid.7700.00000 0001 2190 4373Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | - Shahina Pardhan
- grid.5115.00000 0001 2299 5510Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Jay Patel
- grid.9909.90000 0004 1936 8403Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Paolo Pedersini
- grid.418563.d0000 0001 1090 9021IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Marina Pinheiro
- grid.5808.50000 0001 1503 7226Department of Chemistry, University of Porto, Porto, Portugal
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Chythra R. Rao
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Salman Rawaf
- grid.7445.20000 0001 2113 8111Department of Primary Care and Public Health, Imperial College London, London, UK ,grid.271308.f0000 0004 5909 016XAcademic Public Health Department, Public Health England, London, UK
| | - David Laith Rawaf
- grid.7445.20000 0001 2113 8111World Health Organization (WHO) Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK ,grid.439749.40000 0004 0612 2754University College London Hospitals, London, UK
| | | | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Dominic Sagoe
- grid.7914.b0000 0004 1936 7443Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Francesco Sanmarchi
- grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Milena M. Santric-Milicevic
- grid.7149.b0000 0001 2166 9385Faculty of Medicine, University of Belgrade, Belgrade, Serbia ,grid.7149.b0000 0001 2166 9385School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Brijesh Sathian
- grid.413548.f0000 0004 0571 546XGeriatrics and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar ,grid.17236.310000 0001 0728 4630Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Aziz Sheikh
- grid.4305.20000 0004 1936 7988Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK ,grid.38142.3c000000041936754XDivision of General Internal Medicine, Harvard University, Boston, MA USA
| | - Rahman Shiri
- grid.6975.d0000 0004 0410 5926Finnish Institute of Occupational Health, Helsinki, Finland
| | - Siddharudha Shivalli
- grid.8991.90000 0004 0425 469XDepartment of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Inga Dora Sigfusdottir
- grid.9580.40000 0004 0643 5232Department of Psychology, Reykjavik University, Reykjavik, Iceland ,Icelandic Centre for Social Research and Analysis (ICSRA), Reykjavik, Iceland ,grid.21729.3f0000000419368729Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY USA
| | - Rannveig Sigurvinsdottir
- grid.9580.40000 0004 0643 5232Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | | | | | - Catalin-Gabriel Smarandache
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Socea
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Raúl A. R. C. Sousa
- Professional Association of Licensed Optometry Professionals, Linda-a-Velha, Portugal
| | - Paschalis Steiropoulos
- grid.12284.3d0000 0001 2170 8022Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, Alexandroupolis, Greece
| | - Rafael Tabarés-Seisdedos
- grid.413448.e0000 0000 9314 1427Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain ,grid.5338.d0000 0001 2173 938XDepartment of Medicine, University of Valencia, Valencia, Spain
| | - Marcos Roberto Tovani-Palone
- grid.11899.380000 0004 1937 0722Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Fimka Tozija
- grid.7858.20000 0001 0708 5391Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | - Sarah Van de Velde
- grid.5284.b0000 0001 0790 3681Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Antwerp, Belgium
| | | | - Massimiliano Veroux
- grid.8158.40000 0004 1757 1969Department of Medical, Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Francesco S. Violante
- grid.6292.f0000 0004 1757 1758Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy ,grid.412311.4Occupational Health Unit, Sant’Orsola Malpighi Hospital, Bologna, Italy
| | - Vasiliy Vlassov
- grid.410682.90000 0004 0578 2005Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yanzhong Wang
- grid.13097.3c0000 0001 2322 6764School of Population Health and Environmental Sciences, King’s College London, London, UK
| | - Ali Yadollahpour
- grid.11835.3e0000 0004 1936 9262Psychology Department, University of Sheffield, Sheffield, UK
| | - Sanni Yaya
- grid.28046.380000 0001 2182 2255School of International Development and Global Studies, University of Ottawa, Ottawa, ON Canada ,grid.4991.50000 0004 1936 8948The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Mikhail Sergeevich Zastrozhin
- Laboratory of Genetics and Genomics, Moscow Research and Practical Centre On Addictions, Moscow, Russia ,grid.465497.dAddictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Anasthasia Zastrozhina
- grid.465497.dPediatrics Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Suzanne Polinder
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marek Majdan
- grid.412903.d0000 0001 1212 1596Department of Public Health, Institute for Global Health and Epidemiology, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
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Castelpietra G, Knudsen AKS, Agardh EE, Armocida B, Beghi M, Iburg KM, Logroscino G, Ma R, Starace F, Steel N, Addolorato G, Andrei CL, Andrei T, Ayuso-Mateos JL, Banach M, Bärnighausen TW, Barone-Adesi F, Bhagavathula AS, Carvalho F, Carvalho M, Chandan JS, Chattu VK, Couto RA, Cruz-Martins N, Dargan PI, Deuba K, da Silva DD, Fagbamigbe AF, Fernandes E, Ferrara P, Fischer F, Gaal PA, Gialluisi A, Haagsma JA, Haro JM, Hasan MT, Hasan SS, Hostiuc S, Iacoviello L, Iavicoli I, Jamshidi E, Jonas JB, Joo T, Jozwiak JJ, Katikireddi SV, Kauppila JH, Khan MA, Kisa A, Kisa S, Kivimäki M, Koly KN, Koyanagi A, Kumar M, Lallukka T, Langguth B, Ledda C, Lee PH, Lega I, Linehan C, Loureiro JA, Madureira-Carvalho ÁM, Martinez-Raga J, Mathur MR, McGrath JJ, Mechili EA, Mentis AFA, Mestrovic T, Miazgowski B, Mirica A, Mirijello A, Moazen B, Mohammed S, Mulita F, Nagel G, Negoi I, Negoi RI, Nwatah VE, Padron-Monedero A, Panda-Jonas S, Pardhan S, Pasovic M, Patel J, Petcu IR, Pinheiro M, Pollok RCG, Postma MJ, Rawaf DL, Rawaf S, Romero-Rodríguez E, Ronfani L, Sagoe D, Sanmarchi F, Schaub MP, Sharew NT, Shiri R, Shokraneh F, Sigfusdottir ID, Silva JP, Silva R, Socea B, Szócska M, Tabarés-Seisdedos R, Torrado M, Tovani-Palone MR, Vasankari TJ, Veroux M, Viner RM, Werdecker A, Winkler AS, Hay SI, Ferrari AJ, Naghavi M, Allebeck P, Monasta L. The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019: Findings from the Global Burden of Disease Study 2019. Lancet Reg Health Eur 2022; 16:100341. [PMID: 35392452 PMCID: PMC8980870 DOI: 10.1016/j.lanepe.2022.100341] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time. Methods Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated. Findings In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 - 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432-912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9-412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (-29·1%;23·8-38·5). YLLs decreased in self-harm (-27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs. Interpretation Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people. Funding The Bill and Melinda Gates Foundation.
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Affiliation(s)
- Giulio Castelpietra
- Outpatient and Inpatient Care Service, Central Health Directorate, Region Friuli Venezia Giulia, Italy
| | | | - Emilie E. Agardh
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
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- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
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- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Department of Clinical Research in Neurology, Fondazione Cardinale Giovanni Panico Hospital, Tricase, Italy
| | - Rui Ma
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Fabrizio Starace
- Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - Nicholas Steel
- Department of Primary Care and Public Health, University of East Anglia, Norwich, UK
- Public Health England, London, UK
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- Department of Statistics and Econometrics Bucharest Carol Davila University of Economic Studies, Bucharest, Romania
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- CIBERSAM, Institute of Health Carlos III, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid (Autonomous University of Madrid), Madrid, Spain
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- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
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- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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- Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
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- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Márcia Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
- Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
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- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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- Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago
- Independent Consultant, Athens, Greece
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- Department of Chemical Sciences, University of Porto, Porto, Portugal
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- Department of Medicine (Prof N Cruz-Martins PhD), University of Porto, Porto, Portugal
- Department of Health Sciences Institute of Research and Advanced Training in Health Sciences and Technologies (CESPU), Famalicão, Portugal
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- Faculty of Life Sciences and Medicine, King's College London, London, UK
- Department of Clinical Toxicology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
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- National Centre for AIDS and STD Control, Save the Children, Kathmandu, Nepal
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
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- Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
- Population and Behavioural Sciences, University of St Andrews, St Andrews, UK
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- Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
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- Research Center on Public Health, University of Milan Bicocca, Monza, Italy
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- Institute of Public Health, Charité Universitätsmedizin Berlin (Charité Medical University Berlin), Berlin, Germany
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- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
- Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania
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- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
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- Research Unit, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Barcelona, Spain
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- Department of Pharmacy, University of Huddersfield, Huddersfield, UK
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
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- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
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- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
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- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
- Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
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- Department of Public Health, University of Naples Federico II, Naples, Italy
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- Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehram, Iran
- Division of Pulmonary Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
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- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
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- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
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- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
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- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Surgery Research Unit, University of Oulu, Oulu, Finland
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- Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
- Primary Care Department, NHS North West London, London, UK
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- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Mika Kivimäki
- Department of Epidemiology and Public Health University College London, London, UK
- Department of Public Health, University of Helsinki, Helsinki, Finland
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- Health System and Population Studies Divisions, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Center for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Manasi Kumar
- Division of Psychology and Language Sciences, University College London, London, UK
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
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- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Caterina Ledda
- Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Paul H. Lee
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Ilaria Lega
- National Center for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Insitute of Health, Rome, Italy
| | - Christine Linehan
- UCD Centre for Disability Studies, University College Dublin, Dublin, Ireland
| | - Joana A. Loureiro
- Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE) University of Porto, Porto, Portugal
- School of Health, Polytechnic Institute of Porto, Portugal
| | - Áurea M Madureira-Carvalho
- Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
- Institute for Research and Advanced Training in Health Sciences and Technologies, Instituto Universitário de Ciências da Saúde (University Institute of Health Sciences), Gandra, Portugal
| | - Jose Martinez-Raga
- Psychiatry Department, Hospital Universitario Doctor Peset, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Manu Raj Mathur
- Health Policy Research Public Health Foundation of India, Gurugram, India
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - John J. McGrath
- Queensland Brain Institute, School of Public Health, The University of Queensland, Brisbane, QLD, Australia
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Enkeleint A. Mechili
- Department of Healthcare, University of Vlora, Vlora city, Albania
- Clinic of Social and Family Medicine, University of Crete, Heraklion, Greece
| | | | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
| | - Andreea Mirica
- Department of Statistics and Econometrics Bucharest University of Economic Studies, Bucharest, Romania
| | - Antonio Mirijello
- Department of Medical Sciences IRCCS Casa Sollievo della Sofferenza General Hospital, San Giovanni Rotondo, Italy
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Shafiu Mohammed
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
- Department of Health Care Management, Technical University of Berlin, Berlin, Germany
| | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Patras, Greece
- Medical School, University of Thessaly, Larissa, Greece
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry Ulm University, Ulm, Germany
| | - Ionut Negoi
- Department of General Surgery Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Ruxandra Irina Negoi
- Department of Anatomy and Embryology Romania, Bucharest, Romania
- Cardio-Aid, Bucharest, Romania
| | - Vincent Ebuka Nwatah
- Department of Pediatrics, National Hospital, Abuja, Nigeria
- Department of International Public Health, University of Liverpool, Liverpool, UK
| | | | | | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Maja Pasovic
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Jay Patel
- Global Health Governance Programme, University of Edinburgh, Edinburgh, UK
- School of Dentistry, University of Leeds, Leeds, UK
| | - Ionela-Roxana Petcu
- Department of Statistics and Econometrics Bucharest University of Economic Studies, Bucharest, Romania
| | - Marina Pinheiro
- Department of Chemistry, University of Porto, Porto, Portugal
| | | | - Maarten J. Postma
- University Medical Center Groningen, School of Economics and Business University of Groningen, Groningen, Netherlands
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training Imperial College London, London, UK
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- University College London Hospitals, London, UK
- Academic Public Health England, London, UK
| | - Esperanza Romero-Rodríguez
- Clinical and Epidemiological Research in Primary Care (GICEAP), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Dominic Sagoe
- Department of Psychosocial Science University of Bergen, Bergen, Norway
| | - Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction University of Zürich, Zurich, Switzerland
| | - Nigussie Tadesse Sharew
- Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE) University of Groningen, Groningen, Netherlands
- Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Farhad Shokraneh
- London Institute for Healthcare Engineering, King's College London, London, UK
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Health and Behavior Studies, Columbia University, New York, NY, USA
| | - João Pedro Silva
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Renata Silva
- Department of Biological Sciences, University of Porto, Porto, Portugal
| | - Bogdan Socea
- Surgery, "Sf. Pantelimon" Emergency Clinical Hospital Bucharest, Bucharest, Romania
| | - Miklós Szócska
- Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Marco Torrado
- Psychiatry and Medical Psychology Department, University of Lisbon, Lisbon, Portugal
- Child and Adolescent Mental Health Services (CAMHS), Hospital Garcia de Orta, Almada, Portugal
| | - Marcos Roberto Tovani-Palone
- Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
- Modestum LTD, London, UK
| | - Tommi Juhani Vasankari
- UKK Institute, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Massimiliano Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Russell M. Viner
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Andrea Werdecker
- Demographic Change and Aging Research Area, Federal Institute for Population Research, Wiesbaden, Germany
| | - Andrea Sylvia Winkler
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Alize J. Ferrari
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
- School of Public Health (A J Ferrari PhD), The University of Queensland, Brisbane, QLD, Australia
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Peter Allebeck
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
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Cousin E, Duncan BB, Stein C, Ong KL, Vos T, Abbafati C, Abbasi-Kangevari M, Abdelmasseh M, Abdoli A, Abd-Rabu R, Abolhassani H, Abu-Gharbieh E, Accrombessi MMK, Adnani QES, Afzal MS, Agarwal G, Agrawaal KK, Agudelo-Botero M, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi K, Ahmadi S, Ahmadi A, Ahmed A, Ahmed Salih Y, Akande-Sholabi W, Akram T, Al Hamad H, Al-Aly Z, Alcalde-Rabanal JE, Alipour V, Aljunid SM, Al-Raddadi RM, Alvis-Guzman N, Amini S, Ancuceanu R, Andrei T, Andrei CL, Anjana RM, Ansar A, Antonazzo IC, Antony B, Anyasodor AE, Arabloo J, Arizmendi D, Armocida B, Artamonov AA, Arulappan J, Aryan Z, Asgari S, Ashraf T, Astell-Burt T, Atorkey P, Atout MMW, Ayanore MA, Badiye AD, Baig AA, Bairwa M, Baker JL, Baltatu OC, Banik PC, Barnett A, Barone MTU, Barone-Adesi F, Barrow A, Bedi N, Belete R, Belgaumi UI, Bell AW, Bennett DA, Bensenor IM, Beran D, Bhagavathula AS, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bijani A, Bikbov B, Birara S, Bodolica V, Bonny A, Brenner H, Briko NI, Butt ZA, Caetano dos Santos FL, Cámera LA, Campos-Nonato IR, Cao Y, Cao C, Cerin E, Chakraborty PA, Chandan JS, Chattu VK, Chen S, Choi JYJ, Choudhari SG, Chowdhury EK, Chu DT, Corso B, Dadras O, Dai X, Damasceno AAM, Dandona L, Dandona R, Dávila-Cervantes CA, De Neve JW, Denova-Gutiérrez E, Dhamnetiya D, Diaz D, Ebtehaj S, Edinur HA, Eftekharzadeh S, El Sayed I, Elgendy IY, Elhadi M, Elmonem MA, Faisaluddin M, Farooque U, Feng X, Fernandes E, Fischer F, Flood D, Freitas M, Gaal PA, Gad MM, Gaewkhiew P, Getacher L, Ghafourifard M, Ghanei Gheshlagh R, Ghashghaee A, Ghith N, Ghozali G, Gill PS, Ginawi IA, Glushkova EV, Golechha M, Gopalani SV, Guimarães RA, Gupta RD, Gupta R, Gupta VK, Gupta VB, Gupta S, Habtewold TD, Hafezi-Nejad N, Halwani R, Hanif A, Hankey GJ, Haque S, Hasaballah AI, Hasan SS, Hashi A, Hassanipour S, Hay SI, Hayat K, Heidari M, Hossain MBH, Hossain S, Hosseini M, Hoveidamanesh S, Huang J, Humayun A, Hussain R, Hwang BF, Ibitoye SE, Ikuta KS, Inbaraj LR, Iqbal U, Islam MS, Islam SMS, Islam RM, Ismail NE, Isola G, Itumalla R, Iwagami M, Iyamu IO, Jahani MA, Jakovljevic M, Jayawardena R, Jha RP, John O, Jonas JB, Joo T, Kabir A, Kalhor R, Kamath A, Kanchan T, Kandel H, Kapoor N, Kayode GA, Kebede SA, Keshavarz P, Keykhaei M, Khader YS, Khajuria H, Khan MAB, Khan MN, Khan M, Khater AM, Khoja TAM, Khubchandani J, Kim MS, Kim YJ, Kimokoti RW, Kisa S, Kisa A, Kivimäki M, Korshunov VA, Korzh O, Koyanagi A, Krishan K, Kuate Defo B, Kumar GA, Kumar N, Kusuma D, La Vecchia C, Lacey B, Larsson AO, Lasrado S, Lee WC, Lee CB, Lee PH, Lee SWH, Li MC, Lim SS, Lim LL, Lucchetti G, Majeed A, Malik AA, Mansouri B, Mantovani LG, Martini S, Mathur P, McAlinden C, Mehedi N, Mekonnen T, Menezes RG, Mersha AG, Miao Jonasson J, Miazgowski T, Michalek IM, Mirica A, Mirrakhimov EM, Mirza AZ, Mithra P, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed A, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moradpour F, Moradzadeh R, Mostafavi E, Mueller UO, Murray CJL, Mustafa A, Nagel G, Nangia V, Naqvi AA, Nayak BP, Nazari J, Ndejjo R, Negoi RI, Neupane Kandel S, Nguyen CT, Nguyen HLT, Noubiap JJ, Nowak C, Oancea B, Odukoya OO, Oguntade AS, Ojo TT, Olagunju AT, Onwujekwe OE, Ortiz A, Owolabi MO, Palladino R, Panda-Jonas S, Pandi-Perumal SR, Pardhan S, Parekh T, Parvizi M, Pepito VCF, Perianayagam A, Petcu IR, Pilania M, Podder V, Polibin RV, Postma MJ, Prashant A, Rabiee N, Rabiee M, Rahimi-Movaghar V, Rahman MA, Rahman MM, Rahman M, Rahmawaty S, Rajai N, Ram P, Rana J, Ranabhat K, Ranasinghe P, Rao CR, Rao S, Rawaf S, Rawaf DL, Rawal L, Renzaho AMN, Rezaei N, Rezapour A, Riahi SM, Ribeiro D, Rodriguez JAB, Roever L, Rohloff P, Rwegerera GM, Ryan PM, Saber-Ayad MM, Sabour S, Saddik B, Saeedi Moghaddam S, Sahebkar A, Sahoo H, Saif-Ur-Rahman KM, Salimzadeh H, Samaei M, Sanabria J, Santric-Milicevic MM, Sathian B, Sathish T, Schlaich MP, Seidu AA, Šekerija M, Senthil Kumar N, Seylani A, Shaikh MA, Shamshad H, Shawon MSR, Sheikhbahaei S, Shetty JK, Shiri R, Shivakumar KM, Shuval K, Singh JA, Singh A, Skryabin VY, Skryabina AA, Sofi-Mahmudi A, Soheili A, Sun J, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Tadbiri H, Tadesse EG, Tariqujjaman M, Thankappan KR, Thapar R, Thomas N, Timalsina B, Tobe-Gai R, Tonelli M, Tovani-Palone MR, Tran BX, Tripathy JP, Tudor Car L, Tusa BS, Uddin R, Upadhyay E, Valadan Tahbaz S, Valdez PR, Vasankari TJ, Verma M, Villalobos-Daniel VE, Vladimirov SK, Vo B, Vu GT, Vukovic R, Waheed Y, Wamai RG, Werdecker A, Wickramasinghe ND, Winkler AS, Wubishet BL, Xu X, Xu S, Yahyazadeh Jabbari SH, Yatsuya H, Yaya S, Yazie TSY, Yi S, Yonemoto N, Yunusa I, Zadey S, Zaman SB, Zamanian M, Zamora N, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Zhong C, Zmaili M, Zumla A, Naghavi M, Schmidt MI. Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019. Lancet Diabetes Endocrinol 2022; 10:177-192. [PMID: 35143780 PMCID: PMC8860753 DOI: 10.1016/s2213-8587(21)00349-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/27/2021] [Accepted: 12/10/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990-2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. FINDINGS In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (-28·4 to -2·9) for all diabetes, and by 21·0% (-33·0 to -5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (-13·6% [-28·4 to 3·4]) and for type 1 diabetes (-13·6% [-29·3 to 8·9]). INTERPRETATION Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. FUNDING Bill & Melinda Gates Foundation.
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Kocarnik JM, Compton K, Dean FE, Fu W, Gaw BL, Harvey JD, Henrikson HJ, Lu D, Pennini A, Xu R, Ababneh E, Abbasi-Kangevari M, Abbastabar H, Abd-Elsalam SM, Abdoli A, Abedi A, Abidi H, Abolhassani H, Adedeji IA, Adnani QES, Advani SM, Afzal MS, Aghaali M, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi A, Ahmadi S, Ahmed Rashid T, Ahmed Salih Y, Akalu GT, Aklilu A, Akram T, Akunna CJ, Al Hamad H, Alahdab F, Al-Aly Z, Ali S, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Almasi-Hashiani A, Almasri NA, Al-Maweri SAA, Almustanyir S, Alonso N, Alvis-Guzman N, Amu H, Anbesu EW, Ancuceanu R, Ansari F, Ansari-Moghaddam A, Antwi MH, Anvari D, Anyasodor AE, Aqeel M, Arabloo J, Arab-Zozani M, Aremu O, Ariffin H, Aripov T, Arshad M, Artaman A, Arulappan J, Asemi Z, Asghari Jafarabadi M, Ashraf T, Atorkey P, Aujayeb A, Ausloos M, Awedew AF, Ayala Quintanilla BP, Ayenew T, Azab MA, Azadnajafabad S, Azari Jafari A, Azarian G, Azzam AY, Badiye AD, Bahadory S, Baig AA, Baker JL, Balakrishnan S, Banach M, Bärnighausen TW, Barone-Adesi F, Barra F, Barrow A, Behzadifar M, Belgaumi UI, Bezabhe WMM, Bezabih YM, Bhagat DS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Bisignano C, Bjørge T, Bleyer A, Blyuss O, Bolarinwa OA, Bolla SR, Braithwaite D, Brar A, Brenner H, Bustamante-Teixeira MT, Butt NS, Butt ZA, Caetano dos Santos FL, Cao Y, Carreras G, Catalá-López F, Cembranel F, Cerin E, Cernigliaro A, Chakinala RC, Chattu SK, Chattu VK, Chaturvedi P, Chimed-Ochir O, Cho DY, Christopher DJ, Chu DT, Chung MT, Conde J, Cortés S, Cortesi PA, Costa VM, Cunha AR, Dadras O, Dagnew AB, Dahlawi SMA, Dai X, Dandona L, Dandona R, Darwesh AM, das Neves J, De la Hoz FP, Demis AB, Denova-Gutiérrez E, Dhamnetiya D, Dhimal ML, Dhimal M, Dianatinasab M, Diaz D, Djalalinia S, Do HP, Doaei S, Dorostkar F, dos Santos Figueiredo FW, Driscoll TR, Ebrahimi H, Eftekharzadeh S, El Tantawi M, El-Abid H, Elbarazi I, Elhabashy HR, Elhadi M, El-Jaafary SI, Eshrati B, Eskandarieh S, Esmaeilzadeh F, Etemadi A, Ezzikouri S, Faisaluddin M, Faraon EJA, Fares J, Farzadfar F, Feroze AH, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Fisher JL, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gadanya MA, Gallus S, Gaspar Fonseca M, Getachew Obsa A, Ghafourifard M, Ghashghaee A, Ghith N, Gholamalizadeh M, Gilani SA, Ginindza TG, Gizaw ATT, Glasbey JC, Golechha M, Goleij P, Gomez RS, Gopalani SV, Gorini G, Goudarzi H, Grosso G, Gubari MIM, Guerra MR, Guha A, Gunasekera DS, Gupta B, Gupta VB, Gupta VK, Gutiérrez RA, Hafezi-Nejad N, Haider MR, Haj-Mirzaian A, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hanif A, Haque S, Harlianto NI, Haro JM, Hasaballah AI, Hassanipour S, Hay RJ, Hay SI, Hayat K, Heidari G, Heidari M, Herrera-Serna BY, Herteliu C, Hezam K, Holla R, Hossain MM, Hossain MBH, Hosseini MS, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huang J, Hugo FN, Hussain R, Hussein NR, Hwang BF, Iavicoli I, Ibitoye SE, Ida F, 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J, Zhong C, Zhou L, Zhu C, Ziapour A, Zimmermann IR, Fitzmaurice C, Murray CJL, Force LM. Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA Oncol 2022; 8:420-444. [PMID: 34967848 PMCID: PMC8719276 DOI: 10.1001/jamaoncol.2021.6987] [Citation(s) in RCA: 585] [Impact Index Per Article: 292.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.
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Affiliation(s)
| | | | - Kelly Compton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Frances E. Dean
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Weijia Fu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Brian L. Gaw
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - James D. Harvey
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hannah Jacqueline Henrikson
- Department of Global Health, Boston University, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Dan Lu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alyssa Pennini
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Rixing Xu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emad Ababneh
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Mohsen Abbasi-Kangevari
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hedayat Abbastabar
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Aidin Abedi
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles
| | - Hassan Abidi
- Laboratory Technology Sciences Department, Yasouj University, Yasuj, Iran
| | - Hassan Abolhassani
- Department of Laboratory Medicine, Karolinska University Hospital, Huddinge, Sweden
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Qorinah Estiningtyas Sakilah Adnani
- Department of Midwifery, Karya Husada Institute of Health Sciences, Kediri, Indonesia
- Department of Midwifery, Auckland University of Technology, Auckland, New Zealand
| | - Shailesh M. Advani
- Terasaki Institute for Biomedical Innovation, Los Angeles, California
- School of Medicine, Georgetown University, Washington, DC
| | - Muhammad Sohail Afzal
- Department of Life Sciences, University of Management and Technology, Lahore, Pakistan
| | - Mohammad Aghaali
- Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
| | - Bright Opoku Ahinkorah
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Sajjad Ahmad
- Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China
| | - Ali Ahmadi
- Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Ahmadi
- School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tarik Ahmed Rashid
- Department of Computer Science and Engineering, University of Kurdistan Hewler, Erbil, Iraq
| | - Yusra Ahmed Salih
- Database Technology Department, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
- College of Informatics, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
| | - Gizachew Taddesse Akalu
- Microbiology, Immunology and Parasitology Department, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Microbial, Cellular and Molecular Biology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Addis Aklilu
- Department of Medical Laboratory Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tayyaba Akram
- School of Mathematical Sciences, University of Science Malaysia, Penang, Malaysia
| | - Chisom Joyqueenet Akunna
- Department of Public Health, Intercountry Centre for Oral Health for Africa, Jos, Nigeria
- Department of Public Health, Federal Ministry of Health, Garki, Nigeria
| | - Hanadi Al Hamad
- Geriatric and Long-Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fares Alahdab
- Mayo Evidence-Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota
| | - Ziyad Al-Aly
- John T. Milliken Department of Internal Medicine, Washington University in St Louis, St Louis, Missouri
- Clinical Epidemiology Center, Department of Veterans Affairs, St Louis, Missouri
| | - Saqib Ali
- Department of Information Systems, Sultan Qaboos University, Muscat, Oman
| | - Yousef Alimohamadi
- Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | | | | | - Sadeq Ali Ali Al-Maweri
- College of Dental Medicine, Qatar University, Doha, Qatar
- Faculty of Dentistry, Sana'a University, Sana’a, Yemen
| | - Sami Almustanyir
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Ministry of Health, Riyadh, Saudi Arabia
| | - Nivaldo Alonso
- Department of Surgery, University of São Paulo, São Paulo, Brazil
| | - Nelson Alvis-Guzman
- Research Group in Hospital Management and Health Policies, Universidad de la Costa, Barranquilla, Colombia
- Research Group in Health Economics, University of Cartagena, Cartagena, Colombia
| | - Hubert Amu
- Department of Population and Behavioural Sciences, University of Health and Allied Sciences, Ho, Ghana
| | | | - Robert Ancuceanu
- Pharmacy Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Fereshteh Ansari
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education, and Extension Organization, Tehran, Iran
| | - Alireza Ansari-Moghaddam
- Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maxwell Hubert Antwi
- Clinical Laboratory Department, Ghana Health Service, Kumasi, Ghana
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Davood Anvari
- Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | | | - Muhammad Aqeel
- Department of Psychology, Foundation University Islamabad, Rawalpandi, Pakistan
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Olatunde Aremu
- Department of Public Health, Birmingham City University, Birmingham, England
| | - Hany Ariffin
- Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
- University of Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - Timur Aripov
- Public Health and Healthcare Management, Tashkent Institute of Postgraduate Medical Education, Tashkent, Uzbekistan
- Boston Children's Hospital, Boston, Massachusetts
| | - Muhammad Arshad
- Allied Health Sciences, Khyber Medical University, Timergara, Lower Dir, Pakistan
| | - Al Artaman
- Zayed University, Abu Dhabi, United Arab Emirates
| | - Judie Arulappan
- Department of Maternal and Child Health, Sultan Qaboos University, Muscat, Oman
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Biostatistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Biostatistics and Epidemiology, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Tahira Ashraf
- Institute of Radiological Sciences and Medical Imaging Technology, University of Lahore, Lahore, Pakistan
| | - Prince Atorkey
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Avinash Aujayeb
- Northumbria HealthCare National Health Service (NHS) Foundation Trust, NHS England, Newcastle upon Tyne, England
| | - Marcel Ausloos
- School of Business, University of Leicester, Leicester, England
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | | | | | - Temesgen Ayenew
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
| | | | | | | | - Ghasem Azarian
- Department of Environmental Health Engineering, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ahmed Y. Azzam
- Faculty of Medicine, October 6 University, 6th of October City, Egypt
| | - Ashish D. Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Saeed Bahadory
- Department of Parasitology, Tarbiat Modares University, Tehran, Iran
- Department of Parasitology, Alborz University of Medical Sciences, Karaj, Iran
| | - Atif Amin Baig
- Unit of Biochemistry, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Jennifer L. Baker
- Center for Clinical Research and Prevention, Bispebjerg University Hospital, Frederiksberg, Denmark
| | | | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, University of Genoa, Genoa, Italy
| | - Amadou Barrow
- Department of Public and Environmental Health, University of the Gambia, Brikama, The Gambia
- Epidemiology and Disease Control Unit, Ministry of Health, Kotu, The Gambia
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Uzma Iqbal Belgaumi
- Department of Oral Pathology and Microbiology, Krishna Institute of Medical Sciences, Karad, India
| | | | - Yihienew Mequanint Bezabih
- Department of Internal Medicine, Bahir Dar University, Bahir Dar, Ethiopia
- One Health, University of Nantes, Nantes, France
| | - Devidas S. Bhagat
- Department of Forensic Chemistry, Government Institute of Forensic Science, Aurangabad, India
| | - Akshaya Srikanth Bhagavathula
- Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nikha Bhardwaj
- Department of Anatomy, Government Medical College Pali, Pali, India
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, India
| | - Sonu Bhaskar
- Neurovascular Imaging Laboratory, New South Wales Brain Clot Bank, Sydney, New South Wales, Australia
- Department of Neurology and Neurophysiology, South West Sydney Local Heath District and Liverpool Hospital, Sydney, New South Wales, Australia
| | - Krittika Bhattacharyya
- Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
- Department of Statistics, University of Calcutta, Kolkata, India
| | | | - Sadia Bibi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Archie Bleyer
- Department of Radiation Medicine, Oregon Health and Science University, Portland
- McGovern Medical School, University of Texas, Houston
| | - Oleg Blyuss
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield, England
- Institute for Women's Health, University College London, London, England
| | | | - Srinivasa Rao Bolla
- Department of Biomedical Sciences, Nazarbayev University, Nur-Sultan City, Kazakhstan
| | - Dejana Braithwaite
- Department of Epidemiology, University of Florida, Gainesville
- Cancer Population Sciences Program, University of Florida Health Cancer Center, Gainesville
| | - Amanpreet Brar
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | | | - Nadeem Shafique Butt
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Zahid A. Butt
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | | | - Yin Cao
- Department of Surgery, Washington University in St Louis, St Louis, Missouri
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Ferrán Catalá-López
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Francieli Cembranel
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Achille Cernigliaro
- Regional Epidemiological Observatory Department, Sicilian Regional Health Authority, Palermo, Italy
| | | | | | - Vijay Kumar Chattu
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Saveetha Medical College, Saveetha University, Chennai, India
| | - Pankaj Chaturvedi
- Center for Cancer Epidemiology, Tata Memorial Hospital, Navi Mumbai, India
- Department of Head Neck Surgery, Tata Memorial Hospital, Mumbai, India
| | - Odgerel Chimed-Ochir
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan
| | | | | | - Dinh-Toi Chu
- Center for Biomedicine and Community Health, VNU International School, Hanoi, Vietnam
| | - Michael T. Chung
- Department of Otolaryngology, Wayne State University, Detroit, Michigan
| | - Joao Conde
- Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Sanda Cortés
- Department of Public Health, Pontifical Catholic University of Chile, Santiago, Chile
- Research Line in Environmental Exposures and Health Effects at Population Level, Centro de Desarrollo Urbano Sustentable, Santiago, Chile
| | | | - Vera Marisa Costa
- Research Unit on Applied Molecular Biosciences, University of Porto, Porto, Portugal
| | - Amanda Ramos Cunha
- Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Omid Dadras
- School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Saad M. A. Dahlawi
- Environmental Health Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
- Indian Council of Medical Research, New Delhi, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
| | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | - José das Neves
- Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
- Institute of Biomedical Engineering, University of Porto, Porto, Portugal
| | | | - Asmamaw Bizuneh Demis
- Department of Nursing, Woldia University, Woldia, Ethiopia
- School of Nursing, Jimma University, Jimma, Ethiopia
| | - Edgar Denova-Gutiérrez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Deepak Dhamnetiya
- Department of Community Medicine, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
| | - Mandira Lamichhane Dhimal
- Policy Research Institute, Kathmandu, Nepal
- Global Institute for Interdisciplinary Studies, Kathmandu, Nepal
| | - Meghnath Dhimal
- Health Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Mostafa Dianatinasab
- Department of Epidemiology and Biostatistics, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Daniel Diaz
- Center of Complexity Sciences, National Autonomous University of Mexico, Mexico City, Mexico
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
| | - Shirin Djalalinia
- Development of Research and Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Huyen Phuc Do
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Saeid Doaei
- School of Health, Guilan University of Medical Sciences, Rasht, Iran
- Department of Community Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Dorostkar
- Department of Medical Laboratory Sciences, Iran University of Medical Sciences, Tehran, Iran
| | | | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Hedyeh Ebrahimi
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobilliary Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Eftekharzadeh
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Maha El Tantawi
- Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt
| | - Hassan El-Abid
- Direction de L'épidémiologie et la Lutte Contre les Maladies, Ministry of Health, Rabat, Morocco
| | - Iffat Elbarazi
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | | | | | - Babak Eshrati
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Firooz Esmaeilzadeh
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Sayeh Ezzikouri
- Department of Virology, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Mohammed Faisaluddin
- Department of Internal Medicine, Rochester General Hospital, Rochester, New York
| | - Emerito Jose A. Faraon
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
| | - Jawad Fares
- Department of Neurological Surgery, Northwestern University, Chicago, Illinois
| | - Farshad Farzadfar
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdullah Hamid Feroze
- Department of Neurological Surgery, University of Washington, Seattle
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Simone Ferrero
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | | | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, California
- School of Health Sciences, A.T. Still University, Mesa, Arizona
| | - Florian Fischer
- Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
| | | | - Masoud Foroutan
- Department of Medical Parasitology, Abadan University of Medical Sciences, Abadan, Iran
- Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
| | | | - Peter Andras Gaal
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
- Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania
| | - Mohamed M. Gad
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
- Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill
| | - Muktar A. Gadanya
- Community Medicine Department, Bayero University, Kano, Kano, Nigeria
- Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Silvano Gallus
- Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | | | | | - Mansour Ghafourifard
- Department of Medical Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Ghashghaee
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Nermin Ghith
- Research Group for Genomic Epidemiology, Technical University of Denmark, Copenhagen, Denmark
| | - Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Syed Amir Gilani
- Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan
- Afro-Asian Institute, Lahore, Pakistan
| | - Themba G. Ginindza
- Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | | | - James C. Glasbey
- National Institute for Health Research Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, England
| | - Mahaveer Golechha
- Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India
| | - Pouya Goleij
- Department of Genetics, Sana Institute of Higher Education, Sari, Iran
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Sameer Vali Gopalani
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City
- Department of Health and Social Affairs, Government of the Federated States of Micronesia, Palikir, Federated States of Micronesia
| | - Giuseppe Gorini
- Oncological Network, Prevention and Research Institute, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Houman Goudarzi
- Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | | | - Avirup Guha
- Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio
- Division of Cardiovascular Medicine, Ohio State University, Columbus
| | | | - Bhawna Gupta
- Department of Public Health, Torrens University, Melbourne, Victoria, Australia
| | - Veer Bala Gupta
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Vivek Kumar Gupta
- Department of Clinical Medicine, Macquarie University, Sydney, New South Wales, Australia
| | - Reyna Alma Gutiérrez
- Department of Epidemiology and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Nima Hafezi-Nejad
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Arvin Haj-Mirzaian
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rabih Halwani
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Randah R. Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Sajid Hameed
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Asif Hanif
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
| | - Shafiul Haque
- Research & Scientific Studies Unit, Jazan University, Jazan, Saudi Arabia
| | - Netanja I. Harlianto
- Faculty of Medicine, Utrecht University, Utrecht, Netherlands
- Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Josep Maria Haro
- Research Unit, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network, Barcelona, Spain
| | | | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Roderick J. Hay
- International Foundation for Dermatology, London, England
- St John's Institute of Dermatology, King's College London, London, England
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Khezar Hayat
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
| | | | - Mohammad Heidari
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | | | - Claudiu Herteliu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- School of Business, London South Bank University, London, England
| | - Kamal Hezam
- Department of Applied Microbiology, Taiz University, Taiz, Yemen
- Department of Microbiology, Nankai University, Tianjin, China
| | - Ramesh Holla
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Md Mahbub Hossain
- Social and Environmental Health Research, Nature Study Society of Bangladesh, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M University, College Station
| | | | | | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hosseinzadeh
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Department of Computer Science, University of Human Development, Sulaymaniyah, Iraq
| | - Mihaela Hostiuc
- Internal Medicine Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Mowafa Househ
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Mohamed Hsairi
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Junjie Huang
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Fernando N. Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rabia Hussain
- School of Pharmaceutical Sciences, University of Science Malaysia, Penang, Malaysia
| | - Nawfal R. Hussein
- Department of Biomolecular Sciences, University of Zakho, Zakho, Iraq
| | - Bing-Fang Hwang
- Department of Occupational Safety and Health, China Medical University, Taichung, Taiwan
| | - Ivo Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Fidelia Ida
- Pharmacoepidemiology Department, Sanofi, Cambridge, Massachusetts
| | - Kevin S. Ikuta
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Division of Allergy and Infectious Diseases, University of Washington, Seattle
| | - Olayinka Stephen Ilesanmi
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Irena M. Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena D. Ilic
- Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | - Lalu Muhammad Irham
- School of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Faculty of Pharmacy, Ahmad Dahlan University, Yogyakarta, Indonesia
| | - Jessica Y. Islam
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Rakibul M. Islam
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | | | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Masao Iwagami
- Department of Health Services Research, University of Tsukuba, Tsukuba, Japan
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England
| | - Louis Jacob
- Research and Development Unit, Biomedical Research Networking Center for Mental Health Network, Sant Boi de Llobregat, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Vardhmaan Jain
- Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Mihajlo B. Jakovljevic
- Institute of Comparative Economic Studies, Hosei University, Tokyo, Japan
- Department of Global Health, Economics and Policy, University of Kragujevac, Kragujevac, Serbia
| | | | - Shubha Jayaram
- Department of Biochemistry, Government Medical College, Mysuru, India
| | | | - Ravi Prakash Jha
- Department of Community Medicine, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | - Jost B. Jonas
- Department of Ophthalmology, Heidelberg University, Heidelberg, Germany
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Tamas Joo
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Nitin Joseph
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Danial Kahrizi
- Department of Genetics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Leila R. Kalankesh
- School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Kalhor
- Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Feroze Kaliyadan
- Dermatology Department, King Faisal University, Hofuf, Saudi Arabia
| | - Yogeshwar Kalkonde
- Public Health Division, Society for Education, Action and Research in Community Health, Gadchiroli, India
| | - Ashwin Kamath
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
- Manipal Academy of Higher Education, Manipal, India
| | | | - Himal Kandel
- Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
- Sydney Eye Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - André Karch
- Institute for Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Ayele Semachew Kasa
- Department of Adult Health Nursing, Bahir Dar University, Bahir Dar, Ethiopia
| | - Srinivasa Vittal Katikireddi
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Joonas H. Kauppila
- Surgery Research Unit, University of Oulu, Oulu, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Taras Kavetskyy
- Department of Surface Engineering, John Paul II Catholic University of Lublin, Lublin, Poland
- Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
| | - Sewnet Adem Kebede
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Faroe Islands
| | - Pedram Keshavarz
- School of Science and Technology, University of Georgia, Tbilisi, Georgia
- Department of Diagnostic and Interventional Radiology, New Hospitals LTD, Tbilisi, Georgia
| | - Mohammad Keykhaei
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Rovshan Khalilov
- Department of Biophysics and Biochemistry, Baku State University, Baku, Azerbaijan
- Russian Institute for Advanced Study, Moscow State Pedagogical University, Moscow, Russia
| | - Gulfaraz Khan
- Department of Medical Microbiology and Immunology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Maseer Khan
- Epidemiology Department, Jazan University, Jazan, Saudi Arabia
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | - Moien A. B. Khan
- Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
- Primary Care Department, NHS North West London, London, England
| | - Young-Ho Khang
- Department of Health Policy and Management, Seoul National University, Seoul, South Korea
- Institute of Health Policy and Management, Seoul National University, Seoul, South Korea
| | - Amir M. Khater
- National Hepatology and Tropical Medicine Research Institute, Cairo University, Cairo, Egypt
| | - Maryam Khayamzadeh
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- The Iranian Academy of Medical Sciences, Tehran, Iran
| | - Gyu Ri Kim
- Department of Preventive Medicine, Yonsei University, Seoul, South Korea
| | - Yun Jin Kim
- School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Jacek A. Kopec
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | | | - Parvaiz A. Koul
- Department of Internal and Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
| | | | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | | | - Nuworza Kugbey
- University of Environment and Sustainable Development, Somanya, Ghana
| | | | - Narinder Kumar
- Department of Orthopaedics, Medanta Hospital, Lucknow, India
| | - Nithin Kumar
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Om P. Kurmi
- Faculty of Health and Life Sciences, Coventry University, Coventry, England
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University, Ankara, Turkey
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | - Iván Landires
- Unit of Genetics and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Ministry of Health, Herrera, Panama
| | - Paolo Lauriola
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Sang-woong Lee
- Pattern Recognition and Machine Learning Lab, Gachon University, Seongnam, South Korea
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | - Wei-Chen Lee
- Office of Health Policy & Legislative Affairs, University of Texas, Galveston
| | - Yo Han Lee
- Graduate School of Public Health, Ajou University, Suwon-si, South Korea
| | - James Leigh
- Asbestos Diseases Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Elvynna Leong
- Faculty of Science, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei
| | - Jiarui Li
- Department of Medical Oncology, Peking Union Medical College, Beijing, China
| | - Ming-Chieh Li
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Xuefeng Liu
- Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Quantitative Health Science, Case Western Reserve University, Cleveland, Ohio
| | - Joana A. Loureiro
- Laboratory for Process Engineering, Environment, Biotechnology and Energy, University of Porto, Porto, Portugal
- School of Health, Polytechnic Institute of Porto, Portugal
| | - Raimundas Lunevicius
- Department of General Surgery, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England
- Department of Surgery, University of Liverpool, Liverpool, England
| | | | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, England
| | - Alaa Makki
- Mass Communication Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Shilpa Male
- Department of Ophthalmology, M M Joshi Eye Institute, Hubli, India
| | - Ahmad Azam Malik
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
- Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Santi Martini
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
- Indonesian Public Health Association, Surabaya, Indonesia
| | | | - Prashant Mathur
- National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, India
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, England
| | - Ravi Mehrotra
- India Cancer Research Consortium, Indian Council of Medical Research, New Delhi, India
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund, Lima, Peru
| | - Ritesh G. Menezes
- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Mohamed Kamal Mesregah
- Department of Orthopaedic Surgery, Menoufia University Faculty of Medicine, Shebin El-Kom, Egypt
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Polyclinic “Dr. Zora Profozic”, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Junmei Miao Jonasson
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
- Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases and Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | | | - Ted R. Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Mirzaei
- Department of Medical Immunology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanjeev Misra
- Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - Prasanna Mithra
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Masoud Moghadaszadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | - Mokhtar Mohammadi
- Department of Information Technology, Lebanese French University, Erbil, Iraq
| | | | | | - Shafiu Mohammed
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
- Department of Health Care Management, Technical University of Berlin, Berlin, Germany
| | - Nagabhishek Moka
- Oncology Department, Appalachian Regional Healthcare, Hazard, Kentucky
- Internal Medicine, University of Kentucky, Lexington
| | - Ali H. Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, England
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Mohammad Ali Moni
- Department of Computer Science and Engineering, Pabna University of Science and Technology, Pabna, Bangladesh
| | - Mohammad Amin Moosavi
- Department of Molecular Medicine, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Paula Moraga
- Computer, Electrical, and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | | | | | - Abbas Mosapour
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
- Department of Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Adeaide, South Australia, Australia
| | - Ahamarshan Jayaraman Nagarajan
- Research and Analytics Department, Initiative for Financing Health and Human Development, Chennai, India
- Department of Research and Analytics, Bioinsilico Technologies, Chennai, India
| | | | - Chie Nagata
- Department of Education for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russia
| | | | - Atta Abbas Naqvi
- Department of Pharmacy Practice, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Discipline of Social and Administrative Pharmacy, University of Science, Malaysia, Penang, Malaysia
| | | | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - Sabina O. Nduaguba
- Pharmaceutical Outcomes and Policy Department, University of Florida, Gainesville
| | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Serban Mircea Negru
- Department of Oncology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | | | - Chukwudi A. Nnaji
- South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nurulamin M. Noor
- Medical Research Council Clinical Trials Unit, University College London, London, England
- Department of Gastroenterology, Cambridge University Hospitals, Cambridge, England
| | - Virginia Nuñez-Samudio
- Unit of Microbiology and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Department of Public Health, Ministry of Health, Herrera, Panama
| | | | - Bogdan Oancea
- Administrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania
| | - Chimedsuren Ochir
- Department of International Cyber Education, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
- Advisory Board, Ministry of Health, Ulaanbaatar, Mongolia
| | - Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, University of Lagos, Idi Araba, Nigeria
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Andrew T. Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | | | - Emad Omar
- Mass Communication Department, Ajman University, Dubai, United Arab Emirates
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaymaniyah, Iraq
| | - Abidemi E. Emmanuel Omonisi
- Department of Anatomic Pathology, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Anatomic Pathology, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Sokking Ong
- Noncommunicable Disease Prevention Unit, Ministry of Health, Bandar Seri Begawan, Brunei
- Early Detection and Cancer Prevention Services, Pantai Jerudong Specialist Centre, Bandar Seri Begawan, Brunei
| | - Obinna E. Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
- Section of Sustainable Health, Umeå University, Umea, Sweden
| | | | - Nikita Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - Stanislav S. Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Mayowa O. Owolabi
- Department of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | - Jagadish Rao Padubidri
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Keyvan Pakshir
- Department of Medical Mycology and Parasitology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Adrian Pana
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- Department of Health Metrics, Center for Health Outcomes and Evaluation, Bucharest, Romania
| | | | | | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, England
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University, Seoul, South Korea
- Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | | | - Harsh K. Patel
- Department of Internal Medicine, Ochsner Medical Center, New Orleans, Louisiana
| | - Jenil R. Patel
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Dallas
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock
| | - Siddhartha Pati
- Centre of Excellence, Khallikote University, Berhampur, India
- Research Division, Association for Biodiversity Conservation and Research, Balasore, India
| | | | - Uttam Paudel
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
- Faculty of Humanities and Social Sciences, Tribhuvan University, Kathmandu, Nepal
| | - David M. Pereira
- Associated Laboratory for Green Chemistry, University of Porto, Porto, Portugal
| | | | - Arokiasamy Perianayagam
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Julian David Pillay
- Basic Medical Sciences Department, Durban University of Technology, Durban, South Africa
| | - Saeed Pirouzpanah
- Department of Biochemistry and Dietetics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Pishgar
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Urooncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Indrashis Podder
- Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, India
| | - Maarten J. Postma
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- School of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Hadi Pourjafar
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Akila Prashant
- Department of Biochemistry, Jagadguru Sri Shivarathreeswara University, Mysuru, India
| | - Liliana Preotescu
- National Institute of Infectious Diseases, Bucuresti, Romania
- Department of Infectious Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Navid Rabiee
- Department of Physics, Sharif University of Technology, Tehran, Iran
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando
| | | | | | - Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Fakher Rahim
- Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Rahimzadeh
- Department of Natural Science, Middlesex University, London, England
| | - Mosiur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Victoria, Australia
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Amir Masoud Rahmani
- Future Technology Research Center, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Nazanin Rajai
- Department of Internal Medicine, Harvard University, Boston, Massachusetts
| | - Aashish Rajesh
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio
| | - Ivo Rakovac
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russia
| | - Pradhum Ram
- Department of Cardiology, Emory University, Atlanta, Georgia
| | - Kiana Ramezanzadeh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamal Ranabhat
- Health Emergency Operation Center, Ministry of Health and Population, Kathmandu, Nepal
- Central Department of Public Health, Institute of Medicine, Kathmandu, Nepal
| | | | - Chythra R. Rao
- Department of Community Medicine, Manipal Academy of Higher Education, Manipal, India
| | - Sowmya J. Rao
- Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
| | - Reza Rawassizadeh
- Department of Computer Science, Boston University, Boston, Massachusetts
| | - Mohammad Sadegh Razeghinia
- Department of Immunology and Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
- Department of Immunology, Kerman University of Medical Sciences, Kerman, Iran
| | - Andre M. N. Renzaho
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Negar Rezaei
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Peter Rohloff
- Department of Global Health and Population, Harvard University, Boston, Massachusetts
- Center for Indigenous Health Research, Wuqu' Kawoq Maya Health Alliance, Tecpan, Guatemala
| | | | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Manjula S
- Oral and Maxillofacial Surgery, Jagadguru Sri Shivarathreeswara University, Mysore, India
| | - Siamak Sabour
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Basema Saddik
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Umar Saeed
- Research and Development, Islamabad Diagnostic Center Pakistan, Islamabad, Pakistan
- Biological Production Development, National Institute of Health, Islamabad, Pakistan
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Harihar Sahoo
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Sana Salehi
- Department of Radiology, University of Southern California, Los Angeles
| | - Marwa Rashad Salem
- Public Health and Community Medicine Department, Cairo University, Giza, Egypt
| | - Hamideh Salimzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnoosh Samaei
- Emergency Department, Brown University, Providence, Rhode Island
| | | | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, West Virginia
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Senthilkumar Sankararaman
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
| | - Milena M. Santric-Milicevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Yaeesh Sardiwalla
- Division of Plastic and Reconstructive Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Brijesh Sathian
- Geriatric and Long-Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, England
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte
| | | | | | - Mario Sekerija
- Department of Medical Statistics, Epidemiology and Medical Informatics, University of Zagreb, Zagreb, Croatia
- Department of Epidemiology and Prevention of Chronic Noncommunicable Diseases, Croatian Institute of Public Health, Zagreb, Croatia
| | - Allen Seylani
- National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, Maryland
| | - Omid Shafaat
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
- Department of Radiology and Interventional Neuroradiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Shaghaghi
- Clinical Research Development Unit of Farshchian Heart Center, Hamedan University of Medical Sciences, Hamadan, Iran
| | | | - Erfan Shamsoddin
- Department of Oral Health, Non-Communicable Diseases Research Center, Tehran, Iran
- Noncommunicable Diseases Committee, National Institute for Medical Research Developmen, Tehran, Iran
| | - Mohammed Shannawaz
- Symbiosis Medical College for Women, Symbiosis International University, Pune, India
| | - Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, Delhi, India
| | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, Scotland
- Division of General Internal Medicine, Harvard University, Boston, Massachusetts
| | - Sara Sheikhbahaei
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
| | - Adithi Shetty
- Department of Obstetrics and Gynaecology, Manipal Academy of Higher Education, Mangalore, India
| | - Jeevan K. Shetty
- Department of Biochemistry, Manipal University College Melaka, Melaka, Malaysia
| | - Pavanchand H. Shetty
- Department of Forensic Medicine, Manipal Academy of Higher Education, Mangalore, India
| | | | - Reza Shirkoohi
- Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - K. M. Shivakumar
- Public Health Dentistry Department, Krishna Institute of Medical Sciences, Karad, India
| | - Velizar Shivarov
- Clinical Immunology and Hematology, Sofiamed University Hospital, Sofia, Bulgaria
- Department of Genetics, Sofia University St. Kliment Ohridiski, Sofia, Bulgaria
| | - Soraya Siabani
- Department of Health Education and Health Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
- School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | | | | | - Jasvinder A. Singh
- School of Medicine, University of Alabama at Birmingham, Birmingham
- Medicine Service Department of Veterans Affairs, Birmingham, Alabama
| | | | | | | | - Matthew J. Soeberg
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia
| | - Ahmad Sofi-Mahmudi
- Department of Oral Health, Non-Communicable Diseases Research Center, Tehran, Iran
- Cochrane Iran Associate Centre, National Institute for Medical Research Development, Iranian Ministry of Health and Medical Education, Tehran, Iran
| | - Houman Sotoudeh
- Department of Radiology, University of Alabama at Birmingham, Birmingham
| | | | - Kurt Straif
- Schiller Institute, Boston College, Boston, Massachusetts
- Barcelona Institute for Global Health, Barcelona, Spain
| | | | | | - Iyad Sultan
- Pediatric Services, King Hussein Cancer Center, Amman, Jordan
- Pediatrics, University of Jordan, Amman, Jordan
| | - Saima Sultana
- Maternal and Child Health, Projahnmo Research Foundation, Dhaka, Bangladesh
| | - Daniel Sur
- Department of Medical Oncology, The Oncology Institute “Prof Dr Ion Chiricuţă” Cluj-Napoca, Cluj-Napoca, Romania
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Viktória Szerencsés
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Miklós Szócska
- Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network, Madrid, Spain
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | | | - Amir Taherkhani
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ken Takahashi
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia
| | - Iman M. Talaat
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- Pathology Department, Alexandria University, Alexandria, Egypt
| | - Ker-Kan Tan
- Department of Surgery, National University of Singapore, Singapore, Singapore
| | - Vivian Y. Tat
- Department of Pathology, University of Texas, Galveston
| | - Bemnet Amare A. Tedla
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
- University of Gondar, Gondar, Ethiopia
| | | | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Fisaha Haile Tesfay
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Southgate Institute for Health and Society, Flinders University, Adelaide, South Australia, Australia
| | - Gizachew Assefa Tessema
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Rekha Thapar
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Aravind Thavamani
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio
- Division of Pediatric Gastroenterology, Case Western Reserve University, Cleveland, Ohio
| | | | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - Hamid Reza Tohidinik
- HIV/STI Surveillance Research Center and World Health Organization Collaborating Center for HIV Surveillance, Kerman University of Medical Sciences, Kerman, Iran
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team, National Institute for Health and Medical Research Institut national de la santé et de la recherche médicale, Paris, France
- Department of Health, Medicine and Human Biology, Sorbonne Paris Nord University, Bobigny, France
| | - Marcos Roberto Tovani-Palone
- Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
- Modestum LTD, London, England
| | - Eugenio Traini
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Maurice Wilkins Centre, Auckland, New Zealand
| | - Mai Thi Ngoc Tran
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Health Informatics Department, Nursing and Midwifery Faculty, Hanoi Medical University, Ha Noi, Vietnam
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Biruk Shalmeno Tusa
- Department of Epidemiology and Biostatistics, Haramaya University, Haramaya, Ethiopia
| | - Irfan Ullah
- Department of Allied Health Sciences, Iqra National University, Peshawar, Pakistan
- Pakistan Council for Science and Technology, Ministry of Science and Technology, Islamabad, Pakistan
| | - Saif Ullah
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
| | | | | | - Era Upadhyay
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Maryam Vaezi
- Alzahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahel Valadan Tahbaz
- Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran
- Department of Microbiology, Islamic Azad University, Tehran, Iran
| | - Diana Zuleika Velazquez
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
| | - Massimiliano Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Francesco S. Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Bay Vo
- Faculty of Information Technology, Ho Chi Minh City University of Technology, Ho Chi Minh City, Vietnam
| | - Victor Volovici
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands
- Center for Experimental Microsurgery, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Giang Thu Vu
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Yasir Waheed
- Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan
| | - Richard G. Wamai
- Cultures, Societies and Global Studies, Integrated Initiative for Global Health, Northeastern University, Boston, Massachusetts
- School of Public Health, University of Nairobi, Nairobi, Kenya
| | - Paul Ward
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Yi Feng Wen
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Stomatological Hospital (College) of Xi'an Jiaotong University, Xi'an, China
| | - Ronny Westerman
- Competence Center of Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany
| | - Andrea Sylvia Winkler
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - Lalit Yadav
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Research and Development Division, The George Institute for Global Health, New Delhi, India
| | | | - Lin Yang
- Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, British Columbia, Canada
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- George Institute for Global Health, University of Oxford, Oxford, England
| | | | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Public Health, Juntendo University, Tokyo, Japan
| | - Mustafa Z. Younis
- Department of Health Policy and Management, Jackson State University, Jackson, Mississippi
- School of Medicine, Tsinghua University, Beijing, China
| | - Zabihollah Yousefi
- Department of Environmental Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Deniz Yuce
- Cancer Institute, Hacettepe University, Ankara, Turkey
| | - Ismaeel Yunusa
- Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina, Columbia
| | - Vesna Zadnik
- Epidemiology and Cancer Registry Sector, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Fariba Zare
- Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mikhail Sergeevich Zastrozhin
- Laboratory of Genetics and Genomics, Moscow Research and Practical Centre on Addictions, Moscow, Russia
- Addictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Anasthasia Zastrozhina
- Pediatrics Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Jianrong Zhang
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Chenwen Zhong
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Linghui Zhou
- Bone Marrow Transplantation Center, Zhejiang University, Hangzhou, China
| | - Cong Zhu
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, Houston
| | - Arash Ziapour
- Department of Health Education and Health Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Christina Fitzmaurice
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Division of Hematology, University of Washington, Seattle
| | - Christopher J. L. Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lisa M. Force
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Division of Pediatric Hematology-Oncology, University of Washington, Seattle
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Ledesma JR, Ma J, Vongpradith A, Maddison ER, Novotney A, Biehl MH, LeGrand KE, Ross JM, Jahagirdar D, Bryazka D, Feldman R, Abolhassani H, Abosetugn AE, Abu-Gharbieh E, Adebayo OM, Adnani QES, Afzal S, Ahinkorah BO, Ahmad SA, Ahmadi S, Ahmed Rashid T, Ahmed Salih Y, Aklilu A, Akunna CJ, Al Hamad H, Alahdab F, Alemayehu Y, Alene KA, Ali BA, Ali L, Alipour V, Alizade H, Al-Raddadi RM, Alvis-Guzman N, Amini S, Amit AML, Anderson JA, Androudi S, Antonio CAT, Antony CM, Anwer R, Arabloo J, Arja A, Asemahagn MA, Atre SR, Azhar GS, B DB, Babar ZUD, Baig AA, Banach M, Barqawi HJ, Barra F, Barrow A, Basu S, Belgaumi UI, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharjee NV, Bhattacharyya K, Bijani A, Bikbov B, Boloor A, Briko NI, Buonsenso D, Burugina Nagaraja S, Butt ZA, Carter A, Carvalho F, Charan J, Chatterjee S, Chattu SK, Chattu VK, Christopher DJ, Chu DT, Claassens MM, Dadras O, Dagnew AB, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Darwesh AM, Dhamnetiya D, Dianatinasab M, Diaz D, Doan LP, Eftekharzadeh S, Elhadi M, Emami A, Enany S, Faraon EJA, Farzadfar F, Fernandes E, Ferro Desideri L, Filip I, Fischer F, Foroutan M, Frank TD, Garcia-Basteiro AL, Garcia-Calavaro C, Garg T, Geberemariyam BS, Ghadiri K, Ghashghaee A, Golechha M, Goodridge A, Gupta B, Gupta S, Gupta VB, Gupta VK, Haider MR, Hamidi S, Hanif A, Haque S, Harapan H, Hargono A, Hasaballah AI, Hashi A, Hassan S, Hassankhani H, Hayat K, Hezam K, Holla R, Hosseinzadeh M, Hostiuc M, Househ M, Hussain R, Ibitoye SE, Ilic IM, Ilic MD, Irvani SSN, Ismail NE, Itumalla R, Jaafari J, Jacobsen KH, Jain V, Javanmardi F, Jayapal SK, Jayaram S, Jha RP, Jonas JB, Joseph N, Joukar F, Kabir Z, Kamath A, Kanchan T, Kandel H, Katoto PDMC, Kayode GA, Kendrick PJ, Kerbo AA, Khajuria H, Khalilov R, Khatab K, Khoja AT, Khubchandani J, Kim MS, Kim YJ, Kisa A, Kisa S, Kosen S, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kucuk Bicer B, Kumar A, Kumar GA, Kumar N, Kumar N, Kwarteng A, Lak HM, Lal DK, Landires I, Lasrado S, Lee SWH, Lee WC, Lin C, Liu X, Lopukhov PD, Lozano R, Machado DB, Madhava Kunjathur S, Madi D, Mahajan PB, Majeed A, Malik AA, Martins-Melo FR, Mehta S, Memish ZA, Mendoza W, Menezes RG, Merie HE, Mersha AG, Mesregah MK, Mestrovic T, Mheidly NM, Misra S, Mithra P, Moghadaszadeh M, Mohammadi M, Mohammadian-Hafshejani A, Mohammed S, Molokhia M, Moni MA, Montasir AA, Moore CE, Nagarajan AJ, Nair S, Nair S, Naqvi AA, Narasimha Swamy S, Nayak BP, Nazari J, Neupane Kandel S, Nguyen TH, Nixon MR, Nnaji CA, Ntsekhe M, Nuñez-Samudio V, Oancea B, Odukoya OO, Olagunju AT, Oren E, P A M, Parthasarathi R, Pashazadeh Kan F, Pattanshetty SM, Paudel R, Paul P, Pawar S, Pepito VCF, Perico N, Pirestani M, Polibin RV, Postma MJ, Pourshams A, Prashant A, Pribadi DRA, Radfar A, Rafiei A, Rahim F, Rahimi-Movaghar V, Rahman M, Rahman M, Rahmani AM, Ranasinghe P, Rao CR, Rawaf DL, Rawaf S, Reitsma MB, Remuzzi G, Renzaho AMN, Reta MA, Rezaei N, Rezahosseini O, Rezai MS, Rezapour A, Roshandel G, Roshchin DO, Sabour S, Saif-Ur-Rahman KM, Salam N, Samadi Kafil H, Samaei M, Samy AM, Saroshe S, Sartorius B, Sathian B, Sawyer SM, Senthilkumaran S, Seylani A, Shafaat O, Shaikh MA, Sharafi K, Shetty RS, Shigematsu M, Shin JI, Silva JP, Singh JK, Sinha S, Skryabin VY, Skryabina AA, Spurlock EE, Sreeramareddy CT, Steiropoulos P, Sufiyan MB, Tabuchi T, Tadesse EG, Tamir Z, Tarkang EE, Tekalegn Y, Tesfay FH, Tessema B, Thapar R, Tleyjeh II, Tobe-Gai R, Tran BX, Tsegaye B, Tsegaye GW, Ullah A, Umeokonkwo CD, Valadan Tahbaz S, Vo B, Vu GT, Waheed Y, Walters MK, Whisnant JL, Woldekidan MA, Wubishet BL, Yahyazadeh Jabbari SH, Yazie TSY, Yeshaw Y, Yi S, Yiğit V, Yonemoto N, Yu C, Yunusa I, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Zumla A, Mokdad AH, Salomon JA, Reiner Jr RC, Lim SS, Naghavi M, Vos T, Hay SI, Murray CJL, Kyu HH. Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990-2019: results from the Global Burden of Disease Study 2019. Lancet Infect Dis 2022; 22:222-241. [PMID: 34563275 PMCID: PMC8799634 DOI: 10.1016/s1473-3099(21)00449-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/21/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019. METHODS We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates. FINDINGS Globally, in 2019, among HIV-negative individuals, there were 1·18 million (95% uncertainty interval 1·08-1·29) deaths due to tuberculosis and 8·50 million (7·45-9·73) incident cases of tuberculosis. Among HIV-positive individuals, there were 217 000 (153 000-279 000) deaths due to tuberculosis and 1·15 million (1·01-1·32) incident cases in 2019. More deaths and incident cases occurred in males than in females among HIV-negative individuals globally in 2019, with 342 000 (234 000-425 000) more deaths and 1·01 million (0·82-1·23) more incident cases in males than in females. Among HIV-positive individuals, 6250 (1820-11 400) more deaths and 81 100 (63 300-100 000) more incident cases occurred among females than among males in 2019. Age-standardised mortality rates among HIV-negative males were more than two times greater in 105 countries and age-standardised incidence rates were more than 1·5 times greater in 74 countries than among HIV-negative females in 2019. The fraction of global tuberculosis deaths among HIV-negative individuals attributable to alcohol use, smoking, and diabetes was 4·27 (3·69-5·02), 6·17 (5·48-7·02), and 1·17 (1·07-1·28) times higher, respectively, among males than among females in 2019. Among individuals with HIV and tuberculosis coinfection, the fraction of mortality attributable to injection drug use was 2·23 (2·03-2·44) times greater among males than females, whereas the fraction due to unsafe sex was 1·06 (1·05-1·08) times greater among females than males. INTERPRETATION As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis. This strategy will be crucial in reaching both equity and burden targets outlined by global health milestones. FUNDING Bill & Melinda Gates Foundation.
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Nichols E, Steinmetz JD, Vollset SE, Fukutaki K, Chalek J, Abd-Allah F, Abdoli A, Abualhasan A, Abu-Gharbieh E, Akram TT, Al Hamad H, Alahdab F, Alanezi FM, Alipour V, Almustanyir S, Amu H, Ansari I, Arabloo J, Ashraf T, Astell-Burt T, Ayano G, Ayuso-Mateos JL, Baig AA, Barnett A, Barrow A, Baune BT, Béjot Y, Bezabhe WMM, Bezabih YM, Bhagavathula AS, Bhaskar S, Bhattacharyya K, Bijani A, Biswas A, Bolla SR, Boloor A, Brayne C, Brenner H, Burkart K, Burns RA, Cámera LA, Cao C, Carvalho F, Castro-de-Araujo LFS, Catalá-López F, Cerin E, Chavan PP, Cherbuin N, Chu DT, Costa VM, Couto RAS, Dadras O, Dai X, Dandona L, Dandona R, De la Cruz-Góngora V, Dhamnetiya D, Dias da Silva D, Diaz D, Douiri A, Edvardsson D, Ekholuenetale M, El Sayed I, El-Jaafary SI, Eskandari K, Eskandarieh S, Esmaeilnejad S, Fares J, Faro A, Farooque U, Feigin VL, Feng X, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fillit H, Fischer F, Gaidhane S, Galluzzo L, Ghashghaee A, Ghith N, Gialluisi A, Gilani SA, Glavan IR, Gnedovskaya EV, Golechha M, Gupta R, Gupta VB, Gupta VK, Haider MR, Hall BJ, Hamidi S, Hanif A, Hankey GJ, Haque S, Hartono RK, Hasaballah AI, Hasan MT, Hassan A, Hay SI, Hayat K, Hegazy MI, Heidari G, Heidari-Soureshjani R, Herteliu C, Househ M, Hussain R, Hwang BF, Iacoviello L, Iavicoli I, Ilesanmi OS, Ilic IM, Ilic MD, Irvani SSN, Iso H, Iwagami M, Jabbarinejad R, Jacob L, Jain V, Jayapal SK, Jayawardena R, Jha RP, Jonas JB, Joseph N, Kalani R, Kandel A, Kandel H, Karch A, Kasa AS, Kassie GM, Keshavarz P, Khan MAB, Khatib MN, Khoja TAM, Khubchandani J, Kim MS, Kim YJ, Kisa A, Kisa S, Kivimäki M, Koroshetz WJ, Koyanagi A, Kumar GA, Kumar M, Lak HM, Leonardi M, Li B, Lim SS, Liu X, Liu Y, Logroscino G, Lorkowski S, Lucchetti G, Lutzky Saute R, Magnani FG, Malik AA, Massano J, Mehndiratta MM, Menezes RG, Meretoja A, Mohajer B, Mohamed Ibrahim N, Mohammad Y, Mohammed A, Mokdad AH, Mondello S, Moni MAA, Moniruzzaman M, Mossie TB, Nagel G, Naveed M, Nayak VC, Neupane Kandel S, Nguyen TH, Oancea B, Otstavnov N, Otstavnov SS, Owolabi MO, Panda-Jonas S, Pashazadeh Kan F, Pasovic M, Patel UK, Pathak M, Peres MFP, Perianayagam A, Peterson CB, Phillips MR, Pinheiro M, Piradov MA, Pond CD, Potashman MH, Pottoo FH, Prada SI, Radfar A, Raggi A, Rahim F, Rahman M, Ram P, Ranasinghe P, Rawaf DL, Rawaf S, Rezaei N, Rezapour A, Robinson SR, Romoli M, Roshandel G, Sahathevan R, Sahebkar A, Sahraian MA, Sathian B, Sattin D, Sawhney M, Saylan M, Schiavolin S, Seylani A, Sha F, Shaikh MA, Shaji KS, Shannawaz M, Shetty JK, Shigematsu M, Shin JI, Shiri R, Silva DAS, Silva JP, Silva R, Singh JA, Skryabin VY, Skryabina AA, Smith AE, Soshnikov S, Spurlock EE, Stein DJ, Sun J, Tabarés-Seisdedos R, Thakur B, Timalsina B, Tovani-Palone MR, Tran BX, Tsegaye GW, Valadan Tahbaz S, Valdez PR, Venketasubramanian N, Vlassov V, Vu GT, Vu LG, Wang YP, Wimo A, Winkler AS, Yadav L, Yahyazadeh Jabbari SH, Yamagishi K, Yang L, Yano Y, Yonemoto N, Yu C, Yunusa I, Zadey S, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Murray CJL, Vos T. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health 2022; 7:e105-e125. [PMID: 34998485 PMCID: PMC8810394 DOI: 10.1016/s2468-2667(21)00249-8] [Citation(s) in RCA: 963] [Impact Index Per Article: 481.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/17/2021] [Accepted: 10/28/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. METHODS We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. FINDINGS We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4-65·1) million cases globally in 2019 to 152·8 (130·8-175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [-7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64-1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52-1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41-67]) and western Europe (74% [58-90]), and the largest in north Africa and the Middle East (367% [329-403]) and eastern sub-Saharan Africa (357% [323-395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. INTERPRETATION Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. FUNDING Bill & Melinda Gates Foundation and Gates Ventures.
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Alvarez EM, Force LM, Xu R, Compton K, Lu D, Henrikson HJ, Kocarnik JM, Harvey JD, Pennini A, Dean FE, Fu W, Vargas MT, Keegan THM, Ariffin H, Barr RD, Erdomaeva YA, Gunasekera DS, John-Akinola YO, Ketterl TG, Kutluk T, Malogolowkin MH, Mathur P, Radhakrishnan V, Ries LAG, Rodriguez-Galindo C, Sagoyan GB, Sultan I, Abbasi B, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abbastabar H, Abdelmasseh M, Abd-Elsalam S, Abdoli A, Abebe H, Abedi A, Abidi H, Abolhassani H, Abubaker Ali H, Abu-Gharbieh E, Achappa B, Acuna JM, Adedeji IA, Adegboye OA, Adnani QES, Advani SM, Afzal MS, Aghaie Meybodi M, Ahadinezhad B, Ahinkorah BO, Ahmad S, Ahmadi S, Ahmed MB, Ahmed Rashid T, Ahmed Salih Y, Aiman W, Akalu GT, Al Hamad H, Alahdab F, AlAmodi AA, Alanezi FM, Alanzi TM, Alem AZ, Alem DT, Alemayehu Y, Alhalaiqa FN, Alhassan RK, Ali S, Alicandro G, Alipour V, Aljunid SM, Alkhayyat M, Alluri S, Almasri NA, Al-Maweri SA, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Ameyaw EK, Amini S, Amu H, Ancuceanu R, Andrei CL, Andrei T, Ansari F, Ansari-Moghaddam A, Anvari D, Anyasodor AE, Arabloo J, Arab-Zozani M, Argaw AM, Arshad M, Arulappan J, Aryannejad A, Asemi Z, Asghari Jafarabadi M, Atashzar MR, Atorkey P, Atreya A, Attia S, Aujayeb A, Ausloos M, Avila-Burgos L, Awedew AF, Ayala Quintanilla BP, Ayele AD, Ayen SS, Azab MA, Azadnajafabad S, Azami H, Azangou-Khyavy M, Azari Jafari A, Azarian G, Azzam AY, Bahadory S, Bai J, Baig AA, Baker JL, Banach M, Bärnighausen TW, Barone-Adesi F, Barra F, Barrow A, Basaleem H, Batiha AMM, Behzadifar M, Bekele NC, Belete R, Belgaumi UI, Bell AW, Berhie AY, Bhagat DS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Birara S, Bjørge T, Bolarinwa OA, Bolla SR, Boloor A, Braithwaite D, Brenner H, Bulamu NB, Burkart K, Bustamante-Teixeira MT, Butt NS, Butt ZA, Caetano dos Santos FL, Cao C, Cao Y, Carreras G, Catalá-López F, Cembranel F, Cerin E, Chakinala RC, Chakraborty PA, Chattu VK, Chaturvedi P, Chaurasia A, Chavan PP, Chimed-Ochir O, Choi JYJ, Christopher DJ, Chu DT, Chung MT, Conde J, Costa VM, Da'ar OB, Dadras O, Dahlawi SMA, Dai X, Damiani G, D'Amico E, Dandona L, Dandona R, Daneshpajouhnejad P, Darwish AH, Daryani A, De la Hoz FP, Debela SA, Demie TGG, Demissie GD, Demissie ZG, Denova-Gutiérrez E, Derbew Molla M, Desai R, Desta AA, Dhamnetiya D, Dharmaratne SD, Dhimal ML, Dhimal M, Dianatinasab M, Didehdar M, Diress M, Djalalinia S, Do HP, Doaei S, Dorostkar F, dos Santos WM, Drake TM, Ekholuenetale M, El Sayed I, El Sayed Zaki M, El Tantawi M, El-Abid H, Elbahnasawy MA, Elbarazi I, Elhabashy HR, Elhadi M, El-Jaafary SI, Enyew DB, Erkhembayar R, Eshrati B, Eskandarieh S, Faisaluddin M, Fares J, Farooque U, Fasanmi AO, Fatima W, Ferreira de Oliveira JMP, Ferrero S, Ferro Desideri L, Fetensa G, Filip I, Fischer F, Fisher JL, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gaewkhiew P, Gallus S, Garg T, Gebremeskel TG, Gemeda BNB, Getachew T, Ghafourifard M, Ghamari SH, Ghashghaee A, Ghassemi F, Ghith N, Gholami A, Gholizadeh Navashenaq J, Gilani SA, Ginindza TG, Gizaw AT, Glasbey JC, Goel A, Golechha M, Goleij P, Golinelli D, Gopalani SV, Gorini G, Goudarzi H, Goulart BNG, Grada A, Gubari MIM, Guerra MR, Guha A, Gupta B, Gupta S, Gupta VB, Gupta VK, Haddadi R, Hafezi-Nejad N, Hailu A, Haj-Mirzaian A, Halwani R, Hamadeh RR, Hambisa MT, Hameed S, Hamidi S, Haque S, Hariri S, Haro JM, Hasaballah AI, Hasan SMM, Hashemi SM, Hassan TS, Hassanipour S, Hay SI, Hayat K, Hebo SH, Heidari G, Heidari M, Herrera-Serna BY, Herteliu C, Heyi DZ, Hezam K, Hole MK, Holla R, Horita N, Hossain MM, Hossain MB, Hosseini MS, Hosseini M, Hosseinzadeh A, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huang J, Hussein NR, Hwang BF, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Innos K, Irham LM, Islam RM, Islam SMS, Ismail NE, Isola G, Iwagami M, Jacob L, Jadidi-Niaragh F, Jain V, Jakovljevic M, Janghorban R, Javadi Mamaghani A, Jayaram S, Jayawardena R, Jazayeri SB, Jebai R, Jha RP, Joo T, Joseph N, Joukar F, Jürisson M, Kaambwa B, Kabir A, Kalankesh LR, Kaliyadan F, Kamal Z, Kamath A, Kandel H, Kar SS, Karaye IM, Karimi A, Kassa BG, Kauppila JH, Kemp Bohan PM, Kengne AP, Kerbo AA, Keykhaei M, Khader YS, Khajuria H, Khalili N, Khalili N, Khan EA, Khan G, Khan M, Khan MN, Khan MAB, Khanali J, Khayamzadeh M, Khosravizadeh O, Khubchandani J, Khundkar R, Kim MS, Kim YJ, Kisa A, Kisa S, Kissimova-Skarbek K, Kolahi AA, Kopec JA, Koteeswaran R, Koulmane Laxminarayana SL, Koyanagi A, Kugbey N, Kumar GA, Kumar N, Kwarteng A, La Vecchia C, Lan Q, Landires I, Lasrado S, Lauriola P, Ledda C, Lee SW, Lee WC, Lee YY, Lee YH, Leigh J, Leong E, Li B, Li J, Li MC, Lim SS, Liu X, Lobo SW, Loureiro JA, Lugo A, Lunevicius R, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahmoudi M, Majeed A, Makki A, Male S, Malekpour MR, Malekzadeh R, Malik AA, Mamun MA, Manafi N, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Martini S, Masoumi SZ, Matei CN, Mathur MR, McAlinden C, Mehrotra R, Mendoza W, Menezes RG, Mentis AFA, Meretoja TJ, Mersha AG, Mesregah MK, Mestrovic T, Miao Jonasson J, Miazgowski B, Michalek IM, Miller TR, Mingude AB, Mirmoeeni S, Mirzaei H, Misra S, Mithra P, Mohammad KA, Mohammadi M, Mohammadi SM, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed A, Mohammed S, Mohammed TA, Moka N, Mokdad AH, Molokhia M, Momtazmanesh S, Monasta L, Moni MA, Moradi G, Moradi Y, Moradzadeh M, Moradzadeh R, Moraga P, Morrison SD, Mostafavi E, Mousavi Khaneghah A, Mpundu-Kaambwa C, Mubarik S, Mwanri L, Nabhan AF, Nagaraju SP, Nagata C, Naghavi M, Naimzada MD, Naldi L, Nangia V, Naqvi AA, Narasimha Swamy S, Narayana AI, Nayak BP, Nayak VC, Nazari J, Nduaguba SO, Negoi I, Negru SM, Nejadghaderi SA, Nepal S, Neupane Kandel S, Nggada HA, Nguyen CT, Nnaji CA, Nosrati H, Nouraei H, Nowroozi A, Nuñez-Samudio V, Nwatah VE, Nzoputam CI, Oancea B, Odukoya OO, Oguntade AS, Oh IH, Olagunju AT, Olagunju TO, Olakunde BO, Oluwasanu MM, Omar E, Omar Bali A, Ong S, Onwujekwe OE, Ortega-Altamirano DV, Otstavnov N, Otstavnov SS, Oumer B, Owolabi MO, P A M, Padron-Monedero A, Padubidri JR, Pakshir K, Pana A, Pandey A, Pardhan S, Pashazadeh Kan F, Pasovic M, Patel JR, Pati S, Pattanshetty SM, Paudel U, Pereira RB, Peres MFP, Perianayagam A, Postma MJ, Pourjafar H, Pourshams A, Prashant A, Pulakunta T, Qadir MMFF, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Rafiee A, Rafiei A, Rafiei S, Rahim F, Rahimzadeh S, Rahman M, Rahman MA, Rahmani AM, Rajesh A, Ramezani-Doroh V, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rashedi S, Rashidi M, Rashidi MM, Rath GK, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Razeghinia MS, Regasa MT, Renzaho AMN, Rezaei M, Rezaei N, Rezaei N, Rezaeian M, Rezapour A, Rezazadeh-Khadem S, Riad A, Rios Lopez LE, Rodriguez JAB, Ronfani L, Roshandel G, Rwegerera GM, Saber-Ayad MM, Sabour S, Saddik B, Sadeghi E, Sadeghian S, Saeed U, Sahebkar A, Saif-Ur-Rahman KM, Sajadi SM, Salahi S, Salehi S, Salem MR, Salimzadeh H, Samy AM, Sanabria J, Sanmarchi F, Sarveazad A, Sathian B, Sawhney M, Sawyer SM, Saylan M, Schneider IJC, Seidu AA, Šekerija M, Sendo EG, Sepanlou SG, Seylani A, Seyoum K, Sha F, Shafaat O, Shaikh MA, Shamsoddin E, Shannawaz M, Sharma R, Sheikhbahaei S, Shetty A, Shetty BSK, Shetty PH, Shin JI, Shirkoohi R, Shivakumar KM, Shobeiri P, Siabani S, Sibhat MM, Siddappa Malleshappa SK, Sidemo NB, Silva DAS, Silva Julian G, Singh AD, Singh JA, Singh JK, Singh S, Sinke AH, Sintayehu Y, Skryabin VY, Skryabina AA, Smith L, Sofi-Mahmudi A, Soltani-Zangbar MS, Song S, Spurlock EE, Steiropoulos P, Straif K, Subedi R, Sufiyan MB, Suliankatchi Abdulkader R, Sultana S, Szerencsés V, Szócska M, Tabaeian SP, Tabarés-Seisdedos R, Tabary M, Tabuchi T, Tadbiri H, Taheri M, Taherkhani A, Takahashi K, Tampa M, Tan KK, Tat VY, Tavakoli A, Tbakhi A, Tehrani-Banihashemi A, Temsah MH, Tesfay FH, Tesfaye B, Thakur JS, Thapar R, Thavamani A, Thiyagarajan A, Thomas N, Tobe-Gai R, Togtmol M, Tohidast SA, Tohidinik HR, Tolani MA, Tollosa DN, Touvier M, Tovani-Palone MR, Traini E, Tran BX, Tran MTN, Tripathy JP, Tusa BS, Ukke GG, Ullah I, Ullah S, Umapathi KK, Unnikrishnan B, Upadhyay E, Ushula TW, Vacante M, Valadan Tahbaz S, Varthya SB, Veroux M, Villeneuve PJ, Violante FS, Vlassov V, Vu GT, Waheed Y, Wang N, Ward P, Weldesenbet AB, Wen YF, Westerman R, Winkler AS, Wubishet BL, Xu S, Yahyazadeh Jabbari SH, Yang L, Yaya S, Yazdi-Feyzabadi V, Yazie TS, Yehualashet SS, Yeshaneh A, Yeshaw Y, Yirdaw BW, Yonemoto N, Younis MZ, Yousefi Z, Yu C, Yunusa I, Zadnik V, Zahir M, Zahirian Moghadam T, Zamani M, Zamanian M, Zandian H, Zare F, Zastrozhin MS, Zastrozhina A, Zhang J, Zhang ZJ, Ziapour A, Zoladl M, Murray CJL, Fitzmaurice C, Bleyer A, Bhakta N. The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Oncol 2022; 23:27-52. [PMID: 34871551 PMCID: PMC8716339 DOI: 10.1016/s1470-2045(21)00581-7] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. METHODS Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. FINDINGS There were 1·19 million (95% UI 1·11-1·28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5-65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8-57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9-15·6] per 100 000 person-years) and middle SDI (13·6 [12·6-14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9-25·2) DALYs to the global burden of disease, of which 2·7% (1·9-3·6) came from YLDs and 97·3% (96·4-98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. INTERPRETATION Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. FUNDING Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute.
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Ward JL, Azzopardi PS, Francis KL, Santelli JS, Skirbekk V, Sawyer SM, Kassebaum NJ, Mokdad AH, Hay SI, Abd-Allah F, Abdoli A, Abdollahi M, Abedi A, Abolhassani H, Abreu LG, Abrigo MRM, Abu-Gharbieh E, Abushouk AI, Adebayo OM, Adekanmbi V, Adham D, Advani SM, Afshari K, Agrawal A, Ahmad T, Ahmadi K, Ahmed AE, Aji B, Akombi-Inyang B, Alahdab F, Al-Aly Z, Alam K, Alanezi FM, Alanzi TM, Alcalde-Rabanal JE, Alemu BW, Al-Hajj S, Alhassan RK, Ali S, Alicandro G, Alijanzadeh M, Aljunid SM, Almasi-Hashiani A, Almasri NA, Al-Mekhlafi HM, Alonso J, Al-Raddadi RM, Altirkawi KA, Alvis-Guzman N, Amare AT, Amini S, Aminorroaya A, Amit AML, Amugsi DA, Ancuceanu R, Anderlini D, Andrei CL, Androudi S, Ansari F, Ansari I, Antonio CAT, Anvari D, Anwer R, Appiah SCY, Arabloo J, Arab-Zozani M, Ärnlöv J, Asaad M, Asadi-Aliabadi M, Asadi-Pooya AA, Atout MMW, Ausloos M, Avenyo EK, Avila-Burgos L, Ayala Quintanilla BP, Ayano G, Aynalem YA, Azari S, Azene ZN, Bakhshaei MH, Bakkannavar SM, Banach M, Banik PC, Barboza MA, Barker-Collo SL, Bärnighausen TW, Basu S, Baune BT, Bayati M, Bedi N, Beghi E, Bekuma TT, Bell AW, Bell ML, Benjet C, Bensenor IM, Berhe AK, Berhe K, Berman AE, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhattarai S, Bhutta ZA, Bijani A, Bikbov B, Biondi A, Birhanu TTM, Biswas RK, Bohlouli S, Bolla SR, Boloor A, Borschmann R, Boufous S, Bragazzi NL, Braithwaite D, Breitborde NJK, Brenner H, Britton GB, Burns RA, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Cámera LA, Campos-Nonato IR, Campuzano Rincon JC, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Cerin E, Chandan JS, Chang HY, Chang JC, Charan J, Chattu VK, Chaturvedi S, Choi JYJ, Chowdhury MAK, Christopher DJ, Chu DT, Chung MT, Chung SC, Cicuttini FM, Constantin TV, Costa VM, Dahlawi SMA, Dai H, Dai X, Damiani G, Dandona L, Dandona R, Daneshpajouhnejad P, Darwesh AM, Dávila-Cervantes CA, Davletov K, De la Hoz FP, De Leo D, Dervenis N, Desai R, Desalew A, Deuba K, Dharmaratne SD, Dhungana GP, Dianatinasab M, Dias da Silva D, Diaz D, Didarloo A, Djalalinia S, Dorostkar F, Doshi CP, Doshmangir L, Doyle KE, Duraes AR, Ebrahimi Kalan M, Ebtehaj S, Edvardsson D, El Tantawi M, Elgendy IY, El-Jaafary SI, Elsharkawy A, Eshrati B, Eskandarieh S, Esmaeilnejad S, Esmaeilzadeh F, Esteghamati S, Faro A, Farzadfar F, Fattahi N, Feigin VL, Ferede TY, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fischer F, Fisher JL, Foigt NA, Folayan MO, Fomenkov AA, Foroutan M, Fukumoto T, Gad MM, Gaidhane AM, Gallus S, Gebre T, Gebremedhin KB, Gebremeskel GG, Gebremeskel L, Gebreslassie AA, Gesesew HA, Ghadiri K, Ghafourifard M, Ghamari F, Ghashghaee A, Gilani SA, Gnedovskaya EV, Godinho MA, Golechha M, Goli S, Gona PN, Gopalani SV, Gorini G, Grivna M, Gubari MIM, Gugnani HC, Guimarães RA, Guo Y, Gupta R, Haagsma JA, Hafezi-Nejad N, Haile TG, Haj-Mirzaian A, Haj-Mirzaian A, Hall BJ, Hamadeh RR, Hamagharib Abdullah K, Hamidi S, Handiso DW, Hanif A, Hankey GJ, Haririan H, Haro JM, Hasaballah AI, Hashi A, Hassan A, Hassanipour S, Hassankhani H, Hayat K, Heidari-Soureshjani R, Herteliu C, Heydarpour F, Ho HC, Hole MK, Holla R, Hoogar P, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huda TM, Humayun A, Hussain R, Hwang BF, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Intarut N, Iqbal U, Irvani SSN, Islam MM, Islam SMS, Iso H, Ivers RQ, Jahani MA, Jakovljevic M, Jalali A, Janodia MD, Javaheri T, Jeemon P, Jenabi E, Jha RP, Jha V, Ji JS, Jonas JB, Jones KM, Joukar F, Jozwiak JJ, Juliusson PB, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kalhor R, Kamyari N, Kanchan T, Karch A, Karimi SE, Kaur S, Kayode GA, Keiyoro PN, Khalid N, Khammarnia M, Khan M, Khan MN, Khatab K, Khater MM, Khatib MN, Khayamzadeh M, Khazaie H, Khoja AT, Kieling C, Kim YE, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kivimäki M, Koolivand A, Kosen S, Koyanagi A, Krishan K, Kugbey N, Kumar GA, Kumar M, Kumar N, Kurmi OP, Kusuma D, La Vecchia C, Lacey B, Lal DK, Lalloo R, Lan Q, Landires I, Lansingh VC, Larsson AO, Lasrado S, Lassi ZS, Lauriola P, Lee PH, Lee SWH, Leigh J, Leonardi M, Leung J, Levi M, Lewycka S, Li B, Li MC, Li S, Lim LL, Lim SS, Liu X, Lorkowski S, Lotufo PA, Lunevicius R, Maddison R, Mahasha PW, Mahdavi MM, Mahmoudi M, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mamun AA, Mansouri B, Mansournia MA, Martinez G, Martinez-Raga J, Martins-Melo FR, Mason-Jones AJ, Masoumi SZ, Mathur MR, Maulik PK, McGrath JJ, Mehndiratta MM, Mehri F, Memiah PTN, Mendoza W, Menezes RG, Mengesha EW, Meretoja A, Meretoja TJ, Mestrovic T, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mirzaei H, Mirzaei M, Moazen B, Mohammad DK, Mohammadi S, Mohammadian-Hafshejani A, Mohammadifard N, Mohammadpourhodki R, Mohammed S, Monasta L, Moradi G, Moradi-Lakeh M, Moradzadeh R, Moraga P, Morrison SD, Mosapour A, Mousavi Khaneghah A, Mueller UO, Muriithi MK, Murray CJL, Muthupandian S, Naderi M, Nagarajan AJ, Naghavi M, Naimzada MD, Nangia V, Nayak VC, Nazari J, Ndejjo R, Negoi I, Negoi RI, Netsere HB, Nguefack-Tsague G, Nguyen DN, Nguyen HLT, Nie J, Ningrum DNA, Nnaji CA, Nomura S, Noubiap JJ, Nowak C, Nuñez-Samudio V, Ogbo FA, Oghenetega OB, Oh IH, Oladnabi M, Olagunju AT, Olusanya BO, Olusanya JO, Omar Bali A, Omer MO, Onwujekwe OE, Ortiz A, Otoiu A, Otstavnov N, Otstavnov SS, Øverland S, Owolabi MO, P A M, Padubidri JR, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Pandey A, Panelo CIA, Park EK, Patten SB, Peden AE, Pepito VCF, Peprah EK, Pereira J, Pesudovs K, Pham HQ, Phillips MR, Piradov MA, Pirsaheb M, Postma MJ, Pottoo FH, Pourjafar H, Pourshams A, Prada SI, Pupillo E, Quazi Syed Z, Rabiee MH, Rabiee N, Radfar A, Rafiee A, Raggi A, Rahim F, Rahimi-Movaghar V, Rahman MHU, Rahman MA, Ramezanzadeh K, Ranabhat CL, Rao SJ, Rashedi V, Rastogi P, Rathi P, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Renzaho AMN, Rezaei N, Rezaei N, Rezai MS, Riahi SM, Rickard J, Roever L, Ronfani L, Roth GA, Rubagotti E, Rumisha SF, Rwegerera GM, Sabour S, Sachdev PS, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sagar R, Sahebkar A, Sahraian MA, Sajadi SM, Salem MR, Salimzadeh H, Samy AM, Sanabria J, Santric-Milicevic MM, Saraswathy SYI, Sarrafzadegan N, Sarveazad A, Sathish T, Sattin D, Saxena D, Saxena S, Schiavolin S, Schwebel DC, Schwendicke F, Senthilkumaran S, Sepanlou SG, Sha F, Shafaat O, Shahabi S, Shaheen AA, Shaikh MA, Shakiba S, Shamsi M, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shetty BSK, Shi P, Shigematsu M, Shin JI, Shiri R, Shuval K, Siabani S, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Silva JP, Simonetti B, Singh JA, Singh V, Sinke AH, Skryabin VY, Slater H, Smith EUR, Sobhiyeh MR, Sobngwi E, Soheili A, Somefun OD, Sorrie MB, Soyiri IN, Sreeramareddy CT, Stein DJ, Stokes MA, Sudaryanto A, Sultan I, Tabarés-Seisdedos R, Tabuchi T, Tadakamadla SK, Taherkhani A, Tamiru AT, Tareque MI, Thankappan KR, Thapar R, Thomas N, Titova MV, Tonelli M, Tovani-Palone MR, Tran BX, Travillian RS, Tsai AC, Tsatsakis A, Tudor Car L, Uddin R, Unim B, Unnikrishnan B, Upadhyay E, Vacante M, Valadan Tahbaz S, Valdez PR, Varughese S, Vasankari TJ, Venketasubramanian N, Villeneuve PJ, Violante FS, Vlassov V, Vos T, Vu GT, Waheed Y, Wamai RG, Wang Y, Wang Y, Wang YP, Westerman R, Wickramasinghe ND, Wu AM, Wu C, Yahyazadeh Jabbari SH, Yamagishi K, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yeshitila YG, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yousefinezhadi T, Yu C, Yu Y, Yuce D, Zaidi SS, Zaman SB, Zamani M, Zamanian M, Zarafshan H, Zarei A, Zastrozhin MS, Zhang Y, Zhang ZJ, Zhao XJG, Zhu C, Patton GC, Viner RM. Global, regional, and national mortality among young people aged 10-24 years, 1950-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2021; 398:1593-1618. [PMID: 34755628 PMCID: PMC8576274 DOI: 10.1016/s0140-6736(21)01546-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/07/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10-24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10-24 years by age group (10-14 years, 15-19 years, and 20-24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10-24 years with that in children aged 0-9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10-24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). FINDINGS In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39-1·59) worldwide in people aged 10-24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10-14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15-19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1-4 years (2·4%), and around a third less than in females aged 1-4 years (2·5%). The proportion of global deaths in people aged 0-24 years that occurred in people aged 10-24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. INTERPRETATION Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10-24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. FUNDING Bill & Melinda Gates Foundation.
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Micah AE, Cogswell IE, Cunningham B, Ezoe S, Harle AC, Maddison ER, McCracken D, Nomura S, Simpson KE, Stutzman HN, Tsakalos G, Wallace LE, Zhao Y, Zende RR, Abbafati C, Abdelmasseh M, Abedi A, Abegaz KH, Abhilash ES, Abolhassani H, Abrigo MRM, Adhikari TB, Afzal S, Ahinkorah BO, Ahmadi S, Ahmed H, Ahmed MB, Ahmed Rashid T, Ajami M, Aji B, Akalu Y, Akunna CJ, Al Hamad H, Alam K, Alanezi FM, Alanzi TM, Alemayehu Y, Alhassan RK, Alinia C, Aljunid SM, Almustanyir SA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amini S, Amini-Rarani M, Amu H, Ancuceanu R, Andrei CL, Andrei T, Angell B, Anjomshoa M, Antonio CAT, Antony CM, Aqeel M, Arabloo J, Arab-Zozani M, Aripov T, Arrigo A, Ashraf T, Atnafu DD, Ausloos M, Avila-Burgos L, Awan AT, Ayano G, Ayanore MA, Azari S, Azhar GS, Babalola TK, Bahrami MA, Baig AA, Banach M, Barati N, Bärnighausen TW, Barrow A, Basu S, Baune BT, Bayati M, Benzian H, Berman AE, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhaskar S, Bibi S, Bijani A, Bodolica V, Bragazzi NL, Braithwaite D, Breitborde NJK, Breusov AV, Briko NI, Busse R, Cahuana-Hurtado L, Callander EJ, Cámera LA, Castañeda-Orjuela CA, Catalá-López F, Charan J, Chatterjee S, Chattu SK, Chattu VK, Chen S, Cicero AFG, Dadras O, Dahlawi SMA, Dai X, Dalal K, Dandona L, Dandona R, Davitoiu DV, De Neve JW, de Sá-Junior AR, Denova-Gutiérrez E, Dhamnetiya D, Dharmaratne SD, Doshmangir L, Dube J, Ehsani-Chimeh E, El Sayed Zaki M, El Tantawi M, Eskandarieh S, Farzadfar F, Ferede TY, Fischer F, Foigt NA, Freitas A, Friedman SD, Fukumoto T, Fullman N, Gaal PA, Gad MM, Garcia-Gordillo MA, Garg T, Ghafourifard M, Ghashghaee A, Gholamian A, Gholamrezanezhad A, Ghozali G, Gilani SA, Glăvan IR, Glushkova EV, Goharinezhad S, Golechha M, Goli S, Guha A, Gupta VB, Gupta VK, Haakenstad A, Haider MR, Hailu A, Hamidi S, Hanif A, Harapan H, Hartono RK, Hasaballah AI, Hassan S, Hassanein MH, Hayat K, Hegazy MI, Heidari G, Hendrie D, Heredia-Pi I, Herteliu C, Hezam K, Holla R, Hossain SJ, Hosseinzadeh M, Hostiuc S, Huda TM, Hwang BF, Iavicoli I, Idrisov B, Ilesanmi OS, Irvani SSN, Islam SMS, Ismail NE, Isola G, Jahani MA, Jahanmehr N, Jakovljevic M, Janodia MD, Javaheri T, Jayapal SK, Jayawardena R, Jazayeri SB, Jha RP, Jonas JB, Joo T, Joukar F, Jürisson M, Kaambwa B, Kalhor R, Kanchan T, Kandel H, Karami Matin B, Karimi SE, Kassahun G, Kayode GA, Kazemi Karyani A, Keikavoosi-Arani L, Khader YS, Khajuria H, Khalilov R, Khammarnia M, Khan J, Khubchandani J, Kianipour N, Kim GR, Kim YJ, Kisa A, Kisa S, Kohler S, Kosen S, Koteeswaran R, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kumar GA, Kusuma D, Lamnisos D, Lansingh VC, Larsson AO, Lasrado S, Le LKD, Lee SWH, Lee YY, Lim SS, Lobo SW, Lozano R, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahdavi MM, Majeed A, Makki A, Maleki A, Malekzadeh R, Manda AL, Mansour-Ghanaei F, Mansournia MA, Marrugo Arnedo CA, Martinez-Valle A, Masoumi SZ, Maude RJ, McKee M, Medina-Solís CE, Menezes RG, Meretoja A, Meretoja TJ, Mesregah MK, Mestrovic T, Milevska Kostova N, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mohajer B, Mohamed TA, Mohammadi M, Mohammadian-Hafshejani A, Mohammed S, Moitra M, Mokdad AH, Molokhia M, Moni MA, Moradi Y, Morze J, Mousavi SM, Mpundu-Kaambwa C, Muriithi MK, Muthupandian S, Nagarajan AJ, Naimzada MD, Nangia V, Naqvi AA, Narayana AI, Nascimento BR, Naveed M, Nayak BP, Nazari J, Ndejjo R, Negoi I, Neupane Kandel S, Nguyen TH, Nonvignon J, Noubiap JJ, Nwatah VE, Oancea B, Ojelabi FAO, Olagunju AT, Olakunde BO, Olgiati S, Olusanya JO, Onwujekwe OE, Otoiu A, Otstavnov N, Otstavnov SS, Owolabi MO, Padubidri JR, Palladino R, Panda-Jonas S, Park EC, Pashazadeh Kan F, Pawar S, Pazoki Toroudi H, Pereira DM, Perianayagam A, Pesudovs K, Piccinelli C, Postma MJ, Prada SI, Rabiee M, Rabiee N, Rahim F, Rahimi-Movaghar V, Rahman MHU, Rahman M, Rahmani AM, Ram U, Ranabhat CL, Ranasinghe P, Rao CR, Rathi P, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Reiner Jr RC, Renzaho AMN, Reshmi B, Riaz MA, Ripon RK, Saad AM, Sahraian MA, Sahu M, Salama JS, Salehi S, Samy AM, Sanabria J, Sanmarchi F, Santos JV, Santric-Milicevic MM, Sathian B, Savic M, Saxena D, Sayyah M, Schwendicke F, Senthilkumaran S, Sepanlou SG, Seylani A, Shahabi S, Shaikh MA, Sheikh A, Shetty A, Shetty PH, Shibuya K, Shrime MG, Shuja KH, Singh JA, Skryabin VY, Skryabina AA, Soltani S, Soofi M, Spurlock EE, Stefan SC, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Taddele BW, Tefera YG, Thavamani A, Tobe-Gai R, Topor-Madry R, Tovani-Palone MR, Tran BX, Tudor Car L, Ullah A, Ullah S, Umar N, Undurraga EA, Valdez PR, Vasankari TJ, Villafañe JH, Violante FS, Vlassov V, Vo B, Vollmer S, Vos T, Vu GT, Vu LG, Wamai RG, Werdecker A, Woldekidan MA, Wubishet BL, Xu G, Yaya S, Yazdi-Feyzabadi V, Yiğit V, Yip P, Yirdaw BW, Yonemoto N, Younis MZ, Yu C, Yunusa I, Zahirian Moghadam T, Zandian H, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Ziapour A, Zuniga YMH, Hay SI, Murray CJL, Dieleman JL. Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050. Lancet 2021; 398:1317-1343. [PMID: 34562388 PMCID: PMC8457757 DOI: 10.1016/s0140-6736(21)01258-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/15/2021] [Accepted: 05/20/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. METHODS We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. FINDINGS In 2019, health spending globally reached $8·8 trillion (95% uncertainty interval [UI] 8·7-8·8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40·4 billion (0·5%, 95% UI 0·5-0·5) was development assistance for health provided to low-income and middle-income countries, which made up 24·6% (UI 24·0-25·1) of total spending in low-income countries. We estimate that $54·8 billion in development assistance for health was disbursed in 2020. Of this, $13·7 billion was targeted toward the COVID-19 health response. $12·3 billion was newly committed and $1·4 billion was repurposed from existing health projects. $3·1 billion (22·4%) of the funds focused on country-level coordination and $2·4 billion (17·9%) was for supply chain and logistics. Only $714·4 million (7·7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34·3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. INTERPRETATION Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. FUNDING Bill & Melinda Gates Foundation.
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Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, Abbasifard M, Abbasi-Kangevari M, Abd-Allah F, Abedi V, Abualhasan A, Abu-Rmeileh NME, Abushouk AI, Adebayo OM, Agarwal G, Agasthi P, Ahinkorah BO, Ahmad S, Ahmadi S, Ahmed Salih Y, Aji B, Akbarpour S, Akinyemi RO, Al Hamad H, Alahdab F, Alif SM, Alipour V, Aljunid SM, Almustanyir S, Al-Raddadi RM, Al-Shahi Salman R, Alvis-Guzman N, Ancuceanu R, Anderlini D, Anderson JA, Ansar A, Antonazzo IC, Arabloo J, Ärnlöv J, Artanti KD, Aryan Z, Asgari S, Ashraf T, Athar M, Atreya A, Ausloos M, Baig AA, Baltatu OC, Banach M, Barboza MA, Barker-Collo SL, Bärnighausen TW, Barone MTU, Basu S, Bazmandegan G, Beghi E, Beheshti M, Béjot Y, Bell AW, Bennett DA, Bensenor IM, Bezabhe WM, Bezabih YM, Bhagavathula AS, Bhardwaj P, Bhattacharyya K, Bijani A, Bikbov B, Birhanu MM, Boloor A, Bonny A, Brauer M, Brenner H, Bryazka D, Butt ZA, Caetano dos Santos FL, Campos-Nonato IR, Cantu-Brito C, Carrero JJ, Castañeda-Orjuela CA, Catapano AL, Chakraborty PA, Charan J, Choudhari SG, Chowdhury EK, Chu DT, Chung SC, Colozza D, Costa VM, Costanzo S, Criqui MH, Dadras O, Dagnew B, Dai X, Dalal K, Damasceno AAM, D'Amico E, Dandona L, Dandona R, Darega Gela J, Davletov K, De la Cruz-Góngora V, Desai R, Dhamnetiya D, Dharmaratne SD, Dhimal ML, Dhimal M, Diaz D, Dichgans M, Dokova K, Doshi R, Douiri A, Duncan BB, Eftekharzadeh S, Ekholuenetale M, El Nahas N, Elgendy IY, Elhadi M, El-Jaafary SI, Endres M, Endries AY, Erku DA, Faraon EJA, Farooque U, Farzadfar F, Feroze AH, Filip I, Fischer F, Flood D, Gad MM, Gaidhane S, Ghanei Gheshlagh R, Ghashghaee A, Ghith N, Ghozali G, Ghozy S, Gialluisi A, Giampaoli S, Gilani SA, Gill PS, Gnedovskaya EV, Golechha M, Goulart AC, Guo Y, Gupta R, Gupta VB, Gupta VK, Gyanwali P, Hafezi-Nejad N, Hamidi S, Hanif A, Hankey GJ, Hargono A, Hashi A, Hassan TS, Hassen HY, Havmoeller RJ, Hay SI, Hayat K, Hegazy MI, Herteliu C, Holla R, Hostiuc S, Househ M, Huang J, Humayun A, Hwang BF, Iacoviello L, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Iqbal U, Irvani SSN, Islam SMS, Ismail NE, Iso H, Isola G, Iwagami M, Jacob L, Jain V, Jang SI, Jayapal SK, Jayaram S, Jayawardena R, Jeemon P, Jha RP, Johnson WD, Jonas JB, Joseph N, Jozwiak JJ, Jürisson M, Kalani R, Kalhor R, Kalkonde Y, Kamath A, Kamiab Z, Kanchan T, Kandel H, Karch A, Katoto PDMC, Kayode GA, Keshavarz P, Khader YS, Khan EA, Khan IA, Khan M, Khan MAB, Khatib MN, Khubchandani J, Kim GR, Kim MS, Kim YJ, Kisa A, Kisa S, Kivimäki M, Kolte D, Koolivand A, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Krishnamoorthy V, Krishnamurthi RV, Kumar GA, Kusuma D, La Vecchia C, Lacey B, Lak HM, Lallukka T, Lasrado S, Lavados PM, Leonardi M, Li B, Li S, Lin H, Lin RT, Liu X, Lo WD, Lorkowski S, Lucchetti G, Lutzky Saute R, Magdy Abd El Razek H, Magnani FG, Mahajan PB, Majeed A, Makki A, Malekzadeh R, Malik AA, Manafi N, Mansournia MA, Mantovani LG, Martini S, Mazzaglia G, Mehndiratta MM, Menezes RG, Meretoja A, Mersha AG, Miao Jonasson J, Miazgowski B, Miazgowski T, Michalek IM, Mirrakhimov EM, Mohammad Y, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Mokhayeri Y, Molokhia M, Moni MA, Montasir AA, Moradzadeh R, Morawska L, Morze J, Muruet W, Musa KI, Nagarajan AJ, Naghavi M, Narasimha Swamy S, Nascimento BR, Negoi RI, Neupane Kandel S, Nguyen TH, Norrving B, Noubiap JJ, Nwatah VE, Oancea B, Odukoya OO, Olagunju AT, Orru H, Owolabi MO, Padubidri JR, Pana A, Parekh T, Park EC, Pashazadeh Kan F, Pathak M, Peres MFP, Perianayagam A, Pham TM, Piradov MA, Podder V, Polinder S, Postma MJ, Pourshams A, Radfar A, Rafiei A, Raggi A, Rahim F, Rahimi-Movaghar V, Rahman M, Rahman MA, Rahmani AM, Rajai N, Ranasinghe P, Rao CR, Rao SJ, Rathi P, Rawaf DL, Rawaf S, Reitsma MB, Renjith V, Renzaho AMN, Rezapour A, Rodriguez JAB, Roever L, Romoli M, Rynkiewicz A, Sacco S, Sadeghi M, Saeedi Moghaddam S, Sahebkar A, Saif-Ur-Rahman KM, Salah R, Samaei M, Samy AM, Santos IS, Santric-Milicevic MM, Sarrafzadegan N, Sathian B, Sattin D, Schiavolin S, Schlaich MP, Schmidt MI, Schutte AE, Sepanlou SG, Seylani A, Sha F, Shahabi S, Shaikh MA, Shannawaz M, Shawon MSR, Sheikh A, Sheikhbahaei S, Shibuya K, Siabani S, Silva DAS, Singh JA, Singh JK, Skryabin VY, Skryabina AA, Sobaih BH, Stortecky S, Stranges S, Tadesse EG, Tarigan IU, Temsah MH, Teuschl Y, Thrift AG, Tonelli M, Tovani-Palone MR, Tran BX, Tripathi M, Tsegaye GW, Ullah A, Unim B, Unnikrishnan B, Vakilian A, Valadan Tahbaz S, Vasankari TJ, Venketasubramanian N, Vervoort D, Vo B, Volovici V, Vosoughi K, Vu GT, Vu LG, Wafa HA, Waheed Y, Wang Y, Wijeratne T, Winkler AS, Wolfe CDA, Woodward M, Wu JH, Wulf Hanson S, Xu X, Yadav L, Yadollahpour A, Yahyazadeh Jabbari SH, Yamagishi K, Yatsuya H, Yonemoto N, Yu C, Yunusa I, Zaman MS, Zaman SB, Zamanian M, Zand R, Zandifar A, Zastrozhin MS, Zastrozhina A, Zhang Y, Zhang ZJ, Zhong C, Zuniga YMH, Murray CJL. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2021; 20:795-820. [PMID: 34487721 PMCID: PMC8443449 DOI: 10.1016/s1474-4422(21)00252-0] [Citation(s) in RCA: 1651] [Impact Index Per Article: 550.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/01/2021] [Accepted: 07/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. METHODS We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. FINDINGS In 2019, there were 12·2 million (95% UI 11·0-13·6) incident cases of stroke, 101 million (93·2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6·55 million (6·00-7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8-12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1-6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0-73·0), prevalent strokes increased by 85·0% (83·0-88·0), deaths from stroke increased by 43·0% (31·0-55·0), and DALYs due to stroke increased by 32·0% (22·0-42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0-18·0), mortality decreased by 36·0% (31·0-42·0), prevalence decreased by 6·0% (5·0-7·0), and DALYs decreased by 36·0% (31·0-42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0-24·0) and incidence rates increased by 15·0% (12·0-18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5-3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5-3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57-8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97-3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01-1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7-90·8] DALYs or 55·5% [48·2-62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3-48·6] DALYs or 24·3% [15·7-33·2]), high fasting plasma glucose (28·9 million [19·8-41·5] DALYs or 20·2% [13·8-29·1]), ambient particulate matter pollution (28·7 million [23·4-33·4] DALYs or 20·1% [16·6-23·0]), and smoking (25·3 million [22·6-28·2] DALYs or 17·6% [16·4-19·0]). INTERPRETATION The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. FUNDING Bill & Melinda Gates Foundation.
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Paulson KR, Kamath AM, Alam T, Bienhoff K, Abady GG, Abbas J, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, Abd-Elsalam SM, Abdoli A, Abedi A, Abolhassani H, Abreu LG, Abu-Gharbieh E, Abu-Rmeileh NME, Abushouk AI, Adamu AL, Adebayo OM, Adegbosin AE, Adekanmbi V, Adetokunboh OO, Adeyinka DA, Adsuar JC, Afshari K, Aghaali M, Agudelo-Botero M, Ahinkorah BO, Ahmad T, Ahmadi K, Ahmed MB, Aji B, Akalu Y, Akinyemi OO, Aklilu A, Al-Aly Z, Alam K, Alanezi FM, Alanzi TM, Alcalde-Rabanal JE, Al-Eyadhy A, Ali T, Alicandro G, Alif SM, Alipour V, Alizade H, Aljunid SM, Almasi-Hashiani A, Almasri NA, Al-Mekhlafi HM, Alonso J, Al-Raddadi RM, Altirkawi KA, Alumran AK, Alvis-Guzman N, Alvis-Zakzuk NJ, Ameyaw EK, Amini S, Amini-Rarani M, Amit AML, Amugsi DA, Ancuceanu R, Anderlini D, Andrei CL, Ansari F, Ansari-Moghaddam A, Antonio CAT, Antriyandarti E, Anvari D, Anwer R, Aqeel M, Arabloo J, Arab-Zozani M, Aripov T, Ärnlöv J, Artanti KD, Arzani A, Asaad M, Asadi-Aliabadi M, Asadi-Pooya AA, Asghari Jafarabadi M, Athari SS, Athari SM, Atnafu DD, Atreya A, Atteraya MS, Ausloos M, Awan AT, Ayala Quintanilla BP, Ayano G, Ayanore MA, Aynalem YA, Azari S, Azarian G, Azene ZN, B DB, Babaee E, Badiye AD, Baig AA, Banach M, Banik PC, Barker-Collo SL, Barqawi HJ, Bassat Q, Basu S, Baune BT, Bayati M, Bedi N, Beghi E, Beghi M, Bell ML, Bendak S, Bennett DA, Bensenor IM, Berhe K, Berman AE, Bezabih YM, Bhagavathula AS, Bhandari D, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhattarai S, Bhutta ZA, Bikbov B, Biondi A, Birihane BM, Biswas RK, Bohlouli S, Bragazzi NL, Breusov AV, Brunoni AR, Burkart K, Burugina Nagaraja S, Busse R, Butt ZA, Caetano dos Santos FL, Cahuana-Hurtado L, Camargos P, Cámera LA, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Cerin E, Chang JC, Chanie WF, Charan J, Chatterjee S, Chattu SK, Chattu VK, Chaturvedi S, Chen S, Cho DY, Choi JYJ, Chu DT, Ciobanu LG, Cirillo M, Conde J, Costa VM, Couto RAS, Dachew BA, Dahlawi SMA, Dai H, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Darmstadt GL, Das JK, Dávila-Cervantes CA, Davis AC, Davletov K, De la Hoz FP, De Leo D, Deeba F, Denova-Gutiérrez E, Dervenis N, Desalew A, Deuba K, Dey S, Dharmaratne SD, Dhingra S, Dhungana GP, Dias da Silva D, Diaz D, Dorostkar F, Doshmangir L, Dubljanin E, Duraes AR, Eagan AW, Edinur HA, Efendi F, Eftekharzadeh S, El Sayed I, El Tantawi M, Elbarazi I, Elgendy IY, El-Jaafary SI, Emami A, Enany S, Eyawo O, Ezzikouri S, Faris PS, Farzadfar F, Fattahi N, Fauk NK, Fazlzadeh M, Feigin VL, Ferede TY, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fischer F, Fisher JL, Foigt NA, Folayan MO, Foroutan M, Franklin RC, Freitas M, Friedman SD, Fukumoto T, Gad MM, Gaidhane AM, Gaidhane S, Gaihre S, Gallus S, Garcia-Basteiro AL, Garcia-Gordillo MA, Gardner WM, Gaspar Fonseca M, Gebremedhin KB, Getacher L, Ghashghaee A, Gholamian A, Gilani SA, Gill TK, Giussani G, Gnedovskaya EV, Godinho MA, Goel A, Golechha M, Gona PN, Gopalani SV, Goudarzi H, Grivna M, Gugnani HC, Guido D, Guimarães RA, Gupta RD, Gupta R, Hafezi-Nejad N, Haider MR, Haj-Mirzaian A, Hamidi S, Hanif A, Hankey GJ, Hargono A, Hasaballah AI, Hasan MM, Hasan SS, Hassan A, Hassanipour S, Hassankhani H, Havmoeller RJ, Hayat K, Heidari-Soureshjani R, Henry NJ, Herteliu C, Hole MK, Holla R, Hossain N, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Huang J, Humayun A, Hwang BF, Iavicoli I, Ibitoye SE, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Inamdar S, Inbaraj LR, Iqbal K, Iqbal U, Islam MM, Islam SMS, Iso H, Iwagami M, Iwu CCD, Jaafari J, Jacobsen KH, Jagnoor J, Jain V, Janodia MD, Javaheri T, Javanmardi F, Jayaram S, Jayatilleke AU, Jenabi E, Jha RP, Ji JS, John O, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kamyari N, Kanchan T, Kapoor N, Karami Matin B, Karch A, Karimi SE, Kassahun G, Kayode GA, Kazemi Karyani A, Kemmer L, Khalid N, Khalilov R, Khammarnia M, Khan EA, Khan G, Khan M, Khan MN, Khang YH, Khatab K, Khater AM, Khater MM, Khayamzadeh M, Khosravi A, Kim D, Kim YE, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kissoon N, Kopec JA, Kosen S, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Krishnamoorthy V, Kuate Defo B, Kucuk Bicer B, Kulkarni V, Kumar GA, Kumar M, Kumar N, Kurmi OP, Kusuma D, La Vecchia C, Lacey B, Lalloo R, Lami FH, Landires I, Larsson AO, Lasrado S, Lassi ZS, Lauriola P, Lee PH, Lee SWH, Lee YH, Leigh J, Leonardi M, Lewycka S, Li B, Li S, Liang J, Lim LL, Limenih MA, Lin RT, Liu X, Lodha R, Lopez AD, Lozano R, Lugo A, Lunevicius R, Mackay MT, Madhava Kunjathur S, Magnani FG, Mahadeshwara Prasad DR, Maheri M, Mahmoudi M, Majeed A, Maled V, Maleki A, Maleki S, Malekzadeh R, Malik AA, Malta DC, Mamun AA, Mansouri B, Mansournia MA, Martinez G, Martini S, Martins-Melo FR, Masoumi SZ, Maulik PK, McAlinden C, McGrath JJ, Medina-Solís CE, Mehrabi Nasab E, Mejia-Rodriguez F, Memish ZA, Mendoza W, Menezes RG, Mengesha EW, Mensah GA, Meretoja A, Meretoja TJ, Mersha AM, Mestrovic T, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mini GK, Miri M, Mirica A, Mirrakhimov EM, Mirzaei H, Mirzaei M, Moazen B, Moghadaszadeh M, Mohajer B, Mohamad O, Mohammad Y, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Molokhia M, Monasta L, Mondello S, Moni MA, Moore CE, Moradi G, Moradi M, Moradzadeh R, Moraga P, Morawska L, Morrison SD, Mosser JF, Mousavi Khaneghah A, Mustafa G, Naderi M, Nagarajan AJ, Nagaraju SP, Naghavi M, Naghshtabrizi B, Naimzada MD, Nangia V, Narasimha Swamy S, Nascimento BR, Naveed M, Nazari J, Ndejjo R, Negoi I, Negoi RI, Nena E, Nepal S, Netsere HB, Nguefack-Tsague G, Ngunjiri JW, Nguyen CTY, Nguyen CT, Nguyen HLT, Nigatu YT, Nigussie SN, Nixon MR, Nnaji CA, Nomura S, Noor NM, Noubiap JJ, Nuñez-Samudio V, Nwatah VE, Oancea B, Odukoya OO, Ogbo FA, Olusanya BO, Olusanya JO, Omar Bali A, Onwujekwe OE, Ortiz A, Otoiu A, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Padubidri JR, Pakhale S, Pakshir K, Pal PK, Palladino R, Pana A, Panda-Jonas S, Pandey A, Pandey A, Pandi-Perumal SR, Pangaribuan HU, Pardo-Montaño AM, Park EK, Patel SK, Patton GC, Pawar S, Pazoki Toroudi H, Peden AE, Pepito VCF, Peprah EK, Pereira J, Pérez-Gómez J, Perico N, Pesudovs K, Pilgrim T, Pinheiro M, Piradov MA, Pirsaheb M, Platts-Mills JA, Pokhrel KN, Postma MJ, Pourjafar H, Prada SI, Prakash S, Pupillo E, Quazi Syed Z, Rabiee N, Radfar A, Rafiee A, Rafiei A, Raggi A, Rahimzadeh S, Rahman MHU, Rahmani AM, Ramezanzadeh K, Rana J, Ranabhat CL, Rao SJ, Rasella D, Rastogi P, Rathi P, Rawaf DL, Rawaf S, Rawasia WF, Rawassizadeh R, Reiner Jr RC, Remuzzi G, Renzaho AMN, Reshmi B, Resnikoff S, Rezaei N, Rezaei N, Rezapour A, Riahi SM, Ribeiro D, Rickard J, Roever L, Ronfani L, Rothenbacher D, Rubagotti E, Rumisha SF, Ryan PM, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sagar R, Sahebkar A, Salahshoor MR, Salehi S, Salem MR, Salimzadeh H, Salomon JA, Samodra YL, Samy AM, Sanabria J, Santric-Milicevic MM, Saraswathy SYI, Sarker AR, Sarrafzadegan N, Sarveazad A, Sathian B, Sathish T, Sattin D, Saxena S, Saya GK, Saylan M, Schiavolin S, Schlaich MP, Schwebel DC, Schwendicke F, Senthilkumaran S, Sepanlou SG, Serván-Mori E, Sha F, Shafaat O, Shahabi S, Shahbaz M, Shaheen AA, Shahid I, Shaikh MA, Shakiba S, Shalash AS, Shams-Beyranvand M, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shiferaw WS, Shigematsu M, Shin JI, Shiri R, Shiue I, Shuval K, Siddiqi TJ, Sidemo NB, Sigfusdottir ID, Sigurvinsdottir R, Silva JP, Silverberg JIS, Simonetti B, Singh BB, Singh JA, Singhal D, Sinha DN, Skiadaresi E, Skryabin VY, Skryabina AA, Sleet DA, Sobaih BH, Sobhiyeh MR, Soltani S, Soriano JB, Spurlock EE, Sreeramareddy CT, Steiropoulos P, Stokes MA, Stortecky S, Sufiyan MB, Suliankatchi Abdulkader R, Sulo G, Swope CB, Sykes BL, Szeto MD, Szócska M, Tabarés-Seisdedos R, Tadesse EG, Taherkhani A, Tamiru AT, Tareque MI, Tehrani-Banihashemi A, Temsah MH, Tesfay FH, Tessema GA, Tessema ZT, Thankappan KR, Thapar R, Tolani MA, Tovani-Palone MR, Traini E, Tran BX, Tripathy JP, Tsapparellas G, Tsatsakis A, Tudor Car L, Uddin R, Ullah A, Umeokonkwo CD, Unim B, Unnikrishnan B, Upadhyay E, Usman MS, Vacante M, Vaezi M, Valadan Tahbaz S, Valdez PR, Vasankari TJ, Venketasubramanian N, Verma M, Violante FS, Vlassov V, Vo B, Vu GT, Wado YD, Waheed Y, Wamai RG, Wang Y, Wang Y, Wang YP, Ward P, Werdecker A, Westerman R, Wickramasinghe ND, Wilner LB, Wiysonge CS, Wu AM, Wu C, Xie Y, Yahyazadeh Jabbari SH, Yamagishi K, Yandrapalli S, Yaya S, Yazdi-Feyzabadi V, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yousefi Z, Yousefinezhadi T, Yu C, Yusuf SS, Zaidi SS, Zaman SB, Zamani M, Zamanian M, Zastrozhin MS, Zastrozhina A, Zhang Y, Zhang ZJ, Zhao XJG, Ziapour A, Hay SI, Murray CJL, Wang H, Kassebaum NJ. Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019. Lancet 2021; 398:870-905. [PMID: 34416195 PMCID: PMC8429803 DOI: 10.1016/s0140-6736(21)01207-1] [Citation(s) in RCA: 180] [Impact Index Per Article: 60.0] [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: 01/11/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. METHODS We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. FINDINGS Global U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3-74·0) in 2000 to 37·1 (33·2-41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8-29·5) in 2000 to 17·9 (16·3-19·8) in 2019. In 2019, 136 (67%) of 204 countries had a U5MR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030, 154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9·65 million (95% UI 9·05-10·30) in 2000 and 5·05 million (4·27-6·02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3·76 million [95% UI 3·53-4·02]) in 2000 to 48% (2·42 million; 2·06-2·86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0·80 (95% UI 0·71-0·86) deaths per 1000 livebirths and U5MR to 1·44 (95% UI 1·27-1·58) deaths per 1000 livebirths, and in 2019, there were as many as 1·87 million (95% UI 1·35-2·58; 37% [95% UI 32-43]) of 5·05 million more deaths of children younger than 5 years than the survival potential frontier. INTERPRETATION Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. FUNDING Bill & Melinda Gates Foundation.
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Galles NC, Liu PY, Updike RL, Fullman N, Nguyen J, Rolfe S, Sbarra AN, Schipp MF, Marks A, Abady GG, Abbas KM, Abbasi SW, Abbastabar H, Abd-Allah F, Abdoli A, Abolhassani H, Abosetugn AE, Adabi M, Adamu AA, Adetokunboh OO, Adnani QES, Advani SM, Afzal S, Aghamir SMK, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi S, Ahmed H, Ahmed MB, Ahmed Rashid T, Ahmed Salih Y, Akalu Y, Aklilu A, Akunna CJ, Al Hamad H, Alahdab F, Albano L, Alemayehu Y, Alene KA, Al-Eyadhy A, Alhassan RK, Ali L, Aljunid SM, Almustanyir S, Altirkawi KA, Alvis-Guzman N, Amu H, Andrei CL, Andrei T, Ansar A, Ansari-Moghaddam A, Antonazzo IC, Antony B, Arabloo J, Arab-Zozani M, Artanti KD, Arulappan J, Awan AT, Awoke MA, Ayza MA, Azarian G, Azzam AY, B DB, Babar ZUD, Balakrishnan S, Banach M, Bante SA, Bärnighausen TW, Barqawi HJ, Barrow A, Bassat Q, Bayarmagnai N, Bejarano Ramirez DF, Bekuma TT, Belay HG, Belgaumi UI, Bhagavathula AS, Bhandari D, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bibi S, Bijani A, Biondi A, Boloor A, Braithwaite D, Buonsenso D, Butt ZA, Camargos P, Carreras G, Carvalho F, Castañeda-Orjuela CA, Chakinala RC, Charan J, Chatterjee S, Chattu SK, Chattu VK, Chowdhury FR, Christopher DJ, Chu DT, Chung SC, Cortesi PA, Costa VM, Couto RAS, Dadras O, Dagnew AB, Dagnew B, Dai X, Dandona L, Dandona R, De Neve JW, Derbew Molla M, Derseh BT, Desai R, Desta AA, Dhamnetiya D, Dhimal ML, Dhimal M, Dianatinasab M, Diaz D, Djalalinia S, Dorostkar F, Edem B, Edinur HA, Eftekharzadeh S, El Sayed I, El Sayed Zaki M, Elhadi M, El-Jaafary SI, Elsharkawy A, Enany S, Erkhembayar R, Esezobor CI, Eskandarieh S, Ezeonwumelu IJ, Ezzikouri S, Fares J, Faris PS, Feleke BE, Ferede TY, Fernandes E, Fernandes JC, Ferrara P, Filip I, Fischer F, Francis MR, Fukumoto T, Gad MM, Gaidhane S, Gallus S, Garg T, Geberemariyam BS, Gebre T, Gebregiorgis BG, Gebremedhin KB, Gebremichael B, Gessner BD, Ghadiri K, Ghafourifard M, Ghashghaee A, Gilani SA, Glăvan IR, Glushkova EV, Golechha M, Gonfa KB, Gopalani SV, Goudarzi H, Gubari MIM, Guo Y, Gupta VB, Gupta VK, Gutiérrez RA, Haeuser E, Halwani R, Hamidi S, Hanif A, Haque S, Harapan H, Hargono A, Hashi A, Hassan S, Hassanein MH, Hassanipour S, Hassankhani H, Hay SI, Hayat K, Hegazy MI, Heidari G, Hezam K, Holla R, Hoque ME, Hosseini M, Hosseinzadeh M, Hostiuc M, Househ M, Hsieh VCR, Huang J, Humayun A, Hussain R, Hussein NR, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Inamdar S, Iqbal U, Irham LM, Irvani SSN, Islam SMS, Ismail NE, Itumalla R, Jha RP, Joukar F, Kabir A, Kabir Z, Kalhor R, Kamal Z, Kamande SM, Kandel H, Karch A, Kassahun G, Kassebaum NJ, Katoto PDMC, Kelkay B, Kengne AP, Khader YS, Khajuria H, Khalil IA, Khan EA, Khan G, Khan J, Khan M, Khan MAB, Khang YH, Khoja AT, Khubchandani J, Kim GR, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Korshunov VA, Kosen S, Kuate Defo B, Kulkarni V, Kumar A, Kumar GA, Kumar N, Kwarteng A, La Vecchia C, Lami FH, Landires I, Lasrado S, Lassi ZS, Lee H, Lee YY, Levi M, Lewycka S, Li S, Liu X, Lobo SW, Lopukhov PD, Lozano R, Lutzky Saute R, Magdy Abd El Razek M, Makki A, Malik AA, Mansour-Ghanaei F, Mansournia MA, Mantovani LG, Martins-Melo FR, Matthews PC, Medina JRC, Mendoza W, Menezes RG, Mengesha EW, Meretoja TJ, Mersha AG, Mesregah MK, Mestrovic T, Miazgowski B, Milne GJ, Mirica A, Mirrakhimov EM, Mirzaei HR, Misra S, Mithra P, Moghadaszadeh M, Mohamed TA, Mohammad KA, Mohammad Y, Mohammadi M, Mohammadian-Hafshejani A, Mohammed A, Mohammed S, Mohapatra A, Mokdad AH, Molokhia M, Monasta L, Moni MA, Montasir AA, Moore CE, Moradi G, Moradzadeh R, Moraga P, Mueller UO, Munro SB, Naghavi M, Naimzada MD, Naveed M, Nayak BP, Negoi I, Neupane Kandel S, Nguyen TH, Nikbakhsh R, Ningrum DNA, Nixon MR, Nnaji CA, Noubiap JJ, Nuñez-Samudio V, Nwatah VE, Oancea B, Ochir C, Ogbo FA, Olagunju AT, Olakunde BO, Onwujekwe OE, Otstavnov N, Otstavnov SS, Owolabi MO, Padubidri JR, Pakshir K, Park EC, Pashazadeh Kan F, Pathak M, Paudel R, Pawar S, Pereira J, Peres MFP, Perianayagam A, Pinheiro M, Pirestani M, Podder V, Polibin RV, Pollok RCG, Postma MJ, Pottoo FH, Rabiee M, Rabiee N, Radfar A, Rafiei A, Rahimi-Movaghar V, Rahman M, Rahmani AM, Rahmawaty S, Rajesh A, Ramshaw RE, Ranasinghe P, Rao CR, Rao SJ, Rathi P, Rawaf DL, Rawaf S, Renzaho AMN, Rezaei N, Rezai MS, Rios-Blancas M, Rogowski ELB, Ronfani L, Rwegerera GM, Saad AM, Sabour S, Saddik B, Saeb MR, Saeed U, Sahebkar A, Sahraian MA, Salam N, Salimzadeh H, Samaei M, Samy AM, Sanabria J, Sanmarchi F, Santric-Milicevic MM, Sartorius B, Sarveazad A, Sathian B, Sawhney M, Saxena D, Saxena S, Seidu AA, Seylani A, Shaikh MA, Shamsizadeh M, Shetty PH, Shigematsu M, Shin JI, Sidemo NB, Singh A, Singh JA, Sinha S, Skryabin VY, Skryabina AA, Soheili A, Tadesse EG, Tamiru AT, Tan KK, Tekalegn Y, Temsah MH, Thakur B, Thapar R, Thavamani A, Tobe-Gai R, Tohidinik HR, Tovani-Palone MR, Traini E, Tran BX, Tripathi M, Tsegaye B, Tsegaye GW, Ullah A, Ullah S, Ullah S, Unim B, Vacante M, Velazquez DZ, Vo B, Vollmer S, Vu GT, Vu LG, Waheed Y, Winkler AS, Wiysonge CS, Yiğit V, Yirdaw BW, Yon DK, Yonemoto N, Yu C, Yuce D, Yunusa I, Zamani M, Zamanian M, Zewdie DT, Zhang ZJ, Zhong C, Zumla A, Murray CJL, Lim SS, Mosser JF. Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019: a systematic analysis for the Global Burden of Disease Study 2020, Release 1. Lancet 2021; 398:503-521. [PMID: 34273291 PMCID: PMC8358924 DOI: 10.1016/s0140-6736(21)00984-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [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: 02/26/2021] [Revised: 04/16/2021] [Accepted: 04/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. METHODS For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in country-reported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. FINDINGS By 2019, global coverage of third-dose DTP (DTP3; 81·6% [95% uncertainty interval 80·4-82·7]) more than doubled from levels estimated in 1980 (39·9% [37·5-42·1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38·5% [35·4-41·3] in 1980 to 83·6% [82·3-84·8] in 2019). Third-dose polio vaccine (Pol3) coverage also increased, from 42·6% (41·4-44·1) in 1980 to 79·8% (78·4-81·1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56·8 million (52·6-60·9) to 14·5 million (13·4-15·9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. INTERPRETATION After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. FUNDING Bill & Melinda Gates Foundation.
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Sartorius B, VanderHeide JD, Yang M, Goosmann EA, Hon J, Haeuser E, Cork MA, Perkins S, Jahagirdar D, Schaeffer LE, Serfes AL, LeGrand KE, Abbastabar H, Abebo ZH, Abosetugn AE, Abu-Gharbieh E, Accrombessi MMK, Adebayo OM, Adegbosin AE, Adekanmbi V, Adetokunboh OO, Adeyinka DA, Ahinkorah BO, Ahmadi K, Ahmed MB, Akalu Y, Akinyemi OO, Akinyemi RO, Aklilu A, Akunna CJ, Alahdab F, Al-Aly Z, Alam N, Alamneh AA, Alanzi TM, Alemu BW, Alhassan RK, Ali T, Alipour V, Amini S, Ancuceanu R, Ansari F, Anteneh ZA, Anvari D, Anwer R, Appiah SCY, Arabloo J, Asemahagn MA, Asghari Jafarabadi M, Asmare WN, Atnafu DD, Atout MMW, Atreya A, Ausloos M, Awedew AF, Ayala Quintanilla BP, Ayanore MA, Aynalem YA, Ayza MA, Azari S, Azene ZN, Babar ZUD, Baig AA, Balakrishnan S, Banach M, Bärnighausen TW, Basu S, Bayati M, Bedi N, Bekuma TT, Bezabhe WMM, Bhagavathula AS, Bhardwaj P, Bhattacharyya K, Bhutta ZA, Bibi S, Bikbov B, Birhan TA, Bitew ZW, Bockarie MJ, Boloor A, Brady OJ, Bragazzi NL, Briko AN, Briko NI, Burugina Nagaraja S, Butt ZA, Cárdenas R, Carvalho F, Charan J, Chatterjee S, Chattu SK, Chattu VK, Chowdhury MAK, Chu DT, Cook AJ, Cormier NM, Cowden RG, Culquichicon C, Dagnew B, Dahlawi SMA, Damiani G, Daneshpajouhnejad P, Daoud F, Daryani A, das Neves J, Davis Weaver N, Derbew Molla M, Deribe K, Desta AA, Deuba K, Dharmaratne SD, Dhungana GP, Diaz D, Djalalinia S, Doku PN, Dubljanin E, Duko B, Eagan AW, Earl L, Eaton JW, Effiong A, El Sayed Zaki M, El Tantawi M, Elayedath R, El-Jaafary SI, Elsharkawy A, Eskandarieh S, Eyawo O, Ezzikouri S, Fasanmi AO, Fasil A, Fauk NK, Feigin VL, Ferede TY, Fernandes E, Fischer F, Foigt NA, Folayan MO, Foroutan M, Francis JM, Fukumoto T, Gad MM, Geberemariyam BS, Gebregiorgis BG, Gebremichael B, Gesesew HA, Getacher L, Ghadiri K, Ghashghaee A, Gilani SA, Ginindza TG, Glagn M, Golechha M, Gona PN, Gubari MIM, Gugnani HC, Guido D, Guled RA, Hall BJ, Hamidi S, Handiso DW, Hargono A, Hashi A, Hassanipour S, Hassankhani H, Hayat K, Herteliu C, Hidru HDD, Holla R, Hosgood HD, Hossain N, Hosseini M, Hosseinzadeh M, Househ M, Hwang BF, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Irvani SSN, Iwu CCD, Iwu CJ, Iyamu IO, Jain V, Jakovljevic M, Jalilian F, Jha RP, Johnson KB, Joshua V, Joukar F, Jozwiak JJ, Kabir A, Kalankesh LR, Kalhor R, Kamath A, Kamyari N, Kanchan T, Karami Matin B, Karch A, Karimi SE, Kasa AS, Kassahun G, Kayode GA, Kazemi Karyani A, Keiyoro PN, Kelkay B, Khalid N, Khan G, Khan J, Khan MN, Khatab K, Khazaei S, Kim YJ, Kisa A, Kisa S, Kochhar S, Kopec JA, Kosen S, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kuate Defo B, Kugbey N, Kulkarni V, Kumar M, Kumar N, Kurmi OP, Kusuma D, Kuupiel D, Kyu HH, La Vecchia C, Lal DK, Lam JO, Landires I, Lasrado S, Lazarus JV, Lazzar-Atwood A, Lee PH, Leshargie CT, Li B, Liu X, Lopukhov PD, M. Amin HI, Madi D, Mahasha PW, Majeed A, Maleki A, Maleki S, Mamun AA, Manafi N, Mansournia MA, Martins-Melo FR, Masoumi SZ, Mayala BK, Meharie BG, Meheretu HAA, Meles HG, Melku M, Mendoza W, Mengesha EW, Meretoja TJ, Mersha AM, Mestrovic T, Miller TR, Mirica A, Mirzaei-Alavijeh M, Mohamad O, Mohammad Y, Mohammadian-Hafshejani A, Mohammed JA, Mohammed S, Mohammed S, Mokdad AH, Mokonnon TM, Molokhia M, Moradi M, Moradi Y, Moradzadeh R, Moraga P, Mosser JF, Munro SB, Mustafa G, Muthupandian S, Naderi M, Nagarajan AJ, Naghavi M, Naveed M, Nayak VC, Nazari J, Ndejjo R, Nepal S, Netsere HB, Ngalesoni FN, Nguefack-Tsague G, Ngunjiri JW, Nigatu YT, Nigussie SN, Nnaji CA, Noubiap JJ, Nuñez-Samudio V, Oancea B, Odukoya OO, Ogbo FA, Oladimeji O, Olagunju AT, Olusanya BO, Olusanya JO, Omer MO, Omonisi AEE, Onwujekwe OE, Orisakwe OE, Otstavnov N, Owolabi MO, P A M, Padubidri JR, Pakhale S, Pana A, Pandi-Perumal SR, Patel UK, Pathak M, Patton GC, Pawar S, Peprah EK, Pokhrel KN, Postma MJ, Pottoo FH, Pourjafar H, Pribadi DRA, Quazi Syed Z, Rafiei A, Rahim F, Rahman MHU, Rahmani AM, Ram P, Rana J, Ranabhat CL, Rao S, Rao SJ, Rathi P, Rawaf DL, Rawaf S, Rawassizadeh R, Renjith V, Reta MA, Rezaei N, Rezapour A, Ribeiro AI, Ross JM, Rumisha SF, Sagar R, Sahu M, Sajadi SM, Salem MR, Samy AM, Sathian B, Schutte AE, Seidu AA, Sha F, Shafaat O, Shahbaz M, Shaikh MA, Shaka MF, Sheikh A, Shibuya K, Shin JI, Shivakumar KM, Sidemo NB, Singh JA, Skryabin VY, Skryabina AA, Soheili A, Soltani S, Somefun OD, Sorrie MB, Spurlock EE, Sufiyan MB, Taddele BW, Tadesse EG, Tamir Z, Tamiru AT, Tanser FC, Taveira N, Tehrani-Banihashemi A, Tekalegn Y, Tesfay FH, Tessema B, Tessema ZT, Thakur B, Tolani MA, Topor-Madry R, Torrado M, Tovani-Palone MR, Traini E, Tsai AC, Tsegaye GW, Ullah I, Ullah S, Umeokonkwo CD, Unnikrishnan B, Vardavas C, Violante FS, Vo B, Wado YD, Waheed Y, Wamai RG, Wang Y, Ward P, Werdecker A, Wickramasinghe ND, Wijeratne T, Wiysonge CS, Wondmeneh TG, Yamada T, Yaya S, Yeshaw Y, Yeshitila YG, Yilma MT, Yip P, Yonemoto N, Yosef T, Yusefzadeh H, Zaidi SS, Zaki L, Zamanian M, Zastrozhin MS, Zastrozhina A, Zewdie DT, Zhang Y, Zhang ZJ, Ziapour A, Hay SI, Dwyer-Lindgren L. Subnational mapping of HIV incidence and mortality among individuals aged 15-49 years in sub-Saharan Africa, 2000-18: a modelling study. Lancet HIV 2021; 8:e363-e375. [PMID: 34087097 PMCID: PMC8187986 DOI: 10.1016/s2352-3018(21)00051-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND High-resolution estimates of HIV burden across space and time provide an important tool for tracking and monitoring the progress of prevention and control efforts and assist with improving the precision and efficiency of targeting efforts. We aimed to assess HIV incidence and HIV mortality for all second-level administrative units across sub-Saharan Africa. METHODS In this modelling study, we developed a framework that used the geographically specific HIV prevalence data collected in seroprevalence surveys and antenatal care clinics to train a model that estimates HIV incidence and mortality among individuals aged 15-49 years. We used a model-based geostatistical framework to estimate HIV prevalence at the second administrative level in 44 countries in sub-Saharan Africa for 2000-18 and sought data on the number of individuals on antiretroviral therapy (ART) by second-level administrative unit. We then modified the Estimation and Projection Package (EPP) to use these HIV prevalence and treatment estimates to estimate HIV incidence and mortality by second-level administrative unit. FINDINGS The estimates suggest substantial variation in HIV incidence and mortality rates both between and within countries in sub-Saharan Africa, with 15 countries having a ten-times or greater difference in estimated HIV incidence between the second-level administrative units with the lowest and highest estimated incidence levels. Across all 44 countries in 2018, HIV incidence ranged from 2·8 (95% uncertainty interval 2·1-3·8) in Mauritania to 1585·9 (1369·4-1824·8) cases per 100 000 people in Lesotho and HIV mortality ranged from 0·8 (0·7-0·9) in Mauritania to 676·5 (513·6-888·0) deaths per 100 000 people in Lesotho. Variation in both incidence and mortality was substantially greater at the subnational level than at the national level and the highest estimated rates were accordingly higher. Among second-level administrative units, Guijá District, Gaza Province, Mozambique, had the highest estimated HIV incidence (4661·7 [2544·8-8120·3]) cases per 100 000 people in 2018 and Inhassunge District, Zambezia Province, Mozambique, had the highest estimated HIV mortality rate (1163·0 [679·0-1866·8]) deaths per 100 000 people. Further, the rate of reduction in HIV incidence and mortality from 2000 to 2018, as well as the ratio of new infections to the number of people living with HIV was highly variable. Although most second-level administrative units had declines in the number of new cases (3316 [81·1%] of 4087 units) and number of deaths (3325 [81·4%]), nearly all appeared well short of the targeted 75% reduction in new cases and deaths between 2010 and 2020. INTERPRETATION Our estimates suggest that most second-level administrative units in sub-Saharan Africa are falling short of the targeted 75% reduction in new cases and deaths by 2020, which is further compounded by substantial within-country variability. These estimates will help decision makers and programme implementers expand access to ART and better target health resources to higher burden subnational areas. FUNDING Bill & Melinda Gates Foundation.
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Arnfinsen JL, Kisa A. Assessment of Norwegian physicians’ knowledge, experience and attitudes towards medical cannabis. Drugs: Education, Prevention and Policy 2021. [DOI: 10.1080/09687637.2020.1806208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- John Laurence Arnfinsen
- Department of Health Management and Health Economics, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
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Laughter MR, Maymone MBC, Karimkhani C, Rundle C, Hu S, Wolfe S, Abuabara K, Hollingsworth P, Weintraub GS, Dunnick CA, Kisa A, Damiani G, Sheikh A, Singh JA, Fukumoto T, Desai R, Grada A, Filip I, Radfar A, Naghavi M, Dellavalle RP. The Burden of Skin and Subcutaneous Diseases in the United States From 1990 to 2017. JAMA Dermatol 2021; 156:874-881. [PMID: 32520352 DOI: 10.1001/jamadermatol.2020.1573] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Importance Skin and subcutaneous diseases affect the health of millions of individuals in the US. Data are needed that highlight the geographic trends and variations of skin disease burden across the country to guide health care decision-making. Objective To characterize trends and variations in the burden of skin and subcutaneous tissue diseases across the US from 1990 to 2017. Design, Setting, and Participants For this cohort study, data were obtained from the Global Burden of Disease (GBD), a study with an online database that incorporates current and previous epidemiological studies of disease burden, and from GBD 2017, which includes more than 90 000 data sources such as systematic reviews, surveys, population-based disease registries, hospital inpatient and outpatient data, cohort studies, and autopsy data. The GBD separated skin conditions into 15 subcategories according to incidence, prevalence, adequacy of data, and standardized disease definitions. GBD 2017 also estimated the burden from melanoma of the skin and keratinocyte carcinoma. Data analysis for the present study was conducted from September 9, 2019, to March 31, 2020. Main Outcomes and Measures Primary study outcomes included age-standardized disability-adjusted life-years (DALYs), incidence, and prevalence. The data were stratified by US states with the highest and lowest age-standardized DALY rate per 100 000 people, incidence, and prevalence of each skin condition. The percentage change in DALY rates in each state was calculated from 1990 to 2017. Results Overall, age-standardized DALY rates for skin and subcutaneous diseases increased from 1990 (821.6; 95% uncertainty interval [UI], 570.3-1124.9) to 2017 (884.2; 95% UI, 614.0-1207.9) in all 50 states and the District of Columbia. The degree of increase varied according to geographic location, with the largest percentage change of 0.12% (95% UI, 0.09%-0.15%) in New York and the smallest percentage change of 0.04% (95% UI, 0.02%-0.07%) in Colorado, 0.04% (95% UI, 0.01%-0.06%) in Nevada, 0.04% (95% UI, 0.02%-0.07%) in New Mexico, and 0.04% (95% UI, 0.02%-0.07%) in Utah. The age-standardized DALY rate, incidence, and prevalence of specific skin conditions differed among the states. New York had the highest age-standardized DALY rate for skin and subcutaneous disease in 2017 (1097.0 [95% UI, 764.9-1496.1]), whereas Wyoming had the lowest age-standardized DALY rate (672.9 [95% UI, 465.6-922.3]). In all 50 states and the District of Columbia, women had higher age-standardized DALY rates for overall skin and subcutaneous diseases than men (women: 971.20 [95% UI, 676.76-1334.59] vs men: 799.23 [95% UI, 559.62-1091.50]). However, men had higher DALY rates than women for malignant melanoma (men: 80.82 [95% UI, 51.68-123.18] vs women: 42.74 [95% UI, 34.05-70.66]) and keratinocyte carcinomas (men: 37.56 [95% UI, 29.35-49.52] vs women: 14.42 [95% UI, 10.01-20.66]). Conclusions and Relevance Data from the GBD suggest that the burden of skin and subcutaneous disease was large and that DALY rate trends varied across the US; the age-standardized DALY rate for keratinocyte carcinoma appeared greater in men. These findings can be used by states to target interventions and meet the needs of their population.
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Affiliation(s)
- Melissa R Laughter
- Department of Dermatology, University of Colorado School of Medicine, Denver
| | - Mayra B C Maymone
- Department of Dermatology, University of Colorado School of Medicine, Denver
| | - Chante Karimkhani
- Department of Dermatology, University of Colorado School of Medicine, Denver
| | - Chandler Rundle
- Department of Dermatology, University of Colorado School of Medicine, Denver
| | - Sophia Hu
- Department of Dermatology, University of Colorado School of Medicine, Denver
| | - Sophia Wolfe
- Department of Dermatology, University of Colorado School of Medicine, Denver
| | - Katrina Abuabara
- Department of Dermatology, University of California San Francisco, San Francisco
| | - Parker Hollingsworth
- Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Gil S Weintraub
- Department of Dermatology, University of Colorado School of Medicine, Denver
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado School of Medicine, Denver
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway.,Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana
| | - Giovanni Damiani
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio.,Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Jasvinder A Singh
- Medicine Service, Veterans Affairs Medical Center, Birmingham, Alabama.,Department of Medicine at the School of Medicine, University of Alabama at Birmingham, Birmingham.,Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham
| | - Takeshi Fukumoto
- Kobe University Graduate School of Medicine, Division of Dermatology, Department of Internal Related, Kobe, Japan.,Gene Expression and Regulation Program, The Wistar Institute, Philadelphia, Pennsylvania
| | - Rupak Desai
- Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia
| | - Ayman Grada
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | | | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando
| | - Mohsen Naghavi
- Institute of Health Metrics and Evaluation, University of Washington, Seattle
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado School of Medicine, Denver
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Lozano R, Fullman N, Mumford JE, Knight M, Barthelemy CM, Abbafati C, Abbastabar H, Abd-Allah F, Abdollahi M, Abedi A, Abolhassani H, Abosetugn AE, Abreu LG, Abrigo MRM, Abu Haimed AK, Abushouk AI, Adabi M, Adebayo OM, Adekanmbi V, Adelson J, Adetokunboh OO, Adham D, Advani SM, Afshin A, Agarwal G, Agasthi P, Aghamir SMK, Agrawal A, Ahmad T, Akinyemi RO, Alahdab F, Al-Aly Z, Alam K, Albertson SB, Alemu YM, Alhassan RK, Ali M, Ali S, Alipour V, Aljunid SM, Alla F, Almadi MAH, Almasi A, Almasi-Hashiani A, Almasri NA, Al-Mekhlafi HM, Almulhim AM, Alonso J, Al-Raddadi RM, Altirkawi KA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amini S, Amini-Rarani M, Amiri F, Amit AML, Amugsi DA, Ancuceanu R, Anderlini D, Andrei CL, Androudi S, Ansari F, Ansari-Moghaddam A, Antonio CAT, Antony CM, Antriyandarti E, Anvari D, Anwer R, Arabloo J, Arab-Zozani M, Aravkin AY, Aremu O, Ärnlöv J, Asaad M, Asadi-Aliabadi M, Asadi-Pooya AA, Ashbaugh C, Athari SS, Atout MMW, Ausloos M, Avila-Burgos L, Ayala Quintanilla BP, Ayano G, Ayanore MA, Aynalem YA, Aynalem GL, Ayza MA, Azari S, Azzopardi PS, B DB, Babaee E, Badiye AD, Bahrami MA, Baig AA, Bakhshaei MH, Bakhtiari A, Bakkannavar SM, Balachandran A, Balassyano S, Banach M, Banerjee SK, Banik PC, Bante AB, Bante SA, Barker-Collo SL, Bärnighausen TW, Barrero LH, Bassat Q, Basu S, Baune BT, Bayati M, Baye BA, Bedi N, Beghi E, Behzadifar M, Bekuma TTT, Bell ML, Bensenor IM, Berman AE, Bernabe E, Bernstein RS, Bhagavathula AS, Bhandari D, Bhardwaj P, Bhat AG, Bhattacharyya K, Bhattarai S, Bhutta ZA, Bijani A, Bikbov B, Bilano V, Biondi A, Birihane BM, Bockarie MJ, Bohlouli S, Bojia HA, Bolla SRR, Boloor A, Brady OJ, Braithwaite D, Briant PS, Briggs AM, Briko NI, Burugina Nagaraja S, Busse R, Butt ZA, Caetano dos Santos FL, Cahuana-Hurtado L, Cámera LA, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Castro F, Catalá-López F, Causey K, Cederroth CR, Cercy KM, Cerin E, Chandan JS, Chang AY, Charan J, Chattu VK, Chaturvedi S, Chin KL, Cho DY, Choi JYJ, Christensen H, Chu DT, Chung MT, Ciobanu LG, Cirillo M, Comfort H, Compton K, Cortesi PA, Costa VM, Cousin E, Dahlawi SMA, Damiani G, Dandona L, Dandona R, Darega Gela J, Darwesh AM, Daryani A, Dash AP, Davey G, Dávila-Cervantes CA, Davletov K, De Neve JW, Denova-Gutiérrez E, Deribe K, Dervenis N, Desai R, Dharmaratne SD, Dhungana GP, Dianatinasab M, Dias da Silva D, Diaz D, Dippenaar IN, Do HT, Dorostkar F, Doshmangir L, Duncan BB, Duraes AR, Eagan AW, Edvardsson D, El Sayed I, El Tantawi M, Elgendy IY, Elyazar IRF, Eskandari K, Eskandarieh S, Esmaeilnejad S, Esteghamati A, Ezekannagha O, Farag T, Farahmand M, Faraon EJA, Farinha CSES, Farioli A, Faris PS, Faro A, Fazlzadeh M, Feigin VL, Fernandes E, Ferrara P, Feyissa GT, Filip I, Fischer F, Fisher JL, Flor LS, Foigt NA, Folayan MO, Fomenkov AA, Foroutan M, Francis JM, Fu W, Fukumoto T, Furtado JM, Gad MM, Gaidhane AM, Gakidou E, Galles NC, Gallus S, Gardner WM, Geberemariyam BS, Gebrehiwot AM, Gebremeskel LG, Gebremeskel GG, Gesesew HA, Ghadiri K, Ghafourifard M, Ghashghaee A, Ghith N, Gholamian A, Gilani SA, Gill PS, Gill TK, Ginindza TG, Gitimoghaddam M, Giussani G, Glagn M, Gnedovskaya EV, Godinho MA, Goharinezhad S, Gopalani SV, Goudarzian AH, Goulart BNG, Gubari MIM, Guimarães RA, Guled RA, Gultie T, Guo Y, Gupta R, Gupta R, Hafezi-Nejad N, Hafiz A, Haile TG, Hamadeh RR, Hameed S, Hamidi S, Han C, Han H, Handiso DW, Hanif A, Hankey GJ, Haro JM, Hasaballah AI, Hasan MM, Hashi A, Hassan S, Hassan A, Hassanipour S, Hassankhani H, Havmoeller RJ, Hay SI, Hayat K, Heidari G, Heidari-Soureshjani R, Hendrie D, Herteliu C, Hird TR, Ho HC, Hole MK, Holla R, Hollingsworth B, Hoogar P, Hopf KP, Horita N, Hossain N, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsieh VCR, Hu G, Huda TM, Humayun A, Hwang BF, Iavicoli I, Ibitoye SE, Ikeda N, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Iqbal U, Irvani SSN, Irvine CMS, Islam MM, Islam SMS, Islami F, Iso H, Iwu CJ, Iwu CCD, Jaafari J, Jadidi-Niaragh F, Jafarinia M, Jahagirdar D, Jahani MA, Jahanmehr N, Jakovljevic M, Janjani H, Javaheri T, Jayatilleke AU, Jenabi E, Jha RP, Jha V, Ji JS, Jia P, John-Akinola YO, Jonas JB, Joukar F, Jozwiak JJ, Jürisson M, Kabir Z, Kalankesh LR, Kalhor R, Kamath AM, Kanchan T, Kapoor N, Karami Matin B, Karanikolos M, Karimi SM, Kassebaum NJ, Katikireddi SV, Kayode GA, Keiyoro PN, Khader YS, Khammarnia M, Khan M, Khan EA, Khang YH, Khatab K, Khater AM, Khater MM, Khatib MN, Khayamzadeh M, Khubchandani J, Kianipour N, Kim YE, Kim YJ, Kimokoti RW, Kinfu Y, Kisa A, Kissimova-Skarbek K, Kivimäki M, Kneib CJ, Kocarnik JM, Kochhar S, Kohler S, Kopec JA, Korotkova AV, Korshunov VA, Kosen S, Kotlo A, Koul PA, Koyanagi A, Krishan K, Krohn KJ, Kugbey N, Kulkarni V, Kumar GA, Kumar N, Kumar M, Kurmi OP, Kusuma D, Kyu HH, La Vecchia C, Lacey B, Lal DK, Lalloo R, Landires I, Lansingh VC, Larsson AO, Lasrado S, Lau KMM, Lauriola P, Lazarus JV, Ledesma JR, Lee PH, Lee SWH, 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Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1250-1284. [PMID: 32861314 PMCID: PMC7562819 DOI: 10.1016/s0140-6736(20)30750-9] [Citation(s) in RCA: 251] [Impact Index Per Article: 62.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/05/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. METHODS Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. FINDINGS Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2-47·5) in 1990 to 60·3 (58·7-61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9-3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6-421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0-3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5-1040·3]) residing in south Asia. INTERPRETATION The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC. FUNDING Bill & Melinda Gates Foundation.
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LE, Schiavolin S, Schmidt MI, Schutte AE, Schwebel DC, Schwendicke F, Senbeta AM, Senthilkumaran S, Sepanlou SG, Shackelford KA, Shadid J, Shahabi S, Shaheen AA, Shaikh MA, Shalash AS, Shams-Beyranvand M, Shamsizadeh M, Shannawaz M, Sharafi K, Sharara F, Sheena BS, Sheikhtaheri A, Shetty RS, Shibuya K, Shiferaw WS, Shigematsu M, Shin JI, Shiri R, Shirkoohi R, Shrime MG, Shuval K, Siabani S, Sigfusdottir ID, Sigurvinsdottir R, Silva JP, Simpson KE, Singh A, Singh JA, Skiadaresi E, Skou ST, Skryabin VY, Sobngwi E, Sokhan A, Soltani S, Sorensen RJD, Soriano JB, Sorrie MB, Soyiri IN, Sreeramareddy CT, Stanaway JD, Stark BA, Ştefan SC, Stein C, Steiner C, Steiner TJ, Stokes MA, Stovner LJ, Stubbs JL, Sudaryanto A, Sufiyan MB, Sulo G, Sultan I, Sykes BL, Sylte DO, Szócska M, Tabarés-Seisdedos R, Tabb KM, Tadakamadla SK, Taherkhani A, Tajdini M, Takahashi K, Taveira N, Teagle WL, Teame H, Tehrani-Banihashemi A, Teklehaimanot BF, Terrason S, Tessema ZT, Thankappan KR, Thomson AM, Tohidinik HR, Tonelli M, Topor-Madry R, Torre AE, Touvier M, Tovani-Palone MRR, Tran BX, Travillian R, Troeger CE, Truelsen TC, Tsai AC, Tsatsakis A, Tudor Car L, Tyrovolas S, Uddin R, Ullah S, Undurraga EA, Unnikrishnan B, Vacante M, Vakilian A, Valdez PR, Varughese S, Vasankari TJ, Vasseghian Y, Venketasubramanian N, Violante FS, Vlassov V, Vollset SE, Vongpradith A, Vukovic A, Vukovic R, Waheed Y, Walters MK, Wang J, Wang Y, Wang YP, Ward JL, Watson A, Wei J, Weintraub RG, Weiss DJ, Weiss J, Westerman R, Whisnant JL, Whiteford HA, Wiangkham T, Wiens KE, Wijeratne T, Wilner LB, Wilson S, Wojtyniak B, Wolfe CDA, Wool EE, Wu AM, Wulf Hanson S, Wunrow HY, Xu G, Xu R, Yadgir S, Yahyazadeh Jabbari SH, Yamagishi K, Yaminfirooz M, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yearwood JA, Yeheyis TY, Yeshitila YG, Yip P, Yonemoto N, Yoon SJ, Yoosefi Lebni J, Younis MZ, Younker TP, Yousefi Z, Yousefifard M, Yousefinezhadi T, Yousuf AY, Yu C, Yusefzadeh H, Zahirian Moghadam T, Zaki L, Zaman SB, Zamani M, Zamanian M, Zandian H, Zangeneh A, Zastrozhin MS, Zewdie KA, Zhang Y, Zhang ZJ, Zhao JT, Zhao Y, Zheng P, Zhou M, Ziapour A, Zimsen SRM, Naghavi M, Murray CJL. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1204-1222. [PMID: 33069326 PMCID: PMC7567026 DOI: 10.1016/s0140-6736(20)30925-9] [Citation(s) in RCA: 6299] [Impact Index Per Article: 1574.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/27/2020] [Accepted: 04/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. METHODS GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. FINDINGS Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. INTERPRETATION As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. FUNDING Bill & Melinda Gates Foundation.
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Murray CJL, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, Abd-Allah F, Abdelalim A, Abdollahi M, Abdollahpour I, Abegaz KH, Abolhassani H, Aboyans V, Abreu LG, Abrigo MRM, Abualhasan A, Abu-Raddad LJ, Abushouk AI, Adabi M, Adekanmbi V, Adeoye AM, Adetokunboh OO, Adham D, Advani SM, Agarwal G, Aghamir SMK, Agrawal A, Ahmad T, Ahmadi K, Ahmadi M, Ahmadieh H, Ahmed MB, Akalu TY, Akinyemi RO, Akinyemiju T, Akombi B, Akunna CJ, Alahdab F, Al-Aly Z, Alam K, Alam S, Alam T, Alanezi FM, Alanzi TM, Alemu BW, Alhabib KF, Ali M, Ali S, Alicandro G, Alinia C, Alipour V, Alizade H, Aljunid SM, Alla F, Allebeck P, Almasi-Hashiani A, Al-Mekhlafi HM, Alonso J, Altirkawi KA, Amini-Rarani M, Amiri F, Amugsi DA, Ancuceanu R, Anderlini D, Anderson JA, Andrei CL, Andrei T, Angus C, Anjomshoa M, Ansari F, Ansari-Moghaddam A, Antonazzo IC, Antonio CAT, Antony CM, Antriyandarti E, Anvari D, Anwer R, Appiah SCY, Arabloo J, Arab-Zozani M, Ariani F, Armoon B, Ärnlöv J, Arzani A, Asadi-Aliabadi 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Cámera LLAA, Campos-Nonato IR, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Castro F, Causey K, Cederroth CR, Cercy KM, Cerin E, Chandan JS, Chang KL, Charlson FJ, Chattu VK, Chaturvedi S, Cherbuin N, Chimed-Ochir O, Cho DY, Choi JYJ, Christensen H, Chu DT, Chung MT, Chung SC, Cicuttini FM, Ciobanu LG, Cirillo M, Classen TKD, Cohen AJ, Compton K, Cooper OR, Costa VM, Cousin E, Cowden RG, Cross DH, Cruz JA, Dahlawi SMA, Damasceno AAM, Damiani G, Dandona L, Dandona R, Dangel WJ, Danielsson AK, Dargan PI, Darwesh AM, Daryani A, Das JK, Das Gupta R, das Neves J, Dávila-Cervantes CA, Davitoiu DV, De Leo D, Degenhardt L, DeLang M, Dellavalle RP, Demeke FM, Demoz GT, Demsie DG, Denova-Gutiérrez E, Dervenis N, Dhungana GP, Dianatinasab M, Dias da Silva D, Diaz D, Dibaji Forooshani ZS, Djalalinia S, Do HT, Dokova K, Dorostkar F, Doshmangir L, Driscoll TR, Duncan BB, Duraes AR, Eagan AW, Edvardsson D, El Nahas N, El Sayed I, El 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Gupta T, Haddock B, Hafezi-Nejad N, Hafiz A, Haj-Mirzaian A, Haj-Mirzaian A, Hall BJ, Halvaei I, Hamadeh RR, Hamidi S, Hammer MS, Hankey GJ, Haririan H, Haro JM, Hasaballah AI, Hasan MM, Hasanpoor E, Hashi A, Hassanipour S, Hassankhani H, Havmoeller RJ, Hay SI, Hayat K, Heidari G, Heidari-Soureshjani R, Henrikson HJ, Herbert ME, Herteliu C, Heydarpour F, Hird TR, Hoek HW, Holla R, Hoogar P, Hosgood HD, Hossain N, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Hsieh VCR, Hu G, Hu K, Huda TM, Humayun A, Huynh CK, Hwang BF, Iannucci VC, Ibitoye SE, Ikeda N, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Ippolito H, Iqbal U, Irvani SSN, Irvine CMS, Islam MM, Islam SMS, Iso H, Ivers RQ, Iwu CCD, Iwu CJ, Iyamu IO, Jaafari J, Jacobsen KH, Jafari H, Jafarinia M, Jahani MA, Jakovljevic M, Jalilian F, James SL, Janjani H, Javaheri T, Javidnia J, Jeemon P, Jenabi E, Jha RP, Jha V, Ji JS, Johansson L, John O, John-Akinola YO, Johnson CO, Jonas JB, Joukar F, Jozwiak JJ, 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Zandian H, Zastrozhin MS, Zhang Y, Zhang ZJ, Zhao JT, Zhao XJG, Zhao Y, Zhou M, Ziapour A, Zimsen SRM, Brauer M, Afshin A, Lim SS. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1223-1249. [PMID: 33069327 PMCID: PMC7566194 DOI: 10.1016/s0140-6736(20)30752-2] [Citation(s) in RCA: 3208] [Impact Index Per Article: 802.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. METHODS GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. FINDINGS The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51-12·1) deaths (19·2% [16·9-21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12-9·31) deaths (15·4% [14·6-16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11·6% [10·3-13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. INTERPRETATION Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. FUNDING Bill & Melinda Gates Foundation.
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Wang H, Abbas KM, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, Abdelalim A, Abolhassani H, Abreu LG, Abrigo MRM, Abushouk AI, Adabi M, Adair T, Adebayo OM, Adedeji IA, Adekanmbi V, Adeoye AM, Adetokunboh OO, Advani SM, Afshin A, Aghaali M, Agrawal A, Ahmadi K, Ahmadieh H, Ahmed MB, Al-Aly Z, Alam K, Alam T, Alanezi FM, Alanzi TM, Alcalde-Rabanal JE, Ali M, Alicandro G, Alijanzadeh M, Alinia C, Alipour V, Alizade H, Aljunid SM, Allebeck P, Almadi MAH, Almasi-Hashiani A, Al-Mekhlafi HM, Altirkawi KA, Alumran AK, Alvis-Guzman N, Amini-Rarani M, Aminorroaya A, Amit AML, Ancuceanu R, Andrei CL, Androudi S, Angus C, Anjomshoa M, Ansari F, Ansari I, Ansari-Moghaddam A, Antonio CAT, Antony CM, Anvari D, Appiah SCY, Arabloo J, Arab-Zozani M, Aravkin AY, Aremu O, Ärnlöv J, Aryal KK, Asadi-Pooya AA, Asgari S, Asghari Jafarabadi M, Atteraya MS, Ausloos M, Avila-Burgos L, Avokpaho EFGA, Ayala Quintanilla BP, Ayano G, Ayanore MA, Azarian G, Babaee E, Badiye AD, Bagli E, Bahrami MA, Bakhtiari A, Balassyano S, Banach M, Banik PC, Barker-Collo SL, Bärnighausen TW, Barzegar A, Basu S, Baune BT, Bayati M, Bazmandegan G, Bedi N, Bell ML, Bennett DA, Bensenor IM, Berhe K, Berman AE, Bertolacci GJ, Bhageerathy R, Bhala N, Bhattacharyya K, Bhutta ZA, Bijani A, Biondi A, Bisanzio D, Bisignano C, Biswas RK, Bjørge T, Bohlouli S, Bohluli M, Bolla SRR, Borzì AM, Borzouei S, Brady OJ, Braithwaite D, Brauer M, Briko AN, Briko NI, Bumgarner BR, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Cai T, Callender CSKH, Cámera LLAA, Campos-Nonato IR, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castelpietra G, Castro F, Catalá-López F, Cederroth CR, Cerin E, Chattu VK, Chin KL, Chu DT, Ciobanu LG, Cirillo M, Comfort H, Costa VM, Cowden RG, Cromwell EA, Croneberger AJ, Cunningham M, Dahlawi SMA, Damiani G, D'Amico E, Dandona L, Dandona R, Dargan PI, Darwesh AM, Daryani A, Das Gupta R, das Neves J, Davletov K, De Leo D, Denova-Gutiérrez E, Deribe K, Dervenis N, Desai R, Dhungana GP, Dias da Silva D, Diaz D, Dippenaar IN, Djalalinia S, Do HT, Dokova K, Doku DT, Dorostkar F, Doshi CP, Doshmangir L, Doyle KE, Dubljanin E, Duraes AR, Edvardsson D, Effiong A, El Sayed I, El Tantawi M, Elbarazi I, El-Jaafary SI, Emamian MH, Eskandarieh S, Esmaeilzadeh F, Estep K, Farahmand M, Faraj A, Fareed M, Faridnia R, Faro A, Farzadfar F, Fattahi N, Fazaeli AA, Fazlzadeh M, Feigin VL, Fereshtehnejad SM, Fernandes E, Ferreira ML, Filip I, Fischer F, Flohr C, Foigt NA, Folayan MO, Fomenkov AA, Freitas M, Fukumoto T, Fuller JE, Furtado JM, Gad MM, Gakidou E, Gallus S, Gebrehiwot AM, Gebremedhin KB, Gething PW, Ghamari F, Ghashghaee A, Gholamian A, Gilani SA, Gitimoghaddam M, Glushkova EV, Gnedovskaya EV, Gopalani SV, Goulart AC, Gugnani HC, Guo Y, Gupta R, Gupta SS, Haagsma JA, Haj-Mirzaian A, Haj-Mirzaian A, Halvaei I, Hamadeh RR, Hamagharib Abdullah K, Han C, Handiso DW, Hankey GJ, Haririan H, Haro JM, Hasaballah AI, Hassanipour S, Hassankhani H, Hay SI, Heibati B, Heidari-Soureshjani R, Henny K, Henry NJ, Herteliu C, Heydarpour F, Hole MK, Hoogar P, Hosgood HD, Hossain N, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hoy DG, Hu G, Huda TM, Ibitoye SE, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Imani-Nasab MH, Islam M, Iso H, Iwu CJ, Jaafari J, Jacobsen KH, Jahagirdar D, Jahanmehr N, Jalali A, Jalilian F, James SL, Janjani H, Jenabi E, Jha RP, Jha V, Ji JS, Jonas JB, Joukar F, Jozwiak JJ, Jürisson M, Kabir Z, Kalani H, Kalankesh LR, Kamiab Z, Kanchan T, Kapoor N, Karch A, Karimi SE, Karimi SA, Kassebaum NJ, Katikireddi SV, Kawakami N, Kayode GA, Keiyoro PN, Keller C, Khader YS, Khalid N, Khan EA, Khan M, Khang YH, Khater AM, Khater MM, Khazaei S, Khazaie H, Khodayari MT, Khubchandani J, Kianipour N, Kim CI, Kim YE, Kim YJ, Kinfu Y, Kisa A, Kisa S, Kissimova-Skarbek K, Kivimäki M, Komaki H, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kravchenko MA, Krishan K, Krohn KJ, Kuate Defo B, Kumar GA, Kumar M, Kumar P, Kumar V, Kusuma D, Kyu HH, La Vecchia C, Lacey B, Lal DK, Lalloo R, Lami FH, Lansky S, Larson SL, Larsson AO, Lasrado S, Lassi ZS, Lazarus JV, Lee PH, Lee SWH, Leever AT, LeGrand KE, Leonardi M, Li S, Lim LL, Lim SS, Linn S, Lodha R, Logroscino G, Lopez AD, Lopukhov PD, Lotufo PA, Lozano R, Lu A, Lunevicius R, Madadin M, Maddison ER, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahasha PW, Mahdavi MM, Malekzadeh R, Mamun AA, Manafi N, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Mapoma CC, Martini S, Martins-Melo FR, Masaka A, Mastrogiacomo CI, Mathur MR, May EA, McAlinden C, McGrath JJ, McKee M, Mehndiratta MM, Mehri F, Mehta KM, Meitei WB, Memiah PTN, Mendoza W, Menezes RG, Mengesha EW, Mensah GA, Meretoja A, Meretoja TJ, Mestrovic T, Michalek IM, Mihretie KM, Miller TR, Mills EJ, Milne GJ, Mirrakhimov EM, Mirzaei H, Mirzaei M, Mirzaei-Alavijeh M, Misganaw AT, Moazen B, Moghadaszadeh M, Mohamadi E, Mohammad DK, Mohammad Y, Mohammad Gholi Mezerji N, Mohammadbeigi A, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed H, Mohammed S, Mohebi F, Mohseni Bandpei MA, Mokari A, Mokdad AH, Momen NC, Monasta L, Mooney MD, Moradi G, Moradi M, Moradi-Joo M, Moradi-Lakeh M, Moradzadeh R, Moraga P, Moreno Velásquez I, Morgado-da-Costa J, Morrison SD, Mosser JF, Mouodi S, Mousavi SM, Mousavi Khaneghah A, Mueller UO, Musa KI, Muthupandian S, Nabavizadeh B, Naderi M, Nagarajan AJ, Naghavi M, Naghshtabrizi B, Naik G, Najafi F, Nangia V, Nansseu JR, Ndwandwe DE, Negoi I, Negoi RI, Ngunjiri JW, Nguyen HLT, Nguyen TH, Nigatu YT, Nikbakhsh R, Nikpoor AR, Nixon MR, Nnaji CA, Nomura S, Noubiap JJ, Nouraei Motlagh S, Nowak C, Oţoiu A, Odell CM, Oh IH, Oladnabi M, Olagunju AT, Olusanya BO, Olusanya JO, Omar Bali A, Ong KL, Onwujekwe OE, Ortiz A, Otstavnov N, Otstavnov SS, Øverland S, Owolabi MO, P A M, Padubidri JR, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Park J, Pasupula DK, Patel JR, Patel SK, Patton GC, Paulson KR, Pazoki Toroudi H, Pease SA, Peden AE, Pepito VCF, Peprah EK, Pereira A, Pereira DM, Perico N, Pigott DM, Pilgrim T, Pilz TM, Piradov MA, Pirsaheb M, Pokhrel KN, Postma MJ, Pourjafar H, Pourmalek F, Pourshams A, Poznańska A, Prada SI, Prakash S, Preotescu L, Quazi Syed Z, Rabiee M, Rabiee N, Radfar A, Rafiei A, Raggi A, Rahman MA, Rajabpour-Sanati A, Ram P, Ranabhat CL, Rao SJ, Rasella D, Rashedi V, Rastogi P, Rathi P, Rawal L, Remuzzi G, Renjith V, Renzaho AMN, Resnikoff S, Rezaei N, Rezai MS, Rezapour A, Rickard J, Roever L, Ronfani L, Roshandel G, Rostamian M, Rubagotti E, Rwegerera GM, Sabour S, Saddik B, Sadeghi E, Sadeghi M, Saeedi Moghaddam S, Safari Y, Safi S, Safiri S, Sagar R, Sahebkar A, Sahraian MA, Sajadi SM, Salahshoor MR, Salama JS, Salamati P, Salem MRR, Salimi Y, Salomon JA, Salz I, Samad Z, Samy AM, Sanabria J, Santric-Milicevic MM, Saraswathy SYI, Sartorius B, Sarveazad A, Sathian B, Sathish T, Sattin D, Saylan M, Schaeffer LE, Schiavolin S, Schwebel DC, Schwendicke F, Sekerija M, Senbeta AM, Senthilkumaran S, Sepanlou SG, Serván-Mori E, Shabani M, Shahabi S, Shahbaz M, Shaheen AA, Shaikh MA, Shalash AS, Shams-Beyranvand M, Shamsi M, Shamsizadeh M, Shannawaz M, Sharafi K, Sharafi Z, Sharara F, Sharma R, Shaw DH, Sheikh A, Shin JI, Shiri R, Shrime MG, Shuval K, Siabani S, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Simonetti B, Simpson KE, Singh JA, Skiadaresi E, Skryabin VY, Soheili A, Sokhan A, Sorensen RJD, Soriano JB, Sorrie MB, Soyiri IN, Spurlock EE, Sreeramareddy CT, Stockfelt L, Stokes MA, Stubbs JL, Sudaryanto A, Sufiyan MB, Suliankatchi Abdulkader R, Sykes BL, Tabarés-Seisdedos R, Tabb KM, Tadakamadla SK, Taherkhani A, Tang M, Taveira N, Taylor HJ, Teagle WL, Tehrani-Banihashemi A, Teklehaimanot BF, Tessema ZT, Thankappan KR, Thomas N, Thrift AG, Titova MV, Tohidinik HR, Tonelli M, Topor-Madry R, Topouzis F, Tovani-Palone MRR, Traini E, Tran BX, Travillian R, Trias-Llimós S, Truelsen TC, Tudor Car L, Unnikrishnan B, Upadhyay E, Vacante M, Vakilian A, Valdez PR, Valli A, Vardavas C, Vasankari TJ, Vasconcelos AMN, Vasseghian Y, Veisani Y, Venketasubramanian N, Vidale S, Violante FS, Vlassov V, Vollset SE, Vos T, Vujcic IS, Vukovic A, Vukovic R, Waheed Y, Wallin MT, Walters MK, Wang H, Wang YP, Watson S, Wei J, Weiss J, Weldesamuel GT, Werdecker A, Westerman R, Whiteford HA, Wiangkham T, Wiens KE, Wijeratne T, Wiysonge CS, Wojtyniak B, Wolfe CDA, Wondmieneh AB, Wool EE, Wu AM, Wu J, Xu G, Yamada T, Yamagishi K, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yearwood JA, Yeheyis TY, Yilgwan CS, Yip P, Yonemoto N, Yoon SJ, Yoosefi Lebni J, York HW, Younis MZ, Younker TP, Yousefi Z, Yousefinezhadi T, Yousuf AY, Yusefzadeh H, Zahirian Moghadam T, Zakzuk J, Zaman SB, Zamani M, Zamanian M, Zandian H, Zhang ZJ, Zheng P, Zhou M, Ziapour A, Murray CJL. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1160-1203. [PMID: 33069325 PMCID: PMC7566045 DOI: 10.1016/s0140-6736(20)30977-6] [Citation(s) in RCA: 701] [Impact Index Per Article: 175.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/10/2020] [Accepted: 04/20/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. METHODS 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10-14 and 50-54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. FINDINGS The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66-2·79) in 2000 to 2·31 (2·17-2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5-137·8) in 2000 to a peak of 139·6 million (133·0-146·9) in 2016. Global livebirths then declined to 135·3 million (127·2-144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4-27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8-67·6) in 2000 to 73·5 years (72·8-74·3) in 2019. The total number of deaths increased from 50·7 million (49·5-51·9) in 2000 to 56·5 million (53·7-59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1-10·3) in 2000 to 5·0 million (4·3-6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0-6·3) in 2000 to 7·7 billion (7·5-8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1-60·8) in 2000 to 63·5 years (60·8-66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. INTERPRETATION Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. FUNDING Bill & Melinda Gates Foundation.
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James SL, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Liu Z, Roberts NLS, Sylte DO, Bertolacci GJ, Cunningham M, Henry NJ, LeGrand KE, Abdelalim A, Abdollahpour I, Abdulkader RS, Abedi A, Abegaz KH, Abosetugn AE, Abushouk AI, Adebayo OM, Adsuar JC, Advani SM, Agudelo-Botero M, Ahmad T, Ahmed MB, Ahmed R, Eddine Aichour MT, Alahdab F, Alanezi FM, Alema NM, Alemu BW, Alghnam SA, Ali BA, Ali S, Alinia C, Alipour V, Aljunid SM, Almasi-Hashiani A, Almasri NA, Altirkawi K, Abdeldayem Amer YS, Andrei CL, Ansari-Moghaddam A, T Antonio CA, Anvari D, Yaw Appiah SC, Arabloo J, Arab-Zozani M, Arefi Z, Aremu O, Ariani F, Arora A, Asaad M, Ayala Quintanilla BP, Ayano G, Ayanore MA, Azarian G, Badawi A, Badiye AD, Baig AA, Bairwa M, Bakhtiari A, Balachandran A, Banach M, Banerjee SK, Banik PC, Banstola A, Barker-Collo SL, Bärnighausen TW, Barzegar A, Bayati M, Bazargan-Hejazi S, Bedi N, Behzadifar M, Belete H, Bennett DA, Bensenor IM, Berhe K, Bhagavathula AS, Bhardwaj P, Bhat AG, Bhattacharyya K, Bhutta ZA, Bibi S, Bijani A, Boloor A, Borges G, Borschmann R, Borzì AM, Boufous S, Braithwaite D, Briko NI, Brugha T, Budhathoki SS, Car J, Cárdenas R, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Cerin E, Chandan JS, Chapman JR, Chattu VK, Chattu SK, Chatziralli I, Chaudhary N, Cho DY, Choi JYJ, Kabir Chowdhury MA, Christopher DJ, Chu DT, Cicuttini FM, Coelho JM, Costa VM, Dahlawi SMA, Daryani A, Dávila-Cervantes CA, Leo DD, Demeke FM, Demoz GT, Demsie DG, Deribe K, Desai R, Nasab MD, Silva DDD, Dibaji Forooshani ZS, Do HT, Doyle KE, Driscoll TR, Dubljanin E, Adema BD, Eagan AW, Elemineh DA, El-Jaafary SI, El-Khatib Z, Ellingsen CL, Zaki MES, Eskandarieh S, Eyawo O, Faris PS, Faro A, Farzadfar F, Fereshtehnejad SM, Fernandes E, Ferrara P, Fischer F, Folayan MO, Fomenkov AA, Foroutan M, Francis JM, Franklin RC, Fukumoto T, Geberemariyam BS, Gebremariam H, Gebremedhin KB, Gebremeskel LG, Gebremeskel GG, Gebremichael B, Gedefaw GA, Geta B, Getenet AB, Ghafourifard M, Ghamari F, Gheshlagh RG, Gholamian A, Gilani SA, Gill TK, Goudarzian AH, Goulart AC, Grada A, Grivna M, Guimarães RA, Guo Y, Gupta G, Haagsma JA, Hall BJ, Hamadeh RR, Hamidi S, Handiso DW, Haro JM, Hasanzadeh A, Hassan S, Hassanipour S, Hassankhani H, Hassen HY, Havmoeller R, Hendrie D, Heydarpour F, Híjar M, Ho HC, Hoang CL, Hole MK, Holla R, Hossain N, Hosseinzadeh M, Hostiuc S, Hu G, Ibitoye SE, Ilesanmi OS, Inbaraj LR, Naghibi Irvani SS, Mofizul Islam M, Shariful Islam SM, Ivers RQ, Jahani MA, Jakovljevic M, Jalilian F, Jayaraman S, Jayatilleke AU, Jha RP, John-Akinola YO, Jonas JB, Jones KM, Joseph N, Joukar F, Jozwiak JJ, Jungari SB, Jürisson M, Kabir A, Kahsay A, Kalankesh LR, Kalhor R, Kamil TA, Kanchan T, Kapoor N, Karami M, Kasaeian A, Kassaye HG, Kavetskyy T, Kayode GA, Keiyoro PN, Kelbore AG, Khader YS, Khafaie MA, Khalid N, Khalil IA, Khalilov R, Khan M, Khan EA, Khan J, Khanna T, Khazaei S, Khazaie H, Khundkar R, Kiirithio DN, Kim YE, Kim YJ, Kim D, Kisa S, Kisa A, Komaki H, Kondlahalli SKM, Koolivand A, Korshunov VA, Koyanagi A, Kraemer MUG, Krishan K, Defo BK, Bicer BK, Kugbey N, Kumar N, Kumar M, Kumar V, Kumar N, Kumaresh G, Lami FH, Lansingh VC, Lasrado S, Latifi A, Lauriola P, Vecchia CL, Leasher JL, Huey Lee SW, Li S, Liu X, Lopez AD, Lotufo PA, Lyons RA, Machado DB, Madadin M, Abd El Razek MM, Mahotra NB, Majdan M, Majeed A, Maled V, Malta DC, Manafi N, Manafi A, Manda AL, Manjunatha N, Mansour-Ghanaei F, Mansournia MA, Maravilla JC, Mason-Jones AJ, Masoumi SZ, Massenburg BB, Maulik PK, Mehndiratta MM, Melketsedik ZA, Memiah PTN, Mendoza W, Menezes RG, Mengesha MM, Meretoja TJ, Meretoja A, Merie HE, Mestrovic T, Miazgowski B, Miazgowski T, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mirzaei-Alavijeh M, Mithra P, Moazen B, Moghadaszadeh M, Mohamadi E, Mohammad Y, Darwesh AM, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed S, Mohammed JA, Mohebi F, Mohseni Bandpei MA, Molokhia M, Monasta L, Moodley Y, Moradi 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T, Wolde HF, Woldeyes DH, Wondmeneh TG, Wondmieneh AB, Wu AM, Wyper GMA, Yadav R, Yadollahpour A, Yano Y, Yaya S, Yazdi-Feyzabadi V, Ye P, Yip P, Yisma E, Yonemoto N, Yoon SJ, Youm Y, Younis MZ, Yousefi Z, Yu C, Yu Y, Moghadam TZ, Zaidi Z, Zaman SB, Zamani M, Zandian H, Zarei F, Zhang ZJ, Zhang Y, Ziapour A, Zodpey S, Dandona R, Dharmaratne SD, Hay SI, Mokdad AH, Pigott DM, Reiner RC, Vos T. Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study. Inj Prev 2020; 26:i125-i153. [PMID: 32839249 PMCID: PMC7571362 DOI: 10.1136/injuryprev-2019-043531] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/29/2019] [Accepted: 12/06/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. METHODS In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. RESULTS GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. CONCLUSIONS GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
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Affiliation(s)
- Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Gregory J Bertolacci
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Matthew Cunningham
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nathaniel J Henry
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kate E LeGrand
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Ibrahim Abdollahpour
- Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Aidin Abedi
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA
| | - Kedir Hussein Abegaz
- Biostatistics and Health Informatics, Madda Walabu University, Bale Robe, Ethiopia
- Radiotherapy Center, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | | | - Jose C Adsuar
- Sport Science Department, University of Extremadura, Badajoz, Spain
| | - Shailesh M Advani
- Social Behavioral Research Branch, National Institute of Health, Bethesda, MD, USA
- Cancer Prevention and Control, Georgetown University, Washington, DC, USA
| | - Marcela Agudelo-Botero
- School of Medicine, Center for Politics, Population and Health Research, National Autonomous University of Mexico, Mexico City, Mexico
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, Southeast University Nanjing, Nanjing, China
- Microbiology Department, Hazara University, Mansehra, Pakistan
| | | | - Rushdia Ahmed
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA
| | - Fahad Mashhour Alanezi
- Department of Computer Sciences, Imam Abdulrehman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Biresaw Wassihun Alemu
- Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- Midwifery Department, Arba Minch University, Injbara, Ethiopia
| | - Suliman A Alghnam
- Department of Population Health Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | - Saqib Ali
- Department of Information Systems, College of Economics and Political Science, Sultan Qaboos University, Muscat, Oman
| | - Cyrus Alinia
- Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | - Nihad A Almasri
- Physiotherapy Department, The University of Jordan, Amman, Jordan
| | | | - Yasser Sami Abdeldayem Amer
- Clinical Practice Guidelines Unit, King Saud University, Riyadh, Saudi Arabia
- Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt
| | | | | | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Davood Anvari
- Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Microbiology and Immunology, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for International Health, Ludwig Maximilians University, Munich, Germany
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Zohreh Arefi
- Department of Health Promotion and Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Filippo Ariani
- Regional Centre for the Analysis of Data on Occupational and Work-related Injuries and Diseases, Local Health Unit Tuscany Centre, Florence, Italy
| | - Amit Arora
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
- Oral Health Services, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Malke Asaad
- Plastic Surgery Department, University of Texas, Houston, TX, USA
| | - Beatriz Paulina Ayala Quintanilla
- The Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, Peru
| | - Getinet Ayano
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Martin Amogre Ayanore
- Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana
| | - Ghasem Azarian
- Department of Environmental Health Engineering, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ashish D Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Atif Amin Baig
- Biochemistry Unit, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
- School of Health Sciences, Univeristi Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Mohan Bairwa
- Institute of Health Management Research, Indian Institute of Health Management Research University, Jaipur, India
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Ahad Bakhtiari
- Health Policy and Management Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Arun Balachandran
- Department of Demography, University of Groningen, Groningen, Netherlands
- Population Research Centre, Institute for Social and Economic Change, Bengaluru, India
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | | | - Palash Chandra Banik
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Amrit Banstola
- Department of Research, Public Health Perspective Nepal, Pokhara-Lekhnath Metropolitan City, Nepal
| | | | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Akbar Barzegar
- Occupational Health Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Neeraj Bedi
- Department of Community Medicine, Gandhi Medical College Bhopal, Bhopal, India
- Jazan University, Jazan, Saudi Arabia
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Habte Belete
- Psychiatry Department, Bahir Dar University, Bhair Dar, Ethiopia
| | - Derrick A Bennett
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Isabela M Bensenor
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
| | - Kidanemaryam Berhe
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Akshaya Srikanth Bhagavathula
- Department of Internal Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
- Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
| | - Pankaj Bhardwaj
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Anusha Ganapati Bhat
- Internal Medicine Department, University of Massachusetts Medical School, Springfield, MA, USA
| | - Krittika Bhattacharyya
- Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
- Department of Statistics, University of Calcutta, Kolkata, India
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, University of Toronto, Toronto, Ontario, Canada
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sadia Bibi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Archith Boloor
- Department of Internal Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Guilherme Borges
- Department of Epidemiology and Psychosocial Reseach, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Rohan Borschmann
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Antonio Maria Borzì
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research Department, University of New South Wales, Sydney, New South Wales, Australia
| | - Dejana Braithwaite
- Division of Hematology and Oncology, Georgetown University, Washington DC, USA
| | - Nikolay Ivanovich Briko
- Department of Epidemiology and Evidence Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Traolach Brugha
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Josip Car
- Centre for Population Health Sciences, Nanyang Technological University, Singapore, Singapore
- Global eHealth Unit, Imperial College London, London, UK
| | - Rosario Cárdenas
- Department of Population and Health, Metropolitan Autonomous University, Mexico City, Mexico
| | - Félix Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | | | - Carlos A Castañeda-Orjuela
- Colombian National Health Observatory, National Institute of Health, Bogota, Colombia
- Epidemiology and Public Health Evaluation Group, National University of Colombia, Bogota, Colombia
| | - Giulio Castelpietra
- Primary Care Services Area, Central Health Directorate, Region Friuli Venezia Giulia, Trieste, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Ferrán Catalá-López
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Joht S Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jens Robert Chapman
- Swedish Neuroscience Institute, Swedish Brain and Spine Specialists, Seattle, WA, USA
| | | | | | - Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Haidari, Greece
- Ophthalmology Independent Consultant, Athens, Greece
| | - Neha Chaudhary
- Pediatrics Department, Harvard University, Boston, MA, USA
- Neonatology Department, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Daniel Youngwhan Cho
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Jee-Young J Choi
- Department of Biochemistry and Biomedical Science, Seoul National University Hospital, Seoul, South Korea
| | - Mohiuddin Ahsanul Kabir Chowdhury
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | | | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - João M Coelho
- Centro Hospitalar Universitário do Porto - Serviço de Oftalmologia, University of Porto, Porto, Portugal
| | - Vera M Costa
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Saad M A Dahlawi
- Department of Environmental Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Mount Gravatt, Queensland, Australia
| | | | - Gebre Teklemariam Demoz
- School of Pharmacy, Aksum University, Aksum, Ethiopia
- Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rupak Desai
- Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | | | | | | | - Hoa Thi Do
- Center of Excellence in Public Health Nutrition, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Kerrie E Doyle
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Bundoora, Victoria, Australia
| | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Bereket Duko Adema
- Public Health Department, Hawassa University, Hawassa, Ethiopia
- Curtin University, Perth, Western Australia, Australia
| | - Arielle Wilder Eagan
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
- Department of Social Services, Tufts Medical Center, Boston, MA, USA
| | | | | | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | - Christian Lycke Ellingsen
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Oghenowede Eyawo
- Epidemiology and Population Health, York University, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Pawan Sirwan Faris
- Biology Department, Salahaddin University-Erbil, Erbil, Iraq
- Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy
| | - Andre Faro
- Department of Psychology, Federal University of Sergipe, Sao Cristovao, Brazil
| | - Farshad Farzadfar
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurobiology, Karolinska Institutet, Stockholm, Sweden
- Division of Neurology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Pietro Ferrara
- Research Centre on Public Health (CESP), University of Milan Bicocca, Monza, Italy
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | | | | | - Masoud Foroutan
- Abadan School of Medical Sciences, Abadan University of Medical Sciences, Abadan, Iran
| | - Joel Msafiri Francis
- Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Science, James Cook University, Douglas, Queensland, Australia
- Royal Life Saving Society, Sydney, New South Wales, Australia
| | - Takeshi Fukumoto
- Department of Dermatology, Kobe University, Kobe, Japan
- Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, PA, USA
| | | | - Hadush Gebremariam
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | | | - Leake G Gebremeskel
- School of Pharmacy, Aksum University, Aksum, Ethiopia
- Pharmacy Department, Mekelle University, Mekelle, Ethiopia
| | | | | | - Getnet Azeze Gedefaw
- Bahir Dar University, Bahir Dar, Ethiopia
- Haramaya University, Dire Dawa, Ethiopia
| | - Birhanu Geta
- Department of Pharmacy, Wollo University, Dessie, Ethiopia
| | | | - Mansour Ghafourifard
- Department of Medical Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Ghamari
- Occupational Health Department, Arak University of Medical Sciences, Arak, Iran
| | - Reza Ghanei Gheshlagh
- Department of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Asadollah Gholamian
- Science and Research Branch, Islamic Azad University, Tehran, Iran
- Young Researchers and Elite Club, Islamic Azad University, Rasht, Iran
| | - Syed Amir Gilani
- Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
- Chairman BOG, Afro-Asian Institute, Lahore, Pakistan
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | | | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University of São Paulo, Sao Paulo, Brazil
- Internal Medicine Department, University of São Paulo, Sao Paulo, Brazil
| | - Ayman Grada
- Department of Dermatology, Boston University, Boston, MA, USA
| | - Michal Grivna
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rafael Alves Guimarães
- Instituto de Patologia Tropical e Saúde Pública, Federal University of Goias, Goiânia, Brazil
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Epidemiology and Biostatistics, Zhengzhou University, Zhengzhou, China
| | - Gaurav Gupta
- Non-Communicable Diseases (NCD), World Health Organization (WHO), New Delhi, India
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Brian James Hall
- Global and Community Mental Health Research Group, University of Macau, Macao, China
| | - Randah R Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | | | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
- Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - Amir Hasanzadeh
- Department of Microbiology, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Microbiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Shoaib Hassan
- Centre for International Health and Section for Ethics and Health Economics, University of Bergen, Bergen, Norway
| | - Soheil Hassanipour
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Guilan University of Medical Sciences, Rasht, Iran
| | - Hadi Hassankhani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Independent Consultant, Tabriz, Iran
| | - Hamid Yimam Hassen
- Department of Public Health, Mizan-Tepi University, Tepi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Rasmus Havmoeller
- Department of Clinical Sciences, Karolinska University Hospital, Stockholm, Sweden
| | - Delia Hendrie
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Fatemeh Heydarpour
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Martha Híjar
- Research Coordination, AC Environments Foundation, Cuernavaca, Mexico
- CISS, National Institute of Public Health, Cuernavaca. Mexico
| | - Hung Chak Ho
- Department of Urban Planning and Design, University of Hong Kong, Hong Kong, China
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Michael K Hole
- Department of Pediatrics, Dell Medical School, University of Texas Austin, Austin, TX, USA
| | - Ramesh Holla
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Naznin Hossain
- Department of Pharmacology and Therapeutics, Dhaka Medical College, Dhaka, Bangladesh
- Department of Pharmacology, Bangladesh Industrial Gases Limited, Tangail, Bangladesh
| | - Mehdi Hosseinzadeh
- Department of Computer Engineering, Islamic Azad University, Tehran, Iran
- Computer Science Department, University of Human Development, Sulaymaniyah, Iraq
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Central South University, Changsha, China
| | | | | | | | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Mofizul Islam
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, Victoria, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Mihajlo Jakovljevic
- Department for Health Care and Public Health, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Farzad Jalilian
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sudha Jayaraman
- Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Achala Upendra Jayatilleke
- Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Graduate Studies, University of Colombo, Colombo, Sri Lanka
| | - Ravi Prakash Jha
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Beijing Ophthalmology & Visual Science Key Laboratory, Beijing Tongren Hospital, Beijing, China
| | - Kelly M Jones
- Auckland University of Technology, Auckland, New Zealand
| | - Nitin Joseph
- Community Medicine Department, Manipal Academy of Higher Education, Mangalore, India
| | - Farahnaz Joukar
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | | | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amaha Kahsay
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Leila R Kalankesh
- Department of Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Kalhor
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Teshome Abegaz Kamil
- School of Public Health, Department of Health informatics and Health Innovation, A.C.S. Medical College and Hospital, Mekelle, Ethiopia
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Manoochehr Karami
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Taras Kavetskyy
- Department of Applied Physics, The John Paul II Catholic University of Lublin, Lublin Voivodeship, Poland
- Department of Biology and Chemistry, Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
| | - Gbenga A Kayode
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, Netherlands
| | | | | | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Morteza Abdullatif Khafaie
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nauman Khalid
- School of Food and Agricultural Sciences, University of Management and Technology, Lahore, Pakistan
| | - Ibrahim A Khalil
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Rovshan Khalilov
- Department of Physiology, Baku State University, Baku, Azerbaijan
| | - Maseer Khan
- Epidemiology, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Junaid Khan
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Tripti Khanna
- Department of Health Research, Indian Council of Medical Research, New Delhi, India
- Centre for Ethics, Jawahar Lal Nehru University, New Delhi, India
| | - Salman Khazaei
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Habibolah Khazaie
- Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roba Khundkar
- Nuffield Department of Surgical Sciences, Oxford University Global Surgery Group, University of Oxford, Oxford, UK
| | | | - Young-Eun Kim
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Yun Jin Kim
- School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, MA, USA
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Hamidreza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Brain Engineering Research Center, Institute for Research in Fundamental Sciences, Tehran, Iran
| | - Shivakumar K M Kondlahalli
- Public Health Dentistry Department, Krishna Institute of Medical Sciences Deemed to be University, Karad, India
| | - Ali Koolivand
- Environmental Health Engineering, Arak University of Medical Sciences, Arak, Iran
| | - Vladimir Andreevich Korshunov
- Department of Epidemiology and Evidence Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ai Koyanagi
- CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Kewal Krishan
- Department of Anthropology, Panjab University, Chandigarh, India
| | - Barthelemy Kuate Defo
- Department of Demography, University of Montreal, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Burcu Kucuk Bicer
- Department of Public Health, Yuksek Ihtisas University, Ankara, Turkey
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Nuworza Kugbey
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
- Department of Psychology and Health Promotion, University of KwaZulu-Natal, Durban, South Africa
| | - Nithin Kumar
- Community Medicine Department, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Vivek Kumar
- Department of Medicine Brigham and Women's Hospital, Harvard University, Boston, MA, USA
| | - Narinder Kumar
- Orthopaedics Department, Base Hospital Lucknow Cantt, Lucknow, India
| | - Girikumar Kumaresh
- Mechanical and Industrial Engineering, Indian Institute of Technology, Roorkee, India
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | - Van C Lansingh
- HelpMeSee, New York, NY, USA
- International Relations, Mexican Institute of Ophthalmology, Queretaro, Mexico
| | - Savita Lasrado
- Department of Otorhinolaryngology (ENT), Father Muller Medical College, Mangalore, India
| | - Arman Latifi
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Paolo Lauriola
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Carlo La Vecchia
- Clinical Medicine and Community Health, University of Milan, Milano, Italy
| | - Janet L Leasher
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Xuefeng Liu
- Department of Systems, Populations and Leadership, University of Michigan, Ann Arbor, MI, USA
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Paulo A Lotufo
- Department of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Ronan A Lyons
- Health Data Research UK, Swansea University, Swansea, UK
| | - Daiane Borges Machado
- Center for Integration of Data and Health Knowledge, FIOCRUZ: Cidacs Center for Integration of Data and Health Knowledge, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, England
| | - Mohammed Madadin
- Pathology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Venkatesh Maled
- Health Education and Research Department, SDM College of Medical Sciences & Hospital, Dharwad, India
- Health University, Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Navid Manafi
- Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran
- Ophthalmology Department, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amir Manafi
- Department of Surgery, University of Virginia, Charlottesville, VA, USA
| | - Ana-Laura Manda
- Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Narayana Manjunatha
- Psychiatry Department, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Joemer C Maravilla
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Seyedeh Zahra Masoumi
- Department of Midwifery-Reproductive Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Benjamin Ballard Massenburg
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Pallab K Maulik
- Research Department, The George Institute for Global Health, New Delhi, India
- School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Man Mohan Mehndiratta
- Neurology Department, Janakpuri Super Specialty Hospital Society, New Delhi, India
- Department of Neurology, Govind Ballabh Institute of Medical Education and Research, New Delhi, India
| | | | - Peter T N Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Baltimore, MD, USA
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
| | - Ritesh G Menezes
- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Atte Meretoja
- Neurocenter, Helsinki University Hospital, Helsinki, Finland
- School of Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | | | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
- Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Ted R Miller
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- Pacific Institute for Research & Evaluation, Calverton, MD, USA
| | - G K Mini
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Global Institute of Public Health (GIPH), Ananthapuri Hospitals and Research Centre, Trivandrum, India
| | - Andreea Mirica
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- President's Office, National Institute of Statistics, Bucharest, Romania
| | - Erkin M Mirrakhimov
- Faculty of Internal Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
- Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
| | - Mehdi Mirzaei-Alavijeh
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Prasanna Mithra
- Community Medicine Department, Manipal Academy of Higher Education, Mangalore, India
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Masoud Moghadaszadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Efat Mohamadi
- Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | | | | | - Shafiu Mohammed
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | | | - Farnam Mohebi
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Iran National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad A Mohseni Bandpei
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Yoshan Moodley
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Masoud Moradi
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Shane Douglas Morrison
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | | | - Atalay Goshu Muluneh
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Kamarul Imran Musa
- School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia
| | - Ghulam Mustafa
- Department of Pediatric Medicine, Nishtar Medical University, Multan, Pakistan
- Department of Pediatrics & Pediatric Pulmonology, Institute of Mother & Child Care, Multan, Pakistan
| | - Mehdi Naderi
- Clinical Research Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ahamarshan Jayaraman Nagarajan
- Research and Analytics, Initiative for Financing Health and Human Development, Chennai, India
- Research and Analytics, Bioinsilico Technologies, Chennai, India
| | - Gurudatta Naik
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russia
| | - Farid Najafi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Bruno Ramos Nascimento
- Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Morteza Naserbakht
- Mental Health Research Center, IUMS, Tehran, Iran
- Preventive Medicine and Public Health Research Center, IUMS, Tehran, Iran
| | - Vinod Nayak
- Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Manipal, India
| | - Javad Nazari
- Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran
- Iranian Ministry of Health and Medical Education, Tehran, Iran
| | | | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | | | - Trang Huyen Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Diep Ngoc Nguyen
- Project of ADB, National Institute of Nutrition, Hanoi, Vietnam
- Industrial Management Department, Hanoi University of Science and Technology, Hanoi, Vietnam
| | | | - Rajan Nikbakhsh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Heidelberg University Hospital, Heidelberg, Germany
| | - Dina Nur Anggraini Ningrum
- Public Health Department, Universitas Negeri Semarang, Kota Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | - Chukwudi A Nnaji
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Richard Ofori-Asenso
- Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, Australia
- Independent Consultant, Accra, Ghana
| | | | - Onome Bright Oghenetega
- Reproductive Health Sciences, Department Obstetrics and Gynecology, University of Ibadan, Ibadan, Nigeria
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaimaniyah, Iraq
| | - Obinna E Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
| | - Heather M Orpana
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Erika Ota
- Department of Global Health Nursing, St. Luke's International University, Chuo-ku, Japan
| | - Nikita Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Academic Department, Unium Ltd, Moscow, Russia
| | - Stanislav S Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | | | - Smita Pakhale
- Department of Medicine, Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, Ontario, Canada
| | - Keyvan Pakshir
- Parasitology and Mycology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | - Sangram Kishor Patel
- Research and Evaluation Department, Population Council, New Delhi, India
- Indian Institute of Health Management Research University, Jaipur, India
| | - Ashish Pathak
- Department of Pediatircs, RD Gardi Medical College, Ujjain, India
- Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Sanghamitra Pati
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India
| | - Kebreab Paulos
- Department of Midwifery, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amy E Peden
- Royal Life Saving Society, Sydney, New South Wales, Australia
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Jeevan Pereira
- Department of Orthopedics, Yenepoya Medical College, Mangalore, India
| | - Michael R Phillips
- Department of Psychiatry, Department of Epidemiology, Columbia University, New York, NY, USA
- Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
| | - Roman V Polibin
- Department of Epidemiology and Evidence-Based Medicine, Sechenon University, Moscow, Russia
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Farshad Pourmalek
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Akram Pourshams
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Swayam Prakash
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Parul Puri
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Zahiruddin Quazi Syed
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando, FL, USA
- College of Graduate Health Sciences, A.T. Still University, Mesa, AZ, USA
| | - Anwar Rafay
- Department of Epidemiology & Biostatistics, Contech School of Public Health, Lahore, Pakistan
| | - Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Alireza Rafiei
- Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fakher Rahim
- Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Siavash Rahimi
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Victoria, Australia
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | | | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ivo Rakovac
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization (WHO), Moscow, Russia
| | - Sowmya J Rao
- Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran
| | - Prateek Rastogi
- Department of Forensic Medicine, Manipal Academy of Higher Education, Manipal, India
| | - Priya Rathi
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Academic Public Health Department, Public Health England, London, UK
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, CQ University, Sydney, New South Wales, Australia
| | - Reza Rawassizadeh
- Department of Computer Science, Metropolitan College, Boston University, Boston, USA
| | - Vishnu Renjith
- Neurology Department, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- Organization for the Prevention of Blindness, Paris, France
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ana Isabel Ribeiro
- EPIUnit - Public Health Institute University Porto (ISPUP), University of Porto, Porto, Portugal
| | - Jennifer Rickard
- Surgery Department, University of Minnesota, Minneapolis, MN, USA
- Surgery Department, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Carlos Miguel Rios González
- Research Directorate, Nihon Gakko University, Fernando de la Mora, Paraguay
- Research Direction, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay
| | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Basema Saddik
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hamid Safarpour
- Department of Health in Disasters and Emergencies, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Safdarian
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hosni Salem
- Urology Department, Cairo University, Giza, Egypt
| | - Inbal Salz
- Health and Disability Intelligence Group, Ministry of Health, Wellington, New Zealand
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, WV, USA
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Lidia Sanchez Riera
- Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Institute of Bone and Joint Research, University of Sydney, Syndey, New South Wales, Australia
| | - Milena M Santric Milicevic
- Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
- Centre-School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Abdur Razzaque Sarker
- Health Economics, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Brijesh Sathian
- Surgery Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Mehdi Sayyah
- Education Development Center, Faculty Member of Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | | | - Feng Sha
- Center for Biomedical Information Technology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Faramarz Shaahmadi
- Department of Health Promotion and Education, Alborz University of Medical Sciences, Karaj, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
- Division of General Internal Medicine, Harvard University, Boston, MA, USA
| | | | - Jae Il Shin
- College of Medicine, Yonsei University, Seodaemun-gu, South Korea
- Division of Cardiology, Emory University, Atlanta, GA, USA
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Soraya Siabani
- Department of Health Education & Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
- School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Health and Behavior Studies, Columbia University, New York, NY, USA
| | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Medicine Service, US Department of Veterans Affairs (VA), Birmingham, AL, USA
| | | | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Amin Soheili
- Medical Surgical Nursing Department, Urmia University of Medical Science, Urmia, Iran
- Emergency Nursing Department, Semnan University of Medical Sciences, Semnan, Iran
| | - Joan B Soriano
- Hospital Universitario de la Princesa, Autonomous University of Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | | | - Ireneous N Soyiri
- Hull York Medical School, University of Hull, Hull City, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Mark A Stokes
- Department of Psychology, Deakin University, Melbourne, Victoria, Australia
| | | | - Bryan L Sykes
- Department of Criminology, Law and Society, University of California Irvine, Irvine, CA, USA
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Karen M Tabb
- School of Social Work, University of Illinois, Urbana, IL, USA
| | | | - Yonatal Mesfin Tefera
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Rekha Thapar
- Community Medicine Department, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Mariya Vladimirovna Titova
- Timiryazev Institute of Plant Physiology, Russian Academy of Sciences, Moscow, Russia
- Biology Department, Moscow State University, Moscow, Russia
| | | | - Hamid Reza Tohidinik
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Kerman University of Medical Sciences, Kerman, Iran
| | - Roman Topor-Madry
- Institute of Public Health, Krakow, Poland
- The Agency for Health Technology Assessment and Tariff System, Warszawa, Poland
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Military Medical University, Hanoi, Vietnam
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Alexander C Tsai
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Irfan Ullah
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
- TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan
| | - Saif Ullah
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Pakistan
| | | | - Era Upadhyay
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | | | - Pascual R Valdez
- Argentine Society of Medicine, Buenos Aires, Argentina
- Velez Sarsfield Hospital, Buenos Aires, Argentina
| | | | - Yousef Veisani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Narayanaswamy Venketasubramanian
- Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yasir Waheed
- Foundation University Medical College, Foundation University, Islamabad, Pakistan
| | - Yuan-Pang Wang
- Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Taweewat Wiangkham
- Department of Physical Therapy, Naresuan University, Meung District, Thailand
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Dawit Habte Woldeyes
- Department of Human Anatomy, Histology, and Embryology, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Adam Belay Wondmieneh
- Department of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Nursing, Wollo University, Dessie, Ethiopia
| | - Ai-Min Wu
- Department of Orthopaedics, Wenzhou Medical University, Wenzhou, China
| | - Grant M A Wyper
- Public Health Science Directorate, NHS Health Scotland, Glasgow, Scotland
| | - Rajaram Yadav
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Ali Yadollahpour
- Medical Physics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
| | - Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Health Management, Policy and Economics, Kerman University of Medical Sciences, Kerman, Iran
| | - Pengpeng Ye
- Division of Injury Prevention and Mental Health Improvement, National Center for Chronic and Noncommunicable Disease Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Paul Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Engida Yisma
- School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Naohiro Yonemoto
- Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, South Korea
| | - Mustafa Z Younis
- Department of Health Policy & Management, Jackson State University, Jackson, MS, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Zabihollah Yousefi
- Department of Environmental Health, Mazandaran University of Medical Sciences, Sari, Iran
- Environmental Health, Academy of Medical Science, Sari, Iran
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, China
| | - Telma Zahirian Moghadam
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
| | - Sojib Bin Zaman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
- Department of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran
| | - Fatemeh Zarei
- Faculty of Medical Sciences, Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, Wuhan University, Wuhan, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Arash Ziapour
- Department of Health Education & Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sanjay Zodpey
- Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Public Health Foundation of India, Gurugram, India
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Haagsma JA, James SL, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Liu Z, Lucchesi LR, Roberts NLS, Sylte DO, Adebayo OM, Ahmadi A, Ahmed MB, Aichour MTE, Alahdab F, Alghnam SA, Aljunid SM, Al-Raddadi RM, Alsharif U, Altirkawi K, Anjomshoa M, Antonio CAT, Appiah SCY, Aremu O, Arora A, Asayesh H, Assadi R, Awasthi A, Ayala Quintanilla BP, Balalla S, Banstola A, Barker-Collo SL, Bärnighausen TW, Bazargan-Hejazi S, Bedi N, Behzadifar M, Behzadifar M, Benjet C, Bennett DA, Bensenor IM, Bhaumik S, Bhutta ZA, Bijani A, Borges G, Borschmann R, Bose D, Boufous S, Brazinova A, Campuzano Rincon JC, Cárdenas R, Carrero JJ, Carvalho F, Castañeda-Orjuela CA, Catalá-López F, Choi JYJ, Christopher DJ, Crowe CS, Dalal K, Daryani A, Davitoiu DV, Degenhardt L, De Leo D, De Neve JW, Deribe K, Dessie GA, deVeber GA, Dharmaratne SD, Doan LP, Dolan KA, Driscoll TR, Dubey M, El-Khatib Z, Ellingsen CL, El Sayed Zaki M, Endries AY, Eskandarieh S, Faro A, Fereshtehnejad SM, Fernandes E, Filip I, Fischer F, Franklin RC, Fukumoto T, Gezae KE, Gill TK, Goulart AC, Grada A, Guo Y, Gupta R, Haghparast Bidgoli H, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Haro JM, Hassankhani H, Hassen HY, Havmoeller R, Hendrie D, Henok A, Híjar M, Hole MK, Homaie Rad E, Hossain N, Hostiuc S, Hu G, Igumbor EU, Ilesanmi OS, Irvani SSN, Islam SMS, Ivers RQ, Jacobsen KH, Jahanmehr N, Jakovljevic M, Jayatilleke AU, Jha RP, Jonas JB, Jorjoran Shushtari Z, Jozwiak JJ, Jürisson M, Kabir A, Kalani R, Kasaeian A, Kelbore AG, Kengne AP, Khader YS, Khafaie MA, Khalid N, Khan EA, Khoja AT, Kiadaliri AA, Kim YE, Kim D, Kisa A, Koyanagi A, Kuate Defo B, Kucuk Bicer B, Kumar M, Lalloo R, Lam H, Lami FH, Lansingh VC, Leasher JL, Li S, Linn S, Lunevicius R, Machado FR, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahotra NB, Majdan M, Majeed A, Malekzadeh R, Malik MA, Malta DC, Manda AL, Mansournia MA, Massenburg BB, Maulik PK, Meheretu HAA, Mehndiratta MM, Melese A, Mendoza W, Mengesha MM, Meretoja TJ, Meretoja A, Mestrovic T, Miazgowski T, Miller TR, Mini GK, Mirrakhimov EM, Moazen B, Mohammad Gholi Mezerji N, Mohammadibakhsh R, Mohammed S, Molokhia M, Monasta L, Mondello S, Montero-Zamora PA, Moodley Y, Moosazadeh M, Moradi G, Moradi-Lakeh M, Morawska L, Velásquez IM, Morrison SD, Moschos MM, Mousavi SM, Murthy S, Musa KI, Naik G, Najafi F, Nangia V, Nascimento BR, Ndwandwe DE, Negoi I, Nguyen TH, Nguyen SH, Nguyen LH, Nguyen HLT, Ningrum DNA, Nirayo YL, Ofori-Asenso R, Ogbo FA, Oh IH, Oladimeji O, Olagunju AT, Olagunju TO, Olivares PR, Orpana HM, Otstavnov SS, P A M, Pakhale S, Park EK, Patton GC, Pesudovs K, Phillips MR, Polinder S, Prakash S, Radfar A, Rafay A, Rafiei A, Rahimi S, Rahimi-Movaghar V, Rahman MA, Rai RK, Ramezanzadeh K, Rawaf S, Rawaf DL, Renzaho AMN, Resnikoff S, Rezaeian S, Roever L, Ronfani L, Roshandel G, Sabde YD, Saddik B, Salamati P, Salimi Y, Salz I, Samy AM, Sanabria J, Sanchez Riera L, Santric Milicevic MM, Satpathy M, Sawhney M, Sawyer SM, Saxena S, Saylan M, Schneider IJC, Schwebel DC, Seedat S, Sepanlou SG, Shaikh MA, Shams-Beyranvand M, Shamsizadeh M, Sharif-Alhoseini M, Sheikh A, Shen J, Shigematsu M, Shiri R, Shiue I, Silva JP, Singh JA, Sinha DN, Soares Filho AM, Soriano JB, Soshnikov S, Soyiri IN, Starodubov VI, Stein DJ, Stokes MA, Sufiyan MB, Sunshine JE, Sykes BL, Tabarés-Seisdedos R, Tabb KM, Tehrani-Banihashemi A, Tessema GA, Thakur JS, Tran KB, Tran BX, Tudor Car L, Uthman OA, Uzochukwu BSC, Valdez PR, Varavikova E, Vasconcelos AMN, Venketasubramanian N, Violante FS, Vlassov V, Waheed Y, Wang YP, Wijeratne T, Winkler AS, Yadav P, Yano Y, Yenesew MA, Yip P, Yisma E, Yonemoto N, Younis MZ, Yu C, Zafar S, Zaidi Z, Zaman SB, Zamani M, Zhao Y, Zodpey S, Hay SI, Lopez AD, Mokdad AH, Vos T. Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017. Inj Prev 2020; 26:i12-i26. [PMID: 31915273 PMCID: PMC7571356 DOI: 10.1136/injuryprev-2019-043296] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. METHODS Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. RESULTS For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. CONCLUSIONS The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.
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Affiliation(s)
- Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Lydia R Lucchesi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | - Alireza Ahmadi
- Department of Anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | | | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota, USA
| | - Suliman A Alghnam
- Department of Population Health Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | - Rajaa M Al-Raddadi
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ubai Alsharif
- Department of Oral and Maxillofacial Surgery, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
| | | | - Mina Anjomshoa
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for International Health, Ludwig Maximilians University, Munich, Germany
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Amit Arora
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
- Oral Health Services, Sydney Local Health District, Sydney, New South Wales, Australia
| | | | - Reza Assadi
- Education Development Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Beatriz Paulina Ayala Quintanilla
- The Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, Peru
| | - Shivanthi Balalla
- School of Public Health, Auckland University of Technology, Auckland, New Zealand
| | - Amrit Banstola
- Department of Research, Public Health Perspective Nepal, Pokhara-Lekhnath Metropolitan City, Nepal
| | | | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Neeraj Bedi
- Department of Community Medicine, Gandhi Medical College Bhopal, Bhopal, India
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Meysam Behzadifar
- Department of Epidemiology and Biostatistics, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Corina Benjet
- Department of Epidemiology and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Derrick A Bennett
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Isabela M Bensenor
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Guilherme Borges
- Department of Epidemiology and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Rohan Borschmann
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Dipan Bose
- Transport & Digital Development, World Bank, Washington, District of Columbia, USA
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research Department, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Julio Cesar Campuzano Rincon
- National Institute of Public Health, Cuernavaca, Mexico
- School of Medicine, University of the Valley of Cuernavaca, Cuernavaca, Mexico
| | - Rosario Cárdenas
- Department of Population and Health, Metropolitan Autonomous University, Mexico City, Mexico
| | - Juan J Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Carlos A Castañeda-Orjuela
- Colombian National Health Observatory, National Institute of Health, Bogota, Colombia
- Epidemiology and Public Health Evaluation Group, National University of Colombia, Bogota, Colombia
| | - Ferrán Catalá-López
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Jee-Young J Choi
- Department of Biochemistry and Biomedical Science, Seoul National University Hospital, Seoul, South Korea
| | | | | | - Koustuv Dalal
- Institute of Public Health Kalyani, Kalyani, India
- School of Health Science, Orebro University, Orebro, Sweden
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Dragos Virgil Davitoiu
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Surgery, Clinical Emergency Hospital Sf. Pantelimon, Bucharest, Romania
| | - Louisa Degenhardt
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Mount Gravatt, Queensland, Australia
| | - Jan-Walter De Neve
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Gabrielle Aline deVeber
- Centre for Global Child Health, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Linh Phuong Doan
- Center of Excellence in Health Service Management, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Kate A Dolan
- University of New South Wales, Sydney, New South Wales, Australia
| | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Manisha Dubey
- United Nations World Food Programme, New Delhi, India
| | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | | | | | - Aman Yesuf Endries
- Public Health Department, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Andre Faro
- Department of Psychology, Federal University of Sergipe, Sao Cristovao, Brazil
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Division of Neurology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, California, USA
- School of Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Science, James Cook University, Douglas, Queensland, Australia
| | - Takeshi Fukumoto
- Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, Pennsylvania, USA
- Department of Dermatology, Kobe University, Kobe, Japan
| | | | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University of São Paulo, Sao Paulo, Brazil
- Internal Medicine Department, University Hospital, University of São Paulo, Sao Paulo, Brazil
| | - Ayman Grada
- School of Medicine, Boston University, Boston, Massachusetts, USA
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Epidemiology and Biostatistics, Zhengzhou University, Zhengzhou, China
| | - Rahul Gupta
- March of Dimes, Arlington, Virginia, USA
- School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | | | - Arvin Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arya Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Randah R Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
- Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - Hadi Hassankhani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Independent Consultant, Tabriz, Iran
| | - Hamid Yimam Hassen
- Department of Public Health, Mizan-Tepi University, Teppi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Rasmus Havmoeller
- Clinical Sciences, Karolinska University Hospital, Stockholm, Sweden
| | - Delia Hendrie
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Andualem Henok
- Department of Public Health, Mizan-Tepi University, Teppi, Ethiopia
| | - Martha Híjar
- Research Coordination, AC Environments Foundation, Cuernavaca, Mexico
- CISS, National Institute of Public Health, Cuernavaca, Mexico
| | - Michael K Hole
- Department of Pediatrics, Dell Medical School, University of Texas Austin, Austin, Texas, USA
| | - Enayatollah Homaie Rad
- Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Naznin Hossain
- Department of Pharmacology and Therapeutics, Dhaka Medical College, Dhaka University, Dhaka, Bangladesh
- Department of Pharmacology, Bangladesh Industrial Gases Limited, Tangail, Bangladesh
| | - Sorin Hostiuc
- Faculty of Dentistry, Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Central South University, Changsha, China
| | - Ehimario U Igumbor
- School of Public Health, University of the Western Cape, Bellville, Cape Town, South Africa
- Department of Public Health, Walter Sisulu University, Mthatha, South Africa
| | | | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Q Ivers
- Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Kathryn H Jacobsen
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
| | - Nader Jahanmehr
- School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mihajlo Jakovljevic
- Department for Health Care and Public Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Achala Upendra Jayatilleke
- Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Graduate Studies, University of Colombo, Colombo, Sri Lanka
| | - Ravi Prakash Jha
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Zahra Jorjoran Shushtari
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Rizwan Kalani
- Department of Neurology, University of Washington, Seattle, Washington, USA
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Andre Pascal Kengne
- Non-communicable Diseases Research Unit, Medical Research Council South Africa, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Yousef Saleh Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Ramtha, Jordan
| | - Morteza Abdullatif Khafaie
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nauman Khalid
- School of Food and Agricultural Sciences, University of Management and Technology, Lahore, Pakistan
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Abdullah T Khoja
- Department of Public Health, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Young-Eun Kim
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Ai Koyanagi
- CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Barthelemy Kuate Defo
- Department of Demography, University of Montreal, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Burcu Kucuk Bicer
- Department of Public Health, Yuksek Ihtisas University, Ankara, Turkey
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Hilton Lam
- Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | - Van C Lansingh
- HelpMeSee, New York City, New York, USA
- International Relations Department, Mexican Institute of Ophthalmology, Queretaro, Mexico
| | - Janet L Leasher
- College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shai Linn
- School of Public Health, University of Haifa, Haifa, Israel
| | - Raimundas Lunevicius
- Department of General Surgery, Aintree University Hospital National Health Service (NHS) Foundation Trust, Liverpool, UK
- Department of Surgery, University of Liverpool, Liverpool, UK
| | - Flavia R Machado
- Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, Sao Paulo, Brazil
| | | | | | | | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Manzoor Ahmad Malik
- Department of Humanities and Social Sciences, Indian Institute of Technology, Roorkee, Haridwar, India
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ana-Laura Manda
- Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Pallab K Maulik
- Research Department, The George Institute for Global Health, New Delhi, India
- School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Hailemariam Abiy Alemu Meheretu
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
- School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
| | - Man Mohan Mehndiratta
- Neurology Department, Janakpuri Super Specialty Hospital Society, New Delhi, India
- Neurology Department, Govind Ballabh Institute of Medical Education and Research, New Delhi, India
| | - Addisu Melese
- Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
| | | | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Atte Meretoja
- Neurocenter, Helsinki University Hospital, Helsinki, Finland
- School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Ted R Miller
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- Pacific Institute for Research & Evaluation, Calverton, Maryland, USA
| | - G K Mini
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Global Institute of Public Health (GIPH), Ananthapuri Hospitals and Research Centre, Trivandrum, India
| | - Erkin M Mirrakhimov
- Faculty of Internal Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
- Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
| | | | | | - Shafiu Mohammed
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
- Department of Neurology, Oasi Research Institute, Troina, Italy
| | - Pablo A Montero-Zamora
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Yoshan Moodley
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Marilita M Moschos
- 1st Department of Ophthalmology, University of Athens, Athens, Greece
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Seyyed Meysam Mousavi
- Health Management Reserach Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran, Iran
| | - Srinivas Murthy
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kamarul Imran Musa
- School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia
| | - Gurudatta Naik
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Farid Najafi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Bruno Ramos Nascimento
- Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- General Surgery Department, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Trang Huyen Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Son Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | | | - Dina Nur Anggraini Ningrum
- Public Health Department, Universitas Negeri Semarang, Kota Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | | | - Richard Ofori-Asenso
- Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, Australia
- Independent Consultant, Accra, Ghana
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea
| | - Olanrewaju Oladimeji
- HAST, Human Sciences Research Council, Durban, South Africa
- School of Public Health, Faculty of Health Sciences, University of Namibia, Osakhati, Namibia
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Pedro R Olivares
- Institute of Physical Activity and Health, Autonomous University of Chile, Talca, Chile
| | - Heather M Orpana
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Stanislav S Otstavnov
- Analytical Center, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Committee for the Comprehensive Assessment of Medical Devices and Information Technology, Health Technology Assessment Association, Moscow, Russia
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | - Smita Pakhale
- Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | - George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Population Health Department, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Konrad Pesudovs
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
- Department of Psychiatry, Department of Epidemiology, Columbia University, New York City, New York, USA
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Swayam Prakash
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando, Florida, USA
- College of Graduate Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Anwar Rafay
- Department of Epidemiology & Biostatistics, Contech School of Public Health, Lahore, Pakistan
| | - Alireza Rafiei
- Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavash Rahimi
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University, Heidelberg, Victoria, Australia
- National Centre for Farmer Health, Deakin University, Waurn Ponds, Victoria, Australia
| | - Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, India
- Department of Economics, University of Göttingen, Göttingen, Germany
| | - Kiana Ramezanzadeh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Academic Public Health Department, Public Health England, London, UK
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK
- University College London Hospitals, London, UK
| | - Andre M N Renzaho
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- Organization for the Prevention of Blindness, Paris, France
| | | | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Yogesh Damodar Sabde
- National Institute for Research in Environmental Health, Indian Council of Medical Research, Bhopal, India
| | - Basema Saddik
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yahya Salimi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Inbal Salz
- Health and Disability Intelligence Group, Ministry of Health, Wellington, New Zealand
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, West Virginia, USA
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Lidia Sanchez Riera
- Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Institute of Bone and Joint Research, University of Sydney, Syndey, New South Wales, Australia
| | - Milena M Santric Milicevic
- Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
- Centre-School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Maheswar Satpathy
- UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
- Udyam-Global Association for Sustainable Development, Bhubaneswar, India
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Susan M Sawyer
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Sonia Saxena
- School of Public Health, Imperial College London, London, UK
| | - Mete Saylan
- Market Access Department, Bayer, Istanbul, Turkey
| | - Ione J C Schneider
- School of Health Sciences, Federal University of Santa Catarina, Ararangua, Brazil
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mehran Shams-Beyranvand
- School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
- School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Morteza Shamsizadeh
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
- Division of General Internal Medicine and Primary Care, Harvard University, Boston, Massachusetts, USA
| | - Jiabin Shen
- Center for Pediatric Trauma Research, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ivy Shiue
- Institute of Medical Epidemiology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | | | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Medicine Service, US Department of Veteran Affairs, Birmingham, Alabama, USA
| | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Adauto Martins Soares Filho
- Department of Diseases and Noncommunicable Diseases and Health Promotion, Federal Ministry of Health, Brasilia, Brazil
| | - Joan B Soriano
- Hospital Universitario de la Princesa, Autonomous University of Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Sergey Soshnikov
- Department of Research Development, Federal Research Institute for Health Organization and Informatics of the Ministry of Health (FRIHOI), Moscow, Russia
| | - Ireneous N Soyiri
- Hull York Medical School, University of Hull, Hull City, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Vladimir I Starodubov
- Federal Research Institute for Health Organization and Informatics of the Ministry of Health (FRIHOI), Moscow, Russia
| | - Dan J Stein
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Mark A Stokes
- Department of Psychology, Deakin University, Burwood, Victoria, Australia
| | | | - Jacob E Sunshine
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington, USA
| | - Bryan L Sykes
- Department of Criminology, Law and Society, University of California Irvine, Irvine, California, USA
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Karen M Tabb
- School of Social Work, University of Illinois, Urbana, Illinois, USA
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Gizachew Assefa Tessema
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Jarnail Singh Thakur
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Khanh Bao Tran
- Molecular Medicine and Pathology Department, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Military Medical University, Hanoi, Vietnam
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | | | - Pascual R Valdez
- Argentine Society of Medicine, Buenos Aires, Argentina
- Velez Sarsfield Hospital, Buenos Aires, Argentina
| | - Elena Varavikova
- Central Research Institute of Cytology and Genetics, Federal Research Institute for Health Organization and Informatics of the Ministry of Health (FRIHOI), Moscow, Russia
| | - Ana Maria Nogales Vasconcelos
- Department of Statistics, University of Brasília, Brasília, Brazil
- Directorate of Social Studies and Policies, Federal District Planning Company, Brasília, Brazil
| | - Narayanaswamy Venketasubramanian
- Raffles Neuroscience Centre, Raffles Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yasir Waheed
- Foundation University Medical College, Foundation University, Islamabad, Pakistan
| | - Yuan-Pang Wang
- Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Tissa Wijeratne
- Department of Psychology and Counselling, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, St Albans, Victoria, Australia
| | - Andrea Sylvia Winkler
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - Priyanka Yadav
- Centre for the Study of Regional Development, Jawahar Lal Nehru University, New Delhi, India
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
| | | | - Paul Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Engida Yisma
- School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Naohiro Yonemoto
- Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mustafa Z Younis
- Health Economics & Finance, Jackson State University, Jackson, Mississippi, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Shamsa Zafar
- Department of Obstetrics & Gynaecology, A.C.S. Medical College and Hospital, Islamabad, Pakistan
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
| | - Sojib Bin Zaman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Sanjay Zodpey
- Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- University of Melbourne, Melbourne, Queensland, Australia
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
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James SL, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Liu Z, S Roberts NL, Sylte DO, Henry NJ, LeGrand KE, Abdelalim A, Abdoli A, Abdollahpour I, Abdulkader RS, Abedi A, Abosetugn AE, Abushouk AI, Adebayo OM, Agudelo-Botero M, Ahmad T, Ahmed R, Ahmed MB, Eddine Aichour MT, Alahdab F, Alamene GM, Alanezi FM, Alebel A, Alema NM, Alghnam SA, Al-Hajj S, Ali BA, Ali S, Alikhani M, Alinia C, Alipour V, Aljunid SM, Almasi-Hashiani A, Almasri NA, Altirkawi K, Abdeldayem Amer YS, Amini S, Loreche Amit AM, Andrei CL, Ansari-Moghaddam A, T Antonio CA, Yaw Appiah SC, Arabloo J, Arab-Zozani M, Arefi Z, Aremu O, Ariani F, Arora A, Asaad M, Asghari B, Awoke N, Ayala Quintanilla BP, Ayano G, Ayanore MA, Azari S, Azarian G, Badawi A, Badiye AD, Bagli E, Baig AA, Bairwa M, Bakhtiari A, Balachandran A, Banach M, Banerjee SK, Banik PC, Banstola A, Barker-Collo SL, Bärnighausen TW, Barrero LH, Barzegar A, Bayati M, Baye BA, Bedi N, Behzadifar M, Bekuma TT, Belete H, Benjet C, Bennett DA, Bensenor IM, Berhe K, Bhardwaj P, Bhat AG, Bhattacharyya K, Bibi S, Bijani A, Bin Sayeed MS, Borges G, Borzì AM, Boufous S, Brazinova A, Briko NI, Budhathoki SS, Car J, Cárdenas R, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Cerin E, Chandan JS, Chanie WF, Chattu SK, Chattu VK, Chatziralli I, Chaudhary N, Cho DY, Kabir Chowdhury MA, Chu DT, Colquhoun SM, Constantin MM, Costa VM, Damiani G, Daryani A, Dávila-Cervantes CA, Demeke FM, Demis AB, Demoz GT, Demsie DG, Derakhshani A, Deribe K, Desai R, Nasab MD, da Silva DD, Dibaji Forooshani ZS, Doyle KE, Driscoll TR, Dubljanin E, Adema BD, Eagan AW, Eftekhari A, Ehsani-Chimeh E, Sayed Zaki ME, Elemineh DA, El-Jaafary SI, El-Khatib Z, Ellingsen CL, Emamian MH, Endalew DA, Eskandarieh S, Faris PS, Faro A, Farzadfar F, Fatahi Y, Fekadu W, Ferede TY, Fereshtehnejad SM, Fernandes E, Ferrara P, Feyissa GT, Filip I, Fischer F, Folayan MO, Foroutan M, Francis JM, Franklin RC, Fukumoto T, Geberemariyam BS, Gebre AK, Gebremedhin KB, Gebremeskel GG, Gebremichael B, Gedefaw GA, Geta B, Ghafourifard M, Ghamari F, Ghashghaee A, Gholamian A, Gill TK, Goulart AC, Grada A, Grivna M, Mohialdeen Gubari MI, Guimarães RA, Guo Y, Gupta G, Haagsma JA, Hafezi-Nejad N, Bidgoli HH, Hall BJ, Hamadeh RR, Hamidi S, Haro JM, Hasan MM, Hasanzadeh A, Hassanipour S, Hassankhani H, Hassen HY, Havmoeller R, Hayat K, Hendrie D, Heydarpour F, Híjar M, Ho HC, Hoang CL, Hole MK, Holla R, Hossain N, Hosseinzadeh M, Hostiuc S, Hu G, Ibitoye SE, Ilesanmi OS, Ilic I, Ilic MD, Inbaraj LR, Indriasih E, Naghibi Irvani SS, Shariful Islam SM, Islam MM, Ivers RQ, Jacobsen KH, Jahani MA, Jahanmehr N, Jakovljevic M, Jalilian F, Jayaraman S, Jayatilleke AU, Jha RP, John-Akinola YO, Jonas JB, Joseph N, Joukar F, Jozwiak JJ, Jungari SB, Jürisson M, Kabir A, Kadel R, Kahsay A, Kalankesh LR, Kalhor R, Kamil TA, Kanchan T, Kapoor N, Karami M, Kasaeian A, Kassaye HG, Kavetskyy T, Kebede HK, Keiyoro PN, Kelbore AG, Kelkay B, Khader YS, Khafaie MA, Khalid N, Khalil IA, Khalilov R, Khammarnia M, Khan EA, Khan M, Khanna T, Khazaie H, Shadmani FK, Khundkar R, Kiirithio DN, Kim YE, Kim D, Kim YJ, Kisa A, Kisa S, Komaki H, M Kondlahalli SK, Korshunov VA, Koyanagi A, G Kraemer MU, Krishan K, Bicer BK, Kugbey N, Kumar V, Kumar N, Kumar GA, Kumar M, Kumaresh G, Kurmi OP, Kuti O, Vecchia CL, Lami FH, Lamichhane P, Lang JJ, Lansingh VC, Laryea DO, Lasrado S, Latifi A, Lauriola P, Leasher JL, Huey Lee SW, Lenjebo TL, Levi M, Li S, Linn S, Liu X, Lopez AD, Lotufo PA, Lunevicius R, Lyons RA, Madadin M, El Razek MMA, Mahotra NB, Majdan M, Majeed A, Malagon-Rojas JN, Maled V, Malekzadeh R, Malta DC, Manafi N, Manafi A, Manda AL, Manjunatha N, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Maravilla JC, March LM, Mason-Jones AJ, Masoumi SZ, Massenburg BB, Maulik PK, Meles GG, Melese A, Melketsedik ZA, N Memiah PT, Mendoza W, Menezes RG, Mengesha MB, Mengesha MM, Meretoja TJ, Meretoja A, Merie HE, Mestrovic T, Miazgowski B, Miazgowski T, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mirzaei-Alavijeh M, Mithra P, Moazen B, Moghadaszadeh M, Mohamadi E, Mohammad Y, Mohammad KA, Darwesh AM, Gholi Mezerji NM, Mohammadian-Hafshejani A, Mohammadoo-Khorasani M, Mohammadpourhodki R, Mohammed S, Mohammed JA, Mohebi F, Molokhia M, Monasta L, Moodley Y, Moosazadeh M, Moradi M, Moradi G, Moradi-Lakeh M, Moradpour F, Morawska L, Velásquez IM, Morisaki N, Morrison SD, Mossie TB, Muluneh AG, Murthy S, Musa KI, Mustafa G, Nabhan AF, Nagarajan AJ, Naik G, Naimzada MD, Najafi F, Nangia V, Nascimento BR, Naserbakht M, Nayak V, Ndwandwe DE, Negoi I, Ngunjiri JW, Nguyen CT, Thi Nguyen HL, Nikbakhsh R, Anggraini Ningrum DN, Nnaji CA, Nyasulu PS, Ogbo FA, Oghenetega OB, Oh IH, Okunga EW, Olagunju AT, Olagunju TO, Bali AO, Onwujekwe OE, Asante KO, Orpana HM, Ota E, Otstavnov N, Otstavnov SS, A MP, Padubidri JR, Pakhale S, Pakshir K, Panda-Jonas S, Park EK, Patel SK, Pathak A, Pati S, Patton GC, Paulos K, Peden AE, Filipino Pepito VC, Pereira J, Pham HQ, Phillips MR, Pinheiro M, Polibin RV, Polinder S, Poustchi H, Prakash S, Angga Pribadi DR, Puri P, Syed ZQ, Rabiee M, Rabiee N, Radfar A, Rafay A, Rafiee A, Rafiei A, Rahim F, Rahimi S, Rahimi-Movaghar V, Rahman MA, Rajabpour-Sanati A, Rajati F, Rakovac I, Ranganathan K, Rao SJ, Rashedi V, Rastogi P, Rathi P, Rawaf S, Rawal L, Rawassizadeh R, Renjith V, N Renzaho AM, Resnikoff S, Rezapour A, Ribeiro AI, Rickard J, Rios González CM, Ronfani L, Roshandel G, Saad AM, Sabde YD, Sabour S, Saddik B, Safari S, Safari-Faramani R, Safarpour H, Safdarian M, Sajadi SM, Salamati P, Salehi F, Zahabi SS, Rashad Salem MR, Salem H, Salman O, Salz I, Samy AM, Sanabria J, Riera LS, Santric Milicevic MM, Sarker AR, Sarveazad A, Sathian B, Sawhney M, Sawyer SM, Saxena S, Sayyah M, Schwebel DC, Seedat S, Senthilkumaran S, Sepanlou SG, Seyedmousavi S, Sha F, Shaahmadi F, Shahabi S, Shaikh MA, Shams-Beyranvand M, Shamsizadeh M, Sharif-Alhoseini M, Sharifi H, Sheikh A, Shigematsu M, Shin JI, Shiri R, Siabani S, Sigfusdottir ID, Singh PK, Singh JA, Sinha DN, Smarandache CG, R Smith EU, Soheili A, Soleymani B, Soltanian AR, Soriano JB, Sorrie MB, Soyiri IN, Stein DJ, Stokes MA, Sufiyan MB, Rasul Suleria HA, Sykes BL, Tabarés-Seisdedos R, Tabb KM, Taddele BW, Tadesse DB, Tamiru AT, Tarigan IU, Tefera YM, Tehrani-Banihashemi A, Tekle MG, Tekulu GH, Tesema AK, Tesfay BE, Thapar R, Tilahune AB, Tlaye KG, Tohidinik HR, Topor-Madry R, Tran BX, Tran KB, Tripathy JP, Tsai AC, Car LT, Ullah S, Ullah I, Umar M, Unnikrishnan B, Upadhyay E, Uthman OA, Valdez PR, Vasankari TJ, Venketasubramanian N, Violante FS, Vlassov V, Waheed Y, Weldesamuel GT, Werdecker A, Wiangkham T, Wolde HF, Woldeyes DH, Wondafrash DZ, Wondmeneh TG, Wondmieneh AB, Wu AM, Yadav R, Yadollahpour A, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yip P, Yisma E, Yonemoto N, Yoon SJ, Youm Y, Younis MZ, Yousefi Z, Yu Y, Yu C, Yusefzadeh H, Moghadam TZ, Zaidi Z, Zaman SB, Zamani M, Zamanian M, Zandian H, Zarei A, Zare F, Zhang ZJ, Zhang Y, Zodpey S, Dandona L, Dandona R, Degenhardt L, Dharmaratne SD, Hay SI, Mokdad AH, Reiner RC, Sartorius B, Vos T. Global injury morbidity and mortality from 1990 to 2017: results from the Global Burden of Disease Study 2017. Inj Prev 2020; 26:i96-i114. [PMID: 32332142 PMCID: PMC7571366 DOI: 10.1136/injuryprev-2019-043494] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/29/2019] [Accepted: 12/06/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. METHODS We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). FINDINGS In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). INTERPRETATION Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
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Affiliation(s)
- Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nathaniel J Henry
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kate E LeGrand
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Amir Abdoli
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ibrahim Abdollahpour
- Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Aidin Abedi
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA
| | | | | | - Oladimeji M Adebayo
- Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Marcela Agudelo-Botero
- School of Medicine Center for Politics, Population and Health Research, National Autonomous University of Mexico, Mexico City, Mexico
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, Southeast University Nanjing, Nanjing, China
- Department of Microbiology, Hazara University Mansehra, Mansehra, Pakistan
| | - Rushdia Ahmed
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | | | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA
| | | | - Fahad Mashhour Alanezi
- Department of Computer Sciences, Imam Abdulrehman Bin Faisal University, Dammam, Saudi Arabia
| | - Animut Alebel
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
| | | | - Suliman A Alghnam
- Department of Population Health Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Samar Al-Hajj
- Faculty of Health Sciences - Health Management and Policy, American University of Beirut, Beirut, Lebanon
- British Columbia Injury Research Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Beriwan Abdulqadir Ali
- Medical Technical Institute, Erbil Polytechnic University, Erbil, Iraq
- Faculty of Pharmacy, Ishik University, Erbil, Iraq
| | - Saqib Ali
- Department of Information Systems, College of Economics and Political Science, Sultan Qaboos University, Muscat, Oman
| | - Mahtab Alikhani
- School of Health Management and Information Sciences, Department of Health Services Management, Iran University of Medical Sciences, Tehran, Iran
| | - Cyrus Alinia
- Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | - Nihad A Almasri
- Physiotherapy Department, The University of Jordan, Amman, Jordan
| | | | - Yasser Sami Abdeldayem Amer
- Clinical Practice Guidelines Unit, King Saud University, Riyadh, Saudi Arabia
- Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt
| | - Saeed Amini
- Health Services Management Department, Arak University of Medical Sciences, Arak, Iran
| | - Arianna Maever Loreche Amit
- Department of Epidemiology and Biostatistics, University of the Philippines Manila, Manila, Philippines
- Online Programs for Applied Learning, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for International Health, Ludwig Maximilians University, Munich, Germany
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Zohreh Arefi
- Department of Health Promotion and Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Filippo Ariani
- Regional Centre for the Analysis of Data on Occupational and Work-related Injuries and Diseases, Local Health Unit Tuscany Centre, Florence, Italy
| | - Amit Arora
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
- Oral Health Services, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Malke Asaad
- Department of Plastic Surgery, University of Texas, Houston, TX, USA
| | - Babak Asghari
- Department of Microbiology, Hamedan University of Medical Sciences, Azad Tabriz University, Iran
| | - Nefsu Awoke
- Department of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Beatriz Paulina Ayala Quintanilla
- The Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
- General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, Peru
| | - Getinet Ayano
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Martin Amogre Ayanore
- Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana
| | - Samad Azari
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ghasem Azarian
- Department of Environmental Health Engineering, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ashish D Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Eleni Bagli
- Department of Ophthalmology, University Hospital of Ioannina, Ioannina, Greece
- Institute of Molecular Biology & Biotechnology, Foundation for Research & Technology, Ioannina, Greece
| | - Atif Amin Baig
- Biochemistry Unit, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
- School of Health Sciences, Univeristi Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Mohan Bairwa
- Institute of Health Management Research, Indian Institute of Health Management Research University, Jaipur, India
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Ahad Bakhtiari
- Health Policy And Management Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Arun Balachandran
- Department of Demography, University of Groningen, Groningen, Netherlands
- Population Research Centre, Institute for Social and Economic Change, Bengaluru, India
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | | | - Palash Chandra Banik
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Amrit Banstola
- Department of Research, Public Health Perspective Nepal, Pokhara-Lekhnath Metropolitan City, Nepal
| | | | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Lope H Barrero
- Department of Industrial Engineering, Pontifical Javeriana University, Bogota, Colombia
| | - Akbar Barzegar
- Occupational Health Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Neeraj Bedi
- Department of Community Medicine, Gandhi Medical College Bhopal, Bhopal, India
- Jazan University, Jazan, Saudi Arabia
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Tariku Tesfaye Bekuma
- Institute of Health Sciences, School of Public Health, Wollega University, Nekemte, Ethiopia
| | - Habte Belete
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia
| | - Corina Benjet
- Department of Epidemiology and Psychosocial Reseach, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Derrick A Bennett
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Isabela M Bensenor
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
| | - Kidanemaryam Berhe
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Anusha Ganapati Bhat
- Department of Internal Medicine, University of Massachusetts Medical School, Springfield, MA, USA
| | - Krittika Bhattacharyya
- Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
- Department of Statistics, University of Calcutta, Kolkata, India
| | - Sadia Bibi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Muhammad Shahdaat Bin Sayeed
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
- Department of Clinical Pharmacy and Pharmacology, University of Dhaka, Dhaka, Bangladesh
| | - Guilherme Borges
- Department of Epidemiology and Psychosocial Reseach, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Antonio Maria Borzì
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research Department, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Nikolay Ivanovich Briko
- Department of Epidemiology and Evidence Based Medicine, I M Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Josip Car
- Centre for Population Health Sciences, Nanyang Technological University, Singapore
- Global eHealth Unit, Imperial College London, London, UK
| | - Rosario Cárdenas
- Department of Population and Health, Metropolitan Autonomous University, Mexico City, Mexico
| | - Félix Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | | | - Carlos A Castañeda-Orjuela
- Colombian National Health Observatory, National Institute of Health, Bogota, Colombia
- Epidemiology and Public Health Evaluation Group, National University of Colombia, Bogota, Colombia
| | - Giulio Castelpietra
- Primary Care Services Area, Central Health Directorate, Region Friuli Venezia Giulia, Trieste, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Ferrán Catalá-López
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Joht S Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | | | | | - Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Haidari, Greece
- Ophthalmology Private Practice Office, Independent Consultant, Athens, Greece
| | - Neha Chaudhary
- Department of Pediatrics, Harvard University, Boston, MA, USA
- Department of Neonatology, Beth Israel Deaconess Medical center, Boston, MA, USA
| | - Daniel Youngwhan Cho
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Mohiuddin Ahsanul Kabir Chowdhury
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
| | - Samantha M Colquhoun
- Research School of Population Health, Australian National University, Action, ACT, Australia
| | - Maria-Magdalena Constantin
- Department of Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 2nd Department of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
| | - Vera M Costa
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Giovanni Damiani
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
- Department of Dermatology, University of Milan, Milan, Italy
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | | | - Asmamaw Bizuneh Demis
- Department of Nursing, Woldia University, Woldia, Ethiopia
- School of Nursing, Jimma University, Jimma, Ethiopia
| | - Gebre Teklemariam Demoz
- School of Pharmacy, Aksum University, Aksum, Ethiopia
- Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rupak Desai
- Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | | | | | | | - Kerrie E Doyle
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Bundoora, VIC, Australia
| | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | | | - Bereket Duko Adema
- Public Health Department, Hawassa University, Hawassa, Ethiopia
- Curtin University, Perth, WA, Australia
| | - Arielle Wilder Eagan
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
- Department of Social Services, Tufts Medical Center, Boston, MA, USA
| | - Aziz Eftekhari
- Department of Pharmacology and Toxicology, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Pharmacology and Toxicology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Ehsani-Chimeh
- National Institute for Health Researches, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
| | - Christian Lycke Ellingsen
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Pawan Sirwan Faris
- Biology Department, Salahaddin University-Erbil, Erbil, Iraq
- Biology and Biotechnolaniogy"L Spallanzani", University of Pavia, Pavia, Italy
| | - Andre Faro
- Department of Psychology, Federal University of Sergipe, Sao Cristovao, Brazil
| | - Farshad Farzadfar
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Fatahi
- Pharmaceutical Nanotechnology, Tehran University of Medical Sciences, Tehran, Iran
| | - Wubalem Fekadu
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tomas Y Ferede
- Nursing Department, Hawassa University, Hawassa, Ethiopia
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurobiology, Karolinska Institutet, Stockholm, Sweden
- Division of Neurology, University of Ottawa, Ottawa, ON, Canada
| | | | - Pietro Ferrara
- Research Centre on Public Health (CESP), University of Milan Bicocca, Monza, Italy
| | - Garumma Tolu Feyissa
- Department of Health Education & Behavioral Sciences, Jimma University, Jimma, Ethiopia
| | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, CA, USA
- School of Health Sciences, A T Still University, Mesa, AZ, USA
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | | | - Masoud Foroutan
- Abadan School of Medical Sciences, Abadan University of Medical Sciences, Abadan, Iran
| | - Joel Msafiri Francis
- Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Science, James Cook University, Douglas, QLD, Australia
- Royal Life Saving Society, Sydney, NSW, Australia
| | - Takeshi Fukumoto
- Department of Dermatology, Kobe University, Kobe, Japan
- Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, PA, USA
| | | | | | | | | | | | - Getnet Azeze Gedefaw
- Bahir Dar University, Bahir Dar, Ethiopia
- Haramaya University, Dire Dawa, Ethiopia
| | - Birhanu Geta
- Department of Pharmacy, Wollo University, Dessie, Ethiopia
| | - Mansour Ghafourifard
- Department of Medical Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Ghamari
- Occupational Health Department, Arak University of Medical Sciences, Arak, Iran
| | - Ahmad Ghashghaee
- Department of Health Services Management, Iran University of Medical Sciences, Tehran, Iran
| | - Asadollah Gholamian
- Science and Research Branch, Islamic Azad University, Tehran, Iran
- Young Researchers and Elite Club, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Alessandra C Goulart
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
- Center for Clinical and Epidemiological Research, University of São Paulo, Sao Paulo, Brazil
| | - Ayman Grada
- Department of Dermatology, Boston University, Boston, MA, USA
| | - Michal Grivna
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Rafael Alves Guimarães
- Instituto de Patologia Tropical e Saúde Pública, Federal University of Goias, Goiânia, Brazil
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Epidemiology and Biostatistics, Zhengzhou University, Zhengzhou, China
| | - Gaurav Gupta
- Non-Communicable Diseases (NCD), World Health Organization (WHO), New Delhi, India
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Nima Hafezi-Nejad
- Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, USA
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Brian James Hall
- Global and Community Mental Health Research Group, University of Macau, Macao, China
| | - Randah R Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
- Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - Md Mehedi Hasan
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD, Australia
| | - Amir Hasanzadeh
- Department of Microbiology, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Microbiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hadi Hassankhani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Independent Consultant, Tabriz, Iran
| | - Hamid Yimam Hassen
- Department of Public Health, Mizan-Tepi University, Tepi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Rasmus Havmoeller
- Department of Clinical Sciences, Karolinska University Hospital, Stockholm, Sweden
| | - Khezar Hayat
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
| | - Delia Hendrie
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Fatemeh Heydarpour
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Martha Híjar
- Research Coordination, AC Environments Foundation, Cuernavaca, Mexico
- CISS, National Institute of Public Health, Cuernavaca, Mexico
| | - Hung Chak Ho
- Department of Urban Planning and Design, University of Hong Kong, Hong Kong, China
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Michael K Hole
- Department of Pediatrics, Dell Medical School, University of Texas Austin, Austin, TX, USA
| | - Ramesh Holla
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Naznin Hossain
- Department of Pharmacology and Therapeutics, Dhaka Medical College, Dhaka, Bangladesh
- Department of Pharmacology, Bangladesh Industrial Gases Limited, Tangail, Bangladesh
| | - Mehdi Hosseinzadeh
- Department of Computer Engineering, Islamic Azad University, Tehran, Iran
- Computer Science Department, University of Human Development, Sulaymaniyah, Iraq
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Central South University, Changsha, China
| | | | | | - Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena D Ilic
- Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | | | - Endang Indriasih
- Center for Health Resource and Services Research and Development, National Institute of Health Research & Development, Jakarta, Indonesia
| | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - M Mofizul Islam
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC, Australia
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Kathryn H Jacobsen
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA
| | | | - Nader Jahanmehr
- School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mihajlo Jakovljevic
- Department for Health Care and Public Health, I M Sechenov First Moscow State Medical University, Moscow, Russia
| | - Farzad Jalilian
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sudha Jayaraman
- Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Achala Upendra Jayatilleke
- Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Graduate Studies, University of Colombo, Colombo, Sri Lanka
| | - Ravi Prakash Jha
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Beijing Ophthalmology & Visual Science Key Laboratory, Beijing Tongren Hospital, Beijing, China
| | - Nitin Joseph
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Farahnaz Joukar
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | | | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Rajendra Kadel
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Amaha Kahsay
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Leila R Kalankesh
- Department of Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Kalhor
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Teshome Abegaz Kamil
- School of Public Health, Department of Health Informatics and Health Innovation, A C S Medical College and Hospital, Mekelle, Ethiopia
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Manoochehr Karami
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Taras Kavetskyy
- Department of Applied Physics, The John Paul II Catholic University of Lublin, Lublin Voivodeship, Poland
- Department of Biology and Chemistry, Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
| | | | | | | | - Bayew Kelkay
- Department of Midwifery, University of Gondar, Gondar, Ethiopia
| | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Morteza Abdullatif Khafaie
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nauman Khalid
- School of Food and Agricultural Sciences, University of Management and Technology, Lahore, Pakistan
| | - Ibrahim A Khalil
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Rovshan Khalilov
- Department of Physiology, Baku State University, Baku, Azerbaijan
| | - Mohammad Khammarnia
- Health Care Management, Zahedan University of Medical Sciences, zahedan, Iran
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Maseer Khan
- Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Tripti Khanna
- Department of Health Research, Indian Council of Medical Research, New Delhi, India
- Centre for Ethics, Jawahar Lal Nehru University, New Delhi, India
| | - Habibolah Khazaie
- Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Roba Khundkar
- Nuffield Department of Surgical Sciences, Oxford University Global Surgery Group, University of Oxford, Oxford, UK
| | | | - Young-Eun Kim
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, MA, USA
| | - Yun Jin Kim
- School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Hamidreza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Brain Engineering Research Center, Institute for Research in Fundamental Sciences, Tehran, Iran
| | | | - Vladimir Andreevich Korshunov
- Department of Epidemiology and Evidence Based Medicine, I M Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ai Koyanagi
- CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Kewal Krishan
- Department of Anthropology, Panjab University, Chandigarh, India
| | - Burcu Kucuk Bicer
- Department of Public Health, Yuksek Ihtisas University, Ankara, Turkey
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Nuworza Kugbey
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
- Department of Psychology and Health Promotion, University of KwaZulu-Natal, Durban, South Africa
| | - Vivek Kumar
- Department of Medicine, Brigham and Women's Hospital, Harvard University, Boston, MA, USA
| | - Nithin Kumar
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - G Anil Kumar
- Public Health Foundation of India, Gurugram, India
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
| | - Girikumar Kumaresh
- Mechanical and Industrial Engineering, Indian Institute of Technology, Roorkee, Roorkee, India
| | - Om P Kurmi
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Oluwatosin Kuti
- Health and Nutrition Section, United Nations Childrens' Fund (UNICEF), Accra, Ghana
| | - Carlo La Vecchia
- Department of Clinical Medicine and Community Health, University of Milan, Milano, Italy
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | | | - Justin J Lang
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Van C Lansingh
- HelpMeSee, New York, NY, USA
- International Relations, Mexican Institute of Ophthalmology, Queretaro, Mexico
| | | | - Savita Lasrado
- Department of Otorhinolaryngology (ENT), Father Muller Medical College, Mangalore, India
| | - Arman Latifi
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Paolo Lauriola
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
| | - Janet L Leasher
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | | | - Miriam Levi
- Regional Centre for the Analysis of Data on Occupational and Work-related Injuries and Diseases, Local Health Unit Tuscany Centre, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shai Linn
- School of Public Health, University of Haifa, Haifa, Israel
| | - Xuefeng Liu
- Department of Systems, Populations and Leadership, University of Michigan, Ann Arbor, MI, USA
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Paulo A Lotufo
- Department of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Raimundas Lunevicius
- Department of General Surgery, Aintree University Hospital National Health Service (NHS) Foundation Trust, Liverpool, UK
- Department of Surgery, University of Liverpool, Liverpool, UK
| | - Ronan A Lyons
- Health Data Research UK, Swansea University, Swansea, UK
| | - Mohammed Madadin
- College of Medicine, Pathology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Jeadran N Malagon-Rojas
- Public Health Research Department, National Health Institute Colombia, Bogota, Colombia
- Faculty of Medicine, El Bosque University, Bogota, Colombia
| | - Venkatesh Maled
- Health Education and Research Department, SDM College of Medical Sciences & Hospital, Dharwad, India
- Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Navid Manafi
- Department of Ophthalmology, Iran University of Medical Sciences, Tehran, Iran
- Ophthalmology Department, University of Manitoba, Winnipeg, MB, Canada
| | - Amir Manafi
- Department of Surgery, University of Virginia, Charlottesville, VA, USA
| | - Ana-Laura Manda
- Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Borhan Mansouri
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Joemer C Maravilla
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
| | - Lyn M March
- Institute of Bone and Joint Research, University of Sydney, St Leonards, NSW, Australia
| | | | - Seyedeh Zahra Masoumi
- Department of Midwifery-Reproductive Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Benjamin Ballard Massenburg
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Pallab K Maulik
- Research Department, The George Institute for Global Health, New Delhi, India
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Addisu Melese
- Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Peter T N Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Baltimore, MD, USA
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
| | - Ritesh G Menezes
- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Meresa Berwo Mengesha
- College of Health Science, Department of Midwifery, Adigrat University, Adigrat, Ethiopia
| | | | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Atte Meretoja
- Neurocenter, Helsinki University Hospital, Helsinki, Finland
- School of Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | | | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, ZoraProfozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Ted R Miller
- School of Public Health, Curtin University, Perth, WA, Australia
- Pacific Institute for Research & Evaluation, Calverton, MD, USA
| | - G K Mini
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Global Institute of Public Health (GIPH), Ananthapuri Hospitals and Research Centre, Trivandrum, India
| | - Andreea Mirica
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- President's Office, National Institute of Statistics Romania, Bucharest, Romania
| | - Erkin M Mirrakhimov
- Faculty of Internal Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
- Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
| | - Mehdi Mirzaei-Alavijeh
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Masoud Moghadaszadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Efat Mohamadi
- Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | | | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | | | | | - Milad Mohammadoo-Khorasani
- Department of Clinical Biochemistry, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | | | - Shafiu Mohammed
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | | | - Farnam Mohebi
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Iran National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Yoshan Moodley
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Moradi
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Setagaya, Japan
| | - Shane Douglas Morrison
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | | | - Atalay Goshu Muluneh
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Srinivas Murthy
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Kamarul Imran Musa
- School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia
| | - Ghulam Mustafa
- Department of Pediatric Medicine, Nishtar Medical University, Multan, Pakistan
- Department of Pediatrics & Pediatric Pulmonology, Institute of Mother & Child Care, Multan, Pakistan
| | - Ashraf F Nabhan
- Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt
- Knowledge Translation and Utilization, Egyptian Center for Evidence Based Medicine, Egypt
| | - Ahamarshan Jayaraman Nagarajan
- Research and Analytics, Initiative for Financing Health and Human Development, Chennai, India
- Research and Analytics, Bioinsilico Technologies, Chennai, India
| | - Gurudatta Naik
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russia
| | - Farid Najafi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Bruno Ramos Nascimento
- Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Morteza Naserbakht
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Vinod Nayak
- Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Manipal, India
| | | | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | - Rajan Nikbakhsh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Heidelberg University Hospital, Heidelberg, Germany
| | - Dina Nur Anggraini Ningrum
- Public Health Department, Universitas Negeri Semarang, Kota Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | - Chukwudi A Nnaji
- Cochrane Unit, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Peter S Nyasulu
- Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Felix Akpojene Ogbo
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Onome Bright Oghenetega
- Reproductive Health Sciences, Department Obstetrics and Gynecology, University of Ibadan, Ibadan, Nigeria
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea
| | | | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaimaniyah, Iraq
| | - Obinna E Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
| | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Accra, Ghana
- Discipline of Psychology, University of KwaZulu-Natal, Durban, South Africa
| | - Heather M Orpana
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Erika Ota
- Department of Global Health Nursing, St Luke's International University, Chuo-ku, Japan
| | - Nikita Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Academic department, Unium Ltd, Moscow, Russia
| | - Stanislav S Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | | | - Smita Pakhale
- Department of Medicine, Ottawa Hospital Research Institute, Ottawa ON, Canada
| | - Keyvan Pakshir
- Parasitology and Mycology, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | - Sangram Kishor Patel
- Research and Evaluation, Population Council, New Delhi, India
- Indian Institute of Health Management Research University Delhi, Jaipur, India
| | - Ashish Pathak
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatircs, RD Gardi Medical College, Ujjain, India
| | - Sanghamitra Pati
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India
| | - George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Population Health Theme, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - Kebreab Paulos
- Department of Midwifery, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amy E Peden
- Royal Life Saving Society, Sydney, NSW, Australia
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Jeevan Pereira
- Department of Orthopedics, Yenepoya Medical College, Mangalore, India
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
- Department of Psychiatry, Department of Epidemiology, Columbia University, New York City, NY, USA
| | - Marina Pinheiro
- Department of Chemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Roman V Polibin
- Department of Epidemiology and Evidence-Based Medicine, Sechenon University, Moscow, Russia
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Hossein Poustchi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Swayam Prakash
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Parul Puri
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Zahiruddin Quazi Syed
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando, FL, USA
- College of Graduate Health Sciences, A T Still University, Mesa, AZ, USA
| | - Anwar Rafay
- Department of Epidemiology & Biostatistics, Contech School of Public Health, Lahore, Pakistan
| | - Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Alireza Rafiei
- Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fakher Rahim
- Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Siavash Rahimi
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, VIC, Australia
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
| | | | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ivo Rakovac
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization (WHO), Moscow, Russia
| | | | - Sowmya J Rao
- Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran
| | - Prateek Rastogi
- Forensic Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Priya Rathi
- Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Academic Public Health Department, Public Health England, London, UK
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, CQ University, Sydney, NSW, Australia
| | - Reza Rawassizadeh
- Department of Computer Science, Metropolitan College, Boston University, Boston, USA
| | - Vishnu Renjith
- Neurology Department, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Andre M N Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | | | - Aziz Rezapour
- Organization for the Prevention of Blindness, Paris, France
| | - Ana Isabel Ribeiro
- EPIUnit - Public Health Institute University Porto (ISPUP), University of Porto, Porto, Portugal
| | - Jennifer Rickard
- Surgery Department, University of Minnesota, Minneapolis, MN, USA
- Surgery Department, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Carlos Miguel Rios González
- Research Directorate, Nihon Gakko University, Fernando de la Mora, Paraguay
- Research Direction, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Anas M Saad
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Yogesh Damodar Sabde
- National Institute for Research in Environmental Health, Indian Council of Medical Research, Bhopal, India
| | - Siamak Sabour
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Basema Saddik
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Saeed Safari
- Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Safari-Faramani
- Faculty of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Safarpour
- Department of Health in Disasters and Emergencies, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Safdarian
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
| | | | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farkhonde Salehi
- Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saleh Salehi Zahabi
- Radiology and Nuclear Medicine Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Research Deputy, Taleghani Hospital, Kermanshah, Iran
| | | | - Hosni Salem
- Department of Urology, Cairo University, Cairo, Egypt
| | - Omar Salman
- Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Inbal Salz
- Health and Disability Intelligence Group, Ministry of Health, Wellington, New Zealand
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, WV, USA
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Lidia Sanchez Riera
- Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Institute of Bone and Joint Research, University of Sydney, Syndey, NSW, Australia
| | - Milena M Santric Milicevic
- Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
- Centre-School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Abdur Razzaque Sarker
- Health Economics, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Brijesh Sathian
- Surgery Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Susan M Sawyer
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia
| | - Sonia Saxena
- School of Public Health, Imperial College London, London, UK
| | - Mehdi Sayyah
- Faculty member of Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Feng Sha
- Center for Biomedical Information Technology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Faramarz Shaahmadi
- Department of Health Promotion and Education, Alborz University of Medical Sciences, Karaj, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Morteza Shamsizadeh
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
- Division of General Internal Medicine, Harvard University, Boston, MA, USA
| | | | - Jae Il Shin
- College of Medicine, Yonsei University, Seodaemun-gu, South Korea
- Division of Cardiology, Emory University, Atlanta, GA, USA
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Soraya Siabani
- Department of Health Education & Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
- School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Health and Behavior Studies, Columbia University, New York, NY, USA
| | | | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Medicine Service, US Department of Veterans Affairs (VA), Birmingham, AL, USA
| | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Catalin-Gabriel Smarandache
- 2nd Department of Surgery-SUUB, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 2nd Surgery Department, Bucharest Emergency Hospital, Bucharest, Romania
| | - Emma U R Smith
- Pain Management Research Institute (PMRI), Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
- Michael J Cousins Pain Management & Research Centre, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Amin Soheili
- Department of Medical Surgical Nursing, Urmia University of Medical Science, Urmia, Iran
- Emergency Nursing Department, Semnan University of Medical Sciences, Semnan, Iran
| | - Bija Soleymani
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Reza Soltanian
- Department of Biostatistics, Hamedan University of Medical Sciences, Hamadan, Iran
| | - Joan B Soriano
- Hospital Universitario de la Princesa, Autonomous University of Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | | | - Ireneous N Soyiri
- Hull York Medical School, University of Hull, Hull City, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council, Cape Town, South Africa
| | - Mark A Stokes
- Department of Psychology, Deakin University, Burwood, VIC, Australia
| | | | | | - Bryan L Sykes
- Department of Criminology, Law and Society, University of California Irvine, Irvine, CA, USA
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Karen M Tabb
- School of Social Work, University of Illinois, Urbana, IL, USA
| | - Biruk Wogayehu Taddele
- Department of Public Health, Arbaminch College of Health Sciences, Arbaminch town sikela, Ethiopia
| | - Degena Bahrey Tadesse
- Department of Nursing, Aksum University, Aksum, Ethiopia
- Axum College of Health Science, mekelle, Ethiopia
| | | | - Ingan Ukur Tarigan
- Center for Health Resource and Services Research and Development, National Institute of Health Research & Development, Jakarta, Indonesia
| | - Yonatal Mesfin Tefera
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | - Rekha Thapar
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | | | | | - Hamid Reza Tohidinik
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Roman Topor-Madry
- Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
- The Agency for Health Technology Assessment and Tariff System, Warszawa, Poland
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Military Medical University, Hanoi, Vietnam
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Alexander C Tsai
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Saif Ullah
- Institute of Soil and Environmental Sciences, A T Still University, Faisalabad, Pakistan
| | - Irfan Ullah
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
- TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan
| | - Maida Umar
- Research Department, National Institute of Population Studies (NIPS), Islamabad, Pakistan
| | - Bhaskaran Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Era Upadhyay
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | | | - Pascual R Valdez
- Argentine Society of Medicine, Buenos Aires, Argentina
- Velez Sarsfield Hospital, Buenos Aires, Argentina
| | | | - Narayanaswamy Venketasubramanian
- Raffles Neuroscience Centre, Raffles Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yasir Waheed
- Foundation University Medical College, Foundation University, Islamabad, Pakistan
| | | | - Andrea Werdecker
- Demographic Change and Ageing Research Area, Federal Institute for Population Research, Wiesbaden, Germany
- Center of Population and Health, Wiesbaden, Germany
| | - Taweewat Wiangkham
- Department of Physical Therapy, Naresuan University, Meung District, Thailand
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Dawit Habte Woldeyes
- Department of Human Anatomy, Histology, Embryology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Dawit Zewdu Wondafrash
- Department of Pharmacology and Toxicology, Mekelle University, Mekelle, Ethiopia
- Department of Pharmacology, Addis Ababa University, Addis ababa, Ethiopia
| | | | - Adam Belay Wondmieneh
- Department of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Nursing, Wollo University, Dessie, Ethiopia
| | - Ai-Min Wu
- Department of Orthopaedics, Wenzhou Medical University, Wenzhou, China
| | - Rajaram Yadav
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Ali Yadollahpour
- Medical Physics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa ON, Canada
| | - Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Health Management, Policy and Economics, Kerman University of Medical Sciences, Kerman, Iran
| | - Paul Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Engida Yisma
- School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Naohiro Yonemoto
- Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, South Korea
| | - Mustafa Z Younis
- Department of Health Policy & Management, Jackson State University, Jackson, MS, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Zabihollah Yousefi
- Department of Environmental Health, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Environmental Health, Academy of Medical Science, Sari, Iran
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Hasan Yusefzadeh
- Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
| | - Telma Zahirian Moghadam
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
| | - Sojib Bin Zaman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Zamanian
- Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
- Department of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran
| | - Ahmad Zarei
- Department of Environment Health Engineering, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Fatemeh Zare
- Faculty of Medical Sciences, Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, Wuhan University, Wuhan, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Sanjay Zodpey
- Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Public Health Foundation of India, Gurugram, India
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Public Health Foundation of India, Gurugram, India
| | - Louisa Degenhardt
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Benn Sartorius
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Deshpande A, Miller-Petrie MK, Lindstedt PA, Baumann MM, Johnson KB, Blacker BF, Abbastabar H, Abd-Allah F, Abdelalim A, Abdollahpour I, Abegaz KH, Abejie AN, Abreu LG, Abrigo MR, Abualhasan A, Accrombessi MMK, Adamu AA, Adebayo OM, Adedeji IA, Adedoyin RA, Adekanmbi V, Adetokunboh OO, Adhikari TB, Afarideh M, Agudelo-Botero M, Ahmadi M, Ahmadi K, Ahmed MB, Ahmed AE, Akalu TY, Akanda AS, Alahdab F, Al-Aly Z, Alam S, Alam N, Alamene GM, Alanzi TM, Albright J, Albujeer A, Alcalde-Rabanal JE, Alebel A, Alemu ZA, Ali M, Alijanzadeh M, Alipour V, Aljunid SM, Almasi A, Almasi-Hashiani A, Al-Mekhlafi HM, Altirkawi KA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amini S, Amit AML, Amul GGH, Andrei CL, Anjomshoa M, Ansariadi A, Antonio CAT, Antony B, Antriyandarti E, Arabloo J, Aref HMA, Aremu O, Armoon B, Arora A, Aryal KK, Arzani A, Asadi-Aliabadi M, Asmelash D, Atalay HT, Athari SM, Athari SS, Atre SR, Ausloos M, Awasthi S, Awoke N, Ayala Quintanilla BP, Ayano G, Ayanore MA, Aynalem YA, Azari S, Azman 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Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17. Lancet Glob Health 2020; 8:e1162-e1185. [PMID: 32827479 PMCID: PMC7443708 DOI: 10.1016/s2214-109x(20)30278-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/01/2020] [Accepted: 06/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. METHODS We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. FINDINGS Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4-40·7) to 50·3% (50·0-50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1-46·5) in 2017, compared with 28·7% (28·5-29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2-89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664-711) of the 1830 (1797-1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6-80·7) of countries from 2000 to 2017, and in 53·9% (50·6-59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. INTERPRETATION Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. FUNDING Bill & Melinda Gates Foundation.
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Abstract
Having an accurate account of the number of national COVID‐19 cases is essential for understanding the national and global burden of the disease and managing COVID‐19 prevention and control efforts. There is also substantial under‐reporting of COVID‐19 cases and deaths in many countries. In this article, the COVID‐19 under‐reporting problem in Turkey is addressed, and examples and reasons for the under‐reporting are discussed.
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Affiliation(s)
- Sezer Kisa
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
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