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Bender RG, Sirota SB, Swetschinski LR, Dominguez RMV, Novotney A, Wool EE, Ikuta KS, Vongpradith A, Rogowski ELB, Doxey M, Troeger CE, Albertson SB, Ma J, He J, Maass KL, A.F.Simões E, Abdoun M, Abdul Aziz JM, Abdulah DM, Abu Rumeileh S, Abualruz H, Aburuz S, Adepoju AV, Adha R, Adikusuma W, Adra S, Afraz A, Aghamiri S, Agodi A, Ahmadzade AM, Ahmed H, Ahmed A, Akinosoglou K, AL-Ahdal TMA, Al-amer RM, Albashtawy M, AlBataineh MT, Alemi H, Al-Gheethi AAS, Ali A, Ali SSS, Alqahtani JS, AlQudah M, Al-Tawfiq JA, Al-Worafi YM, Alzoubi KH, Amani R, Amegbor PM, Ameyaw EK, Amuasi JH, Anil A, Anyanwu PE, Arafat M, Areda D, Arefnezhad R, Atalell KA, Ayele F, Azzam AY, Babamohamadi H, Babin FX, Bahurupi Y, Baker S, Banik B, Barchitta M, Barqawi HJ, Basharat Z, Baskaran P, Batra K, Batra R, Bayileyegn NS, Beloukas A, Berkley JA, Beyene KA, Bhargava A, Bhattacharjee P, Bielicki JA, Bilalaga MM, Bitra VR, Brown CS, Burkart K, Bustanji Y, Carr S, Chahine Y, Chattu VK, Chichagi F, Chopra H, Chukwu IS, Chung E, Dadana S, Dai X, Dandona L, Dandona R, Darban I, Dash NR, Dashti M, Dashtkoohi M, Dekker DM, Delgado-Enciso I, Devanbu VGC, Dhama K, Diao N, Do THP, Dokova KG, Dolecek C, Dziedzic AM, Eckmanns T, Ed-Dra A, Efendi F, Eftekharimehrabad A, Eyre DW, Fahim A, Feizkhah A, Felton TW, Ferreira N, Flor LS, Gaihre S, Gebregergis MW, Gebrehiwot M, Geffers C, Gerema U, Ghaffari K, Goldust M, Goleij P, Guan SY, Gudeta MD, Guo C, Gupta VB, Gupta I, Habibzadeh F, Hadi NR, Haeuser E, Hailu WB, Hajibeygi R, Haj-Mirzaian A, Haller S, Hamiduzzaman M, Hanifi N, Hansel J, Hasnain MS, Haubold J, Hoan NQ, Huynh HH, Iregbu KC, Islam MR, Jafarzadeh A, Jairoun AA, Jalili M, Jomehzadeh N, Joshua CE, Kabir MA, Kamal Z, Kanmodi KK, Kantar RS, Karimi Behnagh A, Kaur N, Kaur H, Khamesipour F, Khan MN, Khan suheb MZ, Khanal V, Khatab K, Khatib MN, Kim G, Kim K, Kitila ATT, Komaki S, Krishan K, Krumkamp R, Kuddus MA, Kurniasari MD, Lahariya C, Latifinaibin K, Le NHH, Le TTT, Le TDT, Lee SW, LEPAPE A, Lerango TL, Li MC, Mahboobipour AA, Malhotra K, Mallhi TH, Manoharan A, Martinez-Guerra BA, Mathioudakis AG, Mattiello R, May J, McManigal B, McPhail SM, Mekene Meto T, Mendez-Lopez MAM, Meo SA, Merati M, Mestrovic T, Mhlanga L, Minh LHN, Misganaw A, Mishra V, Misra AK, Mohamed NS, Mohammadi E, Mohammed M, Mohammed M, Mokdad AH, Monasta L, Moore CE, Motappa R, Mougin V, Mousavi P, Mulita F, Mulu AA, Naghavi P, Naik GR, Nainu F, Nair TS, Nargus S, Negaresh M, Nguyen HTH, Nguyen DH, Nguyen VT, Nikolouzakis TK, Noman EA, Nri-Ezedi CA, Odetokun IA, Okwute PG, Olana MD, Olanipekun TO, Olasupo OO, Olivas-Martinez A, Ordak M, Ortiz-Brizuela E, Ouyahia A, Padubidri JR, Pak A, Pandey A, Pantazopoulos I, Parija PP, Parikh RR, Park S, Parthasarathi A, Pashaei A, Peprah P, Pham HT, Poddighe D, Pollard A, Ponce-De-Leon A, Prakash PY, Prates EJS, Quan NK, Raee P, Rahim F, Rahman M, Rahmati M, Ramasamy SK, Ranjan S, Rao IR, Rashid AM, Rattanavong S, Ravikumar N, Reddy MMRK, Redwan EMM, Reiner RC, Reyes LF, Roberts T, Rodrigues M, Rosenthal VD, Roy P, Runghien T, Saeed U, Saghazadeh A, Saheb Sharif-Askari N, Saheb Sharif-Askari F, Sahoo SS, Sahu M, Sakshaug JW, Salami AA, Saleh MA, Salehi omran H, Sallam M, Samadzadeh S, Samodra YL, Sanjeev RK, Sarasmita MA, Saravanan A, Sartorius B, Saulam J, Schumacher AE, Seyedi SA, Shafie M, Shahid S, Sham S, Shamim MA, Shamshirgaran MA, Shastry RP, Sherchan SP, Shiferaw D, Shittu A, Siddig EE, Sinto R, Sood A, Sorensen RJD, Stergachis A, Stoeva TZ, Swain CK, Szarpak L, Tamuzi JL, Temsah MH, Tessema MBT, Thangaraju P, Tran NM, Tran NH, Tumurkhuu M, Ty SS, Udoakang AJ, Ulhaq I, Umar TP, Umer AA, Vahabi SM, Vaithinathan AG, Van den Eynde J, Walson JL, Waqas M, Xing Y, Yadav MK, Yahya G, Yon DK, Zahedi Bialvaei A, Zakham F, Zeleke AM, Zhai C, Zhang Z, Zhang H, Zielińska M, Zheng P, Aravkin AY, Vos T, Hay SI, Mosser JF, Lim SS, Naghavi M, Murray CJL, Kyu HH. Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Infect Dis 2024:S1473-3099(24)00176-2. [PMID: 38636536 DOI: 10.1016/s1473-3099(24)00176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Lower respiratory infections (LRIs) are a major global contributor to morbidity and mortality. In 2020-21, non-pharmaceutical interventions associated with the COVID-19 pandemic reduced not only the transmission of SARS-CoV-2, but also the transmission of other LRI pathogens. Tracking LRI incidence and mortality, as well as the pathogens responsible, can guide health-system responses and funding priorities to reduce future burden. We present estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 of the burden of non-COVID-19 LRIs and corresponding aetiologies from 1990 to 2021, inclusive of pandemic effects on the incidence and mortality of select respiratory viruses, globally, regionally, and for 204 countries and territories. METHODS We estimated mortality, incidence, and aetiology attribution for LRI, defined by the GBD as pneumonia or bronchiolitis, not inclusive of COVID-19. We analysed 26 259 site-years of mortality data using the Cause of Death Ensemble model to estimate LRI mortality rates. We analysed all available age-specific and sex-specific data sources, including published literature identified by a systematic review, as well as household surveys, hospital admissions, health insurance claims, and LRI mortality estimates, to generate internally consistent estimates of incidence and prevalence using DisMod-MR 2.1. For aetiology estimation, we analysed multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature data using a network analysis model to produce the proportion of LRI deaths and episodes attributable to the following pathogens: Acinetobacter baumannii, Chlamydia spp, Enterobacter spp, Escherichia coli, fungi, group B streptococcus, Haemophilus influenzae, influenza viruses, Klebsiella pneumoniae, Legionella spp, Mycoplasma spp, polymicrobial infections, Pseudomonas aeruginosa, respiratory syncytial virus (RSV), Staphylococcus aureus, Streptococcus pneumoniae, and other viruses (ie, the aggregate of all viruses studied except influenza and RSV), as well as a residual category of other bacterial pathogens. FINDINGS Globally, in 2021, we estimated 344 million (95% uncertainty interval [UI] 325-364) incident episodes of LRI, or 4350 episodes (4120-4610) per 100 000 population, and 2·18 million deaths (1·98-2·36), or 27·7 deaths (25·1-29·9) per 100 000. 502 000 deaths (406 000-611 000) were in children younger than 5 years, among which 254 000 deaths (197 000-320 000) occurred in countries with a low Socio-demographic Index. Of the 18 modelled pathogen categories in 2021, S pneumoniae was responsible for the highest proportions of LRI episodes and deaths, with an estimated 97·9 million (92·1-104·0) episodes and 505 000 deaths (454 000-555 000) globally. The pathogens responsible for the second and third highest episode counts globally were other viral aetiologies (46·4 million [43·6-49·3] episodes) and Mycoplasma spp (25·3 million [23·5-27·2]), while those responsible for the second and third highest death counts were S aureus (424 000 [380 000-459 000]) and K pneumoniae (176 000 [158 000-194 000]). From 1990 to 2019, the global all-age non-COVID-19 LRI mortality rate declined by 41·7% (35·9-46·9), from 56·5 deaths (51·3-61·9) to 32·9 deaths (29·9-35·4) per 100 000. From 2019 to 2021, during the COVID-19 pandemic and implementation of associated non-pharmaceutical interventions, we estimated a 16·0% (13·1-18·6) decline in the global all-age non-COVID-19 LRI mortality rate, largely accounted for by a 71·8% (63·8-78·9) decline in the number of influenza deaths and a 66·7% (56·6-75·3) decline in the number of RSV deaths. INTERPRETATION Substantial progress has been made in reducing LRI mortality, but the burden remains high, especially in low-income and middle-income countries. During the COVID-19 pandemic, with its associated non-pharmaceutical interventions, global incident LRI cases and mortality attributable to influenza and RSV declined substantially. Expanding access to health-care services and vaccines, including S pneumoniae, H influenzae type B, and novel RSV vaccines, along with new low-cost interventions against S aureus, could mitigate the LRI burden and prevent transmission of LRI-causing pathogens. FUNDING Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care (UK).
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Romadlon DS, Romero-Rodríguez E, Romoli M, Ronfani L, Roshandel G, Roth GA, Rout HS, Roy N, Roy P, Rubagotti E, Ruela GDA, Rumisha SF, Runghien T, Rwegerera GM, Rynkiewicz A, S N C, Saad AMA, Saadatian Z, Saber K, Saber-Ayad MM, SaberiKamarposhti M, Sabour S, Sacco S, Sachdev PS, Sachdeva R, Saddik B, Saddler A, Sadee BA, Sadeghi E, Sadeghi E, Sadeghian F, Saeb MR, Saeed U, Safaeinejad F, Safi SZ, Sagar R, Saghazadeh A, Sagoe D, Saheb Sharif-Askari F, Saheb Sharif-Askari N, Sahebkar A, Sahoo SS, Sahoo U, Sahu M, Saif Z, Sajid MR, Sakshaug JW, Salam N, Salamati P, Salami AA, Salaroli LB, Saleh MA, Salehi S, Salem MR, Salem MZY, Salimi S, Samadi Kafil H, Samadzadeh S, Samargandy S, Samodra YL, Samy AM, Sanabria J, Sanna F, Santomauro DF, Santos IS, Santric-Milicevic MM, Sao Jose BP, Sarasmita MA, Saraswathy SYI, Saravanan A, Saravi B, Sarikhani Y, Sarkar T, Sarmiento-Suárez R, Sarode GS, Sarode SC, Sarveazad A, Sathian B, Sathish T, Satpathy M, Sayeed A, Sayeed MA, Saylan M, Sayyah M, Scarmeas N, Schaarschmidt BM, Schlaich MP, Schlee W, Schmidt MI, Schneider IJC, Schuermans A, Schumacher AE, Schutte AE, Schwarzinger M, Schwebel DC, Schwendicke F, Šekerija M, Selvaraj S, Senapati S, Senthilkumaran S, Sepanlou SG, Serban D, Sethi Y, Sha F, Shabany M, Shafaat A, Shafie M, Shah NS, Shah PA, Shah SM, Shahabi S, Shahbandi A, Shahid I, Shahid S, Shahid W, Shahsavari HR, Shahwan MJ, Shaikh A, Shaikh MA, Shakeri A, Shalash AS, Sham S, Shamim MA, Shams-Beyranvand M, Shamshad H, Shamsi MA, Shanawaz M, Shankar A, Sharfaei S, Sharifan A, Sharifi-Rad J, Sharma R, Sharma S, Sharma U, Sharma V, Shastry RP, Shavandi A, Shayan M, Shehabeldine AME, Sheikh A, Sheikhi RA, Shen J, Shetty A, Shetty BSK, Shetty PH, Shi P, Shibuya K, Shiferaw D, Shigematsu M, Shin MJ, Shin YH, Shiri R, Shirkoohi R, Shitaye NA, Shittu A, Shiue I, Shivakumar KM, Shivarov V, Shokraneh F, Shokri A, Shool S, Shorofi SA, Shrestha S, Shuval K, Siddig EE, Silva JP, Silva LMLR, Silva S, Simpson CR, Singal A, Singh A, Singh BB, Singh G, Singh J, Singh NP, Singh P, Singh S, Sinha DN, Sinto R, Siraj MS, Sirota SB, Sitas F, Sivakumar S, Skryabin VY, Skryabina AA, Sleet DA, Socea B, Sokhan A, Solanki R, Solanki S, Soleimani H, Soliman SSM, Song S, Song Y, Sorensen RJD, Soriano JB, Soyiri IN, Spartalis M, Spearman S, Sreeramareddy CT, Srivastava VK, Stanaway JD, Stanikzai MH, Stark BA, Starnes JR, Starodubova AV, Stein C, Stein DJ, Steinbeis F, Steiner C, Steinmetz JD, Steiropoulos P, Stevanović A, Stockfelt L, Stokes MA, Stortecky S, Subramaniyan V, Suleman M, Suliankatchi Abdulkader R, Sultana A, Sun HZ, Sun J, Sundström J, Sunkersing D, Sunnerhagen KS, Swain CK, Szarpak L, Szeto MD, Szócska M, Tabaee Damavandi P, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabish M, TADAKAMADLA JYOTHI, Tadakamadla SK, Taheri Abkenar Y, Taheri Soodejani M, Taiba J, Takahashi K, Talaat IM, Talukder A, Tampa M, Tamuzi JL, Tan KK, Tandukar S, Tang H, Tang HK, Tarigan IU, 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Viskadourou M, Vladimirov SK, Vlassov V, Vo B, Vollset SE, Vongpradith A, Vos T, Vujcic IS, Vukovic R, Wafa HA, Waheed Y, Wamai RG, Wang C, Wang N, Wang S, Wang S, Wang Y, Wang YP, Waqas M, Ward P, Wassie EG, Watson S, Watson SLW, Weerakoon KG, Wei MY, Weintraub RG, Weiss DJ, Westerman R, Whisnant JL, Wiangkham T, Wickramasinghe DP, Wickramasinghe ND, Wilandika A, Wilkerson C, Willeit P, Wilson S, Wojewodzic MW, Woldegebreal DH, Wolf AW, Wolfe CDA, Wondimagegene YA, Wong YJ, Wongsin U, Wu AM, Wu C, Wu F, Wu X, Wu Z, Xia J, Xiao H, Xie Y, Xu S, Xu WD, Xu X, Xu YY, Yadollahpour A, Yamagishi K, Yang D, Yang L, Yano Y, Yao Y, Yaribeygi H, Ye P, Yehualashet SS, Yesiltepe M, Yesuf SA, Yezli S, Yi S, Yigezu A, Yiğit A, Yiğit V, Yip P, Yismaw MB, Yismaw Y, Yon DK, Yonemoto N, Yoon SJ, You Y, Younis MZ, Yousefi Z, Yu C, Yu Y, Yuh FH, Zadey S, Zadnik V, Zafari N, Zakham F, Zaki N, Zaman SB, Zamora N, Zand R, Zangiabadian M, Zar HJ, Zare I, Zarrintan A, Zeariya MGM, Zeinali Z, Zhang H, Zhang J, Zhang J, Zhang L, Zhang Y, Zhang ZJ, Zhao H, Zhong C, Zhou J, Zhu B, Zhu L, Ziafati M, Zielińska M, Zitoun OA, Zoladl M, Zou Z, Zuhlke LJ, Zumla A, Zweck E, Zyoud SH, Wool EE, Murray CJL. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00367-2. [PMID: 38582094 DOI: 10.1016/s0140-6736(24)00367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation.
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Sivagnanam S, Yeu S, Lin K, Sakai S, Garzon F, Yoshimoto K, Prantzalos K, Upadhyaya DP, Majumdar A, Sahoo SS, Lytton WW. Towards building a trustworthy pipeline integrating Neuroscience Gateway and Open Science Chain. Database (Oxford) 2024; 2024:baae023. [PMID: 38581360 PMCID: PMC10998337 DOI: 10.1093/database/baae023] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/22/2024] [Accepted: 03/11/2024] [Indexed: 04/08/2024]
Abstract
When the scientific dataset evolves or is reused in workflows creating derived datasets, the integrity of the dataset with its metadata information, including provenance, needs to be securely preserved while providing assurances that they are not accidentally or maliciously altered during the process. Providing a secure method to efficiently share and verify the data as well as metadata is essential for the reuse of the scientific data. The National Science Foundation (NSF) funded Open Science Chain (OSC) utilizes consortium blockchain to provide a cyberinfrastructure solution to maintain integrity of the provenance metadata for published datasets and provides a way to perform independent verification of the dataset while promoting reuse and reproducibility. The NSF- and National Institutes of Health (NIH)-funded Neuroscience Gateway (NSG) provides a freely available web portal that allows neuroscience researchers to execute computational data analysis pipeline on high performance computing resources. Combined, the OSC and NSG platforms form an efficient, integrated framework to automatically and securely preserve and verify the integrity of the artifacts used in research workflows while using the NSG platform. This paper presents the results of the first study that integrates OSC-NSG frameworks to track the provenance of neurophysiological signal data analysis to study brain network dynamics using the Neuro-Integrative Connectivity tool, which is deployed in the NSG platform. Database URL: https://www.opensciencechain.org.
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Affiliation(s)
- S Sivagnanam
- San Diego Supercomputer Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
- Biomedical Engineering, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - S Yeu
- San Diego Supercomputer Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - K Lin
- San Diego Supercomputer Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - S Sakai
- San Diego Supercomputer Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - F Garzon
- San Diego Supercomputer Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - K Yoshimoto
- San Diego Supercomputer Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - K Prantzalos
- School of Medicine, Case Western University, 9501 Euclid Ave, Cleveland, OH 44106, USA
| | - D P Upadhyaya
- School of Medicine, Case Western University, 9501 Euclid Ave, Cleveland, OH 44106, USA
| | - A Majumdar
- San Diego Supercomputer Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - S S Sahoo
- School of Medicine, Case Western University, 9501 Euclid Ave, Cleveland, OH 44106, USA
| | - W W Lytton
- Biomedical Engineering, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
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Panda UK, Sahoo SS, Samantaray S. "Harm reduction approach for tuberculosis and substance use disorders: A review of approaches and implications in the Indian context". Indian J Tuberc 2024; 71:219-224. [PMID: 38589127 DOI: 10.1016/j.ijtb.2023.09.013] [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: 07/17/2023] [Revised: 08/05/2023] [Accepted: 09/22/2023] [Indexed: 04/10/2024]
Abstract
There are limitations to traditional treatment approaches in addressing the needs of individuals with dual comorbidity of TB and SUD. The concept of harm reduction as a distinct approach to addressing substance use, focusing on minimising the negative consequences associated with it rather than advocating for complete abstinence. Different harm reduction strategies, such as opioid substitution therapy, needle and syringe programmes, testing for viral infections etc. have been effectively employed for SUDs in past. Similarly, TB risk minimization approaches like improving housing and nutrition and focused testing strategies are considered as harm reduction strategies for TB management. The relationship between tuberculosis (TB) and substance use disorders (SUDs) involves a complex interplay of biopsychosocial factors. It is crucial to prioritise integrated and closely monitored care in order to address the treatment challenges and potential drug interactions that may arise. In light of the acknowledged challenges like limited awareness, infrastructure, drug resistance, and stigma, it is imperative to explore potential avenues for the implementation of harm reduction strategies targeting individuals with comorbid TB and SUD in India. Potential strategies for addressing the issue includes a range of measures, such as augmenting investments in healthcare, integrating policies, tackling social determinants, and establishing shared platforms for psychosocial rehabilitation.
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Affiliation(s)
- Udit Kumar Panda
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, 751024, India.
| | - Soumya Swaroop Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India
| | - Swayanka Samantaray
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, 751024, India
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Steinmetz JD, Seeher KM, Schiess N, Nichols E, Cao B, Servili C, Cavallera V, Cousin E, Hagins H, Moberg ME, Mehlman ML, Abate YH, Abbas J, Abbasi MA, Abbasian M, Abbastabar H, Abdelmasseh M, Abdollahi M, Abdollahi M, Abdollahifar MA, Abd-Rabu R, Abdulah DM, Abdullahi A, Abedi A, Abedi V, Abeldaño Zuñiga RA, Abidi H, Abiodun O, Aboagye RG, Abolhassani H, Aboyans V, Abrha WA, Abualhasan A, Abu-Gharbieh E, Aburuz S, Adamu LH, Addo IY, Adebayo OM, Adekanmbi V, Adekiya TA, Adikusuma W, Adnani QES, Adra S, Afework T, Afolabi AA, Afraz A, Afzal S, Aghamiri S, Agodi A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad S, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed JQ, Ahmed LA, Ahmed MB, Ahmed SA, Ajami M, Aji B, Ajumobi O, Akade SE, Akbari M, Akbarialiabad H, Akhlaghi S, Akinosoglou K, Akinyemi RO, Akonde M, Al Hasan SM, Alahdab F, AL-Ahdal TMA, Al-amer RM, Albashtawy M, AlBataineh MT, Aldawsari KA, Alemi H, Alemi S, Algammal AM, Al-Gheethi AAS, Alhalaiqa FAN, Alhassan RK, Ali A, Ali EA, Ali L, Ali MU, Ali MM, Ali R, Ali S, Ali SSS, Ali Z, Alif SM, Alimohamadi Y, Aliyi AA, Aljofan M, Aljunid SM, Alladi S, Almazan JU, Almustanyir S, Al-Omari B, Alqahtani JS, Alqasmi I, Alqutaibi AY, Al-Shahi Salman R, Altaany Z, Al-Tawfiq JA, Altirkawi KA, Alvis-Guzman N, Al-Worafi YM, Aly H, Aly S, Alzoubi KH, Amani R, Amindarolzarbi A, Amiri S, Amirzade-Iranaq MH, Amu H, Amugsi DA, Amusa GA, Amzat J, Ancuceanu R, Anderlini D, Anderson DB, Andrei CL, Androudi S, Angappan D, Angesom TW, Anil A, Ansari-Moghaddam A, Anwer R, Arafat M, Aravkin AY, Areda D, Ariffin H, Arifin H, Arkew M, Ärnlöv J, Arooj M, Artamonov AA, Artanti KD, Aruleba RT, Asadi-Pooya AA, Asena TF, Asghari-Jafarabadi M, Ashraf M, Ashraf T, Atalell KA, Athari SS, Atinafu BTT, Atorkey P, Atout MMW, Atreya A, Aujayeb A, Avan A, Ayala Quintanilla BP, Ayatollahi H, Ayinde OO, Ayyoubzadeh SM, Azadnajafabad S, Azizi Z, Azizian K, Azzam AY, Babaei M, Badar M, Badiye AD, Baghdadi S, Bagherieh S, Bai R, Baig AA, Balakrishnan 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A, Mulita F, Musaigwa F, Mustafa A, Mustafa G, Muthu S, Nagarajan AJ, Naghavi P, Naik GR, Nainu F, Nair TS, Najmuldeen HHR, Nakhostin Ansari N, Nambi G, Namdar Areshtanab H, Nargus S, Nascimento BR, Naser AY, Nashwan AJJ, Nasoori H, Nasreldein A, Natto ZS, Nauman J, Nayak BP, Nazri-Panjaki A, Negaresh M, Negash H, Negoi I, Negoi RI, Negru SM, Nejadghaderi SA, Nematollahi MH, Nesbit OD, Newton CRJ, Nguyen DH, Nguyen HTH, Nguyen HQ, Nguyen NTT, Nguyen PT, Nguyen VT, Niazi RK, Nikolouzakis TK, Niranjan V, Nnyanzi LA, Noman EA, Noroozi N, Norrving B, Noubiap JJ, Nri-Ezedi CA, Ntaios G, Nuñez-Samudio V, Nurrika D, Oancea B, Odetokun IA, O'Donnell MJ, Ogunsakin RE, Oguta JO, Oh IH, Okati-Aliabad H, Okeke SR, Okekunle AP, Okonji OC, Okwute PG, Olagunju AT, Olaiya MT, Olana MD, Olatubi MI, Oliveira GMM, Olufadewa II, Olusanya BO, Omar Bali A, Ong S, Onwujekwe OE, Ordak M, Orji AU, Ortega-Altamirano DV, Osuagwu UL, Otstavnov N, Otstavnov SS, Ouyahia A, Owolabi MO, P A MP, Pacheco-Barrios K, 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Wang S, Wang Y, Wang YP, Waqas M, Waris A, Weerakoon KG, Weintraub RG, Weldemariam AH, Westerman R, Whisnant JL, Wickramasinghe DP, Wickramasinghe ND, Willekens B, Wilner LB, Winkler AS, Wolfe CDA, Wu AM, Wulf Hanson S, Xu S, Xu X, Yadollahpour A, Yaghoubi S, Yahya G, Yamagishi K, Yang L, Yano Y, Yao Y, Yehualashet SS, Yeshaneh A, Yesiltepe M, Yi S, Yiğit A, Yiğit V, Yon DK, Yonemoto N, You Y, Younis MZ, Yu C, Yusuf H, Zadey S, Zahedi M, Zakham F, Zaki N, Zali A, Zamagni G, Zand R, Zandieh GGZ, Zangiabadian M, Zarghami A, Zastrozhin MS, Zeariya MGM, Zegeye ZB, Zeukeng F, Zhai C, Zhang C, Zhang H, Zhang Y, Zhang ZJ, Zhao H, Zhao Y, Zheng P, Zhou H, Zhu B, Zhumagaliuly A, Zielińska M, Zikarg YT, Zoladl M, Murray CJL, Ong KL, Feigin VL, Vos T, Dua T. Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 2024; 23:344-381. [PMID: 38493795 PMCID: PMC10949203 DOI: 10.1016/s1474-4422(24)00038-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378-521), affecting 3·40 billion (3·20-3·62) individuals (43·1%, 40·5-45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7-26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6-38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5-32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7-2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. FUNDING Bill & Melinda Gates Foundation.
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Ledesma JR, Ma J, Zhang M, Basting AVL, Chu HT, Vongpradith A, Novotney A, LeGrand KE, Xu YY, Dai X, Nicholson SI, Stafford LK, Carter A, Ross JM, Abbastabar H, Abdoun M, Abdulah DM, Aboagye RG, Abolhassani H, Abrha WA, Abubaker Ali H, Abu-Gharbieh E, Aburuz S, Addo IY, Adepoju AV, Adhikari K, Adnani QES, Adra S, Afework A, Aghamiri S, Agyemang-Duah W, Ahinkorah BO, Ahmad D, Ahmad S, Ahmadzade AM, Ahmed H, Ahmed M, Ahmed A, Akinosoglou K, AL-Ahdal TMA, Alam N, Albashtawy M, AlBataineh MT, Al-Gheethi AAS, Ali A, Ali EA, Ali L, Ali Z, Ali SSS, Allel K, Altaf A, Al-Tawfiq JA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amani R, Amusa GA, Amzat J, Andrews JR, Anil A, Anwer R, Aravkin AY, Areda D, Artamonov AA, Aruleba RT, Asemahagn MA, Atre SR, Aujayeb A, Azadi D, Azadnajafabad S, Azzam AY, Badar M, Badiye AD, Bagherieh S, Bahadorikhalili S, Baig AA, Banach M, Banik B, Bardhan M, Barqawi HJ, Basharat Z, Baskaran P, Basu S, Beiranvand M, Belete MA, Belew MA, Belgaumi UI, Beloukas A, Bettencourt PJG, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhargava A, Bhat V, Bhatti JS, Bhatti GK, Bikbov B, Bitra VR, Bjegovic-Mikanovic V, Buonsenso D, Burkart K, Bustanji Y, Butt ZA, Camargos P, Cao Y, Carr S, Carvalho F, Cegolon L, Cenderadewi M, Cevik M, Chahine Y, Chattu VK, Ching PR, Chopra H, Chung E, Claassens MM, Coberly K, Cruz-Martins N, Dabo B, Dadana S, Dadras O, Darban I, Darega Gela J, Darwesh AM, Dashti M, Demessa BH, Demisse B, Demissie S, Derese AMA, Deribe K, Desai HD, Devanbu VGC, Dhali A, Dhama K, Dhingra S, Do THP, Dongarwar D, Dsouza HL, Dube J, Dziedzic AM, Ed-Dra A, Efendi F, Effendi DE, Eftekharimehrabad A, Ekadinata N, Ekundayo TC, Elhadi M, Elilo LT, Emeto TI, Engelbert Bain L, Fagbamigbe AF, Fahim A, Feizkhah A, Fetensa G, Fischer F, Gaipov A, Gandhi AP, Gautam RK, Gebregergis MW, Gebrehiwot M, Gebrekidan KG, Ghaffari K, Ghassemi F, Ghazy RM, Goodridge A, Goyal A, Guan SY, Gudeta MD, Guled RA, Gultom NB, Gupta VB, Gupta VK, Gupta S, Hagins H, Hailu SG, Hailu WB, Hamidi S, Hanif A, Harapan H, Hasan RS, Hassan S, Haubold J, Hezam K, Hong SH, Horita N, Hossain MB, Hosseinzadeh M, Hostiuc M, Hostiuc S, Huynh HH, Ibitoye SE, Ikuta KS, Ilic IM, Ilic MD, Islam MR, Ismail NE, Ismail F, Jafarzadeh A, Jakovljevic M, Jalili M, Janodia MD, Jomehzadeh N, Jonas JB, Joseph N, Joshua CE, Kabir Z, Kamble BD, Kanchan T, Kandel H, Kanmodi KK, Kantar RS, Karaye IM, Karimi Behnagh A, Kassa GG, Kaur RJ, Kaur N, Khajuria H, Khamesipour F, Khan YH, Khan MN, Khan Suheb MZ, Khatab K, Khatami F, Kim MS, Kosen S, Koul PA, Koulmane Laxminarayana SL, Krishan K, Kucuk Bicer B, Kuddus MA, Kulimbet M, Kumar N, Lal DK, Landires I, Latief K, Le TDT, Le TTT, Ledda C, Lee M, Lee SW, Lerango TL, Lim SS, Liu C, Liu X, Lopukhov PD, Luo H, Lv H, Mahajan PB, Mahboobipour AA, Majeed A, Malakan Rad E, Malhotra K, Malik MSA, Malinga LA, Mallhi TH, Manilal A, Martinez-Guerra BA, Martins-Melo FR, Marzo RR, Masoumi-Asl H, Mathur V, Maude RJ, Mehrotra R, Memish ZA, Mendoza W, Menezes RG, Merza MA, Mestrovic T, Mhlanga L, Misra S, Misra AK, Mithra P, Moazen B, Mohammed H, Mokdad AH, Monasta L, Moore CE, Mousavi P, Mulita F, Musaigwa F, Muthusamy R, Nagarajan AJ, Naghavi P, Naik GR, Naik G, Nair S, Nair TS, Natto ZS, Nayak BP, Negash H, Nguyen DH, Nguyen VT, Niazi RK, Nnaji CA, Nnyanzi LA, Noman EA, Nomura S, Oancea B, Obamiro KO, Odetokun IA, Odo DBO, Odukoya OO, Oh IH, Okereke CO, Okonji OC, Oren E, Ortiz-Brizuela E, Osuagwu UL, Ouyahia A, P A MP, Parija PP, Parikh RR, Park S, Parthasarathi A, Patil S, Pawar S, Peng M, Pepito VCF, Peprah P, Perdigão J, Perico N, Pham HT, Postma MJ, Prabhu ARA, Prasad M, Prashant A, Prates EJS, Rahim F, Rahman M, Rahman MA, Rahmati M, Rajaa S, Ramasamy SK, Rao IR, Rao SJ, Rapaka D, Rashid AM, Ratan ZA, Ravikumar N, Rawaf S, Reddy MMRK, Redwan EMM, Remuzzi G, Reyes LF, Rezaei N, Rezaeian M, Rezahosseini O, Rodrigues M, Roy P, Ruela GDA, Sabour S, Saddik B, Saeed U, Safi SZ, Saheb Sharif-Askari N, Saheb Sharif-Askari F, Sahebkar A, Sahiledengle B, Sahoo SS, Salam N, Salami AA, Saleem S, Saleh MA, Samadi Kafil H, Samadzadeh S, Samodra YL, Sanjeev RK, Saravanan A, Sawyer SM, Selvaraj S, Senapati S, Senthilkumaran S, Shah PA, Shahid S, Shaikh MA, Sham S, Shamshirgaran MA, Shanawaz M, Sharath M, Sherchan SP, Shetty RS, Shirzad-Aski H, Shittu A, Siddig EE, Silva JP, Singh S, Singh P, Singh H, Singh JA, Siraj MS, Siswanto S, Solanki R, Solomon Y, Soriano JB, Sreeramareddy CT, Srivastava VK, Steiropoulos P, Swain CK, Tabuchi T, Tampa M, Tamuzi JJLL, Tat NY, Tavakoli Oliaee R, Teklay G, Tesfaye EG, Tessema B, Thangaraju P, Thapar R, Thum CCC, Ticoalu JHV, Tleyjeh IM, Tobe-Gai R, Toma TM, Tram KH, Udoakang AJ, Umar TP, Umeokonkwo CD, Vahabi SM, Vaithinathan AG, van Boven JFM, Varthya SB, Wang Z, Warsame MSA, Westerman R, Wonde TE, Yaghoubi S, Yi S, Yiğit V, Yon DK, Yonemoto N, Yu C, Zakham F, Zangiabadian M, Zeukeng F, Zhang H, Zhao Y, Zheng P, Zielińska M, Salomon JA, Reiner Jr RC, Naghavi M, Vos T, Hay SI, Murray CJL, Kyu HH. Global, regional, and national age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Infect Dis 2024:S1473-3099(24)00007-0. [PMID: 38518787 DOI: 10.1016/s1473-3099(24)00007-0] [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] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/09/2023] [Accepted: 01/08/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Global evaluations of the progress towards the WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% reduction) have not been age specific. We aimed to assess global, regional, and national-level burdens of and trends in tuberculosis and its risk factors across five separate age groups, from 1990 to 2021, and to report on age-specific progress between 2015 and 2020. METHODS We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021) analytical framework to compute age-specific tuberculosis mortality and incidence estimates for 204 countries and territories (1990-2021 inclusive). We quantified tuberculosis mortality among individuals without HIV co-infection using 22 603 site-years of vital registration data, 1718 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, 680 site-years of mortality surveillance data, and 9 site-years of minimally invasive tissue sample (MITS) diagnoses data as inputs into the Cause of Death Ensemble modelling platform. Age-specific HIV and tuberculosis deaths were established with a population attributable fraction approach. We analysed all available population-based data sources, including prevalence surveys, annual case notifications, tuberculin surveys, and tuberculosis mortality, in DisMod-MR 2.1 to produce internally consistent age-specific estimates of tuberculosis incidence, prevalence, and mortality. We also estimated age-specific tuberculosis mortality without HIV co-infection that is attributable to the independent and combined effects of three risk factors (smoking, alcohol use, and diabetes). As a secondary analysis, we examined the potential impact of the COVID-19 pandemic on tuberculosis mortality without HIV co-infection by comparing expected tuberculosis deaths, modelled with trends in tuberculosis deaths from 2015 to 2019 in vital registration data, with observed tuberculosis deaths in 2020 and 2021 for countries with available cause-specific mortality data. FINDINGS We estimated 9·40 million (95% uncertainty interval [UI] 8·36 to 10·5) tuberculosis incident cases and 1·35 million (1·23 to 1·52) deaths due to tuberculosis in 2021. At the global level, the all-age tuberculosis incidence rate declined by 6·26% (5·27 to 7·25) between 2015 and 2020 (the WHO End TB strategy evaluation period). 15 of 204 countries achieved a 20% decrease in all-age tuberculosis incidence between 2015 and 2020, eight of which were in western sub-Saharan Africa. When stratified by age, global tuberculosis incidence rates decreased by 16·5% (14·8 to 18·4) in children younger than 5 years, 16·2% (14·2 to 17·9) in those aged 5-14 years, 6·29% (5·05 to 7·70) in those aged 15-49 years, 5·72% (4·02 to 7·39) in those aged 50-69 years, and 8·48% (6·74 to 10·4) in those aged 70 years and older, from 2015 to 2020. Global tuberculosis deaths decreased by 11·9% (5·77 to 17·0) from 2015 to 2020. 17 countries attained a 35% reduction in deaths due to tuberculosis between 2015 and 2020, most of which were in eastern Europe (six countries) and central Europe (four countries). There was variable progress by age: a 35·3% (26·7 to 41·7) decrease in tuberculosis deaths in children younger than 5 years, a 29·5% (25·5 to 34·1) decrease in those aged 5-14 years, a 15·2% (10·0 to 20·2) decrease in those aged 15-49 years, a 7·97% (0·472 to 14·1) decrease in those aged 50-69 years, and a 3·29% (-5·56 to 9·07) decrease in those aged 70 years and older. Removing the combined effects of the three attributable risk factors would have reduced the number of all-age tuberculosis deaths from 1·39 million (1·28 to 1·54) to 1·00 million (0·703 to 1·23) in 2020, representing a 36·5% (21·5 to 54·8) reduction in tuberculosis deaths compared to those observed in 2015. 41 countries were included in our analysis of the impact of the COVID-19 pandemic on tuberculosis deaths without HIV co-infection in 2020, and 20 countries were included in the analysis for 2021. In 2020, 50 900 (95% CI 49 700 to 52 400) deaths were expected across all ages, compared to an observed 45 500 deaths, corresponding to 5340 (4070 to 6920) fewer deaths; in 2021, 39 600 (38 300 to 41 100) deaths were expected across all ages compared to an observed 39 000 deaths, corresponding to 657 (-713 to 2180) fewer deaths. INTERPRETATION Despite accelerated progress in reducing the global burden of tuberculosis in the past decade, the world did not attain the first interim milestones of the WHO End TB Strategy in 2020. The pace of decline has been unequal with respect to age, with older adults (ie, those aged >50 years) having the slowest progress. As countries refine their national tuberculosis programmes and recalibrate for achieving the 2035 targets, they could consider learning from the strategies of countries that achieved the 2020 milestones, as well as consider targeted interventions to improve outcomes in older age groups. FUNDING Bill & Melinda Gates Foundation.
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Khusun H, Kifle ZD, Kim G, Kim J, Kimokoti RW, Kinzel KE, Kiross GT, Kisa A, Kisa S, Kiss JB, Kivimäki M, Klu D, Knudsen AKS, Kolahi AA, Kompani F, Koren G, Kosen S, Kostev K, Kotnis AL, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Kravchenko MA, Krishan K, Krishna H, Krishnamoorthy V, Krishnamoorthy Y, Krohn KJ, Kuate Defo B, Kubeisy CM, Kucuk Bicer B, Kuddus MA, Kuddus M, Kuitunen I, Kujan O, Kulimbet M, Kulkarni V, Kumar A, Kumar H, Kumar N, Kumar R, Kumar S, Kumari M, Kurmanova A, Kurmi OP, Kusnali A, Kusuma D, Kutluk T, Kuttikkattu A, Kyei EF, Kyriopoulos I, La Vecchia C, Ladan MA, Laflamme L, Lahariya C, Lahmar A, Lai DTC, Laksono T, Lal DK, Lalloo R, Lallukka T, Lám J, Lamnisos D, Lan T, Lanfranchi F, Langguth B, Lansingh VC, Laplante-Lévesque A, Larijani B, Larsson AO, Lasrado S, Latief K, Latif M, Latifinaibin K, Lauriola P, Le LKD, Le NHH, Le TTT, Le TDT, Lee M, Lee PH, Lee SW, Lee SW, Lee WC, Lee YH, Legesse SM, Leigh J, Lenzi J, Leong E, Lerango TL, Li MC, Li W, Li X, Li Y, Li Z, Libra M, Ligade VS, Likaka ATM, Lim LL, Lin RT, Lin S, Lioutas VA, Listl S, Liu J, Liu S, Liu X, Livingstone KM, Llanaj E, Lo CH, Loreche AM, Lorenzovici L, Lotfi M, Lotfizadeh M, Lozano R, Lubinda J, Lucchetti G, Lugo A, Lunevicius R, Ma J, Ma S, Ma ZF, Mabrok M, Machairas N, Machoy M, Madsen C, Magaña Gómez JA, Maghazachi AA, Maharaj SB, Maharjan P, Mahjoub S, Mahmoud MA, Mahmoudi E, Mahmoudi M, Makram OM, Malagón-Rojas JN, Malakan Rad E, Malekzadeh R, Malhotra AK, Malhotra K, Malik AA, Malik I, Malinga LA, Malta DC, Mamun AA, Manla Y, Mannan F, Mansoori Y, Mansour A, Mansouri V, Mansournia MA, Mantovani LG, Marasini BP, Marateb HR, Maravilla JC, Marconi AM, Mardi P, Marino M, Marjani A, Marrugo Arnedo CA, Martinez-Guerra BA, Martinez-Piedra R, Martins CA, Martins-Melo FR, Martorell M, Marx W, Maryam S, Marzo RR, Mate KKV, Matei CN, Mathioudakis AG, Maude RJ, Maugeri A, May EA, Mayeli M, Mazaheri M, Mazidi M, Mazzotti A, McAlinden C, McGrath JJ, McKee M, McKowen ALW, McLaughlin SA, McPhail MA, McPhail SM, Mechili EA, Mediratta RP, Meena JK, Mehari M, Mehlman ML, Mehra R, Mehrabani-Zeinabad K, Mehrabi Nasab E, Mehrotra R, Mekonnen MM, Mendoza W, Menezes RG, Mengesha EW, Mensah GA, Mensah LG, Mentis AFA, Meo SA, Meretoja A, Meretoja TJ, Mersha AM, Mesfin BA, Mestrovic T, Mhlanga A, Mhlanga L, Mi T, Micha G, Michalek IM, Miller TR, Mindlin SN, Minelli G, Minh LHN, Mini GK, Minja NW, Mirdamadi N, Mirghafourvand M, Mirica A, Mirinezhad SK, Mirmosayyeb O, Mirutse MK, Mirza-Aghazadeh-Attari M, Mirzaei M, Misgana T, Misra S, Mitchell PB, Mithra P, Mittal C, Mittal M, Moazen B, Mohamed AI, Mohamed J, Mohamed MFH, Mohamed NS, Mohammad-Alizadeh-Charandabi S, Mohammadi S, Mohammadian-Hafshejani A, Mohammad-pour S, Mohammadshahi M, Mohammed M, Mohammed S, Mohammed S, Mojiri-forushani H, Mokdad AH, Mokhtarzadehazar P, Momenzadeh K, Momtazmanesh S, Monasta L, Moni MA, Montazeri F, Moodi Ghalibaf A, Moradi M, Moradi Y, Moradi-Lakeh M, Moradinazar M, Moradpour F, 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Ramazanu S, Rana J, Rana K, Ranabhat CL, Rancic N, Rani S, Ranjan S, Rao CR, Rao IR, Rao M, Rao SJ, Rasali DP, Rasella D, Rashedi S, Rashedi V, Rashid AM, Rasouli-Saravani A, Rastogi P, Rasul A, Ravangard R, Ravikumar N, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghian-Jahromi I, Reddy MMRK, Redwan EMM, Rehman FU, Reiner Jr RC, Remuzzi G, Reshmi B, Resnikoff S, Reyes LF, Rezaee M, Rezaei N, Rezaei N, Rezaeian M, Riaz MA, Ribeiro AI, Ribeiro DC, Rickard J, Rios-Blancas MJ, Robinson-Oden HE, Rodrigues M, Rodriguez JAB, Roever L, Rohilla R, Rohloff P, Romadlon DS, Ronfani L, Roshandel G, Roshanzamir S, Rostamian M, Roy B, Roy P, Rubagotti E, Rumisha SF, Rwegerera GM, Rynkiewicz A, S M, S N C, S Sunnerhagen K, Saad AMA, Sabbatucci M, Saber K, Saber-Ayad MM, Sacco S, Saddik B, Saddler A, Sadee BA, Sadeghi E, Sadeghi M, Sadeghian S, Saeed U, Saeedi M, Safi S, Sagar R, Saghazadeh A, Saheb Sharif-Askari N, Sahoo SS, Sahraian MA, Sajedi SA, Sajid MR, Sakshaug JW, Salahi S, Salahi S, Salamati P, Salami AA, Salaroli LB, Saleh MA, Salehi S, Salem MR, Salem MZY, Salimi S, Samadi Kafil H, Samadzadeh S, Samara KA, Samargandy S, Samodra YL, Samuel VP, Samy AM, Sanabria J, Sanadgol N, Sanganyado E, Sanjeev RK, Sanmarchi F, Sanna F, Santri IN, Santric-Milicevic MM, Sarasmita MA, Saravanan A, Saravi B, Sarikhani Y, Sarkar C, Sarmiento-Suárez R, Sarode GS, Sarode SC, Sarveazad A, Sathian B, Sathish T, Sattin D, Saulam J, Sawyer SM, Saxena S, Saya GK, Sayadi Y, Sayeed A, Sayeed MA, Saylan M, Scarmeas N, Schaarschmidt BM, Schlee W, Schmidt MI, Schuermans A, Schwebel DC, Schwendicke F, Šekerija M, Selvaraj S, Semreen MH, Senapati S, Sengupta P, Senthilkumaran S, Sepanlou SG, Serban D, Sertsu A, Sethi Y, SeyedAlinaghi S, Seyedi SA, Shafaat A, Shafaat O, Shafie M, Shafiee A, Shah NS, Shah PA, Shahabi S, Shahbandi A, Shahid I, Shahid S, Shahid W, Shahwan MJ, Shaikh MA, Shakeri A, Shakil H, Sham S, Shamim MA, Shams-Beyranvand M, Shamshad H, Shamshirgaran MA, Shamsi MA, Shanawaz M, Shankar A, Sharfaei S, Sharifan A, Shariff M, Sharifi-Rad J, Sharma M, Sharma R, Sharma S, Sharma V, Shastry RP, Shavandi A, Shaw DH, Shayan AM, Shehabeldine AME, Sheikh A, Sheikhi RA, Shen J, Shenoy MM, Shetty BSK, Shetty RS, Shey RA, Shiani A, Shibuya K, Shiferaw D, Shigematsu M, Shin JI, Shin MJ, Shiri R, Shirkoohi R, Shittu A, Shiue I, Shivakumar KM, Shivarov V, Shool S, Shrestha S, Shuja KH, Shuval K, Si Y, Sibhat MM, Siddig EE, Sigfusdottir ID, Silva JP, Silva LMLR, Silva S, Simões JP, Simpson CR, Singal A, Singh A, Singh A, Singh A, Singh BB, Singh B, Singh M, Singh M, Singh NP, Singh P, Singh S, Siraj MS, Sitas F, Sivakumar S, Skryabin VY, Skryabina AA, Sleet DA, Slepak ELN, Sohrabi H, Soleimani H, Soliman SSM, Solmi M, Solomon Y, Song Y, Sorensen RJD, Soriano JB, Soyiri IN, Spartalis M, Sreeramareddy CT, Starnes JR, Starodubov VI, Starodubova AV, Stefan SC, Stein DJ, Steinbeis F, Steiropoulos P, Stockfelt L, Stokes MA, Stortecky S, Stranges S, Stroumpoulis K, Suleman M, Suliankatchi Abdulkader R, Sultana A, Sun J, Sunkersing D, Susanty S, Swain CK, Sykes BL, Szarpak L, Szeto MD, Szócska M, Tabaee Damavandi P, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabb KM, Tabish M, Taborda-Barata LM, Tabuchi T, Tadesse BT, Taheri A, Taheri Abkenar Y, Taheri Soodejani M, Taherkhani A, Taiba J, Tajbakhsh A, Talaat IM, Talukder A, Tamuzi JL, Tan KK, Tang H, Tang HK, Tat NY, Tat VY, Tavakoli Oliaee R, Tavangar SM, Taveira N, Tebeje TM, Tefera YM, Teimoori M, Temsah MH, Temsah RMH, Teramoto M, Tesfaye SH, Thangaraju P, Thankappan KR, Thapa R, Thapar R, Thomas N, Thrift AG, Thum CCC, Tian J, Tichopad A, Ticoalu JHV, Tiruye TY, Tohidast SA, Tonelli M, Touvier M, Tovani-Palone MR, Tram KH, Tran NM, Trico D, Trihandini I, Tromans SJ, Truong VT, Truyen TTTT, Tsermpini EE, Tumurkhuu M, Tung K, Tyrovolas S, Ubah CS, Udoakang AJ, Udoh A, Ulhaq I, Ullah S, Ullah S, Umair M, Umar TP, Umeokonkwo CD, Umesh A, Unim B, Unnikrishnan B, Upadhyay E, Urso D, Vacante M, Vahdani AM, Vaithinathan AG, Valadan Tahbaz S, Valizadeh R, Van den Eynde J, Varavikova E, Varga O, Varma SA, Vart P, Varthya SB, Vasankari TJ, Veerman LJ, Venketasubramanian N, Venugopal D, Verghese NA, Verma M, Verma P, Veroux M, Verras GI, Vervoort D, Vieira RJ, Villafañe JH, Villani L, Villanueva GI, Villeneuve PJ, Violante FS, Visontay R, Vlassov V, Vo B, Vollset SE, Volovat SR, Volovici V, Vongpradith A, Vos T, Vujcic IS, Vukovic R, Wado YD, Wafa HA, Waheed Y, Wamai RG, Wang C, Wang D, Wang F, Wang S, Wang S, Wang Y, Wang YP, Ward P, Watson S, Weaver MR, Weerakoon KG, Weiss DJ, Weldemariam AH, Wells KM, Wen YF, Werdecker A, Westerman R, Wickramasinghe DP, Wickramasinghe ND, Wijeratne T, Wilson S, Wojewodzic MW, Wool EE, Woolf AD, Wu D, Wulandari RD, Xiao H, Xu B, Xu X, Yadav L, Yaghoubi S, Yang L, Yano Y, Yao Y, Ye P, Yesera GE, Yesodharan R, Yesuf SA, Yiğit A, Yiğit V, Yip P, Yon DK, Yonemoto N, You Y, Younis MZ, Yu C, Zadey S, Zadnik V, Zafari N, Zahedi M, Zahid MN, Zahir M, Zakham F, Zaki N, Zakzuk J, Zamagni G, Zaman BA, Zaman SB, Zamora N, Zand R, Zandi M, Zandieh GGZ, Zanghì A, Zare I, Zastrozhin MS, Zeariya MGM, Zeng Y, Zhai C, Zhang C, Zhang H, Zhang H, Zhang Y, Zhang Z, Zhang Z, Zhao H, Zhao Y, Zhao Y, Zheng P, Zhong C, Zhou J, Zhu B, Zhu Z, Ziaeefar P, Zielińska M, Zou Z, Zumla A, Zweck E, Zyoud SH, Lim SS, Murray CJL. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00476-8. [PMID: 38484753 DOI: 10.1016/s0140-6736(24)00476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period. METHODS 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5-65·1] decline), and increased during the COVID-19 pandemic period (2020-21; 5·1% [0·9-9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98-5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50-6·01) in 2019. An estimated 131 million (126-137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7-17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8-24·8), from 49·0 years (46·7-51·3) to 71·7 years (70·9-72·5). Global life expectancy at birth declined by 1·6 years (1·0-2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67-8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4-52·7]) and south Asia (26·3% [9·0-44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING Bill & Melinda Gates Foundation.
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Mirza M, Verma M, Aggarwal A, Satpathy S, Sahoo SS, Kakkar R. Indian Model of Integrated Healthcare (IMIH): a conceptual framework for a coordinated referral system in resource-constrained settings. BMC Health Serv Res 2024; 24:42. [PMID: 38195544 PMCID: PMC10777560 DOI: 10.1186/s12913-023-10454-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 12/07/2023] [Indexed: 01/11/2024] Open
Abstract
INTRODUCTION With the escalating burden of chronic disease and multimorbidity in India, owing to its ageing population and overwhelming health needs, the Indian Health care delivery System (HDS) is under constant pressure due to rising public expectations and ambitious new health goals. The three tired HDS should work in coherence to ensure continuity of care, which needs a coordinated referral system. This calls for optimising health care through Integrated care (IC). The existing IC models have been primarily developed and adopted in High-Income Countries. The present study attempts to review the applicability of existing IC models and frame a customised model for resource-constrained settings. METHODS A two-stage methodology was used. Firstly, a narrative literature review was done to identify gaps in existing IC models, as per the World Health Organization framework approach. The literature search was done from electronic journal article databases, and relevant literature that reported conceptual and theoretical concepts of IC. Secondly, we conceptualised an IC concept according to India's existing HDS, validated by multiple rounds of brainstorming among co-authors. Further senior co-authors independently reviewed the conceptualised IC model as per national relevance. RESULTS Existing IC models were categorised as individual, group and disease-specific, and population-based models. The limitations of having prolonged delivery time, focusing only on chronic diseases and being economically expensive to implement, along with requirement of completely restructuring and reorganising the existing HDS makes the adoption of existing IC models not feasible for India. The Indian Model of Integrated Healthcare (IMIH) model proposes three levels of integration: Macro, Meso, and Micro levels, using the existing HDS. The core components include a Central Gateway Control Room, using existing digital platforms at macro levels, a bucket overflow model at the meso level, a Triple-layered Concentric Circle outpatient department (OPD) design, and a three-door OPD concept at the micro level. CONCLUSION IMIH offers features that consider resource constraints and local context of LMICs while being economically viable. It envisages a step toward UHC by optimising existing resources and ensuring a continuum of care. However, health being a state subject, various socio-political and legal/administrative issues warrant further discussion before implementation.
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Affiliation(s)
- Moonis Mirza
- Department of Hospital Administration, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India.
| | - Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India.
| | - Arun Aggarwal
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Sidhartha Satpathy
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
| | - Soumya Swaroop Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India
| | - Rakesh Kakkar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India
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Verma M, Panwar S, Sahoo SS, Grover GS, Aggarwal S, Tripathy JP, Shah J, Kakkar R. Mapping the stability of febrile illness hotspots in Punjab from 2012 to 2019- a spatial clustering and regression analysis. BMC Public Health 2023; 23:2014. [PMID: 37845663 PMCID: PMC10580620 DOI: 10.1186/s12889-023-16930-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: 01/31/2023] [Accepted: 10/07/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION Febrile illnesses (FI) represent a typical spectrum of diseases in low-resource settings, either in isolation or with other common symptoms. They contribute substantially to morbidity and mortality in India. The primary objective was to study the burden of FI based on Integrated Disease Surveillance Programme (IDSP) data in Punjab, analyze geospatial and temporal trends and patterns, and identify the potential hotspots for effective intervention. METHODS A retrospective ecological study used the district-level IDSP reports between 2012 and 2019. Diseases responsible for FI on a large scale, like Dengue, Chikungunya, Malaria (Plasmodium Falciparum, P. Vivax), Enteric fever, and Pyrexia of Unknown Origin (PUO), were included in the analysis. The digital map of Punjab was obtained from GitHub. Spatial autocorrelation and cluster analysis were done using Moran's I and Getis-Ord G* to determine hotspots of FI using the incidence and crude disease numbers reported under IDSP. Further, negative binomial regression was used to determine the association between Spatio-temporal and population variables per the census 2011. Stable hotspots were depicted using heat maps generated from district-wise yearly data. RESULTS PUO was the highest reported FI. We observed a rising trend in the incidence of Dengue, Chikungunya, and Enteric fever, which depicted occasional spikes during the study period. FI expressed significant inter-district variations and clustering during the start of the study period, with more dispersion in the latter part of the study period. P.Vivax malaria depicted stable hotspots in southern districts of Punjab. In contrast, P. Falciparum malaria, Chikungunya, and PUO expressed no spatial patterns. Enteric Fever incidence was high in central and northeastern districts but depicted no stable spatial patterns. Certain districts were common incidence hotspots for multiple diseases. The number of cases in each district has shown over-dispersion for each disease and has little dependence on population, gender, or residence as per regression analysis. CONCLUSIONS The study demonstrates that information obtained through IDSP can describe the spatial epidemiology of FI at crude spatial scales and drive concerted efforts against FI by identifying actionable points.
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Affiliation(s)
- Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India.
| | - Shweta Panwar
- Centre for Technology Alternatives for Rural Areas (CTARA), Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | - Soumya Swaroop Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Gagandeep Singh Grover
- Directorate of Health and Family Welfare Punjab and State Programme Officer, Integrated Disease Surveillance Program Punjab, Chandigarh, India
| | - Seema Aggarwal
- Directorate of Health and Family Welfare Punjab and State Programme Officer, Integrated Disease Surveillance Program Punjab, Chandigarh, India
| | - Jaya Prasad Tripathy
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Jitendra Shah
- Centre for Technology Alternatives for Rural Areas (CTARA), Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | - Rakesh Kakkar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
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Parija PP, Tiwari P, Sahoo SS. How much do we follow birth preparedness? A community-based snapshot study from rural Delhi, India. J Family Med Prim Care 2023; 12:1901-1907. [PMID: 38024878 PMCID: PMC10657103 DOI: 10.4103/jfmpc.jfmpc_1867_22] [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: 09/20/2022] [Revised: 04/03/2023] [Accepted: 04/26/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Maternal healthcare remains a challenging public health problem in low and middle-income countries like India. The comprehension and services regarding practices related to birth preparedness and its complications in rural areas of India remain poor and underused. In view of this, we conducted this study to explore the preparedness of the pregnant women in the community residing in rural settlements of Delhi. Methods This cross-sectional community-based study was carried out in 165 currently pregnant women selected through proportionate sampling from rural Delhi. A semi-structured questionnaire adapted from Birth Preparedness and Complication Readiness (BPCR) tool kit was used. Binary and multivariate regression analysis was applied to identify the predictors of BPCR. Results In our study, BPCR index was found to be 25.78%. Only 17.6% pregnant women were well prepared. Multigravida, literacy, and higher socioeconomic status were found significant predictors for well preparedness for child birth and complication readiness in bivariate analysis. In multivariate logistic regression, multigravida and literacy were found to be predictors for well preparedness. Conclusion The skill and knowledge level of the mother-in-laws and other women along with husband in the family needs to be improved in context of pregnancy and child birth. Frontline health workers can assist the to-be mothers and their family members in informed decision-making for better feto-maternal outcomes.
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Affiliation(s)
- Pragyan Paramita Parija
- Department of Community Medicine, All India Institute of Medical Sciences, Vijaypur, Jammu, Jammu and Kashmir, India
| | - Poornima Tiwari
- Department of Community Medicine, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Ong KL, Stafford LK, McLaughlin SA, Boyko EJ, Vollset SE, Smith AE, Dalton BE, Duprey J, Cruz JA, Hagins H, Lindstedt PA, Aali A, Abate YH, Abate MD, Abbasian M, Abbasi-Kangevari Z, Abbasi-Kangevari M, Abd ElHafeez S, Abd-Rabu R, Abdulah DM, Abdullah AYM, Abedi V, Abidi H, Aboagye RG, Abolhassani H, Abu-Gharbieh E, Abu-Zaid A, Adane TD, Adane DE, Addo IY, Adegboye OA, Adekanmbi V, Adepoju AV, Adnani QES, Afolabi RF, Agarwal G, Aghdam ZB, Agudelo-Botero M, Aguilera Arriagada CE, Agyemang-Duah W, Ahinkorah BO, Ahmad D, Ahmad R, Ahmad S, Ahmad A, Ahmadi A, Ahmadi K, Ahmed A, Ahmed A, Ahmed LA, Ahmed SA, Ajami M, Akinyemi RO, Al Hamad H, Al Hasan SM, AL-Ahdal TMA, Alalwan TA, Al-Aly Z, AlBataineh MT, Alcalde-Rabanal JE, Alemi S, Ali H, Alinia T, Aljunid SM, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Amare F, Ameyaw EK, Amiri S, Amusa GA, Andrei CL, Anjana RM, Ansar A, Ansari G, Ansari-Moghaddam A, Anyasodor AE, Arabloo J, Aravkin AY, Areda D, Arifin H, Arkew M, Armocida B, Ärnlöv J, Artamonov AA, Arulappan J, Aruleba RT, Arumugam A, Aryan Z, Asemu MT, Asghari-Jafarabadi M, Askari E, Asmelash D, Astell-Burt T, Athar M, Athari SS, Atout MMW, Avila-Burgos L, Awaisu A, Azadnajafabad S, B DB, Babamohamadi H, Badar M, Badawi A, Badiye AD, Baghcheghi N, Bagheri N, Bagherieh S, Bah S, Bahadory S, Bai R, Baig AA, Baltatu OC, Baradaran HR, Barchitta M, Bardhan M, Barengo NC, Bärnighausen TW, Barone MTU, Barone-Adesi F, Barrow A, Bashiri H, Basiru A, Basu S, Basu S, Batiha AMM, Batra K, Bayih MT, Bayileyegn NS, Behnoush AH, Bekele AB, Belete MA, Belgaumi UI, Belo L, Bennett DA, Bensenor IM, Berhe K, Berhie AY, Bhaskar S, Bhat AN, Bhatti JS, Bikbov B, Bilal F, Bintoro BS, Bitaraf S, Bitra VR, Bjegovic-Mikanovic V, Bodolica V, Boloor A, Brauer M, Brazo-Sayavera J, Brenner H, Butt ZA, Calina D, Campos LA, Campos-Nonato IR, Cao Y, Cao C, Car J, Carvalho M, Castañeda-Orjuela CA, Catalá-López F, Cerin E, Chadwick J, Chandrasekar EK, Chanie GS, Charan J, Chattu VK, Chauhan K, Cheema HA, Chekol Abebe E, Chen S, Cherbuin N, Chichagi F, Chidambaram SB, Cho WCS, Choudhari SG, Chowdhury R, Chowdhury EK, Chu DT, Chukwu IS, Chung SC, Coberly K, Columbus A, Contreras D, Cousin E, Criqui MH, Cruz-Martins N, Cuschieri S, Dabo B, Dadras O, Dai X, Damasceno AAM, Dandona R, Dandona L, Das S, Dascalu AM, Dash NR, Dashti M, Dávila-Cervantes CA, De la Cruz-Góngora V, Debele GR, Delpasand K, Demisse FW, Demissie GD, Deng X, Denova-Gutiérrez E, Deo SV, Dervišević E, Desai HD, Desale AT, Dessie AM, Desta F, Dewan SMR, Dey S, Dhama K, Dhimal M, Diao N, Diaz D, Dinu M, Diress M, Djalalinia S, Doan LP, Dongarwar D, dos Santos Figueiredo FW, Duncan BB, Dutta S, Dziedzic AM, Edinur HA, Ekholuenetale M, Ekundayo TC, Elgendy IY, Elhadi M, El-Huneidi W, Elmeligy OAA, Elmonem MA, Endeshaw D, Esayas HL, Eshetu HB, Etaee F, Fadhil I, Fagbamigbe AF, Fahim A, Falahi S, Faris MEM, Farrokhpour H, Farzadfar F, Fatehizadeh A, Fazli G, Feng X, Ferede TY, Fischer F, Flood D, Forouhari A, Foroumadi R, Foroutan Koudehi M, Gaidhane AM, Gaihre S, Gaipov A, Galali Y, Ganesan B, Garcia-Gordillo MA, Gautam RK, Gebrehiwot M, Gebrekidan KG, Gebremeskel TG, Getacher L, Ghadirian F, Ghamari SH, Ghasemi Nour M, Ghassemi F, Golechha M, Goleij P, Golinelli D, Gopalani SV, Guadie HA, Guan SY, Gudayu TW, Guimarães RA, Guled RA, Gupta R, Gupta K, Gupta VB, Gupta VK, Gyawali B, Haddadi R, Hadi NR, Haile TG, Hajibeygi R, Haj-Mirzaian A, Halwani R, Hamidi S, Hankey GJ, Hannan MA, Haque S, Harandi H, Harlianto NI, Hasan SMM, Hasan SS, Hasani H, Hassanipour S, Hassen MB, Haubold J, Hayat K, Heidari G, Heidari M, Hessami K, Hiraike Y, Holla R, Hossain S, Hossain MS, Hosseini MS, Hosseinzadeh M, Hosseinzadeh H, Huang J, Huda MN, Hussain S, Huynh HH, Hwang BF, Ibitoye SE, Ikeda N, Ilic IM, Ilic MD, Inbaraj LR, Iqbal A, Islam SMS, Islam RM, Ismail NE, Iso H, Isola G, Itumalla R, Iwagami M, Iwu CCD, Iyamu IO, Iyasu AN, Jacob L, Jafarzadeh A, Jahrami H, Jain R, Jaja C, Jamalpoor Z, Jamshidi E, Janakiraman B, Jayanna K, Jayapal SK, Jayaram S, Jayawardena R, Jebai R, Jeong W, Jin Y, Jokar M, Jonas JB, Joseph N, Joseph A, Joshua CE, Joukar F, Jozwiak JJ, Kaambwa B, Kabir A, Kabthymer RH, Kadashetti V, Kahe F, Kalhor R, Kandel H, Karanth SD, Karaye IM, Karkhah S, Katoto PDMC, Kaur N, Kazemian S, Kebede SA, Khader YS, Khajuria H, Khalaji A, Khan MAB, Khan M, Khan A, Khanal S, Khatatbeh MM, Khater AM, Khateri S, khorashadizadeh F, Khubchandani J, Kibret BG, Kim MS, Kimokoti RW, Kisa A, Kivimäki M, Kolahi AA, Komaki S, Kompani F, Koohestani HR, Korzh O, Kostev K, Kothari N, Koyanagi A, Krishan K, Krishnamoorthy Y, Kuate Defo B, Kuddus M, Kuddus MA, Kumar R, Kumar H, Kundu S, Kurniasari MD, Kuttikkattu A, La Vecchia C, Lallukka T, Larijani B, Larsson AO, Latief K, Lawal BK, Le TTT, Le TTB, Lee SWH, Lee M, Lee WC, Lee PH, Lee SW, Lee SW, Legesse SM, Lenzi J, Li Y, Li MC, Lim SS, Lim LL, Liu X, Liu C, Lo CH, Lopes G, Lorkowski S, Lozano R, Lucchetti G, Maghazachi AA, Mahasha PW, Mahjoub S, Mahmoud MA, Mahmoudi R, Mahmoudimanesh M, Mai AT, Majeed A, Majma Sanaye P, Makris KC, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, Mamun AA, Mansouri B, Marateb HR, Mardi P, Martini S, Martorell M, Marzo RR, Masoudi R, Masoudi S, Mathews E, Maugeri A, Mazzaglia G, Mekonnen T, Meshkat M, Mestrovic T, Miao Jonasson J, Miazgowski T, Michalek IM, Minh LHN, Mini GK, Miranda JJ, Mirfakhraie R, Mirrakhimov EM, Mirza-Aghazadeh-Attari M, Misganaw A, Misgina KH, Mishra M, Moazen B, Mohamed NS, Mohammadi E, Mohammadi M, Mohammadian-Hafshejani A, Mohammadshahi M, Mohseni A, Mojiri-forushani H, Mokdad AH, Momtazmanesh S, Monasta L, Moniruzzaman M, Mons U, Montazeri F, Moodi Ghalibaf A, Moradi Y, Moradi M, Moradi Sarabi M, Morovatdar N, Morrison SD, Morze J, Mossialos E, Mostafavi E, Mueller UO, Mulita F, Mulita A, Murillo-Zamora E, Musa KI, Mwita JC, Nagaraju SP, Naghavi M, Nainu F, Nair TS, Najmuldeen HHR, Nangia V, Nargus S, Naser AY, Nassereldine H, Natto ZS, Nauman J, Nayak BP, Ndejjo R, Negash H, Negoi RI, Nguyen HTH, Nguyen DH, Nguyen PT, Nguyen VT, Nguyen HQ, Niazi RK, Nigatu YT, Ningrum DNA, Nizam MA, Nnyanzi LA, Noreen M, Noubiap JJ, Nzoputam OJ, Nzoputam CI, Oancea B, Odogwu NM, Odukoya OO, Ojha VA, Okati-Aliabad H, Okekunle AP, Okonji OC, Okwute PG, Olufadewa II, Onwujekwe OE, Ordak M, Ortiz A, Osuagwu UL, Oulhaj A, Owolabi MO, Padron-Monedero A, Padubidri JR, Palladino R, Panagiotakos D, Panda-Jonas S, Pandey A, Pandey A, Pandi-Perumal SR, Pantea Stoian AM, Pardhan S, Parekh T, Parekh U, Pasovic M, Patel J, Patel JR, Paudel U, Pepito VCF, Pereira M, Perico N, Perna S, Petcu IR, Petermann-Rocha FE, Podder V, Postma MJ, Pourali G, Pourtaheri N, Prates EJS, Qadir MMF, Qattea I, Raee P, Rafique I, Rahimi M, Rahimifard M, Rahimi-Movaghar V, Rahman MO, Rahman MA, Rahman MHU, Rahman M, Rahman MM, Rahmani M, Rahmani S, Rahmanian V, Rahmawaty S, Rahnavard N, Rajbhandari B, Ram P, Ramazanu S, Rana J, Rancic N, Ranjha MMAN, Rao CR, Rapaka D, Rasali DP, Rashedi S, Rashedi V, Rashid AM, Rashidi MM, Ratan ZA, Rawaf S, Rawal L, Redwan EMM, Remuzzi G, Rengasamy KRR, Renzaho AMN, Reyes LF, Rezaei N, Rezaei N, Rezaeian M, Rezazadeh H, Riahi SM, Rias YA, Riaz M, Ribeiro D, Rodrigues M, Rodriguez JAB, Roever L, Rohloff P, Roshandel G, Roustazadeh A, Rwegerera GM, Saad AMA, Saber-Ayad MM, Sabour S, Sabzmakan L, Saddik B, Sadeghi E, Saeed U, Saeedi Moghaddam S, Safi S, Safi SZ, Saghazadeh A, Saheb Sharif-Askari N, Saheb Sharif-Askari F, Sahebkar A, Sahoo SS, Sahoo H, Saif-Ur-Rahman KM, Sajid MR, Salahi S, Salahi S, Saleh MA, Salehi MA, Salomon JA, Sanabria J, Sanjeev RK, Sanmarchi F, Santric-Milicevic MM, Sarasmita MA, Sargazi S, Sathian B, Sathish T, Sawhney M, Schlaich MP, Schmidt MI, Schuermans A, Seidu AA, Senthil Kumar N, Sepanlou SG, Sethi Y, Seylani A, Shabany M, Shafaghat T, Shafeghat M, Shafie M, Shah NS, Shahid S, Shaikh MA, Shanawaz M, Shannawaz M, Sharfaei S, Shashamo BB, Shiri R, Shittu A, Shivakumar KM, Shivalli S, Shobeiri P, Shokri F, Shuval K, Sibhat MM, Silva LMLR, Simpson CR, Singh JA, Singh P, Singh S, Siraj MS, Skryabina AA, Sohag AAM, Soleimani H, Solikhah S, Soltani-Zangbar MS, Somayaji R, Sorensen RJD, Starodubova AV, Sujata S, Suleman M, Sun J, Sundström J, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabaeizadeh SA, Tabish M, Taheri M, Taheri E, Taki E, Tamuzi JJLL, Tan KK, Tat NY, Taye BT, Temesgen WA, Temsah MH, Tesler R, Thangaraju P, Thankappan KR, Thapa R, Tharwat S, Thomas N, Ticoalu JHV, Tiyuri A, Tonelli M, Tovani-Palone MR, Trico D, Trihandini I, Tripathy JP, Tromans SJ, Tsegay GM, Tualeka AR, Tufa DG, Tyrovolas S, Ullah S, Upadhyay E, Vahabi SM, Vaithinathan AG, Valizadeh R, van Daalen KR, Vart P, Varthya SB, Vasankari TJ, Vaziri S, Verma MV, Verras GI, Vo DC, Wagaye B, Waheed Y, Wang Z, Wang Y, Wang C, Wang F, Wassie GT, Wei MYW, Weldemariam AH, Westerman R, Wickramasinghe ND, Wu Y, Wulandari RDWI, Xia J, Xiao H, Xu S, Xu X, Yada DY, Yang L, Yatsuya H, Yesiltepe M, Yi S, Yohannis HK, Yonemoto N, You Y, Zaman SB, Zamora N, Zare I, Zarea K, Zarrintan A, Zastrozhin MS, Zeru NG, Zhang ZJ, Zhong C, Zhou J, Zielińska M, Zikarg YT, Zodpey S, Zoladl M, Zou Z, Zumla A, Zuniga YMH, Magliano DJ, Murray CJL, Hay SI, Vos T. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2023; 402:203-234. [PMID: 37356446 PMCID: PMC10364581 DOI: 10.1016/s0140-6736(23)01301-6] [Citation(s) in RCA: 250] [Impact Index Per Article: 250.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
BACKGROUND Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. METHODS Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. FINDINGS In 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8-6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7-9·9]) and, at the regional level, in Oceania (12·3% [11·5-13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1-79·5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1-96·8) of diabetes cases and 95·4% (94·9-95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5-71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5-30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22-1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1-17·6) in north Africa and the Middle East and 11·3% (10·8-11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. INTERPRETATION Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. FUNDING Bill & Melinda Gates Foundation.
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Chaudhary P, Arora KK, Garg S, Patra A, Sahoo SS. Parameters Affecting the Kidney Size in Individuals without Known Renal Pathology: an Ultrasonographic Study. Maedica (Bucur) 2023; 18:222-226. [PMID: 37588837 PMCID: PMC10427100 DOI: 10.26574/maedica.2023.18.2.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Background:Renal size can be affected by various causal elements such as age, sex, and demographic characteristics. It is crucial for medical professionals to consider these factors when making clinical decisions. The purpose of this investigation was to establish normograms for renal measurements and explore their association with the anthropometric variables in the natives of Northern India. Methods:A total of 105 individuals with presumed healthy kidneys were enrolled in the present study. Kidney length, width and parenchymal thickness were measured, and data were analysed to identify potential differences related to age, gender and side. Correlation analysis was conducted to examine the relationship between kidney measurements and body biometrics, including body height, body weight, body mass index (BMI) and body surface area (BSA). Results:Mean values for kidney length, width and parenchymal thickness in the 209 kidneys analysed were as follows: right kidney - length 10.65 ± 1.34 cm, width 4.5 ± 0.42 cm and parenchymal thickness 0.91 ± 0.16 cm; left kidney - length 10.7 ± 1.69 cm, width 4.78 ± 1.26 cm and parenchymal thickness 0.76 ± 0.40 cm. Thickness showed significant differences between the right and left kidneys. No significant differences in renal parameters were found between males and females. Analysis based on age groups revealed an increase in renal length and thickness with advancing age, while width decreased in the middle age group (31-40 years) and then increased. Weak positive correlations were observed between kidney parameters and body height, body weight, BSA, and BMI. Conclusion:Renal parameters can vary among different populations depending on age, demographic characteristics, and ethnicity. Therefore, relying on commonly cited values for renal sonographic interpretation or clinical decision-making may not be appropriate. Interpreting renal measurements should be based on reference data specific to the studied population.
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Affiliation(s)
- Priti Chaudhary
- Department of Anatomy, All India Institute of Medical Sciences, Bathinda, India
| | - Kamal Kumar Arora
- Department of Orthopaedics, Government Medical College, Amritsar, India
| | - Simmi Garg
- Department of Radiodiagnosis, Guru Gobind Singh Medical College, Faridkot
| | - Apurba Patra
- Department of Anatomy, All India Institute of Medical Sciences, Bathinda, India
| | - Soumya Swaroop Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
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Gupta M, Kankaria A, Sahoo SS, Bhatnagar S, Kakkar R, Grewal A, Pruthi G, Goyal LD. Comprehensive coordinated community based palliative care (C3PaC) model for cancer patients in North India: a mixed-method implementation research study protocol. BMC Palliat Care 2023; 22:61. [PMID: 37217912 DOI: 10.1186/s12904-023-01184-7] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Cancer remains an escalating and challenging public health issue. The management, especially palliative care (PC), is disintegrated and out of reach of in need patients. The overall aim of the project is to develop a feasible and scalable Comprehensive Coordinated Community based PC model for Cancer Patients (C3PaC); congruent with socio-cultural, context and unmet needs in north India. METHODS A mixed method approach will be used for three-phased pre- and post-intervention study in one of the districts of North India, having a high incidence of cancer. During phase I, validated tools will be used for quantitative assessment of palliative needs among cancer patients and their caregivers. Barriers and challenges for provision of palliative care will be explored using in-depth interviews and focus group discussions among participants and health care workers. The findings of phase I along with inputs from national experts and literature review will provide inputs for the development of the C3PAC model in phase II. During phase III C3PAC model will be deployed over a period of 12 months and its impact assessed. Categorical and continuous variables will be depicted as frequency (percentages) and mean ± SD/median (IQR) respectively. Chi-square test/Fischer test, independent samples Student t-tests and Mann-Whitney U tests will be used for categorical, normally and non-normally distributed continuous variables, respectively. Qualitative data will be analyzed using thematic analysis using Atlas.ti 8 software. DISCUSSION The proposed model is designed to address the unmet palliative care needs, to empower community-based healthcare providers in comprehensive home-based PC and to improve the quality of life of cancer patients and caregivers. This model will provide pragmatic scalable solutions in comparable health systems particularly in low- and lower-middle Income countries. TRIAL REGISTRATION The study has been registered with the Clinical Trial Registry-India (CTRI/2023/04/051357).
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Affiliation(s)
- Mayank Gupta
- Department of Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Punjab, India.
| | - Ankita Kankaria
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | - Soumya Swaroop Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | | | - Rakesh Kakkar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | - Anju Grewal
- Department of Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Gegal Pruthi
- Department of Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Lajya Devi Goyal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bathinda, India
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14
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Sahoo SS, Sahoo JR, Taywade M, Patro BK. Quality of life and its determinants among ambulatory diabetic patients attending NCD prevention clinic: A cross sectional study from Eastern India. Clinical Epidemiology and Global Health 2023. [DOI: 10.1016/j.cegh.2023.101275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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15
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Sahoo SS, Parida SP, Singh AK, Palepu S, Sahoo DP, Bhatia V. Decision-making in childhood vaccination: vaccine hesitancy among caregivers of under-5 children from a tertiary care institution in Eastern India. Ther Adv Vaccines Immunother 2023; 11:25151355231152650. [PMID: 36756042 PMCID: PMC9900653 DOI: 10.1177/25151355231152650] [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: 05/19/2022] [Accepted: 01/05/2023] [Indexed: 02/07/2023] Open
Abstract
Background Acceptance of vaccines has been on a decline in recent times, with vaccine hesitancy being listed as one of the top 10 global health threats. This study analysed vaccine hesitancy and belief towards vaccination among caregivers of children aged below 5 years. Methods In this cross-sectional study, 196 caregivers of children aged 6 months to below 5 years who had attended an immunization clinic at a tertiary care institute of Eastern India from March to May 2019 were surveyed. Consecutive sampling was used to recruit eligible study participants. The survey assessed the attitudes of parents towards childhood vaccination by using the Vaccine Hesitancy Scale and their beliefs towards vaccination. Univariate analysis was performed to assess the association of various sociodemographic factors with vaccine hesitancy. Results Among the caregivers, most (48%) mothers were aged 26-35 years, literate and homemakers. Vaccine hesitancy was observed in 9.18% of the participants. Only the age of the child was significantly associated with vaccine hesitancy. Nearly half (48.5%) of the participants were concerned about the serious adverse effects of vaccines, and a third (30.6%) agreed that newer vaccines are associated with higher risks than the older ones. Caregivers felt that vaccines are no longer required for uncommon diseases. Conclusion Concerns regarding vaccine hesitancy are prevalent even among caregivers attending a tertiary care institute. Thus, additional studies are required to assess hesitancy in urban, rural, remote and inaccessible areas. Policymakers ought to conduct periodic assessments and implement necessary remedial measures for the long-term sustenance of the benefits of the national immunization programme.
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Affiliation(s)
| | - Swayam Pragyan Parida
- Department of Community & Family Medicine,
All India Institute of Medical Sciences, Odisha, Bhubaneswar, India
| | - Arvind Kumar Singh
- Department of Community & Family Medicine,
All India Institute of Medical Sciences, Odisha, Bhubaneswar, India
| | - Sarika Palepu
- Department of Community & Family Medicine,
All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Durgesh Prasad Sahoo
- Department of Community & Family Medicine,
All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Vikas Bhatia
- All India Institute of Medical Sciences,
Bibinagar, Telangana, India
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16
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Sahoo SS, Kaur N, Kaur A, Garg S. Lymphadenopathy subsequent to Covishield (ChAdOx1 nCoV-19) Corona virus vaccine: ultrasound findings and clinical implications. Ther Adv Vaccines Immunother 2022; 10:25151355221124018. [PMID: 36133302 PMCID: PMC9482933 DOI: 10.1177/25151355221124018] [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: 04/25/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Post anti-COVID-19 vaccine lymphadenopathies have been recently described in literature, from different parts of the world. Although there have been studies on lymphadenopathy following mRNA vaccines, there is a paucity of studies on lymphadenopathy following inactivated viral vaccines, such as Covishield. Aim In this study, we explored lymphadenopathy subsequent to Covishield vaccine in terms of its various ultrasound parameters in the Indian population. Methods This hospital-based longitudinal study was conducted among 50 adult beneficiaries of Covishield vaccine. Sociodemographic details and relevant clinical history were recorded using a semi-structured performa. Detailed ultrasound (USG) examination of the bilateral axillae was done on the day of vaccination and after 6-12 days post vaccination. Vaccine beneficiaries were evaluated for the presence of any vaccine-associated lymphadenopathy and described the presence, number, size, morphology, cortical thickness, and presence or absence of echogenic hilum. Results Out of total (63) lymph nodes evaluated sonologically, majority (80.9%) of lymph nodes showed the features of benign lymphadenopathy. However, 12.6% (8/63) lymph nodes showed diffusely thickened cortex with preserved central echogenic hilum, 4.76% (3/63) lymph nodes showed eccentric cortical thickness with preserved hilar pattern, while only one lymph node showed diffuse cortical thickening with loss of central echogenic hilum. Conclusion With an increase in vaccination coverage, clinicians are likely to confront increasing cases of vaccine-associated axillary lymphadenopathy. Therefore, they should exercise care, that contemporary anti-COVID-19 vaccination can present an aetiology of axillary lymph nodes with suspicious USG features.
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Affiliation(s)
- Soumya Swaroop Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Navdeep Kaur
- Assistant Professor, Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, 151001, Punjab, India
| | - Amandeep Kaur
- Department of General Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Shivane Garg
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, Punjab, India
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Das M, Verma M, Sahoo SS, Gupta M. Regional Water Availability and WASH Indicators as Predictors of Malnutrition in Under-5 Children: Analysis of the National Family Health Survey, India (2015-16). J Trop Pediatr 2022; 68:6567632. [PMID: 35415753 DOI: 10.1093/tropej/fmac030] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Water, sanitation and hygiene (WASH) practices determine child nutrition in resource-constrained countries and are influenced by regional water availability. We assessed any relationship between malnutrition and WASH practices among under-5 children in India's areas as per water availability. METHODS We did a secondary data analysis of the National Family Health Survey-IV. Stunting, wasting and being underweight were the significant outcomes. Regional water availability, households' source of water, sanitation and disposal of the child stool were the major independent variables. We report the prevalence estimates, bivariate associations and adjusted odds ratio to predict the child's malnutrition per regional water availability after using appropriate sampling weight. RESULTS Of the 186 875 children, 41%, 20% and 36% were stunted, wasted and underweight. Only 26% of children had access to improved drinking water sources, whereas 50.0% were defecating in open. Around 65% of children's stools were disposed of in unhygienic ways. Undernutrition depicted a significant association with independent variables. There were higher chances of stunting with a decrease in regional water availability, unimproved sanitation and unhygienic ways of stool disposal. Wasting was intensified by all these factors, except the safe disposal of stools. CONCLUSIONS WASH indicators exert a protective effect on undernutrition.
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Affiliation(s)
- Milan Das
- Department of Development Studies, International Institute for Population Sciences (IIPS), Mumbai 400088, Maharashtra, India
| | - Madhur Verma
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bathinda 151001, Punjab, India
| | - Soumya Swaroop Sahoo
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bathinda 151001, Punjab, India
| | - Madhu Gupta
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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18
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Jindal HA, Sahoo SS, Jamir L, Kedar A, Sharma S, Bhatt B. Higher coronavirus disease-19 mortality linked to comorbidities: A comparison between low-middle income and high-income countries. J Educ Health Promot 2021; 10:377. [PMID: 34912913 PMCID: PMC8641710 DOI: 10.4103/jehp.jehp_142_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/17/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND Global burden of disease (GBD) provides the estimates of mortality and morbidity, while case fatality rate (CFR) helps in understanding the severity of the disease. People infected with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) with underlying medical conditions have shown higher levels of unfavorable outcomes including mortality. We assessed the association of SARS-CoV-2 CFR with disability-adjusted life years (DALY) of various comorbidities in the low-middle income countries (LMIC) and high-income countries (HIC) to study the relationship of coronavirus disease-19 (COVID-19) mortality with GBDs and to understand the linkage between COVID-19 mortality and comorbidities. MATERIALS AND METHODS This was an ecological study with secondary data analysis comparing the DALY of various morbidities from GBD with CFR of COVID-19. Gross domestic product was the basis of stratifying 177 countries into low-middle income (LMIC) and high-income groups (HIC). The mortality was analyzed using Pearson correlation and linear regression. RESULTS The median global CFR of SARS-CoV-2 was 2.15. The median CFR among LMIC (n = 60) and HIC (n = 117) was 2.01 (0.00-28.20) and 2.29 (0.00-17.26), respectively. The regression analysis found that, in both LMIC and HIC, maternal disorders were associated with higher SARS-CoV-2 CFR, while tuberculosis, mental health disorders, and were associated with lower CFR. Further, in LMIC, musculoskeletal disorders and nutritional deficiencies were associated with higher CFR, while respiratory disorders were associated with lower CFR. CONCLUSIONS SARS-CoV-2 infection appears to be a systemic disease. Individuals with comorbidities, such as maternal disorders, neurological diseases, musculoskeletal disorders, and nutritional deficiencies, have poorer outcomes with COVID-19, leading to higher mortality.
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Affiliation(s)
- Har Ashish Jindal
- Senior Consulatant, Ministry of Health and Family Welfare, New Delhi, India
| | - Soumya Swaroop Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Limalemla Jamir
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Guwahati, Assam, India
| | - Ashwini Kedar
- Senior Consulatant, Ministry of Health and Family Welfare, New Delhi, India
| | - Sugandhi Sharma
- Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhumika Bhatt
- Department of Community Medicine, KD Medical College, Mathura, Uttar Pradesh, India
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19
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Kankaria A, Sahoo SS, Verma M. Awareness regarding the adverse effect of tobacco among adults in India: findings from secondary data analysis of Global Adult Tobacco Survey. BMJ Open 2021; 11:e044209. [PMID: 34183338 PMCID: PMC8240568 DOI: 10.1136/bmjopen-2020-044209] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 06/17/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To quantify the extent of awareness regarding the harmful effects of tobacco among the users (both smoked and smokeless) and non-users in India, and explore the determinants of comprehensive knowledge among the participants of the Global Adult Tobacco Survey (GATS), India. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS The nationally representative GATS I (2009-2010) included 69 296 participants using a multistage sampling method, while GATS II (2015-2016) interviewed 74 037 respondents aged >15 years using a similar sampling method from all the states and union territories in India. PRIMARY AND SECONDARY OUTCOME MEASURES Comprehensive score were derived from nine items that explored awareness regarding the adverse effects of tobacco use among both users and non-users of tobacco in GATS II. Secondary outcome included predictors of awareness regarding adverse effects of tobacco and changes in the awareness compared with the previous round of the survey. RESULTS About 60.2%, 57.5% and 66.5% of the smokers, smokeless tobacco (SLT) users and non-users were aware of the adverse effects of tobacco, respectively. The awareness depicted significant age, gender, marital status, education status, urban-rural, wealth and regional disparities (p<0.05). Intention to quit tobacco use also varied significantly with awareness. Among smokers, awareness was high in those residing in eastern India and the poorest participants. Among SLT users, awareness was more among male participants, those who were poorest and lived in western India. Among non-users, awareness was more among middle-aged, more educated, rich participants of west India. Compared with GATS I, an increase in awareness was observed in GATS II across gender, age groups, residential areas and geographical regions in India. CONCLUSIONS Comprehensive awareness of tobacco's harmful effects is far from desirable among Indian users. We recommend further customised health promotion campaigns to counter the regional disparities, adopt a gender-neutral approach and target adolescents.
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Affiliation(s)
- Ankita Kankaria
- Department of Community & Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India
| | - Soumya Swaroop Sahoo
- Department of Community & Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India
| | - Madhur Verma
- Department of Community & Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India
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Mohanty CR, Bellapukonda S, Mund M, Behera BK, Sahoo SS. Analysis of publication speed of anesthesiology journals: a cross-sectional study. Braz J Anesthesiol 2021; 71:110-115. [PMID: 33731261 PMCID: PMC9373650 DOI: 10.1016/j.bjane.2021.02.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/09/2020] [Accepted: 12/08/2020] [Indexed: 11/29/2022] Open
Abstract
Background Publication speed is one of the critical factors affecting authors’ preference to a journal for manuscript submission. The publication time of submitted manuscripts varies across journals and specialty. Objectives Several bibliometric studies in various fields of medicine, except in anesthesiology, have addressed the issue of publication speed and factors that influence the publication speed. We aimed to identify factors affecting the publication speed of indexed anesthesiology journals. Method Overall, 25 anesthesiology journals indexed in MEDLINE database were retrospectively analyzed for the time required during different stages of publication process. A total of 12 original articles published in the year 2018 were randomly selected from each journal based on the number of issues. Time periods from submission to acceptance and from submission to publication were noted, and their association with impact factor (IF), advanced online publication (AOP), and article processing charges (APCs) were evaluated. Results The median time from submission to acceptance and from submission to publication for the selected journals were 120 (IQR [83-167]) days and 186 (IQR [126-246]) days, respectively. Publication speed was not found to have any correlation with IF and APC. However, journals with AOP required significantly lesser time for publication than those without AOP 138.5 and 240 days, respectively, (p = 0.011). Moreover, the IF of journals with AOP was significantly higher than that of journals without AOP (p = 0.002). Conclusion The study provides an overview of total time required for peer review, acceptance, and publication in indexed anesthesiology journals. Researchers should focus on journals with AOP for expediting the publication process and avoiding publication delays.
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Affiliation(s)
- Chitta Ranjan Mohanty
- All India Institute of Medical Sciences, Department of Trauma and Emergency, Bhubaneswar, India
| | - Snigdha Bellapukonda
- All India Institute of Medical Sciences, Department of Anaesthesiology and Critical Care, Bhubaneswar, India.
| | - Manisha Mund
- All India Institute of Medical Sciences, Department of Anaesthesiology and Critical Care, Bhubaneswar, India
| | - Bikram Kishore Behera
- All India Institute of Medical Sciences, Department of Anaesthesiology and Critical Care, Bhubaneswar, India
| | - Soumya Swaroop Sahoo
- All India Institute of Medical Sciences, Department of Community and Family Medicine, Bathinda, India
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21
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Abstract
BACKGROUND School-going children and adolescents are rarely targeted in nutrition surveys, despite the significant impact of nutritional status on their health, cognition, educational achievements and future economic productivity. The present secondary data analysis evaluated the nutritional status of children and adolescents in the 5-18 years age group. MATERIALS AND METHODS The anthropometric measurements of children and adolescents studying in the government and government-aided schools were collected under the 'Rashtriya Bal Swasthya Karyakram' in the District Fatehgarh Sahib of Punjab, India between March and August 2018. It was analyzed using SPSS version 21. Mean and standard deviation for weight-for-age, height-for-age, body mass index (BMI) for age z-scores were calculated using World Health Organization's Anthro-plus software. RESULTS A total of 897 children's data were included in the study. Out of 352 children in 5-9 years age group, mean weight, height and BMI were 15.7 ± 3.8 kg, 110.7 ± 10.6 cm and 12.7 ± 2.1 kg/m2. About 58.8%, 37.4% and 31.8% of the children were categorized as severely underweight, stunted and thin, respectively. In the 10-18 years age group, mean weight, height and BMI were 30.5 ± 9.5 kg, 140 ± 13.4 cm and 15.2 ± 2.6 kg/m2. Severe stunting was present in 19.4% of adolescents, while 26.9% were severely thin. CONCLUSION Our study depicts a high level of undernutrition in school-going children and adolescents. There is a need to strengthen the nutrition interventions for middle childhood and adolescence period that can help in a healthy transition from childhood to adulthood and break the intergenerational cycle of malnutrition. Lay summaryNational and state-level health-priorities focus mainly on improving the nutrition status of under-5-year children, while the school-going children and adolescents are usually neglected. The present secondary data analysis estimates the burden of malnutrition in school-going children and adolescents. These data were collected under one of India's national health programs that intend to tackle childhood illnesses. Our study depicts a high level of undernutrition in school-going children and adolescents. We found that girls were affected more by malnutrition in middle childhood, i.e. during 5-9 years (both by stunting and thinness) compared to boys. But in middle and late adolescence, males were more stunted and thin compared to females. Programs to support adolescents' nutrition interventions could provide an opportunity for a healthy transition from childhood to adulthood and could be an essential step in breaking the intergenerational cycle of malnutrition.
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Affiliation(s)
| | - Priyanka Sharma
- Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India
| | - Poonam Khanna
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Rachana Srivastava
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Soumya Swaroop Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab 151001, India
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22
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Patra S, Patro BK, Mangaraj M, Sahoo SS. Screening for depression in diabetes in an Indian primary care setting: Is depression related to perceived quality of life? Prim Care Diabetes 2020; 14:709-713. [PMID: 32345555 DOI: 10.1016/j.pcd.2020.03.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 02/18/2020] [Accepted: 03/26/2020] [Indexed: 11/28/2022]
Abstract
AIMS To screen for depression in diabetes and evaluate the contributing factors in a primary care setting in India. To evaluate the relationship of depression with perceived quality of life. METHODS We used convenience sampling method in this cross-sectional study. 388 consecutive patients with type 2 diabetes mellitus were enrolled over a period of one year. 50.3% patients screened positive on Patient Health Questionnaire (PHQ-9) out of which 21.4% reported moderate to severe depression. Male gender, middle age and poor glycaemic control were associated with depression. In stepwise linear regression analysis when depression category was included as an independent variable, significant difference in regression equations were found. Other independent variables which were included in regression equation were age, education, gender, income lifestyle, glycosylated haemoglobin and Body Mass Index whereas dependent variables were transformed domains of World Health Organization Quality of Life questionnaire. RESULTS There is high prevalence of depression in primary care in type 2 diabetes patients in this Indian setting. Depression was strongly associated with all four domains of quality of life. Highest association with depression was seen in Physical domain (β -0.385, p = 0.000) followed by Social domain (β -0.372, p = 0.000). CONCLUSIONS High prevalence of depression and its association with poor quality of life indicates need for improved recognition of depression for improving diabetes outcomes in this centre.
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Affiliation(s)
- Suravi Patra
- Department of Psychiatry, All India Institute of Medical Sciences Bhubaneswar, Odisha, India.
| | - Binod Kumar Patro
- Department of Community & Family Medicine, All India Institute of Medical Sciences Bhubaneswar, Odisha, India.
| | - Manaswini Mangaraj
- Department of Biochemistry, All India Institute of Medical Sciences Bhubaneswar, Odisha, India.
| | - Soumya Swaroop Sahoo
- Department of Community & Family Medicine, All India Institute of Medical Sciences Bhubaneswar, Odisha, India.
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23
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Jain M, Radhakrishnan RV, Mohanty CR, Behera S, Singh AK, Sahoo SS, Guru S, Barik S. Clinicoepidemiological profile of trauma patients admitting to the emergency department of a tertiary care hospital in eastern India. J Family Med Prim Care 2020; 9:4974-4979. [PMID: 33209831 PMCID: PMC7652149 DOI: 10.4103/jfmpc.jfmpc_621_20] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/10/2020] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
Context: Trauma is an immediate cause of patients flowing to the emergency department of any hospital. Besides epidemiology, clinical profile and treatment strategy forms an important aspect to reflect the gap in the existing public sector health-care system and the requirement. Aims: To evaluate the clinicoepidemiological profile of trauma patients admitting to an apex trauma hospital in east India. Settings and Design: A prospective observational study was performed during the time period of December 2018 to July 2019 on trauma patients admitted to the Trauma and Emergency department. Methods and Material: Patient's demographic profile, injury type, mechanism, the vehicle involved in the accident, and transportation were recorded. Various trauma scores (clinical) and outcome measures were recorded. Statistical Analysis Used: Statistical analysis was done by R version 3.6.1. Results: Male: female ratio was 407:93 with the 21–30 age group predominantly. 2–6 PM was the most common time of injury and ambulance was the predominant mode of transport (58%). Road traffic injury (RTI) accounted for 75% victims; two-wheelers (68%) dominated over others. Thirty percent (drivers 18%, pillion riders 12%) were wearing helmet; 41% were wearing seat belts (drivers 34%, passenger 12%). Twenty-five percent of drivers consumed alcohol. The median ± Interquartile range of injury severity score (ISS), revised trauma and trauma score and injury severity score were 17 (11–26), 7.8 (4.1–7.8), and 98.41 (95.95–99.30), respectively. Extremity injury (54% fractures) and head injury (50%) were the frontrunners in the pattern of injury, with half of the victims were polytrauma (ISS > 15). Conclusions: The injury was prominently RTI and the trauma victims/patients were young male drivers on two wheelers. The focus should be directed to make use of safety measures among the youth.
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Affiliation(s)
- Mantu Jain
- Department of Orthopedics, AIIMS, Bhubaneswar, Odisha, India
| | | | | | | | - Arvind Kumar Singh
- Department of Community and Family Medicine, AIIMS, Bhubaneswar, Odisha, India
| | | | - Satyabrata Guru
- Department of Trauma and Emergency, AIIMS, Bhubaneswar, Odisha, India
| | - Sadananda Barik
- Department of Trauma and Emergency, AIIMS, Bhubaneswar, Odisha, India
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Bhatia V, Palepu S, Parida SP, Singh AK, Sahoo SS. Yellow fever vaccination: how much do travelers from Eastern India know? Hum Vaccin Immunother 2020; 16:2151-2155. [PMID: 32412830 PMCID: PMC7553678 DOI: 10.1080/21645515.2020.1757988] [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] [Indexed: 10/25/2022] Open
Abstract
Introduction: International tourism has grown tremendously in the past 2-3 decades in India resulting in exposure of travelers to varied spectrum of diseases prevalent in different parts of the world. Immunization plays a prominent role in protection of the exposed individuals. The objective of the present study was to assess the awareness and knowledge regarding yellow fever and other travel vaccinations amongst travelers of eastern India. Materials and methods: In the present cross-sectional study, participants attending Yellow Fever Vaccination Clinic at All India Institute of Medical Sciences, Bhubaneswar, during August-September 2018 were approached. Newly registered participants aged 15 y and above were interviewed consecutively till the required sample size of 300 was fulfilled. Awareness and knowledge regarding travel vaccinations and their adverse effects were assessed with pretested structured interview schedule. Bivariate and multivariate logistic regressions were done to assess the association of various factors with awareness of travel vaccinations. Results: Among the participants, most of them were males (90.7%), belonged to the age group of 15-45 y (87.3%), married (64.3%), graduates (19%), and were working (78.3%). Most of the participants were traveling to South Africa (85.4%). Only 57.3% participants were aware of any travel vaccinations. Only 37.5% participants knew that yellow fever vaccine confers lifelong immunity. On multivariate logistic regression higher education, working occupation and history of previous vaccination were significantly associated with awareness of travel vaccinations. Conclusion: Awareness regarding travel vaccinations is important to prevent fatal diseases like yellow fever. Vital information pertaining to diseases in different locations and availability of vaccines for prevention needs to be disseminated to the travelers to prevent occurrence of travel bound diseases.
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Affiliation(s)
- Vikas Bhatia
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences , Bhubaneswar, India
| | - Sarika Palepu
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences , Bhubaneswar, India.,Department of Community Medicine, VCSG Govt. Medical Science and Research Institute , Srinagar, India
| | - Swayam Pragyan Parida
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences , Bhubaneswar, India
| | - Arvind Kumar Singh
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences , Bhubaneswar, India
| | - Soumya Swaroop Sahoo
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences , Bhubaneswar, India
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Verma M, Sharma P, Ranjan S, Sahoo SS, Aggarwal R, Mehta K, Tariq R, Kanwale S, Sk SK, Mittal A, Das A, Galhotra A. The perspective of our future doctors towards organ donation: a national representative study from India. Int J Adolesc Med Health 2020; 34:197-204. [PMID: 32866116 DOI: 10.1515/ijamh-2020-0041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/28/2020] [Indexed: 11/15/2022]
Abstract
Introduction Timely donation of organs has helped many get a new life. But in India, the pace of Organ Donation and Transplant (ODT) has been disturbingly sluggish. There is a wide gap between patients who need transplants and the organs that are available in India. Doctors can play a pertinent role in decreasing this gap. Therefore, the present study was done to assess the knowledge, attitude, and perception of the medical students in India regarding Organ Donation (OD). Material and Methods A cross-sectional study was carried out among the undergraduate students (n=1463) in 10 different medical colleges across the country. Data were collected electronically through Google forms by using a pre-designed, semi-structured, self-administered questionnaire. Results About 65% of students had a positive attitude regarding ODT. Most of the students acknowledged that Internet sources (57.7%) and print media (46.5%) played a significant role in their awareness. 83% of the students felt that there is a need for effective laws to regulate the process of ODT. It was encouraging that most of the students (69.6%) were not biased for the type of recipients for the organ. Conclusion In the face of acute shortage of donated organs in India, the medical students can be the torchbearers of a positive change. Topics on ODT should be stressed in the initial years and during the early clinical exposure through rapid implementation of the revised Medical curriculum. They can motivate the general public and patients during their routine interactions to make this idea more accessible and acceptable.
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Affiliation(s)
- Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, India.,Department of Community Medicine, Kalpana Chawla Government Medical College, Karnal, India
| | - Priyanka Sharma
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Sneha Ranjan
- Department of Community Medicine, ESI Medical college, Faridabad, India
| | - Soumya Swaroop Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, India
| | - Ramnika Aggarwal
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, India
| | - Kedar Mehta
- Department of Community Medicine, GMERS Medical College, Vadodara, India
| | | | - Suchita Kanwale
- Department of Community Medicine, Mallareddy Institute of Medical College, Hyderabad, India
| | - Shashi Kantha Sk
- Department of Community Medicine and RNTCP Nodal Officer, Adichunchanagiri Institute of Medical Sciences, Mandya, India
| | - Anshu Mittal
- Department of Community Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, India
| | - Anupi Das
- Department of Physiology, Jorhat Medical College, Jorhat, India
| | - Abhiruchi Galhotra
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhatisgarh, India
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Sahoo SS, Sahu DP, Kankaria A. Mis-infodemic: The Achilles' heel in combating the COVID-19 pandemic in an Indian perspective. Monaldi Arch Chest Dis 2020; 90. [PMID: 32498502 DOI: 10.4081/monaldi.2020.1405] [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: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 11/23/2022] Open
Abstract
In this ongoing SARS-CoV2 Corona virus pandemic, we are witnessing an uninhibited spread of mis-information on various social media platforms. This spread of mis-information or "mis-infodemic" is playing a negative role in our fight against the virus with far reaching consequences. International organizations like the WHO and other governmental organizations have geared up to the occasion to limit the spread of these and bring clarity in this context. In this time of crisis, risk communication is vital in the communication between organizations/government and the people. But apart from the organizations, the onus is on the people and media to realise the importance and verify the authenticity of information being circulated. It is imperative that information, being a double edged sword, is handled with caution and effective communication strategies are devised for the dissemination of accurate and scientific health related information. Social media can be used in a constructive way in mitigating the effects of this pandemic for the betterment of the society.
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Affiliation(s)
- Soumya Swaroop Sahoo
- Department of Community Medicine and Family Medicine, All India Institute of medical Sciences, Bathinda.
| | - Dinesh Prasad Sahu
- Department of Community Medicine and Family Medicine, All India Institute of medical Sciences, Bhubaneswar.
| | - Ankita Kankaria
- Department of Community Medicine and Family Medicine, All India Institute of medical Sciences, Bathinda.
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Sahoo SS, Patro BK. Padma Awards in the field of medicine: A shift in the right direction-from super-specialists to public health practitioners. Natl Med J India 2019; 31:188-190. [PMID: 31044774 DOI: 10.4103/0970-258x.255772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Soumya Swaroop Sahoo
- Department of Community Medicine and Family Medicine, Academic Block Level 3 All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Binod Kumar Patro
- Department of Community Medicine and Family Medicine, Academic Block Level 3 All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Giri PP, Tripathy D, Sahoo SS, Bhatia V. Prevalence and Correlates of Substance Use in rural Bhubaneswar – A Community based Cross sectional Study. Indian J Community Health 2019. [DOI: 10.47203/ijch.2019.v31i01.015] [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: 11/27/2022]
Abstract
Background: Substance use is an ever-increasing public health problem in the Indian society. Besides being a personal health risk, it is also a social and economic issue. The present study was undertaken to find out the prevalence and pattern of substance use in rural Bhubaneswar, Odisha. Material & Methods: A cross sectional community-based study was undertaken in rural Bhubaneswar in two phases, a pre survey qualitative assessment followed by the quantitative assessment. The prevalence, pattern and habit of use of different psychoactive substances were accessed using a predesigned pretested questionnaire among 574 study participants of greater than ten years of age. Results: The prevalence of use of at least one substance was 44.1%. Tobacco (smokeless) was the most commonly used substance followed by alcohol and smoked tobacco. Male gender, age greater than 40 years, joint family and being illiterate were the important predictors of substance use. Conclusions: A predominance of smokeless tobacco consumption was found in our study. Family members’ being the source of introduction in majority of users is a matter of serious concern. Community based intervention strategies can be helpful in targeting the rural population for deaddiction and delivering a social message for curbing the use of harmful substances.
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Bhatia V, Giri PP, Sahoo SS, PS P, Sahu DP. Mass Drug Administration (MDA) for Elimination of Lymphatic Filariasis: Experiences from Nayagarh District of Odisha, India. Indian J Community Health 2018. [DOI: 10.47203/ijch.2018.v30i03.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background: India has adopted MDA strategy for elimination of lymphatic filariasis since 2004. It requires constant efforts on a nationwide scale particularly in the endemic areas for interruption of transmission of this neglected tropical disease. Aims & Objectives: This study aims to assess the coverage and compliance along with factors affecting compliance regarding MDA implementation in Nayagarh district of Odisha. Material & Methods: A cross-sectional descriptive study was conducted in November 2016 for evaluation of filariasis elimination activities carried out in the district. A pre-designed, pre-tested semi-structured interview schedule as per National Vector Borne Disease control Programme (NVBDCP) guidelines was used. A qualitative component was added to determine the perceptions and attitudes of the study population regarding MDA implementation. Data was analysed using simple proportion and percentages. Results: A total 120 households (90 rural and 30 urban) were surveyed, covering a population of 590. Overall coverage rate of study population was found to be 91.47%. The effective coverage rate was 71.1% (77.8% in rural areas and 48.8% in urban areas). The overall coverage compliance gap was 22.2, being higher in urban than rural areas. Conclusion: There is a felt need for health education activities to increase acceptance among the population coupled with supervised on the spot consumption of DEC for decreasing the coverage compliance gap. The issues regarding compliance need to be addressed for realizing the global target of eliminating lymphatic filariasis by 2020.
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Verma M, Rajput M, Sahoo SS, Kaur N. Neck Circumference: Independent Predictor for Overweight and Obesity in Adult Population. Indian J Community Med 2017; 42:209-213. [PMID: 29184320 PMCID: PMC5682719 DOI: 10.4103/ijcm.ijcm_196_16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/21/2017] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Neck circumference (NC) measurement, an index of upper body fat (BF) distribution, seems promising as a community-based screening measure for overweight and obesity in want of evidence on its validity as a screener. OBJECTIVE The objective of this study was to determine the validity of NC as a screener for overweight and obesity in adults in community settings against BF percentage (BF%). MATERIALS AND METHODS This cross-sectional community-based study involved data collection on a predesigned, pretested, and semi-structured schedule that included the sociodemographic characteristics and anthropometric measurements of respondents. RESULTS NC correlated positively with body weight, waist circumference, and hip circumference. NC was found to have good discriminatory power with cutoff values of 36.55 cm for males and 34.05 cm for females, with maximum sensitivity and specificity to predict overweight and obesity in comparison to direct BF% estimation on receiver operating characteristic analysis. CONCLUSION NC has a fair validity as a community-based screener for overweight and obese individuals in the study context. Further studies may be carried out to explore the generalizability of this observation.
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Affiliation(s)
- Madhur Verma
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India
| | - Meena Rajput
- Department of Community Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Soumya Swaroop Sahoo
- Department of Community Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
- Department of Community Medicine and Family Medicine, AIIMS, Bhubaneswar, Odisha, India
| | - Navjot Kaur
- Department of ENT, PGIMER, Chandigarh, India
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Verma M, Rajput M, Sahoo SS, Kaur N, Rohilla R. Correlation between the percentage of body fat and surrogate indices of obesity among adult population in rural block of Haryana. J Family Med Prim Care 2016; 5:154-9. [PMID: 27453862 PMCID: PMC4943124 DOI: 10.4103/2249-4863.184642] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION The increasing prevalence of overweight and obesity has raised concerns regarding the importance of different techniques, which are used to assess body growth composition that can be used at the level of primary health care settings with minimal knowledge. The purpose of this study was to evaluate the relationship between different surrogate indices of fatness (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR], and body fat percentage [BF%]) with the percentage of body fat and their usefulness as a predictor of obesity among adult population. MATERIALS AND METHODS The community-based cross-sectional study done over a period of 1-year involved 1080 adult participants from a rural area in Haryana. Anthropometry, along with BF% (using hand held analyzer) were recorded using standard procedures. RESULTS The prevalence of overweight and obesity as per the modified criteria of BMI for the Asian Indians was found to be 15.0% and 34.6%, respectively. Positive correlation was seen among all the indices except between the WHR and body adiposity index (BAI) using Pearson's correlation analysis. Maximum correlation was seen between WHtR and WC (r = 0.923), whereas WHtR depicted maximum correlation (r = 0.810) with BF%. Receiver operating characteristic curve analysis revealed that the WHtR was the most sensitive and specific indicator for the study population to predict overweight and obesity comparable to that calculated by body fat analyser followed by BAI, BMI, and WHR. CONCLUSION A single value of WHtR irrespective of gender and the area of residence can be used as a universal screening tool for the identification of individuals at high risk of development of metabolic complications.
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Affiliation(s)
- Madhur Verma
- Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Meena Rajput
- Department of Community Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | | | - Navjot Kaur
- Department of ENT, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ravi Rohilla
- Department of Community Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
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Abstract
Cervical cancer is the second most common cancer among women worldwide, with about 493,000 new cases diagnosed annually. Of 274,000 deaths due to cervical cancer each year, more than 80% occur in developing countries, and this proportion is expected to increase to 90% by 2020. Up to 70% of sexually active women will become infected with human papilloma virus (HPV) during their lifetime. Even though screening reduces the risk of cervical cancer, it does not prevent HPV infection or development of precancerous lesions which need careful follow-up and often need excision. It was observed in a study, pre-adolescent vaccination alone reduced cancer incidence by 44% and was more effective than screening alone. A combined approach of pre-adolescent vaccination and screening of adult women was more effective than either alone. The high probability of acquiring HPV infection once, one has become sexually active raises the question of whether the vaccine will be effective if given to girls who have already been infected with HPV type 16 or 18. In April 2010, The Indian parliament's Standing Committee on Health, began probing the use of HPV vaccines in 2 states after the reported deaths of 7 girls, and concluded that "safety and rights of children were highly compromised and violated." Though the question of immunization of older girls and women deserves attention, from a public health perspective, the first priority in resource-poor settings would be to vaccinate young adolescent girls.
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Affiliation(s)
- Sumit Chawla
- a Department of Community Medicine; MMMC ; Solan , Himachal Pradesh , India
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Chawla S, Sahoo SS, Singh I, Verma M, Gupta V, Kumari S. Dengue vaccine: Come let's fight the menace. Hum Vaccin Immunother 2015; 11:474-6. [DOI: 10.4161/21645515.2014.981077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Chawla S, Singh I, Jain RB, Khanna P, Mehta B, Sahoo SS. High time!!! Hold hands against hypertension. Int J Prev Med 2014; 5:133-7. [PMID: 24627737 PMCID: PMC3950733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 10/22/2013] [Indexed: 11/09/2022] Open
Affiliation(s)
- Sumit Chawla
- Department of Community Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India,Correspondence to: Dr. Sumit Chawla, House No. 3, Sector 15-A, Chandigarh - 160 015, India. E-mail:
| | - Inderjeet Singh
- Department of Community Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Ram Bilas Jain
- Department of Community Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Pardeep Khanna
- Department of Community Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Bharti Mehta
- Department of Community Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
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Abstract
Getting to zero: zero new HIV infections, zero deaths from AIDS-related illness, zero discrimination is the theme of World AIDS Day 2012. Given the spread of the epidemic today, getting to zero may sound difficult, but significant progress is underway. The total annual loss for the entire country due to HIV is 7% of GDP, which exceeds India's annual health expenditure in 2004. The additional loss due to loss of labor income and increased medical expenditure as measured by the external transfers, account for 5% of the country's health expenditure and 0.23% of GDP. Given that the HIV incidence rate is only 0.27% in India, these losses are quite staggering. Despite the remarkable achievements in development of anti-retroviral therapies against HIV and the recent advances in new prevention technologies, the rate of new HIV infections continue to outpace efforts on HIV prevention and control. Thus, the development of a safe and effective vaccine for prevention and control of AIDS remains a global public health priority and the greatest opportunity to eventually end the AIDS pandemic.
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Affiliation(s)
- Sumit Chawla
- 1Department of Community Medicine; PGIMS; Rohtak, Haryana, India
| | | | - Rambilas Jain
- 1Department of Community Medicine; PGIMS; Rohtak, Haryana, India
| | - Pardeep Khanna
- 1Department of Community Medicine; PGIMS; Rohtak, Haryana, India
| | - Bharti Mehta
- 1Department of Community Medicine; PGIMS; Rohtak, Haryana, India
| | - Inderjeet Singh
- 1Department of Community Medicine; PGIMS; Rohtak, Haryana, India
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