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Rupasinghe N, Ranasinghe P, Wanninayake L. Dilated cardiomyopathy due to hypocalcaemia: a case report. J Med Case Rep 2024; 18:204. [PMID: 38600559 PMCID: PMC11007983 DOI: 10.1186/s13256-024-04505-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Hypocalcaemia is a rare, but reversible, cause of dilated cardiomyopathy causing heart failure. Several case reports have been reported on reversible cardiomyopathy secondary to hypocalcaemia. CASE PRESENTATION We report a case of 54-year-old female Sri Lankan patient who presented with shortness of breath and was diagnosed with heart failure with reduced ejection fraction due to dilated cardiomyopathy. The etiology for dilated cardiomyopathy was identified as hypocalcemic cardiomyopathy, secondary to primary hypoparathyroidism, which was successfully treated with calcium and vitamin D replacement therapy. CONCLUSION This adds to literature of this rare cause of reversible cardiomyopathy secondary to hypocalcemia reported from the South Asian region of the world. This case highlights the impact of proper treatment improving the heart failure in patients with hypocalcemic cardiomyopathy.
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Affiliation(s)
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Leonard Wanninayake
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
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Swarnamali H, Ranasinghe P, Jayawardena R. The effect of coconut oil and palm oil on anthropometric parameters: a clinical trial. BMC Nutr 2024; 10:9. [PMID: 38200608 PMCID: PMC10782760 DOI: 10.1186/s40795-023-00812-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND During recent years several studies have investigated the impact of different dietary oils on body weight. They have shown differential positive and negative effects on anthropometry. We investigated the effects of palm and coconut oils on body weight and other anthropometric parameters, considering their importance as a primary source of saturated fat, controlling for other confounding variable such as total energy intake. METHODS The study was conducted as a sequential feeding clinical trial with 40 healthy men and women divided into two feeding periods of initial palm oil (8 weeks) and subsequent coconut oil (8 weeks), with a 16-week washout period in between. Each participant received a pre-determined volume of each oil, which were integrated into their routine main meals and snacks during the respective study periods. Changes in body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) were evaluated. Physical activity levels and dietary intake were also evaluated as potential confounding factors. RESULTS Thirty-seven participants completed both oil treatment periods. The mean (± SD) age of the participants was 39 (± 13.1) years. There were no significant differences in any of the anthropometric parameters between the initial point of feeding coconut oil and the initial point of feeding palm oil. Following both oil treatment phases, no significant changes in the subjects' body weight, BMI, or other anthropometric measurements (WC, HC, and WHR) were observed. CONCLUSION Neither coconut oil nor palm oil significantly changed anthropometry-related cardiovascular risk factors such as body weight, BMI, WC, HC, and WHR. TRIAL REGISTRATION Sri Lankan Clinical Trial Registry: SLCTR/2019/034 on 4th October 2019 ( https://slctr.lk/trials/slctr-2019-034 ).
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Affiliation(s)
- Hasinthi Swarnamali
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, No 25, Kynsey Road, Colombo 08, Colombo, Sri Lanka.
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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Burmen B, Bell C, Sharma GN, Nguni R, Gribble R, Ranasinghe P, Vernaccini L, Yu L, Sreedharan R, Wang N, Stephen M, Samhouri D, Chamla D, Perehinets I, Nguyen PN, Samuel R, Alatrista CB, Chungong S, Kandel N. Low scoring IHR core capacities in low-income and lower-middle-income countries, 2018-2020. BMJ Glob Health 2023; 8:e013525. [PMID: 38081772 PMCID: PMC10729134 DOI: 10.1136/bmjgh-2023-013525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/21/2023] [Indexed: 12/18/2023] Open
Affiliation(s)
| | | | | | | | | | | | | | - Lina Yu
- World Health Organization, Geneva, Switzerland
| | | | | | - Mary Stephen
- WHO Regional Office for Africa, Brazzaville, Congo
| | - Dalia Samhouri
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Dick Chamla
- WHO Regional Office for Africa, Brazzaville, Congo
| | | | | | - Reuben Samuel
- WHO Regional Office for South-East Asia, New Delhi, India
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Abstract
Hypertension remains the leading cause of cardiovascular disease and premature death globally, affecting half of US adults. A high proportion of hypertensive patients exhibit uncontrolled blood pressure (BP), associated with poor adherence, linked to pill burden and adverse effects. Novel pharmacological strategies are urgently needed to improve BP control. Dysregulation of the renin-angiotensin system increases BP through its primary effector, Ang II (angiotensin II), which results in tissue remodeling and end-organ damage. Silencing liver angiotensinogen (the sole source of Ang II) has been achieved using novel RNA therapeutics, including the antisense oligonucleotide, IONIS-AGT (angiotensinogen)-LRX, and the small-interfering RNA, zilebesiran. Conjugation to N-acetylgalactosamine enables targeted delivery to hepatocytes, where endosomal storage, slow leakage, and small-interfering RNA recycling (for zilebesiran) result in knockdown over several months. Indeed, zilebesiran has an impressive and durable effect on systolic BP, reduced by up to 20 mm Hg and sustained for 6 months after a single administration, likely due to its very effective knockdown of angiotensinogen, without causing acute kidney injury or hyperkalemia. By contrast, IONIS-AGT-LRX caused less knockdown and marginal effects on BP. Future studies should evaluate any loss of efficacy relating to antidrug antibodies, safety issues associated with long-term angiotensinogen suppression, and broader benefits, especially in the context of common comorbidities such as type 2 diabetes and chronic kidney disease.
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Affiliation(s)
- Melisande L Addison
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, College of Medicine & Veterinary Medicine, The University of Edinburgh, Scotland, United Kingdom (M.L.A., P.R., D.J.W.)
| | - Priyanga Ranasinghe
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, College of Medicine & Veterinary Medicine, The University of Edinburgh, Scotland, United Kingdom (M.L.A., P.R., D.J.W.)
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Sri Lanka (P.R.)
| | - David J Webb
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, College of Medicine & Veterinary Medicine, The University of Edinburgh, Scotland, United Kingdom (M.L.A., P.R., D.J.W.)
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Ranasinghe P, Addison ML, Dear JW, Webb DJ. Small interfering RNA: Discovery, pharmacology and clinical development-An introductory review. Br J Pharmacol 2023; 180:2697-2720. [PMID: 36250252 DOI: 10.1111/bph.15972] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/23/2022] [Accepted: 09/29/2022] [Indexed: 11/28/2022] Open
Abstract
Post-transcriptional gene silencing targets and degrades mRNA transcripts, silencing the expression of specific genes. RNA interference technology, using synthetic structurally well-defined short double-stranded RNA (small interfering RNA [siRNA]), has advanced rapidly in recent years. This introductory review describes the utility of siRNA, by exploring the underpinning biology, pharmacology, recent advances and clinical developments, alongside potential limitations and ongoing challenges. Mediated by the RNA-induced silencing complex, siRNAs bind to specific complementary mRNAs, which are subsequently degraded. siRNA therapy offers advantages over other therapeutic approaches, including ability of specifically designed siRNAs to potentially target any mRNA and improved patient adherence through infrequent administration associated with a very long duration of action. Key pharmacokinetic and pharmacodynamic challenges include targeted administration, poor tissue penetration, nuclease inactivation, rapid renal elimination, immune activation and off-target effects. These have been overcome by chemical modification of siRNA and/or by utilising a range of delivery systems, increasing bioavailability and stability to allow successful clinical translation. Patisiran (hereditary transthyretin-mediated amyloidosis) was the first licensed siRNA, followed by givosiran (acute hepatic porphyria), lumasiran (primary hyperoxaluria type 1) and inclisiran (familial hypercholesterolaemia), which all use N-acetylgalactosamine (GalNAc) linkage for effective liver-directed delivery. Others are currently under development for indications varying from rare genetic diseases to common chronic non-communicable diseases (hypertension, cancer). Technological advances are paving the way for broader clinical use. Ongoing challenges remain in targeting organs beyond the liver and reaching special sites (e.g., brain). By overcoming these barriers, siRNA therapy has the potential to substantially widen its therapeutic impact.
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Affiliation(s)
- Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Melisande L Addison
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - James W Dear
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - David J Webb
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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Liyanage CK, Gunawardane M, Kumaradasa PP, Ranasinghe P, Jayakody RL, Galappatthy P. A national survey on registered products, availability, prices, and affordability of 100 essential medicines in community pharmacies across Sri Lanka. BMC Health Serv Res 2023; 23:1121. [PMID: 37858145 PMCID: PMC10585786 DOI: 10.1186/s12913-023-10137-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 10/12/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Availability of essential medicines that meet the expected quality standards, in appropriate dosage forms at affordable prices is a fundamental prerequisite to fulfill healthcare needs of given a population. This study assessed available products, prices and affordability of essential medicines (EM) in community pharmacies in Sri Lanka with comparison of registration status from the National Medicines Regulatory Authority(NMRA). METHODS A cross-sectional island-wide survey of 80 pharmacies was conducted according to World Health Organization and Health Action International Manual (WHO/HAI). Hundred medicines were selected from the global core list(n = 14), regional core list(n = 16) and the Sri Lanka Essential Medicine List (SL-EML) (n = 70) based on healthcare needs. Number of registered products in 2015 and 2021 were compared. FINDINGS Average availability was 85.4%(± 12.31) and availability was lowest in the Northern province (69.38 ± 21.18%)(p = 0.008). Availability between the state owned, franchise and privately owned pharmacies was not significantly different (p > 0.05). 89.4% medicines were affordable except for amiodarone, hydroxychloroquine, sitagliptin, soluble insulin, isophane insulin, losartan, levodopa carbidopa combination, clonazepam and ceftriaxone. The median price ratio (MPR) of 33.7% of medicines was less than 1 and MPR of 37.1% originator brands (OB) was over 3. Median number of generic brands in the market was 8(range 2-44), 9% of medicines had 20 or more products in the market and 72.7% medicines had more products available than the number registered in 2015. The average number of registered products were similar in 2015 (8.27) and 2021(7.59) (p = 0.15). CONCLUSION The overall availability of EMs in Sri Lanka was high in all categories of community pharmacies. Medicines were largely affordable and reasonably priced in 2015, although OBs were generally more expensive. Majority of medicines had more products in the market than the number of registered products.
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Affiliation(s)
- Chiranthi Kongala Liyanage
- Department of Pharmacology, Faculty of Medicine, University of Colombo, 25 Kynsey Rd, Colombo, 00800, Sri Lanka.
| | - Mekala Gunawardane
- Department of Pharmacology, Faculty of Medicine, University of Colombo, 25 Kynsey Rd, Colombo, 00800, Sri Lanka
| | | | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, 25 Kynsey Rd, Colombo, 00800, Sri Lanka
| | - Raveendra Laal Jayakody
- Department of Pharmacology, Faculty of Medicine, University of Colombo, 25 Kynsey Rd, Colombo, 00800, Sri Lanka
| | - Priyadarshani Galappatthy
- Department of Pharmacology, Faculty of Medicine, University of Colombo, 25 Kynsey Rd, Colombo, 00800, Sri Lanka
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Jayawardena R, Wickramawardhane P, Dalpatadu C, Hills AP, Ranasinghe P. The impact of an oral nutritional supplement on body weight gain in older adults with malnutrition: an open-label randomized controlled trial. Trials 2023; 24:625. [PMID: 37784119 PMCID: PMC10544200 DOI: 10.1186/s13063-023-07622-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 09/04/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND The global aging population is expanding rapidly and many individuals have a particularly higher risk of malnutrition. Malnutrition can lead to impaired body function, morbidity, and mortality. Meeting nutritional requirements is a key strategy to minimize multiple debilitating adverse outcomes associated with malnutrition in the elderly. Oral nutritional supplements (ONS) have been widely used as a dietary intervention for malnutrition in older adults. These supplements provide additional nutrients and calories to support nutritional requirements and have been shown to improve nutritional status, physical function, and quality of life in malnourished older adults. METHODS This is an open-label, randomized controlled, parallel-group study including 50 institutionalized older adults (aged > 60 years) with malnutrition or at risk of malnutrition, living in a selected elderly care institution in Colombo, Sri Lanka. The aim is to assess improvement in healthy body weight gain and body composition in older adults with malnutrition at risk of malnutrition by using an ONS. Older adults will be screened for malnutrition using the Mini Nutrition Assessment (MNA) tool and eligible participants randomized using the simple random sampling technique to intervention and control groups (1:1 allocation ratio). The intervention group will consume 200 mL of ONS before bed continuously for 12 weeks. The primary outcome is the percentage who achieved at least 5% weight gain in the intervention group compared to the control group. Nutritional status (anthropometric, biochemical, clinical, and dietary), body composition (dual-energy X-ray absorptiometry), frailty, functional capacity (hand grip strength, knee extension, and Barthel index) cognitive status (Montreal Cognitive Assessment), and physical activity will be assessed as secondary outcomes at baseline and at the end of the 12-week intervention. Some measurements (anthropometry, dietary, and functional assessments) will also be performed at the end of the 4th week. Data will be analyzed using SPSS V-23. DISCUSSION This study will determine whether the use of an ONS is effective in promoting healthy weight gain in older adults with malnutrition or at risk of malnutrition. In addition, investigating the impact of an ONS on multiple outcomes via clinical, nutritional, functional, and cognitive function will provide a more comprehensive understanding of the potential benefits of these supplements. TRIAL REGISTRATION Sri Lanka Clinical Trail Registry SLCTR/2022/021. Oct. 6, 2022.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | | | - Chamila Dalpatadu
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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Ranasinghe P, Sirisena N, Ariadurai JN, Vishnukanthan T, Thilakarathne S, Anandagoda G, Dissanayake VH. Pharmacogenomic variants affecting efficacy and toxicity of statins in a south Asian population from Sri Lanka. Pharmacogenomics 2023; 24:809-819. [PMID: 37877238 DOI: 10.2217/pgs-2023-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Aim: To describe the diversity of pharmacogenetic variants of statins among Sri Lankans. Materials & methods: Variant data of relevant genes were obtained from an anonymized database of 426 Sri Lankans. Minor allele frequencies (MAFs) were compared with published data from other populations. Results: The MAF of SLCO1B1*5 (rs4149056 [T>C]) was 18.19% (95% CI: 14.53-21.85). MAFs of CYP2C9*2 (rs1799853 [C>T]) and CYP2C9*3 (rs1057910 [A>C]) were 2.58% (95% CI: 1.08-4.08) and 10.30% (95% CI: 7.75-13.61), respectively. MAFs of rs2231142 (G>T) (ABCG2), rs7412 (C>T) (APOE) and rs20455 (A>G) (KIF6) variants were 10.68% (95% CI: 7.76-13.60), 3.52% (95% CI: 1.77-5.27) and 50.7% (95% CI: 45.96-55.45), respectively. Compared with western/other Asian populations, rs20455 (A>G), CYP2C9*3 (A>C) and SLCO1B1*5 (T>C) variants were significantly higher in Sri Lankans. Conclusion: Variants that affect efficacy of statins (KIF6 [rs20455], CYP2C9*3) and increase risk of statin-induced myotoxicity (SLCO1B1*5 and CYP2C9*3) were prevalent in higher frequencies among Sri Lankans compared with western populations.
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Affiliation(s)
- Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, Scotland, UK
| | - Nirmala Sirisena
- Department of Anatomy, Genetics & Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
| | - Jeremy N Ariadurai
- Department of Anatomy, Genetics & Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
| | - Thuwaragesh Vishnukanthan
- Department of Anatomy, Genetics & Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
| | - Sathsarani Thilakarathne
- Department of Anatomy, Genetics & Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
| | - Gayani Anandagoda
- Department of Anatomy, Genetics & Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
| | - Vajira Hw Dissanayake
- Department of Anatomy, Genetics & Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
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Addison ML, Ranasinghe P, Webb DJ. Emerging insights and future prospects for therapeutic application of siRNA targeting angiotensinogen in hypertension. Expert Rev Clin Pharmacol 2023; 16:1025-1033. [PMID: 37897397 DOI: 10.1080/17512433.2023.2277330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/26/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Hypertension is the main global risk factor for cardiovascular disease. Despite this, less than half of treated hypertensive patients are controlled. One reason for this is nonadherence, a major unmet need in hypertension pharmacotherapy. Small interfering RNA (small interfering ribonucleic acid) therapies inhibit protein translation, and, when linked to N-acetylgalactosamine, allow liver-specific targeting, and durability over several months. Targeted knockdown of hepatic angiotensinogen, the source of all angiotensins, offers a precision medicine approach. AREAS COVERED This article describes the molecular basis for durability over months and the 24-h tonic target inhibition observed after one administration. We present an analysis of the published phase I trials using zilebesiran, a siRNA targeting hepatic angiotensinogen, which reduces blood pressure (BP) by up to 20 mmHg, lasting 24 weeks. Finally, we examine data evaluating reversibility of angiotensinogen knockdown and its relevance to the future clinical utility of zilebesiran. EXPERT OPINION Further studies should assess safety, efficacy, and outcomes in larger, more broadly representative groups. An advantage of zilebesiran is the potential for bi-annual dosing, thereby reducing nonadherence and improving control rates. It may also reduce nighttime BP due to 24-h tonic control. The provision of adherence assessment services will maximize the clinical value of zilebesiran.
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Affiliation(s)
- Melisande L Addison
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Priyanga Ranasinghe
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - David J Webb
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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Swarnamali H, Ranasinghe P, Hills AP, Jayawardena R. Coconut oil consumption and bodyweight reduction: a systematic review and meta-analysis. Minerva Endocrinol (Torino) 2023; 48:76-87. [PMID: 34786908 DOI: 10.23736/s2724-6507.21.03654-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Due to the composition and biological properties of coconut oil, there is still considerable debate regarding potential benefits for the management of obesity, including the specific impact on body weight (BW) reduction. This systematic review and meta-analysis of clinical trials aims to assess the impact of coconut oil on BW reduction in comparison to other oils and fats. EVIDENCE ACQUISITION The databases, PubMed®, Web of Science®, EMBASE®, and SciVerse Scopus® were systematically searched. A combination of medical subject headings and words linked to coconut oil and obesity parameters were utilized. Any clinical trials comparing coconut oil to any other form of oil or fat, with more than one month feeding period among adults were considered. EVIDENCE SYNTHESIS From the 540 potentially relevant papers, 9 were included. The period of coconut oil intake varied from four to twelve weeks, apart from one long-term trial where coconut oil was consumed for two years. When compared to other oils and fats, coconut oil substantially decreased BW (N.=546), Body Mass Index (BMI) (N.=551), and percentage of fat mass (FM%) (N.=491) by 0.75 kg (P=0.04), 0.28 kg/m2 (P=0.03), and 0.35% (P=0.008), respectively. Coconut oil consumption did not result in any significant alteration in waist circumference (WC) (N.=385) (-0.61 cm; P=0.30), waist-to-hip ratio (WHR) (N.=330) (-0.01; P=0.39) and FM (N.=86) (-0.25 kg; P=0.29). CONCLUSIONS Results indicate a small statistically significant reduction in BW, BMI, and FM% in the coconut oil group. In contrast, consumption of coconut oil had no statistically significant effect on WC, WHR, or FM.
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Affiliation(s)
- Hasinthi Swarnamali
- Unit of Health and Wellness, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia.,Mater Research Institute - The University of Queensland, Brisbane, Australia
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka - .,School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
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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, 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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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Ranasinghe P, Sirisena N, Senadeera V, Anandagoda G, Dissanayake VHW. Diversity of pharmacogenomic variants affecting warfarin metabolism in Sri Lankans. Pharmacogenomics 2022; 23:917-923. [DOI: 10.2217/pgs-2022-0026] [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: 11/21/2022] Open
Abstract
Aims: To describe the diversity of pharmacogenomic variants affecting warfarin metabolism in Sri Lankans. Materials & methods: Genotype data were filtered out from an anonymized database of 400 Sri Lankans, and minor allele frequencies (MAF) were calculated. Variants of CYP2C9, VKORC1 and CYP4F2 genes were studied. Results: Overall, CYP2C9*2 and CYP2C9*3 alleles had MAFs of 2.25% (95% CI: 0.80–3.70) and 10.38% (95% CI: 7.50–13.50), respectively. CYP2C9*11 and CYP2C9*14 alleles had MAFs of 0.13% (95% CI: 0–0.74) and 2.50% (95% CI: 0.97–4.03), respectively. MAFs of VKORC1 variants rs7294, rs9934438, rs8050894 and rs2884737 were 47.25% (95% CI: 42.36–52.14), 10.13% (95% CI: 7.28–13.22), 9.88% (95% CI: 7.06–12.94) and 4.88% (95% CI: 2.86–7.14), respectively. MAF of CYP4F2 variant rs2108622 was 45.63% (95% CI: 40.87–50.63). Conclusion: Compared with other populations, the frequencies of some studied variants were significantly different in Sri Lankans, and these are likely to account for variability in warfarin dosage requirements.
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Affiliation(s)
- Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
| | - Nirmala Sirisena
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
| | - Vidarsha Senadeera
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
| | - Gayani Anandagoda
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
| | - Vajira HW Dissanayake
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
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Ranasinghe P, Addison ML, Webb DJ. Small Interfering RNA Therapeutics in Hypertension: A Viewpoint on Vasopressor and Vasopressor-Sparing Strategies for Counteracting Blood Pressure Lowering by Angiotensinogen-Targeting Small Interfering RNA. J Am Heart Assoc 2022; 11:e027694. [PMID: 36216481 DOI: 10.1161/jaha.122.027694] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Priyanga Ranasinghe
- Faculty of Medicine, Department of Pharmacology University of Colombo Colombo Sri Lanka.,University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh Edinburgh United Kingdom
| | - Melisande L Addison
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh Edinburgh United Kingdom
| | - David J Webb
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh Edinburgh United Kingdom
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ANC, Bernabe E, Bhagavathula AS, Bhala N, Bhandari BB, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhojaraja VS, Bhuyan SS, Bibi S, Bilchut AH, Bintoro BS, Biondi A, Birega MGB, Birhan HE, Bjørge T, Blyuss O, Bodicha BBA, Bolla SR, Boloor A, Bosetti C, Braithwaite D, Brauer M, Brenner H, Briko AN, Briko NI, Buchanan CM, Bulamu NB, Bustamante-Teixeira MT, Butt MH, Butt NS, Butt ZA, Caetano dos Santos FL, Cámera LA, Cao C, Cao Y, Carreras G, Carvalho M, Cembranel F, Cerin E, Chakraborty PA, Charalampous P, Chattu VK, Chimed-Ochir O, Chirinos-Caceres JL, Cho DY, Cho WCS, Christopher DJ, Chu DT, Chukwu IS, Cohen AJ, Conde J, Cortés S, Costa VM, Cruz-Martins N, Culbreth GT, Dadras O, Dagnaw FT, Dahlawi SMA, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Danielewicz A, Dao ATM, Darvishi Cheshmeh Soltani R, Darwesh AM, Das S, Davitoiu DV, Davtalab Esmaeili E, De la Hoz FP, Debela SA, Dehghan A, Demisse B, Demisse FW, Denova-Gutiérrez E, Derakhshani A, Derbew Molla M, Dereje D, Deribe KS, Desai R, Desalegn MD, Dessalegn FN, Dessalegni SAA, Dessie G, Desta AA, Dewan SMR, Dharmaratne SD, Dhimal M, Dianatinasab M, Diao N, Diaz D, Digesa LE, Dixit SG, Doaei S, Doan LP, Doku PN, Dongarwar D, dos Santos WM, Driscoll TR, Dsouza HL, Durojaiye OC, Edalati S, Eghbalian F, Ehsani-Chimeh E, Eini E, Ekholuenetale M, Ekundayo TC, Ekwueme DU, El Tantawi M, Elbahnasawy MA, Elbarazi I, Elghazaly H, Elhadi M, El-Huneidi W, Emamian MH, Engelbert Bain L, Enyew DB, Erkhembayar R, Eshetu T, Eshrati B, Eskandarieh S, Espinosa-Montero J, Etaee F, Etemadimanesh A, Eyayu T, Ezeonwumelu IJ, Ezzikouri S, Fagbamigbe AF, Fahimi S, Fakhradiyev IR, Faraon EJA, Fares J, Farmany A, Farooque U, Farrokhpour H, Fasanmi AO, Fatehizadeh A, Fatima W, Fattahi H, Fekadu G, Feleke BE, Ferrari AA, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Foroumadi R, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gadanya MA, Gaipov A, Galehdar N, Gallus S, Garg T, Gaspar Fonseca M, Gebremariam YH, Gebremeskel TG, Gebremichael MA, Geda YF, Gela YY, Gemeda BNB, Getachew M, Getachew ME, Ghaffari K, Ghafourifard M, Ghamari SH, Ghasemi Nour M, Ghassemi F, Ghimire A, Ghith N, Gholamalizadeh M, Gholizadeh Navashenaq J, Ghozy S, Gilani SA, Gill PS, Ginindza TG, Gizaw ATT, Glasbey JC, Godos J, Goel A, Golechha M, Goleij P, Golinelli D, Golitaleb M, Gorini G, Goulart BNG, Grosso G, Guadie HA, Gubari MIM, Gudayu TW, Guerra MR, Gunawardane DA, Gupta B, Gupta S, Gupta VB, Gupta VK, Gurara MK, Guta A, Habibzadeh P, Haddadi Avval A, Hafezi-Nejad N, Hajj Ali A, Haj-Mirzaian A, Halboub ES, Halimi A, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hanif A, Hariri S, Harlianto NI, Haro JM, Hartono RK, Hasaballah AI, Hasan SMM, Hasani H, Hashemi SM, Hassan AM, Hassanipour S, Hayat K, Heidari G, Heidari M, Heidarymeybodi Z, Herrera-Serna BY, Herteliu C, Hezam K, Hiraike Y, Hlongwa MM, Holla R, Holm M, Horita N, Hoseini M, Hossain MM, Hossain MBH, Hosseini MS, Hosseinzadeh A, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Huang J, Hugo FN, Humayun A, Hussain S, Hussein NR, Hwang BF, Ibitoye SE, Iftikhar PM, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Immurana M, Innos K, Iranpour P, Irham LM, Islam MS, Islam RM, Islami F, Ismail NE, Isola G, Iwagami M, J LM, Jaiswal A, Jakovljevic M, Jalili M, Jalilian S, Jamshidi E, Jang SI, Jani CT, Javaheri T, Jayarajah UU, Jayaram S, Jazayeri SB, Jebai R, Jemal B, Jeong W, Jha RP, Jindal HA, John-Akinola YO, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kacimi SEO, Kadashetti V, Kahe F, Kakodkar PV, Kalankesh LR, Kalankesh LR, Kalhor R, Kamal VK, Kamangar F, Kamath A, Kanchan T, Kandaswamy E, Kandel H, Kang H, Kanno GG, Kapoor N, Kar SS, Karanth SD, Karaye IM, Karch A, Karimi A, Kassa BG, Katoto PDMC, Kauppila JH, Kaur H, Kebede AG, Keikavoosi-Arani L, Kejela GG, Kemp Bohan PM, Keramati M, Keykhaei M, Khajuria H, Khan A, Khan AAK, Khan EA, Khan G, Khan MN, Khan MAB, Khanali J, Khatab K, Khatatbeh MM, Khatib MN, Khayamzadeh M, Khayat Kashani HR, Khazeei Tabari MA, Khezeli M, Khodadost M, Kim MS, Kim YJ, Kisa A, Kisa S, Klugar M, Klugarová J, Kolahi AA, Kolkhir P, Kompani F, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Krishnamoorthy Y, Kucuk Bicer B, Kugbey N, Kulimbet M, Kumar A, Kumar GA, Kumar N, Kurmi OP, Kuttikkattu A, La Vecchia C, Lahiri A, Lal DK, Lám J, Lan Q, Landires I, Larijani B, Lasrado S, Lau J, Lauriola P, Ledda C, Lee SW, Lee SWH, Lee WC, Lee YY, Lee YH, Legesse SM, Leigh J, Leong E, Li MC, Lim SS, Liu G, Liu J, Lo CH, Lohiya A, Lopukhov PD, Lorenzovici L, Lotfi M, Loureiro JA, Lunevicius R, Madadizadeh F, Mafi AR, Magdeldin S, Mahjoub S, Mahmoodpoor A, Mahmoudi M, Mahmoudimanesh M, Mahumud RA, Majeed A, Majidpoor J, Makki A, Makris KC, Malakan Rad E, Malekpour MR, Malekzadeh R, Malik AA, Mallhi TH, Mallya SD, Mamun MA, Manda AL, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Mantovani LG, Martini S, Martorell M, Masoudi S, Masoumi SZ, Matei CN, Mathews E, Mathur MR, Mathur V, McKee M, Meena JK, Mehmood K, Mehrabi Nasab E, Mehrotra R, Melese A, Mendoza W, Menezes RG, Mengesha SID, Mensah LG, Mentis AFA, Mera-Mamián AYM, Meretoja TJ, Merid MW, Mersha AG, Meselu BT, Meshkat M, Mestrovic T, Miao Jonasson J, Miazgowski T, Michalek IM, Mijena GFW, Miller TR, Mir SA, Mirinezhad SK, Mirmoeeni S, Mirza-Aghazadeh-Attari M, Mirzaei H, Mirzaei HR, Misganaw AS, Misra S, Mohammad KA, Mohammadi E, Mohammadi M, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed A, Mohammed S, Mohan S, Mohseni M, Moka N, Mokdad AH, Molassiotis A, Molokhia M, Momenzadeh K, Momtazmanesh S, Monasta L, Mons U, Montasir AA, Montazeri F, Montero A, Moosavi MA, Moradi A, Moradi Y, Moradi Sarabi M, Moraga P, Morawska L, Morrison SD, Morze J, Mosapour A, Mostafavi E, Mousavi SM, Mousavi Isfahani H, Mousavi Khaneghah A, Mpundu-Kaambwa C, Mubarik S, Mulita F, Munblit D, Munro SB, Murillo-Zamora E, Musa J, Nabhan AF, Nagarajan AJ, Nagaraju SP, Nagel G, Naghipour M, Naimzada MD, Nair TS, Naqvi AA, Narasimha Swamy S, Narayana AI, Nassereldine H, Natto ZS, Nayak BP, Ndejjo R, Nduaguba SO, Negash WW, Nejadghaderi SA, Nejati K, Neupane Kandel S, Nguyen HVN, Niazi RK, Noor NM, Noori M, Noroozi N, Nouraei H, Nowroozi A, Nuñez-Samudio V, Nzoputam CI, Nzoputam OJ, Oancea B, Odukoya OO, Oghenetega OB, Ogunsakin RE, Oguntade AS, Oh IH, Okati-Aliabad H, Okekunle AP, Olagunju AT, Olagunju TO, Olakunde BO, Olufadewa II, Omer E, Omonisi AEE, Ong S, Onwujekwe OE, Orru H, Otstavnov SS, Oulhaj A, Oumer B, Owopetu OF, Oyinloye BE, P A M, Padron-Monedero A, Padubidri JR, Pakbin B, Pakshir K, Pakzad R, Palicz T, Pana A, Pandey A, Pandey A, Pant S, Pardhan S, Park EC, Park EK, Park S, Patel J, Pati S, Paudel R, Paudel U, Paun M, Pazoki Toroudi H, Peng M, Pereira J, Pereira RB, Perna S, Perumalsamy N, Pestell RG, Pezzani R, Piccinelli C, Pillay JD, Piracha ZZ, Pischon T, Postma MJ, Pourabhari Langroudi A, Pourshams A, Pourtaheri N, Prashant A, Qadir MMF, Quazi Syed Z, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Radhakrishnan V, Raeisi M, Rafiee A, Rafiei A, Raheem N, Rahim F, Rahman MO, Rahman M, Rahman MA, Rahmani AM, Rahmani S, Rahmanian V, Rajai N, Rajesh A, Ram P, Ramezanzadeh K, Rana J, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rashedi S, Rashidi A, Rashidi M, Rashidi MM, Ratan ZA, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Razeghinia MS, Rehman AU, Rehman IU, Reitsma MB, Renzaho AMN, Rezaei M, Rezaei N, Rezaei N, Rezaei N, Rezaei S, Rezaeian M, Rezapour A, Riad A, Rikhtegar R, Rios-Blancas M, Roberts TJ, Rohloff P, Romero-Rodríguez E, Roshandel G, Rwegerera GM, S M, Saber-Ayad MM, Saberzadeh-Ardestani B, Sabour S, Saddik B, Sadeghi E, Saeb MR, Saeed U, Safaei M, Safary A, Sahebazzamani M, Sahebkar A, Sahoo H, Sajid MR, Salari H, Salehi S, Salem MR, Salimzadeh H, Samodra YL, Samy AM, Sanabria J, Sankararaman S, Sanmarchi F, Santric-Milicevic MM, Saqib MAN, Sarveazad A, Sarvi F, Sathian B, Satpathy M, Sayegh N, Schneider IJC, Schwarzinger M, Šekerija M, Senthilkumaran S, Sepanlou SG, Seylani A, Seyoum K, Sha F, Shafaat O, Shah PA, Shahabi S, Shahid I, Shahrbaf MA, Shahsavari HR, Shaikh MA, Shaka MF, Shaker E, Shannawaz M, Sharew MMS, Sharifi A, Sharifi-Rad J, Sharma P, Shashamo BB, Sheikh A, Sheikh M, Sheikhbahaei S, Sheikhi RA, Sheikhy A, Shepherd PR, Shetty A, Shetty JK, Shetty RS, Shibuya K, Shirkoohi R, Shirzad-Aski H, Shivakumar KM, Shivalli S, Shivarov V, Shobeiri P, Shokri Varniab Z, Shorofi SA, Shrestha S, Sibhat MM, Siddappa Malleshappa SK, Sidemo NB, Silva DAS, Silva LMLR, Silva Julian G, Silvestris N, Simegn W, Singh AD, Singh A, Singh G, Singh H, Singh JA, Singh JK, Singh P, Singh S, Sinha DN, Sinke AH, Siraj MS, Sitas F, Siwal SS, Skryabin VY, Skryabina AA, Socea B, Soeberg MJ, Sofi-Mahmudi A, Solomon Y, Soltani-Zangbar MS, Song S, Song Y, Sorensen RJD, Soshnikov S, Sotoudeh H, Sowe A, Sufiyan MB, Suk R, Suleman M, Suliankatchi Abdulkader R, Sultana S, Sur D, Szócska M, Tabaeian SP, Tabarés-Seisdedos R, Tabatabaei SM, Tabuchi T, Tadbiri H, Taheri E, Taheri M, Taheri Soodejani M, Takahashi K, Talaat IM, Tampa M, Tan KK, Tat NY, Tat VY, Tavakoli A, Tavakoli A, Tehrani-Banihashemi A, Tekalegn Y, Tesfay FH, Thapar R, Thavamani A, Thoguluva Chandrasekar V, Thomas N, Thomas NK, Ticoalu JHV, Tiyuri A, Tollosa DN, Topor-Madry R, Touvier M, Tovani-Palone MR, Traini E, Tran MTN, Tripathy JP, Ukke GG, Ullah I, Ullah S, Ullah S, Unnikrishnan B, Vacante M, Vaezi M, Valadan Tahbaz S, Valdez PR, Vardavas C, Varthya SB, Vaziri S, Velazquez DZ, Veroux M, Villeneuve PJ, Violante FS, Vladimirov SK, Vlassov V, Vo B, Vu LG, Wadood AW, Waheed Y, Walde MT, Wamai RG, Wang C, Wang F, Wang N, Wang Y, Ward P, Waris A, Westerman R, Wickramasinghe ND, Woldemariam M, Woldu B, Xiao H, Xu S, Xu X, Yadav L, Yahyazadeh Jabbari SH, Yang L, Yazdanpanah F, Yeshaw Y, Yismaw Y, Yonemoto N, Younis MZ, Yousefi Z, Yousefian F, Yu C, Yu Y, Yunusa I, Zahir M, Zaki N, Zaman BA, Zangiabadian M, Zare F, Zare I, Zareshahrabadi Z, Zarrintan A, Zastrozhin MS, Zeineddine MA, Zhang D, Zhang J, Zhang Y, Zhang ZJ, Zhou L, Zodpey S, Zoladl M, Vos T, Hay SI, Force LM, Murray CJL. 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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Bryazka D, Reitsma MB, Griswold MG, Abate KH, Abbafati C, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abdoli A, Abdollahi M, Abdullah AYM, Abhilash ES, Abu-Gharbieh E, Acuna JM, Addolorato G, Adebayo OM, Adekanmbi V, Adhikari K, Adhikari S, Adnani QES, Afzal S, Agegnehu WY, Aggarwal M, Ahinkorah BO, Ahmad AR, Ahmad S, Ahmad T, Ahmadi A, Ahmadi S, Ahmed H, Ahmed Rashid T, Akunna CJ, Al Hamad H, Alam MZ, Alem DT, Alene KA, Alimohamadi Y, Alizadeh A, Allel K, Alonso J, Alvand S, Alvis-Guzman N, Amare F, Ameyaw EK, Amiri S, Ancuceanu R, Anderson JA, Andrei CL, Andrei T, Arabloo J, Arshad M, Artamonov AA, Aryan Z, Asaad M, Asemahagn MA, Astell-Burt T, Athari SS, Atnafu DD, Atorkey P, Atreya A, Ausloos F, Ausloos M, Ayano G, Ayanore MAA, Ayinde OO, Ayuso-Mateos JL, Azadnajafabad S, Azanaw MM, Azangou-Khyavy M, Azari Jafari A, Azzam AY, Badiye AD, Bagheri N, Bagherieh S, Bairwa M, Bakkannavar SM, Bakshi RK, Balchut/Bilchut AH, Bärnighausen TW, Barra F, Barrow A, Baskaran P, Belo L, Bennett DA, Benseñor IM, Bhagavathula AS, Bhala N, Bhalla A, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bintoro BS, Blokhina EAE, Bodicha BBA, Boloor A, Bosetti C, Braithwaite D, Brenner H, Briko NI, Brunoni AR, Butt ZA, Cao C, Cao Y, Cárdenas R, Carvalho AF, Carvalho M, Castaldelli-Maia JM, Castelpietra G, Castro-de-Araujo LFS, Cattaruzza MS, Chakraborty PA, Charan J, Chattu VK, Chaurasia A, Cherbuin N, Chu DT, Chudal N, Chung SC, Churko C, Ciobanu LG, Cirillo M, Claro RM, Costanzo S, Cowden RG, Criqui MH, Cruz-Martins N, Culbreth GT, Dachew BA, Dadras O, Dai X, Damiani G, Dandona L, Dandona R, Daniel BD, Danielewicz A, Darega Gela J, Davletov K, de Araujo JAP, de Sá-Junior AR, Debela SA, Dehghan A, Demetriades AK, Derbew Molla M, Desai R, Desta AA, Dias da Silva D, Diaz D, Digesa LE, Diress M, Dodangeh M, Dongarwar D, Dorostkar F, Dsouza HL, Duko B, Duncan BB, Edvardsson K, Ekholuenetale M, Elgar FJ, Elhadi M, Elmonem MA, Endries AY, Eskandarieh S, Etemadimanesh A, Fagbamigbe AF, Fakhradiyev IR, Farahmand F, Farinha CSES, Faro A, Farzadfar F, Fatehizadeh A, Fauk NK, Feigin VL, Feldman R, Feng X, Fentaw Z, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Francis JM, Franklin RC, Gaal PA, Gad MM, Gallus S, Galvano F, Ganesan B, Garg T, Gebrehiwot MGD, Gebremeskel TG, Gebremichael MA, Gemechu TR, Getacher L, Getachew ME, Getachew Obsa A, Getie A, Ghaderi A, Ghafourifard M, Ghajar A, Ghamari SH, Ghandour LA, Ghasemi Nour M, Ghashghaee A, Ghozy S, Glozah FN, Glushkova EV, Godos J, Goel A, Goharinezhad S, Golechha M, Goleij P, Golitaleb M, Greaves F, Grivna M, Grosso G, Gudayu TW, Gupta B, Gupta R, Gupta S, Gupta VB, Gupta VK, Hafezi-Nejad N, Haj-Mirzaian A, Hall BJ, Halwani R, Handiso TB, Hankey GJ, Hariri S, Haro JM, Hasaballah AI, Hassanian-Moghaddam H, Hay SI, Hayat K, Heidari G, Heidari M, Hendrie D, Herteliu C, Heyi DZ, Hezam K, Hlongwa MM, Holla R, Hossain MM, Hossain S, Hosseini SK, hosseinzadeh M, Hostiuc M, Hostiuc S, Hu G, Huang J, Hussain S, Ibitoye SE, Ilic IM, Ilic MD, Immurana M, Irham LM, Islam MM, Islam RM, Islam SMS, Iso H, Itumalla R, Iwagami M, Jabbarinejad R, Jacob L, Jakovljevic M, Jamalpoor Z, Jamshidi E, Jayapal SK, Jayarajah UU, Jayawardena R, Jebai R, Jeddi SA, Jema AT, Jha RP, Jindal HA, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabthymer RH, Kamble BD, Kandel H, Kanno GG, Kapoor N, Karaye IM, Karimi SE, Kassa BG, Kaur RJ, Kayode GA, Keykhaei M, Khajuria H, Khalilov R, Khan IA, Khan MAB, Kim H, Kim J, Kim MS, Kimokoti RW, Kivimäki M, Klymchuk V, Knudsen AKS, Kolahi AA, Korshunov VA, Koyanagi A, Krishan K, Krishnamoorthy Y, Kumar GA, Kumar N, Kumar N, Lacey B, Lallukka T, Lasrado S, Lau J, Lee SW, Lee WC, Lee YH, Lim LL, Lim SS, Lobo SW, Lopukhov PD, Lorkowski S, Lozano R, Lucchetti G, Madadizadeh F, Madureira-Carvalho ÁM, Mahjoub S, Mahmoodpoor A, Mahumud RA, Makki A, Malekpour MR, Manjunatha N, Mansouri B, Mansournia MA, Martinez-Raga J, Martinez-Villa FA, Matzopoulos R, Maulik PK, Mayeli M, McGrath JJ, Meena JK, Mehrabi Nasab E, Menezes RG, Mensink GBM, Mentis AFA, Meretoja A, Merga BT, Mestrovic T, Miao Jonasson J, Miazgowski B, Micheletti Gomide Nogueira de Sá AC, Miller TR, Mini GK, Mirica A, Mirijello A, Mirmoeeni S, Mirrakhimov EM, Misra S, Moazen B, Mobarakabadi M, Moccia M, Mohammad Y, Mohammadi E, Mohammadian-Hafshejani A, Mohammed TA, Moka N, Mokdad AH, Momtazmanesh S, Moradi Y, Mostafavi E, Mubarik S, Mullany EC, Mulugeta BT, Murillo-Zamora E, Murray CJL, Mwita JC, Naghavi M, Naimzada MD, Nangia V, Nayak BP, Negoi I, Negoi RI, Nejadghaderi SA, Nepal S, Neupane SPP, Neupane Kandel S, Nigatu YT, Nowroozi A, Nuruzzaman KM, Nzoputam CI, Obamiro KO, Ogbo FA, Oguntade AS, Okati-Aliabad H, Olakunde BO, Oliveira GMM, Omar Bali A, Omer E, Ortega-Altamirano DV, Otoiu A, Otstavnov SS, Oumer B, P A M, Padron-Monedero A, Palladino R, Pana A, Panda-Jonas S, Pandey A, Pandey A, Pardhan S, Parekh T, Park EK, Parry CDH, Pashazadeh Kan F, Patel J, Pati S, Patton GC, Paudel U, Pawar S, Peden AE, Petcu IR, Phillips MR, Pinheiro M, Plotnikov E, Pradhan PMS, Prashant A, Quan J, Radfar A, Rafiei A, Raghav PR, Rahimi-Movaghar V, Rahman A, Rahman MM, Rahman M, Rahmani AM, Rahmani S, Ranabhat CL, Ranasinghe P, Rao CR, Rasali DP, Rashidi MM, Ratan ZA, Rawaf DL, Rawaf S, Rawal L, Renzaho AMN, Rezaei N, Rezaei S, Rezaeian M, Riahi SM, Romero-Rodríguez E, Roth GA, Rwegerera GM, Saddik B, Sadeghi E, Sadeghian R, Saeed U, Saeedi F, Sagar R, Sahebkar A, Sahoo H, Sahraian MA, Saif-Ur-Rahman KM, Salahi S, Salimzadeh H, Samy AM, Sanmarchi F, Santric-Milicevic MM, Sarikhani Y, Sathian B, Saya GK, Sayyah M, Schmidt MI, Schutte AE, Schwarzinger M, Schwebel DC, Seidu AA, Senthil Kumar N, SeyedAlinaghi S, Seylani A, Sha F, Shahin S, Shahraki-Sanavi F, Shahrokhi S, Shaikh MA, Shaker E, Shakhmardanov MZ, Shams-Beyranvand M, Sheikhbahaei S, Sheikhi RA, Shetty A, Shetty JK, Shiferaw DS, Shigematsu M, Shiri R, Shirkoohi R, Shivakumar KM, Shivarov V, Shobeiri P, Shrestha R, Sidemo NB, Sigfusdottir ID, Silva DAS, Silva NTD, Singh JA, Singh S, Skryabin VY, Skryabina AA, Sleet DA, Solmi M, SOLOMON YONATAN, Song S, Song Y, Sorensen RJD, Soshnikov S, Soyiri IN, Stein DJ, Subba SH, Szócska M, Tabarés-Seisdedos R, Tabuchi T, Taheri M, Tan KK, Tareke M, Tarkang EE, Temesgen G, Temesgen WA, Temsah MH, Thankappan KR, Thapar R, Thomas NK, Tiruneh C, Todorovic J, Torrado M, Touvier M, Tovani-Palone MR, Tran MTN, Trias-Llimós S, Tripathy JP, Vakilian A, Valizadeh R, Varmaghani M, Varthya SB, Vasankari TJ, Vos T, Wagaye B, Waheed Y, Walde MT, Wang C, Wang Y, Wang YP, Westerman R, Wickramasinghe ND, Wubetu AD, Xu S, Yamagishi K, Yang L, Yesera GEE, Yigit A, Yiğit V, Yimaw AEAE, Yon DK, Yonemoto N, Yu C, Zadey S, Zahir M, Zare I, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Zhong C, Zmaili M, Zuniga YMH, Gakidou E. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. Lancet 2022; 400:185-235. [PMID: 35843246 PMCID: PMC9289789 DOI: 10.1016/s0140-6736(22)00847-9] [Citation(s) in RCA: 122] [Impact Index Per Article: 61.0] [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: 11/18/2021] [Revised: 04/11/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. METHODS For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. FINDINGS The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. INTERPRETATION There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. FUNDING Bill & Melinda Gates Foundation.
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Attia JR, Holliday E, Weaver N, Peel R, Fleming KC, Hure A, Wiggers J, McEvoy M, Searles A, Reeves P, Ranasinghe P, Jayawardena R, Samman S, Luu J, Rissel C, Acharya S. The effect of zinc supplementation on glucose homeostasis: a randomised double-blind placebo-controlled trial. Acta Diabetol 2022; 59:965-975. [PMID: 35451678 PMCID: PMC9026040 DOI: 10.1007/s00592-022-01888-x] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022]
Abstract
AIMS The burden and health costs of Type 2 Diabetes Mellitus continue to increase globally and prevention strategies in at-risk people need to be explored. Previous work, in both animal models and humans, supports the role of zinc in improving glucose homeostasis. We, therefore, aimed to test the effectiveness of zinc supplementation on glycaemic control in pre-diabetic adults. METHODS We conducted a randomized, double-blind, placebo-controlled trial across 10 General Practitioner (GP) practices in NSW, Australia. The trial is known as Zinc in Preventing the Progression of pre-Diabetes (ZIPPeD)Study. Pre-diabetic (haemoglobin A1c [HbA1c] 5.7-6.4%, 39-46 mmol/mol) men and women (N = 98) were all assigned to a free state government telephone health coaching service (New South Wales Get Healthy Information and Coaching Service) and then randomised to either daily 30 mg zinc gluconate or placebo. Blood tests were collected at baseline, 1, 6 and 12 months for the primary outcomes (HbA1c, fasting blood glucose (FBG)); secondary outcomes included Homeostasis Model Assessment 2 (HOMA 2) parameters, lipids, body weight, height, waist circumference, blood pressure and pulse. RESULTS The baseline-adjusted mean group difference at 6 months, expressed as treatment-placebo, (95% CI) was -0.02 (-0.14, 0.11, p = 0.78) for HbA1c and 0.17 (-0.07, 0.42; p = 0.17) for FBG, neither of which were statistically significant. There were also no significant differences between groups in any of the secondary outcomes. Zinc was well tolerated, and compliance was high (88%). CONCLUSION We believe our results are consistent with other Western clinical trial studies and do not support the use of supplemental zinc in populations with a Western diet. There may still be a role for supplemental zinc in the developing world where diets may be zinc deficient. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry, ACTRN12618001120268. Registered on 6 July 2018.
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Affiliation(s)
- John R Attia
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia.
- Division of Medicine, Hunter New England Local Health District, New Lambton Heights, Australia.
| | - Elizabeth Holliday
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Natasha Weaver
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Roseanne Peel
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Kerry C Fleming
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Alexis Hure
- Diabetes Service and Diabetes Alliance Hunter New England Local Health District, New Lambton Heights, Australia
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
- Hunter New England Local Health District, New Lambton Heights, Australia
| | - Mark McEvoy
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, VIC, Australia
| | - Andrew Searles
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Penny Reeves
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | | | | | - Samir Samman
- School of Life and Environmental Sciences, University of Sydney, New Lambton Heights, Australia
| | - Judy Luu
- Diabetes Stream, Diabetes Alliance HNELHD, New Lambton Heights, Australia
| | - Chris Rissel
- The University of Sydney, Camperdown, 2050, Australia
| | - Shamasunder Acharya
- Endocrinology and Diabetes Service and Diabetes Alliance Hunter New England Local Health District, New Lambton Heights, Australia
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Sheena BS, Hiebert L, Han H, Ippolito H, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abbastabar H, Abdoli A, Abubaker Ali H, Adane MM, Adegboye OA, Adnani QES, Advani SM, Afzal MS, Afzal S, Aghaie Meybodi M, Ahadinezhad B, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi S, Ahmed H, Ahmed MB, Ahmed Rashid T, Akalu GT, Aklilu A, Akram T, Al Hamad H, Alahdab F, Alem AZ, Alem DT, Alhalaiqa FAN, Alhassan RK, Ali L, Ali MA, Alimohamadi Y, Alipour V, Alkhayyat M, Almustanyir S, Al-Raddadi RM, Altawalah H, Amini S, Amu H, Ancuceanu R, Andrei CL, Andrei T, Anoushiravani A, Ansar A, Anyasodor AE, Arabloo J, Arab-Zozani M, Argaw AM, Argaw ZG, Arshad M, Artamonov AA, Ashraf T, Atlaw D, Ausloos F, Ausloos M, Azadnajafabad S, Azangou-Khyavy M, Azari Jafari A, Azarian G, Bagheri S, Bahadory S, Baig AA, Banach M, Barati N, Barrow A, Batiha AMM, Bejarano Ramirez DF, Belgaumi UI, Berhie AY, Bhagat DS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhojaraja VS, Bijani A, Biondi A, Bodicha BBA, Bojia HA, Boloor A, Bosetti C, Braithwaite D, Briko NI, Butt ZA, Cámera LA, Chakinala RC, Chakraborty PA, Charan J, Chen S, Choi JYJ, Choudhari SG, Chowdhury FR, Chu DT, Chung SC, Cortesi PA, Cowie BC, Culbreth GT, Dadras O, Dai X, Dandona L, Dandona R, De la Hoz FP, Debela SA, Dedefo MG, Demeke FM, Demie TGG, Demissie GD, Derbew Molla M, Desta AA, Dhamnetiya D, Dhimal ML, Dhimal M, Didehdar M, Doan LP, Dorostkar F, Drake TM, Eghbalian F, Ekholuenetale M, El Sayed I, El Sayed Zaki M, Elhadi M, Elmonem MA, Elsharkawy A, Enany S, Enyew DB, Erkhembayar R, Eskandarieh S, Esmaeilzadeh F, Ezzikouri S, Farrokhpour H, Fetensa G, Fischer F, Foroutan M, Gad MM, Gaidhane AM, Gaidhane S, Galles NC, Gallus S, Gebremeskel TG, Gebreyohannes EAA, Ghadiri K, Ghaffari K, Ghafourifard M, Ghamari SH, Ghashghaee A, Gholami A, Gholizadeh A, Gilani A, Goel A, Golechha M, Goleij P, Golinelli D, Gorini G, Goshu YA, Griswold MG, Gubari MIM, Gupta B, Gupta S, Gupta VB, Gupta VK, Haddadi R, Halwani R, Hamid SS, Hamidi S, Hanif A, Haque S, Harapan H, Hargono A, Hariri S, Hasaballah AI, Hasan SMM, Hassanipour S, Hassankhani H, Hay SI, Hayat K, Heidari G, Herteliu C, Heyi DZ, Hezam K, Holla R, Hosseini MS, Hosseini M, Hosseinzadeh M, Hostiuc M, Househ M, Huang J, Hussein NR, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Irham LM, Islam JY, Ismail NE, Jacobsen KH, Jadidi-Niaragh F, Javadi Mamaghani A, Jayaram S, Jayawardena R, Jebai R, Jha RP, Joseph N, Joukar F, Kaambwa B, Kabir A, Kabir Z, Kalhor R, Kandel H, Kanko TKT, Kantar RS, Karaye IM, Kassa BG, Kemp Bohan PM, Keykhaei M, Khader YS, Khajuria H, Khan G, Khan IA, Khan J, Khan MAB, Khanali J, Khater AM, Khatib MN, Khodadost M, Khoja AT, Khosravizadeh O, Khubchandani J, Kim GR, Kim H, Kim MS, Kim YJ, Kocarnik JM, Kolahi AA, Koteeswaran R, Kumar GA, La Vecchia C, Lal DK, Landires I, Lasrado S, Lazarus JV, Ledda C, Lee DW, Lee SW, Lee YY, Levi M, Li J, Lim SS, Lobo SW, Lopukhov PD, Loureiro JA, MacLachlan JH, Magdy Abd El Razek H, Magdy Abd El Razek M, Majeed A, Makki A, Malekpour MR, Malekzadeh R, Malik AA, Mansour-Ghanaei F, Mansournia MA, Martins-Melo FR, Matthews PC, Mendoza W, Menezes RG, Meretoja TJ, Mersha AG, Mestrovic T, Miller TR, Minh LHN, Mirica A, Mirmoeeni S, Mirrakhimov EM, Misra S, Mithra P, Moazen B, Mohamadkhani A, Mohammadi M, Mohammed S, Moka N, Mokdad AH, Moludi J, Momtazmanesh S, Monasta L, Moradi G, Moradzadeh M, Moradzadeh R, Moraga P, Mostafavi E, Mubarik S, Muniyandi M, Murray CJL, Naghavi M, Naimzada MD, Narasimha Swamy S, Natto ZS, Nayak BP, Nazari J, Negoi I, Negru SM, Nejadghaderi SA, Neupane Kandel S, Nguyen HLT, Ngwa CH, Niazi RK, Nnaji CA, Noubiap JJ, Nowroozi A, Nuñez-Samudio V, Oancea B, Ochir C, Odukoya OO, Oh IH, Olagunju AT, Olakunde BO, Omar Bali A, Omer E, Otstavnov SS, Oumer B, Padubidri JR, Pana A, Pandey A, Park EC, Pashazadeh Kan F, Patel UK, Paudel U, Petcu IR, Piracha ZZ, Pollok RCG, Postma MJ, Pourshams A, Poustchi H, Rabiee M, Rabiee N, Rafiei A, Rafiei S, Raghuram PM, Rahman M, Rahmani AM, Rahmawaty S, Rajesh A, Ranasinghe P, Rao CR, Rao SJ, Rashidi M, Rashidi MM, Rawaf DL, Rawaf S, Rawassizadeh R, Rezaei N, Rezapour A, Rezazadeh-Khadem S, Rodriguez JAB, Rwegerera GM, Sabour S, Saddik B, Saeb MR, Saeed U, Sahebkar A, Saif-Ur-Rahman KM, Salahi S, Salimzadeh H, Sampath C, Samy AM, Sanabria J, Sanmarchi F, Santric-Milicevic MM, Sarveazad A, Sathian B, Sawhney M, Seidu AA, Sepanlou SG, Seylani A, Shahabi S, Shaikh MA, Shaker E, Shakhmardanov MZ, Shannawaz M, Shenoy SM, Shetty JK, Shetty PH, Shibuya K, Shin JI, Shobeiri P, Sibhat MM, Singh AD, Singh JA, Singh S, Skryabin VY, Skryabina AA, Sohrabpour AA, Song S, Tabaeian SP, Tadesse EG, Taheri M, Tampa M, Tan KK, Tavakoli A, Tbakhi A, Tefera BN, Tehrani-Banihashemi A, Tesfaw HM, Thapar R, Thavamani A, Tohidast SA, Tollosa DN, Tosti ME, Tovani-Palone MR, Traini E, Tran MTN, Trihandini I, Tusa BS, Ullah I, Vacante M, Valadan Tahbaz S, Valdez PR, Varthya SB, Vo B, Waheed Y, Weldesenbet AB, Woldemariam M, Xu S, Yahyazadeh Jabbari SH, Yaseri M, Yeshaw Y, Yiğit V, Yirdaw BW, Yonemoto N, Yu C, Yunusa I, Zahir M, Zaki L, Zamani M, Zamanian M, Zastrozhin MS, Vos T, Ward JW, Dirac MA. Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol 2022; 7:796-829. [PMID: 35738290 PMCID: PMC9349325 DOI: 10.1016/s2468-1253(22)00124-8] [Citation(s) in RCA: 174] [Impact Index Per Article: 87.0] [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: 09/10/2021] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 12/23/2022]
Abstract
Background Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 000 global deaths (487 000 to 630 000) in 2019. The number of HBV-related deaths increased between 1990 and 2019 (by 5·9% [–5·6 to 19·2]) and between 2015 and 2019 (by 2·9% [–5·9 to 11·3]). By contrast, all-age and age-standardised death rates due to HBV-related diseases decreased during these periods. We compared estimates for 2019 in 194 WHO locations to WHO-GHSS 2020 targets, and found that four countries achieved a 10% reduction in deaths, 15 countries achieved a 30% reduction in new cases, and 147 countries achieved a 1% prevalence in children younger than 5 years. As of 2019, 68 of 194 countries had already achieved the 2030 target proposed in WHO Interim Guidance of an all-age HBV-related death rate of four per 100 000. Interpretation The prevalence of chronic HBV infection declined over time, particularly in children younger than 5 years, since the introduction of hepatitis B vaccination. HBV-related death rates also decreased, but HBV-related death counts increased as a result of population growth, ageing, and cohort effects. By 2019, many countries had met the interim seroprevalence target for children younger than 5 years, but few countries had met the WHO-GHSS interim targets for deaths and new cases. Progress according to all indicators must be accelerated to meet 2030 targets, and there are marked disparities in burden and progress across the world. HBV interventions, such as vaccination, testing, and treatment, must be strategically supported and scaled up to achieve elimination. Funding Bill & Melinda Gates Foundation.
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Dissanayake HA, de Silva NL, Sumanatilleke M, de Silva SDN, Gamage KKK, Dematapitiya C, Kuruppu DC, Ranasinghe P, Pathmanathan S, Katulanda P. Prognostic and Therapeutic Role of Vitamin D in COVID-19: Systematic Review and Meta-analysis. J Clin Endocrinol Metab 2022; 107:1484-1502. [PMID: 34894254 PMCID: PMC8689831 DOI: 10.1210/clinem/dgab892] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Indexed: 12/03/2022]
Abstract
PURPOSE Vitamin D deficiency/insufficiency may increase the susceptibility to coronavirus disease 2019 (COVID-19). We aimed to determine the association between vitamin D deficiency/insufficiency and susceptibility to COVID-19, its severity, mortality, and role of vitamin D in its treatment. METHODS We searched CINAHL, Cochrane library, EMBASE, PubMED, Scopus, and Web of Science up to May 30, 2021, for observational studies on association between vitamin D deficiency/insufficiency and susceptibility to COVID-19, severe disease, and death among adults, and, randomized controlled trials (RCTs) comparing vitamin D treatment against standard care or placebo, in improving severity or mortality among adults with COVID-19. Risk of bias was assessed using Newcastle-Ottawa scale for observational studies and AUB-KQ1 Cochrane tool for RCTs. Study-level data were analyzed using RevMan 5.3 and R (v4.1.0). Heterogeneity was determined by I2 and sources were explored through prespecified sensitivity analyses, subgroup analyses, and meta-regressions. RESULTS Of 1877 search results, 76 studies satisfying eligibility criteria were included. Seventy-two observational studies were included in the meta-analysis (n = 1 976 099). Vitamin D deficiency/insufficiency increased the odds of developing COVID-19 (odds ratio [OR] 1.46; 95% CI, 1.28-1.65; P < 0.0001; I2 = 92%), severe disease (OR 1.90; 95% CI, 1.52-2.38; P < 0.0001; I2 = 81%), and death (OR 2.07; 95% CI, 1.28-3.35; P = 0.003; I2 = 73%). The 25-hydroxy vitamin D concentrations were lower in individuals with COVID-19 compared with controls (mean difference [MD] -3.85 ng/mL; 95% CI, -5.44 to -2.26; P ≤ 0.0001), in patients with severe COVID-19 compared with controls with nonsevere COVID-19 (MD -4.84 ng/mL; 95% CI, -7.32 to -2.35; P = 0.0001) and in nonsurvivors compared with survivors (MD -4.80 ng/mL; 95% CI, -7.89 to -1.71; P = 0.002). The association between vitamin D deficiency/insufficiency and death was insignificant when studies with high risk of bias or studies reporting unadjusted effect estimates were excluded. Risk of bias and heterogeneity were high across all analyses. Discrepancies in timing of vitamin D testing, definitions of severe COVID-19, and vitamin D deficiency/insufficiency partly explained the heterogeneity. Four RCTs were widely heterogeneous precluding meta-analysis. CONCLUSION Multiple observational studies involving nearly 2 million adults suggest vitamin D deficiency/insufficiency increases susceptibility to COVID-19 and severe COVID-19, although with a high risk of bias and heterogeneity. Association with mortality was less robust. Heterogeneity in RCTs precluded their meta-analysis.
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Affiliation(s)
- Harsha Anuruddhika Dissanayake
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
- Corresponding author: Name : HA Dissanayake, Address: Department of Clinical Medicine, Faculty of Medicine, No 25, Kynsey Road, Colombo 08, Sri Lanka E mail : Telephone : +94714219893
| | - Nipun Lakshitha de Silva
- Department of Clinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Sri Lanka
| | | | | | | | | | | | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Sri Lanka
| | | | - Prasad Katulanda
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
- Cruddas Link Fellow, Harris Manchester College, University of Oxford
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Kodikara KAS, Lewandowski S, De Silva PMCS, Gunarathna SD, Madarasinghe SK, Ranasinghe P, Jayatissa LP, Dahdouh-Guebas F. Heavy metal pollution in selected upland tributaries of Sri Lanka: comprehension towards the localization of sources of pollution. J Water Health 2022; 20:505-517. [PMID: 35350003 DOI: 10.2166/wh.2022.250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study aimed to assess the heavy metal (HM) profile of the main upland tributaries of three major rivers, the Mahaweli, the Deduru and the Gin Rivers, which are commonly used for urban water supply in Sri Lanka. The HM profiles of arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg) were investigated by ICP-MS. Land-use classification was performed to locate the main sources of pollution. Mean pH, TDS and conductivity showed significant inter-site mean differences (p < 0.001). The mean contents of the HMs, considering all rivers, were observed in the order [Hg] > [As] > [Pb] > [Cd] at the sources and [As] > [Hg] > [Pb] > [Cd] at the river mouths. Particularly, in the Mahaweli River, the mean As content was 0.08 ± 0.05 μg·L-1 and showed an increasing trend from the source to the river mouth. In the Deduru River, the mean Hg content was 0.14 ± 0.15 μg·L-1, and of all rivers studied, the highest content of 0.50 ± 0.17 μg·L-1 was recorded. The Gin River showed significant inter-site mean differences (p < 0.05) in [Pb], [As] and [Hg]. In all rivers studied, [As] was significantly higher in water samples collected near agricultural lands and urban areas as compared with the other land-use/cover types, which was further proved by a significant positive correlation (coefficient = 0.479, p = 0.0325). We, therefore, emphasized that HM pollution is more likely due to anthropogenic activities in the upper catchment with less lithogenic contamination. However, national water quality management should be further strengthened and new policy enforcement is emphasized.
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Affiliation(s)
- K A S Kodikara
- Department of Botany, Faculty of Science, University of Ruhuna, Matara, Sri Lanka E-mail: ; First co-authors
| | - S Lewandowski
- Systems Ecology and Resource Management Research Unit, Département de Biologie des Organismes, Université Libre de Bruxelles - ULB, Av. F.D. Roosevelt 50, CPi 264/1, 1050 Brussels, Belgium; First co-authors
| | - P M C S De Silva
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara, Sri Lanka
| | - S D Gunarathna
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara, Sri Lanka
| | - S K Madarasinghe
- Department of Physics, Faculty of Science, University of Ruhuna, Matara, Sri Lanka
| | - P Ranasinghe
- Herbal Technology Section, Industrial Technology Institute, Colombo 7, Sri Lanka
| | - L P Jayatissa
- Department of Botany, Faculty of Science, University of Ruhuna, Matara, Sri Lanka E-mail:
| | - F Dahdouh-Guebas
- Systems Ecology and Resource Management Research Unit, Département de Biologie des Organismes, Université Libre de Bruxelles - ULB, Av. F.D. Roosevelt 50, CPi 264/1, 1050 Brussels, Belgium; Ecology & Biodiversity, Laboratory of Plant Biology and Nature Management, Biology Department, Vrije Universiteit Brussel - VUB, Pleinlaan 2, VUB-APNA-WE, 1050 Brussels, Belgium
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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, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Irham LM, Islam JY, Islam RM, Islam SMS, Ismail NE, Isola G, Iwagami M, Jacob L, Jain V, Jakovljevic MB, Javaheri T, Jayaram S, Jazayeri SB, Jha RP, Jonas JB, Joo T, Joseph N, Joukar F, Jürisson M, Kabir A, Kahrizi D, Kalankesh LR, Kalhor R, Kaliyadan F, Kalkonde Y, Kamath A, Kameran Al-Salihi N, Kandel H, Kapoor N, Karch A, Kasa AS, Katikireddi SV, Kauppila JH, Kavetskyy T, Kebede SA, Keshavarz P, Keykhaei M, Khader YS, Khalilov R, Khan G, Khan M, Khan MN, Khan MAB, Khang YH, Khater AM, Khayamzadeh M, Kim GR, Kim YJ, Kisa A, Kisa S, Kissimova-Skarbek K, Kopec JA, Koteeswaran R, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Kucuk Bicer B, Kugbey N, Kumar GA, Kumar N, Kumar N, Kurmi OP, Kutluk T, La Vecchia C, Lami FH, Landires I, Lauriola P, Lee SW, Lee SWH, Lee WC, Lee YH, Leigh J, Leong E, Li J, Li MC, Liu X, Loureiro JA, Lunevicius R, Magdy Abd El Razek M, Majeed A, Makki A, Male S, Malik AA, Mansournia MA, Martini S, Masoumi SZ, Mathur P, McKee M, Mehrotra R, Mendoza W, Menezes RG, Mengesha EW, Mesregah MK, Mestrovic T, Miao Jonasson J, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mirzaei H, Mirzaei HR, Misra S, Mithra P, Moghadaszadeh M, Mohammad KA, Mohammad Y, Mohammadi M, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Moka N, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moosavi MA, Moradi Y, Moraga P, Morgado-da-Costa J, Morrison SD, Mosapour A, Mubarik S, Mwanri L, Nagarajan AJ, Nagaraju SP, Nagata C, Naimzada MD, Nangia V, Naqvi AA, Narasimha Swamy S, Ndejjo R, Nduaguba SO, Negoi I, Negru SM, Neupane Kandel S, Nguyen CT, Nguyen HLT, Niazi RK, Nnaji CA, Noor NM, Nuñez-Samudio V, Nzoputam CI, Oancea B, Ochir C, Odukoya OO, Ogbo FA, Olagunju AT, Olakunde BO, Omar E, Omar Bali A, Omonisi AEE, Ong S, Onwujekwe OE, Orru H, Ortega-Altamirano DV, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Padubidri JR, Pakshir K, Pana A, Panagiotakos D, Panda-Jonas S, Pardhan S, Park EC, Park EK, Pashazadeh Kan F, Patel HK, Patel JR, Pati S, Pattanshetty SM, Paudel U, Pereira DM, Pereira RB, Perianayagam A, Pillay JD, Pirouzpanah S, Pishgar F, Podder I, Postma MJ, Pourjafar H, Prashant A, Preotescu L, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Radhakrishnan V, Rafiee A, Rahim F, Rahimzadeh S, Rahman M, Rahman MA, Rahmani AM, Rajai N, Rajesh A, Rakovac I, Ram P, Ramezanzadeh K, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rawassizadeh R, Razeghinia MS, Renzaho AMN, Rezaei N, Rezaei N, Rezapour A, Roberts TJ, Rodriguez JAB, Rohloff P, Romoli M, Ronfani L, Roshandel G, Rwegerera GM, S M, Sabour S, Saddik B, Saeed U, Sahebkar A, Sahoo H, Salehi S, Salem MR, Salimzadeh H, Samaei M, Samy AM, Sanabria J, Sankararaman S, Santric-Milicevic MM, Sardiwalla Y, Sarveazad A, Sathian B, Sawhney M, Saylan M, Schneider IJC, Sekerija M, Seylani A, Shafaat O, Shaghaghi Z, Shaikh MA, Shamsoddin E, Shannawaz M, Sharma R, Sheikh A, Sheikhbahaei S, Shetty A, Shetty JK, Shetty PH, Shibuya K, Shirkoohi R, Shivakumar KM, Shivarov V, Siabani S, Siddappa Malleshappa SK, Silva DAS, Singh JA, Sintayehu Y, Skryabin VY, Skryabina AA, Soeberg MJ, Sofi-Mahmudi A, Sotoudeh H, Steiropoulos P, Straif K, Subedi R, Sufiyan MB, Sultan I, Sultana S, Sur D, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Tabuchi T, Tadbiri H, Taherkhani A, Takahashi K, Talaat IM, Tan KK, Tat VY, Tedla BAA, Tefera YG, Tehrani-Banihashemi A, Temsah MH, Tesfay FH, Tessema GA, Thapar R, Thavamani A, Thoguluva Chandrasekar V, Thomas N, Tohidinik HR, Touvier M, Tovani-Palone MR, Traini E, Tran BX, Tran KB, Tran MTN, Tripathy JP, Tusa BS, Ullah I, Ullah S, Umapathi KK, Unnikrishnan B, Upadhyay E, Vacante M, Vaezi M, Valadan Tahbaz S, Velazquez DZ, Veroux M, Violante FS, Vlassov V, Vo B, Volovici V, Vu GT, Waheed Y, Wamai RG, Ward P, Wen YF, Westerman R, Winkler AS, Yadav L, Yahyazadeh Jabbari SH, Yang L, Yaya S, Yazie TSY, Yeshaw Y, Yonemoto N, Younis MZ, Yousefi Z, Yu C, Yuce D, Yunusa I, Zadnik V, Zare F, Zastrozhin MS, Zastrozhina A, Zhang 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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22
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Barrea L, Vetrani C, Verde L, Frias-Toral E, Garcia-Velasquez E, Ranasinghe P, Mendez V, Jayawardena R, Savastano S, Colao A, Muscogiuri G. Gestational obesity: An unconventional endocrine disruptor for the fetus. Biochem Pharmacol 2022; 198:114974. [PMID: 35202578 DOI: 10.1016/j.bcp.2022.114974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 12/16/2022]
Abstract
Obesity has reached pandemic proportions and is a growing concern throughout the world. A parallel trend has also been observed among women in reproductive age, leading to the increasing global prevalence of gestational obesity (GO). The well-known obesity-related health problems also extend to pregnancy, where they are responsible for giving rise to a variety of medical and obstetrical complications, resulting in an increased incidence of adverse maternal and fetal outcomes. In this context, several epidemiological and clinical studies have shown that nutritional changes through different stages of gestation can have a substantial impact on the future health and development of the child. Therefore, it is clear that GO is a modifiable endocrine disruptor that negatively influences the health of the fetus and the newborn, with long-term metabolic implications. This review aims to describe the impact of GO on maternal and fetal outcomes using the available scientific literature and highlighting the evidence-based nutritional approaches currently recommended for the management of GO.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, 80143 Napoli, Italy; Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Claudia Vetrani
- Dipartimento di Medicina Clinica e Chirurgia, Endocrinology Unit, University Federico II, Italy
| | - Ludovica Verde
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Evelyn Frias-Toral
- Universidad Católica Santiago de Guayaquil, Av Pdte. Carlos Julio Arosemena Tola, Guayaquil 090615, Ecuador
| | | | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Verna Mendez
- Department of Internal Medicine, Hospital General de Zona 49, Mexican Institute of Social Security, Los Mochis, Sinaloa, Mexico
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; Queensland University of Technology (QUT), Faculty of Health, School of Exercise and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Silvia Savastano
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy; Dipartimento di Medicina Clinica e Chirurgia, Endocrinology Unit, University Federico II, Italy
| | - Annamaria Colao
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy; Dipartimento di Medicina Clinica e Chirurgia, Endocrinology Unit, University Federico II, Italy; Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Italy
| | - Giovanna Muscogiuri
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy; Dipartimento di Medicina Clinica e Chirurgia, Endocrinology Unit, University Federico II, Italy; Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Italy.
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23
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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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Ranasinghe P, Monge-Nájera J, Liyanage CK, Ho YS. Half a century of Sri Lanka research: Subjects, researchers, institutions, journals and impact (1973-2019). REV BIOL TROP 2022. [DOI: 10.15517/rev.biol.trop..v70i1.46065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction: Bibliometric analyses of research in Sri Lanka, a lower-middle income island nation in South Asia, has focused mainly on medical research, concluding that there is a need for increased research productivity and impact, and for local solutions to health concerns. There has been no general bibliometric analysis across scientific disciplines in the nation, or any study that covers a long period of time to identify general time trends. Objective: To measure and analyse Sri Lankan research by focusing on subjects, authors, institutions, journals and citation for half a century. Methods: We used an advanced search method to extract publications with the word “Sri Lanka” in the SCI-EXPANDED, and calculated indicators such as total citations from Web of Science Core Collection since publication year to the end of 2019, citations in 2019, and mean citations per publication. Journal data were taken from 2019 Journal Citation Report. Affiliation re-classification was done to ensure consistency regarding the origin of all publications. Publications were further analysed based on collaboration, and first and corresponding authorship. Results: We retrieved 16 069 publications in 19 document types (77 % articles). Corrections had the highest number of authors per publication (616) followed by articles (116). Four articles had more than 5 000 authors and 593 articles had more than 1 000 authors. The highest citations in this database were for international megaprojects where Sri Lankan authors played minor roles. The UK had the most collaborative articles with Sri Lanka (19 %). The articles were published in 3 051 journals across 177 Web of Science categories. The category of Public, environmental and occupational health, with 193 journals, had 6.7 % of all articles, followed by environmental sciences (6.6 %). Conclusion: Sri Lanka has an unusually strong pattern of participating as small role players in international megaprojects about health and physics. Sri Lankan authors should be encouraged to expand their horizons by researching non-applied fields that are the basis of all innovation; to strengthen their own journals so that they have better visibility and impact, and to improve their positions in international projects that are published in larger journals.
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Swarnamali H, Jayawardena R, Michail Chourdakis, Ranasinghe P. Is the proportion of per capita fat supply associated with the prevalence of overweight and obesity? an ecological analysis. BMC Nutr 2022; 8:4. [PMID: 35022072 PMCID: PMC8756625 DOI: 10.1186/s40795-021-00496-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although it is reported in numerous interventional and observational studies, that a low-fat diet is an effective method to combat overweight and obesity, the relationship at the global population level is not well established. This study aimed to quantify the associations between worldwide per capita fat supply and prevalence of overweight and obesity and further classify this association based on per capita Gross National Income (GNI). METHODS A total of 93 countries from four GNI groups were selected. Country-specific overweight and obesity prevalence data were retrieved from the most recent WHO Global Health Observatory database. Per capita supply of fat and calories were obtained from the United Nations Food and Agricultural Organization database; FAOSTAT, Food Balance Sheet for years 2014-2016. The categorizations of countries were done based on GNI based classification by the World Bank. RESULTS Among the selected countries, the overweight prevalence ranged from 3.9% (India) to 78.8% (Kiribati), while obesity prevalence ranged from 3.6% (Bangladesh) to 46.0% (Kiribati). The highest and the lowest per capita fat supply from total calorie supply were documented in Australia (41.2%) and Madagascar (10.5%) respectively. A significant strong positive correlation was observed between the prevalence of overweight (r = 0.64, p < 0.001) and obesity (r = 0.59, p < 0.001) with per capita fat supply. The lower ends of both trend lines were densely populated by the low- and lower-middle-income countries and the upper ends of both lines were greatly populated by the high-income countries. CONCLUSIONS Per capita fat supply per country is significantly associated with both prevalence of overweight and obesity.
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Affiliation(s)
- Hasinthi Swarnamali
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124, Thessaloniki, Greece
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
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Dilrukshi MDSA, Thotamuna V, Senarath Yapa DJ, De Silva L, Ranasinghe P, Katulanda P. Influence of Overweight and Obesity on Morbidity and Mortality among Hospitalized Patients in Sri Lanka: A Single-Center Analysis. J Obes 2022; 2022:9172365. [PMID: 36033432 PMCID: PMC9411002 DOI: 10.1155/2022/9172365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Current evidence regarding the association between overweight and obesity and in-hospital morbidity and mortality is inconsistent and South Asian populations are underrepresented. METHODS Data relevant to anthropometry, hospital outcomes, complications, and medical diagnoses of all acute medical admissions to the National Hospital of Sri Lanka were collected over a period of 3 months. Analysis was performed with WHO international (ICs) and Asian obesity cut-offs (ACs). RESULTS Sample size was 2,128 (median age: 57 years [IQR: 42, 67], males: 49.7%). High prevalence of overweight (23.5%), generalized obesity (10.4%), central obesity (28.5%), and underweight (15.4%) was observed (ICs). Patients with either generalized or central obesity had significantly higher in-hospital mortality (4.8% versus 2.5%, p = 0.031) and acute kidney injury (AKI) (3.9% versus 1.2%) (p = 0.001) compared to normal weight. With ACs, overweight and obesity prevalence increased, without any significant increment in morbidity and mortality, but median length of hospital stay was significantly reduced in patients with generalized obesity compared to normal (3 [IQR: 2, 5] versus 4 [IQR: 2, 6], p = 0.014). Infections (44.4%) and cardiovascular diseases (CVDs) (25.9%) were the most common causes of admission. Overweight and generalized obesity or central obesity were associated with increased prevalence of acute CVDs and CVD risk factors and lower prevalence of acute infections, whilst underweight showed an inverse association. CONCLUSION A double burden of malnutrition and diseases were noted among hospital admissions, with obesity being a risk factor for in-hospital all-cause mortality and AKI. Overweight and obesity were associated with increased CVDs and reduced infections. Larger prospective studies are required to characterize these associations among South Asians.
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Affiliation(s)
| | - V. Thotamuna
- Diabetes Trial Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - D. J. Senarath Yapa
- Diabetes Trial Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - L. De Silva
- Diabetes Trial Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - P. Ranasinghe
- National Hospital of Sri Lanka, Colombo, Sri Lanka
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - P. Katulanda
- National Hospital of Sri Lanka, Colombo, Sri Lanka
- Diabetes Trial Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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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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Fleming K, Weaver N, Peel R, Hure A, McEvoy M, Holliday E, Parsons M, Acharya S, Luu J, Wiggers J, Rissel C, Ranasinghe P, Jayawardena R, Samman S, Attia J. Using the AUSDRISK score to screen for pre-diabetes and diabetes in GP practices: a case-finding approach. Aust N Z J Public Health 2021; 46:203-207. [PMID: 34762354 DOI: 10.1111/1753-6405.13181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/01/2021] [Accepted: 10/01/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To identify the optimal AUSDRISK threshold score to screen for pre-diabetes and diabetes. METHODS A total of 406 adult patients not diagnosed with diabetes were screened in General Practices (GP) between May and October 2019. All patients received a point of care (POC) HbA1c test. HbA1c test results were categorised into diabetes (≥6.5% or ≥48 mmol/mol), pre-diabetes (5.7-6.4% or 39-47 mmol/mol), or normal (<5.7% or 39 mmol/mol). RESULTS Of these patients, 9 (2%) had undiagnosed diabetes and 60 (15%) had pre-diabetes. A Receiver Operator Characteristic (ROC) curve was constructed to predict the presence of pre-diabetes and diabetes; the area under the ROC curve was 0.72 (95%CI 0.65-0.78) indicating modest predictive ability. The optimal threshold cut point for AUSDRISK score was 17 (sensitivity 76%, specificity 61%, + likelihood ratio (LR) 1.96, - likelihood ratio of 0.39) while the accepted cut point of 12 performed less well (sensitivity 94%, specificity 23%, +LR=1.22 -LR+0.26). CONCLUSIONS The AUSDRISK tool has the potential to be used as a screening tool for pre-diabetes/diabetes in GP practices. A cut point of ≥17 would potentially identify 75% of all people at risk and three in 10 sent for further testing would be positive for prediabetes or diabetes. Implications for public health: Routine case-finding in high-risk patients will enable GPs to intervene early and prevent further public health burden from the sequelae of diabetes.
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Affiliation(s)
- Kerry Fleming
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, New South Wales.,Endocrinology and Diabetes Service and Diabetes Alliance, Hunter New England Health Local Health District (HNELHD), New south Wales.,Hunter Medical Research Institute, Newcastle, New South Wales
| | - Natasha Weaver
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, Newcastle, New South Wales
| | - Roseanne Peel
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, Newcastle, New South Wales
| | - Alexis Hure
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, Newcastle, New South Wales
| | - Mark McEvoy
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, New South Wales.,La Trobe Rural Health School, College of Science, Health and Engineering, Victoria
| | - Elizabeth Holliday
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, Newcastle, New South Wales
| | - Martha Parsons
- Endocrinology and Diabetes Service and Diabetes Alliance, Hunter New England Health Local Health District (HNELHD), New south Wales
| | - Shamasunder Acharya
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, New South Wales.,Endocrinology and Diabetes Service and Diabetes Alliance, Hunter New England Health Local Health District (HNELHD), New south Wales.,Division Of Medicine, HNELHD, New South Wales
| | - Judy Luu
- Endocrinology and Diabetes Service and Diabetes Alliance, Hunter New England Health Local Health District (HNELHD), New south Wales.,Division Of Medicine, HNELHD, New South Wales
| | - John Wiggers
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, New South Wales.,HNELHD, New South Wales
| | - Chris Rissel
- The University of Sydney, Camperdown, New south Wales
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Sri Lanka
| | - Ranil Jayawardena
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Sri Lanka.,Department of Physiology, Faculty of Medicine, University of Colombo, Sri Lanka
| | - Samir Samman
- School of Life and Environmental Sciences, University of Sydney, New South Wales
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, Newcastle, New South Wales.,Division Of Medicine, HNELHD, New South Wales
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Jayawardena R, Francis TV, Abhayaratna S, Ranasinghe P. The use of Caralluma fimbriata as an appetite suppressant and weight loss supplement: a systematic review and meta-analysis of clinical trials. BMC Complement Med Ther 2021; 21:279. [PMID: 34758791 PMCID: PMC8579607 DOI: 10.1186/s12906-021-03450-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/28/2020] [Accepted: 10/22/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Obesity prevalence has increased during the past few decades, causing a pandemic with an influx in other co-morbidities. Many factors influence weight gain in an obesogenic environment therefore strategies for treating obesity may vary from conventional dietary and physical activity interventions to pharamacotherapy. A shift in unconventional strategies as herbal products for treating obesity have been investigated and one such plant extract is Caralluma fimbriata (C. fimbriata). Further, the studies included were systematically reviewed to gather evidence on potential effects of C. fimbriata as an appetite suppressant and weight loss supplement. METHODS A systematic review of clinical trials reporting the effects of C. fimbriata as appetite suppression and anti-obesity supplement was reported according to PRISMA guidelines. Data were obtained by searching three databases: PubMed®, Web of Science® and SciVerse Scopus® for studies published until 30th April 2020. RESULTS A total of 7 articles studying C. fimbriata satisfied the inclusion and exclusion criteria and were sourced from various countries including Australia (3), Cuba (1), India (2) and Spain (1). Almost all studies recruited adults who were overweight or obese with a BMI > 25 kg/m2 (n = 5), with the exception of two studies, one that recruited healthy adults with a BMI average of 26.5 kg/m2 and the second one utilised a population of children and adolescents with Prader-Willis Syndrome (PWS). Parameters assessing obesity, biochemical and appetite factors were analysed by carrying out a meta-analysis. Compared to placebo controlled group, C. fimbriata extract significantly reduced WC by 1.59 cm (95% CI, - 3.07 to - 0.10, p = 0.041) and WHR by 0.06 (95% CI, - 0.12 to - 0.01, p = 0.05) although no significant effects were seen on BW, BMI and HC. Biochemical and appetite parameters outcome on C. fimbriata consumption had no significant changes. Any side effects of individuals who ingested the extract were reported by few studies of which most common effects were constipation, diarrhoea, nausea and rashes. CONCLUSION Appetite parameters showed no significant changes and metabolic parameters did not improve with C.fimbriata supplementation therefore it is unlikely to recommend C. fimbriata as a weight loss supplement and an appetite suppressant.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. .,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
| | - Tormalli V Francis
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Sachith Abhayaratna
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Galappatthy P, Ranasinghe P, Liyanage CK, Wijayabandara MS, Mythily S, Jayakody RL. WHO/INRUD Core drug use indicators and commonly prescribed medicines: a National Survey from Sri Lanka. BMC Pharmacol Toxicol 2021; 22:67. [PMID: 34711271 PMCID: PMC8555184 DOI: 10.1186/s40360-021-00535-5] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 10/20/2021] [Indexed: 12/02/2022] Open
Abstract
Background Identification of internationally comparable indicators of medicines use are important for a country to implement strategies and regulations to improve usage of medicines. Sri Lanka established a new National Medicines Regulatory Authority in 2015 and this survey evaluated the medication use indicators in Sri Lanka, according to the International Network on Rational Use of Drugs (INRUD), prior to its implementation. Methods This descriptive-cross-sectional study was conducted in 80 pharmacies, representing all 25 districts of the country. Three pharmacy categories were included; privately owned pharmacies, ‘Rajya Osusala’ pharmacies operated by the State Pharmaceuticals Corporation (SPC) of Sri Lanka and SPC Franchisee pharmacy outlets. Selection of pharmacies from respective districts were done proportionate to estimated population. Data were collected to identify WHO/INRUD core drug use indicators and the commonly prescribed medicines. Results Total of 2328 prescriptions were included (‘Rajya Osusala 559; SPC Franchise 711; private pharmacies 1058). Altogether 7,255 medicines were prescribed, and the 3 most commonly prescribed medicines were atorvastatin, losartan and metformin. Average number of medicines per encounter was 3.1±1.9 (Median: 3; range 1-12) Highest average number of medicines per encounter was reported in prescriptions received at ‘Rajya Osusala’ pharmacies (3.6±2.2), significantly higher than in other categories of pharmacies (p<0.001). Percentage of medicines prescribed by generic name was only 35.5%, highest at the ‘Rajya Osusala’ pharmacies (40.6%), significantly higher than other categories of pharmacies. The overall percentage of medicines prescribed from essential medicine list (EML) was 68.8%, without any significant variation between different categories of pharmacies. The percentage of medicines actually dispensed and accurately labelled were 92.4 and 98.5% respectively. Conclusions The average number of medicines per encounter was higher than the WHO recommended value but the usage of antibiotic and injectable drugs were within recommended standards. Generic prescribing, was very much lower. The EML prescribing, labelling and percentage dispensed medicines fared much better although lower than the WHO recommended 100% compliance. This island wide study has provided national wide data before the implementation of key changes in regulation of medicines in Sri Lanka and a repeat survey will be useful to identify impact of the new legislations. Supplementary Information The online version contains supplementary material available at 10.1186/s40360-021-00535-5.
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Affiliation(s)
- P Galappatthy
- Department of Pharmacology, Faculty of Medicine, University of Colombo, No 25, Kynsey Road, Colombo, 08, Sri Lanka
| | - P Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, No 25, Kynsey Road, Colombo, 08, Sri Lanka.
| | - C K Liyanage
- Department of Pharmacology, Faculty of Medicine, University of Colombo, No 25, Kynsey Road, Colombo, 08, Sri Lanka
| | - M S Wijayabandara
- Department of Pharmacology, Faculty of Medicine, University of Colombo, No 25, Kynsey Road, Colombo, 08, Sri Lanka
| | - S Mythily
- Department of Pharmacology, Faculty of Medicine, University of Colombo, No 25, Kynsey Road, Colombo, 08, Sri Lanka
| | - R L Jayakody
- Department of Pharmacology, Faculty of Medicine, University of Colombo, No 25, Kynsey Road, Colombo, 08, Sri Lanka
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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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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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Thilakarathna GC, Navaratne SB, Wickramasinghe I, Ranasinghe P, Samarkoon SR, Samarasekera JKRR. The effect of Salaciareticulata, Syzygiumcumini, Artocarpusheterophyllus, and Cassiaauriculata on controlling the rapid formation of advanced glycation end-products. J Ayurveda Integr Med 2021; 12:261-268. [PMID: 33731265 PMCID: PMC8185973 DOI: 10.1016/j.jaim.2020.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The excessive formation of Advanced Glycation End-products (AGEs) by non-enzymatic glycation mediates many health complications in the human body and the formation of AGEs largely accelerated under the hyperglycaemic condition. OBJECTIVE The prospect of the study to assess the strength of inhibiting the rapid AGE formations in four Ayurvedic medicinal plants, namely; Salacia reticulata (stems), Syzygium cumini (barks), Artocarpus heterophyllus (mature leaves) and, Cassia auriculata (flowers). MATERIALS AND METHODS Herbal decoctions of four medicinal plant materials were prepared by simmering with hot water as prescribed by the Ayurvedic medicine. The effectiveness of the decoctions was analyzed in vitro based on their Anti-AGE formation activity, glycation reversing, and anti-oxidant potentials. RESULTS According to the results, the decoctions of S. reticulata, A. heterophyllus and C. auriculata indicated the strong Anti-AGE forming (IC50: 23.01 ± 2.70, 32.01 ± 2.09, 43.66 ± 2.11 mg/mL, respectively), glycation reversing (EC50: 183.15 ± 7.67, 91.85 ± 1.93, 252.35 ± 4.03 mg/mL, respectively) and antioxidant potentials in terms of total polyphenol content (TPC), total flavonoid content (TFC), ferric ion reducing power (FRAP), ABTS and DPPH radical scavenging activities. However, the decoction of S. cumini reported the significantly high (p < 0.05) Anti-AGE forming, (IC50: 9.75 ± 0.32 mg/mL), glycation reversing (EC50: 66.45 ± 4.51 mg/mL), and antioxidant potentials against the decoctions of the other three plant materials. CONCLUSION S. cumini bark extract was identified as the best source in controlling the formation of AGEs excessively. Further, the other three plant extracts can also be effectively used as potential therapeutic agents to control the pathological conditions associated with AGEs-mediated health complications.
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Affiliation(s)
- G C Thilakarathna
- Department of Food Science and Technology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka; Department of Animal and Food Sciences, Faculty of Agriculture, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka.
| | - S B Navaratne
- Department of Food Science and Technology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka
| | - I Wickramasinghe
- Department of Food Science and Technology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka
| | - P Ranasinghe
- Herbal Technology Section (HTS), Industrial Technology Institute (ITI), 363, Bauddhaloka Mawatha, Colombo, 07, Sri Lanka
| | - S R Samarkoon
- Institute of Biochemistry, Molecular Biology and Biotechnology (IBMBB), University of Colombo, Cumarathunga Munidasa Mawatha, 90, Colombo, 3, Sri Lanka
| | - J K R R Samarasekera
- Herbal Technology Section (HTS), Industrial Technology Institute (ITI), 363, Bauddhaloka Mawatha, Colombo, 07, Sri Lanka
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Jayawardena R, Ranasinghe P, Kodithuwakku W, Dalpatadu C, Attia J. Zinc supplementation in pre-diabetes mellitus: a systematic review and meta-analysis. Minerva Endocrinol (Torino) 2021; 47:334-343. [PMID: 33759442 DOI: 10.23736/s2724-6507.21.03234-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Certain pharmacological and lifestyle interventions have been shown to reduce progression of pre-diabetes. We aimed to perform a systematic review and meta-analyses of studies assessing the outcomes of zinc supplementation in individuals with pre-diabetes. EVIDENCE ACQUISITION A comprehensive search was conducted in PubMed, SciVerse Scopus and Web of Science databases. Controlled clinical trials in pre-diabetics, on zinc supplement with or without other nutrients, assessing at least one accepted glycaemic parameter as an outcome were deemed eligible. EVIDENCE SYNTHESIS Three papers were included in the systematic review and meta analysis, with a total of 265 participants. Duration of zinc supplementation ranged from 6-12 months. The zinc dose ranged from 20-30 mg/day. In the pooled analysis, zinc supplementation significantly reduced FBG both when given alone (-10.86 mg/dL; 95% CI, -14.74 to -6.98; p<0.001) and with other micronutrients (-11.77 mg/dL; p<0.001). Similarly, 2hr-OGTT blood glucose was reduced by 21.08 mg/dL (95% CI, -40.05 to -2.11; p=0.03) in the pooled analysis of studies using zinc alone and in combination with other micronutrients. One study demonstrated a significant reduction of HbA1c by 0.5% with combined supplementation, while another reported a significant reduction in CRP with zinc supplementation. When all trials were considered, TC, HDL-c and HOMA-β showed significant improvement. Zinc supplementation significantly improved the zinc status from baseline. CONCLUSIONS Zinc supplementation demonstrated beneficial effects on glycaemic and lipid parameters in individuals with pre-diabetes. It may have the potential to reduce the prevalence of pre-diabetes and control associated morbidity and mortality.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka - .,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia -
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Wasana Kodithuwakku
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Chamila Dalpatadu
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - John Attia
- Division of Medicine, Hunter New England Local Health District, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
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Ranasinghe P, Jayawardena R, Gamage N, Sivanandam N, Misra A. Prevalence and trends of the diabetes epidemic in urban and rural India: A pooled systematic review and meta-analysis of 1.7 million adults. Ann Epidemiol 2021; 58:128-148. [PMID: 33727086 DOI: 10.1016/j.annepidem.2021.02.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 02/19/2021] [Accepted: 02/21/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE India has experienced a recent sharp increase in diabetes/pre-diabetes. We conducted a systematic-review and meta-analyses to describe the most recent prevalence and trends of pre-diabetes/diabetes in urban and rural India. METHODS MethodsA literature search was conducted in PubMed and Scopus databases for population-based studies describing prevalence of diabetes/pre-diabetes in urban/rural populations. Trends were analysed in rural and urban settings overall, genderwise and statewise. RESULTS The study reports data from 1,778,706 adults in India (69-studies), from surveys conducted from 1972-2017. Prevalence of diabetes increased in both rural and urban India from 2.4% and 3.3% in 1972 to 15.0% and 19.0% respectively in year 2015-2019. This was independently observed in both genders. Similar increasing prevalence was observed for pre-diabetes, overall and in both genders. In the latest decade (2010-2019) rural and urban prevalence was highest in states of Goa (17.4%) and Tamil Nadu (24.0%) respectively. Statewise analysis observed a wide disparity in prevalence between the North and the South of India. CONCLUSION Pooled estimates show a relatively high burden of diabetes and pre-diabetes in rural and urban India, with narrowed urban-rural gap. Hence, it is important to plan urgent primary and secondary prevention strategies to minimize further increase in areas with high prevalence.
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Affiliation(s)
- Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colmbo, Sri Lanka; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Nishadi Gamage
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Nilani Sivanandam
- Department of Physiology, Faculty of Medicine, University of Colombo, Colmbo, Sri Lanka
| | - Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, New Delhi, India
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Jayawardena R, Swarnamali H, Ranasinghe P, Misra A. Health effects of coconut oil: Summary of evidence from systematic reviews and meta-analysis of interventional studies. Diabetes Metab Syndr 2021; 15:549-555. [PMID: 33689936 DOI: 10.1016/j.dsx.2021.02.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Systemic review (SR) and meta-analysis (MA) of interventional studies are considered as the highest level of evidence for clinical decision making. Therefore, we systematically summarized all high-quality evidence on the usage of coconut oil for health-related benefits from SRs and MA. METHODS PubMed®, Web of science®, SciVerse Scopus®, and EMBASE® databases were systematically searched to select SRs and SRs with MA of interventional studies reporting health-related clinical outcomes of coconut oil. Similar studies were grouped based on their respective clinical areas. A methodological quality appraisal was conducted for all included SRs and SRs with MA using the Critical Appraisal Checklist for Systematic Reviews. RESULTS A total of seven papers were selected for inclusion in this review, consisting of three MA and one SR on cardio-metabolic health, one SR on oral health, and one SR and one MA each on skin health. Coconut oil significantly increases serum total cholesterol, low-density- and high-density- lipoprotein cholesterol levels compared to poly- and mono-unsaturated oils. Limited studies showed that topical use of coconut oil helps in the prevention and treatment of atopic dermatitis and oil pulling for the prevention of dental caries. All four studies on cardiometabolic health and the SR on oral health had a high score in the quality assessment, SR with MA on skin health fulfilled high-quality scoring whereas the SR on the same topic had a low-quality scoring. CONCLUSIONS In summary, consistent and strong evidence shows that coconut oil has an adverse effect on the lipids parameters associated with cardio-metabolic health, with limited studies to conclude the effects of atopic dermatitis and oil pulling.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Hasinthi Swarnamali
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, New Delhi, India
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Jayawardena R, Swarnamali H, Ranasinghe P, Hills AP. Impact of portion-control plates (PCP) on weight reduction: A systematic review and meta-analysis of intervention studies. Obes Res Clin Pract 2021; 15:106-113. [DOI: 10.1016/j.orcp.2021.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/18/2021] [Accepted: 01/24/2021] [Indexed: 12/24/2022]
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Ranasinghe P, Senadeera V, Gamage N, Weerarathna MF, Ponnamperuma G. Temporal changes in emotional intelligence (EI) among medical undergraduates: a 5-year follow up study. BMC Med Educ 2020; 20:496. [PMID: 33298046 PMCID: PMC7724823 DOI: 10.1186/s12909-020-02404-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/13/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Emotional intelligence (EI) is thought to play a significant role in professional and academic success. EI is important for medical personnel to cope with highly stressful circumstances during clinical and academic settings. The present prospective follow-up study intends to evaluate the changes in EI and their correlates among medical undergraduates over a five-year period. METHODS Data were collected in 2015 and 2020 at the Faculty of Medicine, University of Colombo, Sri Lanka. EI was assessed using the validated 33-item self-assessment tool, Schutte Self-Report Emotional Intelligence Test (SSEIT). In addition, socio-demographic details, students' involvement in extracurricular-activities during undergraduate life, students' satisfaction regarding the choice of studying medicine and plans to do postgraduate studies were also evaluated. A multiple-regression analysis was conducted among all students using percentage change in EI score as the continuous dependent variable, together with other independent variables (plan to do postgraduate studies, satisfaction in choice of medicine and extracurricular-activities). RESULTS Sample size was 170 (response rates-96.6%), with 41.2% males (n = 70). Mean EI scores at baseline among all students was 122.7 ± 11.6, and it had significantly increased at follow-up to 128.9 ± 11.2 (p < 0.001). This significant increase was independently observed in both males (122.1 ± 12.2 vs. 130.0 ± 12.4, p < 0.001) and females (123.1 ± 11.1 vs. 128.2 ± 10.3, p = 0.001). During follow-up, an increase in EI score was observed in students of all religions and ethnicities. Mean EI score also increased in all categories of monthly income, irrespective of the employment status or attainment of higher education of either parent. An increase in mean EI score during follow-up was observed in students irrespective of their engagement in or number of extracurricular-activities, they were involved. In the multiple regression analysis, being satisfied regarding their choice of the medical undergraduate programme (OR:11.75, p = 0.001) was the only significant factor associated with the percentage change in EI score. CONCLUSION EI in this group significantly improved over 5-years of follow-up and was independent of gender, religion, ethnicity, socio-economic parameters and academic performance. Satisfaction in the chosen field was a significant predictor of the overall change in EI. Future studies are needed to identify and measure factors responsible for improvement in EI among medical undergraduates.
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Affiliation(s)
- Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Vidarsha Senadeera
- Department of Anatomy, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Nishadi Gamage
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Gominda Ponnamperuma
- Department of Medical Education, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Jayawardena R, Swarnamali H, Lanerolle P, Ranasinghe P. Effect of coconut oil on cardio-metabolic risk: A systematic review and meta-analysis of interventional studies. Diabetes Metab Syndr 2020; 14:2007-2020. [PMID: 33096510 DOI: 10.1016/j.dsx.2020.09.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/25/2020] [Accepted: 09/27/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND AIMS High total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) could be major risk factors for cardiovascular disease burden among high risk populations especially in South Asians. This systematic review and meta-analysis aimed to quantify the effects of coconut oil compared with other oils and fats on cardio-metabolic parameters. METHODS PubMed, Scopus and Web of Science were systematically searched. The main outcomes included are lipid and glycemic parameters. Subgroup analyses were performed to evaluate individual comparisons of vegetable oils and animal fat with coconut oil. Data were pooled using random-effects meta-analysis. RESULTS Coconut oil consumption significantly increased TC by 15.42 mg/dL (95% CI, 8.96-21.88, p < 0.001), LDL-C by 10.14 mg/dL (95% CI, 4.44-15.84, p < 0.001) and high density lipoprorein cholesterol (HDL-C) by 2.61 mg/dL (95% CI, 0.95-4.26, p = 0.002), and significantly decreased glycosylated hemoglobin (HbA1c) by 0.39 mg/dL (95% CI, -0.50 to -0.27, p < 0.001) but, it had no effects on triglycerides (TG), (4.25 mg/dL; 95% CI, -0.49-8.99, p = 0.08) when compared with the control group. Sub-group analysis demonstrated that coconut oil significantly increased TC and LDL-C over corn, palm, soybean and safflower oils and not over olive oil. Compared with butter, coconut oil showed a better pattern in cardio-metabolic markers by significantly increasing HDL-C (4.38 mg/dL, 95% CI, 0.40 to 8.36, p = 0.03) and decreasing LDL-C (-14.90 mg/dL, 95% CI, -23.02 to-6.77, p < 0.001). CONCLUSIONS Our results suggest that coconut oil consumption results in significantly higher TC, LDL-C and HDL-C than other oils. Consumption of coconut oil can be one of the risk factors for CVDs in South Asians.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Sri Lanka; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Hasinthi Swarnamali
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Sri Lanka
| | - Pulani Lanerolle
- Department of Biochemistry & Molecular Biology, Faculty of Medicine, University of Colombo, Sri Lanka
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Sri Lanka
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Jayawardena R, Jeyakumar DT, Misra A, Hills AP, Ranasinghe P. Obesity: A potential risk factor for infection and mortality in the current COVID-19 epidemic. Diabetes Metab Syndr 2020; 14:2199-2203. [PMID: 33395781 PMCID: PMC7656158 DOI: 10.1016/j.dsx.2020.11.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIMS COVID-19 is an ongoing global pandemic, affecting nearly 35 million people from 214 countries as at September 30, 2020 and emerging evidence suggests that obesity is a potential risk factor for communicable diseases, including viral infections. Therefore, we investigated the relationship between obesity prevalence of the total adult population and COVID-19 infection and mortality rates, in different countries. METHODS A total of 54 countries from six continents were selected. Country-specific obesity prevalence data were retrieved from the latest non-communicable diseases profiles released by the Non-communicable Diseases and Mental Health Cluster of World Health Organization, while the real time statistics from the Worldometer website were used to extract data on COVID-19 infections and mortality per million of the total population as of September 30, 2020. RESULTS Obesity prevalence data ranged from 2.0% (Vietnam) to 35.0% (Saudi Arabia). Among the selected countries, the highest number of COVID-19 cases per million was documented in Qatar (n = 44,789) while the lowest was reported from Vietnam (n = 11). Highest mortality per million population due to COVID-19 infections occurred in Peru (n = 981), in contrast with the smallest number reported in Mongolia (n = 0). A significant positive correlation (r = 0.46; p < 0.001) was observed between the total number of COVID-19 infections and the prevalence of obesity. COVID-19 mortality was also significantly correlated (r = 0.34; p < 0.05) with the prevalence of obesity. CONCLUSIONS Obesity prevalence in each country was significantly associated with both infection and mortality rate of COVID-19.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; School of Exercise & Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Dhanushya T Jeyakumar
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, New Delhi, India
| | - Andrew P Hills
- School of Exercise & Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia; School of Health Sciences, Faculty of Health, University of Tasmania, Newnham Drive, Launceston, Tasmania, Australia; Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Ranasinghe P, Jayawardena R, Chandrasena L. Effects of the Lysulin™ supplementation on pre-diabetes: A randomized double-blind, placebo-controlled clinical trial. Diabetes Metab Syndr 2020; 14:1479-1486. [PMID: 32795739 DOI: 10.1016/j.dsx.2020.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/19/2020] [Accepted: 07/15/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS Diabetes is a leading cause of morbidity and mortality worldwide. Recent studies have demonstrated that nutraceutical products have beneficial effects in diabetes. Present study aims to investigate whether a product (Lysulin™) containing amino acid lysine, micronutrient zinc and vitamin C will have beneficial effects in pre-diabetes. METHODS A randomized, double-blind, placebo-controlled trial was conducted for a period of 6 months. The two parallel groups (1:1) were Lysulin™ (Interventional group-IG) and placebo (control group-CG). Evaluations were done at baseline, 1, 3 and 6 months. Primary outcome was defined as change in glycaemic control measured by HbA1c from baseline. Other outcomes included change in; fasting plasma glucose (FPG), 2-h OGTT plasma glucose and lipid profile from baseline. Three multiple regression analyses were performed, where change in FPG, 2-h OGTT, and HbA1c post intervention from baseline respectively were the continuous dependent variable with other independent variables. RESULTS One hundred and ten participants were recruited, 50% (n = 55) were males and mean age (±SD) was 46.7 ± 9.9 years. A significantly higher percentage of participants in CG (25.4%, n = 14) developed diabetes in comparison to IG (7.3%, n = 4) (p = 0.018). FPG, 2-h OGTT and HbA1c significantly reduced in the IG only. Both total cholesterol and LDL cholesterol decreased significantly from baseline only in the IG. In all three regression models the best predictor of respective dependent variable was Lysulin™ treatment. CONCLUSIONS Lysulin™ improved glycaemic control, with reduced progression to diabetes, in those with pre-diabetes. Treatment also showed a beneficial reduction in total and LDL cholesterol levels. TRIAL REGISTRATION Sri Lanka Clinical Trials Registry, identifier: SLCTR/2018/022 (http://slctr.lk/trials/1290). Registered on 13th July 2018; Study protocol version 2.0 (23rd March 2018).
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Affiliation(s)
- Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Lal Chandrasena
- Nawaloka Hospital Research and Education Foundation (NHREF), Nawaloka Hospitals PLC, Colombo, Sri Lanka.
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Jayawardena R, Sooriyaarachchi P, Chourdakis M, Jeewandara C, Ranasinghe P. Response to the letter of L. Santacroce regarding article "Enhancing immunity in viral infections, with special emphasis on COVID-19: A review" (Jayawardena et al.). Diabetes Metab Syndr 2020; 14:839. [PMID: 32540739 PMCID: PMC7287472 DOI: 10.1016/j.dsx.2020.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; Queensland University of Technology (QUT), Faculty of Health, School of Exercise and Nutrition Sciences, Brisbane, Queensland, Australia.
| | - Piumika Sooriyaarachchi
- Queensland University of Technology (QUT), Faculty of Health, School of Exercise and Nutrition Sciences, Brisbane, Queensland, Australia; Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Michael Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 4, Thessaloniki, Greece
| | - Chandima Jeewandara
- National Center for Primary Care and Allergy Research, University of Sri Jayewardenepura, Sri Lanka
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Ranasinghe P, Jayawardena R, Gamage N, Pujitha Wickramasinghe V, Hills AP. The range of non-traditional anthropometric parameters to define obesity and obesity-related disease in children: a systematic review. Eur J Clin Nutr 2020; 75:373-384. [PMID: 32801306 DOI: 10.1038/s41430-020-00715-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 07/08/2020] [Accepted: 08/04/2020] [Indexed: 01/05/2023]
Abstract
Obesity is defined as an abnormal/excessive accumulation of body fat, associated with health consequences. Although overall obesity does confer a significant threat to the health of individuals, the distribution of body fat, especially abdominal/central obesity is of greater importance. For practical reasons, proxy anthropometric measurements have been developed to identify central obesity, however, major limitations are noted in these traditional measurements. The present study aims to evaluate the literature, to identify and describe non-traditional anthropometric measurements of overweight and obesity in children. The current systematic review was conducted in accordance with the PRISMA guidelines, and the search was undertaken in the PubMed® database, using MeSH (Medical Subject Headings) terms. Data extracted from each study were: (a) details of the study, (b) anthropometric parameter(s) evaluated in the study and its details, (c) study methods, (d) objectives of the study and/or comparisons, and (e) main findings/conclusions of the study. The search yielded a total of 3697 articles, of which 31 studies were deemed eligible to be included. The literature search identified 13 non-traditional anthropometric parameters. Data on non-traditional anthropometric parameters were derived from 24 countries. Majority were descriptive cross-sectional studies (n = 29), while sample size varied from 65 to 23,043. Non-traditional anthropometric parameters showed variable correlation with obesity and/or related metabolic risk factors. Some parameters involved complex calculations, while others were based on a single anthropometric measurement or derived from traditional measures. Most studies lacked comparison with a 'gold standard' assessment of body fat, hence further research is required to determine their accuracy and precision.
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Affiliation(s)
- Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Nishadi Gamage
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Newnham Drive, Launceston, TAS, Australia
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Jayawardena R, Sooriyaarachchi P, Chourdakis M, Jeewandara C, Ranasinghe P. Enhancing immunity in viral infections, with special emphasis on COVID-19: A review. Diabetes Metab Syndr 2020; 14:367-382. [PMID: 32334392 PMCID: PMC7161532 DOI: 10.1016/j.dsx.2020.04.015] [Citation(s) in RCA: 255] [Impact Index Per Article: 63.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/12/2020] [Accepted: 04/12/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Balanced nutrition which can help in maintaining immunity is essential for prevention and management of viral infections. While data regarding nutrition in coronavirus infection (COVID-19) are not available, in this review, we aimed to evaluate evidence from previous clinical trials that studied nutrition-based interventions for viral diseases (with special emphasis on respiratory infections), and summarise our observations. METHODS A systematic search strategy was employed using keywords to search the literature in 3 key medical databases: PubMed®, Web of Science® and SciVerse Scopus®. Studies were considered eligible if they were controlled trials in humans, measuring immunological parameters, on viral and respiratory infections. Clinical trials on vitamins, minerals, nutraceuticals and probiotics were included. RESULTS A total of 640 records were identified initially and 22 studies were included from other sources. After excluding duplicates and articles that did not meet the inclusion criteria, 43 studies were obtained (vitamins: 13; minerals: 8; nutraceuticals: 18 and probiotics: 4). Among vitamins, A and D showed a potential benefit, especially in deficient populations. Among trace elements, selenium and zinc have also shown favourable immune-modulatory effects in viral respiratory infections. Several nutraceuticals and probiotics may also have some role in enhancing immune functions. Micronutrients may be beneficial in nutritionally depleted elderly population. CONCLUSIONS We summaries possible benefits of some vitamins, trace elements, nutraceuticals and probiotics in viral infections. Nutrition principles based on these data could be useful in possible prevention and management of COVID-19.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Piumika Sooriyaarachchi
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia; Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 4, Thessaloniki, Greece
| | - Chandima Jeewandara
- National Center for Primary Care and Allergy Research, University of Sri Jayewardenepura, Sri Lanka
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Jayawardena R, Ranasinghe P, Ranawaka H, Gamage N, Dissanayake D, Misra A. Exploring the Therapeutic Benefits of Pranayama (Yogic Breathing): A Systematic Review. Int J Yoga 2020; 13:99-110. [PMID: 32669763 PMCID: PMC7336946 DOI: 10.4103/ijoy.ijoy_37_19] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/14/2019] [Accepted: 08/31/2019] [Indexed: 01/19/2023] Open
Abstract
Background: Pranayama (yogic breathing) has demonstrated numerous beneficial health effects. At present, there are no systematic reviews evaluating the beneficial health effects of pranayama alone as a practice. Aim: The aim of this study is to perform a systematic review about the beneficial health effects of pranayama. Methods: Data were obtained using a stepwise search process by searching the online PubMed, Web of Science, and SciVerse Scopus databases using keywords. Controlled clinical trials in humans, using “Pranayama” as an intervention with an appropriate control group and evaluating health-related outcomes were selected for inclusion. Results: Initial database searching indicated 669 potentially eligible articles, of which 18 studies satisfying the inclusion/exclusion criteria were selected. All were controlled trials, of which 13 were randomized and 1 was a crossover study. Number of participants ranged from 16 to 160, and the duration of pranayama practice varied from 4 days to 6 months. Studies demonstrated a significant effect on cardiorespiratory functions, in patients with bronchial asthma, with the improvement of pulse rate, systolic blood pressure, and respiratory function measurements. Furthermore, reduction in the frequency of attacks, severity, and medication requirement was also observed, with improved quality of life (QOL). In patients with chronic obstructive pulmonary disease, symptom, activity, and impact scores were improved. QOL improvement was also noted in cancer patients. Conclusions: Available evidence on pranayama indicates physiological and psychological benefits. Beneficial effects were mostly observed in patients with respiratory diseases such as bronchial asthma. It also helped those with cancer and cardiovascular disease. However, further high-quality randomized trials are required to provide definitive evidence.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Himansa Ranawaka
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Nishadi Gamage
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Dilshani Dissanayake
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Diabetes Foundation and National Diabetes Obesity and Cholesterol Foundation, New Delhi, India
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Jayawardena R, Sooriyaarachchi P, Ranasinghe P, Perera A, Hills AP. Availability and composition of weight‐loss supplements in Sri Lanka. Nutr Diet 2020; 77:247-252. [DOI: 10.1111/1747-0080.12501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/23/2018] [Accepted: 10/22/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of MedicineUniversity of Colombo Colombo Sri Lanka
- Health and Wellness Unit, Faculty of MedicineUniversity of Colombo Colombo Sri Lanka
| | | | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of MedicineUniversity of Colombo Colombo Sri Lanka
| | - Amila Perera
- Department of NutritionMedical Research Institute Colombo Sri Lanka
| | - Andrew P. Hills
- College of Health and MedicineUniversity of Tasmania Launceston TAS Australia
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Jayawardena R, Waniganayake YC, Abhayaratna SA, Ranasinghe P. Prediction of body fat in Sri Lankan adults: Development and validation of a skinfold thickness equation. Diabetes Metab Syndr 2020; 14:147-150. [PMID: 32087566 DOI: 10.1016/j.dsx.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The study aimed to develop and validate a percentage body fat (%BF) prediction equation using SFT for Sri Lankan adults. METHODS Healthy adults (≥18 years) were randomly selected and SFT was measured in five areas (triceps, biceps, calf, suprailliac and subscapular). Body composition analysis was evaluated by Deuterium oxide (D2O) dilution. Prediction equation for %BF was derived by linear-regression-analysis. RESULTS Study population included 170 adults (Males: 32.9%; age: 43.2 ± 12.6 years). Final equation for %BF (r = 0.715, p < 0.001) correlated significantly D2O dilution derived %BF. CONCLUSIONS The equation is suitable for estimation of %BF in Sri Lankan adults and is possibly appropriate for other South-Asian populations.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
| | | | - Sachith A Abhayaratna
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Jayawardena R, Ranasinghe P, Ranathunga T, Mathangasinghe Y, Wasalathanththri S, Hills AP. Novel anthropometric parameters to define obesity and obesity-related disease in adults: a systematic review. Nutr Rev 2019; 78:498-513. [DOI: 10.1093/nutrit/nuz078] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abstract
Context
Obesity is defined as an abnormal or excessive accumulation of body fat. Traditionally, it has been assessed using a wide range of anthropometric, biochemical, and radiological measurements, with each having its advantages and disadvantages.
Objective
A systematic review of the literature was conducted to identify novel anthropometric measurements of obesity in adults.
Data Sources
Using a combination of MeSH terms, the PubMed database was searched.
Data Extraction
The current systematic review was conducted in accordance with the PRISMA guidelines. The data extracted from each study were (1) details of the study, (2) anthropometric parameter(s) evaluated, (3) study methods, (4) objectives of the study and/or comparisons, and (5) main findings/conclusions of the study.
Data Analysis
The search yielded 2472 articles, of which 66 studies were deemed eligible to be included. The literature search identified 25 novel anthropometric parameters. Data on novel anthropometric parameters were derived from 26 countries. Majority were descriptive cross-sectional studies (n = 43), while 22 were cohort studies. Age range of the study populations was 17–103 years, while sample size varied from 45 to 384 612.
Conclusions
The novel anthropometric parameters identified in the present study showed variable correlation with obesity and/or related metabolic risk factors. Some parameters involved complex calculations, while others were derived from traditional anthropometric measurements. Further research is required in order to determine the accuracy and precision.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Yasith Mathangasinghe
- Department of Anatomy, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
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