1
|
Ferrari AJ, Santomauro DF, Aali A, Abate YH, Abbafati C, Abbastabar H, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdollahi A, Abdullahi A, Abegaz KH, Abeldaño Zuñiga RA, Aboagye RG, Abolhassani H, Abreu LG, Abualruz H, Abu-Gharbieh E, Abu-Rmeileh NME, Ackerman IN, Addo IY, Addolorato G, Adebiyi AO, Adepoju AV, Adewuyi HO, Afyouni S, Afzal S, Afzal S, Agodi A, Ahmad A, Ahmad D, Ahmad F, Ahmad S, Ahmed A, Ahmed LA, Ahmed MB, Ajami M, Akinosoglou K, Akkaif MA, Al Hasan SM, Alalalmeh SO, Al-Aly Z, Albashtawy M, Aldridge RW, Alemu MD, Alemu YM, Alene KA, Al-Gheethi AAS, Alharrasi M, Alhassan RK, Ali MU, Ali R, Ali SSS, Alif SM, Aljunid SM, Al-Marwani S, Almazan JU, Alomari MA, Al-Omari B, Altaany Z, Alvis-Guzman N, Alvis-Zakzuk NJ, Alwafi H, Al-Wardat MS, Al-Worafi YM, Aly S, Alzoubi KH, Amare AT, Amegbor PM, Ameyaw EK, Amin TT, Amindarolzarbi A, Amiri S, Amugsi DA, Ancuceanu R, Anderlini D, Anderson DB, Andrade PP, Andrei CL, Ansari H, Antony CM, Anwar S, Anwar SL, Anwer R, Anyanwu PE, Arab JP, Arabloo J, Arafat M, Araki DT, Aravkin AY, Arkew M, Armocida B, Arndt MB, Arooj M, Artamonov AA, Aruleba RT, Arumugam A, Ashbaugh C, Ashemo MY, Ashraf M, Asika MO, Askari E, Astell-Burt T, Athari SS, Atorkey P, Atout MMW, Atreya A, Aujayeb A, Ausloos M, Avan A, Awotidebe AW, Awuviry-Newton K, Ayala Quintanilla BP, Ayuso-Mateos JL, Azadnajafabad S, Azevedo RMS, Babu AS, Badar M, Badiye AD, Baghdadi S, Bagheri N, Bah S, Bai R, Baker JL, Bakkannavar SM, Bako AT, Balakrishnan S, Bam K, Banik PC, Barchitta M, Bardhan M, Bardideh E, Barker-Collo SL, Barqawi HJ, Barrow A, Barteit S, Barua L, Bashiri Aliabadi S, Basiru A, Basu S, Basu S, Bathini PP, Batra K, Baune BT, Bayileyegn NS, Behnam B, Behnoush AH, Beiranvand M, Bejarano Ramirez DF, Bell ML, Bello OO, Beloukas A, Bensenor IM, Berezvai Z, Bernabe E, Bernstein RS, Bettencourt PJG, Bhagavathula AS, Bhala N, Bhandari D, Bhargava A, Bhaskar S, Bhat V, Bhatti GK, Bhatti JS, Bhatti MS, Bhatti R, Bhutta ZA, Bikbov B, Bishai JD, Bisignano C, Bitra VR, Bjørge T, Bodolica V, Bodunrin AO, Bogale EK, Bonakdar Hashemi M, Bonny A, Bora Basara B, Borhany H, Boxe C, Brady OJ, Bragazzi NL, Braithwaite D, Brant LC, Brauer M, Breitner S, Brenner H, Brown J, Brugha T, Bulamu NB, Buonsenso D, Burkart K, Burns RA, Busse R, Bustanji Y, Butt ZA, Byun J, Caetano dos Santos FL, Calina D, Cámera LA, Campos-Nonato IR, Cao C, Capodici A, Carr S, Carreras G, Carugno A, Carvalho M, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catapano AL, Cattaruzza MS, Caye A, Cegolon L, Cembranel F, Cenderadewi M, Cerin E, Chakraborty PA, Chan JSK, Chan RNC, Chandika RM, Chandrasekar EK, Charalampous P, Chattu VK, Chatzimavridou-Grigoriadou V, Chen AW, Chen AT, Chen CS, Chen H, Chen NM, Cheng ETW, Chimed-Ochir O, Chimoriya R, Ching PR, Cho WCS, Choi S, Chong B, Chong YY, Choudhari SG, Chowdhury R, Christensen SWM, Chu DT, Chukwu IS, Chung E, Chung E, Chutiyami M, Claassens MM, Cogen RM, Columbus A, Conde J, Cortesi PA, Cousin E, Criqui MH, Cruz-Martins N, Dadras O, Dai S, Dai X, Dai Z, Dalaba MA, Damiani G, Das JK, Das S, Dashti M, Dávila-Cervantes CA, Davletov K, De Leo D, Debele AT, Debopadhaya S, DeCleene NK, Deeba F, Degenhardt L, Del Bo' C, Delgado-Enciso I, Demetriades AK, Denova-Gutiérrez E, Dervenis N, Desai HD, Desai R, Deuba K, Dhama K, Dharmaratne SD, Dhingra S, Dias da Silva D, Diaz D, Diaz LA, Diaz MJ, Dima A, Ding DD, Dirac MA, Do THP, do Prado CB, Dohare S, Dominguez RMV, Dong W, Dongarwar D, D'Oria M, Dorsey ER, Doshmangir L, Dowou RK, Driscoll TR, Dsouza HL, Dsouza V, Dube J, Dumith SC, Duncan BB, Duraes AR, Duraisamy S, Durojaiye OC, Dzianach PA, Dziedzic AM, Eboreime E, Ebrahimi A, Edinur HA, Edvardsson D, Eikemo TA, Eini E, Ekholuenetale M, Ekundayo TC, El Sayed I, El Tantawi M, Elbarazi I, Elemam NM, ElGohary GMT, Elhadi M, Elmeligy OAA, ELNahas G, Elshaer M, Elsohaby I, Engelbert Bain L, Erkhembayar R, Eshrati B, Estep K, Fabin N, Fagbamigbe AF, Falzone L, Fareed M, Farinha CSES, Faris MEM, Faro A, Farrokhi P, Fatehizadeh A, Fauk NK, Feigin VL, Feng X, Fereshtehnejad SM, Feroze AH, Ferreira N, Ferreira PH, Fischer F, Flavel J, Flood D, Flor LS, Foigt NA, Folayan MO, Force LM, Fortuna D, Foschi M, Franklin RC, Freitas A, Fukumoto T, Furtado JM, Gaal PA, Gadanya MA, Gaidhane AM, Gaihre S, Galali Y, Ganbat M, Gandhi AP, Ganesan B, Ganie MA, Ganiyani MA, Gardner WM, Gebi TG, Gebregergis MW, Gebrehiwot M, Gebremariam TBB, Gebremeskel TG, Gela YY, Georgescu SR, Getachew Obsa A, Gething PW, Getie M, Ghadiri K, Ghadirian F, Ghailan KY, Ghajar A, Ghasemi M, Ghasempour Dabaghi G, Ghasemzadeh A, Ghazy RM, Gholamrezanezhad A, Ghorbani M, Ghotbi E, Gibson RM, Gill TK, Ginindza TG, Girmay A, Glasbey JC, Göbölös L, Godinho MA, Goharinezhad S, Goldust M, Golechha M, Goleij P, Gona PN, Gorini G, Goulart AC, Grada A, Grivna M, Guan SY, Guarducci G, Gubari MIM, Gudeta MD, Guha A, Guicciardi S, Gulati S, Gulisashvili D, Gunawardane DA, Guo C, Gupta AK, Gupta B, Gupta I, Gupta M, Gupta R, Gupta VB, Gupta VK, Gupta VK, Gutiérrez RA, Habibzadeh F, Habibzadeh P, Haddadi R, Hadi NR, Haep N, Hafezi-Nejad N, Hafiz A, Hagins H, Halboub ES, Halimi A, Haller S, Halwani R, Hamilton EB, Hankey GJ, Hannan MA, Haque MN, Harapan H, Haro JM, Hartvigsen J, Hasaballah AI, Hasan I, Hasanian M, Hasnain MS, Hassan A, Haubold J, Havmoeller RJ, Hay SI, Hayat K, Hebert JJ, Hegazi OE, Heidari G, Helfer B, Hemmati M, Hendrie D, Henson CA, Hezam K, Hiraike Y, Hoan NQ, Holla R, Hon J, Hossain MM, Hosseinzadeh H, Hosseinzadeh M, Hostiuc M, Hostiuc S, Hsu JM, Huang J, Hugo FN, Hushmandi K, Hussain J, Hussein NR, Huynh CK, Huynh HH, Hwang BF, Iannucci VC, Ihler AL, Ikiroma AI, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Imam MT, Immurana M, Irham LM, Islam MR, Islam SMS, Islami F, Ismail F, Ismail NE, Isola G, Iwagami M, Iwu CCD, Iyer M, Jaafari J, Jacobsen KH, Jadidi-Niaragh F, Jafarinia M, Jaggi K, Jahankhani K, Jahanmehr N, Jahrami H, Jain A, Jain N, Jairoun AA, Jaiswal A, Jakovljevic M, Jatau AI, Javadov S, Javaheri T, Jayapal SK, Jayaram S, Jee SH, Jeganathan J, Jeyakumar A, Jha AK, Jiang H, Jin Y, Jonas JB, Joo T, Joseph A, Joseph N, Joshua CE, Jozwiak JJ, Jürisson M, K V, Kaambwa B, Kabir A, Kabir Z, Kadashetti V, Kalani R, Kalankesh LR, Kaliyadan F, Kalra S, Kamenov K, Kamyari N, Kanagasabai T, Kandel H, Kanmanthareddy AR, Kanmodi KK, Kantar RS, Karaye IM, Karim A, Karimi SE, Karimi Y, Kasraei H, Kassel MB, Kauppila JH, Kawakami N, Kayode GA, Kazemi F, Kazemian S, Keikavoosi-Arani L, Keller C, Kempen JH, Kerr JA, Keshtkar K, Kesse-Guyot E, Keykhaei M, Khajuria H, Khalaji A, Khalid A, Khalid N, Khalilian A, Khamesipour F, Khan A, Khan I, Khan M, Khan MAB, Khanmohammadi S, Khatab K, Khatami F, Khatatbeh MM, Khater AM, Khayat Kashani HR, Khidri FF, Khodadoust E, Khormali M, Khorrami Z, Kifle ZD, Kim MS, Kimokoti RW, Kisa A, Kisa S, Knudsen AKS, Kocarnik JM, Kochhar S, Koh HY, Kolahi AA, Kompani F, Koren G, Korzh O, Kosen S, Koulmane Laxminarayana SL, Krishan K, Krishna V, Krishnamoorthy V, Kuate Defo B, Kuddus MA, Kuddus M, Kuitunen I, Kulkarni V, Kumar M, Kumar N, Kumar R, Kurmi OP, Kusuma D, Kyu HH, La Vecchia C, Lacey B, Ladan MA, Laflamme L, Lafranconi A, Lahariya C, Lai DTC, Lal DK, Lalloo R, Lallukka T, Lám J, Lan Q, Lan T, Landires I, Lanfranchi F, Langguth B, Laplante-Lévesque A, Larijani B, Larsson AO, Lasrado S, Lauriola P, Le HH, Le LKD, Le NHH, Le TDT, Leasher JL, Ledda C, Lee M, Lee PH, Lee SW, Lee SW, Lee WC, Lee YH, LeGrand KE, Lenzi J, Leong E, Leung J, Li MC, Li W, Li X, Li Y, Li Y, Lim LL, Lim SS, Lindstrom M, Linn S, Liu G, Liu R, Liu S, Liu W, Liu X, Liu X, Llanaj E, Lo CH, López-Bueno R, Loreche AM, Lorenzovici L, Lozano R, Lubinda J, Lucchetti G, Lunevicius R, Lusk JB, lv H, Ma ZF, Machairas N, Madureira-Carvalho ÁM, Magaña Gómez JA, Maghazachi AA, Maharjan P, Mahasha PW, Maheri M, Mahjoub S, Mahmoud MA, Mahmoudi E, Majeed A, Makris KC, Malakan Rad E, Malhotra K, Malik AA, Malik I, Malta DC, Manla Y, Mansour A, Mansouri P, Mansournia MA, Mantilla Herrera AM, Mantovani LG, Manu E, Marateb HR, Mardi P, Martinez G, Martinez-Piedra R, Martini D, Martins-Melo FR, Martorell M, Marx W, Maryam S, Marzo RR, Mathangasinghe Y, Mathieson S, Mathioudakis AG, Mattumpuram J, Maugeri A, Mayeli M, Mazidi M, Mazzotti A, McGrath JJ, McKee M, McKowen ALW, McPhail MA, Mehrabani-Zeinabad K, Mehrabi Nasab E, Mekene Meto T, Mendoza W, Menezes RG, Mensah GA, Mentis AFA, Meo SA, Meresa HA, Meretoja A, Meretoja TJ, Mersha AM, Mestrovic T, Mettananda KCD, Mettananda S, Michalek IM, Miller PA, Miller TR, Mills EJ, Minh LHN, Mirijello A, Mirrakhimov EM, Mirutse MK, Mirza-Aghazadeh-Attari M, Mirzaei M, Mirzaei R, Misganaw A, Mishra AK, Mitchell PB, Mittal C, Moazen B, Moberg ME, Mohamed J, Mohamed MFH, Mohamed NS, Mohammadi E, Mohammadi S, Mohammed H, Mohammed S, Mohammed S, Mohr RM, Mokdad AH, Molinaro S, Momtazmanesh S, Monasta L, Mondello S, Moodi Ghalibaf A, Moradi M, Moradi Y, Moradi-Lakeh M, Moraga P, Morawska L, Moreira RS, Morovatdar N, Morrison SD, Morze J, Mosapour A, Mosser JF, Mossialos E, Motappa R, Mougin V, Mouodi S, Mrejen M, Msherghi A, Mubarik S, Mueller UO, Mulita F, Munjal K, Murillo-Zamora E, Murlimanju BV, Mustafa G, Muthu S, Muzaffar M, Myung W, Nagarajan AJ, Naghavi P, Naik GR, Nainu F, Nair S, Najmuldeen HHR, Nangia V, Naqvi AA, Narayana AI, Nargus S, Nascimento GG, Nashwan AJ, Nasrollahizadeh A, Nasrollahizadeh A, Natto ZS, Nayak BP, Nayak VC, Nduaguba SO, Negash H, Negoi I, Negoi RI, Nejadghaderi SA, Nesbit OD, Netsere HB, Ng M, Nguefack-Tsague G, Ngunjiri JW, Nguyen DH, Nguyen HQ, Niazi RK, Nikolouzakis TK, Nikoobar A, Nikoomanesh F, Nikpoor AR, Nnaji CA, Nnyanzi LA, Noman EA, Nomura S, Norrving B, Nri-Ezedi CA, Ntaios G, Ntsekhe M, Nurrika D, Nzoputam CI, Nzoputam OJ, Oancea B, Odetokun IA, O'Donnell MJ, Oguntade AS, Oguta JO, Okati-Aliabad H, Okeke SR, Okekunle AP, Okonji OC, Olagunju AT, Olasupo OO, Olatubi MI, Oliveira GMM, Olufadewa II, Olusanya BO, Olusanya JO, Omar HA, Omer GL, Omonisi AEE, Onie S, Onwujekwe OE, Ordak M, Orish VN, Ortega-Altamirano DV, Ortiz A, Ortiz-Brizuela E, Osman WMS, Ostroff SM, Osuagwu UL, Otoiu A, Otstavnov N, Otstavnov SS, Ouyahia A, Ouyang G, Owolabi MO, P A MP, Padron-Monedero A, Padubidri JR, Palicz T, Palladino C, Pan F, Pandi-Perumal SR, Pangaribuan HU, Panos GD, Panos LD, Pantea Stoian AM, Pardhan S, Parikh RR, Pashaei A, Pasovic M, Passera R, Patel J, Patel SK, Patil S, Patoulias D, Patthipati VS, Pawar S, Pazoki Toroudi H, Pease SA, Peden AE, Pedersini P, Peng M, Pensato U, Pepito VCF, Peprah EK, Peprah P, Perdigão J, Pereira MO, Perianayagam A, Perico N, Pesudovs K, Petermann-Rocha FE, Petri WA, Pham HT, Philip AK, Phillips MR, Pigeolet M, Pigott DM, Pillay JD, Piracha ZZ, Pirouzpanah S, Plass D, Plotnikov E, Poddighe D, Polinder S, Postma MJ, Pourtaheri N, Prada SI, Pradhan PMS, Prakash V, Prasad M, Prates EJS, Priscilla T, Pritchett N, Puri P, Puvvula J, Qasim NH, Qattea I, Qazi AS, Qian G, Rabiee Rad M, Radhakrishnan RA, Radhakrishnan V, Raeisi Shahraki H, Rafferty Q, Raggi A, Raghav PR, Rahim MJ, Rahman MM, Rahman MHU, Rahman M, Rahman MA, Rahmani S, Rahmanian M, Rahmawaty S, Rajaa S, Ramadan MM, Ramasamy SK, Ramasubramani P, Ramazanu S, Rana K, Ranabhat CL, Rancic N, Rane A, Rao CR, Rao K, Rao M, Rao SJ, Rashidi MM, Rathnaiah Babu G, Rauniyar SK, Rawaf DL, Rawaf S, Razo C, Reddy MMRK, Redwan EMM, Reifels L, Reiner Jr RC, Remuzzi G, Renzaho AMN, Reshmi B, Reyes LF, Rezaei N, Rezaei N, Rezaei N, Rezaei Hachesu P, Rezaeian M, Rickard J, Rodrigues CF, Rodriguez JAB, Roever L, Ronfani L, Roshandel G, Rotimi K, Rout HS, Roy B, Roy N, Roy P, Rubagotti E, S N C, Saad AMA, Saber-Ayad MM, Sabour S, Sacco S, Sachdev PS, Saddik B, Saddler A, Sadee BA, Sadeghi E, Sadeghi M, Saeb MR, Saeed U, Safi SZ, Sagar R, Sagoe D, Saif Z, Sajid MR, Sakshaug JW, Salam N, Salami AA, Salaroli LB, Saleh MA, Salem MR, Salem MZY, Sallam M, Samadzadeh S, Samargandy S, Samodra YL, Samy AM, Sanabria J, Sanna F, Santos IS, Santric-Milicevic MM, Sarasmita MA, Sarikhani Y, Sarmiento-Suárez R, Sarode GS, Sarode SC, Sarveazad A, Sathian B, Sathyanarayan A, Satpathy M, Sawhney M, Scarmeas N, Schaarschmidt BM, Schmidt MI, Schneider IJC, Schumacher AE, Schwebel DC, Schwendicke F, Sedighi M, Senapati S, Senthilkumaran S, Sepanlou SG, Sethi Y, Setoguchi S, Seylani A, Shadid J, Shafie M, Shah H, Shah NS, Shah PA, Shahbandi A, Shahid S, Shahid W, Shahwan MJ, Shaikh MA, Shakeri A, Shalash AS, Sham S, Shamim MA, Shamshirgaran MA, Shamsi MA, Shanawaz M, Shankar A, Shannawaz M, Sharath M, Sharifan A, Sharifi-Rad J, Sharma M, Sharma R, Sharma S, Sharma U, Sharma V, Shastry RP, Shavandi A, Shayan AM, Shayan M, Shehabeldine AME, Shetty PH, Shibuya K, Shifa JE, Shiferaw D, Shiferaw WS, Shigematsu M, Shiri R, Shitaye NA, Shittu A, Shivakumar KM, Shivarov V, Shokati Eshkiki Z, Shool S, Shrestha S, Shuval K, Sibhat MM, Siddig EE, Sigfusdottir ID, Silva DAS, Silva JP, Silva LMLR, Silva S, Simpson CR, Singal A, Singh A, Singh BB, Singh H, Singh JA, Singh M, Singh P, Skou ST, Sleet DA, Slepak ELN, Solanki R, Soliman SSM, Song S, Song Y, Sorensen RJD, Soriano JB, Soyiri IN, Spartalis M, Sreeramareddy CT, Stark BA, Starodubova AV, Stein C, Stein DJ, Steiner C, Steiner TJ, Steinmetz JD, Steiropoulos P, Stockfelt L, Stokes MA, Subedi NS, Subramaniyan V, Suemoto CK, Suleman M, Suliankatchi Abdulkader R, Sultana A, Sundström J, Swain CK, Szarpak L, Tabaee Damavandi P, Tabarés-Seisdedos R, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabche C, Tabish M, Tadakamadla SK, Taheri Abkenar Y, Taheri Soodejani M, Taherkhani A, Taiba J, Talaat IM, Talukder A, Tampa M, Tamuzi JL, Tan KK, Tandukar S, Tang H, Tavakoli Oliaee R, Tavangar SM, Teimoori M, Temsah MH, Teramoto M, Thangaraju P, Thankappan KR, Thapar R, Thayakaran R, Thirunavukkarasu S, Thomas N, Thomas NK, Thum CCC, Tichopad A, Ticoalu JHV, Tillawi T, Tiruye TY, Tobe-Gai R, Tonelli M, Topor-Madry R, Torre AE, Touvier M, Tovani-Palone MR, Tran JT, Tran MTN, Tran NM, Tran NH, Trico D, Tromans SJ, Truyen TTTT, Tsatsakis A, Tsegay GM, Tsermpini EE, Tumurkhuu M, Tyrovolas S, Udoh A, Umair M, Umakanthan S, Umar TP, Undurraga EA, Unim B, Unnikrishnan B, Unsworth CA, Upadhyay E, Urso D, Usman JS, Vahabi SM, Vaithinathan AG, Van den Eynde J, Varga O, Varma RP, Vart P, Vasankari TJ, Vasic M, Vaziri S, Vellingiri B, Venketasubramanian N, Veroux M, Verras GI, Vervoort D, Villafañe JH, Violante FS, Vlassov V, Vollset SE, Volovat SR, Vongpradith A, Waheed Y, Wang C, Wang F, Wang N, Wang S, Wang Y, Wang YP, Ward P, Wassie EG, Weaver MR, Weerakoon KG, Weintraub RG, Weiss DJ, Weldemariam AH, Wells KM, Wen YF, Whisnant JL, Whiteford HA, Wiangkham T, Wickramasinghe DP, Wickramasinghe ND, Wilandika A, Wilkerson C, Willeit P, Wimo A, Woldegebreal DH, Wolf AW, Wong YJ, Woolf AD, Wu C, Wu F, Wu X, Wu Z, Wulf Hanson S, Xia Y, Xiao H, Xu X, Xu YY, Yadav L, Yadollahpour A, Yaghoubi S, Yamagishi K, Yang L, Yano Y, Yao Y, Yaribeygi H, Yazdanpanah MH, Ye P, Yehualashet SS, Yesuf SA, Yezli S, Yiğit A, Yiğit V, Yigzaw ZA, Yismaw Y, Yon DK, Yonemoto N, Younis MZ, Yu C, Yu Y, Yusuf H, Zahid MH, Zakham F, Zaki L, Zaki N, Zaman BA, Zamora N, Zand R, Zandieh GGZ, Zar HJ, Zarrintan A, Zastrozhin MS, Zhang H, Zhang N, Zhang Y, Zhao H, Zhong C, Zhong P, Zhou J, Zhu Z, Ziafati M, Zielińska M, Zimsen SRM, Zoladl M, Zumla A, Zyoud SH, Vos T, Murray CJL. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00757-8. [PMID: 38642570 DOI: 10.1016/s0140-6736(24)00757-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/07/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
2
|
Naghavi M, Ong KL, Aali A, Ababneh HS, Abate YH, Abbafati C, Abbasgholizadeh R, Abbasian M, Abbasi-Kangevari M, Abbastabar H, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdelwahab A, Abdollahi M, Abdollahifar MA, Abdoun M, Abdulah DM, Abdullahi A, Abebe M, Abebe SS, Abedi A, Abegaz KH, Abhilash ES, Abidi H, Abiodun O, Aboagye RG, Abolhassani H, Abolmaali M, Abouzid M, Aboye GB, Abreu LG, Abrha WA, Abtahi D, Abu Rumeileh S, Abualruz H, Abubakar B, Abu-Gharbieh E, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Accrombessi MMK, Adal TG, Adamu AA, Addo IY, Addolorato G, Adebiyi AO, Adekanmbi V, Adepoju AV, Adetunji CO, Adetunji JB, Adeyeoluwa TE, Adeyinka DA, Adeyomoye OI, Admass BAA, Adnani QES, Adra S, Afolabi AA, Afzal MS, Afzal S, Agampodi SB, Agasthi P, Aggarwal M, Aghamiri S, Agide FD, Agodi A, Agrawal A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad F, Ahmad MM, Ahmad S, Ahmad S, Ahmad T, Ahmadi K, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed LA, Ahmed MS, Ahmed MS, Ahmed MB, Ahmed SA, Ajami M, Aji B, Akara EM, Akbarialiabad H, Akinosoglou K, Akinyemiju T, Akkaif MA, Akyirem S, Al Hamad H, Al Hasan SM, Alahdab F, Alalalmeh SO, Alalwan TA, Al-Aly Z, Alam K, Alam M, Alam N, Al-amer RM, Alanezi FM, Alanzi TM, Al-Azzam S, Albakri A, Albashtawy M, AlBataineh MT, Alcalde-Rabanal JE, Aldawsari KA, Aldhaleei WA, Aldridge RW, Alema HB, Alemayohu MA, Alemi S, Alemu YM, Al-Gheethi AAS, Alhabib KF, Alhalaiqa FAN, Al-Hanawi MK, Ali A, Ali A, Ali L, Ali MU, Ali R, Ali S, Ali SSS, Alicandro G, Alif SM, Alikhani R, Alimohamadi Y, Aliyi AA, Aljasir MAM, Aljunid SM, Alla F, Allebeck P, Al-Marwani S, Al-Maweri SAA, Almazan JU, Al-Mekhlafi HM, Almidani L, Almidani O, Alomari MA, Al-Omari B, Alonso J, Alqahtani JS, Alqalyoobi S, Alqutaibi AY, Al-Sabah SK, Altaany Z, Altaf A, Al-Tawfiq JA, Altirkawi KA, Aluh DO, Alvis-Guzman N, Alwafi H, Al-Worafi YM, Aly H, Aly S, Alzoubi KH, Amani R, Amare AT, Amegbor PM, Ameyaw EK, Amin TT, Amindarolzarbi A, Amiri S, Amirzade-Iranaq MH, Amu H, Amugsi DA, Amusa GA, Ancuceanu R, Anderlini D, Anderson DB, Andrade PP, Andrei CL, Andrei T, Angus C, Anil A, Anil S, Anoushiravani A, Ansari H, Ansariadi A, Ansari-Moghaddam A, Antony CM, Antriyandarti E, Anvari D, Anvari S, Anwar S, Anwar SL, Anwer R, Anyasodor AE, Aqeel M, Arab JP, Arabloo J, Arafat M, Aravkin AY, Areda D, Aremu A, Aremu O, Ariffin H, Arkew M, Armocida B, Arndt MB, Ärnlöv J, Arooj M, Artamonov AA, Arulappan J, Aruleba RT, Arumugam A, Asaad M, Asadi-Lari M, Asgedom AA, Asghariahmadabad M, Asghari-Jafarabadi M, Ashraf M, Aslani A, Astell-Burt T, Athar M, Athari SS, Atinafu BTT, Atlaw HW, Atorkey P, Atout MMW, Atreya A, Aujayeb A, Ausloos M, Avan A, Awedew AF, Aweke AM, Ayala Quintanilla BP, Ayatollahi H, Ayuso-Mateos JL, Ayyoubzadeh SM, Azadnajafabad S, Azevedo RMS, Azzam AY, B DB, Babu AS, Badar M, Badiye AD, Baghdadi S, Bagheri N, Bagherieh S, Bah S, Bahadorikhalili S, Bahmanziari N, Bai R, Baig AA, Baker JL, Bako AT, Bakshi RK, Balakrishnan S, Balasubramanian M, Baltatu OC, Bam K, Banach M, Bandyopadhyay S, Banik PC, Bansal H, Bansal K, Barbic F, Barchitta M, Bardhan M, Bardideh E, Barker-Collo SL, Bärnighausen TW, Barone-Adesi F, Barqawi HJ, Barrero LH, Barrow A, Barteit S, Barua L, Basharat Z, Bashiri A, Basiru A, Baskaran P, Basnyat B, Bassat Q, Basso JD, Basting AVL, Basu S, Batra K, Baune BT, Bayati M, Bayileyegn NS, Beaney T, Bedi N, Beghi M, Behboudi E, Behera P, Behnoush AH, Behzadifar M, Beiranvand M, Bejarano Ramirez DF, Béjot Y, Belay SA, Belete CM, Bell ML, Bello MB, Bello OO, Belo L, Beloukas A, Bender RG, Bensenor IM, Beran A, Berezvai Z, Berhie AY, Berice BN, Bernstein RS, Bertolacci GJ, Bettencourt PJG, Beyene KA, Bhagat DS, Bhagavathula AS, Bhala N, Bhalla A, Bhandari D, Bhangdia K, Bhardwaj N, Bhardwaj P, Bhardwaj PV, Bhargava A, Bhaskar S, Bhat V, Bhatti GK, Bhatti JS, Bhatti MS, Bhatti R, Bhutta ZA, Bikbov B, Bishai JD, Bisignano C, Bisulli F, Biswas A, Biswas B, Bitaraf S, Bitew BD, Bitra VR, Bjørge T, Boachie MK, Boampong MS, Bobirca AV, Bodolica V, Bodunrin AO, Bogale EK, Bogale KA, Bohlouli S, Bolarinwa OA, Boloor A, Bonakdar Hashemi M, Bonny A, Bora K, Bora Basara B, Borhany H, Borzutzky A, Bouaoud S, Boustany A, Boxe C, Boyko EJ, Brady OJ, Braithwaite D, Brant LC, Brauer M, Brazinova A, Brazo-Sayavera J, Breitborde NJK, Breitner S, Brenner H, Briko AN, Briko NI, Britton G, Brown J, Brugha T, Bulamu NB, Bulto LN, Buonsenso D, Burns RA, Busse R, Bustanji Y, Butt NS, Butt ZA, Caetano dos Santos FL, Calina D, Cámera LA, Campos LA, Campos-Nonato IR, Cao C, Cao Y, Capodici A, Cárdenas R, Carr S, Carreras G, Carrero JJ, Carugno A, Carvalheiro CG, Carvalho F, Carvalho M, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Catapano AL, Cattaruzza MS, Cederroth CR, Cegolon L, Cembranel F, Cenderadewi M, Cercy KM, Cerin E, Cevik M, Chadwick J, Chahine Y, Chakraborty C, Chakraborty PA, Chan JSK, Chan RNC, Chandika RM, Chandrasekar EK, Chang CK, Chang JC, Chanie GS, Charalampous P, Chattu VK, Chaturvedi P, Chatzimavridou-Grigoriadou V, Chaurasia A, Chen AW, Chen AT, Chen CS, Chen H, Chen MX, Chen S, Cheng CY, Cheng ETW, Cherbuin N, Cheru WA, Chien JH, Chimed-Ochir O, Chimoriya R, Ching PR, Chirinos-Caceres JL, Chitheer A, Cho WCS, Chong B, Chopra H, Choudhari SG, Chowdhury R, Christopher DJ, Chukwu IS, Chung E, Chung E, Chung E, Chung SC, Chutiyami M, Cindi Z, Cioffi I, Claassens MM, Claro RM, Coberly K, Cogen RM, Columbus A, Comfort H, Conde J, Cortese S, Cortesi PA, Costa VM, Costanzo S, Cousin E, Couto RAS, Cowden RG, Cramer KM, Criqui MH, Cruz-Martins N, Cuadra-Hernández SM, Culbreth GT, Cullen P, Cunningham M, Curado MP, Dadana S, Dadras O, Dai S, Dai X, Dai Z, Dalli LL, Damiani G, Darega Gela J, Das JK, Das S, Das S, Dascalu AM, Dash NR, Dashti M, Dastiridou A, Davey G, Dávila-Cervantes CA, Davis Weaver N, Davletov K, De Leo D, de Luca K, Debele AT, Debopadhaya S, Degenhardt L, Dehghan A, Deitesfeld L, Del Bo' C, Delgado-Enciso I, Demessa BH, Demetriades AK, Deng K, Deng X, Denova-Gutiérrez E, Deravi N, Dereje N, Dervenis N, Dervišević E, Des Jarlais DC, Desai HD, Desai R, Devanbu VGC, Dewan SMR, Dhali A, Dhama K, Dhimal M, Dhingra S, Dhulipala VR, Dias da Silva D, Diaz D, Diaz MJ, Dima A, Ding DD, Ding H, Dinis-Oliveira RJ, Dirac MA, Djalalinia S, Do THP, do Prado CB, Doaei S, Dodangeh M, Dodangeh M, Dohare S, Dokova KG, Dolecek C, Dominguez RMV, Dong W, Dongarwar D, D'Oria M, Dorostkar F, Dorsey ER, dos Santos WM, Doshi R, Doshmangir L, Dowou RK, Driscoll TR, Dsouza HL, Dsouza V, Du M, Dube J, Duncan BB, Duraes AR, Duraisamy S, Durojaiye OC, Dwyer-Lindgren L, Dzianach PA, Dziedzic AM, E'mar AR, Eboreime E, Ebrahimi A, Echieh CP, Edinur HA, Edvardsson D, Edvardsson K, Efendi D, Efendi F, Effendi DE, Eikemo TA, Eini E, Ekholuenetale M, Ekundayo TC, El Sayed I, Elbarazi I, Elema TB, Elemam NM, Elgar FJ, Elgendy IY, ElGohary GMT, Elhabashy HR, Elhadi M, El-Huneidi W, Elilo LT, Elmeligy OAA, Elmonem MA, Elshaer M, Elsohaby I, Emeto TI, Engelbert Bain L, Erkhembayar R, Esezobor CI, Eshrati B, Eskandarieh S, Espinosa-Montero J, Esubalew H, Etaee F, Fabin N, Fadaka AO, Fagbamigbe AF, Fahim A, Fahimi S, Fakhri-Demeshghieh A, Falzone L, Fareed M, Farinha CSES, Faris MEM, Faris PS, Faro A, Fasanmi AO, Fatehizadeh A, Fattahi H, Fauk NK, Fazeli P, Feigin VL, Feizkhah A, Fekadu G, Feng X, Fereshtehnejad SM, Feroze AH, Ferrante D, Ferrari AJ, Ferreira N, Fetensa G, Feyisa BR, Filip I, Fischer F, Flavel J, Flood D, Florin BT, Foigt NA, Folayan MO, Fomenkov AA, Foroutan B, Foroutan M, Forthun I, Fortuna D, Foschi M, Fowobaje KR, Francis KL, Franklin RC, Freitas A, Friedman J, Friedman SD, Fukumoto T, Fuller JE, Fux B, Gaal PA, Gadanya MA, Gaidhane AM, Gaihre S, Gakidou E, Galali Y, Galles NC, Gallus S, Ganbat M, Gandhi AP, Ganesan B, Ganiyani MA, Garcia-Gordillo MA, Gardner WM, Garg J, Garg N, Gautam RK, Gbadamosi SO, Gebi TG, Gebregergis MW, Gebrehiwot M, Gebremeskel TG, Georgescu SR, Getachew T, Gething PW, Getie M, Ghadiri K, Ghahramani S, Ghailan KY, Ghasemi MR, Ghasempour Dabaghi G, Ghasemzadeh A, Ghashghaee A, Ghassemi F, Ghazy RM, Ghimire A, Ghoba S, Gholamalizadeh M, Gholamian A, Gholamrezanezhad A, Gholizadeh N, Ghorbani M, Ghorbani Vajargah P, Ghoshal AG, Gill PS, Gill TK, Gillum RF, Ginindza TG, Girmay A, Glasbey JC, Gnedovskaya EV, Göbölös L, Godinho MA, Goel A, Golchin A, Goldust M, Golechha M, Goleij P, Gomes NGM, Gona PN, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Goulart BNG, Goyal A, Grada A, Graham SM, Grivna M, Grosso G, Guan SY, Guarducci G, Gubari MIM, Gudeta MD, Guha A, Guicciardi S, Guimarães RA, Gulati S, Gunawardane DA, Gunturu S, Guo C, Gupta AK, Gupta B, Gupta MK, Gupta M, Gupta RD, Gupta R, Gupta S, Gupta VB, Gupta VK, Gupta VK, Gurmessa L, Gutiérrez RA, Habibzadeh F, Habibzadeh P, Haddadi R, Hadei M, Hadi NR, Haep N, Hafezi-Nejad N, Hailu A, Haj-Mirzaian A, Halboub ES, Hall BJ, Haller S, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hamilton EB, Han C, Han Q, Hanif A, Hanifi N, Hankey GJ, Hanna F, Hannan MA, Haque MN, Harapan H, Hargono A, Haro JM, Hasaballah AI, Hasan I, Hasan MT, Hasani H, Hasanian M, Hashi A, Hasnain MS, Hassan I, Hassanipour S, Hassankhani H, Haubold J, Havmoeller RJ, Hay SI, He J, Hebert JJ, Hegazi OE, Heidari G, Heidari M, Heidari-Foroozan M, Helfer B, Hendrie D, Herrera-Serna BY, Herteliu C, Hesami H, Hezam K, Hill CL, Hiraike Y, Holla R, Horita N, Hossain MM, Hossain S, Hosseini MS, Hosseinzadeh H, Hosseinzadeh M, Hosseinzadeh Adli A, Hostiuc M, Hostiuc S, Hsairi M, Hsieh VCR, Hsu RL, Hu C, Huang J, Hultström M, Humayun A, Hundie TG, Hussain J, Hussain MA, Hussein NR, Hussien FM, Huynh HH, Hwang BF, Ibitoye SE, Ibrahim KS, Iftikhar PM, Ijo D, Ikiroma AI, Ikuta KS, Ikwegbue PC, Ilesanmi OS, Ilic IM, Ilic MD, Imam MT, Immurana M, Inamdar S, Indriasih E, Iqhrammullah M, Iradukunda A, Iregbu KC, Islam MR, Islam SMS, Islami F, Ismail F, Ismail NE, Iso H, Isola G, Iwagami M, Iwu CCD, Iyamu IO, Iyer M, J LM, Jaafari J, Jacob L, Jacobsen KH, Jadidi-Niaragh F, Jafarinia M, Jafarzadeh A, Jaggi K, Jahankhani K, Jahanmehr N, Jahrami H, Jain N, Jairoun AA, Jaiswal A, Jamshidi E, Janko MM, Jatau AI, Javadov S, Javaheri T, Jayapal SK, Jayaram S, Jebai R, Jee SH, Jeganathan J, Jha AK, Jha RP, Jiang H, Jin Y, Johnson O, Jokar M, Jonas JB, Joo T, Joseph A, Joseph N, Joshua CE, Joshy G, Jozwiak JJ, Jürisson M, K V, Kaambwa B, Kabir A, Kabir Z, Kadashetti V, Kadir DH, Kalani R, Kalankesh LR, Kalankesh LR, Kaliyadan F, Kalra S, Kamal VK, Kamarajah SK, Kamath R, Kamiab Z, Kamyari N, Kanagasabai T, Kanchan T, Kandel H, Kanmanthareddy AR, Kanmiki EW, Kanmodi KK, Kannan S S, Kansal SK, Kantar RS, Kapoor N, Karajizadeh M, Karanth SD, Karasneh RA, Karaye IM, Karch A, Karim A, Karimi SE, Karimi Behnagh A, Kashoo FZ, Kasnazani QHA, Kasraei H, Kassebaum NJ, Kassel MB, Kauppila JH, Kaur N, Kawakami N, Kayode GA, Kazemi F, Kazemian S, Kazmi TH, Kebebew GM, Kebede AD, Kebede F, Keflie TS, Keiyoro PN, Keller C, Kelly JT, Kempen JH, Kerr JA, Kesse-Guyot E, Khajuria H, Khalaji A, Khalid N, Khalil AA, Khalilian A, Khamesipour F, Khan A, Khan A, Khan G, Khan I, Khan IA, Khan MN, Khan M, Khan MJ, Khan MAB, Khan ZA, Khan suheb MZ, Khanmohammadi S, Khatab K, Khatami F, Khatatbeh H, Khatatbeh MM, Khavandegar A, Khayat Kashani HR, Khidri FF, Khodadoust E, Khorgamphar M, Khormali M, Khorrami Z, Khosravi A, Khosravi MA, Kifle ZD, Kim G, Kim J, Kim K, Kim MS, Kim YJ, Kimokoti RW, Kinzel KE, Kisa A, Kisa S, Klu D, Knudsen AKS, Kocarnik JM, Kochhar S, Kocsis T, Koh DSQ, Kolahi AA, Kolves K, Kompani F, Koren G, Kosen S, Kostev K, Koul PA, Koulmane Laxminarayana SL, Krishan K, Krishna H, Krishna V, Krishnamoorthy V, Krishnamoorthy Y, Krohn KJ, Kuate Defo B, Kucuk Bicer B, Kuddus MA, Kuddus M, Kuitunen I, Kulimbet M, Kulkarni V, Kumar A, Kumar A, Kumar H, Kumar M, Kumar R, Kumari M, Kumie FT, Kundu S, Kurmi OP, Kusnali A, Kusuma D, Kwarteng A, Kyriopoulos I, Kyu HH, La Vecchia C, Lacey B, Ladan MA, Laflamme L, Lagat AK, Lager ACJ, Lahmar A, Lai DTC, Lal DK, Lalloo R, Lallukka T, Lam H, Lám J, Landrum KR, Lanfranchi F, Lang JJ, Langguth B, Lansingh VC, Laplante-Lévesque A, Larijani B, Larsson AO, Lasrado S, Lassi ZS, Latief K, Latifinaibin K, Lauriola P, Le NHH, Le TTT, Le TDT, Ledda C, Ledesma JR, Lee M, Lee PH, Lee SW, Lee SWH, Lee WC, Lee YH, LeGrand KE, Leigh J, Leong E, Lerango TL, Li MC, Li W, Li X, Li Y, Li Z, Ligade VS, Likaka ATM, Lim LL, Lim SS, Lindstrom M, Linehan C, Liu C, Liu G, Liu J, Liu R, Liu S, Liu X, Liu X, Llanaj E, Loftus MJ, López-Bueno R, Lopukhov PD, Loreche AM, Lorkowski S, Lotufo PA, Lozano R, Lubinda J, Lucchetti G, Lugo A, Lunevicius R, Ma ZF, Maass KL, Machairas N, Machoy M, Madadizadeh F, Madsen C, Madureira-Carvalho ÁM, Maghazachi AA, Maharaj SB, Mahjoub S, Mahmoud MA, Mahmoudi A, Mahmoudi E, Mahmoudi R, Majeed A, Makhdoom IF, Malakan Rad E, Maled V, Malekzadeh R, Malhotra AK, Malhotra K, Malik AA, Malik I, Malta DC, Mamun AA, Mansouri P, Mansournia MA, Mantovani LG, Maqsood S, Marasini BP, Marateb HR, Maravilla JC, Marconi AM, Mardi P, Marino M, Marjani A, Martinez G, Martinez-Guerra BA, Martinez-Piedra R, Martini D, Martini S, Martins-Melo FR, Martorell M, Marx W, Maryam S, Marzo RR, Masaka A, Masrie A, Mathieson S, Mathioudakis AG, Mathur MR, Mattumpuram J, Matzopoulos R, Maude RJ, Maugeri A, Maulik PK, Mayeli M, Mazaheri M, Mazidi M, McGrath JJ, McKee M, McKowen ALW, McLaughlin SA, McPhail SM, Mechili EA, Medina JRC, Mediratta RP, Meena JK, Mehra R, Mehrabani-Zeinabad K, Mehrabi Nasab E, Mekene Meto T, Meles GG, Mendez-Lopez MAM, Mendoza W, Menezes RG, Mengist B, Mentis AFA, Meo SA, Meresa HA, Meretoja A, Meretoja TJ, Mersha AM, Mesfin BA, Mestrovic T, Mettananda KCD, Mettananda S, Meylakhs P, Mhlanga A, Mhlanga L, Mi T, Miazgowski T, Micha G, Michalek IM, Miller TR, Mills EJ, Minh LHN, Mini GK, Mir Mohammad Sadeghi P, Mirica A, Mirijello A, Mirrakhimov EM, Mirutse MK, Mirzaei M, Misganaw A, Mishra A, Misra S, Mitchell PB, Mithra P, Mittal C, Mobayen M, Moberg ME, Mohamadkhani A, Mohamed J, Mohamed MFH, Mohamed NS, Mohammad-Alizadeh-Charandabi S, Mohammadi S, Mohammadian-Hafshejani A, Mohammadifard N, Mohammed H, Mohammed H, Mohammed M, Mohammed S, Mohammed S, Mohan V, Mojiri-Forushani H, Mokari A, Mokdad AH, Molinaro S, Molokhia M, Momtazmanesh S, Monasta L, Mondello S, Moni MA, Moodi Ghalibaf A, Moradi M, Moradi Y, Moradi-Lakeh M, Moradzadeh M, Moraga P, Morawska L, Moreira RS, Morovatdar N, Morrison SD, Morze J, Mosser JF, Motappa R, Mougin V, Mouodi S, Mousavi P, Mousavi SE, Mousavi Khaneghah A, Mpolya EA, Mrejen M, Mubarik S, Muccioli L, Mueller UO, Mughal F, Mukherjee S, Mulita F, Munjal K, Murillo-Zamora E, Musaigwa F, Musallam KM, Mustafa A, Mustafa G, Muthupandian S, Muthusamy R, Muzaffar M, Myung W, Nagarajan AJ, Nagel G, Naghavi P, Naheed A, Naik GR, Naik G, Nainu F, Nair S, Najmuldeen HHR, Nakhostin Ansari N, Nangia V, Naqvi AA, Narasimha Swamy S, Narayana AI, Nargus S, Nascimento BR, Nascimento GG, Nasehi S, Nashwan AJ, Natto ZS, Nauman J, Naveed M, Nayak BP, Nayak VC, Nazri-Panjaki A, Ndejjo R, Nduaguba SO, Negash H, Negoi I, Negoi RI, Negru SM, Nejadghaderi SA, Nejjari C, Nena E, Nepal S, Ng M, Nggada HA, Nguefack-Tsague G, Ngunjiri JW, Nguyen AH, Nguyen DH, Nguyen HTH, Nguyen PT, Nguyen VT, Niazi RK, Nielsen KR, Nigatu YT, Nikolouzakis TK, Nikoobar A, Nikoomanesh F, Nikpoor AR, Ningrum DNA, Nnaji CA, Nnyanzi LA, Noman EA, Nomura S, Noreen M, Noroozi N, Norrving B, Noubiap JJ, Novotney A, Nri-Ezedi CA, Ntaios G, Ntsekhe M, Nuñez-Samudio V, Nurrika D, Nutor JJ, Oancea B, Obamiro KO, Oboh MA, Odetokun IA, Odogwu NM, O'Donnell MJ, Oduro MS, Ofakunrin AOD, Ogunkoya A, Oguntade AS, Oh IH, Okati-Aliabad H, Okeke SR, Okekunle AP, Okonji OC, Olagunju AT, Olaiya MT, Olatubi MI, Oliveira GMM, Olufadewa II, Olusanya BO, Olusanya JO, Oluwafemi YD, Omar HA, Omar Bali A, Omer GL, Ondayo MA, Ong S, Onwujekwe OE, Onyedibe KI, Ordak M, Orisakwe OE, Orish VN, Ortega-Altamirano DV, Ortiz A, Osman WMS, Ostroff SM, Osuagwu UL, Otoiu A, Otstavnov N, Otstavnov SS, Ouyahia A, Ouyang G, Owolabi MO, Ozten Y, P A MP, Padron-Monedero A, Padubidri JR, Pal PK, Palicz T, Palladino C, Palladino R, Palma-Alvarez RF, Pan F, Pan HF, Pana A, Panda P, Panda-Jonas S, Pandi-Perumal SR, Pangaribuan HU, Panos GD, Panos LD, Pantazopoulos I, Pantea Stoian AM, Papadopoulou P, Parikh RR, Park S, Parthasarathi A, Pashaei A, Pasovic M, Passera R, Pasupula DK, Patel HM, Patel J, Patel SK, Patil S, Patoulias D, Patthipati VS, Paudel U, Pazoki Toroudi H, Pease SA, Peden AE, Pedersini P, Pensato U, Pepito VCF, Peprah EK, Peprah P, Perdigão J, Pereira M, Peres MFP, Perianayagam A, Perico N, Pestell RG, Pesudovs K, Petermann-Rocha FE, Petri WA, Pham HT, Philip AK, Phillips MR, Pierannunzio D, Pigeolet M, Pigott DM, Pilgrim T, Piracha ZZ, Piradov MA, Pirouzpanah S, Plakkal N, Plotnikov E, Podder V, Poddighe D, Polinder S, Polkinghorne KR, Poluru R, Ponkilainen VT, Porru F, Postma MJ, Poudel GR, Pourshams A, Pourtaheri N, Prada SI, Pradhan PMS, Prakasham TN, Prasad M, Prashant A, Prates EJS, Prieto Alhambra D, PRISCILLA TINA, Pritchett N, Purohit BM, Puvvula J, Qasim NH, Qattea I, Qazi AS, Qian G, Qiu S, Qureshi MF, Rabiee Rad M, Radfar A, Radhakrishnan RA, Radhakrishnan V, Raeisi Shahraki H, Rafferty Q, Raggi A, Raghav PR, Raheem N, Rahim F, Rahim MJ, Rahimi-Movaghar V, Rahman MM, Rahman MHU, Rahman M, Rahman MA, Rahmani AM, Rahmani S, Rahmanian V, Rajaa S, Rajput P, Rakovac I, Ramasamy SK, Ramazanu S, Rana K, Ranabhat CL, Rancic N, Rane A, Rao CR, Rao IR, Rao M, Rao SJ, Rasali DP, Rasella D, Rashedi S, Rashedi V, Rashidi MM, Rasouli-Saravani A, Rasul A, Rathnaiah Babu G, Rauniyar SK, Ravangard R, Ravikumar N, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Rawlley B, Raza RZ, Razo C, Redwan EMM, Rehman FU, Reifels L, Reiner Jr RC, Remuzzi G, Reyes LF, Rezaei M, Rezaei N, Rezaei N, Rezaeian M, Rhee TG, Riaz MA, Ribeiro ALP, Rickard J, Riva HR, Robinson-Oden HE, Rodrigues CF, Rodrigues M, Roever L, Rogowski ELB, Rohloff P, 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, Tariku MK, Tariqujjaman M, Tarkang EE, Tavakoli Oliaee R, Tavangar SM, Taveira N, Tefera YM, Temsah MH, Temsah RMH, Teramoto M, Tesler R, Teye-Kwadjo E, Thakur R, Thangaraju P, Thankappan KR, Tharwat S, Thayakaran R, Thomas N, Thomas NK, Thomson AM, Thrift AG, Thum CCC, Thygesen LC, Tian J, Tichopad A, Ticoalu JHV, Tillawi T, Tiruye TY, Titova MV, Tonelli M, Topor-Madry R, Toriola AT, Torre AE, Touvier M, Tovani-Palone MR, Tran JT, Tran NM, Trico D, Tromans SJ, Truyen TTTT, Tsatsakis A, Tsegay GM, Tsermpini EE, Tumurkhuu M, Tung K, Tyrovolas S, Uddin SMN, Udoakang AJ, Udoh A, Ullah A, Ullah I, Ullah S, Ullah S, Umakanthan S, Umeokonkwo CD, Unim B, Unnikrishnan B, Unsworth CA, Upadhyay E, Urso D, Usman JS, Vahabi SM, Vaithinathan AG, Valizadeh R, Van de Velde SM, Van den Eynde J, Varga O, Vart P, Varthya SB, Vasankari TJ, Vasic M, Vaziri S, Vellingiri B, Venketasubramanian N, Verghese NA, Verma M, Veroux M, Verras GI, Vervoort D, Villafañe JH, Villanueva GI, Vinayak M, Violante FS, 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.
Collapse
|
3
|
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 S, Balalla S, Baltatu OC, Banach M, Bandyopadhyay S, Banerjee I, Baran MF, Barboza MA, Barchitta M, Bardhan M, Barker-Collo SL, Bärnighausen TW, Barrow A, Bashash D, Bashiri H, Bashiru HA, Basiru A, Basso JD, Basu S, Batiha AMM, Batra K, Baune BT, Bedi N, Begde A, Begum T, Behnam B, Behnoush AH, Beiranvand M, Béjot Y, Bekele A, Belete MA, Belgaumi UI, Bemanalizadeh M, Bender RG, Benfor B, Bennett DA, Bensenor IM, Berice B, Bettencourt PJG, Beyene KA, Bhadra A, Bhagat DS, Bhangdia K, Bhardwaj N, Bhardwaj P, Bhargava A, Bhaskar S, Bhat AN, Bhat V, Bhatti GK, Bhatti JS, Bhatti R, Bijani A, Bikbov B, Bilalaga MM, Biswas A, Bitaraf S, Bitra VR, Bjørge T, Bodolica V, Bodunrin AO, Boloor A, Braithwaite D, Brayne C, Brenner H, Briko A, Bringas Vega ML, Brown J, Budke CM, Buonsenso D, Burkart K, Burns RA, Bustanji Y, Butt MH, Butt NS, Butt ZA, Cabral LS, Caetano dos Santos FL, Calina D, Campos-Nonato IR, Cao C, Carabin H, Cárdenas R, Carreras G, Carvalho AF, Castañeda-Orjuela CA, Casulli A, Catalá-López F, Catapano AL, Caye A, Cegolon L, Cenderadewi M, Cerin E, Chacón-Uscamaita PRU, Chan JSK, Chanie GS, Charan J, Chattu VK, Chekol Abebe E, Chen H, Chen J, Chi G, Chichagi F, Chidambaram SB, Chimoriya R, Ching PR, Chitheer A, Chong YY, Chopra H, Choudhari SG, Chowdhury EK, Chowdhury R, Christensen H, Chu DT, Chukwu IS, Chung E, Coberly K, Columbus A, Comachio J, Conde J, Cortesi PA, Costa VM, Couto RAS, Criqui MH, Cruz-Martins N, Dabbagh Ohadi MA, Dadana S, Dadras O, Dai X, Dai Z, D'Amico E, Danawi HA, Dandona L, Dandona R, Darwish AH, Das S, Das S, Dascalu AM, Dash NR, Dashti M, De la Hoz FP, de la Torre-Luque A, De Leo D, Dean FE, Dehghan A, Dehghan A, Dejene H, Demant D, Demetriades AK, Demissie S, Deng X, Desai HD, Devanbu VGC, Dhama K, Dharmaratne SD, Dhimal M, Dias da Silva D, Diaz D, Dibas M, Ding DD, Dinu M, Dirac MA, Diress M, Do TC, Do THP, Doan KDK, Dodangeh M, Doheim MF, Dokova KG, Dongarwar D, Dsouza HL, Dube J, Duraisamy S, Durojaiye OC, Dutta S, Dziedzic AM, Edinur HA, Eissazade N, Ekholuenetale M, Ekundayo TC, El Nahas N, El Sayed I, Elahi Najafi MA, Elbarazi I, Elemam NM, Elgar FJ, Elgendy IY, Elhabashy HR, Elhadi M, Elilo LT, Ellenbogen RG, Elmeligy OAA, Elmonem MA, Elshaer M, Elsohaby I, Emamverdi M, Emeto TI, Endres M, Esezobor CI, Eskandarieh S, Fadaei A, Fagbamigbe AF, Fahim A, Faramarzi A, Fares J, Farjoud Kouhanjani M, Faro A, Farzadfar F, Fatehizadeh A, Fathi M, Fathi S, Fatima SAF, Feizkhah A, Fereshtehnejad SM, Ferrari AJ, Ferreira N, Fetensa G, Firouraghi N, Fischer F, Fonseca AC, Force LM, Fornari A, Foroutan B, Fukumoto T, Gadanya MA, Gaidhane AM, Galali Y, Galehdar N, Gan Q, Gandhi AP, Ganesan B, Gardner WM, Garg N, Gau SY, Gautam RK, Gebre T, Gebrehiwot M, Gebremeskel GG, Gebreslassie HG, Getacher L, Ghaderi Yazdi B, Ghadirian F, Ghaffarpasand F, Ghanbari R, Ghasemi M, Ghazy RM, Ghimire S, Gholami A, Gholamrezanezhad A, Ghotbi E, Ghozy S, Gialluisi A, Gill PS, Glasstetter LM, Gnedovskaya EV, Golchin A, Golechha M, Goleij P, Golinelli D, Gomes-Neto M, Goulart AC, Goyal A, Gray RJ, Grivna M, Guadie HA, Guan B, Guarducci G, Guicciardi S, Gunawardane DA, Guo H, Gupta B, Gupta R, Gupta S, Gupta VB, Gupta VK, Gutiérrez RA, Habibzadeh F, Hachinski V, Haddadi R, Hadei M, Hadi NR, Haep N, Haile TG, Haj-Mirzaian A, Hall BJ, Halwani R, Hameed S, Hamiduzzaman M, Hammoud A, Han H, Hanifi N, Hankey GJ, Hannan MA, Hao J, Harapan H, Hareru HE, Hargono A, Harlianto NI, Haro JM, Hartman NN, Hasaballah AI, Hasan F, Hasani H, Hasanian M, Hassan A, Hassan S, Hassanipour S, Hassankhani H, Hassen MB, Haubold J, Hay SI, Hayat K, Hegazy MI, Heidari G, Heidari M, Heidari-Soureshjani R, Hesami H, Hezam K, Hiraike Y, Hoffman HJ, Holla R, Hopf KP, Horita N, Hossain MM, Hossain MB, Hossain S, Hosseinzadeh H, Hosseinzadeh M, Hostiuc S, Hu C, Huang J, Huda MN, Hussain J, Hussein NR, Huynh HH, Hwang BF, Ibitoye SE, Ilaghi M, Ilesanmi OS, Ilic IM, Ilic MD, Immurana M, Iravanpour F, Islam SMS, Ismail F, Iso H, Isola G, Iwagami M, Iwu CCD, Iyer M, Jaan A, Jacob L, Jadidi-Niaragh F, Jafari M, Jafarinia M, Jafarzadeh A, Jahankhani K, Jahanmehr N, Jahrami H, Jaiswal A, Jakovljevic M, Jamora RDG, Jana S, Javadi N, Javed S, Javeed S, Jayapal SK, Jayaram S, Jiang H, Johnson CO, Johnson WD, Jokar M, Jonas JB, Joseph A, Joseph N, Joshua CE, Jürisson M, Kabir A, Kabir Z, Kabito GG, Kadashetti V, Kafi F, Kalani R, Kalantar F, Kaliyadan F, Kamath A, Kamath S, Kanchan T, Kandel A, Kandel H, Kanmodi KK, Karajizadeh M, Karami J, Karanth SD, Karaye IM, Karch A, Karimi A, Karimi H, Karimi Behnagh A, Kasraei H, Kassebaum NJ, Kauppila JH, Kaur H, Kaur N, Kayode GA, Kazemi F, Keikavoosi-Arani L, Keller C, Keykhaei M, Khadembashiri MA, Khader YS, Khafaie MA, Khajuria H, Khalaji A, Khamesipour F, Khammarnia M, Khan M, Khan MAB, Khan YH, Khan Suheb MZ, Khanmohammadi S, Khanna T, Khatab K, Khatatbeh H, Khatatbeh MM, Khateri S, Khatib MN, Khayat Kashani HR, Khonji MS, khorashadizadeh F, Khormali M, Khubchandani J, Kian S, Kim G, Kim J, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kivimäki M, Kochhar S, Kolahi AA, Koly KN, Kompani F, Koroshetz WJ, Kosen S, Kourosh Arami M, Koyanagi A, Kravchenko MA, Krishan K, Krishnamoorthy V, Kuate Defo B, Kuddus MA, Kumar A, Kumar GA, Kumar M, Kumar N, Kumsa NB, Kundu S, Kurniasari MD, Kusuma D, Kuttikkattu A, Kyu HH, La Vecchia C, Ladan MA, Lahariya C, Laksono T, Lal DK, Lallukka T, Lám J, Lami FH, Landires I, Langguth B, Lasrado S, Latief K, Latifinaibin K, Lau KMM, Laurens MB, Lawal BK, Le LKD, Le TTT, Ledda C, Lee M, Lee SW, Lee SW, Lee WC, Lee YH, Leonardi M, Lerango TL, Li MC, Li W, Ligade VS, Lim SS, Linehan C, Liu C, Liu J, Liu W, Lo CH, Lo WD, Lobo SW, Logroscino G, Lopes G, Lopukhov PD, Lorenzovici L, Lorkowski S, Loureiro JA, Lubinda J, Lucchetti G, Lutzky Saute R, Ma ZF, Mabrok M, Machoy M, Madadizadeh F, Magdy Abd El Razek M, Maghazachi AA, Maghbouli N, Mahjoub S, Mahmoudi M, Majeed A, Malagón-Rojas JN, Malakan Rad E, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, Manilal A, Mansouri V, Mansournia MA, Marasini BP, Marateb HR, Maroufi SF, Martinez-Raga J, Martini S, Martins-Melo FR, Martorell M, März W, Marzo RR, Massano J, Mathangasinghe Y, Mathews E, Maude RJ, Maugeri A, Maulik PK, Mayeli M, Mazaheri M, McAlinden C, McGrath JJ, Meena JK, Mehndiratta MM, Mendez-Lopez MAM, Mendoza W, Mendoza-Cano O, Menezes RG, Merati M, Meretoja A, Merkin A, Mersha AM, Mestrovic T, Mi T, Miazgowski T, Michalek IM, Mihretie ET, Minh LHN, Mirfakhraie R, Mirica A, Mirrakhimov EM, Mirzaei M, Misganaw A, Misra S, Mithra P, Mizana BA, Mohamadkhani A, Mohamed NS, Mohammadi E, Mohammadi H, Mohammadi S, Mohammadi S, Mohammadshahi M, Mohammed M, Mohammed S, Mohammed S, Mohan S, Mojiri-forushani H, Moka N, Mokdad AH, Molinaro S, Möller H, Monasta L, Moniruzzaman M, Montazeri F, Moradi M, Moradi Y, Moradi-Lakeh M, Moraga P, Morovatdar N, Morrison SD, Mosapour A, Mosser JF, Mossialos E, Motaghinejad M, Mousavi P, Mousavi SE, Mubarik S, Muccioli L, Mughal F, Mukoro GD, Mulita 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, Padubidri JR, Pal PK, Palange PN, Palladino C, Palladino R, Palma-Alvarez RF, Pan F, Panagiotakos D, Panda-Jonas S, Pandey A, Pandey A, Pandian JD, Pangaribuan HU, Pantazopoulos I, Pardhan S, Parija PP, Parikh RR, Park S, Parthasarathi A, Pashaei A, Patel J, Patil S, Patoulias D, Pawar S, Pedersini P, Pensato U, Pereira DM, Pereira J, Pereira MO, Peres MFP, Perico N, Perna S, Petcu IR, Petermann-Rocha FE, Pham HT, Phillips MR, Pinilla-Monsalve GD, Piradov MA, Plotnikov E, Poddighe D, Polat B, Poluru R, Pond CD, Poudel GR, Pouramini A, Pourbagher-Shahri AM, Pourfridoni M, Pourtaheri N, Prakash PY, Prakash S, Prakash V, Prates EJS, Pritchett N, Purnobasuki H, Qasim NH, Qattea I, Qian G, Radhakrishnan V, Raee P, Raeisi Shahraki H, Rafique I, Raggi A, Raghav PR, Rahati MM, Rahim F, Rahimi Z, Rahimifard M, Rahman MO, Rahman MHU, Rahman M, Rahman MA, Rahmani AM, Rahmani S, Rahmani Youshanlouei H, Rahmati M, Raj Moolambally S, Rajabpour-Sanati A, Ramadan H, Ramasamy SK, Ramasubramani P, Ramazanu S, Rancic N, Rao IR, Rao SJ, Rapaka D, Rashedi V, Rashid AM, Rashidi MM, Rashidi Alavijeh M, Rasouli-Saravani A, Rawaf S, Razo C, Redwan EMM, Rekabi Bana A, Remuzzi G, Rezaei N, Rezaei N, Rezaei N, Rezaeian M, Rhee TG, Riad A, Robinson SR, Rodrigues M, Rodriguez JAB, Roever L, Rogowski ELB, Romoli M, Ronfani L, Roy P, Roy Pramanik K, Rubagotti E, Ruiz MA, Russ TC, S Sunnerhagen K, Saad AMA, Saadatian Z, Saber K, SaberiKamarposhti M, Sacco S, Saddik B, Sadeghi E, Sadeghian S, Saeed U, Saeed U, Safdarian M, Safi SZ, Sagar R, Sagoe D, Saheb Sharif-Askari F, Saheb Sharif-Askari N, Sahebkar A, Sahoo SS, Sahraian MA, Sajedi SA, Sakshaug JW, Saleh MA, Salehi Omran H, Salem MR, Salimi S, Samadi Kafil H, Samadzadeh S, Samargandy S, Samodra YL, Samuel VP, Samy AM, Sanadgol N, Sanjeev RK, Sanmarchi F, Santomauro DF, Santri IN, Santric-Milicevic MM, Saravanan A, Sarveazad A, Satpathy M, Saylan M, Sayyah M, Scarmeas N, Schlaich MP, Schuermans A, Schwarzinger M, Schwebel DC, Selvaraj S, Sendekie AK, Sengupta P, Senthilkumaran S, Serban D, Sergindo MT, Sethi Y, SeyedAlinaghi S, Seylani A, Shabani M, Shabany M, Shafie M, Shahabi S, Shahbandi A, Shahid S, Shahraki-Sanavi F, Shahsavari HR, Shahwan MJ, Shaikh MA, Shaji KS, Sham S, Shama ATT, Shamim MA, Shams-Beyranvand M, Shamsi MA, Shanawaz M, Sharath M, Sharfaei S, Sharifan A, Sharma M, Sharma R, Shashamo BB, Shayan M, Sheikhi RA, Shekhar S, Shen J, Shenoy SM, Shetty PH, Shiferaw DS, Shigematsu M, Shiri R, Shittu A, Shivakumar KM, Shokri F, Shool S, Shorofi SA, Shrestha S, Siankam Tankwanchi AB, Siddig EE, Sigfusdottir ID, Silva JP, Silva LMLR, Sinaei E, Singh BB, Singh G, Singh P, Singh S, Sirota SB, Sivakumar S, Sohag AAM, Solanki R, Soleimani H, Solikhah S, Solomon Y, Solomon Y, Song S, Song Y, Sotoudeh H, Spartalis M, Stark BA, Starnes JR, Starodubova AV, Stein DJ, Steiner TJ, Stovner LJ, Suleman M, Suliankatchi Abdulkader R, Sultana A, Sun J, Sunkersing D, Sunny A, Susianti H, Swain CK, Szeto MD, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabai S, Tabish M, Taheri M, Tahvildari A, Tajbakhsh A, Tampa M, Tamuzi JJLL, Tan KK, Tang H, Tareke M, Tarigan IU, Tat NY, Tat VY, Tavakoli Oliaee R, Tavangar SM, Tavasol A, Tefera YM, Tehrani-Banihashemi A, Temesgen WA, Temsah MH, Teramoto M, Tesfaye AH, Tesfaye EG, Tesler R, Thakali O, Thangaraju P, Thapa R, Thapar R, Thomas NK, Thrift AG, Ticoalu JHV, Tillawi T, Toghroli R, Tonelli M, Tovani-Palone MR, Traini E, Tran NM, Tran NH, Tran PV, Tromans SJ, Truelsen TC, Truyen TTTT, Tsatsakis A, Tsegay GM, Tsermpini EE, Tualeka AR, Tufa DG, Ubah CS, Udoakang AJ, Ulhaq I, Umair M, Umakanthan S, Umapathi KK, Unim B, Unnikrishnan B, Vaithinathan AG, Vakilian A, Valadan Tahbaz S, Valizadeh R, Van den Eynde J, Vart P, Varthya SB, Vasankari TJ, Vaziri S, Vellingiri B, Venketasubramanian N, Verras GI, Vervoort D, Villafañe JH, Villani L, Vinueza Veloz AF, Viskadourou M, Vladimirov SK, Vlassov V, Volovat SR, Vu LT, Vujcic IS, Wagaye B, Waheed Y, Wahood W, Walde MT, Wang F, 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.
Collapse
|
4
|
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.
Collapse
|
5
|
Schumacher AE, Kyu HH, Aali A, Abbafati C, Abbas J, Abbasgholizadeh R, Abbasi MA, Abbasian M, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdelwahab A, Abdollahi M, Abdoun M, Abdullahi A, Abdurehman AM, Abebe M, Abedi A, Abedi A, Abegaz TM, Abeldaño Zuñiga RA, Abhilash ES, Abiodun OO, Aboagye RG, Abolhassani H, Abouzid M, Abreu LG, Abrha WA, Abrigo MRM, Abtahi D, Abu Rumeileh S, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Acuna JM, Adair T, Addo IY, Adebayo OM, Adegboye OA, Adekanmbi V, Aden B, Adepoju AV, Adetunji CO, Adeyeoluwa TE, Adeyomoye OI, Adha R, Adibi A, Adikusuma W, Adnani QES, Adra S, Afework A, Afolabi AA, Afraz A, Afyouni S, Afzal S, Agasthi P, Aghamiri S, Agodi A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad F, Ahmad MM, Ahmad T, Ahmadi K, Ahmadzade AM, Ahmadzade M, Ahmed A, Ahmed H, Ahmed LA, Ahmed MB, Ahmed SA, Ajami M, Aji B, Ajumobi O, Akalu GT, Akara EM, Akinosoglou K, Akkala S, Akyirem S, Al Hamad H, Al Hasan SM, Al Homsi A, Al Qadire M, Ala M, Aladelusi TO, AL-Ahdal TMA, Alalalmeh SO, Al-Aly Z, Alam K, Alam M, Alam Z, Al-amer RM, Alanezi FM, Alanzi TM, Albashtawy M, AlBataineh MT, Aldridge RW, Alemi S, Al-Eyadhy A, Al-Gheethi AAS, Alhabib KF, Alhalaiqa FAN, Al-Hanawi MK, Ali A, Ali A, Ali BA, Ali H, Ali MU, Ali R, Ali SSS, Ali Z, Alian Samakkhah S, Alicandro G, Alif SM, Aligol M, Alimi R, Aliyi AA, Al-Jumaily A, Aljunid SM, Almahmeed W, Al-Marwani S, Al-Maweri SAA, Almazan JU, Al-Mekhlafi HM, Almidani O, Alomari MA, Alonso N, Alqahtani JS, Alqutaibi AY, Al-Sabah SK, Altaf A, Al-Tawfiq JA, Altirkawi KA, Alvi FJ, Alwafi H, Al-Worafi YM, Aly H, Alzoubi KH, Amare AT, Ameyaw EK, Amhare AF, Amin TT, Amindarolzarbi A, Aminian Dehkordi J, Amiri S, Amu H, Amugsi DA, Amzat J, Ancuceanu R, Anderlini D, Andrade PP, Andrei CL, Andrei T, Angappan D, Anil A, Anjum A, Antony CM, Antriyandarti E, Anuoluwa IA, Anwar SL, Anyasodor AE, Appiah SCY, Aqeel M, Arabloo J, Arabzadeh Bahri R, Arab-Zozani M, Arafat M, Araújo AM, Aravkin AY, Aremu A, Ariffin H, Aripov T, Armocida B, Arooj M, Artamonov AA, Artanti KD, Arulappan J, Aruleba IT, Aruleba RT, Arumugam A, Asaad M, Asgary S, Ashemo MY, Ashraf M, Asika MO, Athari SS, Atout MMW, Atreya A, Attia S, Aujayeb A, Avan A, Awotidebe AW, Ayala Quintanilla BP, Ayanore MA, Ayele GM, Ayuso-Mateos JL, Ayyoubzadeh SM, Azadnajafabad S, Azhar GS, Aziz S, Azzam AY, Babashahi M, Babu AS, Badar M, Badawi A, Badiye AD, Baghdadi S, Bagheri N, Bagherieh S, Bah S, Bahadorikhalili S, Bai J, Bai R, Baker JL, Bakkannavar SM, Bako AT, Balakrishnan S, Balogun SA, Baltatu OC, Bam K, Banach M, Bandyopadhyay S, Banik B, Banik PC, Bansal H, Barati S, Barchitta M, Bardhan M, Barker-Collo SL, Barone-Adesi F, Barqawi HJ, Barr RD, Barrero LH, Basharat Z, Bashir AIJ, Bashiru HA, Baskaran P, Basnyat B, Bassat Q, Basso JD, Basu S, Batra K, Batra R, Baune BT, Bayati M, Bayileyegn NS, Beaney T, Bedi N, Begum T, Behboudi E, Behnoush AH, Beiranvand M, Bejarano Ramirez DF, Belgaumi UI, Bell ML, Bello AK, Bello MB, Bello OO, Belo L, Beloukas A, Bendak S, Bennett DA, Bensenor IM, Benzian H, Berezvai Z, Berman AE, Bermudez ANC, Bettencourt PJG, Beyene HB, Beyene KA, Bhagat DS, Bhagavathula AS, Bhala N, Bhalla A, Bhandari D, Bhardwaj N, Bhardwaj P, Bhardwaj PV, Bhargava A, Bhaskar S, Bhat V, Bhatti GK, Bhatti JS, Bhatti MS, Bhatti R, Bhutta ZA, Bikbov B, Binmadi N, Bintoro BS, Biondi A, Bisignano C, Bisulli F, Biswas A, Biswas RK, Bitaraf S, Bjørge T, Bleyer A, Boampong MS, Bodolica V, Bodunrin AO, Bolarinwa OA, Bonakdar Hashemi M, Bonny A, Bora K, Bora Basara B, Borodo SB, Borschmann R, Botero Carvajal A, Bouaoud S, Boudalia S, Boyko EJ, Bragazzi NL, Braithwaite D, Brenner H, Britton G, Browne AJ, Brunoni AR, Bulamu NB, Bulto LN, Buonsenso D, Burkart K, Burns RA, Burugina Nagaraja S, Busse R, Bustanji Y, Butt ZA, Caetano dos Santos FL, Cai T, Calina D, Cámera LA, Campos LA, Campos-Nonato IR, Cao C, Cardenas CA, Cárdenas R, Carr S, Carreras G, Carrero JJ, Carugno A, Carvalho F, Carvalho M, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Catapano AL, Cattaruzza MS, Caye A, Cederroth CR, Cembranel F, Cenderadewi M, Cercy KM, Cerin E, Cevik M, Chacón-Uscamaita PRU, Chahine Y, Chakraborty C, Chan JSK, Chang CK, Charalampous P, Charan J, Chattu VK, Chatzimavridou-Grigoriadou V, Chavula MP, Cheema HA, Chen AT, Chen H, Chen L, Chen MX, Chen S, Cherbuin N, Chew DS, Chi G, Chirinos-Caceres JL, Chitheer A, Cho SMJ, Cho WCS, Chong B, Chopra H, Choudhary R, Chowdhury R, Chu DT, Chukwu IS, Chung E, Chung E, Chung SC, Cini KI, Clark CCT, Coberly K, Columbus A, Comfort H, Conde J, Conti S, Cortesi PA, Costa VM, Cousin E, Cowden RG, Criqui MH, Cruz-Martins N, Culbreth GT, Cullen P, Cunningham M, da Silva e Silva D, Dadana S, Dadras O, Dai Z, Dalal K, Dalli LL, Damiani G, D'Amico E, Daneshvar S, Darwesh AM, Das JK, Das S, Dash NR, Dashti M, Dávila-Cervantes CA, Davis Weaver N, Davletov K, De Leo D, Debele AT, Degenhardt L, Dehbandi R, Deitesfeld L, Delgado-Enciso I, Delgado-Ortiz L, Demant D, Demessa BH, Demetriades AK, Deng X, Denova-Gutiérrez E, Deribe K, Dervenis N, Des Jarlais DC, Desai HD, Desai R, Deuba K, Devanbu VGC, Dey S, Dhali A, Dhama K, Dhimal ML, Dhimal M, Dhingra S, Dias da Silva D, Diaz D, Dima A, Ding DD, Dirac MA, Dixit A, Dixit SG, Do TC, Do THP, do Prado CB, Dodangeh M, Dokova KG, Dolecek C, Dorsey ER, dos Santos WM, Doshi R, Doshmangir L, Douiri A, Dowou RK, Driscoll TR, Dsouza HL, Dube J, Dumith SC, Dunachie SJ, Duncan BB, Duraes AR, Duraisamy S, Durojaiye OC, Dutta S, Dzianach PA, Dziedzic AM, Ebenezer O, Eboreime E, Ebrahimi A, Echieh CP, Ed-Dra A, Edinur HA, Edvardsson D, Edvardsson K, Efendi D, Efendi F, Eghdami S, Eikemo TA, Eini E, Ekholuenetale M, Ekpor E, Ekundayo TC, El Arab RA, El Morsi DAW, El Sayed Zaki M, El Tantawi M, Elbarazi I, Elemam NM, Elgar FJ, Elgendy IY, ElGohary GMT, Elhabashy HR, Elhadi M, Elmeligy OAA, Elshaer M, Elsohaby I, Emami Zeydi A, Emamverdi M, Emeto TI, Engelbert Bain L, Erkhembayar R, Eshetie TC, Eskandarieh S, Espinosa-Montero J, Estep K, Etaee F, Eze UA, Fabin N, Fadaka AO, Fagbamigbe AF, Fahimi S, Falzone L, Farinha CSES, Faris MEM, Farjoud Kouhanjani M, Faro A, Farrokhpour H, Fatehizadeh A, Fattahi H, Fauk NK, Fazeli P, Feigin VL, Fekadu G, Fereshtehnejad SM, Feroze AH, Ferrante D, Ferrara P, Ferreira N, Fetensa G, Filip I, Fischer F, Flavel J, Flaxman AD, Flor LS, Florin BT, Folayan MO, Foley KM, Fomenkov AA, Force LM, Fornari C, Foroutan B, Foschi M, Francis KL, Franklin RC, Freitas A, Friedman J, Friedman SD, Fukumoto T, Fuller JE, Gaal PA, Gadanya MA, Gaihre S, Gaipov A, Gakidou E, Galali Y, Galehdar N, Gallus S, Gan Q, Gandhi AP, Ganesan B, Garg J, Gau SY, Gautam P, Gautam RK, Gazzelloni F, Gebregergis MW, Gebrehiwot M, Gebremariam TB, Gerema U, Getachew ME, Getachew T, Gething PW, Ghafourifard M, Ghahramani S, Ghailan KY, Ghajar A, Ghanbarnia MJ, Ghasemi M, Ghasemzadeh A, Ghassemi F, Ghazy RM, Ghimire S, Gholamian A, Gholamrezanezhad A, Ghorbani Vajargah P, Ghozali G, Ghozy S, Ghuge AD, Gialluisi A, Gibson RM, Gil AU, Gill PS, Gill TK, Gillum RF, Ginindza TG, Girmay A, Glasbey JC, Gnedovskaya EV, Göbölös L, Goel A, Goldust M, Golechha M, Goleij P, Golestanfar A, Golinelli D, Gona PN, Goudarzi H, Goudarzian AH, Goyal A, Greenhalgh S, Grivna M, Guarducci G, Gubari MIM, Gudeta MD, Guha A, Guicciardi S, Gunawardane DA, Gunturu S, Guo C, Gupta AK, Gupta B, Gupta IR, Gupta RD, Gupta S, Gupta VB, Gupta VK, Gupta VK, Gutiérrez RA, Habibzadeh F, Habibzadeh P, Hachinski V, Haddadi M, Haddadi R, Haep N, Hajj Ali A, Halboub ES, Halim SA, Hall BJ, Haller S, Halwani R, Hamadeh RR, Hamagharib Abdullah K, Hamidi S, Hamiduzzaman M, Hammoud A, Hanifi N, Hankey GJ, Hannan MA, Haque MN, Harapan H, Haro JM, Hasaballah AI, Hasan F, Hasan I, Hasan MT, Hasani H, Hasanian M, Hasanpour- Dehkordi A, Hassan AM, Hassan A, Hassanian-Moghaddam H, Hassanipour S, Haubold J, Havmoeller RJ, Hay SI, Hbid Y, Hebert JJ, Hegazi OE, Heidari G, Heidari M, Heidari-Foroozan M, Heidari-Soureshjani R, Helfer B, Herteliu C, Hesami H, Hettiarachchi D, Heyi DZ, Hezam K, Hiraike Y, Hoffman HJ, Holla R, Horita N, Hossain MB, Hossain MM, Hossain S, Hosseini MS, Hosseinzadeh H, Hosseinzadeh M, Hostiuc M, Hostiuc S, Hsairi M, Hsieh VCR, Hu C, Huang J, Huda MN, Hugo FN, Hultström M, Hussain J, Hussain S, Hussein NR, Huy LD, Huynh HH, Hwang BF, Ibitoye SE, Idowu OO, Ijo D, Ikuta KS, Ilaghi M, Ilesanmi OS, Ilic IM, Ilic MD, Immurana M, Inbaraj LR, Iradukunda A, Iravanpour F, Iregbu KC, Islam MR, Islam MM, Islam SMS, Islami F, Ismail NE, Isola G, Iwagami M, Iwu CCD, Iwu-Jaja CJ, Iyer M, J LM, Jaafari J, Jacob L, Jacobsen KH, Jadidi-Niaragh F, Jafarinia M, Jaggi K, Jahankhani K, Jahanmehr N, Jahrami H, Jain A, Jain N, Jairoun AA, Jakovljevic M, Jalilzadeh Yengejeh R, Jamshidi E, Jani CT, Janko MM, Jatau AI, Jayapal SK, Jayaram S, Jeganathan J, Jema AT, Jemere DM, Jeong W, Jha AK, Jha RP, Ji JS, Jiang H, Jin Y, Jin Y, Johnson O, Jomehzadeh N, Jones DP, Joo T, Joseph A, Joseph N, Joshua CE, Jozwiak JJ, Jürisson M, Kaambwa B, Kabir A, Kabir H, Kabir Z, Kadashetti V, Kahe F, Kakodkar PV, Kalani R, Kalankesh LR, Kaliyadan F, Kalra S, Kamath A, Kamireddy A, Kanagasabai T, Kandel H, Kanmiki EW, Kanmodi KK, Kantar RS, Kapoor N, Karajizadeh M, Karami Matin B, Karanth SD, Karaye IM, Karim A, Karimi H, Karimi SE, Karimi Behnagh A, Karkhah S, Karna AK, Kashoo FZ, Kasraei H, Kassaw NA, Kassebaum NJ, Kassel MB, Katamreddy A, Katikireddi SV, Katoto PDMC, Kauppila JH, Kaur N, Kaydi N, Kayibanda JF, Kayode GA, Kazemi F, Kazemian S, Kazeminia S, Keikavoosi-Arani L, Keller C, Kempen JH, Kerr JA, Kesse-Guyot E, Keykhaei M, Khadembashiri MM, Khadembashiri MA, Khafaie MA, Khajuria H, Khalafi M, Khalaji A, Khalid N, Khalil IA, Khamesipour F, Khan A, Khan G, Khan I, Khan IA, Khan M, Khan MAB, Khan T, Khan suheb MZ, Khanmohammadi S, Khatab K, Khatami F, Khavandegar A, Khayat Kashani HR, Kheirallah KA, Khidri FF, Khodadoust E, Khormali M, Khosrowjerdi M, Khubchandani J, 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, Moraga P, Morawska L, Moreira RS, Morovatdar N, Morrison SD, Morze J, Mosaddeghi Heris R, Mosser JF, Mossialos E, Mostafavi H, Mostofinejad A, Mougin V, Mouodi S, Mousavi P, Mousavi SE, Mousavi Khaneghah A, Mpundu-Kaambwa C, Mrejen M, Mubarik S, Muccioli L, Mueller UO, Mughal F, Mukherjee S, Mukoro GD, Mulita A, Mulita F, Muniyandi M, Munjal K, Musaigwa F, Musallam KM, Mustafa G, Muthu S, Muthupandian S, Myung W, Nabhan AF, Nafukho FM, Nagarajan AJ, Naghavi M, Naghavi P, Naik GR, Naik G, Naimzada MD, Nair S, Nair TS, Najmuldeen HHR, Naldi L, Nangia V, Nargus S, Nascimento BR, Nascimento GG, Naser AY, Nasiri MJ, Natto ZS, Nauman J, Naveed M, Nayak BP, Nayak VC, Nayyar AK, Nazri-Panjaki A, Negash H, Negero AK, Negoi I, Negoi RI, Negru SM, Nejadghaderi SA, Nejjari C, Nematollahi MH, Nena E, Nepal S, Nesbit OD, Newton CRJ, Ngunjiri JW, Nguyen DH, Nguyen PT, Nguyen PT, Nguyen TT, Nguyen VT, Nigatu YT, Nikolouzakis TK, Nikoobar A, Nikpoor AR, Nizam MA, Nomura S, Noreen M, Noroozi N, Norouzian Baghani A, Norrving B, Noubiap JJ, Novotney A, Nri-Ezedi CA, Ntaios G, Ntsekhe M, Nuñez-Samudio V, Nurrika D, Oancea B, Obamiro KO, Odetokun IA, Ofakunrin AOD, Ogunsakin RE, Oguta JO, Oh IH, Okati-Aliabad H, Okeke SR, Okekunle AP, Okidi L, Okonji OC, Okwute PG, Olagunju AT, Olaiya MT, Olanipekun TO, Olatubi MI, Olivas-Martinez A, Oliveira GMM, Oliver S, Olorukooba AA, Olufadewa II, Olusanya BO, Olusanya JO, Oluwafemi YD, Oluwatunase GO, Omar HA, Omer GL, Ong S, Onwujekwe OE, Onyedibe KI, Opio JN, Ordak M, Orellana ER, Orisakwe OE, Orish VN, Orru H, Ortega-Altamirano DV, Ortiz A, Ortiz-Brizuela E, Ortiz-Prado E, Osuagwu UL, Otoiu A, Otstavnov N, Ouyahia A, Ouyang G, Owolabi MO, Oyeyemi IT, Oyeyemi OT, Ozten Y, P A MP, Padubidri JR, Pahlavikhah Varnosfaderani M, Pal PK, Palicz T, Palladino C, Palladino R, Palma-Alvarez RF, Pana A, Panahi P, Pandey A, Pandi-Perumal SR, Pando-Robles V, Pangaribuan HU, Panos GD, Pantazopoulos I, Papadopoulou P, Pardhan S, Parikh RR, Park S, Parthasarathi A, Pashaei A, Pasupula DK, Patel JR, Patel SK, Pathan AR, Patil A, Patil S, Patoulias D, Patthipati VS, Paudel U, Pawar S, Pazoki Toroudi H, Pease SA, Peden AE, Pedersini P, Peng M, Pensato U, Pepito VCF, Peprah EK, Pereira G, Pereira J, Pereira M, Peres MFP, Perianayagam A, Perico N, Petcu IR, Petermann-Rocha FE, Pezzani R, Pham HT, Phillips MR, Pierannunzio D, Pigeolet M, Pigott DM, Pilgrim T, Pinheiro M, Piradov MA, Plakkal N, Plotnikov E, Poddighe D, Pollner P, Poluru R, Pond CD, Postma MJ, Poudel GR, Poudel L, Pourali G, Pourtaheri N, Prada SI, Pradhan PMS, Prajapati VK, Prakash V, Prasad CP, Prasad M, Prashant A, Prates EJS, Purnobasuki H, Purohit BM, Puvvula J, Qaisar R, Qasim NH, Qattea I, Qian G, Quan NK, Radfar A, Radhakrishnan V, Raee P, Raeisi Shahraki H, Rafiei Alavi SN, Rafique I, Raggi A, Rahim F, Rahman MM, Rahman M, Rahman MA, Rahman T, Rahmani AM, Rahmani S, Rahnavard N, Rai P, Rajaa S, Rajabpour-Sanati A, Rajput P, Ram P, Ramadan H, Ramasamy SK, 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.
Collapse
|
6
|
Tekpınar L, Yiğit V. Cost-Effectiveness Analysis of Implant-Supported Single Crown and Tooth-Supported Fixed Dental Prostheses in Türkiye. Value Health Reg Issues 2024; 42:11-17. [PMID: 38340673 DOI: 10.1016/j.vhri.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/19/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES The most cost-effective option for replacing lost teeth is not evident because there is a dearth of evidence-based information on implant-supported single crowns versus tooth-supported fixed dental prostheses. This study conducted the analysis of cost-effectiveness of implant-supported single crown and tooth-supported fixed dental prostheses from a social perspective in Türkiye. METHODS Costs were calculated in the analysis from a social perspective for 2021. Costs and quality-adjusted prosthesis year (QAPY) values were computed over a 20-year period in the study using the Markov model. The computed values were discounted by 5%. The results are presented as the incremental cost-effectiveness ratio. To assess the impact of uncertainty on cost-effectiveness analyses, a tornado diagram and Monte Carlo simulations were created. RESULTS Throughout the 20-year time horizon, tooth-supported fixed dental prostheses cost $985.58 cumulatively, whereas implant-supported single crown cost $2161.64 (US $1 = 9.22 ₺ as of 15 October 2021). The calculated incremental cost-effectiveness ratio is 1.333 per QAPY. Compared with the implant-supported single crown tooth-supported fixed dental prostheses, it offers a QAPY of 0.882 over a 20-year period, while costing an additional $1176.06. CONCLUSIONS These results suggest that the implant-supported single crown provided higher QAPY value but was costlier. When the research's findings are compared with the literature, it becomes clear that Türkiye has lower dental care expenses than most other nations.
Collapse
Affiliation(s)
- Lütfiye Tekpınar
- Department of Health Economics, Nezahat Keleşoğlu Faculty of Health Sciences, Necmettin Erbakan University, Konya, Türkiye; Department of Health Management, Nezahat Keleşoğlu Faculty of Health Sciences, Necmettin Erbakan University, Konya, Türkiye.
| | - Vahit Yiğit
- Department of Hospital Management, Faculty of Economics and Administrative Sciences, Süleyman Demirel University, Isparta, Türkiye; Department of Health Management, Faculty of Economics and Administrative Sciences, Süleyman Demirel University, Isparta, Türkiye
| |
Collapse
|
7
|
Wunrow HY, Bender RG, Vongpradith A, Sirota SB, Swetschinski LR, Novotney A, Gray AP, Ikuta KS, Sharara F, Wool EE, Aali A, Abd-Elsalam S, Abdollahi A, Abdul Aziz JM, Abidi H, Aboagye RG, Abolhassani H, Abu-Gharbieh E, Adamu LH, Adane TD, Addo IY, Adegboye OA, Adekiya TA, Adnan M, Adnani QES, Afzal S, Aghamiri S, Aghdam ZB, Agodi A, Ahinkorah BO, Ahmad A, Ahmad S, Ahmadzade M, Ahmed A, Ahmed A, Ahmed JQ, Ahmed MS, Akinosoglou K, Aklilu A, Akonde M, Alahdab F, AL-Ahdal TMA, Alanezi FM, Albelbeisi AH, Alemayehu TBB, Alene KA, Al-Eyadhy A, Al-Gheethi AAS, Ali A, Ali BA, Ali L, Ali SS, Alimohamadi Y, Alipour V, Aljunid SM, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Al-Worafi YM, Aly H, Ameyaw EK, Ancuceanu R, Ansar A, Ansari G, Anyasodor AE, Arabloo J, Aravkin AY, Areda D, Artamonov AA, Arulappan J, Aruleba RT, Asaduzzaman M, Atalell KA, Athari SS, Atlaw D, Atout MMW, Attia S, Awoke T, Ayalew MK, Ayana TM, Ayele AD, Azadnajafabad S, Azizian K, Badar M, Badiye AD, Baghcheghi N, Bagheri M, Bagherieh S, Bahadory S, Baig AA, Barac A, Barati S, Bardhan M, Basharat Z, Bashiri A, Basnyat B, Bassat Q, Basu S, Bayileyegn NS, Bedi N, Behnoush AH, Bekel AA, Belete MA, Bello OO, Bhagavathula AS, Bhandari D, Bhardwaj P, Bhaskar S, Bhat AN, Bijani A, Bineshfar N, Boloor A, Bouaoud S, Buonsenso D, Burkart K, Cámera LA, Castañeda-Orjuela CA, Cernigliaro A, Charan J, Chattu VK, Ching PR, Chopra H, Choudhari SG, Christopher DJ, Chu DT, Couto RAS, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Das S, Dash NR, Dashti M, De la Hoz FP, Debela SA, Dejen D, Dejene H, Demeke D, Demeke FM, Demessa BH, Demetriades AK, Demissie S, Dereje D, Dervišević E, Desai HD, Dessie AM, Desta F, Dhama K, Djalalinia S, Do TC, Dodangeh M, Dodangeh M, Dominguez RMV, Dongarwar D, Dsouza HL, Durojaiye OC, Dziedzic AM, Ekat MH, Ekholuenetale M, Ekundayo TC, El Sayed Zaki M, El-Abid H, Elhadi M, El-Hajj VG, El-Huneidi W, El-Sakka AA, Esayas HL, Fagbamigbe AF, Falahi S, Fares J, Fatehizadeh A, Fatima SAF, Feasey NA, Fekadu G, Fetensa G, Feyissa D, Fischer F, Foroutan B, Gaal PA, Gadanya MA, Gaipov A, Ganesan B, Gebrehiwot M, Gebrekidan KG, Gebremeskel TG, Gedef GM, Gela YY, Gerema U, Gessner BD, Getachew ME, Ghadiri K, Ghaffari K, Ghamari SH, Ghanbari R, Ghazy RMM, Ghozali G, Gizaw ABAB, Glushkova EV, Goldust M, Golechha M, Guadie HA, Guled RA, Gupta M, Gupta S, Gupta VB, Gupta VK, Gupta VK, Hadi NR, Haj-Mirzaian A, Haller S, Hamidi S, Haque S, Harapan H, Hasaballah AI, Hasan I, Hasani H, Hasanian M, Hassankhani H, Hassen MB, Hayat K, Heidari M, Heidari-Foroozan M, Heidari-Soureshjani R, Hezam K, Holla R, Horita N, Hossain MM, Hosseini MS, Hosseinzadeh M, Hostiuc S, Hussain S, Hussein NR, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Imam MT, Iregbu KC, Ismail NE, Iwu CCD, Jaja C, Jakovljevic M, Jamshidi E, Javadi Mamaghani A, Javidnia J, Jokar M, Jomehzadeh N, Joseph N, Joshua CE, Jozwiak JJ, Kabir Z, Kalankesh LR, Kalhor R, Kamal VK, Kandel H, Karaye IM, Karch A, Karimi H, Kaur H, Kaur N, Keykhaei M, Khajuria H, Khalaji A, Khan A, Khan IA, Khan M, Khan T, Khatab K, Khatatbeh MM, Khayat Kashani HR, Khubchandani J, Kim MS, Kisa A, Kisa S, Kompani F, Koohestani HR, Kothari N, Krishan K, Krishnamoorthy Y, Kulimbet M, Kumar M, Kumaran SD, Kuttikkattu A, Kwarteng A, Laksono T, Landires I, Laryea DO, Lawal BK, Le TTT, Ledda C, Lee SW, Lee S, Lema GK, Levi M, Lim SS, Liu X, Lopes G, Lutzky Saute R, Machado Teixeira PH, Mahmoodpoor A, Mahmoud MA, Malakan Rad E, Malhotra K, Malik AA, Martinez-Guerra BA, Martorell M, Mathur V, Mayeli M, Medina JRC, Melese A, Memish ZA, Mentis AFA, Merza MA, Mestrovic T, Michalek IM, Minh LHN, Mirahmadi A, Mirmosayyeb O, Misganaw A, Misra AK, Moghadasi J, Mohamed NS, Mohammad Y, Mohammadi E, Mohammed S, Mojarrad Sani M, Mojiri-forushani H, Mokdad AH, Momtazmanesh S, Monasta L, Moni MA, Mossialos E, Mostafavi E, Motaghinejad M, Mousavi Khaneghah A, Mubarik S, Muccioli L, Muhammad JS, Mulita F, Mulugeta T, Murillo-Zamora E, Mustafa G, Muthupandian S, Nagarajan AJ, Nainu F, Nair TS, Nargus S, Nassereldine H, Natto ZS, Nayak BP, Negoi I, Negoi RI, Nejadghaderi SA, Nguyen HQ, Nguyen PT, Nguyen VT, Niazi RK, Noroozi N, Nouraei H, Nuñez-Samudio V, Nuruzzaman KM, Nwatah VE, Nzoputam CI, Nzoputam OJ, Oancea B, Obaidur RM, Odetokun IA, Ogunsakin RE, Okonji OC, Olagunju AT, Olana LT, Olufadewa II, Oluwafemi YD, Oumer KS, Ouyahia A, P A M, Pakshir K, Palange PN, Pardhan S, Parikh RR, Patel J, Patel UK, Patil S, Paudel U, Pawar S, Pensato U, Perdigão J, Pereira M, Peres MFP, Petcu IR, Pinheiro M, Piracha ZZ, Pokhrel N, Postma MJ, Prates EJS, Qattea I, Raghav PR, Rahbarnia L, Rahimi-Movaghar V, Rahman M, Rahman MA, Rahmanian V, Rahnavard N, Ramadan H, Ramasubramani P, Rani U, Rao IR, Rapaka D, Ratan ZA, Rawaf S, Redwan EMM, Reiner Jr RC, Rezaei N, Riad A, Ribeiro da Silva TM, Roberts T, Robles Aguilar G, Rodriguez JAB, Rosenthal VD, Saddik B, Sadeghian S, Saeed U, Safary A, Saheb Sharif-Askari F, Saheb Sharif-Askari N, Sahebkar A, Sahu M, Sajedi SA, Saki M, Salahi S, Salahi S, Saleh MA, Sallam M, Samadzadeh S, Samy AM, Sanjeev RK, Satpathy M, Seylani A, Sha'aban A, Shafie M, Shah PA, Shahrokhi S, Shahzamani K, Shaikh MA, Sham S, Shannawaz M, Sheikh A, Shenoy SM, Shetty PH, Shin JI, Shokri F, Shorofi SA, Shrestha S, Sibhat MM, Siddig EE, Silva LMLR, Singh H, Singh JA, Singh P, Singh S, Sinto R, Skryabina AA, Socea B, Sokhan A, Solanki R, Solomon Y, Sood P, Soshnikov S, Stergachis A, Sufiyan MB, Suliankatchi Abdulkader R, Sultana A, T Y SS, Taheri E, Taki E, Tamuzi JJLL, Tan KK, Tat NY, Temsah MH, Terefa DR, Thangaraju P, Tibebu NS, Ticoalu JHV, Tillawi T, Tincho MB, Tleyjeh II, Toghroli R, Tovani-Palone MR, Tufa DG, Turner P, Ullah I, Umeokonkwo CD, Unnikrishnan B, Vahabi SM, Vaithinathan AG, Valizadeh R, Varthya SB, Vos T, Waheed Y, Walde MT, Wang C, Weerakoon KG, Wickramasinghe ND, Winkler AS, Woldemariam M, Worku NA, Wright C, Yada DY, Yaghoubi S, Yahya GATY, Yenew CYY, Yesiltepe M, Yi S, Yiğit V, You Y, Yusuf H, Zakham F, Zaman M, Zaman SB, Zare I, Zareshahrabadi Z, Zarrintan A, Zastrozhin MS, Zhang H, Zhang J, Zhang ZJ, Zheng P, Zoladl M, Zumla A, Hay SI, Murray CJL, Naghavi M, Kyu HH. Global, regional, and national burden of meningitis and its aetiologies, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2023; 22:685-711. [PMID: 37479374 PMCID: PMC10356620 DOI: 10.1016/s1474-4422(23)00195-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. METHODS We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. FINDINGS In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000-277 000) and 2·51 million (2·11-2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400-145 000) and 1·28 million incident cases (0·947-1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6-8·4) per 100 000 population in 1990 to 3·3 (2·8-3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1-19·2]), followed by N meningitidis (13·6% [12·7-14·4]) and K pneumoniae (12·2% [10·2-14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5-81·8]), followed by N meningitidis (72·3% [64·4-78·5]) and viruses (58·2% [47·1-67·3]). INTERPRETATION Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
8
|
Thomson AM, McHugh TA, Oron AP, Teply C, Lonberg N, Vilchis Tella V, Wilner LB, Fuller K, Hagins H, Aboagye RG, Aboye MB, Abu-Gharbieh E, Abu-Zaid A, Addo IY, Ahinkorah BO, Ahmad A, AlRyalat SAS, Amu H, Aravkin AY, Arulappan J, Atout MMW, Badiye AD, Bagherieh S, Banach M, Banakar M, Bardhan M, Barrow A, Bedane DA, Bensenor IM, Bhagavathula AS, Bhardwaj P, Bhardwaj PV, Bhat AN, Bhutta ZA, Bilalaga MM, Bishai JD, Bitaraf S, Boloor A, Butt MH, Chattu VK, Chu DT, Dadras O, Dai X, Danaei B, Dang AK, Demisse FW, Dhimal M, Diaz D, Djalalinia S, Dongarwar D, Elhadi M, Elmonem MA, Esezobor CI, Etaee F, Eyawo O, Fagbamigbe AF, Fatehizadeh A, Force LM, Gardner WM, Ghaffari K, Gill PS, Golechha M, Goleij P, Gupta VK, Hasani H, Hassan TS, Hassen MB, Ibitoye SE, Ikiroma AI, Iwu CCD, James PB, Jayaram S, Jebai R, Jha RP, Joseph N, Kalantar F, Kandel H, Karaye IM, Kassahun WD, Khan IA, Khanmohammadi S, Kisa A, Kompani F, Krishan K, Landires I, Lim SS, Mahajan PB, Mahjoub S, Majeed A, Marasini BP, Meresa HA, Mestrovic T, Minhas S, Misganaw A, Mokdad AH, Monasta L, Mustafa G, Nair TS, Narasimha Swamy S, Nassereldine H, Natto ZS, Naveed M, Nayak BP, Noubiap JJ, Noyes T, Nri-ezedi CA, Nwatah VE, Nzoputam CI, Nzoputam OJ, Okonji OC, Onikan AO, Owolabi MO, Patel J, Pati S, Pawar S, Petcu IR, Piel FB, Qattea I, Rahimi M, Rahman M, Rawaf S, Redwan EMM, Rezaei N, Saddik B, Saeed U, Saheb Sharif-Askari F, Samy AM, Schumacher AE, Shaker E, Shetty A, Sibhat MM, Singh JA, Suleman M, Sunuwar DR, Szeto MD, Tamuzi JJLL, Tat NY, Taye BT, Temsah MH, Umair M, Valadan Tahbaz S, Wang C, Wickramasinghe ND, Yigit A, Yiğit V, Yunusa I, Zaman BA, Zangiabadian M, Zheng P, Hay SI, Naghavi M, Murray CJL, Kassebaum NJ. Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000-2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Haematol 2023:S2352-3026(23)00118-7. [PMID: 37331373 PMCID: PMC10390339 DOI: 10.1016/s2352-3026(23)00118-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Previous global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population health effect of sickle cell disease. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study delivers a comprehensive global assessment of prevalence of sickle cell disease and mortality burden by age and sex for 204 countries and territories from 2000 to 2021. METHODS We estimated cause-specific sickle cell disease mortality using standardised GBD approaches, in which each death is assigned to a single underlying cause, to estimate mortality rates from the International Classification of Diseases (ICD)-coded vital registration, surveillance, and verbal autopsy data. In parallel, our goal was to estimate a more accurate account of sickle cell disease health burden using four types of epidemiological data on sickle cell disease: birth incidence, age-specific prevalence, with-condition mortality (total deaths), and excess mortality (excess deaths). Systematic reviews, supplemented with ICD-coded hospital discharge and insurance claims data, informed this modelling approach. We employed DisMod-MR 2.1 to triangulate between these measures-borrowing strength from predictive covariates and across age, time, and geography-and generated internally consistent estimates of incidence, prevalence, and mortality for three distinct genotypes of sickle cell disease: homozygous sickle cell disease and severe sickle cell β-thalassaemia, sickle-haemoglobin C disease, and mild sickle cell β-thalassaemia. Summing the three models yielded final estimates of incidence at birth, prevalence by age and sex, and total sickle cell disease mortality, the latter of which was compared directly against cause-specific mortality estimates to evaluate differences in mortality burden assessment and implications for the Sustainable Development Goals (SDGs). FINDINGS Between 2000 and 2021, national incidence rates of sickle cell disease were relatively stable, but total births of babies with sickle cell disease increased globally by 13·7% (95% uncertainty interval 11·1-16·5), to 515 000 (425 000-614 000), primarily due to population growth in the Caribbean and western and central sub-Saharan Africa. The number of people living with sickle cell disease globally increased by 41·4% (38·3-44·9), from 5·46 million (4·62-6·45) in 2000 to 7·74 million (6·51-9·2) in 2021. We estimated 34 400 (25 000-45 200) cause-specific all-age deaths globally in 2021, but total sickle cell disease mortality burden was nearly 11-times higher at 376 000 (303 000-467 000). In children younger than 5 years, there were 81 100 (58 800-108 000) deaths, ranking total sickle cell disease mortality as 12th (compared to 40th for cause-specific sickle cell disease mortality) across all causes estimated by the GBD in 2021. INTERPRETATION Our findings show a strikingly high contribution of sickle cell disease to all-cause mortality that is not apparent when each death is assigned to only a single cause. Sickle cell disease mortality burden is highest in children, especially in countries with the greatest under-5 mortality rates. Without comprehensive strategies to address morbidity and mortality associated with sickle cell disease, attainment of SDG 3.1, 3.2, and 3.4 is uncertain. Widespread data gaps and correspondingly high uncertainty in the estimates highlight the urgent need for routine and sustained surveillance efforts, further research to assess the contribution of conditions associated with sickle cell disease, and widespread deployment of evidence-based prevention and treatment for those with sickle cell disease. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
9
|
Haakenstad A, Yearwood JA, Fullman N, Bintz C, Bienhoff K, Weaver MR, Nandakumar V, LeGrand KE, Knight M, Abbafati C, Abbasi-Kangevari M, Abdoli A, Abeldaño Zuñiga RA, Adedeji IA, Adekanmbi V, Adetokunboh OO, Afzal MS, Afzal S, Agudelo-Botero M, Ahinkorah BO, Ahmad S, Ahmadi A, Ahmadi S, Ahmed A, Ahmed Rashid T, Aji B, Akande-Sholabi W, Alam K, Al Hamad H, Alhassan RK, Ali L, Alipour V, Aljunid SM, Ameyaw EK, Amin TT, Amu H, Amugsi DA, Ancuceanu R, Andrade PP, Anjum A, Arabloo J, Arab-Zozani M, Ariffin H, Arulappan J, Aryan Z, Ashraf T, Atnafu DD, Atreya A, Ausloos M, Avila-Burgos L, Ayano G, Ayanore MA, Azari S, Badiye AD, Baig AA, Bairwa M, Bakkannavar SM, Baliga S, Banik PC, Bärnighausen TW, Barra F, Barrow A, Basu S, Bayati M, Belete R, Bell AW, Bhagat DS, Bhagavathula AS, Bhardwaj P, Bhardwaj N, Bhaskar S, Bhattacharyya K, Bhurtyal A, Bhutta ZA, Bibi S, Bijani A, Bikbov B, Biondi A, Bolarinwa OA, Bonny A, Brenner H, Buonsenso D, Burkart K, Busse R, Butt ZA, Butt NS, Caetano dos Santos FL, Cahuana-Hurtado L, Cámera LA, Cárdenas R, Carneiro VLA, Catalá-López F, Chandan JS, Charan J, Chavan PP, Chen S, Chen S, Choudhari SG, Chowdhury EK, Chowdhury MAK, Cirillo M, Corso B, Dadras O, Dahlawi SMA, Dai X, Dandona L, Dandona R, Dangel WJ, Dávila-Cervantes CA, Davletov K, Deuba K, Dhimal M, Dhimal ML, Djalalinia S, Do HP, Doshmangir L, Duncan BB, Effiong A, Ehsani-Chimeh E, Elgendy IY, Elhadi M, El Sayed I, El Tantawi M, Erku DA, Eskandarieh S, Fares J, Farzadfar F, Ferrero S, Ferro Desideri L, Fischer F, Foigt NA, Foroutan M, Fukumoto T, Gaal PA, Gaihre S, Gardner WM, Garg T, Getachew Obsa A, Ghafourifard M, Ghashghaee A, Ghith N, Gilani SA, Gill PS, Goharinezhad S, Golechha M, Guadamuz JS, Guo Y, Gupta RD, Gupta R, Gupta VK, Gupta VB, Hamiduzzaman M, Hanif A, Haro JM, Hasaballah AI, Hasan MM, Hasan MT, Hashi A, Hay SI, Hayat K, Heidari M, Heidari G, Henry NJ, Herteliu C, Holla R, Hossain S, Hossain SJ, Hossain MBH, Hosseinzadeh M, Hostiuc S, Hoveidamanesh S, Hsieh VCR, Hu G, Huang J, Huda MM, Ifeagwu SC, Ikuta KS, Ilesanmi OS, Irvani SSN, Islam RM, Islam SMS, Ismail NE, Iso H, Isola G, Itumalla R, Iwagami M, Jahani MA, Jahanmehr N, Jain R, Jakovljevic M, Janodia MD, Jayapal SK, Jayaram S, Jha RP, Jonas JB, Joo T, Joseph N, Jürisson M, Kabir A, Kalankesh LR, Kalhor R, Kamath AM, Kamenov K, Kandel H, Kantar RS, Kapoor N, Karanikolos M, Katikireddi SV, Kavetskyy T, Kawakami N, Kayode GA, Keikavoosi-Arani L, Keykhaei M, Khader YS, Khajuria H, Khalilov R, Khammarnia M, Khan MN, Khan MAB, Khan M, Khezeli M, Kim MS, Kim YJ, Kisa S, Kisa A, Klymchuk V, Koly KN, Korzh O, Kosen S, Koul PA, Kuate Defo B, Kumar GA, Kusuma D, Kyu HH, Larsson AO, Lasrado S, Lee WC, Lee YH, Lee CB, Li S, Lucchetti G, Mahajan PB, Majeed A, Makki A, Malekzadeh R, Malik AA, Malta DC, Mansournia MA, Mantovani LG, Martinez-Valle A, Martins-Melo FR, Masoumi SZ, Mathur MR, Maude RJ, Maulik PK, McKee M, Mendoza W, Menezes RG, Mensah GA, Meretoja A, Meretoja TJ, Mestrovic T, Michalek IM, Mirrakhimov EM, Misganaw A, Misra S, Moazen B, Mohammadi M, Mohammed S, Moitra M, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moradi G, Moreira RS, Mosser JF, Mostafavi E, Mouodi S, Nagarajan AJ, Nagata C, Naghavi M, Nangia V, Narasimha Swamy S, Narayana AI, Nascimento BR, Nassereldine H, Nayak BP, Nazari J, Negoi I, Nepal S, Neupane Kandel S, Ngunjiri JW, Nguyen HLT, Nguyen CT, Ningrum DNA, Noubiap JJ, Oancea B, Oghenetega OB, Oh IH, Olagunju AT, Olakunde BO, Omar Bali A, Omer E, Onwujekwe OE, Otoiu A, Padubidri JR, Palladino R, Pana A, Panda-Jonas S, Pandi-Perumal SR, Pardhan S, Pasupula DK, Pathak PK, Patton GC, Pawar S, Pereira J, Pilania M, Piroozi B, Podder V, Pokhrel KN, Postma MJ, Prada SI, Quazi Syed Z, Rabiee N, Radhakrishnan RA, Rahman MM, Rahman M, Rahman M, Rahman MHU, Rahmani AM, Ranabhat CL, Rao CR, Rao SJ, Rasella D, Rawaf S, Rawaf DL, Rawal L, Renzaho AM, Reshmi B, Resnikoff S, Rezapour A, Riahi SM, Ripon RK, Sacco S, Sadeghi M, Saeed U, Sahebkar A, Sahiledengle B, Sahoo H, Sahu M, Salama JS, Salamati P, Samy AM, Sanabria J, Santric-Milicevic MM, Sathian B, Sawhney M, Schmidt MI, Seidu AA, Sepanlou SG, Seylani A, Shaikh MA, Sheikh A, Shetty A, Shigematsu M, Shiri R, Shivakumar KM, Shokri A, Singh JA, Sinha DN, Skryabin VY, Skryabina AA, Sofi-Mahmudi A, Sousa RARC, Stephens JH, Sun J, Szócska M, Tabarés-Seisdedos R, Tadbiri H, Tamiru AT, Thankappan KR, Topor-Madry R, Tovani-Palone MR, Tran MTN, Tran BX, Tripathi N, Tripathy JP, Troeger CE, Uezono DR, Ullah S, Ullah A, Unnikrishnan B, Vacante M, Valadan Tahbaz S, Valdez PR, Vasic M, Veroux M, Vervoort D, Violante FS, Vladimirov SK, Vlassov V, Vo B, Waheed Y, Wamai RG, Wang YP, Wang Y, Ward P, Wiangkham T, Yadav L, Yahyazadeh Jabbari SH, Yamagishi K, Yaya S, Yazdi-Feyzabadi V, Yi S, Yiğit V, Yonemoto N, Younis MZ, Yu C, Yunusa I, Zaman SB, Zastrozhin MS, Zhang ZJ, Zhong C, Zuniga YMH, Lim SS, Murray CJL, Lozano R. Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Glob Health 2022; 10:e1715-e1743. [PMID: 36209761 PMCID: PMC9666426 DOI: 10.1016/s2214-109x(22)00429-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/13/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. METHODS We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. FINDINGS Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9-21·3), as well as among the young (22·5, 19·9-24·7), working (17·2, 15·2-19·1), and post-working (15·1, 13·2-17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6-33·0) on average in low-SDI countries to 83·4 (82·4-84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4-89·0), working (33·8-82·8), and post-working (30·4-79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. INTERPRETATION Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
10
|
Bryazka D, Reitsma MB, Griswold MG, Abate KH, Abbafati C, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abdoli A, Abdollahi M, Abdullah AYM, Abhilash ES, Abu-Gharbieh E, Acuna JM, Addolorato G, Adebayo OM, Adekanmbi V, Adhikari K, Adhikari S, Adnani QES, Afzal S, Agegnehu WY, Aggarwal M, Ahinkorah BO, Ahmad AR, Ahmad S, Ahmad T, Ahmadi A, Ahmadi S, Ahmed H, Ahmed Rashid T, Akunna CJ, Al Hamad H, Alam MZ, Alem DT, Alene KA, Alimohamadi Y, Alizadeh A, Allel K, Alonso J, Alvand S, Alvis-Guzman N, Amare F, Ameyaw EK, Amiri S, Ancuceanu R, Anderson JA, Andrei CL, Andrei T, Arabloo J, Arshad M, Artamonov AA, Aryan Z, Asaad M, Asemahagn MA, Astell-Burt T, Athari SS, Atnafu DD, Atorkey P, Atreya A, Ausloos F, Ausloos M, Ayano G, Ayanore MAA, Ayinde OO, Ayuso-Mateos JL, Azadnajafabad S, Azanaw MM, Azangou-Khyavy M, Azari Jafari A, Azzam AY, Badiye AD, Bagheri N, Bagherieh S, Bairwa M, Bakkannavar SM, Bakshi RK, Balchut/Bilchut AH, Bärnighausen TW, Barra F, Barrow A, Baskaran P, Belo L, Bennett DA, Benseñor IM, Bhagavathula AS, Bhala N, Bhalla A, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bintoro BS, Blokhina EAE, Bodicha BBA, Boloor A, Bosetti C, Braithwaite D, Brenner H, Briko NI, Brunoni AR, Butt ZA, Cao C, Cao Y, Cárdenas R, Carvalho AF, Carvalho M, Castaldelli-Maia JM, Castelpietra G, Castro-de-Araujo LFS, Cattaruzza MS, Chakraborty PA, Charan J, Chattu VK, Chaurasia A, Cherbuin N, Chu DT, Chudal N, Chung SC, Churko C, Ciobanu LG, Cirillo M, Claro RM, Costanzo S, Cowden RG, Criqui MH, Cruz-Martins N, Culbreth GT, Dachew BA, Dadras O, Dai X, Damiani G, Dandona L, Dandona R, Daniel BD, Danielewicz A, Darega Gela J, Davletov K, de Araujo JAP, de Sá-Junior AR, Debela SA, Dehghan A, Demetriades AK, Derbew Molla M, Desai R, Desta AA, Dias da Silva D, Diaz D, Digesa LE, Diress M, Dodangeh M, Dongarwar D, Dorostkar F, Dsouza HL, Duko B, Duncan BB, Edvardsson K, Ekholuenetale M, Elgar FJ, Elhadi M, Elmonem MA, Endries AY, Eskandarieh S, Etemadimanesh A, Fagbamigbe AF, Fakhradiyev IR, Farahmand F, Farinha CSES, Faro A, Farzadfar F, Fatehizadeh A, Fauk NK, Feigin VL, Feldman R, Feng X, Fentaw Z, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Francis JM, Franklin RC, Gaal PA, Gad MM, Gallus S, Galvano F, Ganesan B, Garg T, Gebrehiwot MGD, Gebremeskel TG, Gebremichael MA, Gemechu TR, Getacher L, Getachew ME, Getachew Obsa A, Getie A, Ghaderi A, Ghafourifard M, Ghajar A, Ghamari SH, Ghandour LA, Ghasemi Nour M, Ghashghaee A, Ghozy S, Glozah FN, Glushkova EV, Godos J, Goel A, Goharinezhad S, Golechha M, Goleij P, Golitaleb M, Greaves F, Grivna M, Grosso G, Gudayu TW, Gupta B, Gupta R, Gupta S, Gupta VB, Gupta VK, Hafezi-Nejad N, Haj-Mirzaian A, Hall BJ, Halwani R, Handiso TB, Hankey GJ, Hariri S, Haro JM, Hasaballah AI, Hassanian-Moghaddam H, Hay SI, Hayat K, Heidari G, Heidari M, Hendrie D, Herteliu C, Heyi DZ, Hezam K, Hlongwa MM, Holla R, Hossain MM, Hossain S, Hosseini SK, hosseinzadeh M, Hostiuc M, Hostiuc S, Hu G, Huang J, Hussain S, Ibitoye SE, Ilic IM, Ilic MD, Immurana M, Irham LM, Islam MM, Islam RM, Islam SMS, Iso H, Itumalla R, Iwagami M, Jabbarinejad R, Jacob L, Jakovljevic M, Jamalpoor Z, Jamshidi E, Jayapal SK, Jayarajah UU, Jayawardena R, Jebai R, Jeddi SA, Jema AT, Jha RP, Jindal HA, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabthymer RH, Kamble BD, Kandel H, Kanno GG, Kapoor N, Karaye IM, Karimi SE, Kassa BG, Kaur RJ, Kayode GA, Keykhaei M, Khajuria H, Khalilov R, Khan IA, Khan MAB, Kim H, Kim J, Kim MS, Kimokoti RW, Kivimäki M, Klymchuk V, Knudsen AKS, Kolahi AA, Korshunov VA, Koyanagi A, Krishan K, Krishnamoorthy Y, Kumar GA, Kumar N, Kumar N, Lacey B, Lallukka T, Lasrado S, Lau J, Lee SW, Lee WC, Lee YH, Lim LL, Lim SS, Lobo SW, Lopukhov PD, Lorkowski S, Lozano R, Lucchetti G, Madadizadeh F, Madureira-Carvalho ÁM, Mahjoub S, Mahmoodpoor A, Mahumud RA, Makki A, Malekpour MR, Manjunatha N, Mansouri B, Mansournia MA, Martinez-Raga J, Martinez-Villa FA, Matzopoulos R, Maulik PK, Mayeli M, McGrath JJ, Meena JK, Mehrabi Nasab E, Menezes RG, Mensink GBM, Mentis AFA, Meretoja A, Merga BT, Mestrovic T, Miao Jonasson J, Miazgowski B, Micheletti Gomide Nogueira de Sá AC, Miller TR, Mini GK, Mirica A, Mirijello A, Mirmoeeni S, Mirrakhimov EM, Misra S, Moazen B, Mobarakabadi M, Moccia M, Mohammad Y, Mohammadi E, Mohammadian-Hafshejani A, Mohammed TA, Moka N, Mokdad AH, Momtazmanesh S, Moradi Y, Mostafavi E, Mubarik S, Mullany EC, Mulugeta BT, Murillo-Zamora E, Murray CJL, Mwita JC, Naghavi M, Naimzada MD, Nangia V, Nayak BP, Negoi I, Negoi RI, Nejadghaderi SA, Nepal S, Neupane SPP, Neupane Kandel S, Nigatu YT, Nowroozi A, Nuruzzaman KM, Nzoputam CI, Obamiro KO, Ogbo FA, Oguntade AS, Okati-Aliabad H, Olakunde BO, Oliveira GMM, Omar Bali A, Omer E, Ortega-Altamirano DV, Otoiu A, Otstavnov SS, Oumer B, P A M, Padron-Monedero A, Palladino R, Pana A, Panda-Jonas S, Pandey A, Pandey A, Pardhan S, Parekh T, Park EK, Parry CDH, Pashazadeh Kan F, Patel J, Pati S, Patton GC, Paudel U, Pawar S, Peden AE, Petcu IR, Phillips MR, Pinheiro M, Plotnikov E, Pradhan PMS, Prashant A, Quan J, Radfar A, Rafiei A, Raghav PR, Rahimi-Movaghar V, Rahman A, Rahman MM, Rahman M, Rahmani AM, Rahmani S, Ranabhat CL, Ranasinghe P, Rao CR, Rasali DP, Rashidi MM, Ratan ZA, Rawaf DL, Rawaf S, Rawal L, Renzaho AMN, Rezaei N, Rezaei S, Rezaeian M, Riahi SM, Romero-Rodríguez E, Roth GA, Rwegerera GM, Saddik B, Sadeghi E, Sadeghian R, Saeed U, Saeedi F, Sagar R, Sahebkar A, Sahoo H, Sahraian MA, Saif-Ur-Rahman KM, Salahi S, Salimzadeh H, Samy AM, Sanmarchi F, Santric-Milicevic MM, Sarikhani Y, Sathian B, Saya GK, Sayyah M, Schmidt MI, Schutte AE, Schwarzinger M, Schwebel DC, Seidu AA, Senthil Kumar N, SeyedAlinaghi S, Seylani A, Sha F, Shahin S, Shahraki-Sanavi F, Shahrokhi S, Shaikh MA, Shaker E, Shakhmardanov MZ, Shams-Beyranvand M, Sheikhbahaei S, Sheikhi RA, Shetty A, Shetty JK, Shiferaw DS, Shigematsu M, Shiri R, Shirkoohi R, Shivakumar KM, Shivarov V, Shobeiri P, Shrestha R, Sidemo NB, Sigfusdottir ID, Silva DAS, Silva NTD, Singh JA, Singh S, Skryabin VY, Skryabina AA, Sleet DA, Solmi M, SOLOMON YONATAN, Song S, Song Y, Sorensen RJD, Soshnikov S, Soyiri IN, Stein DJ, Subba SH, Szócska M, Tabarés-Seisdedos R, Tabuchi T, Taheri M, Tan KK, Tareke M, Tarkang EE, Temesgen G, Temesgen WA, Temsah MH, Thankappan KR, Thapar R, Thomas NK, Tiruneh C, Todorovic J, Torrado M, Touvier M, Tovani-Palone MR, Tran MTN, Trias-Llimós S, Tripathy JP, Vakilian A, Valizadeh R, Varmaghani M, Varthya SB, Vasankari TJ, Vos T, Wagaye B, Waheed Y, Walde MT, Wang C, Wang Y, Wang YP, Westerman R, Wickramasinghe ND, Wubetu AD, Xu S, Yamagishi K, Yang L, Yesera GEE, Yigit A, Yiğit V, Yimaw AEAE, Yon DK, Yonemoto N, Yu C, Zadey S, Zahir M, Zare I, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Zhong C, Zmaili M, Zuniga YMH, Gakidou E. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. Lancet 2022; 400:185-235. [PMID: 35843246 PMCID: PMC9289789 DOI: 10.1016/s0140-6736(22)00847-9] [Citation(s) in RCA: 122] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/11/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. METHODS For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. FINDINGS The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. INTERPRETATION There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
11
|
Sheena BS, Hiebert L, Han H, Ippolito H, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abbastabar H, Abdoli A, Abubaker Ali H, Adane MM, Adegboye OA, Adnani QES, Advani SM, Afzal MS, Afzal S, Aghaie Meybodi M, Ahadinezhad B, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi S, Ahmed H, Ahmed MB, Ahmed Rashid T, Akalu GT, Aklilu A, Akram T, Al Hamad H, Alahdab F, Alem AZ, Alem DT, Alhalaiqa FAN, Alhassan RK, Ali L, Ali MA, Alimohamadi Y, Alipour V, Alkhayyat M, Almustanyir S, Al-Raddadi RM, Altawalah H, Amini S, Amu H, Ancuceanu R, Andrei CL, Andrei T, Anoushiravani A, Ansar A, Anyasodor AE, Arabloo J, Arab-Zozani M, Argaw AM, Argaw ZG, Arshad M, Artamonov AA, Ashraf T, Atlaw D, Ausloos F, Ausloos M, Azadnajafabad S, Azangou-Khyavy M, Azari Jafari A, Azarian G, Bagheri S, Bahadory S, Baig AA, Banach M, Barati N, Barrow A, Batiha AMM, Bejarano Ramirez DF, Belgaumi UI, Berhie AY, Bhagat DS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhojaraja VS, Bijani A, Biondi A, Bodicha BBA, Bojia HA, Boloor A, Bosetti C, Braithwaite D, Briko NI, Butt ZA, Cámera LA, Chakinala RC, Chakraborty PA, Charan J, Chen S, Choi JYJ, Choudhari SG, Chowdhury FR, Chu DT, Chung SC, Cortesi PA, Cowie BC, Culbreth GT, Dadras O, Dai X, Dandona L, Dandona R, De la Hoz FP, Debela SA, Dedefo MG, Demeke FM, Demie TGG, Demissie GD, Derbew Molla M, Desta AA, Dhamnetiya D, Dhimal ML, Dhimal M, Didehdar M, Doan LP, Dorostkar F, Drake TM, Eghbalian F, Ekholuenetale M, El Sayed I, El Sayed Zaki M, Elhadi M, Elmonem MA, Elsharkawy A, Enany S, Enyew DB, Erkhembayar R, Eskandarieh S, Esmaeilzadeh F, Ezzikouri S, Farrokhpour H, Fetensa G, Fischer F, Foroutan M, Gad MM, Gaidhane AM, Gaidhane S, Galles NC, Gallus S, Gebremeskel TG, Gebreyohannes EAA, Ghadiri K, Ghaffari K, Ghafourifard M, Ghamari SH, Ghashghaee A, Gholami A, Gholizadeh A, Gilani A, Goel A, Golechha M, Goleij P, Golinelli D, Gorini G, Goshu YA, Griswold MG, Gubari MIM, Gupta B, Gupta S, Gupta VB, Gupta VK, Haddadi R, Halwani R, Hamid SS, Hamidi S, Hanif A, Haque S, Harapan H, Hargono A, Hariri S, Hasaballah AI, Hasan SMM, Hassanipour S, Hassankhani H, Hay SI, Hayat K, Heidari G, Herteliu C, Heyi DZ, Hezam K, Holla R, Hosseini MS, Hosseini M, Hosseinzadeh M, Hostiuc M, Househ M, Huang J, Hussein NR, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Irham LM, Islam JY, Ismail NE, Jacobsen KH, Jadidi-Niaragh F, Javadi Mamaghani A, Jayaram S, Jayawardena R, Jebai R, Jha RP, Joseph N, Joukar F, Kaambwa B, Kabir A, Kabir Z, Kalhor R, Kandel H, Kanko TKT, Kantar RS, Karaye IM, Kassa BG, Kemp Bohan PM, Keykhaei M, Khader YS, Khajuria H, Khan G, Khan IA, Khan J, Khan MAB, Khanali J, Khater AM, Khatib MN, Khodadost M, Khoja AT, Khosravizadeh O, Khubchandani J, Kim GR, Kim H, Kim MS, Kim YJ, Kocarnik JM, Kolahi AA, Koteeswaran R, Kumar GA, La Vecchia C, Lal DK, Landires I, Lasrado S, Lazarus JV, Ledda C, Lee DW, Lee SW, Lee YY, Levi M, Li J, Lim SS, Lobo SW, Lopukhov PD, Loureiro JA, MacLachlan JH, Magdy Abd El Razek H, Magdy Abd El Razek M, Majeed A, Makki A, Malekpour MR, Malekzadeh R, Malik AA, Mansour-Ghanaei F, Mansournia MA, Martins-Melo FR, Matthews PC, Mendoza W, Menezes RG, Meretoja TJ, Mersha AG, Mestrovic T, Miller TR, Minh LHN, Mirica A, Mirmoeeni S, Mirrakhimov EM, Misra S, Mithra P, Moazen B, Mohamadkhani A, Mohammadi M, Mohammed S, Moka N, Mokdad AH, Moludi J, Momtazmanesh S, Monasta L, Moradi G, Moradzadeh M, Moradzadeh R, Moraga P, Mostafavi E, Mubarik S, Muniyandi M, Murray CJL, Naghavi M, Naimzada MD, Narasimha Swamy S, Natto ZS, Nayak BP, Nazari J, Negoi I, Negru SM, Nejadghaderi SA, Neupane Kandel S, Nguyen HLT, Ngwa CH, Niazi RK, Nnaji CA, Noubiap JJ, Nowroozi A, Nuñez-Samudio V, Oancea B, Ochir C, Odukoya OO, Oh IH, Olagunju AT, Olakunde BO, Omar Bali A, Omer E, Otstavnov SS, Oumer B, Padubidri JR, Pana A, Pandey A, Park EC, Pashazadeh Kan F, Patel UK, Paudel U, Petcu IR, Piracha ZZ, Pollok RCG, Postma MJ, Pourshams A, Poustchi H, Rabiee M, Rabiee N, Rafiei A, Rafiei S, Raghuram PM, Rahman M, Rahmani AM, Rahmawaty S, Rajesh A, Ranasinghe P, Rao CR, Rao SJ, Rashidi M, Rashidi MM, Rawaf DL, Rawaf S, Rawassizadeh R, Rezaei N, Rezapour A, Rezazadeh-Khadem S, Rodriguez JAB, Rwegerera GM, Sabour S, Saddik B, Saeb MR, Saeed U, Sahebkar A, Saif-Ur-Rahman KM, Salahi S, Salimzadeh H, Sampath C, Samy AM, Sanabria J, Sanmarchi F, Santric-Milicevic MM, Sarveazad A, Sathian B, Sawhney M, Seidu AA, Sepanlou SG, Seylani A, Shahabi S, Shaikh MA, Shaker E, Shakhmardanov MZ, Shannawaz M, Shenoy SM, Shetty JK, Shetty PH, Shibuya K, Shin JI, Shobeiri P, Sibhat MM, Singh AD, Singh JA, Singh S, Skryabin VY, Skryabina AA, Sohrabpour AA, Song S, Tabaeian SP, Tadesse EG, Taheri M, Tampa M, Tan KK, Tavakoli A, Tbakhi A, Tefera BN, Tehrani-Banihashemi A, Tesfaw HM, Thapar R, Thavamani A, Tohidast SA, Tollosa DN, Tosti ME, Tovani-Palone MR, Traini E, Tran MTN, Trihandini I, Tusa BS, Ullah I, Vacante M, Valadan Tahbaz S, Valdez PR, Varthya SB, Vo B, Waheed Y, Weldesenbet AB, Woldemariam M, Xu S, Yahyazadeh Jabbari SH, Yaseri M, Yeshaw Y, Yiğit V, Yirdaw BW, Yonemoto N, Yu C, Yunusa I, Zahir M, Zaki L, Zamani M, Zamanian M, Zastrozhin MS, Vos T, Ward JW, Dirac MA. Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol 2022; 7:796-829. [PMID: 35738290 PMCID: PMC9349325 DOI: 10.1016/s2468-1253(22)00124-8] [Citation(s) in RCA: 176] [Impact Index Per Article: 88.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 12/23/2022]
Abstract
Background Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 000 global deaths (487 000 to 630 000) in 2019. The number of HBV-related deaths increased between 1990 and 2019 (by 5·9% [–5·6 to 19·2]) and between 2015 and 2019 (by 2·9% [–5·9 to 11·3]). By contrast, all-age and age-standardised death rates due to HBV-related diseases decreased during these periods. We compared estimates for 2019 in 194 WHO locations to WHO-GHSS 2020 targets, and found that four countries achieved a 10% reduction in deaths, 15 countries achieved a 30% reduction in new cases, and 147 countries achieved a 1% prevalence in children younger than 5 years. As of 2019, 68 of 194 countries had already achieved the 2030 target proposed in WHO Interim Guidance of an all-age HBV-related death rate of four per 100 000. Interpretation The prevalence of chronic HBV infection declined over time, particularly in children younger than 5 years, since the introduction of hepatitis B vaccination. HBV-related death rates also decreased, but HBV-related death counts increased as a result of population growth, ageing, and cohort effects. By 2019, many countries had met the interim seroprevalence target for children younger than 5 years, but few countries had met the WHO-GHSS interim targets for deaths and new cases. Progress according to all indicators must be accelerated to meet 2030 targets, and there are marked disparities in burden and progress across the world. HBV interventions, such as vaccination, testing, and treatment, must be strategically supported and scaled up to achieve elimination. Funding Bill & Melinda Gates Foundation.
Collapse
|
12
|
Ledesma JR, Ma J, Vongpradith A, Maddison ER, Novotney A, Biehl MH, LeGrand KE, Ross JM, Jahagirdar D, Bryazka D, Feldman R, Abolhassani H, Abosetugn AE, Abu-Gharbieh E, Adebayo OM, Adnani QES, Afzal S, Ahinkorah BO, Ahmad SA, Ahmadi S, Ahmed Rashid T, Ahmed Salih Y, Aklilu A, Akunna CJ, Al Hamad H, Alahdab F, Alemayehu Y, Alene KA, Ali BA, Ali L, Alipour V, Alizade H, Al-Raddadi RM, Alvis-Guzman N, Amini S, Amit AML, Anderson JA, Androudi S, Antonio CAT, Antony CM, Anwer R, Arabloo J, Arja A, Asemahagn MA, Atre SR, Azhar GS, B DB, Babar ZUD, Baig AA, Banach M, Barqawi HJ, Barra F, Barrow A, Basu S, Belgaumi UI, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharjee NV, Bhattacharyya K, Bijani A, Bikbov B, Boloor A, Briko NI, Buonsenso D, Burugina Nagaraja S, Butt ZA, Carter A, Carvalho F, Charan J, Chatterjee S, Chattu SK, Chattu VK, Christopher DJ, Chu DT, Claassens MM, Dadras O, Dagnew AB, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Darwesh AM, Dhamnetiya D, Dianatinasab M, Diaz D, Doan LP, Eftekharzadeh S, Elhadi M, Emami A, Enany S, Faraon EJA, Farzadfar F, Fernandes E, Ferro Desideri L, Filip I, Fischer F, Foroutan M, Frank TD, Garcia-Basteiro AL, Garcia-Calavaro C, Garg T, Geberemariyam BS, Ghadiri K, Ghashghaee A, Golechha M, Goodridge A, Gupta B, Gupta S, Gupta VB, Gupta VK, Haider MR, Hamidi S, Hanif A, Haque S, Harapan H, Hargono A, Hasaballah AI, Hashi A, Hassan S, Hassankhani H, Hayat K, Hezam K, Holla R, Hosseinzadeh M, Hostiuc M, Househ M, Hussain R, Ibitoye SE, Ilic IM, Ilic MD, Irvani SSN, Ismail NE, Itumalla R, Jaafari J, Jacobsen KH, Jain V, Javanmardi F, Jayapal SK, Jayaram S, Jha RP, Jonas JB, Joseph N, Joukar F, Kabir Z, Kamath A, Kanchan T, Kandel H, Katoto PDMC, Kayode GA, Kendrick PJ, Kerbo AA, Khajuria H, Khalilov R, Khatab K, Khoja AT, Khubchandani J, Kim MS, Kim YJ, Kisa A, Kisa S, Kosen S, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kucuk Bicer B, Kumar A, Kumar GA, Kumar N, Kumar N, Kwarteng A, Lak HM, Lal DK, Landires I, Lasrado S, Lee SWH, Lee WC, Lin C, Liu X, Lopukhov PD, Lozano R, Machado DB, Madhava Kunjathur S, Madi D, Mahajan PB, Majeed A, Malik AA, Martins-Melo FR, Mehta S, Memish ZA, Mendoza W, Menezes RG, Merie HE, Mersha AG, Mesregah MK, Mestrovic T, Mheidly NM, Misra S, Mithra P, Moghadaszadeh M, Mohammadi M, Mohammadian-Hafshejani A, Mohammed S, Molokhia M, Moni MA, Montasir AA, Moore CE, Nagarajan AJ, Nair S, Nair S, Naqvi AA, Narasimha Swamy S, Nayak BP, Nazari J, Neupane Kandel S, Nguyen TH, Nixon MR, Nnaji CA, Ntsekhe M, Nuñez-Samudio V, Oancea B, Odukoya OO, Olagunju AT, Oren E, P A M, Parthasarathi R, Pashazadeh Kan F, Pattanshetty SM, Paudel R, Paul P, Pawar S, Pepito VCF, Perico N, Pirestani M, Polibin RV, Postma MJ, Pourshams A, Prashant A, Pribadi DRA, Radfar A, Rafiei A, Rahim F, Rahimi-Movaghar V, Rahman M, Rahman M, Rahmani AM, Ranasinghe P, Rao CR, Rawaf DL, Rawaf S, Reitsma MB, Remuzzi G, Renzaho AMN, Reta MA, Rezaei N, Rezahosseini O, Rezai MS, Rezapour A, Roshandel G, Roshchin DO, Sabour S, Saif-Ur-Rahman KM, Salam N, Samadi Kafil H, Samaei M, Samy AM, Saroshe S, Sartorius B, Sathian B, Sawyer SM, Senthilkumaran S, Seylani A, Shafaat O, Shaikh MA, Sharafi K, Shetty RS, Shigematsu M, Shin JI, Silva JP, Singh JK, Sinha S, Skryabin VY, Skryabina AA, Spurlock EE, Sreeramareddy CT, Steiropoulos P, Sufiyan MB, Tabuchi T, Tadesse EG, Tamir Z, Tarkang EE, Tekalegn Y, Tesfay FH, Tessema B, Thapar R, Tleyjeh II, Tobe-Gai R, Tran BX, Tsegaye B, Tsegaye GW, Ullah A, Umeokonkwo CD, Valadan Tahbaz S, Vo B, Vu GT, Waheed Y, Walters MK, Whisnant JL, Woldekidan MA, Wubishet BL, Yahyazadeh Jabbari SH, Yazie TSY, Yeshaw Y, Yi S, Yiğit V, Yonemoto N, Yu C, Yunusa I, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Zumla A, Mokdad AH, Salomon JA, Reiner Jr RC, Lim SS, Naghavi M, Vos T, Hay SI, Murray CJL, Kyu HH. Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990-2019: results from the Global Burden of Disease Study 2019. Lancet Infect Dis 2022; 22:222-241. [PMID: 34563275 PMCID: PMC8799634 DOI: 10.1016/s1473-3099(21)00449-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/21/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019. METHODS We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates. FINDINGS Globally, in 2019, among HIV-negative individuals, there were 1·18 million (95% uncertainty interval 1·08-1·29) deaths due to tuberculosis and 8·50 million (7·45-9·73) incident cases of tuberculosis. Among HIV-positive individuals, there were 217 000 (153 000-279 000) deaths due to tuberculosis and 1·15 million (1·01-1·32) incident cases in 2019. More deaths and incident cases occurred in males than in females among HIV-negative individuals globally in 2019, with 342 000 (234 000-425 000) more deaths and 1·01 million (0·82-1·23) more incident cases in males than in females. Among HIV-positive individuals, 6250 (1820-11 400) more deaths and 81 100 (63 300-100 000) more incident cases occurred among females than among males in 2019. Age-standardised mortality rates among HIV-negative males were more than two times greater in 105 countries and age-standardised incidence rates were more than 1·5 times greater in 74 countries than among HIV-negative females in 2019. The fraction of global tuberculosis deaths among HIV-negative individuals attributable to alcohol use, smoking, and diabetes was 4·27 (3·69-5·02), 6·17 (5·48-7·02), and 1·17 (1·07-1·28) times higher, respectively, among males than among females in 2019. Among individuals with HIV and tuberculosis coinfection, the fraction of mortality attributable to injection drug use was 2·23 (2·03-2·44) times greater among males than females, whereas the fraction due to unsafe sex was 1·06 (1·05-1·08) times greater among females than males. INTERPRETATION As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis. This strategy will be crucial in reaching both equity and burden targets outlined by global health milestones. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
13
|
Micah AE, Cogswell IE, Cunningham B, Ezoe S, Harle AC, Maddison ER, McCracken D, Nomura S, Simpson KE, Stutzman HN, Tsakalos G, Wallace LE, Zhao Y, Zende RR, Abbafati C, Abdelmasseh M, Abedi A, Abegaz KH, Abhilash ES, Abolhassani H, Abrigo MRM, Adhikari TB, Afzal S, Ahinkorah BO, Ahmadi S, Ahmed H, Ahmed MB, Ahmed Rashid T, Ajami M, Aji B, Akalu Y, Akunna CJ, Al Hamad H, Alam K, Alanezi FM, Alanzi TM, Alemayehu Y, Alhassan RK, Alinia C, Aljunid SM, Almustanyir SA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amini S, Amini-Rarani M, Amu H, Ancuceanu R, Andrei CL, Andrei T, Angell B, Anjomshoa M, Antonio CAT, Antony CM, Aqeel M, Arabloo J, Arab-Zozani M, Aripov T, Arrigo A, Ashraf T, Atnafu DD, Ausloos M, Avila-Burgos L, Awan AT, Ayano G, Ayanore MA, Azari S, Azhar GS, Babalola TK, Bahrami MA, Baig AA, Banach M, Barati N, Bärnighausen TW, Barrow A, Basu S, Baune BT, Bayati M, Benzian H, Berman AE, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhaskar S, Bibi S, Bijani A, Bodolica V, Bragazzi NL, Braithwaite D, Breitborde NJK, Breusov AV, Briko NI, Busse R, Cahuana-Hurtado L, Callander EJ, Cámera LA, Castañeda-Orjuela CA, Catalá-López F, Charan J, Chatterjee S, Chattu SK, Chattu VK, Chen S, Cicero AFG, Dadras O, Dahlawi SMA, Dai X, Dalal K, Dandona L, Dandona R, Davitoiu DV, De Neve JW, de Sá-Junior AR, Denova-Gutiérrez E, Dhamnetiya D, Dharmaratne SD, Doshmangir L, Dube J, Ehsani-Chimeh E, El Sayed Zaki M, El Tantawi M, Eskandarieh S, Farzadfar F, Ferede TY, Fischer F, Foigt NA, Freitas A, Friedman SD, Fukumoto T, Fullman N, Gaal PA, Gad MM, Garcia-Gordillo MA, Garg T, Ghafourifard M, Ghashghaee A, Gholamian A, Gholamrezanezhad A, Ghozali G, Gilani SA, Glăvan IR, Glushkova EV, Goharinezhad S, Golechha M, Goli S, Guha A, Gupta VB, Gupta VK, Haakenstad A, Haider MR, Hailu A, Hamidi S, Hanif A, Harapan H, Hartono RK, Hasaballah AI, Hassan S, Hassanein MH, Hayat K, Hegazy MI, Heidari G, Hendrie D, Heredia-Pi I, Herteliu C, Hezam K, Holla R, Hossain SJ, Hosseinzadeh M, Hostiuc S, Huda TM, Hwang BF, Iavicoli I, Idrisov B, Ilesanmi OS, Irvani SSN, Islam SMS, Ismail NE, Isola G, Jahani MA, Jahanmehr N, Jakovljevic M, Janodia MD, Javaheri T, Jayapal SK, Jayawardena R, Jazayeri SB, Jha RP, Jonas JB, Joo T, Joukar F, Jürisson M, Kaambwa B, Kalhor R, Kanchan T, Kandel H, Karami Matin B, Karimi SE, Kassahun G, Kayode GA, Kazemi Karyani A, Keikavoosi-Arani L, Khader YS, Khajuria H, Khalilov R, Khammarnia M, Khan J, Khubchandani J, Kianipour N, Kim GR, Kim YJ, Kisa A, Kisa S, Kohler S, Kosen S, Koteeswaran R, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kumar GA, Kusuma D, Lamnisos D, Lansingh VC, Larsson AO, Lasrado S, Le LKD, Lee SWH, Lee YY, Lim SS, Lobo SW, Lozano R, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahdavi MM, Majeed A, Makki A, Maleki A, Malekzadeh R, Manda AL, Mansour-Ghanaei F, Mansournia MA, Marrugo Arnedo CA, Martinez-Valle A, Masoumi SZ, Maude RJ, McKee M, Medina-Solís CE, Menezes RG, Meretoja A, Meretoja TJ, Mesregah MK, Mestrovic T, Milevska Kostova N, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mohajer B, Mohamed TA, Mohammadi M, Mohammadian-Hafshejani A, Mohammed S, Moitra M, Mokdad AH, Molokhia M, Moni MA, Moradi Y, Morze J, Mousavi SM, Mpundu-Kaambwa C, Muriithi MK, Muthupandian S, Nagarajan AJ, Naimzada MD, Nangia V, Naqvi AA, Narayana AI, Nascimento BR, Naveed M, Nayak BP, Nazari J, Ndejjo R, Negoi I, Neupane Kandel S, Nguyen TH, Nonvignon J, Noubiap JJ, Nwatah VE, Oancea B, Ojelabi FAO, Olagunju AT, Olakunde BO, Olgiati S, Olusanya JO, Onwujekwe OE, Otoiu A, Otstavnov N, Otstavnov SS, Owolabi MO, Padubidri JR, Palladino R, Panda-Jonas S, Park EC, Pashazadeh Kan F, Pawar S, Pazoki Toroudi H, Pereira DM, Perianayagam A, Pesudovs K, Piccinelli C, Postma MJ, Prada SI, Rabiee M, Rabiee N, Rahim F, Rahimi-Movaghar V, Rahman MHU, Rahman M, Rahmani AM, Ram U, Ranabhat CL, Ranasinghe P, Rao CR, Rathi P, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Reiner Jr RC, Renzaho AMN, Reshmi B, Riaz MA, Ripon RK, Saad AM, Sahraian MA, Sahu M, Salama JS, Salehi S, Samy AM, Sanabria J, Sanmarchi F, Santos JV, Santric-Milicevic MM, Sathian B, Savic M, Saxena D, Sayyah M, Schwendicke F, Senthilkumaran S, Sepanlou SG, Seylani A, Shahabi S, Shaikh MA, Sheikh A, Shetty A, Shetty PH, Shibuya K, Shrime MG, Shuja KH, Singh JA, Skryabin VY, Skryabina AA, Soltani S, Soofi M, Spurlock EE, Stefan SC, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Taddele BW, Tefera YG, Thavamani A, Tobe-Gai R, Topor-Madry R, Tovani-Palone MR, Tran BX, Tudor Car L, Ullah A, Ullah S, Umar N, Undurraga EA, Valdez PR, Vasankari TJ, Villafañe JH, Violante FS, Vlassov V, Vo B, Vollmer S, Vos T, Vu GT, Vu LG, Wamai RG, Werdecker A, Woldekidan MA, Wubishet BL, Xu G, Yaya S, Yazdi-Feyzabadi V, Yiğit V, Yip P, Yirdaw BW, Yonemoto N, Younis MZ, Yu C, Yunusa I, Zahirian Moghadam T, Zandian H, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Ziapour A, Zuniga YMH, Hay SI, Murray CJL, Dieleman JL. Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050. Lancet 2021; 398:1317-1343. [PMID: 34562388 PMCID: PMC8457757 DOI: 10.1016/s0140-6736(21)01258-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/15/2021] [Accepted: 05/20/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. METHODS We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. FINDINGS In 2019, health spending globally reached $8·8 trillion (95% uncertainty interval [UI] 8·7-8·8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40·4 billion (0·5%, 95% UI 0·5-0·5) was development assistance for health provided to low-income and middle-income countries, which made up 24·6% (UI 24·0-25·1) of total spending in low-income countries. We estimate that $54·8 billion in development assistance for health was disbursed in 2020. Of this, $13·7 billion was targeted toward the COVID-19 health response. $12·3 billion was newly committed and $1·4 billion was repurposed from existing health projects. $3·1 billion (22·4%) of the funds focused on country-level coordination and $2·4 billion (17·9%) was for supply chain and logistics. Only $714·4 million (7·7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34·3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. INTERPRETATION Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
14
|
Galles NC, Liu PY, Updike RL, Fullman N, Nguyen J, Rolfe S, Sbarra AN, Schipp MF, Marks A, Abady GG, Abbas KM, Abbasi SW, Abbastabar H, Abd-Allah F, Abdoli A, Abolhassani H, Abosetugn AE, Adabi M, Adamu AA, Adetokunboh OO, Adnani QES, Advani SM, Afzal S, Aghamir SMK, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi S, Ahmed H, Ahmed MB, Ahmed Rashid T, Ahmed Salih Y, Akalu Y, Aklilu A, Akunna CJ, Al Hamad H, Alahdab F, Albano L, Alemayehu Y, Alene KA, Al-Eyadhy A, Alhassan RK, Ali L, Aljunid SM, Almustanyir S, Altirkawi KA, Alvis-Guzman N, Amu H, Andrei CL, Andrei T, Ansar A, Ansari-Moghaddam A, Antonazzo IC, Antony B, Arabloo J, Arab-Zozani M, Artanti KD, Arulappan J, Awan AT, Awoke MA, Ayza MA, Azarian G, Azzam AY, B DB, Babar ZUD, Balakrishnan S, Banach M, Bante SA, Bärnighausen TW, Barqawi HJ, Barrow A, Bassat Q, Bayarmagnai N, Bejarano Ramirez DF, Bekuma TT, Belay HG, Belgaumi UI, Bhagavathula AS, Bhandari D, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bibi S, Bijani A, Biondi A, Boloor A, Braithwaite D, Buonsenso D, Butt ZA, Camargos P, Carreras G, Carvalho F, Castañeda-Orjuela CA, Chakinala RC, Charan J, Chatterjee S, Chattu SK, Chattu VK, Chowdhury FR, Christopher DJ, Chu DT, Chung SC, Cortesi PA, Costa VM, Couto RAS, Dadras O, Dagnew AB, Dagnew B, Dai X, Dandona L, Dandona R, De Neve JW, Derbew Molla M, Derseh BT, Desai R, Desta AA, Dhamnetiya D, Dhimal ML, Dhimal M, Dianatinasab M, Diaz D, Djalalinia S, Dorostkar F, Edem B, Edinur HA, Eftekharzadeh S, El Sayed I, El Sayed Zaki M, Elhadi M, El-Jaafary SI, Elsharkawy A, Enany S, Erkhembayar R, Esezobor CI, Eskandarieh S, Ezeonwumelu IJ, Ezzikouri S, Fares J, Faris PS, Feleke BE, Ferede TY, Fernandes E, Fernandes JC, Ferrara P, Filip I, Fischer F, Francis MR, Fukumoto T, Gad MM, Gaidhane S, Gallus S, Garg T, Geberemariyam BS, Gebre T, Gebregiorgis BG, Gebremedhin KB, Gebremichael B, Gessner BD, Ghadiri K, Ghafourifard M, Ghashghaee A, Gilani SA, Glăvan IR, Glushkova EV, Golechha M, Gonfa KB, Gopalani SV, Goudarzi H, Gubari MIM, Guo Y, Gupta VB, Gupta VK, Gutiérrez RA, Haeuser E, Halwani R, Hamidi S, Hanif A, Haque S, Harapan H, Hargono A, Hashi A, Hassan S, Hassanein MH, Hassanipour S, Hassankhani H, Hay SI, Hayat K, Hegazy MI, Heidari G, Hezam K, Holla R, Hoque ME, Hosseini M, Hosseinzadeh M, Hostiuc M, Househ M, Hsieh VCR, Huang J, Humayun A, Hussain R, Hussein NR, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Inamdar S, Iqbal U, Irham LM, Irvani SSN, Islam SMS, Ismail NE, Itumalla R, Jha RP, Joukar F, Kabir A, Kabir Z, Kalhor R, Kamal Z, Kamande SM, Kandel H, Karch A, Kassahun G, Kassebaum NJ, Katoto PDMC, Kelkay B, Kengne AP, Khader YS, Khajuria H, Khalil IA, Khan EA, Khan G, Khan J, Khan M, Khan MAB, Khang YH, Khoja AT, Khubchandani J, Kim GR, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Korshunov VA, Kosen S, Kuate Defo B, Kulkarni V, Kumar A, Kumar GA, Kumar N, Kwarteng A, La Vecchia C, Lami FH, Landires I, Lasrado S, Lassi ZS, Lee H, Lee YY, Levi M, Lewycka S, Li S, Liu X, Lobo SW, Lopukhov PD, Lozano R, Lutzky Saute R, Magdy Abd El Razek M, Makki A, Malik AA, Mansour-Ghanaei F, Mansournia MA, Mantovani LG, Martins-Melo FR, Matthews PC, Medina JRC, Mendoza W, Menezes RG, Mengesha EW, Meretoja TJ, Mersha AG, Mesregah MK, Mestrovic T, Miazgowski B, Milne GJ, Mirica A, Mirrakhimov EM, Mirzaei HR, Misra S, Mithra P, Moghadaszadeh M, Mohamed TA, Mohammad KA, Mohammad Y, Mohammadi M, Mohammadian-Hafshejani A, Mohammed A, Mohammed S, Mohapatra A, Mokdad AH, Molokhia M, Monasta L, Moni MA, Montasir AA, Moore CE, Moradi G, Moradzadeh R, Moraga P, Mueller UO, Munro SB, Naghavi M, Naimzada MD, Naveed M, Nayak BP, Negoi I, Neupane Kandel S, Nguyen TH, Nikbakhsh R, Ningrum DNA, Nixon MR, Nnaji CA, Noubiap JJ, Nuñez-Samudio V, Nwatah VE, Oancea B, Ochir C, Ogbo FA, Olagunju AT, Olakunde BO, Onwujekwe OE, Otstavnov N, Otstavnov SS, Owolabi MO, Padubidri JR, Pakshir K, Park EC, Pashazadeh Kan F, Pathak M, Paudel R, Pawar S, Pereira J, Peres MFP, Perianayagam A, Pinheiro M, Pirestani M, Podder V, Polibin RV, Pollok RCG, Postma MJ, Pottoo FH, Rabiee M, Rabiee N, Radfar A, Rafiei A, Rahimi-Movaghar V, Rahman M, Rahmani AM, Rahmawaty S, Rajesh A, Ramshaw RE, Ranasinghe P, Rao CR, Rao SJ, Rathi P, Rawaf DL, Rawaf S, Renzaho AMN, Rezaei N, Rezai MS, Rios-Blancas M, Rogowski ELB, Ronfani L, Rwegerera GM, Saad AM, Sabour S, Saddik B, Saeb MR, Saeed U, Sahebkar A, Sahraian MA, Salam N, Salimzadeh H, Samaei M, Samy AM, Sanabria J, Sanmarchi F, Santric-Milicevic MM, Sartorius B, Sarveazad A, Sathian B, Sawhney M, Saxena D, Saxena S, Seidu AA, Seylani A, Shaikh MA, Shamsizadeh M, Shetty PH, Shigematsu M, Shin JI, Sidemo NB, Singh A, Singh JA, Sinha S, Skryabin VY, Skryabina AA, Soheili A, Tadesse EG, Tamiru AT, Tan KK, Tekalegn Y, Temsah MH, Thakur B, Thapar R, Thavamani A, Tobe-Gai R, Tohidinik HR, Tovani-Palone MR, Traini E, Tran BX, Tripathi M, Tsegaye B, Tsegaye GW, Ullah A, Ullah S, Ullah S, Unim B, Vacante M, Velazquez DZ, Vo B, Vollmer S, Vu GT, Vu LG, Waheed Y, Winkler AS, Wiysonge CS, Yiğit V, Yirdaw BW, Yon DK, Yonemoto N, Yu C, Yuce D, Yunusa I, Zamani M, Zamanian M, Zewdie DT, Zhang ZJ, Zhong C, Zumla A, Murray CJL, Lim SS, Mosser JF. Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019: a systematic analysis for the Global Burden of Disease Study 2020, Release 1. Lancet 2021; 398:503-521. [PMID: 34273291 PMCID: PMC8358924 DOI: 10.1016/s0140-6736(21)00984-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/16/2021] [Accepted: 04/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. METHODS For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in country-reported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. FINDINGS By 2019, global coverage of third-dose DTP (DTP3; 81·6% [95% uncertainty interval 80·4-82·7]) more than doubled from levels estimated in 1980 (39·9% [37·5-42·1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38·5% [35·4-41·3] in 1980 to 83·6% [82·3-84·8] in 2019). Third-dose polio vaccine (Pol3) coverage also increased, from 42·6% (41·4-44·1) in 1980 to 79·8% (78·4-81·1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56·8 million (52·6-60·9) to 14·5 million (13·4-15·9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. INTERPRETATION After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. FUNDING Bill & Melinda Gates Foundation.
Collapse
|