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Tian T, Miao L, Wang W, Zhou X. Global, Regional and National Burden of Human Cystic Echinococcosis from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. Trop Med Infect Dis 2024; 9:87. [PMID: 38668548 DOI: 10.3390/tropicalmed9040087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/21/2024] [Accepted: 04/02/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) is a neglected tropical parasitic disease that poses huge disease, social and economic burdens worldwide; however, there has been little knowledge on the global morbidity, mortality and disability-adjusted life years (DALYs) of CE until now. This study aimed to collect the most up-to-date data about the global, regional and national disease burden due to CE from 1990 to 2019 and to project trends in the next 10 years. METHODS We measured the global, regional and national morbidity, mortality and DALYs of CE from 1990 to 2019 based on the Global Burden of Disease Study 2019 (GBD 2019) data, and we examined the correlation between socioeconomic development levels and the disease burden of CE. In addition, the disease burden due to CE was projected from 2020 to 2030. RESULTS The age-standardized incidence rate (ASIR) of CE reduced from 2.65/105 [95% UI: (1.87/105 to 3.7/105)] in 1990 to 2.6/105 [95% UI: (1.72/105 to 3.79/105)] in 2019 (EAPC = -0.18%). The number of deaths, DALYs, age-standardized mortality rate (ASMR) and age-standardized DALY rate due to CE all showed a tendency to decline from 1990 to 2019. A higher disease burden of CE was measured in women than in men in 2019. There was a significant difference in the ASMR of CE by region according to the socio-demographic index (SDI), and lower burdens of CE were estimated in high-SDI regions. The global ASIR of CE is projected to decline from 2020 to 2030; however, the ASMR and age-standardized DALY rate are projected to rise. CONCLUSIONS The global burden of CE remains high, and it is recommended that more health resources are allocated to low-SDI regions, women and the elderly aged 55 to 65 years to reduce the disease burden of CE.
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Affiliation(s)
- Tian Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), WHO Collaborating Centre for Tropical Diseases, National Health Commission Key Laboratory of Parasite and Vector Biology, National Center for International Research on Tropical Diseases, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Shanghai 200025, China
| | - Liyuan Miao
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai 200025, China
| | - Wei Wang
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China
| | - Xiaonong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), WHO Collaborating Centre for Tropical Diseases, National Health Commission Key Laboratory of Parasite and Vector Biology, National Center for International Research on Tropical Diseases, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Shanghai 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai 200025, China
- Hainan Center for Tropical Diseases Research, Haikou 571199, China
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Wei H, Ren J, Li R, Qi X, Yang F, Li Q. Global, regional, and national burden of chronic kidney disease attributable to high fasting plasma glucose from 1990 to 2019: a systematic analysis from the global burden of disease study 2019. Front Endocrinol (Lausanne) 2024; 15:1379634. [PMID: 38601204 PMCID: PMC11004380 DOI: 10.3389/fendo.2024.1379634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/18/2024] [Indexed: 04/12/2024] Open
Abstract
Purpose Given the rising prevalence of high fasting plasma glucose (HFPG) over the past three decades, it is crucial to assess its global, national, and regional impact on chronic kidney disease (CKD). This study aims to investigate the burden of CKD attributed to HFPG and its distribution across various levels. Methods and materials The data for this research was sourced from the Global Burden of Diseases Study 2019. To estimate the burden of CKD attributed to HFPG, we utilized DisMod-MR 2.1, a Bayesian meta-regression tool. The burden was measured using age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALYs) rate. Correlation analysis was performed using the Spearman rank order correlation method. Temporal trends were analyzed by estimating the estimated annual percentage change (EAPC). Results Globally in 2019, there were a total of 487.97 thousand deaths and 13,093.42 thousand DALYs attributed to CKD attributed to HFPG, which represent a substantial increase of 153.8% and 120%, respectively, compared to 1990. Over the period from 1990 to 2019, the burden of CKD attributable to HFPG increased across all regions, with the highest increases observed in regions with high socio-demographic index (SDI) and middle SDI. Regions with lower SDI exhibited higher ASMR and age-standardized DALYs (ASDR) compared to developed nations at the regional level. Additionally, the EAPC values, which indicate the rate of increase, were significantly higher in these regions compared to developed nations. Notably, high-income North America, belonging to the high SDI regions, experienced the greatest increase in both ASMR and ASDR over the past three decades. Furthermore, throughout the years from 1990 to 2019, males bore a greater burden of CKD attributable to HFPG. Conclusion With an increasing population and changing dietary patterns, the burden of CKD attributed to HFPG is expected to worsen. From 1990 to 2019, males and developing regions have experienced a more significant burden. Notably, the EAPC values for both ASMR and ASDR were higher in males and regions with lower SDI (excluding high-income North America). This emphasizes the pressing requirement for effective interventions to reduce the burden of CKD attributable to HFPG.
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Affiliation(s)
- Huizhi Wei
- School of Pharmaceutical Science, Medicinal Basic Research Innovation Center of Chronic Kidney Disease, Ministry of Education, Shanxi Medical University, Taiyuan, China
| | - Jinhong Ren
- Shanxi Key Laboratory of Innovative Drug for the Treatment of Serious Diseases Basing on the Chronic Inflammation, Shanxi University of Chinese Medicine, Taiyuan, China
| | - Rui Li
- School of Pharmaceutical Science, Medicinal Basic Research Innovation Center of Chronic Kidney Disease, Ministry of Education, Shanxi Medical University, Taiyuan, China
| | - Xiaoming Qi
- Shanxi Key Laboratory of Innovative Drug for the Treatment of Serious Diseases Basing on the Chronic Inflammation, Shanxi University of Chinese Medicine, Taiyuan, China
| | - Fan Yang
- School of Pharmaceutical Science, Medicinal Basic Research Innovation Center of Chronic Kidney Disease, Ministry of Education, Shanxi Medical University, Taiyuan, China
| | - Qingshan Li
- School of Pharmaceutical Science, Medicinal Basic Research Innovation Center of Chronic Kidney Disease, Ministry of Education, Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Innovative Drug for the Treatment of Serious Diseases Basing on the Chronic Inflammation, Shanxi University of Chinese Medicine, Taiyuan, China
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Hui Y, Wang H, Guo G, Yang W, Zhang X, Yang J, Yang F, Wang X, Fan X, Cui B, Chen X, Jiao H, Sun C. Association Between Quality of Life Defined by EuroQol Group 5 Dimension and Composite Inferior Outcome Among Inpatients with Cirrhosis. Clin Interv Aging 2024; 19:551-560. [PMID: 38528882 PMCID: PMC10962662 DOI: 10.2147/cia.s444842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
Purpose The utility of the EuroQol Group 5 Dimension (EQ-5D) measuring health-related quality of life (HRQoL) has been verified; however, knowledge gaps remain concerning predictive performance in cirrhosis. We aimed to identify the optimal threshold for risk stratification and the pronounced domain in the EQ-5D linked to inferior outcomes. Patients and Methods The X-tile project was used to obtain a threshold, considering the composite outcome of 1-year all-cause mortality or readmission. A restricted cubic spline (RCS) was performed to test the non-linear relationship between the EQ-5D utility value and the primary outcome. Six multivariate Cox regression models incorporating EQ-5D utility value and each of the five domains were constructed. Setting/Participants Totally, 420 patients with cirrhosis were recruited. Results The median utility value of the study population was 0.77 and 59.8% reported impairment in minimal one EQ-5D domain. RCS indicated a linear relationship between the utility value and composite inferior outcome. X-tile pinpointed a utility value of 0.59 stratifying populations into high- and low-risk groups based on the outcome. Inpatients with cirrhosis and deteriorated HRQoL (utility value ≤0.59) were at higher risk of death or readmission (adjusted HR: 2.18, P < 0.001). Furthermore, mobility and usual activities were the most pronounced domains associated with composite inferior outcome. Conclusion A utility value ≤0.59 can identify cirrhotic inpatients exhibiting compromised HRQoL and mortality/readmission risk. It is tempting to reverse the decreased HRQoL by applying longitudinal measurements and keeping surveillance on utility value, while interventions appear to mainly focus on improving mobility and usual activities.
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Affiliation(s)
- Yangyang Hui
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Han Wang
- Department of Health Management, Tianjin Hospital, Tianjin, People’s Republic of China
| | - Gaoyue Guo
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Wanting Yang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Xuqian Zhang
- Department of Gastroenterology and Hepatology, China Aerospace Science & Industry Corporation 731 Hospital, Beijing, People’s Republic of China
| | - Jie Yang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Fang Yang
- Department of Digestive System, Baodi Clinical College of Tianjin Medical University, Tianjin, People’s Republic of China
| | - Xiaoyu Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Xiaofei Fan
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Binxin Cui
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin Airport Economic Area, Tianjin, People’s Republic of China
| | - Xin Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Huanli Jiao
- Department of Health Management, Tianjin Hospital, Tianjin, People’s Republic of China
| | - Chao Sun
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin Airport Economic Area, Tianjin, People’s Republic of China
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Zhang X, Wang X, Wu J, Wang M, Hu B, Qu H, Zhang J, Li Q. The global burden of periodontal diseases in 204 countries and territories from 1990 to 2019. Oral Dis 2024; 30:754-768. [PMID: 36367304 DOI: 10.1111/odi.14436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/20/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022]
Abstract
AIMS The aim of this study was to report the incidence, prevalence, and disability-adjusted life-years (DALYs) of periodontal diseases during the period 1990-2019. METHODS Data on periodontal diseases were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. The estimated annual percentage changes were calculated to evaluate the changing trend of age-standardized incidence, prevalence, and DALY rates related to periodontal diseases. RESULTS Globally, there were 1,087,367,744.0 cases with 91,518,820.6 new incidence and 7,090,390.3 DALYs of periodontal diseases in 2019, almost twice as many as in 1990. Moreover, the pace of increase in age-standardized incidence, age-standardized prevalence, and age-standardized DALY rates had accelerated during the 1990-2019 time period, with EAPC of 0.29 (95% CI, 0.22 to 0.35), 0.34 (95% CI, 0.26 to 0.43), and 0.35 (95% CI, 0.27 to 0.44) separately. The corresponding age-standardized percentage changes were more pronounced in females, Southeast Asia, and low-middle SDI regions. Western Sub-Saharan Africa was the high-risk area of standardized periodontal diseases burden in 2019, among which Gambia was the country with the heaviest burden. CONCLUSION The globally incidence, prevalence, and DALYs of periodontal diseases are substantially increased from 1990 to 2019, which highlights the importance and urgency of periodontal care.
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Affiliation(s)
- Xuexue Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Xujie Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Jingxian Wu
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Miaoran Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Biaoyan Hu
- Graduate School of Peking University, Beijing, China
| | - Hua Qu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiwei Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiuyan Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Wang FX, Kong XH, Guo Z, Li LX, Zhang S. Global, regional, and national burden of diet high in processed meat from 1990 to 2019: a systematic analysis from the global burden of disease study 2019. Front Nutr 2024; 11:1354287. [PMID: 38414489 PMCID: PMC10896824 DOI: 10.3389/fnut.2024.1354287] [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: 12/18/2023] [Accepted: 01/24/2024] [Indexed: 02/29/2024] Open
Abstract
Objective The objective of this study is to explore the prevalence and attributable burden of diet high in processed meat (DHIPM) in global, regional, and national level due to the burden caused by unhealthy dietary pattern worldwide. Design Cross-sectional study. Materials and design All the data involved in this research were obtained from Global Burden of Diseases Study 2019. DisMod-MR 2.1, a Bayesian meta-regression tool, was used to estimate the prevalence, which was measured by summary exposure value (SEV) and attributable burden of DHIPM. The Spearman rank order correlation method was performed to measure the correlation between sociodemographic index (SDI) and the prevalence as well as attributable burden. The estimated annual percentage change (EAPC) was calculated to demonstrate the temporal trends. Results Globally, there were 304.28 thousand deaths and 8556.88 disability-adjusted life years (DALYs) caused by DHIPM in 2019 and increased by 34.63 and 68.69%, respectively. The prevalence had decreased slightly from 1990 to 2019, however increased in most regions and countries, especially in middle SDI regions, despite the implicitly high prevalence in high SDI regions. Countries with higher SDI values were facing higher prevalence and attributable burden of DHIPM while developing countries were observed with severer temporal trends. Compared with women, men had suffered from lower exposure level however graver attributable burden of DHIPM in the past three decades. Conclusion The progress of continuous urbanization allowed increasingly severe prevalence and attributable burden of DHIPM, thus the challenge to alleviate this trend was acute. Effective measures such as education on beneficial dietary pattern and supplement on healthy food were urgently required, especially in developing regions and countries.
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Affiliation(s)
- Feng-Xia Wang
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiang-Hua Kong
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhe Guo
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Lu-Xia Li
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Shu Zhang
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
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Li Y, Zhang S, Shu P. Global burden of neck pain in 204 countries from 1990-2019. Arch Med Sci 2023; 19:1811-1821. [PMID: 38058733 PMCID: PMC10696998 DOI: 10.5114/aoms/170962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/11/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction The estimation of global burden of neck pain is lacking. To estimate the trends and burden of neck pain by sex, age, region, and sociodemographic index (SDI). Material and methods The incidence and disability-adjusted life years (DALY) data for neck pain were extracted from the Global Burden of Disease 2019 database. The estimated annual percent change (EAPC) and 95% confidence intervals (CIs) were used to assess the trends in age-standardized incidence and DALY rates from 1990 to 2019. Results From 1990 to 2019, the global age-standardized incidence rate and age-standardized DALY rate indicated downward trends, with EAPCs of -0.06 and -0.09, respectively. The EAPCs of the age-standardized incidence rate and age-standardized DALY rate were negatively correlated with the SDI in 2019, respectively. The age-standardized incidence rates and age-standardized DALY rates in regions with a high SDI indicated a downward trend, including in high-income North America, Australia, and New Zealand. In 2019, the Philippines and high-income North America had the highest age-standardized incidence and age-standardized DALY rates. From 1990 to 2019, the areas which increased most rapidly in the age-standardized incidence rate and age-standardized DALY rate were in tropical Latin America (EAPCs of 0.53 and 0.60, respectively). Brazil had the most rapid increase in the age-standardized incidence rate and age-standardized DALY rate (EAPCs of 0.55 and 0.61, respectively). Conclusions The age-standardized incidence rate and age-standardized DALY rate of neck pain decreased globally from 1990 to 2019. However, there were significant differences concerning sex, age, and regional distributions. Therefore, targeted prevention interventions and risk factor control measures should be reasonably allocated.
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Affiliation(s)
- Yongfu Li
- Department of Orthopedics, Beilun District People’s Hospital, Ningbo, Zhejiang, China
| | - Shunan Zhang
- Department of Cardiology, Beilun District People’s Hospital, Ningbo, Zhejiang, China
| | - Peng Shu
- Department of Molecular Laboratory, Beilun District People’s Hospital, Ningbo, Zhejiang, China
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Wang K, Geng B, Shen Q, Wang Y, Shi J, Dong N. Global, regional, and national incidence, mortality, and disability-adjusted life years of non-rheumatic valvular heart disease and trend analysis from 1990 to 2019: Results from the Global Burden of Disease study 2019. Asian Cardiovasc Thorac Ann 2023; 31:706-722. [PMID: 37674443 DOI: 10.1177/02184923231200695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND In the context of the population growing and aging worldwide, the incidence of non-rheumatic valvular heart disease increased rapidly. This study aimed to describe the burden of non-rheumatic valvular heart disease, providing an up-to-date and comprehensive analysis on the global and regional levels and time trends from 1900 to 2019. METHODS The Global Burden of Disease 2019 was used to obtain data for this analysis. Non-rheumatic valvular heart disease in the Global Burden of Disease study includes both non-rheumatic calcific aortic valve disease and non-rheumatic degenerative mitral valve disease. The incidence, mortality, and disability-adjusted life year in 204 countries from 1990 to 2019 were analyzed by location, year, sex, age, and socio-demographic index. Estimated annual percentage change was calculated to represent the temporal trends from 1990 to 2019. Spearman's rank order correlation was used to determine the correlation between socio-demographic index and the incidence and burden of non-rheumatic valvular heart disease. RESULTS Globally, there were 1.65 million (95% uncertainty interval, 1.56-1.76 million) incident cases, 0.16 million (95% uncertainty interval, 0.14-0.18 million) death cases, and 2.79 million (95% uncertainty interval, 2.52-3.31 million) disability-adjusted life years of non-rheumatic valvular heart disease. Compared with 1990, the number of incident cases, death cases, and disability-adjusted life years in 2019 increased by 104.58%, 210.60%, and 167.62%, respectively, the age-standardized incidence rate (estimated annual percentage change, 0.39; 95% confidence interval, 0.29 to 0.49) increased due to population growth, and the age-standardized death rates (estimated annual percentage change, -0.32; 95% confidence interval, -0.39 to -0.25) and age-standardized disability-adjusted life year rate (estimated annual percentage change, -0.81; 95% confidence interval, -0.87 to -0.74) decreased during this period. Regarding the socio-demographic index, the highest age-standardized incidence, death, and disability-adjusted life year rates of non-rheumatic valvular heart disease were found in high-socio-demographic index countries in 2019. Meantime, the age-standardized incidence rate remained increased from 1990 to 2019, while significant decreases were found in the age-standardized death rate and age-standardized disability-adjusted life year rate. Females have higher age-standardized incidence rate, while higher age-standardized death rate and age-standardized disability-adjusted life year rate belong to males globally during the period of 1990-2019. Increasing trends were observed for both incidence, death, and disability-adjusted life year rates with age. High systolic blood pressure was the leading cause for non-rheumatic valvular heart disease across all ages. CONCLUSIONS From 1990 to 2019, the age-standardized incidence rate of non-rheumatic valvular heart disease remained increased, while age-standardized death rate and age-standardized disability-adjusted life year rate decreased, resulting from the growing population worldwide and improving medical resources. The aged, who has high systolic blood pressure and diet high in sodium, should pay more attention to, especially in high-socio-demographic index regions. With the population aging, the number of patients who require heart valve replacement is estimated to increase significantly in the future. Effective measures are warranted to control and treat the incidence and burden of non-rheumatic valvular heart disease.
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Affiliation(s)
- Kan Wang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bingchuan Geng
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiang Shen
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yixuan Wang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - JiaWei Shi
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - NianGuo Dong
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Nejadghaderi SA, Kolahi AA, Noori M, Sullman MJM, Safiri S. The burden of pancreatic cancer and its attributable risk factors in the Middle East and North Africa region, 1990-2019. J Gastroenterol Hepatol 2023; 38:1535-1545. [PMID: 37218385 DOI: 10.1111/jgh.16217] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/07/2023] [Accepted: 05/03/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND AIM Globally, pancreatic cancer is recognized as one of the most lethal types of cancers. We report the burden of pancreatic cancer and its attributable risk factors in the Middle East and North Africa (MENA) region, from 1990 to 2019, by age, sex, and socio-demographic index. METHODS Publicly available data from the Global Burden of Disease 2019 study were used to report the incidence, deaths, and disability-adjusted life years (DALYs) attributable to pancreatic cancer, as counts and age-standardized rates with 95% uncertainty intervals. RESULTS In 2019, pancreatic cancer had an age-standardized incidence rate of 5.3 and a death rate of 5.5 (per 100 000) in MENA, which have increased by 97.5% and 93.4%, respectively, since 1990. There were 563.6 thousand DALYs attributable to pancreatic cancer in 2019, with an age-standardized DALY rate of 123.0, which has increased by 84.9% since 1990. The highest number of incident cases was found in the 60-64 and 65-69 age groups, among male and female, respectively. In addition, the MENA/global DALY ratios were higher in all age groups for both sexes in 2019, than they were in 1990. There was a positive association between socio-demographic index and the burden of pancreatic cancer. Smoking, high fasting plasma glucose, and high body mass index were responsible for 19.2%, 9.3%, and 9.3% of the attributable DALYs in 2019, respectively. CONCLUSIONS There was a clear and substantial increase in the burden of pancreatic cancer in the MENA region. Prevention programs should be implemented in the region that target these three risk factors.
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Affiliation(s)
- Seyed Aria Nejadghaderi
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Saeid Safiri
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Wyper GM, Assuncao R, Fletcher E, Gourley M, Grant I, Haagsma JA, Hilderink H, Idavain J, Lesnik T, von der Lippe E, Majdan M, Mccartney G, Santric-Milicevic M, Pallari E, Pires SM, Plass D, Porst M, Santos JV, de Haro Moro MT, Stockton DL, Devleesschauwer B. The increasing significance of disease severity in a burden of disease framework. Scand J Public Health 2023; 51:296-300. [PMID: 34213383 PMCID: PMC9969303 DOI: 10.1177/14034948211024478] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recent estimates have reiterated that non-fatal causes of disease, such as low back pain, headaches and depressive disorders, are amongst the leading causes of disability-adjusted life years (DALYs). For these causes, the contribution of years lived with disability (YLD) - put simply, ill-health - is what drives DALYs, not mortality. Being able to monitor trends in YLD closely is particularly relevant for countries that sit high on the socio-demographic spectrum of development, as it contributes more than half of all DALYs. There is a paucity of data on how the population-level occurrence of disease is distributed according to severity, and as such, the majority of global and national efforts in monitoring YLD lack the ability to differentiate changes in severity across time and location. This raises uncertainties in interpreting these findings without triangulation with other relevant data sources. Our commentary aims to bring this issue to the forefront for users of burden of disease estimates, as its impact is often easily overlooked as part of the fundamental process of generating DALY estimates. Moreover, the wider health harms of the COVID-19 pandemic have underlined the likelihood of latent and delayed demand in accessing vital health and care services that will ultimately lead to exacerbated disease severity and health outcomes. This places increased importance on attempts to be able to differentiate by both the occurrence and severity of disease.
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Affiliation(s)
- Grant M.A. Wyper
- Place and Wellbeing Directorate, Public
Health Scotland, UK,Grant MA Wyper, Public Health Scotland,
Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | | | - Eilidh Fletcher
- Data Driven Innovation Directorate,
Public Health Scotland, UK
| | - Michelle Gourley
- Burden of Disease and Mortality Unit,
Australian Institute of Health and Welfare, Australia
| | - Ian Grant
- Data Driven Innovation Directorate,
Public Health Scotland, UK
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus
MC, University Medical Centre Rotterdam, The Netherlands
| | - Henk Hilderink
- National Institute for Public Health
and the Environment (RIVM), The Netherlands
| | - Jane Idavain
- National Institute for Health
Development, Estonia
| | - Tina Lesnik
- National Institute of Public Health,
Slovenia
| | - Elena von der Lippe
- Department of Epidemiology and Health
Monitoring, Robert Koch Institute, Germany
| | - Marek Majdan
- Faculty of Health Sciences and Social
Work, Trnava University, Slovakia
| | | | - Milena Santric-Milicevic
- Institute of Social Medicine, Centre
School of Public Health and Health Management, Faculty of Medicine University of
Belgrade, Serbia
| | - Elena Pallari
- MRC Clinical Trials and Methodology
Unit, University College London, UK
| | - Sara M. Pires
- National Food Institute, Technical
University of Denmark, Denmark
| | - Dietrich Plass
- Section Exposure Assessment and
Environmental Health Indicators, German Environment Agency, Germany
| | - Michael Porst
- Department of Epidemiology and Health
Monitoring, Robert Koch Institute, Germany
| | - João V. Santos
- MEDCIDS, Department of Community
Medicine, Information and Health Decision Sciences, Faculty of Medicine, University
of Porto, Portugal,CINTESIS, Centre for Health
Technology and Services Research, Portugal,Public Health Unit, ACES Grande Porto
VIII – Espinho/Gaia, ARS Norte, Portugal
| | | | - Diane L. Stockton
- Clinical and Protecting Health
Directorate, Public Health Scotland, UK
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public
Health, Sciensano, Belgium,Department of Veterinary Public
Health and Food Safety, Faculty of Veterinary Medicine, Ghent University,
Belgium
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10
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Liu J, Wang H, Wang Z, Han W, Hong L. The Global, Regional, and National Uterine Cancer Burden Attributable to High BMI from 1990 to 2019: A Systematic Analysis of the Global Burden of Disease Study 2019. J Clin Med 2023; 12. [PMID: 36902661 DOI: 10.3390/jcm12051874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 03/02/2023] Open
Abstract
Uterine cancer (UC) is the most common gynecologic malignancy, and high body mass index (BMI) is a poor prognostic factor for UC. However, the associated burden has not been fully assessed, which is crucial for women's health management and the prevention and control of UC. Therefore, we utilized the Global Burden of Disease Study (GBD) 2019 to describe the global, regional, and national UC burden due to high BMI from 1990 to 2019. The data show that globally, women's high BMI exposure is increasing annually, with most regions having higher rates of high BMI exposure than the global average. In 2019, 36,486 [95% uncertainty interval (UI): 25,131 to 49,165] UC deaths were attributed to high BMI globally, accounting for 39.81% (95% UI: 27.64 to 52.67) of all UC deaths. The age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALY) rate (ASDR) for high BMI-associated UC remained stable globally from 1990 to 2019, with significant differences across regions. Higher ASDR and ASMR were found in higher socio-demographic index (SDI) regions, and lower SDI regions had the fastest estimated annual percentage changes (EAPCs) for both rates. Among all age groups, the fatal outcome of UC with high BMI occurs most frequently in women over 80 years old.
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11
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Liu Y, Zhang C, Wang Q, Wu K, Sun Z, Tang Z, Zhang B. Temporal Trends in the Disease Burden of Colorectal Cancer with Its Risk Factors at the Global and National Level from 1990 to 2019, and Projections Until 2044. Clin Epidemiol 2023; 15:55-71. [PMID: 36659904 PMCID: PMC9842526 DOI: 10.2147/clep.s388323] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
Background This study aimed to evaluate the global colorectal cancer(CRC) trend and the relevant risk factors from 1990 to 2019 and for better policymaking and resource allocation. Methods Data on CRC, including incidence, mortality and disability adjusted life year (DALY) rates, were extracted from the 2019 Global Burden of Disease (GBD) study. The estimated annual percentage changes (EAPCs) were calculated to assess the temporal trend of incidence, mortality and DALYs. The Bayesian age-period-cohort model(BAPC) was used to predict the future burden of CRC. Results In 2019, a total of 2.17 million CRC cases were reported worldwide, a 157% increase from 1990. In high-social demographic index (SDI) regions, the trend of age-standardized incidence rate(ASIR) tended to decrease, while the proportion of people under 50 years of age tended to increase. Although the number of deaths and DALYs increased, the age-standardized death rate (ASDR) and age-standardized DALY rate decreased. The CRC burden was growing fastest in middle-SDI regions, especially in East Asia, followed by low SDI regions. In addition, the milk intake, High-BMI and high fasting plasma glucose play a more important role in on CRC. The predicted cases and deaths in global continued to increase to 2044. And there is an upward trend in ASIR for both men and women. Conclusion In developed regions, the CRC burden continues to decrease, while the CRC burden become more and more severe in developing regions. Overall, the burden of CRC will rising in the near future. Therefore, reasonable resource allocation and prevention policies should be implemented. Developing countries needs more attention.
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Affiliation(s)
- Yang Liu
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, People’s Republic of China
| | - Chao Zhang
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, People’s Republic of China
| | - Qianwen Wang
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, People’s Republic of China
| | - Kangze Wu
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, People’s Republic of China
| | - Zhouyi Sun
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, People’s Republic of China
| | - Zhe Tang
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, People’s Republic of China
| | - Bo Zhang
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, People’s Republic of China,Correspondence: Bo Zhang, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310000, People’s Republic of China, Tel/Fax +86-0571-87783563, Email
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12
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Yu J, Wang Z, Bao Q, Lei S, You Y, Yin Z, Xie X. Global burden of calcific aortic valve disease and attributable risk factors from 1990 to 2019. Front Cardiovasc Med 2022; 9:1003233. [PMID: 36505369 PMCID: PMC9727398 DOI: 10.3389/fcvm.2022.1003233] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background Calcific aortic valve disease (CAVD) was highly prevalent among developed countries and caused numerous deaths. Based on the Global Burden of Disease 2019, this study was designed to present comprehensive epidemiological information, attributable risks, and relevant factors. Methods All data were available online via the Global Health Data Exchange (GHDx). In this study, we analyzed the global incidence, prevalence, deaths, and disability-adjusted life years (DALYs) of CAVD across different regions from 1990 to 2019. We applied the estimated annual percentage changes (EAPCs) to evaluate the change trends and their attributable risks. In addition, we explored several relevant factors. Results From 1990 to 2019, the incidence cases, prevalence cases, CAVD-related deaths, and DALYs of CAVD gradually increased globally. However, the age-standardized death rate (ASDR) was relatively stable, and the age-standardized DALYs rate gradually declined during the past 30 years. Males and elderly individuals were more likely to suffer from CAVD. High systolic blood pressure (SBP) was the predominant attributable risk of disease burden that presented a global downward trend (death: EAPC = -0.68, 95% CI -0.77~-0.59, P < 0.001; DALYs: EAPC = -0.99, 95% CI -1.09 to -0.89, P < 0.001). Alcohol consumption (R = 0.79, P < 0.001), smoking prevalence (R = 0.75, P < 0.001), and calcium (R = 0.72, P < 0.001) showed a positive correlation with the age-standardized incidence rate (ASIR), whereas classic monsoon region (R = -0.68, P < 0.001) and mean temperature (R = -0.7, P < 0.001) showed a negative correlation with age-standardized incidence rate (ASIR). Besides, medical and healthcare resources presented a positive correlation with ASIR. Meanwhile, similar relationships were found in age-standardized prevalence rate (ASPR), ASDR, and age-standardized DALY rate (ASDALYR). Conclusion CAVD displays widely varied spatial distribution around the world, of which high SDI regions have the highest burdens. Age is a powerful factor and hypertension a predominant attributable risk factor. Moreover, controlling blood pressure, avoiding smoking, reducing alcohol consumption, and so on, could effectively reduce the burden of CAVD.
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Tobollik M, Kienzler S, Schuster C, Wintermeyer D, Plass D. Burden of Disease Due to Ambient Particulate Matter in Germany-Explaining the Differences in the Available Estimates. Int J Environ Res Public Health 2022; 19:13197. [PMID: 36293778 PMCID: PMC9602590 DOI: 10.3390/ijerph192013197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Ambient particulate matter (PM2.5) pollution is an important threat to human health. The aim of this study is to estimate the environmental burden of disease (EBD) for the German population associated with PM2.5 exposure in Germany for the years 2010 until 2018. The EBD method was used to quantify relevant indicators, e.g., disability-adjusted life years (DALYs), and the life table approach was used to estimate the reduction in life expectancy caused by long-term PM2.5 exposure. The impact of varying assumptions and input data was assessed. From 2010 to 2018 in Germany, the annual population-weighted PM2.5 concentration declined from 13.7 to 10.8 µg/m3. The estimates of annual PM2.5-attributable DALYs for all disease outcomes showed a downward trend. In 2018, the highest EBD was estimated for ischemic heart disease (101.776; 95% uncertainty interval (UI) 62,713-145,644), followed by lung cancer (60,843; 95% UI 43,380-79,379). The estimates for Germany differ from those provided by other institutions. This is mainly related to considerable differences in the input data, the use of a specific German national life expectancy and the selected relative risks. A transparent description of input data, computational steps, and assumptions is essential to explain differing results of EBD studies to improve methodological credibility and trust in the results. Furthermore, the different calculated indicators should be explained and interpreted with caution.
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Affiliation(s)
- Myriam Tobollik
- German Environment Agency, Department Environmental Hygiene, Corrensplatz, 14195 Berlin, Germany
| | - Sarah Kienzler
- German Environment Agency, Department Environmental Hygiene, Corrensplatz, 14195 Berlin, Germany
| | - Christian Schuster
- German Environment Agency, Department Environmental Hygiene, Corrensplatz, 14195 Berlin, Germany
- Berlin-Brandenburg Academy of Sciences and Humanities, Transfer Unit Science Communication, 10117 Berlin, Germany
| | - Dirk Wintermeyer
- German Environment Agency, Department Environmental Hygiene, Corrensplatz, 14195 Berlin, Germany
| | - Dietrich Plass
- German Environment Agency, Department Environmental Hygiene, Corrensplatz, 14195 Berlin, Germany
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Tsukamoto K, Inoue M, Mori H, Matsumaru N. [Establishment of Mono-scaled Benefit/Risk Analysis of HPV Vaccine]. YAKUGAKU ZASSHI 2022; 142:1399-1407. [PMID: 36156032 DOI: 10.1248/yakushi.22-00142] [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] [Indexed: 11/22/2022]
Abstract
Decisions concerning approval of human papillomavirus (HPV) vaccines and their use are based on expert evaluation of the vaccines. However, the quantitative differences between vaccine benefits and risks are difficult for non-experts to understand. In this study, we developed a new method to calculate the benefits and risks of the HPV vaccines using disability-adjusted life year (DALY) as the mono-scaled weight for various benefits and risks relevant to the vaccines. We evaluated benefits as a gain of DALY values for cervical cancer and risks as the loss of DALY values for various adverse events by the vaccination. To calculate the loss of DALY values, we integrated all adverse events in the International Classification of Diseases chapters. The novel method reflected the men-women ratio of this epidemiological disease to a certain extent. Among the vaccinated women, 111,372 and 477,190 received a bivalent and quadrivalent vaccine, respectively. The DALY rate of cervical cancer was 148.7. The calculated benefit for the bivalent and quadrivalent vaccines was 149.1 and 638.8, respectively, and set as the theoretical maximum. The risk was calculated as 129.3 and 49.6 in the bivalent and quadrivalent vaccines, respectively. Since HPV vaccines prevent several other cancers, the benefit of the vaccination extends beyond the risk according to this new method.
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Affiliation(s)
| | - Manami Inoue
- Global Regulatory Science, Gifu Pharmaceutical University
| | - Hirohito Mori
- Global Regulatory Science, Gifu Pharmaceutical University
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Safiri S, Nejadghaderi SA, Abdollahi M, Carson‐Chahhoud K, Kaufman JS, Bragazzi NL, Moradi‐Lakeh M, Mansournia MA, Sullman MJM, Almasi‐Hashiani A, Taghizadieh A, Collins GS, Kolahi A. Global, regional, and national burden of cancers attributable to tobacco smoking in 204 countries and territories, 1990-2019. Cancer Med 2022; 11:2662-2678. [PMID: 35621231 PMCID: PMC9249976 DOI: 10.1002/cam4.4647] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/17/2022] [Accepted: 02/25/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Cancers are leading causes of mortality and morbidity, with smoking being recognized as a significant risk factor for many types of cancer. We aimed to report the cancer burden attributable to tobacco smoking by sex, age, socio-demographic index (SDI), and cancer type in 204 countries and territories from 1990 to 2019. METHODS The burden of cancers attributable to smoking was reported between 1990 and 2019, based upon the Comparative Risk Assessment approach used in the Global Burden of Disease (GBD) study 2019. RESULTS Globally, in 2019 there were an estimated 2.5 million cancer-related deaths (95% UI: 2.3 to 2.7) and 56.4 million DALYs (51.3 to 61.7) attributable to smoking. The global age-standardized death and DALY rates of cancers attributable to smoking per 100,000 decreased by 23.0% (-29.5 to -15.8) and 28.6% (-35.1 to -21.5), respectively, over the period 1990-2019. Central Europe (50.4 [44.4 to 57.6]) and Western Sub-Saharan Africa (6.7 [5.7 to 8.0]) had the highest and lowest age-standardized death rates, respectively, for cancers attributable to smoking. In 2019, the age-standardized DALY rate of cancers attributable to smoking was highest in Greenland (2224.0 [1804.5 to 2678.8]) and lowest in Ethiopia (72.2 [51.2 to 98.0]). Also in 2019, the global number of DALYs was highest in the 65-69 age group and there was a positive association between SDI and the age-standardized DALY rate. CONCLUSIONS The results of this study clearly illustrate that renewed efforts are required to increase utilization of evidence-based smoking cessation support in order to reduce the burden of smoking-related diseases.
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Affiliation(s)
- Saeid Safiri
- Aging Research InstituteTabriz University of Medical SciencesTabrizIran
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of MedicineTabriz University of Medical SciencesTabrizIran
| | - Seyed Aria Nejadghaderi
- Aging Research InstituteTabriz University of Medical SciencesTabrizIran
- Systematic Review and Meta‐analysis Expert Group (SRMEG)Universal Scientific Education and Research Network (USERN)TehranIran
| | - Morteza Abdollahi
- Social Determinants of Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Kristin Carson‐Chahhoud
- Australian Centre for Precision HealthUniversity of South AustraliaAdelaideSouth AustraliaAustralia
- School of MedicineUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Jay S. Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of MedicineMcGill UniversityQuebecCanada
| | | | - Maziar Moradi‐Lakeh
- Preventive Medicine and Public Health Research CenterIran University of Medical SciencesTehranIran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Mark J. M. Sullman
- Department of Life and Health SciencesUniversity of NicosiaNicosiaCyprus
- Department of Social SciencesUniversity of NicosiaNicosiaCyprus
| | - Amir Almasi‐Hashiani
- Department of Epidemiology, School of HealthArak University of Medical SciencesArakIran
| | - Ali Taghizadieh
- Tuberculosis and Lung Diseases Research CenterTabriz University of Medical SciencesTabrizIran
| | - Gary S. Collins
- Centre for Statistics in Medicine, NDORMS, Botnar Research CentreUniversity of OxfordOxfordUK
- NIHR Oxford Biomedical Research CentreOxford University Hospitals NHS Foundation TrustOxfordUK
| | - Ali‐Asghar Kolahi
- Social Determinants of Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
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16
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Li Y, Huang Y, He X, Han C, Wu W, Shen H, Xu Y, Liu Y, Zhu Z. The global burden of thyroid cancer in high-income Asia-Pacific: a systematic analysis of the Global Burden of Disease study. Ther Adv Endocrinol Metab 2022; 13:20420188221090012. [PMID: 35464880 PMCID: PMC9019321 DOI: 10.1177/20420188221090012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/04/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Thyroid cancer has become increasingly prevalent and threatens human health. Few studies have explored the incidence of thyroid cancer in Asia and its relationship with social-progress factors. METHODS We analyzed Global Burden of Disease (GBD) Study 2019 data specific to thyroid cancer. Incidence, prevalence, mortality, and disability-adjusted life year (DALY) rates were used to evaluate the burden of thyroid cancer. RESULTS The age-standardized incidence, prevalence, and DALY rates per 100,000 population were 1.34% (95% UI, 2.44-3.07), 2.79% (95% UI, 18.82-23.77) and 16.49% (95% UI, 14.6-18), respectively, for all of Asia in 2019. In 2019, the DALY rate of thyroid cancer in the High-income Asia-Pacific region was the highest and mortality due to thyroid cancer in the High-income Asia-Pacific region was also the highest. The growth trend of DALYs in the High-income Asia-Pacific region was much steeper than those in other Asian regions. In all Asian regions and in the High-income Asia-Pacific region, the incidence, prevalence, mortality and DALY rates of thyroid cancer in female patients were drastically higher than those in male patients. Among Asian patients with thyroid cancer, the DALY rate was higher in men aged 80-89 years than in women. The DALY rate gradually increased with age. In the High-income Asia-Pacific region, the mortality rate of patients with thyroid cancer decreased with age. The prevalence was highest in those aged 40-79 years. CONCLUSION The disease burden of thyroid cancer in the High-income Asia-Pacific region was significantly higher than those in other regions, which may be due to overdiagnosis. The increasing incidence of thyroid cancer seems to indicate that thyroid cancer is still a public health problem in Asia. Therefore, some health policy adjustments will be meaningful.
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Affiliation(s)
| | | | | | - Cheng Han
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Wei Wu
- Department of General Surgery, The Sixth People’s Hospital of Shenyang, Shenyang, China
| | - Hui Shen
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yanbing Xu
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | | | - Zizhao Zhu
- Department of General Surgery, The Sixth People’s Hospital of Shenyang, No. 85 Heping South Street, Heping District, Shenyang 110006, Liaoning, China
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Dong Y, Kang H, Peng R, Song K, Guo Q, Guan H, Zhu M, Ye D, Li F. Global, Regional, and National Burden of Low Bone Mineral Density From 1990 to 2019: Results From the Global Burden of Disease Study 2019. Front Endocrinol (Lausanne) 2022; 13:870905. [PMID: 35685212 PMCID: PMC9172621 DOI: 10.3389/fendo.2022.870905] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE We aim to explore the global spatial prevalence and temporal trends of the burden of low bone mineral density (LBMD) worldwide, due to a lack of related studies. DESIGN Cross-sectional study. METHODS We used data from the Global Burden of Disease Study 2019 to conduct this study. LBMD in the GBD study includes both osteopenia and osteoporosis. The estimation for the prevalence, measured by the summary exposure value (SEV), and burden of LBMD was made in DisMod-MR 2.1, a Bayesian meta-regression tool. Correlation analysis was performed using the Spearman rank order correlation methods. The temporal trends were represented by the estimated annual percentage change (EAPC). RESULTS In 2019, there were 438 thousand deaths and 16.6 million DALYs attributable to LBMD, increasing by 111.1% and 93.8% respectively, compared to that in 1990. From 1990 to 2019, the prevalence of LBMD has decreased worldwide, but has increased in high-income North America. Some countries, such as the United States, Australia, Canada, and China had increased disability and mortality rates of LBMD with time. Countries with low socio-demographic index (SDI) had higher incidence and mortality rate than those with high SDI. The prevalence of LBMD was lower in males, but the attributable disability and mortality were higher in males in all years from 1990 to 2019. CONCLUSION With population aging, countries worldwide, especially those with low-SDI, will face increasing challenges in reducing the burden attributable to LBMD and osteoporosis. The treatment of osteoporosis has been overlooked in men for a long time. Effective measures are warranted to control the prevalence and burden of LBMD.
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Affiliation(s)
- Yimin Dong
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Honglei Kang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Renpeng Peng
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kehan Song
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Guo
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hanfeng Guan
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meipeng Zhu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dawei Ye
- Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Dawei Ye, ; Feng Li,
| | - Feng Li
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Dawei Ye, ; Feng Li,
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Wu Y, Song P, Lin S, Peng L, Li Y, Deng Y, Deng X, Lou W, Yang S, Zheng Y, Xiang D, Hu J, Zhu Y, Wang M, Zhai Z, Zhang D, Dai Z, Gao J. Global Burden of Respiratory Diseases Attributable to Ambient Particulate Matter Pollution: Findings From the Global Burden of Disease Study 2019. Front Public Health 2021; 9:740800. [PMID: 34888281 PMCID: PMC8650086 DOI: 10.3389/fpubh.2021.740800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Exposure to ambient particulate matter pollution (APMP) is a global health issue that directly affects the human respiratory system. Thus, we estimated the spatiotemporal trends in the burden of APMP-related respiratory diseases from 1990 to 2019. Methods: Based on the Global Burden of Disease Study 2019, data on the burden of APMP-related respiratory diseases were analyzed by age, sex, cause, and location. Joinpoint regression analysis was used to analyze the temporal trends in the burden of different respiratory diseases over the 30 years. Results: Globally, in 2019, APMP contributed the most to chronic obstructive pulmonary disease (COPD), with 695.1 thousand deaths and 15.4 million disability-adjusted life years (DALYs); however, the corresponding age-standardized death and DALY rates declined from 1990 to 2019. Similarly, although age-standardized death and DALY rates since 1990 decreased by 24% and 40%, respectively, lower respiratory infections (LRIs) still had the second highest number of deaths and DALYs attributable to APMP. This was followed by tracheal, bronchus, and lung (TBL) cancer, which showed increased age-standardized death and DALY rates during the past 30 years and reached 3.78 deaths per 100,000 persons and 84.22 DALYs per 100,000 persons in 2019. Among children aged < 5 years, LRIs had a huge burden attributable to APMP, whereas for older people, COPD was the leading cause of death and DALYs attributable to APMP. The APMP-related burdens of LRIs and COPD were relatively higher among countries with low and low-middle socio-demographic index (SDI), while countries with high-middle SDI showed the highest burden of TBL cancer attributable to APMP. Conclusions: APMP contributed substantially to the global burden of respiratory diseases, posing a significant threat to human health. Effective actions aimed at air pollution can potentially avoid an increase in the PM2.5-associated disease burden, especially in highly polluted areas.
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Affiliation(s)
- Ying Wu
- Department of Nephrology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ping Song
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shuai Lin
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ling Peng
- Department of Respiratory Disease, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Yizhen Li
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yujiao Deng
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xinyue Deng
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Weiyang Lou
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Si Yang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yi Zheng
- Department of Nephrology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dong Xiang
- Celilo Cancer Center, Oregon Health Science Center Affiliated Mid-Columbia Medical Center, The Dalles, OR, United States
| | - Jingjing Hu
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States
| | - Yuyao Zhu
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Meng Wang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhen Zhai
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dai Zhang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhijun Dai
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Gao
- Department of Nephrology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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19
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Abstract
Objective Calculations of disease burden of COVID-19, used to allocate scarce resources, have historically considered only mortality. However, survivors often develop postinfectious ‘long-COVID’ similar to chronic fatigue syndrome; physical sequelae such as heart damage, or both. This paper quantifies relative contributions of acute case fatality, delayed case fatality, and disability to total morbidity per COVID-19 case. Study Design and Setting Healthy life years lost per COVID-19 case were computed as the sum of (incidence*disability weight*duration) for death and long-COVID by sex and 10-year age category in three plausible scenarios. Results In all models, acute mortality was only a small share of total morbidity. For lifelong moderate symptoms, healthy years lost per COVID-19 case ranged from 0.92 (male in his 30s) to 5.71 (girl under 10) and were 3.5 and 3.6 for the oldest females and males. At higher symptom severities, young people and females bore larger shares of morbidity; if survivors’ later mortality increased, morbidity increased most in young people of both sexes. Conclusions Under most conditions most COVID-19 morbidity was in survivors. Future research should investigate incidence, risk factors, and clinical course of long-COVID to elucidate total disease burden, and decisionmakers should allocate scarce resources to minimize total morbidity.
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Affiliation(s)
- Maia P Smith
- Department of Public Health and Preventive Medicine, St. George's University School of Medicine, True Blue, Grenada, West Indies.
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20
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Qiu H, Cao S, Xu R. Cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020. Cancer Commun (Lond) 2021; 41:1037-1048. [PMID: 34288593 PMCID: PMC8504144 DOI: 10.1002/cac2.12197] [Citation(s) in RCA: 312] [Impact Index Per Article: 104.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/27/2021] [Accepted: 07/11/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Cancer is one of the leading causes of death and a main economic burden in China. Investigating the differences in cancer patterns and control strategies between China and developed countries could provide reference for policy planning and contribute to improving cancer control measures. In this study, we reviewed the rates and trends of cancer incidence and mortality and disability-adjusted life year (DALY) burden in China, and compared them with those in the United States (US) and the United Kingdom (UK). METHODS Cancer incidence, mortality, and DALY data for China, US and UK were obtained from the GLOBOCAN 2020 online database, Global Burden of Disease (GBD) 2019 study, and Cancer Incidence in Five Continents plus database (CI5 plus). Trends of cancer incidence and mortality in China, US, and UK were analyzed using Joinpoint regression models to calculate annual percent changes (APCs) and identify the best-fitting joinpoints. RESULTS An estimated 4,568,754 newly diagnosed cancer cases and 3,002,899 cancer deaths occurred in China in 2020. Additionally, cancers resulted in 67,340,309 DALYs in China. Compared to the US and UK, China had lower cancer incidence but higher cancer mortality and DALY rates. Furthermore, the cancer spectrum of China was changing, with a rapid increase incidence and burden of lung, breast, colorectal, and prostate cancer in addition to a high incidence and heavy burden of liver, stomach, esophageal, and cervical cancer. CONCLUSIONS The cancer spectrum of China is changing from a developing country to a developed country. Population aging and increase of unhealthy lifestyles would continue to increase the cancer burden of China. Therefore, the Chinese authorities should adjust the national cancer control program with reference to the practices of cancer control which have been well-established in the developed countries, and taking consideration of the diversity of cancer types by of different regions in China at the same time.
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Affiliation(s)
- Haibo Qiu
- Department of Gastric SurgeryState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat‐Sen University Cancer CenterGuangzhouGuangdong510060P. R. China
| | - Sumei Cao
- Department of Cancer Prevention Research CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat‐Sen University Cancer CenterGuangzhouGuangdong510060P. R. China
| | - Ruihua Xu
- Department of Medical OncologyState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat‐Sen University Cancer CenterGuangzhouGuangdong510060P. R. China
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21
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Abstract
To investigate the national burden of eye diseases in China from 1990 to 2019. The national burden of eye diseases in China, including case numbers, prevalence rate, age-standardized prevalence rate (ASR), disability-adjusted life year (DALY), DALY rate and age-standardized DALY rate (ASD) were calculated and stratified by sex and age. The trends of eye diseases burden from 1990 to 2019 and the correlation between eye diseases burden and human development index (HDI) were analyzed. In 2019, the total case number of eye diseases in China was 0.21 billion, the ASR was 9511/10, the total number of DALY was 4.72 million, and the ASD was 247.4/10. Near vision loss caused the greatest burden, followed by refraction disorders and cataract, with ASD being 73.8/10, 70.3/10 and 59.2/10, respectively. Men had lower risks of eye diseases than women. People aged old and old had the greatest burden of eye diseases. Compared with the year 1990, the total case number increased by 134.6% and DALY by 113.0% in 2019. The ASD of all decreased by 7.5%, and was negatively correlated with national HDI. Near vision loss, refraction disorders and cataract are of heavy disease burden in China. Although the ASD of eye diseases is decreased with the development of the national socioeconomic status, the eye diseases burden in China still increased with population growth and aging.
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Affiliation(s)
- Binbin Chen
- Ophthalmology Center, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Lixia Lou
- Ophthalmology Center, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Juan Ye
- Ophthalmology Center, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
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22
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Fang H, Zhang Q, Zhang S, Zhang T, Pan F, Cui Y, Thomsen ST, Jakobsen LS, Liu A, Pires SM. Risk-Benefit Assessment of Consumption of Rice for Adult Men in China. Front Nutr 2021; 8:694370. [PMID: 34368209 PMCID: PMC8342936 DOI: 10.3389/fnut.2021.694370] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/18/2021] [Indexed: 01/27/2023] Open
Abstract
Objective: To evaluate the health impact of current and alternative patterns of rice consumption in Chinese adult men (40-79 years of age). Methods: We applied a risk-benefit assessment (RBA) model that took into account the health effects of selenium (Se), cadmium (Cd), and inorganic arsenic (i-As). The health effects included the prevention of prostate cancer associated with exposure to Se, and an increased risk of lung, bladder, and skin cancer for i-As and chronic kidney disease (CKD) for Cd. We defined the baseline scenario (BS) as the current individual mean daily consumption of rice in the population of interest and two alternative scenarios (AS): AS1 = 50 g/day and AS2 = 200 g/day. We estimated the health impact for different age groups in terms of change in Disability-Adjusted Life Years (ΔDALY). Results: The BS of rice consumption was 71.5-105.4 g/day in different age groups of adult men in China. We estimated that for AS1, the mean ΔDALY was -2.76 to 46.2/100,000 adult men of 40-79 years old. For AS2, the mean ΔDALY was 41.3 to 130.8/100,000 individuals in this population group. Conclusion: Our results showed that, based on associated exposure to selenium, cadmium, and i-As in rice, the current consumption of rice does not pose a risk to adult men in China. Also, a lower (50 g/day) or higher (200 g/day) rice consumption will not bring larger beneficial effects.
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Affiliation(s)
- Haiqin Fang
- China Center for Food Safety and Risk Assessment, Beijing, China
| | - Quantao Zhang
- Yantai Huaxin Biomedical Science and Technology Co., Ltd, Yantai, China
| | - Shengjie Zhang
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Tongwei Zhang
- China Center for Food Safety and Risk Assessment, Beijing, China
| | - Feng Pan
- China Center for Food Safety and Risk Assessment, Beijing, China
| | - Yufeng Cui
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Sofie Theresa Thomsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute Technical University of Denmark, Lyngby, Denmark
| | - Lea S. Jakobsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute Technical University of Denmark, Lyngby, Denmark
| | - Aidong Liu
- China Center for Food Safety and Risk Assessment, Beijing, China
| | - Sara M. Pires
- Division of Diet, Disease Prevention and Toxicology, National Food Institute Technical University of Denmark, Lyngby, Denmark
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23
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Langer RD. The role of medications in successful aging. Climacteric 2021; 24:505-512. [PMID: 33977831 DOI: 10.1080/13697137.2021.1911991] [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] [Indexed: 10/21/2022]
Abstract
Successful aging includes good health and low levels of disability. To that end, primary prevention is far better than managing subsequent organ damage. When medication is needed to prevent or manage disease, the preferred choice should be associated with the greatest benefits and fewest adverse effects. Cardiovascular diseases are the leading cause of morbidity and mortality in postmenopausal women worldwide. Considering disease-adjusted life years, other leading causes are chronic obstructive pulmonary disease, diabetes mellitus, dementias, hearing loss, cancers of the breast, lung and bowel, osteoporosis, fractures and falls, depression, osteoarthritis, refractive errors of the eye and non-diabetic chronic kidney disease. This review explores the global prevalence of these diseases in women aged 50 years and older, and medications commonly used for them, and contrasts the effects of menopausal hormone therapy (MHT) with others. When initiated early, there is good evidence for MHT benefit in all-cause mortality and primary prevention of cardiovascular disease, diabetes and osteoporosis; fair evidence for benefit in dementias, depression and osteoarthritis; limited evidence for benefit in chronic obstructive pulmonary disease, hearing loss, non-diabetic chronic kidney disease and colorectal cancer; null effects on lung cancer and refractive errors; and varied effects on breast cancer and stroke. Relative benefits and adverse effects of other medications warrant consideration.
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Affiliation(s)
- R D Langer
- Jackson Hole Center for Preventive Medicine, Jackson, WY, USA.,Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
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24
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Davidović M, Zielonke N, Lansdorp-Vogelaar I, Segnan N, de Koning HJ, Heijnsdijk EA. Disability-Adjusted Life Years Averted Versus Quality-Adjusted Life Years Gained: A Model Analysis for Breast Cancer Screening. Value Health 2021; 24:353-360. [PMID: 33641769 DOI: 10.1016/j.jval.2020.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/03/2020] [Accepted: 10/10/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To quantify the impact of mammography-based screening on the quality of life, disability-adjusted life years (DALYs) averted or quality-adjusted life years (QALYs) gained can be used. We aimed to assess whether the use of DALYs averted or QALYs gained will lead to different cost-effective screening strategies. METHODS Using the microsimulation model MISCAN, we simulated different breast cancer screening strategies varying in starting age (starting at 45, 47, and 50 years), stopping age (stopping at 69, 72, and 74 years), and frequency (annual [A], biennial [B], combination of both [A + B], and triennial [T]). In total, we defined 24 different breast cancer screening strategies, including no screening as a reference strategy. We calculated incremental cost-effectiveness ratios (ICERs) and compared which strategies were on the efficiency frontiers for DALYs and QALYs. RESULTS Breast cancer screening averted between 46.00 and 105.58 DALYs and gained between 28.69 and 64.50 QALYs per 1000 women. For DALYs there were 5 strategies on the efficiency frontier (T50-69, T50-74, T45-74, B45-74, and A45-74). The same strategies plus one (B45-72) were on the efficiency frontier for QALYs. CONCLUSIONS Using DALYs averted instead of QALYs gained to assess the effects on quality of life from breast cancer screening in the Dutch population yields differences in ICERs, but almost the same strategies were on the efficiency frontiers. Whether the choice in outcome measure leads to a difference in optimal policy depends on the cost-effectiveness threshold.
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Affiliation(s)
- Maša Davidović
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Nadine Zielonke
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Iris Lansdorp-Vogelaar
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nereo Segnan
- Department of Cancer Screening, Cancer Epidemiology Unit, Center for Epidemiology and Prevention in Oncology, CPO Piemonte, University Hospital "Citta della Salute e della Scienza di Torino", Turin, Italy
| | - Harry J de Koning
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eveline Am Heijnsdijk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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25
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Yap A, Cheung M, Muzira A, Healy J, Kakembo N, Kisa P, Cunningham D, Youngson G, Sekabira J, Yaesoubi R, Ozgediz D. Best Buy in Public Health or Luxury Expense?: The Cost-effectiveness of a Pediatric Operating Room in Uganda From the Societal Perspective. Ann Surg 2021; 273:379-386. [PMID: 30907755 PMCID: PMC6752983 DOI: 10.1097/sla.0000000000003263] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To determine the cost-effectiveness of building and maintaining a dedicated pediatric operating room (OR) in Uganda from the societal perspective. BACKGROUND Despite the heavy burden of pediatric surgical disease in low-income countries, definitive treatment is limited as surgical infrastructure is inadequate to meet the need, leading to preventable morbidity and mortality in children. METHODS In this economic model, we used a decision tree template to compare the intervention of a dedicated pediatric OR in Uganda for a year versus the absence of a pediatric OR. Costs were included from the government, charity, and patient perspectives. OR and ward case-log informed epidemiological and patient outcomes data, and measured cost per disability adjusted life year averted and cost per life saved. The incremental cost-effectiveness ratio (ICER) was calculated between the intervention and counterfactual scenario. Costs are reported in 2015 US$ and inflated by 5.5%. FINDINGS In Uganda, the implementation of a dedicated pediatric OR has an ICER of $37.25 per disability adjusted life year averted or $3321 per life saved, compared with no existing operating room. The ICER is well below multiple cost-effectiveness thresholds including one times the country's gross domestic product per capita ($694). The ICER remained robust under 1-way and probabilistic sensitivity analyses. CONCLUSION Our model ICER suggests that the construction and maintenance of a dedicated pediatric operating room in sub-Saharan Africa is very-cost effective if hospital space and personnel pre-exist to staff the facility. This supports infrastructure implementation for surgery in sub-Saharan Africa as a worthwhile investment.
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Affiliation(s)
- Ava Yap
- Department of Surgery, University of California San Francisco, San Francisco, CA
| | - Maija Cheung
- Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Arlene Muzira
- Department of Surgery, Makerere University, Mulago Hospital, Kampala, Uganda
| | - James Healy
- Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Nasser Kakembo
- Department of Surgery, Makerere University, Mulago Hospital, Kampala, Uganda
| | - Phyllis Kisa
- Department of Surgery, Makerere University, Mulago Hospital, Kampala, Uganda
| | | | | | - John Sekabira
- Department of Surgery, Makerere University, Mulago Hospital, Kampala, Uganda
| | - Reza Yaesoubi
- Department of Health Management and Policy, Yale School of Public Health, New Haven, CT
| | - Doruk Ozgediz
- Department of Surgery, Yale University School of Medicine, New Haven, CT
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26
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Nittala MR, Kanakamedala MR, Mundra E, Woods WC, Smith ML, Hamilton RD, Jefferson GD, Jackson L, Packianathan S, Vijayakumar S. Quality-Adjusted Life Years and Disability-Adjusted Life Years Are Better With Concurrent Chemoradiation Therapy Than Induction Chemotherapy Followed by Chemoradiation Therapy in Nasopharyngeal Carcinoma. Cureus 2021; 13:e13022. [PMID: 33665048 PMCID: PMC7921606 DOI: 10.7759/cureus.13022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Introduction As traditional measures such as overall survival (OS) or disease-free survival (DFS) alone do not give a holistic view of the outcomes of a treatment paradigm, we determine to add the evidence of quality-adjusted life year (QALY) and disability-adjusted life year (DALY) to the outcomes of the nasopharyngeal carcinoma patients (NCP) treated with definitive chemoradiation therapy (chemoRT) with or without induction chemotherapy (induction chemo). Methods This is a retrospective analysis of 85 NCPs treated at an academic state institution. The OS estimated by the Kaplan-Meier method and the multivariate Cox regression model determined the co-variables associated with the OS. The relationship between QALYs gained and DALYs saved were calculated from age of the disease onset, duration of the disease, quality of life (QoL) and disability weights. Results Of the 85 eligible NCPs of this cohort, the disease frequency distribution per the World Health Organization (WHO) classification was 41.2% for Type-I, 42.4% for Type-II, and 16.5% for Type-III. The median follow-up (24 months). The five-year OS of patients treated with concurrent chemoRT vs. induction chemo followed by concurrent chemoRT was 54.7 vs. 14.8% for WHO Type I, 60.1 vs. 58.3% for WHO Type II, and 83.3 vs. 50.0% for WHO Type III (p=0.029). The average DALYs saved with concurrent chemoRT were 12.2 years vs. 5 years for induction chemo followed by concurrent chemoRT. The average QALYs gained with concurrent chemoRT were 6.9 years vs. 3.1 years for induction chemo followed by concurrent chemoRT. Conclusion Patients treated with concurrent chemoRT had an increased QoL when compared to induction chemo followed by concurrent chemoRT. The average DALYs saved were higher in the patients treated with concurrent chemoRT than treated with induction chemo followed by concurrent chemoRT.
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Affiliation(s)
- Mary R Nittala
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | | | - Eswar Mundra
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - William C Woods
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Maria L Smith
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Robert D Hamilton
- Hematology and Medical Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Gina D Jefferson
- Otolaryngology - Head and Neck Surgery, University of Mississippi Medical Center, Jackson, USA
| | - Lana Jackson
- Otolaryngology - Head and Neck Surgery, University of Mississippi Medical Center, Jackson, USA
| | - Satya Packianathan
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
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27
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Chao TE. Beyond outcomes: applying cost-effectiveness analysis to policy making. Br J Anaesth 2020; 125:850-852. [PMID: 32948296 DOI: 10.1016/j.bja.2020.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/22/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Tiffany E Chao
- Santa Clara Valley Medical Center, San Jose, CA, USA; Stanford School of Medicine, Stanford, CA, USA.
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28
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Ou Z, Yu D, Liang Y, He W, Li Y, Zhang M, You F, He H, Chen Q. Analysis of the Global Burden of Disease study highlights the trends in death and disability-adjusted life years of leukemia from 1990 to 2017. Cancer Commun (Lond) 2020; 40:598-610. [PMID: 32936522 PMCID: PMC7668511 DOI: 10.1002/cac2.12094] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/03/2020] [Accepted: 09/04/2020] [Indexed: 12/18/2022] Open
Abstract
Background The patterns of leukemia burden have dramatically changed in recent years. This study aimed to estimate the global trends of leukemia‐related death and disability‐adjusted life‐years (DALYs) from 1990 to 2017. Methods The data was acquired from the latest version of the Global Burden of Disease (GBD) study. Estimated annual percentage changes (EAPCs) were calculated to estimate the trend of age‐standardized rate (ASR) of death and DALYs due to leukemia and its main subtypes from 1990 to 2017. Results Globally, the numbers of death and DALYs due to leukemia were 347.58 × 103 (95% uncertainty interval [UI] = 317.26 × 103‐364.88 × 103) and 11975.35 × 103 (95% UI = 10749.15 × 103‐12793.58 × 103) in 2017, with a 31.22% and 0.03% increase in absolute numbers from 1990 to 2017, respectively. Both of their ASR showed decreasing trends from 1990 to 2017 with the EAPCs being −1.04 (95% confidence interval [CI] = (−1.10‐−0.99) and −1.52 (95% CI = −1.59‐−1.44), respectively. Globally, the most pronounced decreasing trend of death and DALYs occurred in chronic myeloid leukemia with EAPCs of −2.76 (95% CI = −2.88‐−2.64) and −2.84 (95% CI = −2.97‐−2.70), respectively, while the trend increased in acute myeloid leukemia. The death and DALYs of leukemia decreased in most areas and countries with high socio‐demographic index (SDI) including Bahrain, Finland, and Australia. Conclusions The disease burden of death and DALYs due to leukemia decreased globally, and for most regions and countries from 1990 to 2017. However, the leukemia burden is still a substantial challenge globally and required adequate and affordable medical resources to improve the survival and quality of life of leukemia patients.
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Affiliation(s)
- Zejin Ou
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Danfeng Yu
- Department of Medical Intensive Care Unit, Guangdong Women and Children Hospital, Guangzhou, Guangdong, 510400, P. R. China
| | - Yuanhao Liang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Wenqiao He
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Yongzhi Li
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Minyi Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Fangfei You
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Huan He
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Qing Chen
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
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Ye X, She X, Shen L. Association of sex with the global burden of glaucoma: an analysis from the global burden of disease study 2017. Acta Ophthalmol 2020; 98:e593-e598. [PMID: 31912656 DOI: 10.1111/aos.14330] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/18/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To investigate the association of sex with the global burden of glaucoma by year, age and socio-economic status using disability-adjusted life years (DALYs). METHOD The global, regional and national sex-specific DALY numbers, crude DALY rates and age-standardized DALY rates caused by glaucoma, by year and age, were obtained from the Global Burden of Disease Study 2017. Human development index (HDI) in 2017 as a national socio-economic indicator was obtained from the Human Development Report. t-Test and linear regression were performed to explore the association between sex difference in age-standardized DALY rates and HDI. RESULTS Globally, changes in glaucoma DALY number and crude rates were similar of both sexes between 1990 and 2017. After controlling for population size and age structure, age-standardized DALY rates decreased consistently from 10.7 in 1990 to 9.4 in 2017 among men and from 8.8 in 1990 to 8.0 in 2017 among women. In 2017, the global average age-standardized DALY rates were 11.6 ± 8.6 (mean ± standard deviation) in women and 14.9 ± 12.1 in men. The sex difference in age-standardized DALY of 195 countries was significant (t = 3.109; p < .01) in 2017. Men had higher rates than women of the same age, and sexual differences increased with age. t-Test revealed that age-standardized DALY rates among men were higher than those among women for low-HDI countries (t = 3.102; p < .01) and high-HDI countries (t = 2.110; p < .05). The difference (male minus female) in age-standardized DALY rates (standardized β = -0.434, p < .001) and the female-to-male age-standardized DALY rate ratios (standardized β = -0.315, p < .001) were inversely correlated with HDI. CONCLUSION Although global glaucoma health care is progressing, sexual differences in glaucoma burden showed little improvement in the past few decades. Worldwide, men have higher glaucoma burden than women. Older age and lower socio-economic status are associated with greater sex differences in glaucoma burden. Our findings may enhance public awareness of sexual differences in global glaucoma burden and emphasize the importance of making sex-sensitive health policy to manage global vision loss caused by glaucoma.
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Affiliation(s)
- Xin Ye
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiangjun She
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Lijun Shen
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Hammitt JK, Morfeld P, Tuomisto JT, Erren TC. Premature Deaths, Statistical Lives, and Years of Life Lost: Identification, Quantification, and Valuation of Mortality Risks. Risk Anal 2020; 40:674-695. [PMID: 31820829 PMCID: PMC7217195 DOI: 10.1111/risa.13427] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/29/2019] [Accepted: 09/17/2019] [Indexed: 05/14/2023]
Abstract
Mortality effects of exposure to air pollution and other environmental hazards are often described by the estimated number of "premature" or "attributable" deaths and the economic value of a reduction in exposure as the product of an estimate of "statistical lives saved" and a "value per statistical life." These terms can be misleading because the number of deaths advanced by exposure cannot be determined from mortality data alone, whether from epidemiology or randomized trials (it is not statistically identified). The fraction of deaths "attributed" to exposure is conventionally derived as the hazard fraction (R - 1)/R, where R is the relative risk of mortality between high and low exposure levels. The fraction of deaths advanced by exposure (the "etiologic" fraction) can be substantially larger or smaller: it can be as large as one and as small as 1/e (≈0.37) times the hazard fraction (if the association is causal and zero otherwise). Recent literature reveals misunderstanding about these concepts. Total life years lost in a population due to exposure can be estimated but cannot be disaggregated by age or cause of death. Economic valuation of a change in exposure-related mortality risk to a population is not affected by inability to know the fraction of deaths that are etiologic. When individuals facing larger or smaller changes in mortality risk cannot be identified, the mean change in population hazard is sufficient for valuation; otherwise, the economic value can depend on the distribution of risk reductions.
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Affiliation(s)
- James K. Hammitt
- Harvard University (Center for Risk Analysis & Center for Health Decision Science)Boston, MA, USA and Toulouse School of EconomicsUniversité Toulouse CapitoleToulouseFrance
| | - Peter Morfeld
- Ruhr‐Universität BochumUniversity of Cologne (Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research)KölnGermany
| | | | - Thomas C. Erren
- University of Cologne (Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research)KölnGermany
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Tobollik M, Hintzsche M, Wothge J, Myck T, Plass D. Burden of Disease Due to Traffic Noise in Germany. Int J Environ Res Public Health 2019; 16:ijerph16132304. [PMID: 31261828 PMCID: PMC6651346 DOI: 10.3390/ijerph16132304] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 01/09/2023]
Abstract
Traffic noise is nearly ubiquitous and thus can affect the health of many people. Using the German noise mapping data according to the Directive 2002/49/EC of 2017 and exposure-response functions for ischemic heart disease, noise annoyance and sleep disturbance assessed by the World Health Organization's Environmental Noise Guidelines for the European Region the burden of disease due to traffic noise is quantified. The burden of disease is expressed in disability-adjusted life years (DALYs) and its components. The highest burden was found for road traffic noise, with 75,896 DALYs when only considering moderate evidence. When including all available evidence, 176,888 DALYs can be attributable to road traffic noise. The burden due to aircraft and railway noise is lower because fewer people are exposed. Comparing the burden by health outcomes, the biggest share is due to ischemic heart disease (90%) in regard to aircraft noise, however, the lowest evidence was expressed for the association between traffic noise and ischemic heart disease. Therefore, the results should be interpreted with caution. Using alternative input parameters (e.g., exposure data) can lead to a much higher burden. Nevertheless, environmental noise is an important risk factor which leads to considerable loss of healthy life years.
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Affiliation(s)
- Myriam Tobollik
- German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Corrensplatz 1, 14195 Berlin, Germany.
- Department of Environment and Health, School of Public Health, Bielefeld University, Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany.
| | - Matthias Hintzsche
- German Environment Agency, Section Noise Abatement of Industrial Plants and Products, Noise Impact, Wörlitzer Platz 1, 06844 Dessau-Roßlau, Germany.
| | - Jördis Wothge
- German Environment Agency, Section Noise Abatement of Industrial Plants and Products, Noise Impact, Wörlitzer Platz 1, 06844 Dessau-Roßlau, Germany.
| | - Thomas Myck
- German Environment Agency, Section Noise Abatement of Industrial Plants and Products, Noise Impact, Wörlitzer Platz 1, 06844 Dessau-Roßlau, Germany.
| | - Dietrich Plass
- German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Corrensplatz 1, 14195 Berlin, Germany.
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Kim HJ, Jo MW, Bae SH, Yoon SJ, Lee JY. Measuring the Burden of Disease Due to Preterm Birth Complications in Korea Using Disability-Adjusted Life Years (DALY). Int J Environ Res Public Health 2019; 16:E519. [PMID: 30759822 DOI: 10.3390/ijerph16030519] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 02/06/2019] [Accepted: 02/11/2019] [Indexed: 11/17/2022]
Abstract
The premature birth rate in Korea has increased from 13.5% in 2008 to 15.7% in 2013. The complications of premature birth are a major determinant of neonatal mortality and morbidities. The purpose of this study was to estimate the burden of premature birth in Korea using disability-adjusted life years (DALY). DALY consists of years of life lost (YLL) and years lost due to disability (YLD). In this study, preterm birth complications refer to nine diseases: P07, P22, P25, P26, P27, P28, P52, P77, P612, and H351 (International Classification of Diseases-10th Revision). YLL was calculated using mortality data from the 2012 National Health Insurance Data. YLD is a function of the prevalence, disability weight (DW), and duration of each complication. DW was determined by the Korean Disability Weight Study for National Burden of Disease in Korea 2013/2015. The burden of premature birth in Korea is 79,574 DALY (YLL: 43,725; YLD: 35,849). The burden for men (DALY: 43,603; YLL: 24,004; YLD: 19,599) is higher than that of women (DALY: 35,970; YLL: 19,720; YLD: 16,250). This study could provide essential data for evaluating the effects of policies intended to reduce preterm birth.
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Steckling N, Tobollik M, Plass D, Hornberg C, Ericson B, Fuller R, Bose-O'Reilly S. Global Burden of Disease of Mercury Used in Artisanal Small-Scale Gold Mining. Ann Glob Health 2018; 83:234-247. [PMID: 28619398 DOI: 10.1016/j.aogh.2016.12.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Artisanal small-scale gold mining (ASGM) is the world's largest anthropogenic source of mercury emission. Gold miners are highly exposed to metallic mercury and suffer occupational mercury intoxication. The global disease burden as a result of this exposure is largely unknown because the informal character of ASGM restricts the availability of reliable data. OBJECTIVE To estimate the prevalence of occupational mercury intoxication and the disability-adjusted life years (DALYs) attributable to chronic metallic mercury vapor intoxication (CMMVI) among ASGM gold miners globally and in selected countries. METHODS Estimates of the number of artisanal small-scale gold (ASG) miners were extracted from reviews supplemented by a literature search. Prevalence of moderate CMMVI among miners was determined by compiling a dataset of available studies that assessed frequency of intoxication in gold miners using a standardized diagnostic tool and biomonitoring data on mercury in urine. Severe cases of CMMVI were not included because it was assumed that these persons can no longer be employed as miners. Cases in workers' families and communities were not considered. Years lived with disability as a result of CMMVI among ASG miners were quantified by multiplying the number of prevalent cases of CMMVI by the appropriate disability weight. No deaths are expected to result from CMMVI and therefore years of life lost were not calculated. Disease burden was calculated by multiplying the prevalence rate with the number of miners for each country and the disability weight. Sensitivity analyses were performed using different assumptions on the number of miners and the intoxication prevalence rate. FINDINGS Globally, 14-19 million workers are employed as ASG miners. Based on human biomonitoring data, between 25% and 33% of these miners-3.3-6.5 million miners globally-suffer from moderate CMMVI. The resulting global burden of disease is estimated to range from 1.22 (uncertainty interval [UI] 0.87-1.61) to 2.39 (UI 1.69-3.14) million DALYs. CONCLUSIONS This study presents the first global and country-based estimates of disease burden caused by mercury intoxication in ASGM. Data availability and quality limit the results, and the total disease burden is likely undercounted. Despite these limitations, the data clearly indicate that mercury intoxication in ASG miners is a major, largely neglected global health problem.
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Affiliation(s)
- Nadine Steckling
- Bielefeld University, School of Public Health, Department Environment & Health, Bielefeld, Germany; University Hospital Munich, WHO Collaborating Centre for Occupational Health, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Unit Paediatric Environmental Epidemiology, Munich, Germany; Department of Public Health and Health Technology Assessment, University for Health Sciences, Medical Computer Science and Technology, Hall in Tirol, Austria.
| | - Myriam Tobollik
- Bielefeld University, School of Public Health, Department Environment & Health, Bielefeld, Germany; German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Berlin, Germany
| | - Dietrich Plass
- German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Berlin, Germany
| | - Claudia Hornberg
- Bielefeld University, School of Public Health, Department Environment & Health, Bielefeld, Germany
| | - Bret Ericson
- Pure Earth, formerly Blacksmith Institute, New York, NY
| | | | - Stephan Bose-O'Reilly
- University Hospital Munich, WHO Collaborating Centre for Occupational Health, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Unit Paediatric Environmental Epidemiology, Munich, Germany; Department of Public Health and Health Technology Assessment, University for Health Sciences, Medical Computer Science and Technology, Hall in Tirol, Austria
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Abstract
OBJECTIVE The epidemiology of carpal tunnel syndrome (CTS) has been extensively researched. However, data describing the economic burden of CTS is limited. The purpose of this study was to quantify the disease burden of CTS and determine the economic benefit of its surgical management. METHODS The authors utilized the PearlDiver database to identify the number of individuals with CTS in the Medicare patient population, and then utilized CPT codes to identify which individuals underwent surgical management. These data were used to calculate the total number of disability-adjusted life years (DALYs) associated with CTS. A human capital approach was employed and gross national income per capita was used to calculate the economic burden. RESULTS From 2005 to 2012 there were 1,500,603 individuals identified in the Medicare patient population with the diagnosis of CTS. Without conservative or surgical management, this results in 804,113 DALYs without age weighting and discounting, and 450,235 DALYs with age weighting and a discount rate of 3%. This amounts to between $21.8 and $39 billion in total economic burden, or $2.7-$4.8 billion per year. Surgical management of CTS has resulted in the aversion of 173,000-309,000 DALYs. This has yielded between $780 million and $1.6 billion in economic benefit per year. Endoscopic carpal tunnel release provided between $11,683 and $23,186 per patient at 100% success while open carpal tunnel release provided between $10,711 and $22,132 per patient at 100% success. The benefit-cost ratio at its most conservative is 2.7:1, yet could be as high as 6.9:1. CONCLUSIONS CTS is prevalent in the Medicare patient population, and is associated with a large amount of economic burden. The surgical management of CTS leads to a large reduction in this burden, yielding extraordinary economic benefit.
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Affiliation(s)
| | - Tsun Yee Law
- Holy Cross Orthopedic Institute, Fort Lauderdale, Florida
| | - Samuel Rosas
- Department of Orthopaedics, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Sarah C Jernigan
- Department of Neurosurgery, Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina
| | - Harvey Chim
- Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, Florida
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Wood CL, McInturff A, Young HS, Kim D, Lafferty KD. Human infectious disease burdens decrease with urbanization but not with biodiversity. Philos Trans R Soc Lond B Biol Sci 2018; 372:rstb.2016.0122. [PMID: 28438911 DOI: 10.1098/rstb.2016.0122] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2017] [Indexed: 12/20/2022] Open
Abstract
Infectious disease burdens vary from country to country and year to year due to ecological and economic drivers. Recently, Murray et al. (Murray CJ et al 2012 Lancet380, 2197-2223. (doi:10.1016/S0140-6736(12)61689-4)) estimated country-level morbidity and mortality associated with a variety of factors, including infectious diseases, for the years 1990 and 2010. Unlike other databases that report disease prevalence or count outbreaks per country, Murray et al. report health impacts in per-person disability-adjusted life years (DALYs), allowing comparison across diseases with lethal and sublethal health effects. We investigated the spatial and temporal relationships between DALYs lost to infectious disease and potential demographic, economic, environmental and biotic drivers, for the 60 intermediate-sized countries where data were available and comparable. Most drivers had unique associations with each disease. For example, temperature was positively associated with some diseases and negatively associated with others, perhaps due to differences in disease agent thermal optima, transmission modes and host species identities. Biodiverse countries tended to have high disease burdens, consistent with the expectation that high diversity of potential hosts should support high disease transmission. Contrary to the dilution effect hypothesis, increases in biodiversity over time were not correlated with improvements in human health, and increases in forestation over time were actually associated with increased disease burden. Urbanization and wealth were associated with lower burdens for many diseases, a pattern that could arise from increased access to sanitation and healthcare in cities and increased investment in healthcare. The importance of urbanization and wealth helps to explain why most infectious diseases have become less burdensome over the past three decades, and points to possible levers for further progress in improving global public health.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'.
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Affiliation(s)
- Chelsea L Wood
- Department of Ecology and Evolutionary Biology and Michigan Society of Fellows, University of Michigan, Ann Arbor, MI 48104, USA .,School of Aquatic and Fishery Sciences, University of Washington, Seattle, WA 98195, USA
| | - Alex McInturff
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA 94720, USA
| | - Hillary S Young
- Department of Ecology, Evolution, and Marine Biology, University of California, Santa Barbara, CA 93106, USA
| | - DoHyung Kim
- Department of Geographical Sciences, University of Maryland, College Park, MD 20742, USA
| | - Kevin D Lafferty
- US Geological Survey, Western Ecological Research Center, c/o Marine Science Institute, University of California, Santa Barbara, CA 93106, USA
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Xu G, Chen Y, Liu J, Liu SW, Wang P, Yang J, Huang JL. [Burden of pediatric cancer in Jiangxi, China, in 2010 and 2015]. Zhongguo Dang Dai Er Ke Za Zhi 2018; 20:21-27. [PMID: 29335077 PMCID: PMC7390322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/07/2017] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To study the burden of pediatric cancer in Jiangxi, China, in 2010 and 2015 and its changes from 2010 to 2015. METHODS The data of pediatric cancer in Jiangxi in 2010 and 2015 were collected from the Global Burden of Disease Study 2015 in China, including number of cases, number of deaths, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY). The standardized incidence rate, mortality rate, and DALY rate were calculated with the national census data in 2010 as the standard population, in order to evaluate the changes in incidence, mortality, and disease burden of pediatric cancer in Jiangxi. RESULTS In both 2010 and 2015, boys had higher numbers of cases, deaths, and DALY than girls, and the 5-14 years group had higher numbers than the 0-4 years group; boys had higher incidence rate, mortality rate, and DALY rate than girls, and the 0-4 years group had higher rates than the 5-14 years group. In 2015, the standardized incidence rate of pediatric cancer was reduced by 6.66% in the 0-4 years group and 17.56% in the 5-14 years group; the standardized mortality rate was reduced by 11.34% in the 0-4 years group and 21.78% in the 5-14 years group; the standardized DALY rate was reduced by 11.27% in the 0-4 years group and 21.67% in the 5-14 years group. Among the different types of pediatric cancer, leukemia had the highest standardized DALY rate in 2010 and 2015, followed by brain cancer and non-Hodgkin's lymphoma. CONCLUSIONS There was a certain reduction in the burden of pediatric cancer in Jiangxi from 2010 to 2015. Leukemia, brain cancer, and non-Hodgkin's lymphoma are the focus of prevention and treatment, and children aged less than 5 years and boys should be closely monitored.
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Affiliation(s)
- Gang Xu
- Department of Preventive Medicine, School of Basic Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.
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Xu G, Chen Y, Liu J, Liu SW, Wang P, Yang J, Huang JL. [Burden of pediatric cancer in Jiangxi, China, in 2010 and 2015]. Zhongguo Dang Dai Er Ke Za Zhi 2018; 20:21-27. [PMID: 29335077 PMCID: PMC7390322 DOI: 10.7499/j.issn.1008-8830.2018.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/07/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To study the burden of pediatric cancer in Jiangxi, China, in 2010 and 2015 and its changes from 2010 to 2015. METHODS The data of pediatric cancer in Jiangxi in 2010 and 2015 were collected from the Global Burden of Disease Study 2015 in China, including number of cases, number of deaths, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY). The standardized incidence rate, mortality rate, and DALY rate were calculated with the national census data in 2010 as the standard population, in order to evaluate the changes in incidence, mortality, and disease burden of pediatric cancer in Jiangxi. RESULTS In both 2010 and 2015, boys had higher numbers of cases, deaths, and DALY than girls, and the 5-14 years group had higher numbers than the 0-4 years group; boys had higher incidence rate, mortality rate, and DALY rate than girls, and the 0-4 years group had higher rates than the 5-14 years group. In 2015, the standardized incidence rate of pediatric cancer was reduced by 6.66% in the 0-4 years group and 17.56% in the 5-14 years group; the standardized mortality rate was reduced by 11.34% in the 0-4 years group and 21.78% in the 5-14 years group; the standardized DALY rate was reduced by 11.27% in the 0-4 years group and 21.67% in the 5-14 years group. Among the different types of pediatric cancer, leukemia had the highest standardized DALY rate in 2010 and 2015, followed by brain cancer and non-Hodgkin's lymphoma. CONCLUSIONS There was a certain reduction in the burden of pediatric cancer in Jiangxi from 2010 to 2015. Leukemia, brain cancer, and non-Hodgkin's lymphoma are the focus of prevention and treatment, and children aged less than 5 years and boys should be closely monitored.
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Affiliation(s)
- Gang Xu
- Department of Preventive Medicine, School of Basic Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.
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Abstract
BACKGROUND Disability weights (DWs) are used in disease burden studies, with the calculation of the weight of the disability as years lived with disability versus years of lost life accounting for mortalities. Currently, there is a single DW score available for poisoning, which is considered to be a single health state. This makes it difficult to evaluate the differing burdens of poisonings involving various substances/conditions in comparison with other health states in countries with different patterns of substance abuse. The aim of this study is therefore to estimate the DWs of 18 common poisonings based on the expert elicitation method. METHODS A panel of 10 medical clinicians who were familiar with the clinical aspects of different poisonings estimated the DWs of 50 health states by interpolating them on a calibrated Visual Analogue Scale. The DWs of some poisonings, such as alcohol, cannabis and heroin, had been estimated in previous studies and so were used to determine the external consistency of our panel. As a matter of routine, the DWs could vary on a scale between 0 (best health state) and 1 (worst health state). RESULTS Statistical analysis showed that both the internal (Cronbach's α = 0.912) and external consistency of the panel were acceptable. The DWs for the different poisonings were estimated along a range from 0.830 for severe aluminium phosphide to 0.022 for mild benzodiazepine. CONCLUSIONS Different poisonings should be weighted differently since they vary widely. Unfortunately, they are currently all weighted the same.
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Affiliation(s)
- R Asadi
- Medical Toxicology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - R Afshari
- Addiction Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran BC Disease Control Center, Vancouver, Canada
| | - B Dadpour
- Addiction Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
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Darbà J, Kaskens L, Pérez-Álvarez N, Palacios S, Neyro JL, Rejas J. Disability-adjusted-life-years losses in postmenopausal women with osteoporosis: a burden of illness study. BMC Public Health 2015; 15:324. [PMID: 25880810 PMCID: PMC4392468 DOI: 10.1186/s12889-015-1684-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 03/26/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To estimate the disability-adjusted life years (DALY) in a nationwide representative sample of postmenopausal women with osteoporosis. The effects of drug-based therapy and risk factors for osteoporotic bone fractures on DALY losses were also explored. METHODS DALY were estimated based on participant's clinical characteristics and Health-Related Quality-of-Life (HRQoL) data obtained from a cross-sectional, epidemiological one-visit study (the GINERISK study). The study enrolled postmenopausal women (at least 12-months after their last menstrual period) with osteoporosis, above 18-years old, who attended Spanish outpatient Gynaecology clinics. HRQoL was assessed using the generic SF-12v2 questionnaire, which was used to derive disutility values. Mortality rates were extracted from the Spanish national statistics database. Factors explored to be associated with DALY losses were examined using ANOVA, ANCOVA and MANCOVA models. RESULTS DALY could be computed in 2,782 (67%) out of 4,157 postmenopausal women, with a mean (95% CI) age of 61.0 (60.7-61.2) years. Overall individual undiscounted DALY per woman were 6.1 (5.9-6.2), resulting to be significantly higher in women with severe osteoporosis with prior bone fracture; 7.8 (7.2-8.4) compared to osteoporotic women [5.8 (5.6-6.0)] or postmenopausal women with a BMD > -2.5 T-score that received a drug-based therapy [6.2 (5.8-6.5)]; F = 27.0 (P < 0.01). Models explaining the variation in the levels of health based on the use of a selective estrogen receptor modulator (SERM) or possession of risk factors for osteoporotic BF were found (P < 0.05). CONCLUSIONS DALY losses were considerable amongst postmenopausal women with osteoporosis. Not having a prior bone fracture, being older, using a SERM and having less osteoporotic risk factors were all linked to less DALY losses.
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Affiliation(s)
- Josep Darbà
- Department of Economics, Universitat de Barcelona, Diagonal 690, 08034, Barcelona, Spain.
| | - Lisette Kaskens
- BCN Health Economics & Outcomes Research S.L., Travessera de Gracia 62, 5-6, 08006, Barcelona, Spain.
| | - Nuria Pérez-Álvarez
- BCN Health Economics & Outcomes Research S.L., Travessera de Gracia 62, 5-6, 08006, Barcelona, Spain.
| | - Santiago Palacios
- Instituto Palacios de Salud y Medicina de la Mujer, Calle Antonio Acuña, 9, 28009, Madrid, Spain.
| | - José Luis Neyro
- Department of Obstetrics and Gynaecology, Hospital Universitario Cruces, Gran Vía 81-4, 48011, Bilbao, Spain.
| | - Javier Rejas
- Health Economics and Outcomes Research Department, Pfizer, S.L.U., Avda. Europa 20B. Parque Empresarial la Moraleja, 28108, Alcobendas, Madrid, Spain.
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Linthicum MT, Thornton Snider J, Vaithianathan R, Wu Y, LaVallee C, Lakdawalla DN, Benner JE, Philipson TJ. Economic burden of disease-associated malnutrition in China. Asia Pac J Public Health 2014; 27:407-17. [PMID: 25301845 DOI: 10.1177/1010539514552702] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Disease-associated malnutrition (DAM) is a well-recognized problem in many countries, but the extent of its burden on the Chinese population is unclear. This article reports the results of a burden-of-illness study on DAM in 15 diseases in China. Using data from the World Health Organization (WHO), the China Health and Nutrition Survey, and the published literature, mortality and disability-adjusted life years (DALYs) lost because of DAM were calculated; a financial value of this burden was calculated following WHO guidelines. DALYs lost annually to DAM in China varied across diseases, from a low of 2248 in malaria to a high of 1 315 276 in chronic obstructive pulmonary disease. The total burden was 6.1 million DALYs, for an economic burden of US$66 billion (Chinese ¥ 447 billion) annually. This burden is sufficiently large to warrant immediate attention from public health officials and medical providers, especially given that low-cost and effective interventions are available.
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Affiliation(s)
| | | | | | - Yanyu Wu
- Precision Health Economics, Los Angeles, CA, USA
| | | | - Darius N Lakdawalla
- Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA
| | | | - Tomas J Philipson
- Irving B. Harris Graduate School of Public Policy Studies, University of Chicago, Chicago, IL, USA
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Erskine HE, Ferrari AJ, Polanczyk GV, Moffitt TE, Murray CJL, Vos T, Whiteford HA, Scott JG. The global burden of conduct disorder and attention-deficit/hyperactivity disorder in 2010. J Child Psychol Psychiatry 2014; 55:328-36. [PMID: 24447211 DOI: 10.1111/jcpp.12186] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/29/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The Global Burden of Disease Study 2010 (GBD 2010) is the first to include conduct disorder (CD) and attention-deficit/hyperactivity disorder (ADHD) for burden quantification. METHOD A previous systematic review pooled the available epidemiological data for CD and ADHD, and predicted prevalence by country, region, age and sex for each disorder. Prevalence was then multiplied by a disability weight to calculate years lived with disability (YLDs). As no evidence of deaths resulting directly from either CD or ADHD was found, no years of life lost (YLLs) were calculated. Therefore, the number of disability-adjusted life years (DALYs) was equal to that of YLDs. RESULTS Globally, CD was responsible for 5.75 million YLDs/DALYs with ADHD responsible for a further 491,500. Collectively, CD and ADHD accounted for 0.80% of total global YLDs and 0.25% of total global DALYs. In terms of global DALYs, CD was the 72nd leading contributor and among the 15 leading causes in children aged 5-19 years. Between 1990 and 2010, global DALYs attributable to CD and ADHD remained stable after accounting for population growth and ageing. CONCLUSIONS The global burden of CD and ADHD is significant, particularly in male children. Appropriate allocation of resources to address the high morbidity associated with CD and ADHD is necessary to reduce global burden. However, burden estimation was limited by data lacking for all four epidemiological parameters and by methodological challenges in quantifying disability. Future studies need to address these limitations in order to increase the accuracy of burden quantification.
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Affiliation(s)
- Holly E Erskine
- School of Population Health, University of Queensland, Herston, Qld, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Qld, Australia
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Dalal K, Lin Z, Gifford M, Svanström L. Economics of global burden of road traffic injuries and their relationship with health system variables. Int J Prev Med 2013; 4:1442-50. [PMID: 24498501 PMCID: PMC3898451] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 05/28/2013] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To estimate the economic loss due to road traffic injuries (RTIs) of the World Health Organization (WHO) member countries and to explore the relationship between the economic loss and relevant health system factors. METHODS Data from the World Bank and the WHO were applied to set up the databases. Disability-adjusted life year (DALY) and gross domestic product per capita were used to estimate the economic loss relating to RTIs. Regression analysis was used. Data were analyzed by IBM SPSS Statistics, Versions 20.0. RESULTS In 2005, the total economic loss of RTIs was estimated to be 167,752.4 million United States Dollars. High income countries (HIC) showed the greatest economic losses. The majority (96%) of the top 25 countries with the greatest DALY losses are low and middle income countries while 48% of the top 25 countries with the highest economic losses are HIC. The linear regression model indicates an inverse relationship between nurse density in the health system and economic loss due to RTI. CONCLUSIONS RTIs cause enormous death and DALYs loss in low-middle income countries and enormous economic loss in HIC. More road traffic prevention programs should be promoted in these areas to reduce both incidence and economic burden of RTIs.
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Affiliation(s)
- Koustuv Dalal
- Department of Public Health Science, Centre for Injury Prevention and Safety Promotion, School of Health and Medical Sciences, Örebro University, Örebro, Sweden,Correspondence to: Dr. Koustuv Dalal, Department of Public Health Science, Centre for Injury Prevention and Safety Promotion, School of Health and Medical Sciences, Örebro University, Örebro, Sweden. E-mail:
| | | | - Mervyn Gifford
- Department of Public Health Science, Centre for Injury Prevention and Safety Promotion, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Leif Svanström
- Department of Public Health Science, School of Life Sciences, University of Skövde, Skövde, Sweden
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Chatham-Stephens K, Caravanos J, Ericson B, Sunga-Amparo J, Susilorini B, Sharma P, Landrigan PJ, Fuller R. Burden of disease from toxic waste sites in India, Indonesia, and the Philippines in 2010. Environ Health Perspect 2013; 121:791-6. [PMID: 23649493 PMCID: PMC3702002 DOI: 10.1289/ehp.1206127] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 04/30/2013] [Indexed: 05/20/2023]
Abstract
BACKGROUND Prior calculations of the burden of disease from toxic exposures have not included estimates of the burden from toxic waste sites due to the absence of exposure data. OBJECTIVE We developed a disability-adjusted life year (DALY)-based estimate of the disease burden attributable to toxic waste sites. We focused on three low- and middle-income countries (LMICs): India, Indonesia, and the Philippines. METHODS Sites were identified through the Blacksmith Institute's Toxic Sites Identification Program, a global effort to identify waste sites in LMICs. At least one of eight toxic chemicals was sampled in environmental media at each site, and the population at risk estimated. By combining estimates of disease incidence from these exposures with population data, we calculated the DALYs attributable to exposures at each site. RESULTS We estimated that in 2010, 8,629,750 persons were at risk of exposure to industrial pollutants at 373 toxic waste sites in the three countries, and that these exposures resulted in 828,722 DALYs, with a range of 814,934-1,557,121 DALYs, depending on the weighting factor used. This disease burden is comparable to estimated burdens for outdoor air pollution (1,448,612 DALYs) and malaria (725,000 DALYs) in these countries. Lead and hexavalent chromium collectively accounted for 99.2% of the total DALYs for the chemicals evaluated. CONCLUSIONS Toxic waste sites are responsible for a significant burden of disease in LMICs. Although some factors, such as unidentified and unscreened sites, may cause our estimate to be an underestimate of the actual burden of disease, other factors, such as extrapolation of environmental sampling to the entire exposed population, may result in an overestimate of the burden of disease attributable to these sites. Toxic waste sites are a major, and heretofore underrecognized, global health problem.
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Affiliation(s)
- Kevin Chatham-Stephens
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029 , USA.
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