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Naghavi M, Ong KL, Aali A, Ababneh HS, Abate YH, Abbafati C, Abbasgholizadeh R, Abbasian M, Abbasi-Kangevari M, Abbastabar H, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdelwahab A, Abdollahi M, Abdollahifar MA, Abdoun M, Abdulah DM, Abdullahi A, Abebe M, Abebe SS, Abedi A, Abegaz KH, Abhilash ES, Abidi H, Abiodun O, Aboagye RG, Abolhassani H, Abolmaali M, Abouzid M, Aboye GB, Abreu LG, Abrha WA, Abtahi D, Abu Rumeileh S, Abualruz H, Abubakar B, Abu-Gharbieh E, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Accrombessi MMK, Adal TG, Adamu AA, Addo IY, Addolorato G, Adebiyi AO, Adekanmbi V, Adepoju AV, Adetunji CO, Adetunji JB, Adeyeoluwa TE, Adeyinka DA, Adeyomoye OI, Admass BAA, Adnani QES, Adra S, Afolabi AA, Afzal MS, Afzal S, Agampodi SB, Agasthi P, Aggarwal M, Aghamiri S, Agide FD, Agodi A, Agrawal A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad F, Ahmad MM, Ahmad S, Ahmad S, Ahmad T, Ahmadi K, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed LA, Ahmed MS, Ahmed MS, Ahmed MB, 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K, Deng X, Denova-Gutiérrez E, Deravi N, Dereje N, Dervenis N, Dervišević E, Des Jarlais DC, Desai HD, Desai R, Devanbu VGC, Dewan SMR, Dhali A, Dhama K, Dhimal M, Dhingra S, Dhulipala VR, Dias da Silva D, Diaz D, Diaz MJ, Dima A, Ding DD, Ding H, Dinis-Oliveira RJ, Dirac MA, Djalalinia S, Do THP, do Prado CB, Doaei S, Dodangeh M, Dodangeh M, Dohare S, Dokova KG, Dolecek C, Dominguez RMV, Dong W, Dongarwar D, D'Oria M, Dorostkar F, Dorsey ER, dos Santos WM, Doshi R, Doshmangir L, Dowou RK, Driscoll TR, Dsouza HL, Dsouza V, Du M, Dube J, Duncan BB, Duraes AR, Duraisamy S, Durojaiye OC, Dwyer-Lindgren L, Dzianach PA, Dziedzic AM, E'mar AR, Eboreime E, Ebrahimi A, Echieh CP, Edinur HA, Edvardsson D, Edvardsson K, Efendi D, Efendi F, Effendi DE, Eikemo TA, Eini E, Ekholuenetale M, Ekundayo TC, El Sayed I, Elbarazi I, Elema TB, Elemam NM, Elgar FJ, Elgendy IY, ElGohary GMT, Elhabashy HR, Elhadi M, El-Huneidi W, Elilo LT, Elmeligy OAA, Elmonem MA, Elshaer M, Elsohaby I, Emeto TI, Engelbert 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Ghahramani S, Ghailan KY, Ghasemi MR, Ghasempour Dabaghi G, Ghasemzadeh A, Ghashghaee A, Ghassemi F, Ghazy RM, Ghimire A, Ghoba S, Gholamalizadeh M, Gholamian A, Gholamrezanezhad A, Gholizadeh N, Ghorbani M, Ghorbani Vajargah P, Ghoshal AG, Gill PS, Gill TK, Gillum RF, Ginindza TG, Girmay A, Glasbey JC, Gnedovskaya EV, Göbölös L, Godinho MA, Goel A, Golchin A, Goldust M, Golechha M, Goleij P, Gomes NGM, Gona PN, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Goulart BNG, Goyal A, Grada A, Graham SM, Grivna M, Grosso G, Guan SY, Guarducci G, Gubari MIM, Gudeta MD, Guha A, Guicciardi S, Guimarães RA, Gulati S, Gunawardane DA, Gunturu S, Guo C, Gupta AK, Gupta B, Gupta MK, Gupta M, Gupta RD, Gupta R, Gupta S, Gupta VB, Gupta VK, Gupta VK, Gurmessa L, Gutiérrez RA, Habibzadeh F, Habibzadeh P, Haddadi R, Hadei M, Hadi NR, Haep N, Hafezi-Nejad N, Hailu A, Haj-Mirzaian A, Halboub ES, Hall BJ, Haller S, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hamilton EB, Han C, Han Q, Hanif A, Hanifi N, 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A, Lai DTC, Lal DK, Lalloo R, Lallukka T, Lam H, Lám J, Landrum KR, Lanfranchi F, Lang JJ, Langguth B, Lansingh VC, Laplante-Lévesque A, Larijani B, Larsson AO, Lasrado S, Lassi ZS, Latief K, Latifinaibin K, Lauriola P, Le NHH, Le TTT, Le TDT, Ledda C, Ledesma JR, Lee M, Lee PH, Lee SW, Lee SWH, Lee WC, Lee YH, LeGrand KE, Leigh J, Leong E, Lerango TL, Li MC, Li W, Li X, Li Y, Li Z, Ligade VS, Likaka ATM, Lim LL, Lim SS, Lindstrom M, Linehan C, Liu C, Liu G, Liu J, Liu R, Liu S, Liu X, Liu X, Llanaj E, Loftus MJ, López-Bueno R, Lopukhov PD, Loreche AM, Lorkowski S, Lotufo PA, Lozano R, Lubinda J, Lucchetti G, Lugo A, Lunevicius R, Ma ZF, Maass KL, Machairas N, Machoy M, Madadizadeh F, Madsen C, Madureira-Carvalho ÁM, Maghazachi AA, Maharaj SB, Mahjoub S, Mahmoud MA, Mahmoudi A, Mahmoudi E, Mahmoudi R, Majeed A, Makhdoom IF, Malakan Rad E, Maled V, Malekzadeh R, Malhotra AK, Malhotra K, Malik AA, Malik I, Malta DC, Mamun AA, Mansouri P, Mansournia MA, Mantovani LG, Maqsood S, Marasini 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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2100-2132. [PMID: 38582094 DOI: 10.1016/s0140-6736(24)00367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation.
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Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2204-2256. [PMID: 38762325 DOI: 10.1016/s0140-6736(24)00685-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. METHODS Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. FINDINGS In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8-63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0-45·0] in 2050) and south Asia (31·7% [29·2-34·1] to 15·5% [13·7-17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4-40·3) to 41·1% (33·9-48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6-25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5-43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5-17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7-11·3) in the high-income super-region to 23·9% (20·7-27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5-6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2-26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [-0·6 to 3·6]). INTERPRETATION Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions. FUNDING Bill & Melinda Gates Foundation.
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MZ, Yousefi Z, Yu C, Yu Y, Yuan CW, Zafari N, Zakham F, Zaki N, Zamagni G, Zandi M, Zandieh GGZ, Zangiabadian M, Zastrozhin MS, Zhang H, Zhang M, Zhang Y, Zhong C, Zhou J, Zhu B, Zhu L, Zielińska M, Zou Z, Zyoud SH, Murray CJL, Smith AE, Vollset SE. Global fertility in 204 countries and territories, 1950-2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2057-2099. [PMID: 38521087 PMCID: PMC11122687 DOI: 10.1016/s0140-6736(24)00550-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/28/2023] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Accurate assessments of current and future fertility-including overall trends and changing population age structures across countries and regions-are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. METHODS To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10-54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values-a metric assessing gain in forecasting accuracy-by comparing predicted versus observed ASFRs from the past 15 years (2007-21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. FINDINGS During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63-5·06) to 2·23 (2·09-2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137-147), declining to 129 million (121-138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1-canonically considered replacement-level fertility-in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7-29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59-2·08) in 2050 and 1·59 (1·25-1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6-43·1) in 2050 and 54·3% (47·1-59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions-decreasing, for example, in south Asia from 24·8% (23·7-25·8) in 2021 to 16·7% (14·3-19·1) in 2050 and 7·1% (4·4-10·1) in 2100-but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40-1·92) in 2050 and 1·62 (1·35-1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. INTERPRETATION Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world. FUNDING Bill & Melinda Gates Foundation.
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Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2133-2161. [PMID: 38642570 PMCID: PMC11122111 DOI: 10.1016/s0140-6736(24)00757-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/07/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING Bill & Melinda Gates Foundation.
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Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2162-2203. [PMID: 38762324 DOI: 10.1016/s0140-6736(24)00933-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/11/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. METHODS The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk-outcome pairs. Pairs were included on the basis of data-driven determination of a risk-outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk-outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk-outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. FINDINGS Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7-9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4-9·2]), smoking (5·7% [4·7-6·8]), low birthweight and short gestation (5·6% [4·8-6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8-6·0]). For younger demographics (ie, those aged 0-4 years and 5-14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9-27·7]) and environmental and occupational risks (decrease of 22·0% [15·5-28·8]), coupled with a 49·4% (42·3-56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9-21·7] for high BMI and 7·9% [3·3-12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6-1·9) for high BMI and 1·3% (1·1-1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4-78·8) for child growth failure and 66·3% (60·2-72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). INTERPRETATION Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions. FUNDING Bill & Melinda Gates Foundation.
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Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:1989-2056. [PMID: 38484753 DOI: 10.1016/s0140-6736(24)00476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period. METHODS 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5-65·1] decline), and increased during the COVID-19 pandemic period (2020-21; 5·1% [0·9-9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98-5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50-6·01) in 2019. An estimated 131 million (126-137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7-17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8-24·8), from 49·0 years (46·7-51·3) to 71·7 years (70·9-72·5). Global life expectancy at birth declined by 1·6 years (1·0-2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67-8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4-52·7]) and south Asia (26·3% [9·0-44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING Bill & Melinda Gates Foundation.
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Wang S, Wang Y, Wang YP, Waqas M, Waris A, Weerakoon KG, Weintraub RG, Weldemariam AH, Westerman R, Whisnant JL, Wickramasinghe DP, Wickramasinghe ND, Willekens B, Wilner LB, Winkler AS, Wolfe CDA, Wu AM, Wulf Hanson S, Xu S, Xu X, Yadollahpour A, Yaghoubi S, Yahya G, Yamagishi K, Yang L, Yano Y, Yao Y, Yehualashet SS, Yeshaneh A, Yesiltepe M, Yi S, Yiğit A, Yiğit V, Yon DK, Yonemoto N, You Y, Younis MZ, Yu C, Yusuf H, Zadey S, Zahedi M, Zakham F, Zaki N, Zali A, Zamagni G, Zand R, Zandieh GGZ, Zangiabadian M, Zarghami A, Zastrozhin MS, Zeariya MGM, Zegeye ZB, Zeukeng F, Zhai C, Zhang C, Zhang H, Zhang Y, Zhang ZJ, Zhao H, Zhao Y, Zheng P, Zhou H, Zhu B, Zhumagaliuly A, Zielińska M, Zikarg YT, Zoladl M, Murray CJL, Ong KL, Feigin VL, Vos T, Dua T. Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 2024; 23:344-381. [PMID: 38493795 PMCID: PMC10949203 DOI: 10.1016/s1474-4422(24)00038-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378-521), affecting 3·40 billion (3·20-3·62) individuals (43·1%, 40·5-45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7-26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6-38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5-32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7-2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. FUNDING Bill & Melinda Gates Foundation.
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Cunha ARD, Compton K, Xu R, Mishra R, Drangsholt MT, Antunes JLF, Kerr AR, Acheson AR, Lu D, Wallace LE, Kocarnik JM, Fu W, Dean FE, Pennini A, Henrikson HJ, Alam T, Ababneh E, Abd-Elsalam S, Abdoun M, Abidi H, Abubaker Ali H, Abu-Gharbieh E, Adane TD, Addo IY, Ahmad A, Ahmad S, Ahmed Rashid T, Akonde M, Al Hamad H, Alahdab F, Alimohamadi Y, Alipour V, Al-Maweri SA, Alsharif U, Ansari-Moghaddam A, Anwar SL, Anyasodor AE, Arabloo J, Aravkin AY, Aruleba RT, Asaad M, Ashraf T, Athari SS, Attia S, Azadnajafabad S, Azangou-Khyavy M, Badar M, Baghcheghi N, Banach M, Bardhan M, Barqawi HJ, Bashir NZ, Bashiri A, Benzian H, Bernabe E, Bhagat DS, Bhojaraja VS, Bjørge T, Bouaoud S, Braithwaite D, Briko NI, Calina D, Carreras G, Chakraborty PA, Chattu VK, Chaurasia A, Chen MX, Cho WCS, Chu DT, Chukwu IS, Chung E, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Darvishi Cheshmeh Soltani R, Darwesh AM, Debela SA, Derbew Molla M, Dessalegn FN, Dianati-Nasab M, Digesa LE, Dixit SG, Dixit A, Djalalinia S, El Sayed I, El Tantawi M, Enyew DB, Erku DA, Ezzeddini R, Fagbamigbe AF, Falzone L, Fetensa G, Fukumoto T, Gaewkhiew P, Gallus S, Gebrehiwot M, Ghashghaee A, Gill PS, Golechha M, Goleij P, Gomez RS, Gorini G, Guimaraes ALS, Gupta B, Gupta S, Gupta VB, Gupta VK, Haj-Mirzaian A, Halboub ES, Halwani R, Hanif A, Hariyani N, Harorani M, Hasani H, Hassan AM, Hassanipour S, Hassen MB, Hay SI, Hayat K, Herrera-Serna BY, Holla R, Horita N, Hosseinzadeh M, Hussain S, Ilesanmi OS, Ilic IM, Ilic MD, Isola G, Jaiswal A, Jani CT, Javaheri T, Jayarajah U, Jayaram S, Joseph N, Kadashetti V, Kandaswamy E, Karanth SD, Karaye IM, Kauppila JH, Kaur H, Keykhaei M, Khader YS, Khajuria H, Khanali J, Khatib MN, Khayat Kashani HR, Khazeei Tabari MA, Kim MS, Kompani F, Koohestani HR, Kumar GA, Kurmi OP, La Vecchia C, Lal DK, Landires I, Lasrado S, Ledda C, Lee YH, Libra M, Lim SS, Listl S, Lopukhov PD, Mafi AR, Mahumud RA, Malik AA, Mathur MR, Maulud SQ, Meena JK, Mehrabi Nasab E, Mestrovic T, Mirfakhraie R, Misganaw A, Misra S, Mithra P, Mohammad Y, Mohammadi M, Mohammadi E, Mokdad AH, Moni MA, Moraga P, Morrison SD, Mozaffari HR, Mubarik S, Murray CJL, Nair TS, Narasimha Swamy S, Narayana AI, Nassereldine H, Natto ZS, Nayak BP, Negru SM, Nggada HA, Nouraei H, Nuñez-Samudio V, Oancea B, Olagunju AT, Omar Bali A, Padron-Monedero A, Padubidri JR, Pandey A, Pardhan S, Patel J, Pezzani R, Piracha ZZ, Rabiee N, Radhakrishnan V, Radhakrishnan RA, Rahmani AM, Rahmanian V, Rao CR, Rao SJ, Rath GK, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghinia MS, Rezaei N, Rezaei N, Rezaei N, Rezapour A, Riad A, Roberts TJ, Romero-Rodríguez E, Roshandel G, S M, S N C, Saddik B, Saeb MR, Saeed U, Safaei M, Sahebazzamani M, Sahebkar A, Salek Farrokhi A, Samy AM, Santric-Milicevic MM, Sathian B, Satpathy M, Šekerija M, Senthilkumaran S, Seylani A, Shafaat O, Shahsavari HR, Shamsoddin E, Sharew MM, Sharifi-Rad J, Shetty JK, Shivakumar KM, Shobeiri P, Shorofi SA, Shrestha S, Siddappa Malleshappa SK, Singh P, Singh JA, Singh G, Sinha DN, Solomon Y, Suleman M, Suliankatchi Abdulkader R, Taheri Abkenar Y, Talaat IM, Tan KK, Tbakhi A, Thiyagarajan A, Tiyuri A, Tovani-Palone MR, Unnikrishnan B, Vo B, Volovat SR, Wang C, Westerman R, Wickramasinghe ND, Xiao H, Yu C, Yuce D, Yunusa I, Zadnik V, Zare I, Zhang ZJ, Zoladl M, Force LM, Hugo FN. The Global, Regional, and National Burden of Adult Lip, Oral, and Pharyngeal Cancer in 204 Countries and Territories: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA Oncol 2023; 9:1401-1416. [PMID: 37676656 PMCID: PMC10485745 DOI: 10.1001/jamaoncol.2023.2960] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/04/2023] [Indexed: 09/08/2023]
Abstract
Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning. Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates. Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019. Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia. Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts.
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Affiliation(s)
| | - Kelly Compton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Rixing Xu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Data and Tooling, Sage Bionetworks, Seattle, Washington
| | - Rashmi Mishra
- Department of Oral Medicine, School of Dentistry, University of Washington, Seattle
| | - Mark Thomas Drangsholt
- Department of Oral Medicine, School of Dentistry, University of Washington, Seattle
- Oral Medicine Clinic, School of Dentistry, University of Washington, Seattle
| | | | - Alexander R Kerr
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, College of Dentistry, New York University, New York, New York
| | - Alistair R Acheson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Dan Lu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Lindsey E Wallace
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Jonathan M Kocarnik
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Weijia Fu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Frances E Dean
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Mathematics, University of California, Berkeley
| | - Alyssa Pennini
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hannah Jacqueline Henrikson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts
| | - Tahiya Alam
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emad Ababneh
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Sherief Abd-Elsalam
- Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Meriem Abdoun
- Department of Medicine, University of Setif Algeria, Setif, Algeria
| | - Hassan Abidi
- Laboratory Technology Sciences Department, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Hiwa Abubaker Ali
- Department of Banking and Finance, University of Human Development, Sulaymaniyah, Iraq
| | - Eman Abu-Gharbieh
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Tigist Demssew Adane
- Department of Clinical and Psychosocial Epidemiology, University of Groningen, Groningen, the Netherlands
| | - Isaac Yeboah Addo
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
- Quality and Systems Performance Unit, Cancer Institute NSW, Sydney, New South Wales, Australia
| | - Aqeel Ahmad
- Department of Medical Biochemistry, Shaqra University, Shaqra, Saudi Arabia
| | - Sajjad Ahmad
- Department of Health and Biological Sciences, Abasyn University, Peshawar, Pakistan
| | - Tarik Ahmed Rashid
- Department of Computer Science and Engineering, University of Kurdistan Hewler, Erbil, Iraq
| | - Maxwell Akonde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Hanadi Al Hamad
- Geriatric and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fares Alahdab
- Evidence-Based Practice Center Program, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota
| | - Yousef Alimohamadi
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Alireza Ansari-Moghaddam
- Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sumadi Lukman Anwar
- Department of Surgery, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | | | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Aleksandr Y Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Applied Mathematics, College of Arts & Sciences, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Raphael Taiwo Aruleba
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| | - Malke Asaad
- Department of Plastic Surgery, University of Texas, Houston
| | - Tahira Ashraf
- University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
| | | | - Sameh Attia
- Department of Oral and Maxillofacial Surgery, Justus Liebig University of Giessen, Giessen, Germany
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Azangou-Khyavy
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Muhammad Badar
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
| | - Nayereh Baghcheghi
- Department of Nursing, Saveh University of Medical Sciences, Saveh, Iran
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Mainak Bardhan
- Department of Molecular Microbiology and Bacteriology, National Institute of Cholera and Enteric Diseases, Kolkata, India
- Department of Molecular Microbiology, Indian Council of Medical Research, New Delhi, India
| | - Hiba Jawdat Barqawi
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Nasir Z Bashir
- School of Oral and Dental Sciences, University of Bristol, Bristol, England, United Kingdom
| | - Azadeh Bashiri
- Health Information Management, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Habib Benzian
- Department of Epidemiology and Health Promotion, College of Dentistry, New York University, New York, New York
| | - Eduardo Bernabe
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, England, United Kingdom
| | - Devidas S Bhagat
- Department of Forensic Chemistry, Government Institute of Forensic Science, Aurangabad, India
| | - Vijayalakshmi S Bhojaraja
- Department of Anatomy, Royal College of Surgeons in Ireland Medical, University of Bahrain, Busaiteen, Bahrain
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Souad Bouaoud
- Department of Medicine, University Ferhat Abbas of Setif, Setif, Algeria
- Department of Epidemiology and Preventive Medicine, University Hospital Saadna Abdenour, Setif, Algeria
| | - Dejana Braithwaite
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville
- Cancer Control and Population Sciences Program, University of Florida Health Cancer Center, Gainesville
| | - Nikolay Ivanovich Briko
- Department of Epidemiology and Evidence-Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Daniela Calina
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Vijay Kumar Chattu
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Sawangi, India
- Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
| | - Akhilanand Chaurasia
- Department of Oral Medicine and Radiology, King George's Medical University, Lucknow, India
| | - Meng Xuan Chen
- Department of Oral Biological and Medical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - William C S Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China
| | - Dinh-Toi Chu
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Vietnam
| | | | - Eunice Chung
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Natália Cruz-Martins
- Department of Therapeutic and Diagnostic Technologies, Polytechnic and University Higher Education Cooperative, Gandra, Portugal
- Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Omid Dadras
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Section Global Health and Rehabilitation, Western Norway University of Applied Sciences, Bergen, Norway
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
- Indian Council of Medical Research, New Delhi, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
| | - Parnaz Daneshpajouhnejad
- Department of Pathology, Johns Hopkins Medicine, Baltimore, Maryland
- Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | | | | | - Fikadu Nugusu Dessalegn
- Department of Public Health, College of Medicine, Madda Walabu University, Bale Goba, Ethiopia
| | - Mostafa Dianati-Nasab
- Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Lankamo Ena Digesa
- Department of Comprehensive Nursing, Arba Minch University, Arba Minch, Ethiopia
| | - Shilpi Gupta Dixit
- Department of Anatomy, All India Institute of Medical Sciences, Jodhpur, India
| | - Abhinav Dixit
- Department of Physiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Shirin Djalalinia
- Development of Research and Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Iman El Sayed
- Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Daniel Asfaw Erku
- Centre for Applied Health Economics, Griffith University, Gold Coast, Queensland, Australia
| | - Rana Ezzeddini
- Department of Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
| | - Adeniyi Francis Fagbamigbe
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Luca Falzone
- Epidemiology and Biostatistics Unit, National Cancer Institute IRCCS Fondazione G. Pascale, Naples, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Getahun Fetensa
- Department of Nursing, College of Medical and Health Sciences, Wollega University, Nekemte, Ethiopia
| | | | - Piyada Gaewkhiew
- Department of Community Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Thailand
- Population and Patient Health Group, King's College London, London, England, United Kingdom
| | - Silvano Gallus
- Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Mesfin Gebrehiwot
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ahmad Ghashghaee
- School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Paramjit Singh Gill
- Warwick Medical School, University of Warwick, Coventry, England, United Kingdom
| | - Mahaveer Golechha
- Department of Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India
| | - Pouya Goleij
- Department of Genetics, Sana Institute of Higher Education, Sari, Iran
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Giuseppe Gorini
- Oncological Network, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | | | - Bhawna Gupta
- Department of Public Health, Torrens University Australia, Melbourne, Victoria, Australia
| | - Sapna Gupta
- Toxicology Department, Shriram Institute for Industrial Research, Delhi, India
| | - Veer Bala Gupta
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Vivek Kumar Gupta
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Arvin Haj-Mirzaian
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Esam S Halboub
- College of Dentistry, Jazan University, Jazan, Saudi Arabia
- School of Dentistry, Sana'a University, Sana'a, Yemen
| | - Rabih Halwani
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Asif Hanif
- University Institute of Public Health, The University of Lahore, Lahore, Pakistan
| | - Ninuk Hariyani
- Department of Dental Public Health, Airlangga University, Surabaya, Indonesia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Mehdi Harorani
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Hamidreza Hasani
- Department of Ophthalmology, Iran University of Medical Sciences, Karaj, Iran
| | - Abbas M Hassan
- Department of Plastic Surgery, University of Texas, Houston
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammed Bheser Hassen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- National Data Management Center for Health (NDMC), Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Khezar Hayat
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China
| | | | - Ramesh Holla
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Nobuyuki Horita
- Department of Pulmonology, Yokohama City University, Yokohama, Japan
- National Human Genome Research Institute (NHGRI), National Institutes of Health, Bethesda, Maryland
| | - Mehdi Hosseinzadeh
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Department of Computer Science, University of Human Development, Sulaymaniyah, Iraq
| | - Salman Hussain
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Masaryk University, Brno, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Olayinka Stephen Ilesanmi
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Irena M Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena D Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Abhishek Jaiswal
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Chinmay T Jani
- Department of Internal Medicine, Mount Auburn Hospital, Harvard University, Cambridge, Massachusetts
| | - Tahereh Javaheri
- Health Informatics Lab, Boston University, Boston, Massachusetts
| | - Umesh Jayarajah
- Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Department of Surgery, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Shubha Jayaram
- Department of Biochemistry, Government Medical College, Mysuru, India
| | - Nitin Joseph
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | - Vidya Kadashetti
- Department of Oral and Maxillofacial Pathology, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, India
| | - Eswar Kandaswamy
- Department of Periodontics, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans
| | | | - Ibraheem M Karaye
- School of Health Professions and Human Services, Hofstra University, Hempstead, New York
| | - Joonas H Kauppila
- Surgery Research Unit, University of Oulu, Oulu, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | | | - Mohammad Keykhaei
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Saleh Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Himanshu Khajuria
- Amity Institute of Forensic Sciences, Amity University, Noida, India
| | - Javad Khanali
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahalaqua Nazli Khatib
- Global Consortium for Public Health Research, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, India
| | | | - Mohammad Amin Khazeei Tabari
- Department of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- MAZUMS Office, Universal Scientific Education and Research Network, Tehran, Iran
| | - Min Seo Kim
- Department of Genomics and Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Seoul, South Korea
- Public Health Center, Ministry of Health and Welfare, Wando, South Korea
| | - Farzad Kompani
- Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Koohestani
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - G Anil Kumar
- Public Health Foundation of India, Gurugram, India
| | - Om P Kurmi
- Faculty of Health and Life Sciences, Coventry University, Coventry, England, United Kingdom
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Iván Landires
- Unit of Genetics and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Ministry of Health, Herrera, Panama
| | - Savita Lasrado
- Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
| | - Caterina Ledda
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Yo Han Lee
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Stefan Listl
- Department of Dentistry, Radboud University, Nijmegen, the Netherlands
- Department of Translational Health Economics, Heidelberg University Hospital, Heidelberg, Germany
| | - Platon D Lopukhov
- Department of Epidemiology and Evidence-Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ahmad R Mafi
- Department of Clinical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rashidul Alam Mahumud
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Ahmad Azam Malik
- University Institute of Public Health, The University of Lahore, Lahore, Pakistan
- Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Manu Raj Mathur
- Department of Health Policy Research, Public Health Foundation of India, Gurugram, India
- Institute of Population Health Sciences, University of Liverpool, Liverpool, England, United Kingdom
| | - Sazan Qadir Maulud
- Department of Biology, College of Science, Salahaddin University, Erbil, Iraq
| | - Jitendra Kumar Meena
- Department of Preventive Oncology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Tomislav Mestrovic
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Reza Mirfakhraie
- Department of Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Awoke Misganaw
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- National Data Management Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Sanjeev Misra
- Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | - Mokhtar Mohammadi
- Department of Information Technology, Lebanese French University, Erbil, Iraq
| | - Esmaeil Mohammadi
- Tehran University of Medical Sciences, Tehran, Iran
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Mohammad Ali Moni
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Paula Moraga
- Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Shane Douglas Morrison
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle
| | - Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Medicine, Wuhan University, Wuhan, China
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | | | | | | | - Hasan Nassereldine
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Oral Health Policy and Epidemiology, School of Dental Medicine, Harvard University, Boston, Massachusetts
| | | | - Serban Mircea Negru
- Department of Oncology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Haruna Asura Nggada
- Department of Histopathology, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
- Department of Human Pathology, University of Maiduguri, Maiduguri, Nigeria
| | - Hasti Nouraei
- Department of Medical Mycology and Parasitology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Virginia Nuñez-Samudio
- Unit of Microbiology and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Department of Public Health, Ministry of Health, Herrera, Panama
| | - Bogdan Oancea
- Department of Applied Economics and Quantitative Analysis, University of Bucharest, Bucharest, Romania
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, Faculty of Clinical Science, University of Lagos, Lagos, Nigeria
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaymaniyah, Iraq
| | | | - Jagadish Rao Padubidri
- Department of Forensic Medicine and Toxicology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | | | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, England, United Kingdom
| | - Jay Patel
- Global Health Governance Programme, University of Edinburgh, Edinburgh, Scotland, United Kingdom
- School of Dentistry, University of Leeds, Leeds, England, United Kingdom
| | - Raffaele Pezzani
- Endocrinology Unit, Department of Medicine, University of Padova, Padova, Italy
- Associazione Italiana Ricerca Oncologica di Base (AIROB), Padova, Italy
| | | | - Navid Rabiee
- School of Engineering, Macquarie University, Sydney, New South Wales, Australia
- Pohang University of Science and Technology, Pohang, South Korea
| | | | | | - Amir Masoud Rahmani
- Future Technology Research Center, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Vahid Rahmanian
- Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Chythra R Rao
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Sowmya J Rao
- Department of Oral Pathology and Microbiology, Sharavathi Dental College and Hospital, Shimogga, India
| | - Goura Kishor Rath
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, England, United Kingdom
- Inovus Medical, St Helens, England, United Kingdom
| | - Salman Rawaf
- Department of Primary Care and Public Health, Faculty of Medicine, Imperial College London, London, England, United Kingdom
- Academic Public Health England, Public Health England, London, England, United Kingdom
| | - Reza Rawassizadeh
- Department of Computer Science, College of Arts & Sciences, Boston University, Boston, Massachusetts
| | - Mohammad Sadegh Razeghinia
- Department of Immunology and Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
- Department of Immunology, Kerman University of Medical Sciences, Kerman, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abanoub Riad
- Department of Public Health, Masaryk University, Brno, Czech Republic
- Czech National Centre for Evidence-based Healthcare and Knowledge Translation, Masaryk University, Brno, Czech Republic
| | - Thomas J Roberts
- Department of Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Esperanza Romero-Rodríguez
- Clinical and Epidemiological Research in Primary Care (GICEAP), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Manjula S
- Department of Oral and Maxillofacial Surgery, JSS Academy of Higher Education and Research, Mysore, India
| | - Chandan S N
- Department of Oral and Maxillofacial Surgery, JSS Academy of Higher Education and Research, Mysore, India
| | - Basema Saddik
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohammad Reza Saeb
- Department of Polymer Technology, Faculty of Chemistry, Gdańsk University of Technology, Gdańsk, Poland
| | - Umar Saeed
- International Center of Medical Sciences Research, Islamabad, Pakistan
- Multidisciplinary Laboratory Foundation University School of Health Sciences (FUSH), Foundation University, Islamabad, Pakistan
| | - Mohsen Safaei
- Advanced Dental Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Sahebazzamani
- Department of Medical Biochemistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Medical Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Abdallah M Samy
- Department of Entomology, Faculty of Science, Ain Shams University, Cairo, Egypt
- Medical Ain Shams Research Institute (MARSI), Ain Shams University, Cairo, Egypt
| | - Milena M Santric-Milicevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Brijesh Sathian
- Geriatric and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, England, United Kingdom
| | - Maheswar Satpathy
- UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
- Udyam-Global Association for Sustainable Development, Bhubaneswar, India
| | - Mario Šekerija
- Department of Medical Statistics, University of Zagreb, Zagreb, Croatia
- Department of Epidemiology and Prevention of Chronic Noncommunicable Diseases, Croatian Institute of Public Health, Zagreb, Croatia
| | | | - Allen Seylani
- National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, Maryland
| | - Omid Shafaat
- Department of Radiology and Radiological Science, Johns Hopkins Medicine, Baltimore, Maryland
- Department of Radiology and Interventional Neuroradiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid R Shahsavari
- Department of Chemistry, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan, Iran
| | - Erfan Shamsoddin
- Department of Oral Health, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran
- Non-Communicable Diseases Committee, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | | | | | - Jeevan K Shetty
- Department of Biochemistry, Royal College of Surgeons in Ireland Medical University of Bahrain, Busaiteen, Bahrain
| | - K M Shivakumar
- Department of Public Health Dentistry, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, India
| | - Parnian Shobeiri
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of International Studies, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran
| | - Seyed Afshin Shorofi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Sunil Shrestha
- School of Pharmacy, Monash University, Selangor Darul Ehsan, Malaysia
| | | | - Paramdeep Singh
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Jasvinder A Singh
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham
- Department of Medicine Service, US Department of Veterans Affairs, Birmingham, Alabama
| | - Garima Singh
- Department of Community Medicine, Lady Hardinge Medical College, New Delhi, India
- Department of Community Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Yonatan Solomon
- Department of Nursing, Dire Dawa University, Dire Dawa, Ethiopia
| | - Muhammad Suleman
- Center for Biotechnology and Microbiology, University of Swat, Mingora, Pakistan
- School of Life Sciences, Xiamen University, Xiamen, China
| | | | | | - Iman M Talaat
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- Pathology Department, Alexandria University, Alexandria, Egypt
| | - Ker-Kan Tan
- Department of Surgery, National University of Singapore, Singapore, Singapore
| | - Abdelghani Tbakhi
- Department of Cell Therapy and Applied Genomics, King Hussein Cancer Center, Amman, Jordan
| | - Arulmani Thiyagarajan
- Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Amir Tiyuri
- Department of Epidemiology and Biostatistics, Birjand University of Medical Sciences, Birjand, Iran
- Department of Epidemiology and Biostatistics, Iran University of Medical Sciences, Tehran, Iran
| | - Marcos Roberto Tovani-Palone
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
- Modestum LTD, Eastbourne, England, United Kingdom
| | - Bhaskaran Unnikrishnan
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | - Bay Vo
- Faculty of Information Technology, Ho Chi Minh City University of Technology (HUTECH), Ho Chi Minh City, Vietnam
| | - Simona Ruxandra Volovat
- Department of Medical Oncology, University of Medicine and Pharmacy "Grigore T Popa" Iaşi, Iaşi, Romania
- Department of Medical Oncology, Regional Institute of Oncology, Iaşi, Romania
| | - Cong Wang
- Department of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Ronny Westerman
- Competence Center of Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany
| | - Nuwan Darshana Wickramasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Hong Xiao
- School of Public Health, Zhejiang University, Zhejiang, China
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Medicine, Wuhan University, Wuhan, China
| | - Deniz Yuce
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Ismaeel Yunusa
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia
| | - Vesna Zadnik
- Epidemiology and Cancer Registry Sector, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Iman Zare
- Research and Development Department, Sina Medical Biochemistry Technologies, Shiraz, Iran
| | - Zhi-Jiang Zhang
- School of Medicine, Faculty of Medical Sciences, Wuhan University, Wuhan, China
| | - Mohammad Zoladl
- Department of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Lisa M Force
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Division of Hematology-Oncology, Department of Pediatrics, University of Washington, Seattle
| | - Fernando N Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Steinmetz JD, Culbreth GT, Haile LM, Rafferty Q, Lo J, Fukutaki KG, Cruz JA, Smith AE, Vollset SE, Brooks PM, Cross M, Woolf AD, Hagins H, Abbasi-Kangevari M, Abedi A, Ackerman IN, Amu H, Antony B, Arabloo J, Aravkin AY, Argaw AM, Artamonov AA, Ashraf T, Barrow A, Bearne LM, Bensenor IM, Berhie AY, Bhardwaj N, Bhardwaj P, Bhojaraja VS, Bijani A, Briant PS, Briggs AM, Butt NS, Charan J, Chattu VK, Cicuttini FM, Coberly K, Dadras O, Dai X, Dandona L, Dandona R, de Luca K, Denova-Gutiérrez E, Dharmaratne SD, Dhimal M, Dianatinasab M, Dreinhoefer KE, Elhadi M, Farooque U, Farpour HR, Filip I, Fischer F, Freitas M, Ganesan B, Gemeda BNB, Getachew T, Ghamari SH, Ghashghaee A, Gill TK, Golechha M, Golinelli D, Gupta B, Gupta VB, Gupta VK, Haddadi R, Hafezi-Nejad N, Halwani R, Hamidi S, Hanif A, Harlianto NI, Haro JM, Hartvigsen J, Hay SI, Hebert JJ, Heidari G, Hosseini MS, Hosseinzadeh M, Hsiao AK, Ilic IM, Ilic MD, Jacob L, Jayawardena R, Jha RP, Jonas JB, Joseph N, Kandel H, Karaye IM, Khan MJ, Kim YJ, Kolahi AA, Korzh O, Koteeswaran R, Krishnamoorthy V, Kumar GA, Kumar N, Lee SW, Lim SS, Lobo SW, Lucchetti G, Malekpour MR, Malik AA, Mandarano-Filho LGG, Martini S, Mentis AFA, Mesregah MK, Mestrovic T, Mirrakhimov EM, Misganaw A, Mohammadpourhodki R, Mokdad AH, Momtazmanesh S, Morrison SD, Murray CJL, Nassereldine H, Netsere HB, Neupane Kandel S, Owolabi MO, Panda-Jonas S, Pandey A, Pawar S, Pedersini P, Pereira J, Radfar A, Rashidi MM, Rawaf DL, Rawaf S, Rawassizadeh R, Rayegani SM, Ribeiro D, Roever L, Saddik B, Sahebkar A, Salehi S, Sanchez Riera L, Sanmarchi F, Santric-Milicevic MM, Shahabi S, Shaikh MA, Shaker E, Shannawaz M, Sharma R, Sharma S, Shetty JK, Shiri R, Shobeiri P, Silva DAS, Singh A, Singh JA, Singh S, Skou ST, Slater H, Soltani-Zangbar MS, Starodubova AV, Tehrani-Banihashemi A, Valadan Tahbaz S, Valdez PR, Vo B, Vu LG, Wang YP, Yahyazadeh Jabbari SH, Yonemoto N, Yunusa I, March LM, Ong KL, Vos T, Kopec JA. Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol 2023; 5:e508-e522. [PMID: 37675071 PMCID: PMC10477960 DOI: 10.1016/s2665-9913(23)00163-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Background Osteoarthritis is the most common form of arthritis in adults, characterised by chronic pain and loss of mobility. Osteoarthritis most frequently occurs after age 40 years and prevalence increases steeply with age. WHO has designated 2021-30 the decade of healthy ageing, which highlights the need to address diseases such as osteoarthritis, which strongly affect functional ability and quality of life. Osteoarthritis can coexist with, and negatively effect, other chronic conditions. Here we estimate the burden of hand, hip, knee, and other sites of osteoarthritis across geographies, age, sex, and time, with forecasts of prevalence to 2050. Methods In this systematic analysis for the Global Burden of Disease Study, osteoarthritis prevalence in 204 countries and territories from 1990 to 2020 was estimated using data from population-based surveys from 26 countries for knee osteoarthritis, 23 countries for hip osteoarthritis, 42 countries for hand osteoarthritis, and US insurance claims for all of the osteoarthritis sites, including the other types of osteoarthritis category. The reference case definition was symptomatic, radiographically confirmed osteoarthritis. Studies using alternative definitions from the reference case definition (for example self-reported osteoarthritis) were adjusted to reference using regression models. Osteoarthritis severity distribution was obtained from a pooled meta-analysis of sources using the Western Ontario and McMaster Universities Arthritis Index. Final prevalence estimates were multiplied by disability weights to calculate years lived with disability (YLDs). Prevalence was forecast to 2050 using a mixed-effects model. Findings Globally, 595 million (95% uncertainty interval 535-656) people had osteoarthritis in 2020, equal to 7·6% (95% UI 6·8-8·4) of the global population, and an increase of 132·2% (130·3-134·1) in total cases since 1990. Compared with 2020, cases of osteoarthritis are projected to increase 74·9% (59·4-89·9) for knee, 48·6% (35·9-67·1) for hand, 78·6% (57·7-105·3) for hip, and 95·1% (68·1-135·0) for other types of osteoarthritis by 2050. The global age-standardised rate of YLDs for total osteoarthritis was 255·0 YLDs (119·7-557·2) per 100 000 in 2020, a 9·5% (8·6-10·1) increase from 1990 (233·0 YLDs per 100 000, 109·3-510·8). For adults aged 70 years and older, osteoarthritis was the seventh ranked cause of YLDs. Age-standardised prevalence in 2020 was more than 5·5% in all world regions, ranging from 5677·4 (5029·8-6318·1) per 100 000 in southeast Asia to 8632·7 (7852·0-9469·1) per 100 000 in high-income Asia Pacific. Knee was the most common site for osteoarthritis. High BMI contributed to 20·4% (95% UI -1·7 to 36·6) of osteoarthritis. Potentially modifiable risk factors for osteoarthritis such as recreational injury prevention and occupational hazards have not yet been explored in GBD modelling. Interpretation Age-standardised YLDs attributable to osteoarthritis are continuing to rise and will lead to substantial increases in case numbers because of population growth and ageing, and because there is no effective cure for osteoarthritis. The demand on health systems for care of patients with osteoarthritis, including joint replacements, which are highly effective for late stage osteoarthritis in hips and knees, will rise in all regions, but might be out of reach and lead to further health inequity for individuals and countries unable to afford them. Much more can and should be done to prevent people getting to that late stage. Funding Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.
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Ong KL, Stafford LK, McLaughlin SA, Boyko EJ, Vollset SE, Smith AE, Dalton BE, Duprey J, Cruz JA, Hagins H, Lindstedt PA, Aali A, Abate YH, Abate MD, Abbasian M, Abbasi-Kangevari Z, Abbasi-Kangevari M, Abd ElHafeez S, Abd-Rabu R, Abdulah DM, Abdullah AYM, Abedi V, Abidi H, Aboagye RG, Abolhassani H, Abu-Gharbieh E, Abu-Zaid A, Adane TD, Adane DE, Addo IY, Adegboye OA, Adekanmbi V, Adepoju AV, Adnani QES, Afolabi RF, Agarwal G, Aghdam ZB, Agudelo-Botero M, Aguilera Arriagada CE, Agyemang-Duah W, Ahinkorah BO, Ahmad D, Ahmad R, Ahmad S, Ahmad A, Ahmadi A, Ahmadi K, Ahmed A, Ahmed A, Ahmed LA, Ahmed SA, Ajami M, Akinyemi RO, Al Hamad H, Al Hasan SM, AL-Ahdal TMA, Alalwan TA, Al-Aly Z, AlBataineh MT, Alcalde-Rabanal JE, Alemi S, Ali H, Alinia T, Aljunid SM, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Amare F, Ameyaw EK, Amiri S, Amusa GA, Andrei CL, Anjana RM, Ansar A, Ansari G, Ansari-Moghaddam A, Anyasodor AE, Arabloo J, Aravkin AY, Areda D, Arifin H, Arkew M, Armocida B, Ärnlöv J, Artamonov AA, Arulappan J, Aruleba RT, Arumugam A, Aryan Z, Asemu MT, Asghari-Jafarabadi M, Askari E, Asmelash D, Astell-Burt T, Athar M, Athari SS, Atout MMW, Avila-Burgos L, Awaisu A, Azadnajafabad S, B DB, Babamohamadi H, Badar M, Badawi A, Badiye AD, Baghcheghi N, Bagheri N, Bagherieh S, Bah S, Bahadory S, Bai R, Baig AA, Baltatu OC, Baradaran HR, Barchitta M, Bardhan M, Barengo NC, Bärnighausen TW, Barone MTU, Barone-Adesi F, Barrow A, Bashiri H, Basiru A, Basu S, Basu S, Batiha AMM, Batra K, Bayih MT, Bayileyegn NS, Behnoush AH, Bekele AB, Belete MA, Belgaumi UI, Belo L, Bennett DA, Bensenor IM, Berhe K, Berhie AY, Bhaskar S, Bhat AN, Bhatti JS, Bikbov B, Bilal F, Bintoro BS, Bitaraf S, Bitra VR, Bjegovic-Mikanovic V, Bodolica V, Boloor A, Brauer M, Brazo-Sayavera J, Brenner H, Butt ZA, Calina D, Campos LA, Campos-Nonato IR, Cao Y, Cao C, Car J, Carvalho M, Castañeda-Orjuela CA, Catalá-López F, Cerin E, Chadwick J, Chandrasekar EK, Chanie GS, Charan J, Chattu VK, Chauhan K, Cheema HA, Chekol Abebe E, Chen S, Cherbuin N, Chichagi F, Chidambaram SB, Cho WCS, Choudhari SG, Chowdhury R, Chowdhury EK, Chu DT, Chukwu IS, Chung SC, Coberly K, Columbus A, Contreras D, Cousin E, Criqui MH, Cruz-Martins N, Cuschieri S, Dabo B, Dadras O, Dai X, Damasceno AAM, Dandona R, Dandona L, Das S, Dascalu AM, Dash NR, Dashti M, Dávila-Cervantes CA, De la Cruz-Góngora V, Debele GR, Delpasand K, Demisse FW, Demissie GD, Deng X, Denova-Gutiérrez E, Deo SV, Dervišević E, Desai HD, Desale AT, Dessie AM, Desta F, Dewan SMR, Dey S, Dhama K, Dhimal M, Diao N, Diaz D, Dinu M, Diress M, Djalalinia S, Doan LP, Dongarwar D, dos Santos Figueiredo FW, Duncan BB, Dutta S, Dziedzic AM, Edinur HA, Ekholuenetale M, Ekundayo TC, Elgendy IY, Elhadi M, El-Huneidi W, Elmeligy OAA, Elmonem MA, Endeshaw D, Esayas HL, Eshetu HB, Etaee F, Fadhil I, Fagbamigbe AF, Fahim A, Falahi S, Faris MEM, Farrokhpour H, Farzadfar F, Fatehizadeh A, Fazli G, Feng X, Ferede TY, Fischer F, Flood D, Forouhari A, Foroumadi R, Foroutan Koudehi M, Gaidhane AM, Gaihre S, Gaipov A, Galali Y, Ganesan B, Garcia-Gordillo MA, Gautam RK, Gebrehiwot M, Gebrekidan KG, Gebremeskel TG, Getacher L, Ghadirian F, Ghamari SH, Ghasemi Nour M, Ghassemi F, Golechha M, Goleij P, Golinelli D, Gopalani SV, Guadie HA, Guan SY, Gudayu TW, Guimarães RA, Guled RA, Gupta R, Gupta K, Gupta VB, Gupta VK, Gyawali B, Haddadi R, Hadi NR, Haile TG, Hajibeygi R, Haj-Mirzaian A, Halwani R, Hamidi S, Hankey GJ, Hannan MA, Haque S, Harandi H, Harlianto NI, Hasan SMM, Hasan SS, Hasani H, Hassanipour S, Hassen MB, Haubold J, Hayat K, Heidari G, Heidari M, Hessami K, Hiraike Y, Holla R, Hossain S, Hossain MS, Hosseini MS, Hosseinzadeh M, Hosseinzadeh H, Huang J, Huda MN, Hussain S, Huynh HH, Hwang BF, Ibitoye SE, Ikeda N, Ilic IM, Ilic MD, Inbaraj LR, Iqbal A, Islam SMS, Islam RM, Ismail NE, Iso H, Isola G, Itumalla R, Iwagami M, Iwu CCD, Iyamu IO, Iyasu AN, Jacob L, Jafarzadeh A, Jahrami H, Jain R, Jaja C, Jamalpoor Z, Jamshidi E, Janakiraman B, Jayanna K, Jayapal SK, Jayaram S, Jayawardena R, Jebai R, Jeong W, Jin Y, Jokar M, Jonas JB, Joseph N, Joseph A, Joshua CE, Joukar F, Jozwiak JJ, Kaambwa B, Kabir A, Kabthymer RH, Kadashetti V, Kahe F, Kalhor R, Kandel H, Karanth SD, Karaye IM, Karkhah S, Katoto PDMC, Kaur N, Kazemian S, Kebede SA, Khader YS, Khajuria H, Khalaji A, Khan MAB, Khan M, Khan A, Khanal S, Khatatbeh MM, Khater AM, Khateri S, khorashadizadeh F, Khubchandani J, Kibret BG, Kim MS, Kimokoti RW, Kisa A, Kivimäki M, Kolahi AA, Komaki S, Kompani F, Koohestani HR, Korzh O, Kostev K, Kothari N, Koyanagi A, Krishan K, Krishnamoorthy Y, Kuate Defo B, Kuddus M, Kuddus MA, Kumar R, Kumar H, Kundu S, Kurniasari MD, Kuttikkattu A, La Vecchia C, Lallukka T, Larijani B, Larsson AO, Latief K, Lawal BK, Le TTT, Le TTB, Lee SWH, Lee M, Lee WC, Lee PH, Lee SW, Lee SW, Legesse SM, Lenzi J, Li Y, Li MC, Lim SS, Lim LL, Liu X, Liu C, Lo CH, Lopes G, Lorkowski S, Lozano R, Lucchetti G, Maghazachi AA, Mahasha PW, Mahjoub S, Mahmoud MA, Mahmoudi R, Mahmoudimanesh M, Mai AT, Majeed A, Majma Sanaye P, Makris KC, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, Mamun AA, Mansouri B, Marateb HR, Mardi P, Martini S, Martorell M, Marzo RR, Masoudi R, Masoudi S, Mathews E, Maugeri A, Mazzaglia G, Mekonnen T, Meshkat M, Mestrovic T, Miao Jonasson J, Miazgowski T, Michalek IM, Minh LHN, Mini GK, Miranda JJ, Mirfakhraie R, Mirrakhimov EM, Mirza-Aghazadeh-Attari M, Misganaw A, Misgina KH, Mishra M, Moazen B, Mohamed NS, Mohammadi E, Mohammadi M, Mohammadian-Hafshejani A, Mohammadshahi M, Mohseni A, Mojiri-forushani H, Mokdad AH, Momtazmanesh S, Monasta L, Moniruzzaman M, Mons U, Montazeri F, Moodi Ghalibaf A, Moradi Y, Moradi M, Moradi Sarabi M, Morovatdar N, Morrison SD, Morze J, Mossialos E, Mostafavi E, Mueller UO, Mulita F, Mulita A, Murillo-Zamora E, Musa KI, Mwita JC, Nagaraju SP, Naghavi M, Nainu F, Nair TS, Najmuldeen HHR, Nangia V, Nargus S, Naser AY, Nassereldine H, Natto ZS, Nauman J, Nayak BP, Ndejjo R, Negash H, Negoi RI, Nguyen HTH, Nguyen DH, Nguyen PT, Nguyen VT, Nguyen HQ, Niazi RK, Nigatu YT, Ningrum DNA, Nizam MA, Nnyanzi LA, Noreen M, Noubiap JJ, Nzoputam OJ, Nzoputam CI, Oancea B, Odogwu NM, Odukoya OO, Ojha VA, Okati-Aliabad H, Okekunle AP, Okonji OC, Okwute PG, Olufadewa II, Onwujekwe OE, Ordak M, Ortiz A, Osuagwu UL, Oulhaj A, Owolabi MO, Padron-Monedero A, Padubidri JR, Palladino R, Panagiotakos D, Panda-Jonas S, Pandey A, Pandey A, Pandi-Perumal SR, Pantea Stoian AM, Pardhan S, Parekh T, Parekh U, Pasovic M, Patel J, Patel JR, Paudel U, Pepito VCF, Pereira M, Perico N, Perna S, Petcu IR, Petermann-Rocha FE, Podder V, Postma MJ, Pourali G, Pourtaheri N, Prates EJS, Qadir MMF, Qattea I, Raee P, Rafique I, Rahimi M, Rahimifard M, Rahimi-Movaghar V, Rahman MO, Rahman MA, Rahman MHU, Rahman M, Rahman MM, Rahmani M, Rahmani S, Rahmanian V, Rahmawaty S, Rahnavard N, Rajbhandari B, Ram P, Ramazanu S, Rana J, Rancic N, Ranjha MMAN, Rao CR, Rapaka D, Rasali DP, 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Shokri F, Shuval K, Sibhat MM, Silva LMLR, Simpson CR, Singh JA, Singh P, Singh S, Siraj MS, Skryabina AA, Sohag AAM, Soleimani H, Solikhah S, Soltani-Zangbar MS, Somayaji R, Sorensen RJD, Starodubova AV, Sujata S, Suleman M, Sun J, Sundström J, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabaeizadeh SA, Tabish M, Taheri M, Taheri E, Taki E, Tamuzi JJLL, Tan KK, Tat NY, Taye BT, Temesgen WA, Temsah MH, Tesler R, Thangaraju P, Thankappan KR, Thapa R, Tharwat S, Thomas N, Ticoalu JHV, Tiyuri A, Tonelli M, Tovani-Palone MR, Trico D, Trihandini I, Tripathy JP, Tromans SJ, Tsegay GM, Tualeka AR, Tufa DG, Tyrovolas S, Ullah S, Upadhyay E, Vahabi SM, Vaithinathan AG, Valizadeh R, van Daalen KR, Vart P, Varthya SB, Vasankari TJ, Vaziri S, Verma MV, Verras GI, Vo DC, Wagaye B, Waheed Y, Wang Z, Wang Y, Wang C, Wang F, Wassie GT, Wei MYW, Weldemariam AH, Westerman R, Wickramasinghe ND, Wu Y, Wulandari RDWI, Xia J, Xiao H, Xu S, Xu X, Yada DY, Yang L, Yatsuya H, Yesiltepe M, Yi S, Yohannis HK, Yonemoto N, You Y, Zaman SB, Zamora N, Zare I, Zarea K, Zarrintan A, Zastrozhin MS, Zeru NG, Zhang ZJ, Zhong C, Zhou J, Zielińska M, Zikarg YT, Zodpey S, Zoladl M, Zou Z, Zumla A, Zuniga YMH, Magliano DJ, Murray CJL, Hay SI, Vos T. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2023; 402:203-234. [PMID: 37356446 PMCID: PMC10364581 DOI: 10.1016/s0140-6736(23)01301-6] [Citation(s) in RCA: 250] [Impact Index Per Article: 250.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
BACKGROUND Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. METHODS Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. FINDINGS In 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8-6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7-9·9]) and, at the regional level, in Oceania (12·3% [11·5-13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1-79·5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1-96·8) of diabetes cases and 95·4% (94·9-95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5-71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5-30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22-1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1-17·6) in north Africa and the Middle East and 11·3% (10·8-11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. INTERPRETATION Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. FUNDING Bill & Melinda Gates Foundation.
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Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D'Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T'Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, Arcelus J. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health 2022; 23:S1-S259. [PMID: 36238954 PMCID: PMC9553112 DOI: 10.1080/26895269.2022.2100644] [Citation(s) in RCA: 494] [Impact Index Per Article: 247.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
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Affiliation(s)
- E Coleman
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A E Radix
- Callen-Lorde Community Health Center, New York, NY, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - W P Bouman
- Nottingham Centre for Transgender Health, Nottingham, UK
- School of Medicine, University of Nottingham, Nottingham, UK
| | - G R Brown
- James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
- James H. Quillen VAMC, Johnson City, TN, USA
| | - A L C de Vries
- Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M B Deutsch
- Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA
- UCSF Gender Affirming Health Program, San Francisco, CA, USA
| | - R Ettner
- New Health Foundation Worldwide, Evanston, IL, USA
- Weiss Memorial Hospital, Chicago, IL, USA
| | - L Fraser
- Independent Practice, San Francisco, CA, USA
| | - M Goodman
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - J Green
- Independent Scholar, Vancouver, WA, USA
| | - A B Hancock
- The George Washington University, Washington, DC, USA
| | - T W Johnson
- Department of Anthropology, California State University, Chico, CA, USA
| | - D H Karasic
- University of California San Francisco, San Francisco, CA, USA
- Independent Practice at dankarasic.com
| | - G A Knudson
- University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health, Vancouver, Canada
| | - S F Leibowitz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - H F L Meyer-Bahlburg
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - J Motmans
- Transgender Infopunt, Ghent University Hospital, Gent, Belgium
- Centre for Research on Culture and Gender, Ghent University, Gent, Belgium
| | - L Nahata
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - T O Nieder
- University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany
| | - S L Reisner
- Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - C Richards
- Regents University London, UK
- Tavistock and Portman NHS Foundation Trust, London, UK
| | | | - V Tangpricha
- Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - A C Tishelman
- Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA
| | - M A A Van Trotsenburg
- Bureau GenderPRO, Vienna, Austria
- University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria
| | - S Winter
- School of Population Health, Curtin University, Perth, WA, Australia
| | - K Ducheny
- Howard Brown Health, Chicago, IL, USA
| | - N J Adams
- University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada
- Transgender Professional Association for Transgender Health (TPATH)
| | - T M Adrián
- Asamblea Nacional de Venezuela, Caracas, Venezuela
- Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela
| | - L R Allen
- University of Nevada, Las Vegas, NV, USA
| | - D Azul
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - H Bagga
- Monash Health Gender Clinic, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - K Başar
- Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - D S Bathory
- Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA
| | - J J Belinky
- Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina
| | - D R Berg
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J U Berli
- Oregon Health & Science University, Portland, OR, USA
| | - R O Bluebond-Langner
- NYU Langone Health, New York, NY, USA
- Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA
| | - M-B Bouman
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - M L Bowers
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - P J Brassard
- GrS Montreal, Complexe CMC, Montreal, Quebec, Canada
- Université de Montreal, Quebec, Canada
| | - J Byrne
- University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - L Capitán
- The Facialteam Group, Marbella International Hospital, Marbella, Spain
| | | | - J M Carswell
- Harvard Medical School, Boston, MA, USA
- Boston's Children's Hospital, Boston, MA, USA
| | - S C Chang
- Independent Practice, Oakland, CA, USA
| | - G Chelvakumar
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University, College of Medicine, Columbus, OH, USA
| | - T Corneil
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
| | - K B Dalke
- Penn State Health, PA, USA
- Penn State College of Medicine, Hershey, PA, USA
| | - G De Cuypere
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
| | - E de Vries
- Nelson Mandela University, Gqeberha, South Africa
- University of Cape Town, Cape Town, South Africa
| | - M Den Heijer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - A H Devor
- University of Victoria, Victoria, BC, Canada
| | - C Dhejne
- ANOVA, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - A D'Marco
- UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas
- D M A R C O Organization, Nassau, The Bahamas
| | - E K Edmiston
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L Edwards-Leeper
- Pacific University, Hillsboro, OR, USA
- Independent Practice, Beaverton, OR, USA
| | - R Ehrbar
- Whitman Walker Health, Washington, DC, USA
- Independent Practice, Maryland, USA
| | - D Ehrensaft
- University of California San Francisco, San Francisco, CA, USA
| | - J Eisfeld
- Transvisie, Utrecht, The Netherlands
| | - E Elaut
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium
| | - L Erickson-Schroth
- The Jed Foundation, New York, NY, USA
- Hetrick-Martin Institute, New York, NY, USA
| | - J L Feldman
- Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A D Fisher
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | - M M Garcia
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA
| | - L Gijs
- Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - B P Hall
- Duke University Medical Center, Durham, NC, USA
- Duke Adult Gender Medicine Clinic, Durham, NC, USA
| | - T L D Hardy
- Alberta Health Services, Edmonton, Alberta, Canada
- MacEwan University, Edmonton, Alberta, Canada
| | - M S Irwig
- Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - A C Janssen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - K Johnson
- RMIT University, Melbourne, Australia
- University of Brighton, Brighton, UK
| | - D T Klink
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium
- Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
| | - B P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - L E Kuper
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA
- Department of Endocrinology, Children's Health, Dallas, TX, USA
| | - E J Kvach
- Denver Health, Denver, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - M A Malouf
- Malouf Counseling and Consulting, Baltimore, MD, USA
| | - R Massey
- WPATH Global Education Institute
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - T Mazur
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- John R. Oishei Children's Hospital, Buffalo, NY, USA
| | - C McLachlan
- Professional Association for Transgender Health, South Africa
- Gender DynamiX, Cape Town, South Africa
| | - S D Morrison
- Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
| | - S W Mosser
- Gender Confirmation Center, San Francisco, CA, USA
- Saint Francis Memorial Hospital, San Francisco, CA, USA
| | - P M Neira
- Johns Hopkins Center for Transgender Health, Baltimore, MD, USA
- Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA
| | - U Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - J M Oates
- La Trobe University, Melbourne, Australia
- Melbourne Voice Analysis Centre, East Melbourne, Australia
| | - J Obedin-Maliver
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford, CA, USA
| | - G Pagkalos
- Independent PracticeThessaloniki, Greece
- Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece
| | - J Patton
- Talkspace, New York, NY, USA
- CytiPsychological LLC, San Diego, CA, USA
| | - N Phanuphak
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - K Rachlin
- Independent Practice, New York, NY, USA
| | - T Reed
- Gender Identity Research and Education Society, Leatherhead, UK
| | - G N Rider
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Ristori
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | | | - S A Roberts
- Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA
| | - K A Rodriguez-Wallberg
- Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - S M Rosenthal
- Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA
- UCSF Child and Adolescent Gender Center
| | - K Sabir
- FtM Phoenix Group, Krasnodar Krai, Russia
| | - J D Safer
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA
| | - A I Scheim
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - L J Seal
- Tavistock and Portman NHS Foundation Trust, London, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - K Spencer
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C St Amand
- University of Houston, Houston, TX, USA
- Mayo Clinic, Rochester, MN, USA
| | - T D Steensma
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - J F Strang
- Children's National Hospital, Washington, DC, USA
- George Washington University School of Medicine, Washington, DC, USA
| | - G B Taylor
- Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA
| | - K Tilleman
- Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - G G T'Sjoen
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Endocrinology, Ghent University Hospital, Gent, Belgium
| | - L N Vala
- Independent Practice, Campbell, CA, USA
| | - N M Van Mello
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - J F Veale
- School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - J A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - B Vincent
- Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK
| | - L M Wesp
- College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA
- Health Connections Inc., Glendale, WI, USA
| | - M A West
- North Memorial Health Hospital, Robbinsdale, MN, USA
- University of Minnesota, Minneapolis, MN, USA
| | - J Arcelus
- School of Medicine, University of Nottingham, Nottingham, UK
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
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Hugo FN, Humayun A, Hussain S, Hussein NR, Hwang BF, Ibitoye SE, Iftikhar PM, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Immurana M, Innos K, Iranpour P, Irham LM, Islam MS, Islam RM, Islami F, Ismail NE, Isola G, Iwagami M, J LM, Jaiswal A, Jakovljevic M, Jalili M, Jalilian S, Jamshidi E, Jang SI, Jani CT, Javaheri T, Jayarajah UU, Jayaram S, Jazayeri SB, Jebai R, Jemal B, Jeong W, Jha RP, Jindal HA, John-Akinola YO, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kacimi SEO, Kadashetti V, Kahe F, Kakodkar PV, Kalankesh LR, Kalankesh LR, Kalhor R, Kamal VK, Kamangar F, Kamath A, Kanchan T, Kandaswamy E, Kandel H, Kang H, Kanno GG, Kapoor N, Kar SS, Karanth SD, Karaye IM, Karch A, Karimi A, Kassa BG, Katoto PDMC, Kauppila JH, Kaur H, Kebede AG, Keikavoosi-Arani L, Kejela GG, Kemp Bohan PM, Keramati M, Keykhaei M, Khajuria H, Khan A, Khan AAK, Khan EA, Khan G, Khan MN, Khan MAB, Khanali J, Khatab K, Khatatbeh MM, Khatib MN, Khayamzadeh M, Khayat Kashani HR, Khazeei 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Radhakrishnan V, Raeisi M, Rafiee A, Rafiei A, Raheem N, Rahim F, Rahman MO, Rahman M, Rahman MA, Rahmani AM, Rahmani S, Rahmanian V, Rajai N, Rajesh A, Ram P, Ramezanzadeh K, Rana J, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rashedi S, Rashidi A, Rashidi M, Rashidi MM, Ratan ZA, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Razeghinia MS, Rehman AU, Rehman IU, Reitsma MB, Renzaho AMN, Rezaei M, Rezaei N, Rezaei N, Rezaei N, Rezaei S, Rezaeian M, Rezapour A, Riad A, Rikhtegar R, Rios-Blancas M, Roberts TJ, Rohloff P, Romero-Rodríguez E, Roshandel G, Rwegerera GM, S M, Saber-Ayad MM, Saberzadeh-Ardestani B, Sabour S, Saddik B, Sadeghi E, Saeb MR, Saeed U, Safaei M, Safary A, Sahebazzamani M, Sahebkar A, Sahoo H, Sajid MR, Salari H, Salehi S, Salem MR, Salimzadeh H, Samodra YL, Samy AM, Sanabria J, Sankararaman S, Sanmarchi F, Santric-Milicevic MM, Saqib MAN, Sarveazad A, Sarvi F, Sathian B, Satpathy M, Sayegh N, Schneider IJC, Schwarzinger M, Šekerija M, Senthilkumaran S, Sepanlou SG, Seylani A, Seyoum K, Sha F, Shafaat O, Shah PA, Shahabi S, Shahid I, Shahrbaf MA, Shahsavari HR, Shaikh MA, Shaka MF, Shaker E, Shannawaz M, Sharew MMS, Sharifi A, Sharifi-Rad J, Sharma P, Shashamo BB, Sheikh A, Sheikh M, Sheikhbahaei S, Sheikhi RA, Sheikhy A, Shepherd PR, Shetty A, Shetty JK, Shetty RS, Shibuya K, Shirkoohi R, Shirzad-Aski H, Shivakumar KM, Shivalli S, Shivarov V, Shobeiri P, Shokri Varniab Z, Shorofi SA, Shrestha S, Sibhat MM, Siddappa Malleshappa SK, Sidemo NB, Silva DAS, Silva LMLR, Silva Julian G, Silvestris N, Simegn W, Singh AD, Singh A, Singh G, Singh H, Singh JA, Singh JK, Singh P, Singh S, Sinha DN, Sinke AH, Siraj MS, Sitas F, Siwal SS, Skryabin VY, Skryabina AA, Socea B, Soeberg MJ, Sofi-Mahmudi A, Solomon Y, Soltani-Zangbar MS, Song S, Song Y, Sorensen RJD, Soshnikov S, Sotoudeh H, Sowe A, Sufiyan MB, Suk R, Suleman M, Suliankatchi Abdulkader R, Sultana S, Sur D, Szócska M, Tabaeian SP, Tabarés-Seisdedos R, Tabatabaei SM, Tabuchi T, Tadbiri H, Taheri E, 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D, Zhang J, Zhang Y, Zhang ZJ, Zhou L, Zodpey S, Zoladl M, Vos T, Hay SI, Force LM, Murray CJL. The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2022; 400:563-591. [PMID: 35988567 PMCID: PMC9395583 DOI: 10.1016/s0140-6736(22)01438-6] [Citation(s) in RCA: 189] [Impact Index Per Article: 94.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/13/2022] [Accepted: 07/28/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01-4·94) deaths and 105 million (95·0-116) DALYs for both sexes combined, representing 44·4% (41·3-48·4) of all cancer deaths and 42·0% (39·1-45·6) of all DALYs. There were 2·88 million (2·60-3·18) risk-attributable cancer deaths in males (50·6% [47·8-54·1] of all male cancer deaths) and 1·58 million (1·36-1·84) risk-attributable cancer deaths in females (36·3% [32·5-41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6-28·4) and DALYs by 16·8% (8·8-25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9-42·8] and 33·3% [25·8-42·0]). INTERPRETATION The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. FUNDING Bill & Melinda Gates Foundation.
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Burkart K, Causey K, Cohen AJ, Wozniak SS, Salvi DD, Abbafati C, Adekanmbi V, Adsuar JC, Ahmadi K, Alahdab F, Al-Aly Z, Alipour V, Alvis-Guzman N, Amegah AK, Andrei CL, Andrei T, Ansari F, Arabloo J, Aremu O, Aripov T, Babaee E, Banach M, Barnett A, Bärnighausen TW, Bedi N, Behzadifar M, Béjot Y, Bennett DA, Bensenor IM, Bernstein RS, Bhattacharyya K, Bijani A, Biondi A, Bohlouli S, Breitner S, Brenner H, Butt ZA, Cámera LA, Cantu-Brito C, Carvalho F, Cerin E, Chattu VK, Chauhan BG, Choi JYJ, Chu DT, Dai X, Dandona L, Dandona R, Daryani A, Davletov K, de Courten B, Demeke FM, Denova-Gutiérrez E, Dharmaratne SD, Dhimal M, Diaz D, Djalalinia S, Duncan BB, El Sayed Zaki M, Eskandarieh S, Fareed M, Farzadfar F, Fattahi N, Fazlzadeh M, Fernandes E, Filip I, Fischer F, Foigt NA, Freitas M, Ghashghaee A, Gill PS, Ginawi IA, Gopalani SV, Guo Y, Gupta RD, Habtewold TD, Hamadeh RR, Hamidi S, Hankey GJ, Hasanpoor E, Hassen HY, Hay SI, Heibati B, Hole MK, Hossain N, Househ M, Irvani SSN, Jaafari J, Jakovljevic M, Jha RP, Jonas JB, Jozwiak JJ, Kasaeian A, Kaydi N, Khader YS, Khafaie MA, Khan EA, Khan J, Khan MN, Khatab K, Khater AM, Kim YJ, Kimokoti RW, Kisa A, Kivimäki M, Knibbs LD, Kosen S, Koul PA, Koyanagi A, Kuate Defo B, Kugbey N, Lauriola P, Lee PH, Leili M, Lewycka S, Li S, Lim LL, Linn S, Liu Y, Lorkowski S, Mahasha PW, Mahotra NB, Majeed A, Maleki A, Malekzadeh R, Mamun AA, Manafi N, Martini S, Meharie BG, Menezes RG, Mestrovic T, Miazgowski B, Miazgowski T, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mohajer B, Mohammed S, Mohan V, Mokdad AH, Monasta L, Moraga P, Morrison SD, Mueller UO, Mukhopadhyay S, Mustafa G, Muthupandian S, Naik G, Nangia V, Ndwandwe DE, Negoi RI, Ningrum DNA, Noubiap JJ, Ogbo FA, Olagunju AT, Onwujekwe OE, Ortiz A, Owolabi MO, P A M, Panda-Jonas S, Park EK, Pashazadeh Kan F, Pirsaheb M, Postma MJ, Pourjafar H, Radfar A, Rafiei A, Rahim F, Rahimi-Movaghar V, Rahman MA, Rai RK, Ranabhat CL, Raoofi S, Rawal L, Renzaho AMN, Rezapour A, Ribeiro D, Roever L, Ronfani L, Sabour S, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sahebkar A, Sahraian MA, Salimzadeh H, Salvi SS, Samy AM, Sanabria J, Sarmiento-Suárez R, Sathish T, Schmidt MI, Schutte AE, Sepanlou SG, Shaikh MA, Sharafi K, Sheikh A, Shigematsu M, Shiri R, Shirkoohi R, Shuval K, Soyiri IN, Tabarés-Seisdedos R, Tefera YM, Tehrani-Banihashemi A, Temsah MH, Thankappan KR, Topor-Madry R, Tudor Car L, Ullah I, Vacante M, Valdez PR, Vasankari TJ, Violante FS, Waheed Y, Wolfe CDA, Yamada T, Yonemoto N, Yu C, Zaman SB, Zhang Y, Zodpey S, Lim SS, Stanaway JD, Brauer M. Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM 2·5 air pollution, 1990-2019: an analysis of data from the Global Burden of Disease Study 2019. Lancet Planet Health 2022; 6:e586-e600. [PMID: 35809588 PMCID: PMC9278144 DOI: 10.1016/s2542-5196(22)00122-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. METHODS We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. FINDINGS In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68-4·83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49-17·5) of deaths and 13·6% (9·73-17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22-9·53) of deaths and 5·92% (3·81-8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. INTERPRETATION Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. FUNDING Bill & Melinda Gates Foundation.
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Kocarnik JM, Compton K, Dean FE, Fu W, Gaw BL, Harvey JD, Henrikson HJ, Lu D, Pennini A, Xu R, Ababneh E, Abbasi-Kangevari M, Abbastabar H, Abd-Elsalam SM, Abdoli A, Abedi A, Abidi H, Abolhassani H, Adedeji IA, Adnani QES, Advani SM, Afzal MS, Aghaali M, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi A, Ahmadi S, Ahmed Rashid T, Ahmed Salih Y, Akalu GT, Aklilu A, Akram T, Akunna CJ, Al Hamad H, Alahdab F, Al-Aly Z, Ali S, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Almasi-Hashiani A, Almasri NA, Al-Maweri SAA, Almustanyir S, Alonso N, Alvis-Guzman N, Amu H, Anbesu EW, Ancuceanu R, Ansari F, Ansari-Moghaddam A, Antwi MH, Anvari D, Anyasodor AE, Aqeel M, Arabloo J, Arab-Zozani M, Aremu O, Ariffin H, Aripov T, Arshad M, Artaman A, Arulappan J, Asemi Z, Asghari Jafarabadi M, Ashraf T, Atorkey P, Aujayeb A, Ausloos M, Awedew AF, Ayala Quintanilla BP, Ayenew T, Azab MA, Azadnajafabad S, Azari Jafari A, Azarian G, Azzam AY, Badiye AD, Bahadory S, Baig AA, Baker JL, Balakrishnan S, Banach M, Bärnighausen TW, Barone-Adesi F, Barra F, Barrow A, Behzadifar M, Belgaumi UI, Bezabhe WMM, Bezabih YM, Bhagat DS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Bisignano C, Bjørge T, Bleyer A, Blyuss O, Bolarinwa OA, Bolla SR, Braithwaite D, Brar A, Brenner H, Bustamante-Teixeira MT, Butt NS, Butt ZA, Caetano dos Santos FL, Cao Y, Carreras G, Catalá-López F, Cembranel F, Cerin E, Cernigliaro A, Chakinala RC, Chattu SK, Chattu VK, Chaturvedi P, Chimed-Ochir O, Cho DY, Christopher DJ, Chu DT, Chung MT, Conde J, Cortés S, Cortesi PA, Costa VM, Cunha AR, Dadras O, Dagnew AB, Dahlawi SMA, Dai X, Dandona L, Dandona R, Darwesh AM, das Neves J, De la Hoz FP, Demis AB, Denova-Gutiérrez E, Dhamnetiya D, Dhimal ML, Dhimal M, Dianatinasab M, Diaz D, Djalalinia S, Do HP, Doaei S, Dorostkar F, dos Santos Figueiredo FW, Driscoll TR, Ebrahimi H, Eftekharzadeh S, El Tantawi M, El-Abid H, Elbarazi I, Elhabashy HR, Elhadi M, El-Jaafary SI, Eshrati B, Eskandarieh S, Esmaeilzadeh F, Etemadi A, Ezzikouri S, Faisaluddin M, Faraon EJA, Fares J, Farzadfar F, Feroze AH, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Fisher JL, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gadanya MA, Gallus S, Gaspar Fonseca M, Getachew Obsa A, Ghafourifard M, Ghashghaee A, Ghith N, Gholamalizadeh M, Gilani SA, Ginindza TG, Gizaw ATT, Glasbey JC, Golechha M, Goleij P, Gomez RS, Gopalani SV, Gorini G, Goudarzi H, Grosso G, Gubari MIM, Guerra MR, Guha A, Gunasekera DS, Gupta B, Gupta VB, Gupta VK, Gutiérrez RA, Hafezi-Nejad N, Haider MR, Haj-Mirzaian A, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hanif A, Haque S, Harlianto NI, Haro JM, Hasaballah AI, Hassanipour S, Hay RJ, Hay SI, Hayat K, Heidari G, Heidari M, Herrera-Serna BY, Herteliu C, Hezam K, Holla R, Hossain MM, Hossain MBH, Hosseini MS, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huang J, Hugo FN, Hussain R, Hussein NR, Hwang BF, Iavicoli I, Ibitoye SE, Ida F, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Irham LM, Islam JY, Islam RM, Islam SMS, Ismail NE, Isola G, Iwagami M, Jacob L, Jain V, Jakovljevic MB, Javaheri T, Jayaram S, Jazayeri SB, Jha RP, Jonas JB, Joo T, Joseph N, Joukar F, Jürisson M, Kabir A, Kahrizi D, Kalankesh LR, Kalhor R, Kaliyadan F, Kalkonde Y, Kamath A, Kameran Al-Salihi N, Kandel H, Kapoor N, Karch A, Kasa AS, Katikireddi SV, Kauppila JH, Kavetskyy T, Kebede SA, Keshavarz P, Keykhaei M, Khader YS, Khalilov R, Khan G, Khan M, Khan MN, Khan MAB, Khang YH, Khater AM, Khayamzadeh M, Kim GR, Kim YJ, Kisa A, Kisa S, Kissimova-Skarbek K, Kopec JA, Koteeswaran R, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Kucuk Bicer B, Kugbey N, Kumar GA, Kumar N, Kumar N, Kurmi OP, Kutluk T, La Vecchia C, Lami FH, Landires I, Lauriola P, Lee SW, Lee SWH, Lee WC, Lee YH, Leigh J, Leong E, Li J, Li MC, Liu X, Loureiro JA, Lunevicius R, Magdy Abd El Razek M, Majeed A, Makki A, Male S, Malik AA, Mansournia MA, Martini S, Masoumi SZ, Mathur P, McKee M, Mehrotra R, Mendoza W, Menezes RG, Mengesha EW, Mesregah MK, Mestrovic T, Miao Jonasson J, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mirzaei H, Mirzaei HR, Misra S, Mithra P, Moghadaszadeh M, Mohammad KA, Mohammad Y, Mohammadi M, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Moka N, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moosavi MA, Moradi Y, Moraga P, Morgado-da-Costa J, Morrison SD, Mosapour A, Mubarik S, Mwanri L, Nagarajan AJ, Nagaraju SP, Nagata C, Naimzada MD, Nangia V, Naqvi AA, Narasimha Swamy S, Ndejjo R, Nduaguba SO, Negoi I, Negru SM, Neupane Kandel S, Nguyen CT, Nguyen HLT, Niazi RK, Nnaji CA, Noor NM, Nuñez-Samudio V, Nzoputam CI, Oancea B, Ochir C, Odukoya OO, Ogbo FA, Olagunju AT, Olakunde BO, Omar E, Omar Bali A, Omonisi AEE, Ong S, Onwujekwe OE, Orru H, Ortega-Altamirano DV, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Padubidri JR, Pakshir K, Pana A, Panagiotakos D, Panda-Jonas S, Pardhan S, Park EC, Park EK, Pashazadeh Kan F, Patel HK, Patel JR, Pati S, Pattanshetty SM, Paudel U, Pereira DM, Pereira RB, Perianayagam A, Pillay JD, Pirouzpanah S, Pishgar F, Podder I, Postma MJ, Pourjafar H, Prashant A, Preotescu L, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Radhakrishnan V, Rafiee A, Rahim F, Rahimzadeh S, Rahman M, Rahman MA, Rahmani AM, Rajai N, Rajesh A, Rakovac I, Ram P, Ramezanzadeh K, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rawassizadeh R, Razeghinia MS, Renzaho AMN, Rezaei N, Rezaei N, Rezapour A, Roberts TJ, Rodriguez JAB, Rohloff P, Romoli M, Ronfani L, Roshandel G, Rwegerera GM, S M, Sabour S, Saddik B, Saeed U, Sahebkar A, Sahoo H, Salehi S, Salem MR, Salimzadeh H, Samaei M, Samy AM, Sanabria J, Sankararaman S, Santric-Milicevic MM, Sardiwalla Y, Sarveazad A, Sathian B, Sawhney M, Saylan M, Schneider IJC, Sekerija M, Seylani A, Shafaat O, Shaghaghi Z, Shaikh MA, Shamsoddin E, Shannawaz M, Sharma R, Sheikh A, Sheikhbahaei S, Shetty A, Shetty JK, Shetty PH, Shibuya K, Shirkoohi R, Shivakumar KM, Shivarov V, Siabani S, Siddappa Malleshappa SK, Silva DAS, Singh JA, Sintayehu Y, Skryabin VY, Skryabina AA, Soeberg MJ, Sofi-Mahmudi A, Sotoudeh H, Steiropoulos P, Straif K, Subedi R, Sufiyan MB, Sultan I, Sultana S, Sur D, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Tabuchi T, Tadbiri H, Taherkhani A, Takahashi K, Talaat IM, Tan KK, Tat VY, Tedla BAA, Tefera YG, Tehrani-Banihashemi A, Temsah MH, Tesfay FH, Tessema GA, Thapar R, Thavamani A, Thoguluva Chandrasekar V, Thomas N, Tohidinik HR, Touvier M, Tovani-Palone MR, Traini E, Tran BX, Tran KB, Tran MTN, Tripathy JP, Tusa BS, Ullah I, Ullah S, Umapathi KK, Unnikrishnan B, Upadhyay E, Vacante M, Vaezi M, Valadan Tahbaz S, Velazquez DZ, Veroux M, Violante FS, Vlassov V, Vo B, Volovici V, Vu GT, Waheed Y, Wamai RG, Ward P, Wen YF, Westerman R, Winkler AS, Yadav L, Yahyazadeh Jabbari SH, Yang L, Yaya S, Yazie TSY, Yeshaw Y, Yonemoto N, Younis MZ, Yousefi Z, Yu C, Yuce D, Yunusa I, Zadnik V, Zare F, Zastrozhin MS, Zastrozhina A, Zhang J, Zhong C, Zhou L, Zhu C, Ziapour A, Zimmermann IR, Fitzmaurice C, Murray CJL, Force LM. Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA Oncol 2022; 8:420-444. [PMID: 34967848 PMCID: PMC8719276 DOI: 10.1001/jamaoncol.2021.6987] [Citation(s) in RCA: 616] [Impact Index Per Article: 308.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.
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Affiliation(s)
| | | | - Kelly Compton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Frances E. Dean
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Weijia Fu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Brian L. Gaw
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - James D. Harvey
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hannah Jacqueline Henrikson
- Department of Global Health, Boston University, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Dan Lu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alyssa Pennini
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Rixing Xu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emad Ababneh
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Mohsen Abbasi-Kangevari
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hedayat Abbastabar
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Aidin Abedi
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles
| | - Hassan Abidi
- Laboratory Technology Sciences Department, Yasouj University, Yasuj, Iran
| | - Hassan Abolhassani
- Department of Laboratory Medicine, Karolinska University Hospital, Huddinge, Sweden
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Qorinah Estiningtyas Sakilah Adnani
- Department of Midwifery, Karya Husada Institute of Health Sciences, Kediri, Indonesia
- Department of Midwifery, Auckland University of Technology, Auckland, New Zealand
| | - Shailesh M. Advani
- Terasaki Institute for Biomedical Innovation, Los Angeles, California
- School of Medicine, Georgetown University, Washington, DC
| | - Muhammad Sohail Afzal
- Department of Life Sciences, University of Management and Technology, Lahore, Pakistan
| | - Mohammad Aghaali
- Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
| | - Bright Opoku Ahinkorah
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Sajjad Ahmad
- Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China
| | - Ali Ahmadi
- Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Ahmadi
- School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tarik Ahmed Rashid
- Department of Computer Science and Engineering, University of Kurdistan Hewler, Erbil, Iraq
| | - Yusra Ahmed Salih
- Database Technology Department, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
- College of Informatics, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
| | - Gizachew Taddesse Akalu
- Microbiology, Immunology and Parasitology Department, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Microbial, Cellular and Molecular Biology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Addis Aklilu
- Department of Medical Laboratory Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tayyaba Akram
- School of Mathematical Sciences, University of Science Malaysia, Penang, Malaysia
| | - Chisom Joyqueenet Akunna
- Department of Public Health, Intercountry Centre for Oral Health for Africa, Jos, Nigeria
- Department of Public Health, Federal Ministry of Health, Garki, Nigeria
| | - Hanadi Al Hamad
- Geriatric and Long-Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fares Alahdab
- Mayo Evidence-Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota
| | - Ziyad Al-Aly
- John T. Milliken Department of Internal Medicine, Washington University in St Louis, St Louis, Missouri
- Clinical Epidemiology Center, Department of Veterans Affairs, St Louis, Missouri
| | - Saqib Ali
- Department of Information Systems, Sultan Qaboos University, Muscat, Oman
| | - Yousef Alimohamadi
- Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | | | | | - Sadeq Ali Ali Al-Maweri
- College of Dental Medicine, Qatar University, Doha, Qatar
- Faculty of Dentistry, Sana'a University, Sana’a, Yemen
| | - Sami Almustanyir
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Ministry of Health, Riyadh, Saudi Arabia
| | - Nivaldo Alonso
- Department of Surgery, University of São Paulo, São Paulo, Brazil
| | - Nelson Alvis-Guzman
- Research Group in Hospital Management and Health Policies, Universidad de la Costa, Barranquilla, Colombia
- Research Group in Health Economics, University of Cartagena, Cartagena, Colombia
| | - Hubert Amu
- Department of Population and Behavioural Sciences, University of Health and Allied Sciences, Ho, Ghana
| | | | - Robert Ancuceanu
- Pharmacy Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Fereshteh Ansari
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education, and Extension Organization, Tehran, Iran
| | - Alireza Ansari-Moghaddam
- Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maxwell Hubert Antwi
- Clinical Laboratory Department, Ghana Health Service, Kumasi, Ghana
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Davood Anvari
- Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | | | - Muhammad Aqeel
- Department of Psychology, Foundation University Islamabad, Rawalpandi, Pakistan
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Olatunde Aremu
- Department of Public Health, Birmingham City University, Birmingham, England
| | - Hany Ariffin
- Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
- University of Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - Timur Aripov
- Public Health and Healthcare Management, Tashkent Institute of Postgraduate Medical Education, Tashkent, Uzbekistan
- Boston Children's Hospital, Boston, Massachusetts
| | - Muhammad Arshad
- Allied Health Sciences, Khyber Medical University, Timergara, Lower Dir, Pakistan
| | - Al Artaman
- Zayed University, Abu Dhabi, United Arab Emirates
| | - Judie Arulappan
- Department of Maternal and Child Health, Sultan Qaboos University, Muscat, Oman
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Biostatistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Biostatistics and Epidemiology, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Tahira Ashraf
- Institute of Radiological Sciences and Medical Imaging Technology, University of Lahore, Lahore, Pakistan
| | - Prince Atorkey
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Avinash Aujayeb
- Northumbria HealthCare National Health Service (NHS) Foundation Trust, NHS England, Newcastle upon Tyne, England
| | - Marcel Ausloos
- School of Business, University of Leicester, Leicester, England
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | | | | | - Temesgen Ayenew
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
| | | | | | | | - Ghasem Azarian
- Department of Environmental Health Engineering, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ahmed Y. Azzam
- Faculty of Medicine, October 6 University, 6th of October City, Egypt
| | - Ashish D. Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Saeed Bahadory
- Department of Parasitology, Tarbiat Modares University, Tehran, Iran
- Department of Parasitology, Alborz University of Medical Sciences, Karaj, Iran
| | - Atif Amin Baig
- Unit of Biochemistry, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Jennifer L. Baker
- Center for Clinical Research and Prevention, Bispebjerg University Hospital, Frederiksberg, Denmark
| | | | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, University of Genoa, Genoa, Italy
| | - Amadou Barrow
- Department of Public and Environmental Health, University of the Gambia, Brikama, The Gambia
- Epidemiology and Disease Control Unit, Ministry of Health, Kotu, The Gambia
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Uzma Iqbal Belgaumi
- Department of Oral Pathology and Microbiology, Krishna Institute of Medical Sciences, Karad, India
| | | | - Yihienew Mequanint Bezabih
- Department of Internal Medicine, Bahir Dar University, Bahir Dar, Ethiopia
- One Health, University of Nantes, Nantes, France
| | - Devidas S. Bhagat
- Department of Forensic Chemistry, Government Institute of Forensic Science, Aurangabad, India
| | - Akshaya Srikanth Bhagavathula
- Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nikha Bhardwaj
- Department of Anatomy, Government Medical College Pali, Pali, India
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, India
| | - Sonu Bhaskar
- Neurovascular Imaging Laboratory, New South Wales Brain Clot Bank, Sydney, New South Wales, Australia
- Department of Neurology and Neurophysiology, South West Sydney Local Heath District and Liverpool Hospital, Sydney, New South Wales, Australia
| | - Krittika Bhattacharyya
- Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
- Department of Statistics, University of Calcutta, Kolkata, India
| | | | - Sadia Bibi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Archie Bleyer
- Department of Radiation Medicine, Oregon Health and Science University, Portland
- McGovern Medical School, University of Texas, Houston
| | - Oleg Blyuss
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield, England
- Institute for Women's Health, University College London, London, England
| | | | - Srinivasa Rao Bolla
- Department of Biomedical Sciences, Nazarbayev University, Nur-Sultan City, Kazakhstan
| | - Dejana Braithwaite
- Department of Epidemiology, University of Florida, Gainesville
- Cancer Population Sciences Program, University of Florida Health Cancer Center, Gainesville
| | - Amanpreet Brar
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | | | - Nadeem Shafique Butt
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Zahid A. Butt
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | | | - Yin Cao
- Department of Surgery, Washington University in St Louis, St Louis, Missouri
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Ferrán Catalá-López
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Francieli Cembranel
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Achille Cernigliaro
- Regional Epidemiological Observatory Department, Sicilian Regional Health Authority, Palermo, Italy
| | | | | | - Vijay Kumar Chattu
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Saveetha Medical College, Saveetha University, Chennai, India
| | - Pankaj Chaturvedi
- Center for Cancer Epidemiology, Tata Memorial Hospital, Navi Mumbai, India
- Department of Head Neck Surgery, Tata Memorial Hospital, Mumbai, India
| | - Odgerel Chimed-Ochir
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan
| | | | | | - Dinh-Toi Chu
- Center for Biomedicine and Community Health, VNU International School, Hanoi, Vietnam
| | - Michael T. Chung
- Department of Otolaryngology, Wayne State University, Detroit, Michigan
| | - Joao Conde
- Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Sanda Cortés
- Department of Public Health, Pontifical Catholic University of Chile, Santiago, Chile
- Research Line in Environmental Exposures and Health Effects at Population Level, Centro de Desarrollo Urbano Sustentable, Santiago, Chile
| | | | - Vera Marisa Costa
- Research Unit on Applied Molecular Biosciences, University of Porto, Porto, Portugal
| | - Amanda Ramos Cunha
- Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Omid Dadras
- School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Saad M. A. Dahlawi
- Environmental Health Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
- Indian Council of Medical Research, New Delhi, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
| | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | - José das Neves
- Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
- Institute of Biomedical Engineering, University of Porto, Porto, Portugal
| | | | - Asmamaw Bizuneh Demis
- Department of Nursing, Woldia University, Woldia, Ethiopia
- School of Nursing, Jimma University, Jimma, Ethiopia
| | - Edgar Denova-Gutiérrez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Deepak Dhamnetiya
- Department of Community Medicine, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
| | - Mandira Lamichhane Dhimal
- Policy Research Institute, Kathmandu, Nepal
- Global Institute for Interdisciplinary Studies, Kathmandu, Nepal
| | - Meghnath Dhimal
- Health Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Mostafa Dianatinasab
- Department of Epidemiology and Biostatistics, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Daniel Diaz
- Center of Complexity Sciences, National Autonomous University of Mexico, Mexico City, Mexico
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
| | - Shirin Djalalinia
- Development of Research and Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Huyen Phuc Do
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Saeid Doaei
- School of Health, Guilan University of Medical Sciences, Rasht, Iran
- Department of Community Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Dorostkar
- Department of Medical Laboratory Sciences, Iran University of Medical Sciences, Tehran, Iran
| | | | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Hedyeh Ebrahimi
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobilliary Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Eftekharzadeh
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Maha El Tantawi
- Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt
| | - Hassan El-Abid
- Direction de L'épidémiologie et la Lutte Contre les Maladies, Ministry of Health, Rabat, Morocco
| | - Iffat Elbarazi
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | | | | | - Babak Eshrati
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Firooz Esmaeilzadeh
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Sayeh Ezzikouri
- Department of Virology, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Mohammed Faisaluddin
- Department of Internal Medicine, Rochester General Hospital, Rochester, New York
| | - Emerito Jose A. Faraon
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
| | - Jawad Fares
- Department of Neurological Surgery, Northwestern University, Chicago, Illinois
| | - Farshad Farzadfar
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdullah Hamid Feroze
- Department of Neurological Surgery, University of Washington, Seattle
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Simone Ferrero
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | | | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, California
- School of Health Sciences, A.T. Still University, Mesa, Arizona
| | - Florian Fischer
- Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
| | | | - Masoud Foroutan
- Department of Medical Parasitology, Abadan University of Medical Sciences, Abadan, Iran
- Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
| | | | - Peter Andras Gaal
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
- Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania
| | - Mohamed M. Gad
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
- Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill
| | - Muktar A. Gadanya
- Community Medicine Department, Bayero University, Kano, Kano, Nigeria
- Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Silvano Gallus
- Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | | | | | - Mansour Ghafourifard
- Department of Medical Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Ghashghaee
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Nermin Ghith
- Research Group for Genomic Epidemiology, Technical University of Denmark, Copenhagen, Denmark
| | - Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Syed Amir Gilani
- Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan
- Afro-Asian Institute, Lahore, Pakistan
| | - Themba G. Ginindza
- Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | | | - James C. Glasbey
- National Institute for Health Research Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, England
| | - Mahaveer Golechha
- Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India
| | - Pouya Goleij
- Department of Genetics, Sana Institute of Higher Education, Sari, Iran
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Sameer Vali Gopalani
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City
- Department of Health and Social Affairs, Government of the Federated States of Micronesia, Palikir, Federated States of Micronesia
| | - Giuseppe Gorini
- Oncological Network, Prevention and Research Institute, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Houman Goudarzi
- Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | | | - Avirup Guha
- Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio
- Division of Cardiovascular Medicine, Ohio State University, Columbus
| | | | - Bhawna Gupta
- Department of Public Health, Torrens University, Melbourne, Victoria, Australia
| | - Veer Bala Gupta
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Vivek Kumar Gupta
- Department of Clinical Medicine, Macquarie University, Sydney, New South Wales, Australia
| | - Reyna Alma Gutiérrez
- Department of Epidemiology and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Nima Hafezi-Nejad
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Arvin Haj-Mirzaian
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rabih Halwani
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Randah R. Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Sajid Hameed
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Asif Hanif
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
| | - Shafiul Haque
- Research & Scientific Studies Unit, Jazan University, Jazan, Saudi Arabia
| | - Netanja I. Harlianto
- Faculty of Medicine, Utrecht University, Utrecht, Netherlands
- Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Josep Maria Haro
- Research Unit, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network, Barcelona, Spain
| | | | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Roderick J. Hay
- International Foundation for Dermatology, London, England
- St John's Institute of Dermatology, King's College London, London, England
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Khezar Hayat
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
| | | | - Mohammad Heidari
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | | | - Claudiu Herteliu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- School of Business, London South Bank University, London, England
| | - Kamal Hezam
- Department of Applied Microbiology, Taiz University, Taiz, Yemen
- Department of Microbiology, Nankai University, Tianjin, China
| | - Ramesh Holla
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Md Mahbub Hossain
- Social and Environmental Health Research, Nature Study Society of Bangladesh, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M University, College Station
| | | | | | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hosseinzadeh
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Department of Computer Science, University of Human Development, Sulaymaniyah, Iraq
| | - Mihaela Hostiuc
- Internal Medicine Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Mowafa Househ
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Mohamed Hsairi
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Junjie Huang
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Fernando N. Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rabia Hussain
- School of Pharmaceutical Sciences, University of Science Malaysia, Penang, Malaysia
| | - Nawfal R. Hussein
- Department of Biomolecular Sciences, University of Zakho, Zakho, Iraq
| | - Bing-Fang Hwang
- Department of Occupational Safety and Health, China Medical University, Taichung, Taiwan
| | - Ivo Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Fidelia Ida
- Pharmacoepidemiology Department, Sanofi, Cambridge, Massachusetts
| | - Kevin S. Ikuta
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Division of Allergy and Infectious Diseases, University of Washington, Seattle
| | - Olayinka Stephen Ilesanmi
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Irena M. Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena D. Ilic
- Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | - Lalu Muhammad Irham
- School of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Faculty of Pharmacy, Ahmad Dahlan University, Yogyakarta, Indonesia
| | - Jessica Y. Islam
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Rakibul M. Islam
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | | | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Masao Iwagami
- Department of Health Services Research, University of Tsukuba, Tsukuba, Japan
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England
| | - Louis Jacob
- Research and Development Unit, Biomedical Research Networking Center for Mental Health Network, Sant Boi de Llobregat, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Vardhmaan Jain
- Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Mihajlo B. Jakovljevic
- Institute of Comparative Economic Studies, Hosei University, Tokyo, Japan
- Department of Global Health, Economics and Policy, University of Kragujevac, Kragujevac, Serbia
| | | | - Shubha Jayaram
- Department of Biochemistry, Government Medical College, Mysuru, India
| | | | - Ravi Prakash Jha
- Department of Community Medicine, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | - Jost B. Jonas
- Department of Ophthalmology, Heidelberg University, Heidelberg, Germany
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Tamas Joo
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Nitin Joseph
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Danial Kahrizi
- Department of Genetics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Leila R. Kalankesh
- School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Kalhor
- Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Feroze Kaliyadan
- Dermatology Department, King Faisal University, Hofuf, Saudi Arabia
| | - Yogeshwar Kalkonde
- Public Health Division, Society for Education, Action and Research in Community Health, Gadchiroli, India
| | - Ashwin Kamath
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
- Manipal Academy of Higher Education, Manipal, India
| | | | - Himal Kandel
- Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
- Sydney Eye Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - André Karch
- Institute for Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Ayele Semachew Kasa
- Department of Adult Health Nursing, Bahir Dar University, Bahir Dar, Ethiopia
| | - Srinivasa Vittal Katikireddi
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Joonas H. Kauppila
- Surgery Research Unit, University of Oulu, Oulu, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Taras Kavetskyy
- Department of Surface Engineering, John Paul II Catholic University of Lublin, Lublin, Poland
- Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
| | - Sewnet Adem Kebede
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Faroe Islands
| | - Pedram Keshavarz
- School of Science and Technology, University of Georgia, Tbilisi, Georgia
- Department of Diagnostic and Interventional Radiology, New Hospitals LTD, Tbilisi, Georgia
| | - Mohammad Keykhaei
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Rovshan Khalilov
- Department of Biophysics and Biochemistry, Baku State University, Baku, Azerbaijan
- Russian Institute for Advanced Study, Moscow State Pedagogical University, Moscow, Russia
| | - Gulfaraz Khan
- Department of Medical Microbiology and Immunology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Maseer Khan
- Epidemiology Department, Jazan University, Jazan, Saudi Arabia
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | - Moien A. B. Khan
- Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
- Primary Care Department, NHS North West London, London, England
| | - Young-Ho Khang
- Department of Health Policy and Management, Seoul National University, Seoul, South Korea
- Institute of Health Policy and Management, Seoul National University, Seoul, South Korea
| | - Amir M. Khater
- National Hepatology and Tropical Medicine Research Institute, Cairo University, Cairo, Egypt
| | - Maryam Khayamzadeh
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- The Iranian Academy of Medical Sciences, Tehran, Iran
| | - Gyu Ri Kim
- Department of Preventive Medicine, Yonsei University, Seoul, South Korea
| | - Yun Jin Kim
- School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Jacek A. Kopec
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | | | - Parvaiz A. Koul
- Department of Internal and Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
| | | | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | | | - Nuworza Kugbey
- University of Environment and Sustainable Development, Somanya, Ghana
| | | | - Narinder Kumar
- Department of Orthopaedics, Medanta Hospital, Lucknow, India
| | - Nithin Kumar
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Om P. Kurmi
- Faculty of Health and Life Sciences, Coventry University, Coventry, England
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University, Ankara, Turkey
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | - Iván Landires
- Unit of Genetics and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Ministry of Health, Herrera, Panama
| | - Paolo Lauriola
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Sang-woong Lee
- Pattern Recognition and Machine Learning Lab, Gachon University, Seongnam, South Korea
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | - Wei-Chen Lee
- Office of Health Policy & Legislative Affairs, University of Texas, Galveston
| | - Yo Han Lee
- Graduate School of Public Health, Ajou University, Suwon-si, South Korea
| | - James Leigh
- Asbestos Diseases Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Elvynna Leong
- Faculty of Science, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei
| | - Jiarui Li
- Department of Medical Oncology, Peking Union Medical College, Beijing, China
| | - Ming-Chieh Li
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Xuefeng Liu
- Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Quantitative Health Science, Case Western Reserve University, Cleveland, Ohio
| | - Joana A. Loureiro
- Laboratory for Process Engineering, Environment, Biotechnology and Energy, University of Porto, Porto, Portugal
- School of Health, Polytechnic Institute of Porto, Portugal
| | - Raimundas Lunevicius
- Department of General Surgery, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England
- Department of Surgery, University of Liverpool, Liverpool, England
| | | | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, England
| | - Alaa Makki
- Mass Communication Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Shilpa Male
- Department of Ophthalmology, M M Joshi Eye Institute, Hubli, India
| | - Ahmad Azam Malik
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
- Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Santi Martini
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
- Indonesian Public Health Association, Surabaya, Indonesia
| | | | - Prashant Mathur
- National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, India
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, England
| | - Ravi Mehrotra
- India Cancer Research Consortium, Indian Council of Medical Research, New Delhi, India
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund, Lima, Peru
| | - Ritesh G. Menezes
- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Mohamed Kamal Mesregah
- Department of Orthopaedic Surgery, Menoufia University Faculty of Medicine, Shebin El-Kom, Egypt
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Polyclinic “Dr. Zora Profozic”, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Junmei Miao Jonasson
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
- Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases and Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | | | - Ted R. Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Mirzaei
- Department of Medical Immunology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanjeev Misra
- Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - Prasanna Mithra
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Masoud Moghadaszadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | - Mokhtar Mohammadi
- Department of Information Technology, Lebanese French University, Erbil, Iraq
| | | | | | - Shafiu Mohammed
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
- Department of Health Care Management, Technical University of Berlin, Berlin, Germany
| | - Nagabhishek Moka
- Oncology Department, Appalachian Regional Healthcare, Hazard, Kentucky
- Internal Medicine, University of Kentucky, Lexington
| | - Ali H. Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, England
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Mohammad Ali Moni
- Department of Computer Science and Engineering, Pabna University of Science and Technology, Pabna, Bangladesh
| | - Mohammad Amin Moosavi
- Department of Molecular Medicine, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Paula Moraga
- Computer, Electrical, and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | | | | | - Abbas Mosapour
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
- Department of Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Adeaide, South Australia, Australia
| | - Ahamarshan Jayaraman Nagarajan
- Research and Analytics Department, Initiative for Financing Health and Human Development, Chennai, India
- Department of Research and Analytics, Bioinsilico Technologies, Chennai, India
| | | | - Chie Nagata
- Department of Education for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russia
| | | | - Atta Abbas Naqvi
- Department of Pharmacy Practice, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Discipline of Social and Administrative Pharmacy, University of Science, Malaysia, Penang, Malaysia
| | | | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - Sabina O. Nduaguba
- Pharmaceutical Outcomes and Policy Department, University of Florida, Gainesville
| | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Serban Mircea Negru
- Department of Oncology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | | | - Chukwudi A. Nnaji
- South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nurulamin M. Noor
- Medical Research Council Clinical Trials Unit, University College London, London, England
- Department of Gastroenterology, Cambridge University Hospitals, Cambridge, England
| | - Virginia Nuñez-Samudio
- Unit of Microbiology and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Department of Public Health, Ministry of Health, Herrera, Panama
| | | | - Bogdan Oancea
- Administrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania
| | - Chimedsuren Ochir
- Department of International Cyber Education, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
- Advisory Board, Ministry of Health, Ulaanbaatar, Mongolia
| | - Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, University of Lagos, Idi Araba, Nigeria
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Andrew T. Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | | | - Emad Omar
- Mass Communication Department, Ajman University, Dubai, United Arab Emirates
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaymaniyah, Iraq
| | - Abidemi E. Emmanuel Omonisi
- Department of Anatomic Pathology, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Anatomic Pathology, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Sokking Ong
- Noncommunicable Disease Prevention Unit, Ministry of Health, Bandar Seri Begawan, Brunei
- Early Detection and Cancer Prevention Services, Pantai Jerudong Specialist Centre, Bandar Seri Begawan, Brunei
| | - Obinna E. Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
- Section of Sustainable Health, Umeå University, Umea, Sweden
| | | | - Nikita Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - Stanislav S. Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Mayowa O. Owolabi
- Department of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | - Jagadish Rao Padubidri
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Keyvan Pakshir
- Department of Medical Mycology and Parasitology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Adrian Pana
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- Department of Health Metrics, Center for Health Outcomes and Evaluation, Bucharest, Romania
| | | | | | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, England
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University, Seoul, South Korea
- Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | | | - Harsh K. Patel
- Department of Internal Medicine, Ochsner Medical Center, New Orleans, Louisiana
| | - Jenil R. Patel
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Dallas
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock
| | - Siddhartha Pati
- Centre of Excellence, Khallikote University, Berhampur, India
- Research Division, Association for Biodiversity Conservation and Research, Balasore, India
| | | | - Uttam Paudel
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
- Faculty of Humanities and Social Sciences, Tribhuvan University, Kathmandu, Nepal
| | - David M. Pereira
- Associated Laboratory for Green Chemistry, University of Porto, Porto, Portugal
| | | | - Arokiasamy Perianayagam
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Julian David Pillay
- Basic Medical Sciences Department, Durban University of Technology, Durban, South Africa
| | - Saeed Pirouzpanah
- Department of Biochemistry and Dietetics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Pishgar
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Urooncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Indrashis Podder
- Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, India
| | - Maarten J. Postma
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- School of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Hadi Pourjafar
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Akila Prashant
- Department of Biochemistry, Jagadguru Sri Shivarathreeswara University, Mysuru, India
| | - Liliana Preotescu
- National Institute of Infectious Diseases, Bucuresti, Romania
- Department of Infectious Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Navid Rabiee
- Department of Physics, Sharif University of Technology, Tehran, Iran
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando
| | | | | | - Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Fakher Rahim
- Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Rahimzadeh
- Department of Natural Science, Middlesex University, London, England
| | - Mosiur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Victoria, Australia
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Amir Masoud Rahmani
- Future Technology Research Center, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Nazanin Rajai
- Department of Internal Medicine, Harvard University, Boston, Massachusetts
| | - Aashish Rajesh
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio
| | - Ivo Rakovac
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russia
| | - Pradhum Ram
- Department of Cardiology, Emory University, Atlanta, Georgia
| | - Kiana Ramezanzadeh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamal Ranabhat
- Health Emergency Operation Center, Ministry of Health and Population, Kathmandu, Nepal
- Central Department of Public Health, Institute of Medicine, Kathmandu, Nepal
| | | | - Chythra R. Rao
- Department of Community Medicine, Manipal Academy of Higher Education, Manipal, India
| | - Sowmya J. Rao
- Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
| | - Reza Rawassizadeh
- Department of Computer Science, Boston University, Boston, Massachusetts
| | - Mohammad Sadegh Razeghinia
- Department of Immunology and Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
- Department of Immunology, Kerman University of Medical Sciences, Kerman, Iran
| | - Andre M. N. Renzaho
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Negar Rezaei
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Peter Rohloff
- Department of Global Health and Population, Harvard University, Boston, Massachusetts
- Center for Indigenous Health Research, Wuqu' Kawoq Maya Health Alliance, Tecpan, Guatemala
| | | | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Manjula S
- Oral and Maxillofacial Surgery, Jagadguru Sri Shivarathreeswara University, Mysore, India
| | - Siamak Sabour
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Basema Saddik
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Umar Saeed
- Research and Development, Islamabad Diagnostic Center Pakistan, Islamabad, Pakistan
- Biological Production Development, National Institute of Health, Islamabad, Pakistan
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Harihar Sahoo
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Sana Salehi
- Department of Radiology, University of Southern California, Los Angeles
| | - Marwa Rashad Salem
- Public Health and Community Medicine Department, Cairo University, Giza, Egypt
| | - Hamideh Salimzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnoosh Samaei
- Emergency Department, Brown University, Providence, Rhode Island
| | | | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, West Virginia
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Senthilkumar Sankararaman
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
| | - Milena M. Santric-Milicevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Yaeesh Sardiwalla
- Division of Plastic and Reconstructive Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Brijesh Sathian
- Geriatric and Long-Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, England
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte
| | | | | | - Mario Sekerija
- Department of Medical Statistics, Epidemiology and Medical Informatics, University of Zagreb, Zagreb, Croatia
- Department of Epidemiology and Prevention of Chronic Noncommunicable Diseases, Croatian Institute of Public Health, Zagreb, Croatia
| | - Allen Seylani
- National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, Maryland
| | - Omid Shafaat
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
- Department of Radiology and Interventional Neuroradiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Shaghaghi
- Clinical Research Development Unit of Farshchian Heart Center, Hamedan University of Medical Sciences, Hamadan, Iran
| | | | - Erfan Shamsoddin
- Department of Oral Health, Non-Communicable Diseases Research Center, Tehran, Iran
- Noncommunicable Diseases Committee, National Institute for Medical Research Developmen, Tehran, Iran
| | - Mohammed Shannawaz
- Symbiosis Medical College for Women, Symbiosis International University, Pune, India
| | - Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, Delhi, India
| | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, Scotland
- Division of General Internal Medicine, Harvard University, Boston, Massachusetts
| | - Sara Sheikhbahaei
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
| | - Adithi Shetty
- Department of Obstetrics and Gynaecology, Manipal Academy of Higher Education, Mangalore, India
| | - Jeevan K. Shetty
- Department of Biochemistry, Manipal University College Melaka, Melaka, Malaysia
| | - Pavanchand H. Shetty
- Department of Forensic Medicine, Manipal Academy of Higher Education, Mangalore, India
| | | | - Reza Shirkoohi
- Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - K. M. Shivakumar
- Public Health Dentistry Department, Krishna Institute of Medical Sciences, Karad, India
| | - Velizar Shivarov
- Clinical Immunology and Hematology, Sofiamed University Hospital, Sofia, Bulgaria
- Department of Genetics, Sofia University St. Kliment Ohridiski, Sofia, Bulgaria
| | - Soraya Siabani
- Department of Health Education and Health Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
- School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | | | | | - Jasvinder A. Singh
- School of Medicine, University of Alabama at Birmingham, Birmingham
- Medicine Service Department of Veterans Affairs, Birmingham, Alabama
| | | | | | | | - Matthew J. Soeberg
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia
| | - Ahmad Sofi-Mahmudi
- Department of Oral Health, Non-Communicable Diseases Research Center, Tehran, Iran
- Cochrane Iran Associate Centre, National Institute for Medical Research Development, Iranian Ministry of Health and Medical Education, Tehran, Iran
| | - Houman Sotoudeh
- Department of Radiology, University of Alabama at Birmingham, Birmingham
| | | | - Kurt Straif
- Schiller Institute, Boston College, Boston, Massachusetts
- Barcelona Institute for Global Health, Barcelona, Spain
| | | | | | - Iyad Sultan
- Pediatric Services, King Hussein Cancer Center, Amman, Jordan
- Pediatrics, University of Jordan, Amman, Jordan
| | - Saima Sultana
- Maternal and Child Health, Projahnmo Research Foundation, Dhaka, Bangladesh
| | - Daniel Sur
- Department of Medical Oncology, The Oncology Institute “Prof Dr Ion Chiricuţă” Cluj-Napoca, Cluj-Napoca, Romania
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Viktória Szerencsés
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Miklós Szócska
- Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network, Madrid, Spain
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | | | - Amir Taherkhani
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ken Takahashi
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia
| | - Iman M. Talaat
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- Pathology Department, Alexandria University, Alexandria, Egypt
| | - Ker-Kan Tan
- Department of Surgery, National University of Singapore, Singapore, Singapore
| | - Vivian Y. Tat
- Department of Pathology, University of Texas, Galveston
| | - Bemnet Amare A. Tedla
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
- University of Gondar, Gondar, Ethiopia
| | | | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Fisaha Haile Tesfay
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Southgate Institute for Health and Society, Flinders University, Adelaide, South Australia, Australia
| | - Gizachew Assefa Tessema
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Rekha Thapar
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Aravind Thavamani
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio
- Division of Pediatric Gastroenterology, Case Western Reserve University, Cleveland, Ohio
| | | | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - Hamid Reza Tohidinik
- HIV/STI Surveillance Research Center and World Health Organization Collaborating Center for HIV Surveillance, Kerman University of Medical Sciences, Kerman, Iran
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team, National Institute for Health and Medical Research Institut national de la santé et de la recherche médicale, Paris, France
- Department of Health, Medicine and Human Biology, Sorbonne Paris Nord University, Bobigny, France
| | - Marcos Roberto Tovani-Palone
- Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
- Modestum LTD, London, England
| | - Eugenio Traini
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Maurice Wilkins Centre, Auckland, New Zealand
| | - Mai Thi Ngoc Tran
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Health Informatics Department, Nursing and Midwifery Faculty, Hanoi Medical University, Ha Noi, Vietnam
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Biruk Shalmeno Tusa
- Department of Epidemiology and Biostatistics, Haramaya University, Haramaya, Ethiopia
| | - Irfan Ullah
- Department of Allied Health Sciences, Iqra National University, Peshawar, Pakistan
- Pakistan Council for Science and Technology, Ministry of Science and Technology, Islamabad, Pakistan
| | - Saif Ullah
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
| | | | | | - Era Upadhyay
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Maryam Vaezi
- Alzahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahel Valadan Tahbaz
- Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran
- Department of Microbiology, Islamic Azad University, Tehran, Iran
| | - Diana Zuleika Velazquez
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
| | - Massimiliano Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Francesco S. Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Bay Vo
- Faculty of Information Technology, Ho Chi Minh City University of Technology, Ho Chi Minh City, Vietnam
| | - Victor Volovici
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands
- Center for Experimental Microsurgery, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Giang Thu Vu
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Yasir Waheed
- Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan
| | - Richard G. Wamai
- Cultures, Societies and Global Studies, Integrated Initiative for Global Health, Northeastern University, Boston, Massachusetts
- School of Public Health, University of Nairobi, Nairobi, Kenya
| | - Paul Ward
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Yi Feng Wen
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Stomatological Hospital (College) of Xi'an Jiaotong University, Xi'an, China
| | - Ronny Westerman
- Competence Center of Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany
| | - Andrea Sylvia Winkler
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - Lalit Yadav
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Research and Development Division, The George Institute for Global Health, New Delhi, India
| | | | - Lin Yang
- Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, British Columbia, Canada
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- George Institute for Global Health, University of Oxford, Oxford, England
| | | | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Public Health, Juntendo University, Tokyo, Japan
| | - Mustafa Z. Younis
- Department of Health Policy and Management, Jackson State University, Jackson, Mississippi
- School of Medicine, Tsinghua University, Beijing, China
| | - Zabihollah Yousefi
- Department of Environmental Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Deniz Yuce
- Cancer Institute, Hacettepe University, Ankara, Turkey
| | - Ismaeel Yunusa
- Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina, Columbia
| | - Vesna Zadnik
- Epidemiology and Cancer Registry Sector, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Fariba Zare
- Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mikhail Sergeevich Zastrozhin
- Laboratory of Genetics and Genomics, Moscow Research and Practical Centre on Addictions, Moscow, Russia
- Addictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Anasthasia Zastrozhina
- Pediatrics Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Jianrong Zhang
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Chenwen Zhong
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Linghui Zhou
- Bone Marrow Transplantation Center, Zhejiang University, Hangzhou, China
| | - Cong Zhu
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, Houston
| | - Arash Ziapour
- Department of Health Education and Health Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Christina Fitzmaurice
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Division of Hematology, University of Washington, Seattle
| | - Christopher J. L. Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lisa M. Force
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Division of Pediatric Hematology-Oncology, University of Washington, Seattle
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Alvarez EM, Force LM, Xu R, Compton K, Lu D, Henrikson HJ, Kocarnik JM, Harvey JD, Pennini A, Dean FE, Fu W, Vargas MT, Keegan THM, Ariffin H, Barr RD, Erdomaeva YA, Gunasekera DS, John-Akinola YO, Ketterl TG, Kutluk T, Malogolowkin MH, Mathur P, Radhakrishnan V, Ries LAG, Rodriguez-Galindo C, Sagoyan GB, Sultan I, Abbasi B, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abbastabar H, Abdelmasseh M, Abd-Elsalam S, Abdoli A, Abebe H, Abedi A, Abidi H, Abolhassani H, Abubaker Ali H, Abu-Gharbieh E, Achappa B, Acuna JM, Adedeji IA, Adegboye OA, Adnani QES, Advani SM, Afzal MS, Aghaie Meybodi M, Ahadinezhad B, Ahinkorah BO, Ahmad S, Ahmadi S, Ahmed MB, Ahmed Rashid T, Ahmed Salih Y, Aiman W, Akalu GT, Al Hamad H, Alahdab F, AlAmodi AA, Alanezi FM, Alanzi TM, Alem AZ, Alem DT, Alemayehu Y, Alhalaiqa FN, Alhassan RK, Ali S, Alicandro G, Alipour V, Aljunid SM, Alkhayyat M, Alluri S, Almasri NA, Al-Maweri SA, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Ameyaw EK, Amini S, Amu H, Ancuceanu R, Andrei CL, Andrei T, Ansari F, Ansari-Moghaddam A, Anvari D, Anyasodor AE, Arabloo J, Arab-Zozani M, Argaw AM, Arshad M, Arulappan J, Aryannejad A, Asemi Z, Asghari Jafarabadi M, Atashzar MR, Atorkey P, Atreya A, Attia S, Aujayeb A, Ausloos M, Avila-Burgos L, Awedew AF, Ayala Quintanilla BP, Ayele AD, Ayen SS, Azab MA, Azadnajafabad S, Azami H, Azangou-Khyavy M, Azari Jafari A, Azarian G, Azzam AY, Bahadory S, Bai J, Baig AA, Baker JL, Banach M, Bärnighausen TW, Barone-Adesi F, Barra F, Barrow A, Basaleem H, Batiha AMM, Behzadifar M, Bekele NC, Belete R, Belgaumi UI, Bell AW, Berhie AY, Bhagat DS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Birara S, Bjørge T, Bolarinwa OA, Bolla SR, Boloor A, Braithwaite D, Brenner H, Bulamu NB, Burkart K, Bustamante-Teixeira MT, Butt NS, Butt ZA, Caetano dos Santos FL, Cao C, Cao Y, Carreras G, Catalá-López F, Cembranel F, Cerin E, Chakinala RC, Chakraborty PA, Chattu VK, Chaturvedi P, Chaurasia A, Chavan PP, Chimed-Ochir O, Choi JYJ, Christopher DJ, Chu DT, Chung MT, Conde J, Costa VM, Da'ar OB, Dadras O, Dahlawi SMA, Dai X, Damiani G, D'Amico E, Dandona L, Dandona R, Daneshpajouhnejad P, Darwish AH, Daryani A, De la Hoz FP, Debela SA, Demie TGG, Demissie GD, Demissie ZG, Denova-Gutiérrez E, Derbew Molla M, Desai R, Desta AA, Dhamnetiya D, Dharmaratne SD, Dhimal ML, Dhimal M, Dianatinasab M, Didehdar M, Diress M, Djalalinia S, Do HP, Doaei S, Dorostkar F, dos Santos WM, Drake TM, Ekholuenetale M, El Sayed I, El Sayed Zaki M, El Tantawi M, El-Abid H, Elbahnasawy MA, Elbarazi I, Elhabashy HR, Elhadi M, El-Jaafary SI, Enyew DB, Erkhembayar R, Eshrati B, Eskandarieh S, Faisaluddin M, Fares J, Farooque U, Fasanmi AO, Fatima W, Ferreira de Oliveira JMP, Ferrero S, Ferro Desideri L, Fetensa G, Filip I, Fischer F, Fisher JL, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gaewkhiew P, Gallus S, Garg T, Gebremeskel TG, Gemeda BNB, Getachew T, Ghafourifard M, Ghamari SH, Ghashghaee A, Ghassemi F, Ghith N, Gholami A, Gholizadeh Navashenaq J, Gilani SA, Ginindza TG, Gizaw AT, Glasbey JC, Goel A, Golechha M, Goleij P, Golinelli D, Gopalani SV, Gorini G, Goudarzi H, Goulart BNG, Grada A, Gubari MIM, Guerra MR, Guha A, Gupta B, Gupta S, Gupta VB, Gupta VK, Haddadi R, Hafezi-Nejad N, Hailu A, Haj-Mirzaian A, Halwani R, Hamadeh RR, Hambisa MT, Hameed S, Hamidi S, Haque S, Hariri S, Haro JM, Hasaballah AI, Hasan SMM, Hashemi SM, Hassan TS, Hassanipour S, Hay SI, Hayat K, Hebo SH, Heidari G, Heidari M, Herrera-Serna BY, Herteliu C, Heyi DZ, Hezam K, Hole MK, Holla R, Horita N, Hossain MM, Hossain MB, Hosseini MS, Hosseini M, Hosseinzadeh A, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huang J, Hussein NR, Hwang BF, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Innos K, Irham LM, Islam RM, Islam SMS, Ismail NE, Isola G, Iwagami M, Jacob L, Jadidi-Niaragh F, Jain V, Jakovljevic M, Janghorban R, Javadi Mamaghani A, Jayaram S, Jayawardena R, Jazayeri SB, Jebai R, Jha RP, Joo T, Joseph N, Joukar F, Jürisson M, Kaambwa B, Kabir A, Kalankesh LR, Kaliyadan F, Kamal Z, Kamath A, Kandel H, Kar SS, Karaye IM, Karimi A, Kassa BG, Kauppila JH, Kemp Bohan PM, Kengne AP, Kerbo AA, Keykhaei M, Khader YS, Khajuria H, Khalili N, Khalili N, Khan EA, Khan G, Khan M, Khan MN, Khan MAB, Khanali J, Khayamzadeh M, Khosravizadeh O, Khubchandani J, Khundkar R, Kim MS, Kim YJ, Kisa A, Kisa S, Kissimova-Skarbek K, Kolahi AA, Kopec JA, Koteeswaran R, Koulmane Laxminarayana SL, Koyanagi A, Kugbey N, Kumar GA, Kumar N, Kwarteng A, La Vecchia C, Lan Q, Landires I, Lasrado S, Lauriola P, Ledda C, Lee SW, Lee WC, Lee YY, Lee YH, Leigh J, Leong E, Li B, Li J, Li MC, Lim SS, Liu X, Lobo SW, Loureiro JA, Lugo A, Lunevicius R, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahmoudi M, Majeed A, Makki A, Male S, Malekpour MR, Malekzadeh R, Malik AA, Mamun MA, Manafi N, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Martini S, Masoumi SZ, Matei CN, Mathur MR, McAlinden C, Mehrotra R, Mendoza W, Menezes RG, Mentis AFA, Meretoja TJ, Mersha AG, Mesregah MK, Mestrovic T, Miao Jonasson J, Miazgowski B, Michalek IM, Miller TR, Mingude AB, Mirmoeeni S, Mirzaei H, Misra S, Mithra P, Mohammad KA, Mohammadi M, Mohammadi SM, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed A, Mohammed S, Mohammed TA, Moka N, Mokdad AH, Molokhia M, Momtazmanesh S, Monasta L, Moni MA, Moradi G, Moradi Y, Moradzadeh M, Moradzadeh R, Moraga P, Morrison SD, Mostafavi E, Mousavi Khaneghah A, Mpundu-Kaambwa C, Mubarik S, Mwanri L, Nabhan AF, Nagaraju SP, Nagata C, Naghavi M, Naimzada MD, Naldi L, Nangia V, Naqvi AA, Narasimha Swamy S, Narayana AI, Nayak BP, Nayak VC, Nazari J, Nduaguba SO, Negoi I, Negru SM, Nejadghaderi SA, Nepal S, Neupane Kandel S, Nggada HA, Nguyen CT, Nnaji CA, Nosrati H, Nouraei H, Nowroozi A, Nuñez-Samudio V, Nwatah VE, Nzoputam CI, Oancea B, Odukoya OO, Oguntade AS, Oh IH, Olagunju AT, Olagunju TO, Olakunde BO, Oluwasanu MM, Omar E, Omar Bali A, Ong S, Onwujekwe OE, Ortega-Altamirano DV, Otstavnov N, Otstavnov SS, Oumer B, Owolabi MO, P A M, Padron-Monedero A, Padubidri JR, Pakshir K, Pana A, Pandey A, Pardhan S, Pashazadeh Kan F, Pasovic M, Patel JR, Pati S, Pattanshetty SM, Paudel U, Pereira RB, Peres MFP, Perianayagam A, Postma MJ, Pourjafar H, Pourshams A, Prashant A, Pulakunta T, Qadir MMFF, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Rafiee A, Rafiei A, Rafiei S, Rahim F, Rahimzadeh S, Rahman M, Rahman MA, Rahmani AM, Rajesh A, Ramezani-Doroh V, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rashedi S, Rashidi M, Rashidi MM, Rath GK, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Razeghinia MS, Regasa MT, Renzaho AMN, Rezaei M, Rezaei N, Rezaei N, Rezaeian M, Rezapour A, Rezazadeh-Khadem S, Riad A, Rios Lopez LE, Rodriguez JAB, Ronfani L, Roshandel G, Rwegerera GM, Saber-Ayad MM, Sabour S, Saddik B, Sadeghi E, Sadeghian S, Saeed U, Sahebkar A, Saif-Ur-Rahman KM, Sajadi SM, Salahi S, Salehi S, Salem MR, Salimzadeh H, Samy AM, Sanabria J, Sanmarchi F, Sarveazad A, Sathian B, Sawhney M, Sawyer SM, Saylan M, Schneider IJC, Seidu AA, Šekerija M, Sendo EG, Sepanlou SG, Seylani A, Seyoum K, Sha F, Shafaat O, Shaikh MA, Shamsoddin E, Shannawaz M, Sharma R, Sheikhbahaei S, Shetty A, Shetty BSK, Shetty PH, Shin JI, Shirkoohi R, Shivakumar KM, Shobeiri P, Siabani S, Sibhat MM, Siddappa Malleshappa SK, Sidemo NB, Silva DAS, Silva Julian G, Singh AD, Singh JA, Singh JK, Singh S, Sinke AH, Sintayehu Y, Skryabin VY, Skryabina AA, Smith L, Sofi-Mahmudi A, Soltani-Zangbar MS, Song S, Spurlock EE, Steiropoulos P, Straif K, Subedi R, Sufiyan MB, Suliankatchi Abdulkader R, Sultana S, Szerencsés V, Szócska M, Tabaeian SP, Tabarés-Seisdedos R, Tabary M, Tabuchi T, Tadbiri H, Taheri M, Taherkhani A, Takahashi K, Tampa M, Tan KK, Tat VY, Tavakoli A, Tbakhi A, Tehrani-Banihashemi A, Temsah MH, Tesfay FH, Tesfaye B, Thakur JS, Thapar R, Thavamani A, Thiyagarajan A, Thomas N, Tobe-Gai R, Togtmol M, Tohidast SA, Tohidinik HR, Tolani MA, Tollosa DN, Touvier M, Tovani-Palone MR, Traini E, Tran BX, Tran MTN, Tripathy JP, Tusa BS, Ukke GG, Ullah I, Ullah S, Umapathi KK, Unnikrishnan B, Upadhyay E, Ushula TW, Vacante M, Valadan Tahbaz S, Varthya SB, Veroux M, Villeneuve PJ, Violante FS, Vlassov V, Vu GT, Waheed Y, Wang N, Ward P, Weldesenbet AB, Wen YF, Westerman R, Winkler AS, Wubishet BL, Xu S, Yahyazadeh Jabbari SH, Yang L, Yaya S, Yazdi-Feyzabadi V, Yazie TS, Yehualashet SS, Yeshaneh A, Yeshaw Y, Yirdaw BW, Yonemoto N, Younis MZ, Yousefi Z, Yu C, Yunusa I, Zadnik V, Zahir M, Zahirian Moghadam T, Zamani M, Zamanian M, Zandian H, Zare F, Zastrozhin MS, Zastrozhina A, Zhang J, Zhang ZJ, Ziapour A, Zoladl M, Murray CJL, Fitzmaurice C, Bleyer A, Bhakta N. The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Oncol 2022; 23:27-52. [PMID: 34871551 PMCID: PMC8716339 DOI: 10.1016/s1470-2045(21)00581-7] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. METHODS Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. FINDINGS There were 1·19 million (95% UI 1·11-1·28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5-65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8-57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9-15·6] per 100 000 person-years) and middle SDI (13·6 [12·6-14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9-25·2) DALYs to the global burden of disease, of which 2·7% (1·9-3·6) came from YLDs and 97·3% (96·4-98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. INTERPRETATION Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. FUNDING Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute.
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Ward JL, Azzopardi PS, Francis KL, Santelli JS, Skirbekk V, Sawyer SM, Kassebaum NJ, Mokdad AH, Hay SI, Abd-Allah F, Abdoli A, Abdollahi M, Abedi A, Abolhassani H, Abreu LG, Abrigo MRM, Abu-Gharbieh E, Abushouk AI, Adebayo OM, Adekanmbi V, Adham D, Advani SM, Afshari K, Agrawal A, Ahmad T, Ahmadi K, Ahmed AE, Aji B, Akombi-Inyang B, Alahdab F, Al-Aly Z, Alam K, Alanezi FM, Alanzi TM, Alcalde-Rabanal JE, Alemu BW, Al-Hajj S, Alhassan RK, Ali S, Alicandro G, Alijanzadeh M, Aljunid SM, Almasi-Hashiani A, Almasri NA, Al-Mekhlafi HM, Alonso J, Al-Raddadi RM, Altirkawi KA, Alvis-Guzman N, Amare AT, Amini S, Aminorroaya A, Amit AML, Amugsi DA, Ancuceanu R, Anderlini D, Andrei CL, Androudi S, Ansari F, Ansari I, Antonio CAT, Anvari D, Anwer R, Appiah SCY, Arabloo J, Arab-Zozani M, Ärnlöv J, Asaad M, Asadi-Aliabadi M, Asadi-Pooya AA, Atout MMW, Ausloos M, Avenyo EK, Avila-Burgos L, Ayala Quintanilla BP, Ayano G, Aynalem YA, Azari S, Azene ZN, Bakhshaei MH, Bakkannavar SM, Banach M, Banik PC, Barboza MA, Barker-Collo SL, Bärnighausen TW, Basu S, Baune BT, Bayati M, Bedi N, Beghi E, Bekuma TT, Bell AW, Bell ML, Benjet C, Bensenor IM, Berhe AK, Berhe K, Berman AE, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhattarai S, Bhutta ZA, Bijani A, Bikbov B, Biondi A, Birhanu TTM, Biswas RK, Bohlouli S, Bolla SR, Boloor A, Borschmann R, Boufous S, Bragazzi NL, Braithwaite D, Breitborde NJK, Brenner H, Britton GB, Burns RA, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Cámera LA, Campos-Nonato IR, Campuzano Rincon JC, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Cerin E, Chandan JS, Chang HY, Chang JC, Charan J, Chattu VK, Chaturvedi S, Choi JYJ, Chowdhury MAK, Christopher DJ, Chu DT, Chung MT, Chung SC, Cicuttini FM, Constantin TV, Costa VM, Dahlawi SMA, Dai H, Dai X, Damiani G, Dandona L, Dandona R, Daneshpajouhnejad P, Darwesh AM, Dávila-Cervantes CA, Davletov K, De la Hoz FP, De Leo D, Dervenis N, Desai R, Desalew A, Deuba K, Dharmaratne SD, Dhungana GP, Dianatinasab M, Dias da Silva D, Diaz D, Didarloo A, Djalalinia S, Dorostkar F, Doshi CP, Doshmangir L, Doyle KE, Duraes AR, Ebrahimi Kalan M, Ebtehaj S, Edvardsson D, El Tantawi M, Elgendy IY, El-Jaafary SI, Elsharkawy A, Eshrati B, Eskandarieh S, Esmaeilnejad S, Esmaeilzadeh F, Esteghamati S, Faro A, Farzadfar F, Fattahi N, Feigin VL, Ferede TY, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fischer F, Fisher JL, Foigt NA, Folayan MO, Fomenkov AA, Foroutan M, Fukumoto T, Gad MM, Gaidhane AM, Gallus S, Gebre T, Gebremedhin KB, Gebremeskel GG, Gebremeskel L, Gebreslassie AA, Gesesew HA, Ghadiri K, Ghafourifard M, Ghamari F, Ghashghaee A, Gilani SA, Gnedovskaya EV, Godinho MA, Golechha M, Goli S, Gona PN, Gopalani SV, Gorini G, Grivna M, Gubari MIM, Gugnani HC, Guimarães RA, Guo Y, Gupta R, Haagsma JA, Hafezi-Nejad N, Haile TG, Haj-Mirzaian A, Haj-Mirzaian A, Hall BJ, Hamadeh RR, Hamagharib Abdullah K, Hamidi S, Handiso DW, Hanif A, Hankey GJ, Haririan H, Haro JM, Hasaballah AI, Hashi A, Hassan A, Hassanipour S, Hassankhani H, Hayat K, Heidari-Soureshjani R, Herteliu C, Heydarpour F, Ho HC, Hole MK, Holla R, Hoogar P, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huda TM, Humayun A, Hussain R, Hwang BF, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Intarut N, Iqbal U, Irvani SSN, Islam MM, Islam SMS, Iso H, Ivers RQ, Jahani MA, Jakovljevic M, Jalali A, Janodia MD, Javaheri T, Jeemon P, Jenabi E, Jha RP, Jha V, Ji JS, Jonas JB, Jones KM, Joukar F, Jozwiak JJ, Juliusson PB, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kalhor R, Kamyari N, Kanchan T, Karch A, Karimi SE, Kaur S, Kayode GA, Keiyoro PN, Khalid N, Khammarnia M, Khan M, Khan MN, Khatab K, Khater MM, Khatib MN, Khayamzadeh M, Khazaie H, Khoja AT, Kieling C, Kim YE, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kivimäki M, Koolivand A, Kosen S, Koyanagi A, Krishan K, Kugbey N, Kumar GA, Kumar M, Kumar N, Kurmi OP, Kusuma D, La Vecchia C, Lacey B, Lal DK, Lalloo R, Lan Q, Landires I, Lansingh VC, Larsson AO, Lasrado S, Lassi ZS, Lauriola P, Lee PH, Lee SWH, Leigh J, Leonardi M, Leung J, Levi M, Lewycka S, Li B, Li MC, Li S, Lim LL, Lim SS, Liu X, Lorkowski S, Lotufo PA, Lunevicius R, Maddison R, Mahasha PW, Mahdavi MM, Mahmoudi M, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mamun AA, Mansouri B, Mansournia MA, Martinez G, Martinez-Raga J, Martins-Melo FR, Mason-Jones AJ, Masoumi SZ, Mathur MR, Maulik PK, McGrath JJ, Mehndiratta MM, Mehri F, Memiah PTN, Mendoza W, Menezes RG, Mengesha EW, Meretoja A, Meretoja TJ, Mestrovic T, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mirzaei H, Mirzaei M, Moazen B, Mohammad DK, Mohammadi S, Mohammadian-Hafshejani A, Mohammadifard N, Mohammadpourhodki R, Mohammed S, Monasta L, Moradi G, Moradi-Lakeh M, Moradzadeh R, Moraga P, Morrison SD, Mosapour A, Mousavi Khaneghah A, Mueller UO, Muriithi MK, Murray CJL, Muthupandian S, Naderi M, Nagarajan AJ, Naghavi M, Naimzada MD, Nangia V, Nayak VC, Nazari J, Ndejjo R, Negoi I, Negoi RI, Netsere HB, Nguefack-Tsague G, Nguyen DN, Nguyen HLT, Nie J, Ningrum DNA, Nnaji CA, Nomura S, Noubiap JJ, Nowak C, Nuñez-Samudio V, Ogbo FA, Oghenetega OB, Oh IH, Oladnabi M, Olagunju AT, Olusanya BO, Olusanya JO, Omar Bali A, Omer MO, Onwujekwe OE, Ortiz A, Otoiu A, Otstavnov N, Otstavnov SS, Øverland S, Owolabi MO, P A M, Padubidri JR, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Pandey A, Panelo CIA, Park EK, Patten SB, Peden AE, Pepito VCF, Peprah EK, Pereira J, Pesudovs K, Pham HQ, Phillips MR, Piradov MA, Pirsaheb M, Postma MJ, Pottoo FH, Pourjafar H, Pourshams A, Prada SI, Pupillo E, Quazi Syed Z, Rabiee MH, Rabiee N, Radfar A, Rafiee A, Raggi A, Rahim F, Rahimi-Movaghar V, Rahman MHU, Rahman MA, Ramezanzadeh K, Ranabhat CL, Rao SJ, Rashedi V, Rastogi P, Rathi P, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Renzaho AMN, Rezaei N, Rezaei N, Rezai MS, Riahi SM, Rickard J, Roever L, Ronfani L, Roth GA, Rubagotti E, Rumisha SF, Rwegerera GM, Sabour S, Sachdev PS, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sagar R, Sahebkar A, Sahraian MA, Sajadi SM, Salem MR, Salimzadeh H, Samy AM, Sanabria J, Santric-Milicevic MM, Saraswathy SYI, Sarrafzadegan N, Sarveazad A, Sathish T, Sattin D, Saxena D, Saxena S, Schiavolin S, Schwebel DC, Schwendicke F, Senthilkumaran S, Sepanlou SG, Sha F, Shafaat O, Shahabi S, Shaheen AA, Shaikh MA, Shakiba S, Shamsi M, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shetty BSK, Shi P, Shigematsu M, Shin JI, Shiri R, Shuval K, Siabani S, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Silva JP, Simonetti B, Singh JA, Singh V, Sinke AH, Skryabin VY, Slater H, Smith EUR, Sobhiyeh MR, Sobngwi E, Soheili A, Somefun OD, Sorrie MB, Soyiri IN, Sreeramareddy CT, Stein DJ, Stokes MA, Sudaryanto A, Sultan I, Tabarés-Seisdedos R, Tabuchi T, Tadakamadla SK, Taherkhani A, Tamiru AT, Tareque MI, Thankappan KR, Thapar R, Thomas N, Titova MV, Tonelli M, Tovani-Palone MR, Tran BX, Travillian RS, Tsai AC, Tsatsakis A, Tudor Car L, Uddin R, Unim B, Unnikrishnan B, Upadhyay E, Vacante M, Valadan Tahbaz S, Valdez PR, Varughese S, Vasankari TJ, Venketasubramanian N, Villeneuve PJ, Violante FS, Vlassov V, Vos T, Vu GT, Waheed Y, Wamai RG, Wang Y, Wang Y, Wang YP, Westerman R, Wickramasinghe ND, Wu AM, Wu C, Yahyazadeh Jabbari SH, Yamagishi K, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yeshitila YG, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yousefinezhadi T, Yu C, Yu Y, Yuce D, Zaidi SS, Zaman SB, Zamani M, Zamanian M, Zarafshan H, Zarei A, Zastrozhin MS, Zhang Y, Zhang ZJ, Zhao XJG, Zhu C, Patton GC, Viner RM. Global, regional, and national mortality among young people aged 10-24 years, 1950-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2021; 398:1593-1618. [PMID: 34755628 PMCID: PMC8576274 DOI: 10.1016/s0140-6736(21)01546-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/07/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10-24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10-24 years by age group (10-14 years, 15-19 years, and 20-24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10-24 years with that in children aged 0-9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10-24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). FINDINGS In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39-1·59) worldwide in people aged 10-24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10-14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15-19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1-4 years (2·4%), and around a third less than in females aged 1-4 years (2·5%). The proportion of global deaths in people aged 0-24 years that occurred in people aged 10-24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. INTERPRETATION Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10-24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. FUNDING Bill & Melinda Gates Foundation.
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Paulson KR, Kamath AM, Alam T, Bienhoff K, Abady GG, Abbas J, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, Abd-Elsalam SM, Abdoli A, Abedi A, Abolhassani H, Abreu LG, Abu-Gharbieh E, Abu-Rmeileh NME, Abushouk AI, Adamu AL, Adebayo OM, Adegbosin AE, Adekanmbi V, Adetokunboh OO, Adeyinka DA, Adsuar JC, Afshari K, Aghaali M, Agudelo-Botero M, Ahinkorah BO, Ahmad T, Ahmadi K, Ahmed MB, Aji B, Akalu Y, Akinyemi OO, Aklilu A, Al-Aly Z, Alam K, Alanezi FM, Alanzi TM, Alcalde-Rabanal JE, Al-Eyadhy A, Ali T, Alicandro G, Alif SM, Alipour V, Alizade H, Aljunid SM, Almasi-Hashiani A, Almasri NA, Al-Mekhlafi HM, Alonso J, Al-Raddadi RM, Altirkawi KA, Alumran AK, Alvis-Guzman N, Alvis-Zakzuk NJ, Ameyaw EK, Amini S, Amini-Rarani M, Amit AML, Amugsi DA, Ancuceanu R, Anderlini D, Andrei CL, Ansari F, Ansari-Moghaddam A, Antonio CAT, Antriyandarti E, Anvari D, Anwer R, Aqeel M, Arabloo J, Arab-Zozani M, Aripov T, Ärnlöv J, Artanti KD, Arzani A, Asaad M, Asadi-Aliabadi M, Asadi-Pooya AA, Asghari Jafarabadi M, Athari SS, Athari SM, Atnafu DD, Atreya A, Atteraya MS, Ausloos M, Awan AT, Ayala Quintanilla BP, Ayano G, Ayanore MA, Aynalem YA, Azari S, Azarian G, Azene ZN, B DB, Babaee E, Badiye AD, Baig AA, Banach M, Banik PC, Barker-Collo SL, Barqawi HJ, Bassat Q, Basu S, Baune BT, Bayati M, Bedi N, Beghi E, Beghi M, Bell ML, Bendak S, Bennett DA, Bensenor IM, Berhe K, Berman AE, Bezabih YM, Bhagavathula AS, Bhandari D, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhattarai S, Bhutta ZA, Bikbov B, Biondi A, Birihane BM, Biswas RK, Bohlouli S, Bragazzi NL, Breusov AV, Brunoni AR, Burkart K, Burugina Nagaraja S, Busse R, Butt ZA, Caetano dos Santos FL, Cahuana-Hurtado L, Camargos P, Cámera LA, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Cerin E, Chang JC, Chanie WF, Charan J, Chatterjee S, Chattu SK, Chattu VK, Chaturvedi S, Chen S, Cho DY, Choi JYJ, Chu DT, Ciobanu LG, Cirillo M, Conde J, Costa VM, Couto RAS, Dachew BA, Dahlawi SMA, Dai H, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Darmstadt GL, Das JK, Dávila-Cervantes CA, Davis AC, Davletov K, De la Hoz FP, De Leo D, Deeba F, Denova-Gutiérrez E, Dervenis N, Desalew A, Deuba K, Dey S, Dharmaratne SD, Dhingra S, Dhungana GP, Dias da Silva D, Diaz D, Dorostkar F, Doshmangir L, Dubljanin E, Duraes AR, Eagan AW, Edinur HA, Efendi F, Eftekharzadeh S, El Sayed I, El Tantawi M, Elbarazi I, Elgendy IY, El-Jaafary SI, Emami A, Enany S, Eyawo O, Ezzikouri S, Faris PS, Farzadfar F, Fattahi N, Fauk NK, Fazlzadeh M, Feigin VL, Ferede TY, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fischer F, Fisher JL, Foigt NA, Folayan MO, Foroutan M, Franklin RC, Freitas M, Friedman SD, Fukumoto T, Gad MM, Gaidhane AM, Gaidhane S, Gaihre S, Gallus S, Garcia-Basteiro AL, Garcia-Gordillo MA, Gardner WM, Gaspar Fonseca M, Gebremedhin KB, Getacher L, Ghashghaee A, Gholamian A, Gilani SA, Gill TK, Giussani G, Gnedovskaya EV, Godinho MA, Goel A, Golechha M, Gona PN, Gopalani SV, Goudarzi H, Grivna M, Gugnani HC, Guido D, Guimarães RA, Gupta RD, Gupta R, Hafezi-Nejad N, Haider MR, Haj-Mirzaian A, Hamidi S, Hanif A, Hankey GJ, Hargono A, Hasaballah AI, Hasan MM, Hasan SS, Hassan A, Hassanipour S, Hassankhani H, Havmoeller RJ, Hayat K, Heidari-Soureshjani R, Henry NJ, Herteliu C, Hole MK, Holla R, Hossain N, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Huang J, Humayun A, Hwang BF, Iavicoli I, Ibitoye SE, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Inamdar S, Inbaraj LR, Iqbal K, Iqbal U, Islam MM, Islam SMS, Iso H, Iwagami M, Iwu CCD, Jaafari J, Jacobsen KH, Jagnoor J, Jain V, Janodia MD, Javaheri T, Javanmardi F, Jayaram S, Jayatilleke AU, Jenabi E, Jha RP, Ji JS, John O, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kamyari N, Kanchan T, Kapoor N, Karami Matin B, Karch A, Karimi SE, Kassahun G, Kayode GA, Kazemi Karyani A, Kemmer L, Khalid N, Khalilov R, Khammarnia M, Khan EA, Khan G, Khan M, Khan MN, Khang YH, Khatab K, Khater AM, Khater MM, Khayamzadeh M, Khosravi A, Kim D, Kim YE, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kissoon N, Kopec JA, Kosen S, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Krishnamoorthy V, Kuate Defo B, Kucuk Bicer B, Kulkarni V, Kumar GA, Kumar M, Kumar N, Kurmi OP, Kusuma D, La Vecchia C, Lacey B, Lalloo R, Lami FH, Landires I, Larsson AO, Lasrado S, Lassi ZS, Lauriola P, Lee PH, Lee SWH, Lee YH, Leigh J, Leonardi M, Lewycka S, Li B, Li S, Liang J, Lim LL, Limenih MA, Lin RT, Liu X, Lodha R, Lopez AD, Lozano R, Lugo A, Lunevicius R, Mackay MT, Madhava Kunjathur S, Magnani FG, Mahadeshwara Prasad DR, Maheri M, Mahmoudi M, Majeed A, Maled V, Maleki A, Maleki S, Malekzadeh R, Malik AA, Malta DC, Mamun AA, Mansouri B, Mansournia MA, Martinez G, Martini S, Martins-Melo FR, Masoumi SZ, Maulik PK, McAlinden C, McGrath JJ, Medina-Solís CE, Mehrabi Nasab E, Mejia-Rodriguez F, Memish ZA, Mendoza W, Menezes RG, Mengesha EW, Mensah GA, Meretoja A, Meretoja TJ, Mersha AM, Mestrovic T, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mini GK, Miri M, Mirica A, Mirrakhimov EM, Mirzaei H, Mirzaei M, Moazen B, Moghadaszadeh M, Mohajer B, Mohamad O, Mohammad Y, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Molokhia M, Monasta L, Mondello S, Moni MA, Moore CE, Moradi G, Moradi M, Moradzadeh R, Moraga P, Morawska L, Morrison SD, Mosser JF, Mousavi Khaneghah A, Mustafa G, Naderi M, Nagarajan AJ, Nagaraju SP, Naghavi M, Naghshtabrizi B, Naimzada MD, Nangia V, Narasimha Swamy S, Nascimento BR, Naveed M, Nazari J, Ndejjo R, Negoi I, Negoi RI, Nena E, Nepal S, Netsere HB, Nguefack-Tsague G, Ngunjiri JW, Nguyen CTY, Nguyen CT, Nguyen HLT, Nigatu YT, Nigussie SN, Nixon MR, Nnaji CA, Nomura S, Noor NM, Noubiap JJ, Nuñez-Samudio V, Nwatah VE, Oancea B, Odukoya OO, Ogbo FA, Olusanya BO, Olusanya JO, Omar Bali A, Onwujekwe OE, Ortiz A, Otoiu A, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Padubidri JR, Pakhale S, Pakshir K, Pal PK, Palladino R, Pana A, Panda-Jonas S, Pandey A, Pandey A, Pandi-Perumal SR, Pangaribuan HU, Pardo-Montaño AM, Park EK, Patel SK, Patton GC, Pawar S, Pazoki Toroudi H, Peden AE, Pepito VCF, Peprah EK, Pereira J, Pérez-Gómez J, Perico N, Pesudovs K, Pilgrim T, Pinheiro M, Piradov MA, Pirsaheb M, Platts-Mills JA, Pokhrel KN, Postma MJ, Pourjafar H, Prada SI, Prakash S, Pupillo E, Quazi Syed Z, Rabiee N, Radfar A, Rafiee A, Rafiei A, Raggi A, Rahimzadeh S, Rahman MHU, Rahmani AM, Ramezanzadeh K, Rana J, Ranabhat CL, Rao SJ, Rasella D, Rastogi P, Rathi P, Rawaf DL, Rawaf S, Rawasia WF, Rawassizadeh R, Reiner Jr RC, Remuzzi G, Renzaho AMN, Reshmi B, Resnikoff S, Rezaei N, Rezaei N, Rezapour A, Riahi SM, Ribeiro D, Rickard J, Roever L, Ronfani L, Rothenbacher D, Rubagotti E, Rumisha SF, Ryan PM, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sagar R, Sahebkar A, Salahshoor MR, Salehi S, Salem MR, Salimzadeh H, Salomon JA, Samodra YL, Samy AM, Sanabria J, Santric-Milicevic MM, Saraswathy SYI, Sarker AR, Sarrafzadegan N, Sarveazad A, Sathian B, Sathish T, Sattin D, Saxena S, Saya GK, Saylan M, Schiavolin S, Schlaich MP, Schwebel DC, Schwendicke F, Senthilkumaran S, Sepanlou SG, Serván-Mori E, Sha F, Shafaat O, Shahabi S, Shahbaz M, Shaheen AA, Shahid I, Shaikh MA, Shakiba S, Shalash AS, Shams-Beyranvand M, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shiferaw WS, Shigematsu M, Shin JI, Shiri R, Shiue I, Shuval K, Siddiqi TJ, Sidemo NB, Sigfusdottir ID, Sigurvinsdottir R, Silva JP, Silverberg JIS, Simonetti B, Singh BB, Singh JA, Singhal D, Sinha DN, Skiadaresi E, Skryabin VY, Skryabina AA, Sleet DA, Sobaih BH, Sobhiyeh MR, Soltani S, Soriano JB, Spurlock EE, Sreeramareddy CT, Steiropoulos P, Stokes MA, Stortecky S, Sufiyan MB, Suliankatchi Abdulkader R, Sulo G, Swope CB, Sykes BL, Szeto MD, Szócska M, Tabarés-Seisdedos R, Tadesse EG, Taherkhani A, Tamiru AT, Tareque MI, Tehrani-Banihashemi A, Temsah MH, Tesfay FH, Tessema GA, Tessema ZT, Thankappan KR, Thapar R, Tolani MA, Tovani-Palone MR, Traini E, Tran BX, Tripathy JP, Tsapparellas G, Tsatsakis A, Tudor Car L, Uddin R, Ullah A, Umeokonkwo CD, Unim B, Unnikrishnan B, Upadhyay E, Usman MS, Vacante M, Vaezi M, Valadan Tahbaz S, Valdez PR, Vasankari TJ, Venketasubramanian N, Verma M, Violante FS, Vlassov V, Vo B, Vu GT, Wado YD, Waheed Y, Wamai RG, Wang Y, Wang Y, Wang YP, Ward P, Werdecker A, Westerman R, Wickramasinghe ND, Wilner LB, Wiysonge CS, Wu AM, Wu C, Xie Y, Yahyazadeh Jabbari SH, Yamagishi K, Yandrapalli S, Yaya S, Yazdi-Feyzabadi V, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yousefi Z, Yousefinezhadi T, Yu C, Yusuf SS, Zaidi SS, Zaman SB, Zamani M, Zamanian M, Zastrozhin MS, Zastrozhina A, Zhang Y, Zhang ZJ, Zhao XJG, Ziapour A, Hay SI, Murray CJL, Wang H, Kassebaum NJ. Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019. Lancet 2021; 398:870-905. [PMID: 34416195 PMCID: PMC8429803 DOI: 10.1016/s0140-6736(21)01207-1] [Citation(s) in RCA: 183] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. METHODS We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. FINDINGS Global U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3-74·0) in 2000 to 37·1 (33·2-41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8-29·5) in 2000 to 17·9 (16·3-19·8) in 2019. In 2019, 136 (67%) of 204 countries had a U5MR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030, 154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9·65 million (95% UI 9·05-10·30) in 2000 and 5·05 million (4·27-6·02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3·76 million [95% UI 3·53-4·02]) in 2000 to 48% (2·42 million; 2·06-2·86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0·80 (95% UI 0·71-0·86) deaths per 1000 livebirths and U5MR to 1·44 (95% UI 1·27-1·58) deaths per 1000 livebirths, and in 2019, there were as many as 1·87 million (95% UI 1·35-2·58; 37% [95% UI 32-43]) of 5·05 million more deaths of children younger than 5 years than the survival potential frontier. INTERPRETATION Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. FUNDING Bill & Melinda Gates Foundation.
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Kendrick PJ, Reitsma MB, Abbasi-Kangevari M, Abdoli A, Abdollahi M, Abedi A, Abhilash ES, Aboyans V, Adebayo OM, Advani SM, Ahinkorah BO, Ahmad S, Ahmadi K, Ahmed H, Aji B, Akalu Y, Akunna CJ, Alahdab F, Al-Aly Z, Alanezi FM, Alanzi TM, Alhabib KF, Ali T, Alif SM, Alipour V, Aljunid SM, Alomari MA, Amin TT, Amini S, Amu H, Ancuceanu R, Anderson JA, Andrei CL, Andrei T, Ansari-Moghaddam A, Antony B, Anvari D, Arabloo J, Arian ND, Arora M, Artanti KD, Asmare WN, Atnafu DD, Ausloos M, Awan AT, Ayano G, Aynalem GL, Azari S, B DB, Badiye AD, Baig AA, Banach M, Banerjee SK, Barker-Collo SL, Bärnighausen TW, Barqawi HJ, Basu S, Bayati M, Bazargan-Hejazi S, Bekuma TT, Bennett DA, Bensenor IM, Benzian H, Benziger CP, Berman AE, Bhagavathula AS, Bhala N, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bibi S, Bijani A, Biondi A, Braithwaite D, Brenner H, Brunoni AR, Burkart K, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Car J, Carreras G, Castaldelli-Maia JM, Cattaruzza MSS, Chang JC, Chaturvedi P, Chen S, Chido-Amajuoyi OG, Chu DT, Chung SC, Ciobanu LG, Costa VM, Couto RAS, Dagnew B, Dai X, Damasceno AAM, Damiani G, Dandona L, Dandona R, Daneshpajouhnejad P, Darega Gela J, Derbew Molla M, Desta AA, Dharmaratne SD, Dhimal M, Eagan AW, Ebrahimi Kalan M, Edvardsson K, Effiong A, El Tantawi M, Elbarazi I, Esmaeilnejad S, Fadhil I, Faraon EJA, Farwati M, Farzadfar F, Fazlzadeh M, Feigin VL, Feldman R, Filip I, Filippidis F, Fischer F, Flor LS, Foigt NA, Folayan MO, Foroutan M, Gad MM, Gallus S, Geberemariyam BS, Gebregiorgis BG, Getacher L, Getachew Obsa A, Ghafourifard M, Ghanei Gheshlagh R, Ghashghaee A, Ghith N, Gil GF, Gill PS, Ginawi IA, Goharinezhad S, Golechha M, Gopalani SV, Gorini G, Grivna M, Guha A, Guimarães RA, Guo Y, Gupta RD, Gupta R, Gupta T, Gupta V, Hafezi-Nejad N, Haider MR, Hamadeh RR, Hankey GJ, Hargono A, Hay SI, Heidari G, Herteliu C, Hezam K, Hird TR, Holla R, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsiao T, Huang J, Ibeneme CU, Ibitoye SE, Ilic IM, Ilic MD, Inbaraj LR, Irvani SSN, Islam JY, Islam RM, Islam SMS, Islami F, Iso H, Itumalla R, Jaafari J, Jain V, Jakovljevic M, Jang SI, Jayaram S, Jeemon P, Jha RP, Jonas JB, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kanchan T, Kandel H, Kapoor N, Karch A, Karimi SE, Kebede KM, Kelkay B, Kennedy RD, Khader YS, Khan EA, Khayamzadeh M, Kim GR, Kimokoti RW, Kivimäki M, Kosen S, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kugbey N, Kumar GA, Kumar N, Kurmi OP, Kusuma D, Lacey B, Landires I, Lasrado S, Lauriola P, Lee DW, Lee YH, Leung J, Li S, Lin H, Liu W, Lugo A, Madhava Kunjathur S, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mamun AA, Manjunatha N, Mansouri B, Mansournia MA, Martini S, Mathur MR, Mathur P, Mazidi M, McKee M, Medina-Solís CE, Mehata S, Mendoza W, Menezes RG, Miazgowski B, Michalek IM, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mirzaei H, Misra S, Mohammad Y, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moradzadeh R, Morrison SD, Mossie TB, Mubarik S, Mullany EC, Murray CJL, Nagaraju SP, Naghavi M, Naik N, Nalini M, Nangia V, Naqvi AA, Narasimha Swamy S, Naveed M, Nazari J, Nduaguba SO, Negoi RI, Neupane Kandel S, Nguyen HLT, Nigatu YT, Nixon MR, Nnaji CA, Noubiap JJ, Nowak C, Nuñez-Samudio V, Ogbo FA, Oguntade AS, Oh IH, Olagunju AT, Owolabi MO, P A M, Pakshir K, Pana A, Panagiotakos D, Panda-Jonas S, Pandey A, Parekh U, Park EC, Park EK, Pashazadeh Kan F, Pathak M, Pawar S, Pestell RG, Pham HQ, Pinheiro M, Pokhrel KN, Pourshams A, Prashant A, Radfar A, Rahimi-Movaghar V, Rahman MHU, Rahman MA, Rahmani AM, Ram P, Rana J, Ranabhat CL, Rathi P, Rawaf DL, Rawaf S, Rawassizadeh R, Renzaho AMN, Rezapour A, Riaz MA, Roever L, Ronfani L, Roshandel G, Roy A, Roy B, Saddik B, Sahebkar A, Salehi S, Salimzadeh H, Samy AM, Sanabria J, Santric-Milicevic MM, Sao Jose BP, Sathian B, Sawhney M, Saya GK, Schwendicke F, Seidu AA, Senthil Kumar N, Sepanlou SG, Shafaat O, Shah SM, Shaikh MA, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shigematsu M, Shiri R, Shishani K, Shivakumar KM, Shivalli S, Shrestha R, Siabani S, Sidemo NB, Sigfusdottir ID, Sigurvinsdottir R, Silva JP, Singh A, Singh JA, Singh V, Sinha DN, Skryabin VY, Skryabina AA, Soroush A, Soyiri IN, Sreeramareddy CT, Stein DJ, Steiropoulos P, Stortecky S, Straif K, Suliankatchi Abdulkader R, Sulo G, Sundström J, Tabuchi T, Tadesse EG, Tamiru AT, Tareke M, Tareque MI, Tarigan IU, Thakur B, Thankappan KR, Thapar R, Tolani MA, Tovani-Palone MR, Tran BX, Tripathy JP, Tsegaye GW, Tymeson HD, Ullah S, Unim B, Updike RL, Uthman OA, Vacante M, Vardavas C, Venketasubramanian N, Verma M, Vidale S, Vo B, Vu GT, Waheed Y, Wang Y, Welding K, Werdecker A, Whisnant JL, Wickramasinghe ND, Wubishet BL, Yamagishi K, Yano Y, Yazdi-Feyzabadi V, Yeshaw Y, Yimmer MZ, Yonemoto N, Yousefi Z, Yu C, Yunusa I, Yusefzadeh H, Zaman MS, Zamani M, Zamanian M, Zastrozhin MS, Zastrozhina A, Zhang J, Zhang ZJ, Zhong C, Zuniga YMH, Gakidou E. Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Public Health 2021; 6:e482-e499. [PMID: 34051920 PMCID: PMC8251505 DOI: 10.1016/s2468-2667(21)00065-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. METHODS We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. FINDINGS In 2019, 273·9 million (95% uncertainty interval 258·5 to 290·9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4·72% (4·46 to 5·01). 228·2 million (213·6 to 244·7; 83·29% [82·15 to 84·42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1·21% [-1·26 to -1·16]), similar progress was not observed for chewing tobacco (0·46% [0·13 to 0·79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0·94% [-1·72 to -0·14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. INTERPRETATION Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. FUNDING Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
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Reitsma MB, Kendrick PJ, Ababneh E, Abbafati C, Abbasi-Kangevari M, Abdoli A, Abedi A, Abhilash ES, Abila DB, Aboyans V, Abu-Rmeileh NME, Adebayo OM, Advani SM, Aghaali M, Ahinkorah BO, Ahmad S, Ahmadi K, Ahmed H, Aji B, Akunna CJ, Al-Aly Z, Alanzi TM, Alhabib KF, Ali L, Alif SM, Alipour V, Aljunid SM, Alla F, Allebeck P, Alvis-Guzman N, Amin TT, Amini S, Amu H, Amul GGH, Ancuceanu R, Anderson JA, Ansari-Moghaddam A, Antonio CAT, Antony B, Anvari D, Arabloo J, Arian ND, Arora M, Asaad M, Ausloos M, Awan AT, Ayano G, Aynalem GL, Azari S, B DB, Badiye AD, Baig AA, Bakhshaei MH, Banach M, Banik PC, Barker-Collo SL, Bärnighausen TW, Barqawi HJ, Basu S, Bayati M, Bazargan-Hejazi S, Behzadifar M, Bekuma TT, Bennett DA, Bensenor IM, Berfield KSS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bibi S, Bijani A, Bintoro BS, Biondi A, Birara S, Braithwaite D, Brenner H, Brunoni AR, Burkart K, Butt ZA, Caetano dos Santos FL, Cámera LA, Car J, Cárdenas R, Carreras G, Carrero JJ, Castaldelli-Maia JM, Cattaruzza MSS, Chang JC, Chen S, Chu DT, Chung SC, Cirillo M, Costa VM, Couto RAS, Dadras O, Dai X, Damasceno AAM, Damiani G, Dandona L, Dandona R, Daneshpajouhnejad P, Darega Gela J, Davletov K, Derbew Molla M, Dessie GA, Desta AA, Dharmaratne SD, Dianatinasab M, Diaz D, Do HT, Douiri A, Duncan BB, Duraes AR, Eagan AW, Ebrahimi Kalan M, Edvardsson K, Elbarazi I, El Tantawi M, Esmaeilnejad S, Fadhil I, Faraon EJA, Farinha CSES, Farwati M, Farzadfar F, Fazlzadeh M, Feigin VL, Feldman R, Fernandez Prendes C, Ferrara P, Filip I, Filippidis F, Fischer F, Flor LS, Foigt NA, Folayan MO, Foroutan M, Gad MM, Gaidhane AM, Gallus S, Geberemariyam BS, Ghafourifard M, Ghajar A, Ghashghaee A, Giampaoli S, Gill PS, Glozah FN, Gnedovskaya EV, Golechha M, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Greaves F, Guha A, Guo Y, Gupta B, Gupta RD, Gupta R, Gupta T, Gupta V, Hafezi-Nejad N, Haider MR, Hamadeh RR, Hankey GJ, Hargono A, Hartono RK, Hassankhani H, Hay SI, Heidari G, Herteliu C, Hezam K, Hird TR, Hole MK, Holla R, Hosseinzadeh M, Hostiuc S, Househ M, Hsiao T, Huang J, Iannucci VC, Ibitoye SE, Idrisov B, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Irvani SSN, Islam JY, Islam RM, Islam SMS, Islami F, Iso H, Itumalla R, Iwagami M, Jaafari J, Jain V, Jakovljevic M, Jang SI, Janjani H, Jayaram S, Jeemon P, Jha RP, Jonas JB, Joo T, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kanchan T, Kandel H, Kapoor N, Karimi SE, Katikireddi SV, Kebede HK, Kelkay B, Kennedy RD, Khoja AT, Khubchandani J, Kim GR, Kim YE, Kimokoti RW, Kivimäki M, Kosen S, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kugbey N, Kumar GA, Kumar N, Kurmi OP, Kusuma D, Lacey B, Lam JO, Landires I, Lasrado S, Lauriola P, Lee DW, Lee YH, Leung J, Li S, Lin H, Linn S, Liu W, Lopez AD, Lopukhov PD, Lorkowski S, Lugo A, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mamun AA, Manjunatha N, Mansouri B, Mansournia MA, Martinez-Raga J, Martini S, Mathur MR, Medina-Solís CE, Mehata S, Mendoza W, Menezes RG, Meretoja A, Meretoja TJ, Miazgowski B, Michalek IM, Miller TR, Mirrakhimov EM, Mirzaei H, Mirzaei-Alavijeh M, Misra S, Moghadaszadeh M, Mohammad Y, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Monasta L, Moni MA, Moradi G, Moradi-Lakeh M, Moradzadeh R, Morrison SD, Mossie TB, Mubarik S, Mullany EC, Murray CJL, Naghavi M, Naghshtabrizi B, Nair S, Nalini M, Nangia V, Naqvi AA, Narasimha Swamy S, Naveed M, Nayak S, Nayak VC, Nazari J, Nduaguba SO, Neupane Kandel S, Nguyen CT, Nguyen HLT, Nguyen SH, Nguyen TH, Nixon MR, Nnaji CA, Norrving B, Noubiap JJ, Nowak C, Ogbo FA, Oguntade AS, Oh IH, Olagunju AT, Oren E, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Pakhale S, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Pandey A, Parekh U, Park EC, Park EK, Pashazadeh Kan F, Patton GC, Pawar S, Pestell RG, Pinheiro M, Piradov MA, Pirouzpanah S, Pokhrel KN, Polibin RV, Prashant A, Pribadi DRA, Radfar A, Rahimi-Movaghar V, Rahman A, Rahman MHU, Rahman MA, Rahmani AM, Rajai N, Ram P, Ranabhat CL, Rathi P, Rawal L, Renzaho AMN, Reynales-Shigematsu LM, Rezapour A, Riahi SM, Riaz MA, Roever L, Ronfani L, Roshandel G, Roy A, Roy B, Sacco S, Saddik B, Sahebkar A, Salehi S, Salimzadeh H, Samaei M, Samy AM, Santos IS, Santric-Milicevic MM, Sarrafzadegan N, Sathian B, Sawhney M, Saylan M, Schaub MP, Schmidt MI, Schneider IJC, Schutte AE, Schwendicke F, Seidu AA, Senthil Kumar N, Sepanlou SG, Seylani A, Shafaat O, Shah SM, Shaikh MA, Shalash AS, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shigematsu M, Shiri R, Shishani K, Shivakumar KM, Shivalli S, Shrestha R, Siabani S, Sidemo NB, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Silva JP, Singh A, Singh JA, Singh V, Sinha DN, Sitas F, Skryabin VY, Skryabina AA, Soboka M, Soriano JB, Soroush A, Soshnikov S, Soyiri IN, Spurlock EE, Sreeramareddy CT, Stein DJ, Steiropoulos P, Stortecky S, Straif K, Suliankatchi Abdulkader R, Sulo G, Sundström J, Tabuchi T, Tadakamadla SK, Taddele BW, Tadesse EG, Tamiru AT, Tareke M, Tareque MI, Tarigan IU, Temsah MH, Thankappan KR, Thapar R, Tichopad A, Tolani MA, Topouzis F, Tovani-Palone MR, Tran BX, Tripathy JP, Tsegaye GW, Tsilimparis N, Tymeson HD, Ullah A, Ullah S, Unim B, Updike RL, Vacante M, Valdez PR, Vardavas C, Varona Pérez P, Vasankari TJ, Venketasubramanian N, Verma M, Vetrova MV, Vo B, Vu GT, Waheed Y, Wang Y, Welding K, Werdecker A, Whisnant JL, Wickramasinghe ND, Yamagishi K, Yandrapalli S, Yatsuya H, Yazdi-Feyzabadi V, Yeshaw Y, Yimmer MZ, Yonemoto N, Yu C, Yunusa I, Yusefzadeh H, Zahirian Moghadam T, Zaman MS, Zamanian M, Zandian H, Zar HJ, Zastrozhin MS, Zastrozhina A, Zavala-Arciniega L, Zhang J, Zhang ZJ, Zhong C, Zuniga YMH, Gakidou E. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet 2021; 397:2337-2360. [PMID: 34051883 PMCID: PMC8223261 DOI: 10.1016/s0140-6736(21)01169-7] [Citation(s) in RCA: 496] [Impact Index Per Article: 165.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/15/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. METHODS We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. FINDINGS Globally in 2019, 1·14 billion (95% uncertainty interval 1·13-1·16) individuals were current smokers, who consumed 7·41 trillion (7·11-7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5-28·5] reduction) and females (37·7% [35·4-39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98-1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16-8·20) deaths and 200 million (185-214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3-21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. INTERPRETATION In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. FUNDING Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
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Feigin VL, Vos T, Alahdab F, Amit AML, Bärnighausen TW, Beghi E, Beheshti M, Chavan PP, Criqui MH, Desai R, Dhamminda Dharmaratne S, Dorsey ER, Wilder Eagan A, Elgendy IY, Filip I, Giampaoli S, Giussani G, Hafezi-Nejad N, Hole MK, Ikeda T, Owens Johnson C, Kalani R, Khatab K, Khubchandani J, Kim D, Koroshetz WJ, Krishnamoorthy V, Krishnamurthi RV, Liu X, Lo WD, Logroscino G, Mensah GA, Miller TR, Mohammed S, Mokdad AH, Moradi-Lakeh M, Morrison SD, Shivamurthy VKN, Naghavi M, Nichols E, Norrving B, Odell CM, Pupillo E, Radfar A, Roth GA, Shafieesabet A, Sheikh A, Sheikhbahaei S, Shin JI, Singh JA, Steiner TJ, Stovner LJ, Wallin MT, Weiss J, Wu C, Zunt JR, Adelson JD, Murray CJL. Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study. JAMA Neurol 2021; 78:165-176. [PMID: 33136137 PMCID: PMC7607495 DOI: 10.1001/jamaneurol.2020.4152] [Citation(s) in RCA: 229] [Impact Index Per Article: 76.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Question What is the current burden of neurological disorders in the US by states, and what are the temporal trends (from 1990 to 2017)? Findings Systematic analysis of the Global Burden of Disease study shows that, in 2017, the 3 most burdensome neurological disorders in the US were stroke, Alzheimer disease and other dementias, and migraine. The burden of individual neurological disorders varied moderately to widely by states (a 1.2-fold to 7.5-fold difference), and the absolute numbers of incident, prevalent, and fatal cases and disability-adjusted life-years of neurological disorders (except for traumatic brain injury incidence; spinal cord injury prevalence; meningitis prevalence, deaths, and disability-adjusted life-years; and encephalitis disability-adjusted life-years) across all US states increased from 1990 to 2017. Meaning A large and increasing number of people have various neurological disorders in the US, with significant variation in the burden of and trends in neurological disorders across the US states, and the reasons for these geographic variations need to be explored further. Importance Accurate and up-to-date estimates on incidence, prevalence, mortality, and disability-adjusted life-years (burden) of neurological disorders are the backbone of evidence-based health care planning and resource allocation for these disorders. It appears that no such estimates have been reported at the state level for the US. Objective To present burden estimates of major neurological disorders in the US states by age and sex from 1990 to 2017. Design, Setting, and Participants This is a systematic analysis of the Global Burden of Disease (GBD) 2017 study. Data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of major neurological disorders were derived from the GBD 2017 study of the 48 contiguous US states, Alaska, and Hawaii. Fourteen major neurological disorders were analyzed: stroke, Alzheimer disease and other dementias, Parkinson disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, traumatic brain injury, spinal cord injuries, brain and other nervous system cancers, meningitis, encephalitis, and tetanus. Exposures Any of the 14 listed neurological diseases. Main Outcome and Measure Absolute numbers in detail by age and sex and age-standardized rates (with 95% uncertainty intervals) were calculated. Results The 3 most burdensome neurological disorders in the US in terms of absolute number of DALYs were stroke (3.58 [95% uncertainty interval [UI], 3.25-3.92] million DALYs), Alzheimer disease and other dementias (2.55 [95% UI, 2.43-2.68] million DALYs), and migraine (2.40 [95% UI, 1.53-3.44] million DALYs). The burden of almost all neurological disorders (in terms of absolute number of incident, prevalent, and fatal cases, as well as DALYs) increased from 1990 to 2017, largely because of the aging of the population. Exceptions for this trend included traumatic brain injury incidence (−29.1% [95% UI, −32.4% to −25.8%]); spinal cord injury prevalence (−38.5% [95% UI, −43.1% to −34.0%]); meningitis prevalence (−44.8% [95% UI, −47.3% to −42.3%]), deaths (−64.4% [95% UI, −67.7% to −50.3%]), and DALYs (−66.9% [95% UI, −70.1% to −55.9%]); and encephalitis DALYs (−25.8% [95% UI, −30.7% to −5.8%]). The different metrics of age-standardized rates varied between the US states from a 1.2-fold difference for tension-type headache to 7.5-fold for tetanus; southeastern states and Arkansas had a relatively higher burden for stroke, while northern states had a relatively higher burden of multiple sclerosis and eastern states had higher rates of Parkinson disease, idiopathic epilepsy, migraine and tension-type headache, and meningitis, encephalitis, and tetanus. Conclusions and Relevance There is a large and increasing burden of noncommunicable neurological disorders in the US, with up to a 5-fold variation in the burden of and trends in particular neurological disorders across the US states. The information reported in this article can be used by health care professionals and policy makers at the national and state levels to advance their health care planning and resource allocation to prevent and reduce the burden of neurological disorders.
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Affiliation(s)
| | - Valery L Feigin
- Faculty of Health and Environmental Sciences, Auckland University of Technology School of Public Health and Psychosocial Studies, Auckland, New Zealand.,Institute for Health Metrics and Evaluation, University of Washington, Seattle.,Research Center of Neurology, Moscow, Russia
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle.,Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle
| | - Fares Alahdab
- Mayo Evidence-Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota
| | - Arianna Maever L Amit
- Department of Epidemiology and Biostatistics, University of the Philippines Manila, Manila, Philippines.,Johns Hopkins University School of Public Health, Baltimore, Maryland
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Harvard University T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ettore Beghi
- Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Mahya Beheshti
- Department of Physical Medicine and Rehabilitation, New York University, New York
| | - Prachi P Chavan
- Department of Epidemiology and Environmental Health, the University of Buffalo, Buffalo, New York
| | - Michael H Criqui
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla
| | - Rupak Desai
- Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle.,Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle.,Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Arielle Wilder Eagan
- Department of Global Health and Social Medicine, Harvard University, Boston, Massachusetts.,Department of Social Services, Tufts Medical Center, Boston, Massachusetts
| | - Islam Y Elgendy
- Division of Cardiology, Massachusetts General Hospital, Boston.,Division of Cardiology, Harvard University, Boston, Massachusetts
| | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, California.,A.T. Still University School of Osteopathic Medicine in Arizona, Arizona School of Health Sciences, Mesa, Arizona
| | - Simona Giampaoli
- Department of Cardiovascular Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy
| | - Giorgia Giussani
- Laboratory of Neurological Disorders, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Nima Hafezi-Nejad
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland.,Tehran University of Medical Sciences School of Medicine, Tehran, Iran
| | - Michael K Hole
- Department of Pediatrics, The University of Texas, Austin, Austin
| | - Takayoshi Ikeda
- Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand
| | | | - Rizwan Kalani
- Department of Neurology, University of Washington, Seattle
| | - Khaled Khatab
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, United Kingdom.,Ohio University College of Arts and Sciences, Zanesville
| | - Jagdish Khubchandani
- Department of Nutrition and Health Science, Ball State University, Muncie, Indiana
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Walter J Koroshetz
- National Institutes of Neurological Disorders and Stroke, National Institute of Health, Bethesda, Maryland
| | - Vijay Krishnamoorthy
- Department of Anesthesiology, Duke University, Durham, North Carolina.,Department of Anesthesiology, University of Washington, Seattle
| | - Rita V Krishnamurthi
- Faculty of Health and Environmental Sciences, Auckland University of Technology School of Public Health and Psychosocial Studies, Auckland, New Zealand
| | - Xuefeng Liu
- Department of Systems, Populations, and Leadership, University of Michigan, Ann Arbor
| | - Warren David Lo
- Department of Pediatrics, Ohio State University, Columbus.,Department of Pediatric Neurology, Nationwide Children's Hospital, Columbus, Ohio
| | - Giancarlo Logroscino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, Fondazione Cardinale Giovanni Panico Hospital, Tricase, Italy
| | - George A Mensah
- Center for Translation Research and Implementation Science, National Institutes of Health, Bethesda, Maryland.,Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Ted R Miller
- Pacific Institute for Research & Evaluation, Calverton, Maryland.,School of Public Health, Curtin University, Perth, Australia
| | - Salahuddin Mohammed
- Department of Biomolecular Sciences, University of Mississippi, Oxford.,Department of Pharmacy, Mizan-Tepi University, Mizan, Ethiopia
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle.,Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle.,Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle
| | - Emma Nichols
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Bo Norrving
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Christopher M Odell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Elisabetta Pupillo
- Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Amir Radfar
- University of Central Florida College of Medicine, Orlando
| | - Gregory A Roth
- Institute for Health Metrics and Evaluation, University of Washington, Seattle.,Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle.,Division of Cardiology, University of Washington, Seattle
| | - Azadeh Shafieesabet
- Department of Cardiology, Charité Medical University Berlin, Berlin, Germany.,Center for Stroke Research Berlin, Berlin, Germany
| | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, United Kingdom.,Division of General Internal Medicine, Harvard University, Boston, Massachusetts
| | - Sara Sheikhbahaei
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
| | - Jae Il Shin
- Yonsei University College of Medicine, Seoul, South Korea
| | - Jasvinder A Singh
- The University of Alabama at Birmingham School of Medicine, Birmingham.,Medicine Service, US Department of Veterans Affairs, Birmingham, Alabama
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Lars Jacob Stovner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, Trondheim, Norway
| | - Mitchell Taylor Wallin
- Department of Neurology, George Washington University, Washington, DC.,University of Maryland School of Medicine, Baltimore
| | - Jordan Weiss
- Department of Demography, University of California, Berkeley, Berkeley
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, China.,Duke Global Health Institute, Duke University, Durham, North Carolina
| | | | - Jaimie D Adelson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle.,Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle
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Murray CJL, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, Abd-Allah F, Abdelalim A, Abdollahi M, Abdollahpour I, Abegaz KH, Abolhassani H, Aboyans V, Abreu LG, Abrigo MRM, Abualhasan A, Abu-Raddad LJ, Abushouk AI, Adabi M, Adekanmbi V, Adeoye AM, Adetokunboh OO, Adham D, Advani SM, Agarwal G, Aghamir SMK, Agrawal A, Ahmad T, Ahmadi K, Ahmadi M, Ahmadieh H, Ahmed MB, Akalu TY, Akinyemi RO, Akinyemiju T, Akombi B, Akunna CJ, Alahdab F, Al-Aly Z, Alam K, Alam S, Alam T, Alanezi FM, Alanzi TM, Alemu BW, Alhabib KF, Ali M, Ali S, Alicandro G, Alinia C, Alipour V, Alizade H, Aljunid SM, Alla F, Allebeck P, Almasi-Hashiani A, Al-Mekhlafi HM, Alonso J, Altirkawi KA, Amini-Rarani M, Amiri F, Amugsi DA, Ancuceanu R, Anderlini D, Anderson JA, Andrei CL, Andrei T, Angus C, Anjomshoa M, Ansari F, Ansari-Moghaddam A, Antonazzo IC, Antonio CAT, Antony CM, Antriyandarti E, Anvari D, Anwer R, Appiah SCY, Arabloo J, Arab-Zozani M, Ariani F, Armoon B, Ärnlöv J, Arzani A, Asadi-Aliabadi M, Asadi-Pooya AA, Ashbaugh C, Assmus M, Atafar Z, Atnafu DD, Atout MMW, Ausloos F, Ausloos M, Ayala Quintanilla BP, Ayano G, Ayanore MA, Azari S, Azarian G, Azene ZN, Badawi A, Badiye AD, Bahrami MA, Bakhshaei MH, Bakhtiari A, Bakkannavar SM, Baldasseroni A, Ball K, Ballew SH, Balzi D, Banach M, Banerjee SK, Bante AB, Baraki AG, Barker-Collo SL, Bärnighausen TW, Barrero LH, Barthelemy CM, Barua L, Basu S, Baune BT, Bayati M, Becker JS, Bedi N, Beghi E, Béjot Y, Bell ML, Bennitt FB, Bensenor IM, Berhe K, Berman AE, Bhagavathula AS, Bhageerathy R, Bhala N, Bhandari D, Bhattacharyya K, Bhutta ZA, Bijani A, Bikbov B, Bin Sayeed MS, Biondi A, Birihane BM, Bisignano C, Biswas RK, Bitew H, Bohlouli S, Bohluli M, Boon-Dooley AS, Borges G, Borzì AM, Borzouei S, Bosetti C, Boufous S, Braithwaite D, Breitborde NJK, Breitner S, Brenner H, Briant PS, Briko AN, Briko NI, Britton GB, Bryazka D, Bumgarner BR, Burkart K, Burnett RT, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Cahill LE, Cámera LLAA, Campos-Nonato IR, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Castro F, Causey K, Cederroth CR, Cercy KM, Cerin E, Chandan JS, Chang KL, Charlson FJ, Chattu VK, Chaturvedi S, Cherbuin N, Chimed-Ochir O, Cho DY, Choi JYJ, Christensen H, Chu DT, Chung MT, Chung SC, Cicuttini FM, Ciobanu LG, Cirillo M, Classen TKD, Cohen AJ, Compton K, Cooper OR, Costa VM, Cousin E, Cowden RG, Cross DH, Cruz JA, Dahlawi SMA, Damasceno AAM, Damiani G, Dandona L, Dandona R, Dangel WJ, Danielsson AK, Dargan PI, Darwesh AM, Daryani A, Das JK, Das Gupta R, das Neves J, Dávila-Cervantes CA, Davitoiu DV, De Leo D, Degenhardt L, DeLang M, Dellavalle RP, Demeke FM, Demoz GT, Demsie DG, Denova-Gutiérrez E, Dervenis N, Dhungana GP, Dianatinasab M, Dias da Silva D, Diaz D, Dibaji Forooshani ZS, Djalalinia S, Do HT, Dokova K, Dorostkar F, Doshmangir L, Driscoll TR, Duncan BB, Duraes AR, Eagan AW, Edvardsson D, El Nahas N, El Sayed I, El Tantawi M, Elbarazi I, Elgendy IY, El-Jaafary SI, Elyazar IRF, Emmons-Bell S, Erskine HE, Eskandarieh S, Esmaeilnejad S, Esteghamati A, Estep K, Etemadi A, Etisso AE, Fanzo J, Farahmand M, Fareed M, Faridnia R, Farioli A, Faro A, Faruque M, Farzadfar F, Fattahi N, Fazlzadeh M, Feigin VL, Feldman R, Fereshtehnejad SM, Fernandes E, Ferrara G, Ferrari AJ, Ferreira ML, Filip I, Fischer F, Fisher JL, Flor LS, Foigt NA, Folayan MO, Fomenkov AA, Force LM, Foroutan M, Franklin RC, Freitas M, Fu W, Fukumoto T, Furtado JM, Gad MM, Gakidou E, Gallus S, Garcia-Basteiro AL, Gardner WM, Geberemariyam BS, Gebreslassie AAAA, Geremew A, Gershberg Hayoon A, Gething PW, Ghadimi M, Ghadiri K, Ghaffarifar F, Ghafourifard M, Ghamari F, Ghashghaee A, Ghiasvand H, Ghith N, Gholamian A, Ghosh R, Gill PS, Ginindza TGG, Giussani G, Gnedovskaya EV, Goharinezhad S, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Greaves F, Grivna M, Grosso G, Gubari MIM, Gugnani HC, Guimarães RA, Guled RA, Guo G, Guo Y, Gupta R, Gupta T, Haddock B, Hafezi-Nejad N, Hafiz A, Haj-Mirzaian A, Haj-Mirzaian A, Hall BJ, Halvaei I, Hamadeh RR, Hamidi S, Hammer MS, Hankey GJ, Haririan H, Haro JM, Hasaballah AI, Hasan MM, Hasanpoor E, Hashi A, Hassanipour S, Hassankhani H, Havmoeller RJ, Hay SI, Hayat K, Heidari G, Heidari-Soureshjani R, Henrikson HJ, Herbert ME, Herteliu C, Heydarpour F, Hird TR, Hoek HW, Holla R, Hoogar P, Hosgood HD, Hossain N, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Hsieh VCR, Hu G, Hu K, Huda TM, Humayun A, Huynh CK, Hwang BF, Iannucci VC, Ibitoye SE, Ikeda N, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Ippolito H, Iqbal U, Irvani SSN, Irvine CMS, Islam MM, Islam SMS, Iso H, Ivers RQ, Iwu CCD, Iwu CJ, Iyamu IO, Jaafari J, Jacobsen KH, Jafari H, Jafarinia M, Jahani MA, Jakovljevic M, Jalilian F, James SL, Janjani H, Javaheri T, Javidnia J, Jeemon P, Jenabi E, Jha RP, Jha V, Ji JS, Johansson L, John O, John-Akinola YO, Johnson CO, Jonas JB, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabir Z, Kalani H, Kalani R, Kalankesh LR, Kalhor R, Kanchan T, Kapoor N, Karami Matin B, Karch A, Karim MA, Kassa GM, Katikireddi SV, Kayode GA, Kazemi Karyani A, Keiyoro PN, Keller C, Kemmer L, Kendrick PJ, Khalid N, Khammarnia M, Khan EA, Khan M, Khatab K, Khater MM, Khatib MN, Khayamzadeh M, Khazaei S, Kieling C, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kivimäki M, Knibbs LD, Knudsen AKS, Kocarnik JM, Kochhar S, Kopec JA, Korshunov VA, Koul PA, Koyanagi A, Kraemer MUG, Krishan K, Krohn KJ, Kromhout H, Kuate Defo B, Kumar GA, Kumar V, Kurmi OP, Kusuma D, La Vecchia C, Lacey B, Lal DK, Lalloo R, Lallukka T, Lami FH, Landires I, Lang JJ, Langan SM, Larsson AO, Lasrado S, Lauriola P, Lazarus JV, Lee PH, Lee SWH, LeGrand KE, Leigh J, Leonardi M, Lescinsky H, Leung J, Levi M, Li S, Lim LL, Linn S, Liu S, Liu S, Liu Y, Lo J, Lopez AD, Lopez JCF, Lopukhov PD, Lorkowski S, Lotufo PA, Lu A, Lugo A, Maddison ER, Mahasha PW, Mahdavi MM, Mahmoudi M, Majeed A, Maleki A, Maleki S, Malekzadeh R, Malta DC, Mamun AA, Manda AL, Manguerra H, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Mantilla Herrera AM, Maravilla JC, Marks A, Martin RV, Martini S, Martins-Melo FR, Masaka A, Masoumi SZ, Mathur MR, Matsushita K, Maulik PK, McAlinden C, McGrath JJ, McKee M, Mehndiratta MM, Mehri F, Mehta KM, Memish ZA, Mendoza W, Menezes RG, Mengesha EW, Mereke A, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mills EJ, Mini GK, Miri M, Mirica A, Mirrakhimov EM, Mirzaei H, Mirzaei M, Mirzaei R, Mirzaei-Alavijeh M, Misganaw AT, Mithra P, Moazen B, Mohammad DK, Mohammad Y, Mohammad Gholi Mezerji N, Mohammadian-Hafshejani A, Mohammadifard N, Mohammadpourhodki R, Mohammed AS, Mohammed H, Mohammed JA, Mohammed S, Mokdad AH, Molokhia M, Monasta L, Mooney MD, Moradi G, Moradi M, Moradi-Lakeh M, Moradzadeh R, Moraga P, Morawska L, Morgado-da-Costa J, Morrison SD, Mosapour A, Mosser JF, Mouodi S, Mousavi SM, Mousavi Khaneghah A, Mueller UO, Mukhopadhyay S, Mullany EC, Musa KI, Muthupandian S, Nabhan AF, Naderi M, Nagarajan AJ, Nagel G, Naghavi M, Naghshtabrizi B, Naimzada MD, Najafi F, Nangia V, Nansseu JR, Naserbakht M, Nayak VC, Negoi I, Ngunjiri JW, Nguyen CT, Nguyen HLT, Nguyen M, Nigatu YT, Nikbakhsh R, Nixon MR, Nnaji CA, Nomura S, Norrving B, Noubiap JJ, Nowak C, Nunez-Samudio V, Oţoiu A, Oancea B, Odell CM, Ogbo FA, Oh IH, Okunga EW, Oladnabi M, Olagunju AT, Olusanya BO, Olusanya JO, Omer MO, Ong KL, Onwujekwe OE, Orpana HM, Ortiz A, Osarenotor O, Osei FB, Ostroff SM, Otstavnov N, Otstavnov SS, Øverland S, Owolabi MO, P A M, Padubidri JR, Palladino R, Panda-Jonas S, Pandey A, Parry CDH, Pasovic M, Pasupula DK, Patel SK, Pathak M, Patten SB, Patton GC, Pazoki Toroudi H, Peden AE, Pennini A, Pepito VCF, Peprah EK, Pereira DM, Pesudovs K, Pham HQ, Phillips MR, Piccinelli C, Pilz TM, Piradov MA, Pirsaheb M, Plass D, Polinder S, Polkinghorne KR, Pond CD, Postma MJ, Pourjafar H, Pourmalek F, Poznańska A, Prada SI, Prakash V, Pribadi DRA, Pupillo E, Quazi Syed Z, Rabiee M, Rabiee N, Radfar A, Rafiee A, Raggi A, Rahman MA, Rajabpour-Sanati A, Rajati F, Rakovac I, Ram P, Ramezanzadeh K, Ranabhat CL, Rao PC, Rao SJ, Rashedi V, Rathi P, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Rawat R, Razo C, Redford SB, Reiner RC, Reitsma MB, Remuzzi G, Renjith V, Renzaho AMN, Resnikoff S, Rezaei N, Rezaei N, Rezapour A, Rhinehart PA, Riahi SM, Ribeiro DC, Ribeiro D, Rickard J, Rivera JA, Roberts NLS, Rodríguez-Ramírez S, Roever L, Ronfani L, Room R, Roshandel G, Roth GA, Rothenbacher D, Rubagotti E, Rwegerera GM, Sabour S, Sachdev PS, Saddik B, Sadeghi E, Sadeghi M, Saeedi R, Saeedi Moghaddam S, Safari Y, Safi S, Safiri S, Sagar R, Sahebkar A, Sajadi SM, Salam N, Salamati P, Salem H, Salem MRR, Salimzadeh H, Salman OM, Salomon JA, Samad Z, Samadi Kafil H, Sambala EZ, Samy AM, Sanabria J, Sánchez-Pimienta TG, Santomauro DF, Santos IS, Santos JV, Santric-Milicevic MM, Saraswathy SYI, Sarmiento-Suárez R, Sarrafzadegan N, Sartorius B, Sarveazad A, Sathian B, Sathish T, Sattin D, Saxena S, Schaeffer LE, Schiavolin S, Schlaich MP, Schmidt MI, Schutte AE, Schwebel DC, Schwendicke F, Senbeta AM, Senthilkumaran S, Sepanlou SG, Serdar B, Serre ML, Shadid J, Shafaat O, Shahabi S, Shaheen AA, Shaikh MA, Shalash AS, Shams-Beyranvand M, Shamsizadeh M, Sharafi K, Sheikh A, Sheikhtaheri A, Shibuya K, Shield KD, Shigematsu M, Shin JI, Shin MJ, Shiri R, Shirkoohi R, Shuval K, Siabani S, Sierpinski R, Sigfusdottir ID, Sigurvinsdottir R, Silva JP, Simpson KE, Singh JA, Singh P, Skiadaresi E, Skou ST, Skryabin VY, Smith EUR, Soheili A, Soltani S, Soofi M, Sorensen RJD, Soriano JB, Sorrie MB, Soshnikov S, Soyiri IN, Spencer CN, Spotin A, Sreeramareddy CT, Srinivasan V, Stanaway JD, Stein C, Stein DJ, Steiner C, Stockfelt L, Stokes MA, Straif K, Stubbs JL, Sufiyan MB, Suleria HAR, Suliankatchi Abdulkader R, Sulo G, Sultan I, Szumowski Ł, Tabarés-Seisdedos R, Tabb KM, Tabuchi T, Taherkhani A, Tajdini M, Takahashi K, Takala JS, Tamiru AT, Taveira N, Tehrani-Banihashemi A, Temsah MH, Tesema GA, Tessema ZT, Thurston GD, Titova MV, Tohidinik HR, Tonelli M, Topor-Madry R, Topouzis F, Torre AE, Touvier M, Tovani-Palone MRR, Tran BX, Travillian R, Tsatsakis A, Tudor Car L, Tyrovolas S, Uddin R, Umeokonkwo CD, Unnikrishnan B, Upadhyay E, Vacante M, Valdez PR, van Donkelaar A, Vasankari TJ, Vasseghian Y, Veisani Y, Venketasubramanian N, Violante FS, Vlassov V, Vollset SE, Vos T, Vukovic R, Waheed Y, Wallin MT, Wang Y, Wang YP, Watson A, Wei J, Wei MYW, Weintraub RG, Weiss J, Werdecker A, West JJ, Westerman R, Whisnant JL, Whiteford HA, Wiens KE, Wolfe CDA, Wozniak SS, Wu AM, Wu J, Wulf Hanson S, Xu G, Xu R, Yadgir S, Yahyazadeh Jabbari SH, Yamagishi K, Yaminfirooz M, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yeheyis TY, Yilgwan CS, Yilma MT, Yip P, Yonemoto N, Younis MZ, Younker TP, Yousefi B, Yousefi Z, Yousefinezhadi T, Yousuf AY, Yu C, Yusefzadeh H, Zahirian Moghadam T, Zamani M, Zamanian M, Zandian H, Zastrozhin MS, Zhang Y, Zhang ZJ, Zhao JT, Zhao XJG, Zhao Y, Zhou M, Ziapour A, Zimsen SRM, Brauer M, Afshin A, Lim SS. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1223-1249. [PMID: 33069327 PMCID: PMC7566194 DOI: 10.1016/s0140-6736(20)30752-2] [Citation(s) in RCA: 3324] [Impact Index Per Article: 831.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. METHODS GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. FINDINGS The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51-12·1) deaths (19·2% [16·9-21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12-9·31) deaths (15·4% [14·6-16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11·6% [10·3-13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. INTERPRETATION Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. FUNDING Bill & Melinda Gates Foundation.
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James SL, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Liu Z, Roberts NLS, Sylte DO, Bertolacci GJ, Cunningham M, Henry NJ, LeGrand KE, Abdelalim A, Abdollahpour I, Abdulkader RS, Abedi A, Abegaz KH, Abosetugn AE, Abushouk AI, Adebayo OM, Adsuar JC, Advani SM, Agudelo-Botero M, Ahmad T, Ahmed MB, Ahmed R, Eddine Aichour MT, Alahdab F, Alanezi FM, Alema NM, Alemu BW, Alghnam SA, Ali BA, Ali S, Alinia C, Alipour V, Aljunid SM, Almasi-Hashiani A, Almasri NA, Altirkawi K, Abdeldayem Amer YS, Andrei CL, Ansari-Moghaddam A, T Antonio CA, Anvari D, Yaw Appiah SC, Arabloo J, Arab-Zozani M, Arefi Z, Aremu O, Ariani F, Arora A, Asaad M, Ayala Quintanilla BP, Ayano G, Ayanore MA, Azarian G, Badawi A, Badiye AD, Baig AA, Bairwa M, Bakhtiari A, Balachandran A, Banach M, Banerjee SK, Banik PC, Banstola A, Barker-Collo SL, Bärnighausen TW, Barzegar A, Bayati M, Bazargan-Hejazi S, Bedi N, Behzadifar M, Belete H, Bennett DA, Bensenor IM, Berhe K, Bhagavathula AS, Bhardwaj P, Bhat AG, Bhattacharyya K, 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T, Wolde HF, Woldeyes DH, Wondmeneh TG, Wondmieneh AB, Wu AM, Wyper GMA, Yadav R, Yadollahpour A, Yano Y, Yaya S, Yazdi-Feyzabadi V, Ye P, Yip P, Yisma E, Yonemoto N, Yoon SJ, Youm Y, Younis MZ, Yousefi Z, Yu C, Yu Y, Moghadam TZ, Zaidi Z, Zaman SB, Zamani M, Zandian H, Zarei F, Zhang ZJ, Zhang Y, Ziapour A, Zodpey S, Dandona R, Dharmaratne SD, Hay SI, Mokdad AH, Pigott DM, Reiner RC, Vos T. Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study. Inj Prev 2020; 26:i125-i153. [PMID: 32839249 PMCID: PMC7571362 DOI: 10.1136/injuryprev-2019-043531] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/29/2019] [Accepted: 12/06/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. METHODS In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. RESULTS GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. CONCLUSIONS GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
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Affiliation(s)
- Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Gregory J Bertolacci
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Matthew Cunningham
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nathaniel J Henry
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kate E LeGrand
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Ibrahim Abdollahpour
- Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Aidin Abedi
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA
| | - Kedir Hussein Abegaz
- Biostatistics and Health Informatics, Madda Walabu University, Bale Robe, Ethiopia
- Radiotherapy Center, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | | | - Jose C Adsuar
- Sport Science Department, University of Extremadura, Badajoz, Spain
| | - Shailesh M Advani
- Social Behavioral Research Branch, National Institute of Health, Bethesda, MD, USA
- Cancer Prevention and Control, Georgetown University, Washington, DC, USA
| | - Marcela Agudelo-Botero
- School of Medicine, Center for Politics, Population and Health Research, National Autonomous University of Mexico, Mexico City, Mexico
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, Southeast University Nanjing, Nanjing, China
- Microbiology Department, Hazara University, Mansehra, Pakistan
| | | | - Rushdia Ahmed
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA
| | - Fahad Mashhour Alanezi
- Department of Computer Sciences, Imam Abdulrehman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Biresaw Wassihun Alemu
- Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- Midwifery Department, Arba Minch University, Injbara, Ethiopia
| | - Suliman A Alghnam
- Department of Population Health Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | - Saqib Ali
- Department of Information Systems, College of Economics and Political Science, Sultan Qaboos University, Muscat, Oman
| | - Cyrus Alinia
- Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | - Nihad A Almasri
- Physiotherapy Department, The University of Jordan, Amman, Jordan
| | | | - Yasser Sami Abdeldayem Amer
- Clinical Practice Guidelines Unit, King Saud University, Riyadh, Saudi Arabia
- Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt
| | | | | | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Davood Anvari
- Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Microbiology and Immunology, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for International Health, Ludwig Maximilians University, Munich, Germany
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Zohreh Arefi
- Department of Health Promotion and Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Filippo Ariani
- Regional Centre for the Analysis of Data on Occupational and Work-related Injuries and Diseases, Local Health Unit Tuscany Centre, Florence, Italy
| | - Amit Arora
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
- Oral Health Services, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Malke Asaad
- Plastic Surgery Department, University of Texas, Houston, TX, USA
| | - Beatriz Paulina Ayala Quintanilla
- The Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, Peru
| | - Getinet Ayano
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Martin Amogre Ayanore
- Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana
| | - Ghasem Azarian
- Department of Environmental Health Engineering, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ashish D Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Atif Amin Baig
- Biochemistry Unit, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
- School of Health Sciences, Univeristi Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Mohan Bairwa
- Institute of Health Management Research, Indian Institute of Health Management Research University, Jaipur, India
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Ahad Bakhtiari
- Health Policy and Management Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Arun Balachandran
- Department of Demography, University of Groningen, Groningen, Netherlands
- Population Research Centre, Institute for Social and Economic Change, Bengaluru, India
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | | | - Palash Chandra Banik
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Amrit Banstola
- Department of Research, Public Health Perspective Nepal, Pokhara-Lekhnath Metropolitan City, Nepal
| | | | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Akbar Barzegar
- Occupational Health Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Neeraj Bedi
- Department of Community Medicine, Gandhi Medical College Bhopal, Bhopal, India
- Jazan University, Jazan, Saudi Arabia
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Habte Belete
- Psychiatry Department, Bahir Dar University, Bhair Dar, Ethiopia
| | - Derrick A Bennett
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Isabela M Bensenor
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
| | - Kidanemaryam Berhe
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Akshaya Srikanth Bhagavathula
- Department of Internal Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
- Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
| | - Pankaj Bhardwaj
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Anusha Ganapati Bhat
- Internal Medicine Department, University of Massachusetts Medical School, Springfield, MA, USA
| | - Krittika Bhattacharyya
- Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
- Department of Statistics, University of Calcutta, Kolkata, India
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, University of Toronto, Toronto, Ontario, Canada
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sadia Bibi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Archith Boloor
- Department of Internal Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Guilherme Borges
- Department of Epidemiology and Psychosocial Reseach, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Rohan Borschmann
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Antonio Maria Borzì
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research Department, University of New South Wales, Sydney, New South Wales, Australia
| | - Dejana Braithwaite
- Division of Hematology and Oncology, Georgetown University, Washington DC, USA
| | - Nikolay Ivanovich Briko
- Department of Epidemiology and Evidence Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Traolach Brugha
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Josip Car
- Centre for Population Health Sciences, Nanyang Technological University, Singapore, Singapore
- Global eHealth Unit, Imperial College London, London, UK
| | - Rosario Cárdenas
- Department of Population and Health, Metropolitan Autonomous University, Mexico City, Mexico
| | - Félix Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | | | - Carlos A Castañeda-Orjuela
- Colombian National Health Observatory, National Institute of Health, Bogota, Colombia
- Epidemiology and Public Health Evaluation Group, National University of Colombia, Bogota, Colombia
| | - Giulio Castelpietra
- Primary Care Services Area, Central Health Directorate, Region Friuli Venezia Giulia, Trieste, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Ferrán Catalá-López
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Joht S Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jens Robert Chapman
- Swedish Neuroscience Institute, Swedish Brain and Spine Specialists, Seattle, WA, USA
| | | | | | - Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Haidari, Greece
- Ophthalmology Independent Consultant, Athens, Greece
| | - Neha Chaudhary
- Pediatrics Department, Harvard University, Boston, MA, USA
- Neonatology Department, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Daniel Youngwhan Cho
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Jee-Young J Choi
- Department of Biochemistry and Biomedical Science, Seoul National University Hospital, Seoul, South Korea
| | - Mohiuddin Ahsanul Kabir Chowdhury
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | | | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - João M Coelho
- Centro Hospitalar Universitário do Porto - Serviço de Oftalmologia, University of Porto, Porto, Portugal
| | - Vera M Costa
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Saad M A Dahlawi
- Department of Environmental Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Mount Gravatt, Queensland, Australia
| | | | - Gebre Teklemariam Demoz
- School of Pharmacy, Aksum University, Aksum, Ethiopia
- Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rupak Desai
- Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | | | | | | | - Hoa Thi Do
- Center of Excellence in Public Health Nutrition, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Kerrie E Doyle
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Bundoora, Victoria, Australia
| | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Bereket Duko Adema
- Public Health Department, Hawassa University, Hawassa, Ethiopia
- Curtin University, Perth, Western Australia, Australia
| | - Arielle Wilder Eagan
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
- Department of Social Services, Tufts Medical Center, Boston, MA, USA
| | | | | | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | - Christian Lycke Ellingsen
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Oghenowede Eyawo
- Epidemiology and Population Health, York University, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Pawan Sirwan Faris
- Biology Department, Salahaddin University-Erbil, Erbil, Iraq
- Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy
| | - Andre Faro
- Department of Psychology, Federal University of Sergipe, Sao Cristovao, Brazil
| | - Farshad Farzadfar
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurobiology, Karolinska Institutet, Stockholm, Sweden
- Division of Neurology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Pietro Ferrara
- Research Centre on Public Health (CESP), University of Milan Bicocca, Monza, Italy
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | | | | | - Masoud Foroutan
- Abadan School of Medical Sciences, Abadan University of Medical Sciences, Abadan, Iran
| | - Joel Msafiri Francis
- Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Science, James Cook University, Douglas, Queensland, Australia
- Royal Life Saving Society, Sydney, New South Wales, Australia
| | - Takeshi Fukumoto
- Department of Dermatology, Kobe University, Kobe, Japan
- Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, PA, USA
| | | | - Hadush Gebremariam
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | | | - Leake G Gebremeskel
- School of Pharmacy, Aksum University, Aksum, Ethiopia
- Pharmacy Department, Mekelle University, Mekelle, Ethiopia
| | | | | | - Getnet Azeze Gedefaw
- Bahir Dar University, Bahir Dar, Ethiopia
- Haramaya University, Dire Dawa, Ethiopia
| | - Birhanu Geta
- Department of Pharmacy, Wollo University, Dessie, Ethiopia
| | | | - Mansour Ghafourifard
- Department of Medical Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Ghamari
- Occupational Health Department, Arak University of Medical Sciences, Arak, Iran
| | - Reza Ghanei Gheshlagh
- Department of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Asadollah Gholamian
- Science and Research Branch, Islamic Azad University, Tehran, Iran
- Young Researchers and Elite Club, Islamic Azad University, Rasht, Iran
| | - Syed Amir Gilani
- Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
- Chairman BOG, Afro-Asian Institute, Lahore, Pakistan
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | | | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University of São Paulo, Sao Paulo, Brazil
- Internal Medicine Department, University of São Paulo, Sao Paulo, Brazil
| | - Ayman Grada
- Department of Dermatology, Boston University, Boston, MA, USA
| | - Michal Grivna
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rafael Alves Guimarães
- Instituto de Patologia Tropical e Saúde Pública, Federal University of Goias, Goiânia, Brazil
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Epidemiology and Biostatistics, Zhengzhou University, Zhengzhou, China
| | - Gaurav Gupta
- Non-Communicable Diseases (NCD), World Health Organization (WHO), New Delhi, India
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Brian James Hall
- Global and Community Mental Health Research Group, University of Macau, Macao, China
| | - Randah R Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | | | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
- Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - Amir Hasanzadeh
- Department of Microbiology, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Microbiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Shoaib Hassan
- Centre for International Health and Section for Ethics and Health Economics, University of Bergen, Bergen, Norway
| | - Soheil Hassanipour
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Guilan University of Medical Sciences, Rasht, Iran
| | - Hadi Hassankhani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Independent Consultant, Tabriz, Iran
| | - Hamid Yimam Hassen
- Department of Public Health, Mizan-Tepi University, Tepi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Rasmus Havmoeller
- Department of Clinical Sciences, Karolinska University Hospital, Stockholm, Sweden
| | - Delia Hendrie
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Fatemeh Heydarpour
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Martha Híjar
- Research Coordination, AC Environments Foundation, Cuernavaca, Mexico
- CISS, National Institute of Public Health, Cuernavaca. Mexico
| | - Hung Chak Ho
- Department of Urban Planning and Design, University of Hong Kong, Hong Kong, China
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Michael K Hole
- Department of Pediatrics, Dell Medical School, University of Texas Austin, Austin, TX, USA
| | - Ramesh Holla
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Naznin Hossain
- Department of Pharmacology and Therapeutics, Dhaka Medical College, Dhaka, Bangladesh
- Department of Pharmacology, Bangladesh Industrial Gases Limited, Tangail, Bangladesh
| | - Mehdi Hosseinzadeh
- Department of Computer Engineering, Islamic Azad University, Tehran, Iran
- Computer Science Department, University of Human Development, Sulaymaniyah, Iraq
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Central South University, Changsha, China
| | | | | | | | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Mofizul Islam
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, Victoria, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Mihajlo Jakovljevic
- Department for Health Care and Public Health, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Farzad Jalilian
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sudha Jayaraman
- Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Achala Upendra Jayatilleke
- Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Graduate Studies, University of Colombo, Colombo, Sri Lanka
| | - Ravi Prakash Jha
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Beijing Ophthalmology & Visual Science Key Laboratory, Beijing Tongren Hospital, Beijing, China
| | - Kelly M Jones
- Auckland University of Technology, Auckland, New Zealand
| | - Nitin Joseph
- Community Medicine Department, Manipal Academy of Higher Education, Mangalore, India
| | - Farahnaz Joukar
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | | | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amaha Kahsay
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Leila R Kalankesh
- Department of Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Kalhor
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Teshome Abegaz Kamil
- School of Public Health, Department of Health informatics and Health Innovation, A.C.S. Medical College and Hospital, Mekelle, Ethiopia
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Manoochehr Karami
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Taras Kavetskyy
- Department of Applied Physics, The John Paul II Catholic University of Lublin, Lublin Voivodeship, Poland
- Department of Biology and Chemistry, Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
| | - Gbenga A Kayode
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, Netherlands
| | | | | | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Morteza Abdullatif Khafaie
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nauman Khalid
- School of Food and Agricultural Sciences, University of Management and Technology, Lahore, Pakistan
| | - Ibrahim A Khalil
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Rovshan Khalilov
- Department of Physiology, Baku State University, Baku, Azerbaijan
| | - Maseer Khan
- Epidemiology, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Junaid Khan
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Tripti Khanna
- Department of Health Research, Indian Council of Medical Research, New Delhi, India
- Centre for Ethics, Jawahar Lal Nehru University, New Delhi, India
| | - Salman Khazaei
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Habibolah Khazaie
- Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roba Khundkar
- Nuffield Department of Surgical Sciences, Oxford University Global Surgery Group, University of Oxford, Oxford, UK
| | | | - Young-Eun Kim
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Yun Jin Kim
- School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, MA, USA
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Hamidreza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Brain Engineering Research Center, Institute for Research in Fundamental Sciences, Tehran, Iran
| | - Shivakumar K M Kondlahalli
- Public Health Dentistry Department, Krishna Institute of Medical Sciences Deemed to be University, Karad, India
| | - Ali Koolivand
- Environmental Health Engineering, Arak University of Medical Sciences, Arak, Iran
| | - Vladimir Andreevich Korshunov
- Department of Epidemiology and Evidence Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ai Koyanagi
- CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Kewal Krishan
- Department of Anthropology, Panjab University, Chandigarh, India
| | - Barthelemy Kuate Defo
- Department of Demography, University of Montreal, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Burcu Kucuk Bicer
- Department of Public Health, Yuksek Ihtisas University, Ankara, Turkey
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Nuworza Kugbey
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
- Department of Psychology and Health Promotion, University of KwaZulu-Natal, Durban, South Africa
| | - Nithin Kumar
- Community Medicine Department, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Vivek Kumar
- Department of Medicine Brigham and Women's Hospital, Harvard University, Boston, MA, USA
| | - Narinder Kumar
- Orthopaedics Department, Base Hospital Lucknow Cantt, Lucknow, India
| | - Girikumar Kumaresh
- Mechanical and Industrial Engineering, Indian Institute of Technology, Roorkee, India
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | - Van C Lansingh
- HelpMeSee, New York, NY, USA
- International Relations, Mexican Institute of Ophthalmology, Queretaro, Mexico
| | - Savita Lasrado
- Department of Otorhinolaryngology (ENT), Father Muller Medical College, Mangalore, India
| | - Arman Latifi
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Paolo Lauriola
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Carlo La Vecchia
- Clinical Medicine and Community Health, University of Milan, Milano, Italy
| | - Janet L Leasher
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Xuefeng Liu
- Department of Systems, Populations and Leadership, University of Michigan, Ann Arbor, MI, USA
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Paulo A Lotufo
- Department of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Ronan A Lyons
- Health Data Research UK, Swansea University, Swansea, UK
| | - Daiane Borges Machado
- Center for Integration of Data and Health Knowledge, FIOCRUZ: Cidacs Center for Integration of Data and Health Knowledge, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, England
| | - Mohammed Madadin
- Pathology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Venkatesh Maled
- Health Education and Research Department, SDM College of Medical Sciences & Hospital, Dharwad, India
- Health University, Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Navid Manafi
- Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran
- Ophthalmology Department, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amir Manafi
- Department of Surgery, University of Virginia, Charlottesville, VA, USA
| | - Ana-Laura Manda
- Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Narayana Manjunatha
- Psychiatry Department, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Joemer C Maravilla
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Seyedeh Zahra Masoumi
- Department of Midwifery-Reproductive Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Benjamin Ballard Massenburg
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Pallab K Maulik
- Research Department, The George Institute for Global Health, New Delhi, India
- School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Man Mohan Mehndiratta
- Neurology Department, Janakpuri Super Specialty Hospital Society, New Delhi, India
- Department of Neurology, Govind Ballabh Institute of Medical Education and Research, New Delhi, India
| | | | - Peter T N Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Baltimore, MD, USA
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
| | - Ritesh G Menezes
- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Atte Meretoja
- Neurocenter, Helsinki University Hospital, Helsinki, Finland
- School of Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | | | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
- Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Ted R Miller
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- Pacific Institute for Research & Evaluation, Calverton, MD, USA
| | - G K Mini
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Global Institute of Public Health (GIPH), Ananthapuri Hospitals and Research Centre, Trivandrum, India
| | - Andreea Mirica
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- President's Office, National Institute of Statistics, Bucharest, Romania
| | - Erkin M Mirrakhimov
- Faculty of Internal Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
- Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
| | - Mehdi Mirzaei-Alavijeh
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Prasanna Mithra
- Community Medicine Department, Manipal Academy of Higher Education, Mangalore, India
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Masoud Moghadaszadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Efat Mohamadi
- Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | | | | | - Shafiu Mohammed
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | | | - Farnam Mohebi
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Iran National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad A Mohseni Bandpei
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Yoshan Moodley
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Masoud Moradi
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Shane Douglas Morrison
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | | | - Atalay Goshu Muluneh
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Kamarul Imran Musa
- School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia
| | - Ghulam Mustafa
- Department of Pediatric Medicine, Nishtar Medical University, Multan, Pakistan
- Department of Pediatrics & Pediatric Pulmonology, Institute of Mother & Child Care, Multan, Pakistan
| | - Mehdi Naderi
- Clinical Research Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ahamarshan Jayaraman Nagarajan
- Research and Analytics, Initiative for Financing Health and Human Development, Chennai, India
- Research and Analytics, Bioinsilico Technologies, Chennai, India
| | - Gurudatta Naik
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russia
| | - Farid Najafi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Bruno Ramos Nascimento
- Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Morteza Naserbakht
- Mental Health Research Center, IUMS, Tehran, Iran
- Preventive Medicine and Public Health Research Center, IUMS, Tehran, Iran
| | - Vinod Nayak
- Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Manipal, India
| | - Javad Nazari
- Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran
- Iranian Ministry of Health and Medical Education, Tehran, Iran
| | | | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | | | - Trang Huyen Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Diep Ngoc Nguyen
- Project of ADB, National Institute of Nutrition, Hanoi, Vietnam
- Industrial Management Department, Hanoi University of Science and Technology, Hanoi, Vietnam
| | | | - Rajan Nikbakhsh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Heidelberg University Hospital, Heidelberg, Germany
| | - Dina Nur Anggraini Ningrum
- Public Health Department, Universitas Negeri Semarang, Kota Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | - Chukwudi A Nnaji
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Richard Ofori-Asenso
- Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, Australia
- Independent Consultant, Accra, Ghana
| | | | - Onome Bright Oghenetega
- Reproductive Health Sciences, Department Obstetrics and Gynecology, University of Ibadan, Ibadan, Nigeria
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaimaniyah, Iraq
| | - Obinna E Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
| | - Heather M Orpana
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Erika Ota
- Department of Global Health Nursing, St. Luke's International University, Chuo-ku, Japan
| | - Nikita Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Academic Department, Unium Ltd, Moscow, Russia
| | - Stanislav S Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | | | - Smita Pakhale
- Department of Medicine, Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, Ontario, Canada
| | - Keyvan Pakshir
- Parasitology and Mycology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | - Sangram Kishor Patel
- Research and Evaluation Department, Population Council, New Delhi, India
- Indian Institute of Health Management Research University, Jaipur, India
| | - Ashish Pathak
- Department of Pediatircs, RD Gardi Medical College, Ujjain, India
- Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Sanghamitra Pati
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India
| | - Kebreab Paulos
- Department of Midwifery, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amy E Peden
- Royal Life Saving Society, Sydney, New South Wales, Australia
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Jeevan Pereira
- Department of Orthopedics, Yenepoya Medical College, Mangalore, India
| | - Michael R Phillips
- Department of Psychiatry, Department of Epidemiology, Columbia University, New York, NY, USA
- Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
| | - Roman V Polibin
- Department of Epidemiology and Evidence-Based Medicine, Sechenon University, Moscow, Russia
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Farshad Pourmalek
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Akram Pourshams
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Swayam Prakash
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Parul Puri
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Zahiruddin Quazi Syed
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando, FL, USA
- College of Graduate Health Sciences, A.T. Still University, Mesa, AZ, USA
| | - Anwar Rafay
- Department of Epidemiology & Biostatistics, Contech School of Public Health, Lahore, Pakistan
| | - Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Alireza Rafiei
- Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fakher Rahim
- Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Siavash Rahimi
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Victoria, Australia
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | | | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ivo Rakovac
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization (WHO), Moscow, Russia
| | - Sowmya J Rao
- Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran
| | - Prateek Rastogi
- Department of Forensic Medicine, Manipal Academy of Higher Education, Manipal, India
| | - Priya Rathi
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Academic Public Health Department, Public Health England, London, UK
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, CQ University, Sydney, New South Wales, Australia
| | - Reza Rawassizadeh
- Department of Computer Science, Metropolitan College, Boston University, Boston, USA
| | - Vishnu Renjith
- Neurology Department, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- Organization for the Prevention of Blindness, Paris, France
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ana Isabel Ribeiro
- EPIUnit - Public Health Institute University Porto (ISPUP), University of Porto, Porto, Portugal
| | - Jennifer Rickard
- Surgery Department, University of Minnesota, Minneapolis, MN, USA
- Surgery Department, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Carlos Miguel Rios González
- Research Directorate, Nihon Gakko University, Fernando de la Mora, Paraguay
- Research Direction, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay
| | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Basema Saddik
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hamid Safarpour
- Department of Health in Disasters and Emergencies, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Safdarian
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hosni Salem
- Urology Department, Cairo University, Giza, Egypt
| | - Inbal Salz
- Health and Disability Intelligence Group, Ministry of Health, Wellington, New Zealand
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, WV, USA
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Lidia Sanchez Riera
- Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Institute of Bone and Joint Research, University of Sydney, Syndey, New South Wales, Australia
| | - Milena M Santric Milicevic
- Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
- Centre-School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Abdur Razzaque Sarker
- Health Economics, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Brijesh Sathian
- Surgery Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Mehdi Sayyah
- Education Development Center, Faculty Member of Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | | | - Feng Sha
- Center for Biomedical Information Technology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Faramarz Shaahmadi
- Department of Health Promotion and Education, Alborz University of Medical Sciences, Karaj, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
- Division of General Internal Medicine, Harvard University, Boston, MA, USA
| | | | - Jae Il Shin
- College of Medicine, Yonsei University, Seodaemun-gu, South Korea
- Division of Cardiology, Emory University, Atlanta, GA, USA
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Soraya Siabani
- Department of Health Education & Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
- School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Health and Behavior Studies, Columbia University, New York, NY, USA
| | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Medicine Service, US Department of Veterans Affairs (VA), Birmingham, AL, USA
| | | | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Amin Soheili
- Medical Surgical Nursing Department, Urmia University of Medical Science, Urmia, Iran
- Emergency Nursing Department, Semnan University of Medical Sciences, Semnan, Iran
| | - Joan B Soriano
- Hospital Universitario de la Princesa, Autonomous University of Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | | | - Ireneous N Soyiri
- Hull York Medical School, University of Hull, Hull City, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Mark A Stokes
- Department of Psychology, Deakin University, Melbourne, Victoria, Australia
| | | | - Bryan L Sykes
- Department of Criminology, Law and Society, University of California Irvine, Irvine, CA, USA
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Karen M Tabb
- School of Social Work, University of Illinois, Urbana, IL, USA
| | | | - Yonatal Mesfin Tefera
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Rekha Thapar
- Community Medicine Department, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Mariya Vladimirovna Titova
- Timiryazev Institute of Plant Physiology, Russian Academy of Sciences, Moscow, Russia
- Biology Department, Moscow State University, Moscow, Russia
| | | | - Hamid Reza Tohidinik
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Kerman University of Medical Sciences, Kerman, Iran
| | - Roman Topor-Madry
- Institute of Public Health, Krakow, Poland
- The Agency for Health Technology Assessment and Tariff System, Warszawa, Poland
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Military Medical University, Hanoi, Vietnam
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Alexander C Tsai
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Irfan Ullah
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
- TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan
| | - Saif Ullah
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Pakistan
| | | | - Era Upadhyay
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | | | - Pascual R Valdez
- Argentine Society of Medicine, Buenos Aires, Argentina
- Velez Sarsfield Hospital, Buenos Aires, Argentina
| | | | - Yousef Veisani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Narayanaswamy Venketasubramanian
- Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yasir Waheed
- Foundation University Medical College, Foundation University, Islamabad, Pakistan
| | - Yuan-Pang Wang
- Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Taweewat Wiangkham
- Department of Physical Therapy, Naresuan University, Meung District, Thailand
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Dawit Habte Woldeyes
- Department of Human Anatomy, Histology, and Embryology, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Adam Belay Wondmieneh
- Department of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Nursing, Wollo University, Dessie, Ethiopia
| | - Ai-Min Wu
- Department of Orthopaedics, Wenzhou Medical University, Wenzhou, China
| | - Grant M A Wyper
- Public Health Science Directorate, NHS Health Scotland, Glasgow, Scotland
| | - Rajaram Yadav
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Ali Yadollahpour
- Medical Physics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
| | - Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Health Management, Policy and Economics, Kerman University of Medical Sciences, Kerman, Iran
| | - Pengpeng Ye
- Division of Injury Prevention and Mental Health Improvement, National Center for Chronic and Noncommunicable Disease Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Paul Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Engida Yisma
- School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Naohiro Yonemoto
- Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, South Korea
| | - Mustafa Z Younis
- Department of Health Policy & Management, Jackson State University, Jackson, MS, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Zabihollah Yousefi
- Department of Environmental Health, Mazandaran University of Medical Sciences, Sari, Iran
- Environmental Health, Academy of Medical Science, Sari, Iran
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, China
| | - Telma Zahirian Moghadam
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
| | - Sojib Bin Zaman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
- Department of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran
| | - Fatemeh Zarei
- Faculty of Medical Sciences, Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, Wuhan University, Wuhan, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Arash Ziapour
- Department of Health Education & Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sanjay Zodpey
- Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Public Health Foundation of India, Gurugram, India
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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James SL, Lucchesi LR, Bisignano C, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Henry NJ, McCracken D, Roberts NLS, Sylte DO, Ahmadi A, Ahmed MB, Alahdab F, Alipour V, Andualem Z, Antonio CAT, Arabloo J, Badiye AD, Bagherzadeh M, Banstola A, Bärnighausen TW, Barzegar A, Bayati M, Bhaumik S, Bijani A, Bukhman G, Carvalho F, Crowe CS, Dalal K, Daryani A, Nasab MD, Do HT, Do HP, Endries AY, Fernandes E, Filip I, Fischer F, Fukumoto T, Gebremedhin KBB, Gebremeskel GG, Gilani SA, Haagsma JA, Hamidi S, Hostiuc S, Househ M, Igumbor EU, Ilesanmi OS, Irvani SSN, Jayatilleke AU, Kahsay A, Kapoor N, Kasaeian A, Khader YS, Khalil IA, Khan EA, Khazaee-Pool M, Kokubo Y, Lopez AD, Madadin M, Majdan M, Maled V, Malekzadeh R, Manafi N, Manafi A, Mangalam S, Massenburg BB, Meles HG, Menezes RG, Meretoja TJ, Miazgowski B, Miller TR, Mohammadian-Hafshejani A, Mohammadpourhodki R, Morrison SD, Negoi I, Nguyen TH, Nguyen SH, Nguyen CT, Nixon MR, Olagunju AT, Olagunju TO, Padubidri JR, Polinder S, Rabiee N, Rabiee M, Radfar A, Rahimi-Movaghar V, Rawaf S, Rawaf DL, Rezapour A, Rickard J, Roro EM, Roy N, Safari-Faramani R, Salamati P, Samy AM, Satpathy M, Sawhney M, Schwebel DC, Senthilkumaran S, Sepanlou SG, Shigematsu M, Soheili A, Stokes MA, Tohidinik HR, Tran BX, Valdez PR, Wijeratne T, Yisma E, Zaidi Z, Zamani M, Zhang ZJ, Hay SI, Mokdad AH. Epidemiology of injuries from fire, heat and hot substances: global, regional and national morbidity and mortality estimates from the Global Burden of Disease 2017 study. Inj Prev 2020; 26:i36-i45. [PMID: 31857422 PMCID: PMC7571358 DOI: 10.1136/injuryprev-2019-043299] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/14/2019] [Accepted: 08/18/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Past research has shown how fires, heat and hot substances are important causes of health loss globally. Detailed estimates of the morbidity and mortality from these injuries could help drive preventative measures and improved access to care. METHODS We used the Global Burden of Disease 2017 framework to produce three main results. First, we produced results on incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years from 1990 to 2017 for 195 countries and territories. Second, we analysed these results to measure mortality-to-incidence ratios by location. Third, we reported the measures above in terms of the cause of fire, heat and hot substances and the types of bodily injuries that result. RESULTS Globally, there were 8 991 468 (7 481 218 to 10 740 897) new fire, heat and hot substance injuries in 2017 with 120 632 (101 630 to 129 383) deaths. At the global level, the age-standardised mortality caused by fire, heat and hot substances significantly declined from 1990 to 2017, but regionally there was variability in age-standardised incidence with some regions experiencing an increase (eg, Southern Latin America) and others experiencing a significant decrease (eg, High-income North America). CONCLUSIONS The incidence and mortality of injuries that result from fire, heat and hot substances affect every region of the world but are most concentrated in middle and lower income areas. More resources should be invested in measuring these injuries as well as in improving infrastructure, advancing safety measures and ensuring access to care.
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Affiliation(s)
- Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Lydia R Lucchesi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Nathaniel J Henry
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Darrah McCracken
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Alireza Ahmadi
- Department of Anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA
| | - Vahid Alipour
- Health Management and Economics Research Center, Tehran, Iran
- Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Zewudu Andualem
- Environmental and Occupational Health and Safety Department, University of Gondar, Gondar, Ethiopia
| | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ashish D Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | | | - Amrit Banstola
- Department of Research, Public Health Perspective Nepal, Pokhara-Lekhnath Metropolitan, Nepal
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Akbar Barzegar
- Occupational Health Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, Department of Health Economics, School of Management & Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Gene Bukhman
- Department of Global Health and Social Medicine, Harvard University, Boston, Massachusetts, USA
- Partners In Health, Boston, Massachusetts, USA
| | - Félix Carvalho
- Applied Molecular Biosciences Unit, University of Porto, Porto, Portugal
- Institute of Public Health, University of Porto, Porto, Portugal
| | | | - Koustuv Dalal
- Institute of Public Health Kalyani, Kalyani, India
- School of Health Science, Orebro University, Orebro, Sweden
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Hoa Thi Do
- Center of Excellence in Public Health Nutrition, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Huyen Phuc Do
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Aman Yesuf Endries
- Public Health Department, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, California, USA
- School of Health Sciences, A.T. Still University, Mesa, Missouri, USA
| | - Florian Fischer
- School of Public Health Medicine, Bielefeld University, Bielefeld, Germany
| | - Takeshi Fukumoto
- Gene Expression & Regulation Program, Cancer Institute (W.I.A), Philadelphia, Pennsylvania, USA
- Department of Dermatology, Kobe University, Kobe, Japan
| | | | - Gebreamlak Gebremedhn Gebremeskel
- Nursing Department College of Health Science, Aksum University, Aksum, Ethiopia
- Nursing Department, Mekelle University, Mekelle, Ethiopia
| | - Syed Amir Gilani
- Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
- Chairman BOG, Afro-Asian Institute Lahore, Pakistan
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Sorin Hostiuc
- Faculty of Dentistry, Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
- Qatar Foundation for Education, Science, and Community Development, Doha, Qatar
| | - Ehimario U Igumbor
- School of Public Health, University of the Western Cape, Bellville, South Africa
- Department of Public Health, Walter Sisulu University, Mthatha, South Africa
| | | | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Achala Upendra Jayatilleke
- Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Graduate Studies, University of Colombo, Colombo, Sri Lanka
| | - Amaha Kahsay
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Saleh Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Ramtha, Jordan
| | - Ibrahim A Khalil
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Maryam Khazaee-Pool
- Department of Public Health, School of Health, Mazandaran University of Sciences, Sari, Iran
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- University of Melbourne, Melbourne, Victoria, Australia
| | - Mohammed Madadin
- Pathology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Venkatesh Maled
- Health Education and Research Department, SDM College of Medical Sciences & Hospital, Dharwad, India
- Health University, Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Navid Manafi
- Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran
- Ophthalmology Department, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ali Manafi
- Plastic Surgery Department, Iran University of Medical Sciences, Tehran, Iran
| | - Srikanth Mangalam
- Public Risk Management Institute, Mississauga, Ontario, Canada
- Trade and Competitiveness, World Bank, New York city, New York, USA
| | | | | | - Ritesh G Menezes
- Forensic Medicine Division, Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
| | - Ted R Miller
- Pacific Institute for Research & Evaluation, Calverton, Maryland, USA
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | | | | | | | - Ionut Negoi
- General Surgery Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Trang Huyen Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Son Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Molly R Nixon
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jagadish Rao Padubidri
- Forensic Medicine and Toxicology Department, Manipal Academy of Higher Education, Mangaluru, India
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Amir Radfar
- College of G raduate Health Sciences, A.T. Still University, Mesa, Arizona, USA
- Medichem, Barcelona, Spain
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Academic Public Health Department, Public Health England, London, UK
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK
- University College London Hospitals, London, UK
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jennifer Rickard
- Surgery Department, University of Minnesota, Minneapolis, Minnesota, USA
- Surgery Department, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Elias Merdassa Roro
- Public Health Department, Wollega University, Nekemte, Ethiopia
- Public Health Department, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nobhojit Roy
- Public Health Planning and Evidence Practice Area, National Health Systems Resource Centre, New Delhi, India
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Roya Safari-Faramani
- Faculty of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- School of Health and Policy Management, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Maheswar Satpathy
- UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
- Udyam-Global Association for Sustainable Development, Bhubaneswar, India
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Amin Soheili
- Medical Surgical Nursing Department, Urmia University of Medical Science, Urmia, Iran
- Emergency Nursing Department, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mark A Stokes
- Department of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Hamid Reza Tohidinik
- HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Pascual R Valdez
- Argentine Society of Medicine, Buenos Aires, Argentina
- Velez Sarsfield Hospital, Buenos Aires, Argentina
| | - Tissa Wijeratne
- Department of Psychology and Counselling, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, St Albans, Victoria, Australia
| | - Engida Yisma
- School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, Wuhan University, Wuhan, China
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
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Haagsma JA, James SL, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Liu Z, Lucchesi LR, Roberts NLS, Sylte DO, Adebayo OM, Ahmadi A, Ahmed MB, Aichour MTE, Alahdab F, Alghnam SA, Aljunid SM, Al-Raddadi RM, Alsharif U, Altirkawi K, Anjomshoa M, Antonio CAT, Appiah SCY, Aremu O, Arora A, Asayesh H, Assadi R, Awasthi A, Ayala Quintanilla BP, Balalla S, Banstola A, Barker-Collo SL, Bärnighausen TW, Bazargan-Hejazi S, Bedi N, Behzadifar M, Behzadifar M, Benjet C, Bennett DA, Bensenor IM, Bhaumik S, Bhutta ZA, Bijani A, Borges G, Borschmann R, Bose D, Boufous S, Brazinova A, Campuzano Rincon JC, Cárdenas R, Carrero JJ, Carvalho F, Castañeda-Orjuela CA, Catalá-López F, Choi JYJ, Christopher DJ, Crowe CS, Dalal K, Daryani A, Davitoiu DV, Degenhardt L, De Leo D, De Neve JW, Deribe K, Dessie GA, deVeber GA, Dharmaratne SD, Doan LP, Dolan KA, Driscoll TR, Dubey M, El-Khatib Z, Ellingsen CL, El Sayed Zaki M, Endries AY, Eskandarieh S, Faro A, Fereshtehnejad SM, Fernandes E, Filip I, Fischer F, Franklin RC, Fukumoto T, Gezae KE, Gill TK, Goulart AC, Grada A, Guo Y, Gupta R, Haghparast Bidgoli H, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Haro JM, Hassankhani H, Hassen HY, Havmoeller R, Hendrie D, Henok A, Híjar M, Hole MK, Homaie Rad E, Hossain N, Hostiuc S, Hu G, Igumbor EU, Ilesanmi OS, Irvani SSN, Islam SMS, Ivers RQ, Jacobsen KH, Jahanmehr N, Jakovljevic M, Jayatilleke AU, Jha RP, Jonas JB, Jorjoran Shushtari Z, Jozwiak JJ, Jürisson M, Kabir A, Kalani R, Kasaeian A, Kelbore AG, Kengne AP, Khader YS, Khafaie MA, Khalid N, Khan EA, Khoja AT, Kiadaliri AA, Kim YE, Kim D, Kisa A, Koyanagi A, Kuate Defo B, Kucuk Bicer B, Kumar M, Lalloo R, Lam H, Lami FH, Lansingh VC, Leasher JL, Li S, Linn S, Lunevicius R, Machado FR, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahotra NB, Majdan M, Majeed A, Malekzadeh R, Malik MA, Malta DC, Manda AL, Mansournia MA, Massenburg BB, Maulik PK, Meheretu HAA, Mehndiratta MM, Melese A, Mendoza W, Mengesha MM, Meretoja TJ, Meretoja A, Mestrovic T, Miazgowski T, Miller TR, Mini GK, Mirrakhimov EM, Moazen B, Mohammad Gholi Mezerji N, Mohammadibakhsh R, Mohammed S, Molokhia M, Monasta L, Mondello S, Montero-Zamora PA, Moodley Y, Moosazadeh M, Moradi G, Moradi-Lakeh M, Morawska L, Velásquez IM, Morrison SD, Moschos MM, Mousavi SM, Murthy S, Musa KI, Naik G, Najafi F, Nangia V, Nascimento BR, Ndwandwe DE, Negoi I, Nguyen TH, Nguyen SH, Nguyen LH, Nguyen HLT, Ningrum DNA, Nirayo YL, Ofori-Asenso R, Ogbo FA, Oh IH, Oladimeji O, Olagunju AT, Olagunju TO, Olivares PR, Orpana HM, Otstavnov SS, P A M, Pakhale S, Park EK, Patton GC, Pesudovs K, Phillips MR, Polinder S, Prakash S, Radfar A, Rafay A, Rafiei A, Rahimi S, Rahimi-Movaghar V, Rahman MA, Rai RK, Ramezanzadeh K, Rawaf S, Rawaf DL, Renzaho AMN, Resnikoff S, Rezaeian S, Roever L, Ronfani L, Roshandel G, Sabde YD, Saddik B, Salamati P, Salimi Y, Salz I, Samy AM, Sanabria J, Sanchez Riera L, Santric Milicevic MM, Satpathy M, Sawhney M, Sawyer SM, Saxena S, Saylan M, Schneider IJC, Schwebel DC, Seedat S, Sepanlou SG, Shaikh MA, Shams-Beyranvand M, Shamsizadeh M, Sharif-Alhoseini M, Sheikh A, Shen J, Shigematsu M, Shiri R, Shiue I, Silva JP, Singh JA, Sinha DN, Soares Filho AM, Soriano JB, Soshnikov S, Soyiri IN, Starodubov VI, Stein DJ, Stokes MA, Sufiyan MB, Sunshine JE, Sykes BL, Tabarés-Seisdedos R, Tabb KM, Tehrani-Banihashemi A, Tessema GA, Thakur JS, Tran KB, Tran BX, Tudor Car L, Uthman OA, Uzochukwu BSC, Valdez PR, Varavikova E, Vasconcelos AMN, Venketasubramanian N, Violante FS, Vlassov V, Waheed Y, Wang YP, Wijeratne T, Winkler AS, Yadav P, Yano Y, Yenesew MA, Yip P, Yisma E, Yonemoto N, Younis MZ, Yu C, Zafar S, Zaidi Z, Zaman SB, Zamani M, Zhao Y, Zodpey S, Hay SI, Lopez AD, Mokdad AH, Vos T. Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017. Inj Prev 2020; 26:i12-i26. [PMID: 31915273 PMCID: PMC7571356 DOI: 10.1136/injuryprev-2019-043296] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. METHODS Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. RESULTS For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. CONCLUSIONS The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.
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Affiliation(s)
- Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Lydia R Lucchesi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | - Alireza Ahmadi
- Department of Anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | | | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota, USA
| | - Suliman A Alghnam
- Department of Population Health Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | - Rajaa M Al-Raddadi
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ubai Alsharif
- Department of Oral and Maxillofacial Surgery, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
| | | | - Mina Anjomshoa
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for International Health, Ludwig Maximilians University, Munich, Germany
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Amit Arora
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
- Oral Health Services, Sydney Local Health District, Sydney, New South Wales, Australia
| | | | - Reza Assadi
- Education Development Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Beatriz Paulina Ayala Quintanilla
- The Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, Peru
| | - Shivanthi Balalla
- School of Public Health, Auckland University of Technology, Auckland, New Zealand
| | - Amrit Banstola
- Department of Research, Public Health Perspective Nepal, Pokhara-Lekhnath Metropolitan City, Nepal
| | | | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Neeraj Bedi
- Department of Community Medicine, Gandhi Medical College Bhopal, Bhopal, India
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Meysam Behzadifar
- Department of Epidemiology and Biostatistics, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Corina Benjet
- Department of Epidemiology and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Derrick A Bennett
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Isabela M Bensenor
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Guilherme Borges
- Department of Epidemiology and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Rohan Borschmann
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Dipan Bose
- Transport & Digital Development, World Bank, Washington, District of Columbia, USA
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research Department, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Julio Cesar Campuzano Rincon
- National Institute of Public Health, Cuernavaca, Mexico
- School of Medicine, University of the Valley of Cuernavaca, Cuernavaca, Mexico
| | - Rosario Cárdenas
- Department of Population and Health, Metropolitan Autonomous University, Mexico City, Mexico
| | - Juan J Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Carlos A Castañeda-Orjuela
- Colombian National Health Observatory, National Institute of Health, Bogota, Colombia
- Epidemiology and Public Health Evaluation Group, National University of Colombia, Bogota, Colombia
| | - Ferrán Catalá-López
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Jee-Young J Choi
- Department of Biochemistry and Biomedical Science, Seoul National University Hospital, Seoul, South Korea
| | | | | | - Koustuv Dalal
- Institute of Public Health Kalyani, Kalyani, India
- School of Health Science, Orebro University, Orebro, Sweden
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Dragos Virgil Davitoiu
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Surgery, Clinical Emergency Hospital Sf. Pantelimon, Bucharest, Romania
| | - Louisa Degenhardt
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Mount Gravatt, Queensland, Australia
| | - Jan-Walter De Neve
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Gabrielle Aline deVeber
- Centre for Global Child Health, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Linh Phuong Doan
- Center of Excellence in Health Service Management, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Kate A Dolan
- University of New South Wales, Sydney, New South Wales, Australia
| | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Manisha Dubey
- United Nations World Food Programme, New Delhi, India
| | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | | | | | - Aman Yesuf Endries
- Public Health Department, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Andre Faro
- Department of Psychology, Federal University of Sergipe, Sao Cristovao, Brazil
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Division of Neurology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, California, USA
- School of Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Science, James Cook University, Douglas, Queensland, Australia
| | - Takeshi Fukumoto
- Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, Pennsylvania, USA
- Department of Dermatology, Kobe University, Kobe, Japan
| | | | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University of São Paulo, Sao Paulo, Brazil
- Internal Medicine Department, University Hospital, University of São Paulo, Sao Paulo, Brazil
| | - Ayman Grada
- School of Medicine, Boston University, Boston, Massachusetts, USA
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Epidemiology and Biostatistics, Zhengzhou University, Zhengzhou, China
| | - Rahul Gupta
- March of Dimes, Arlington, Virginia, USA
- School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | | | - Arvin Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arya Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Randah R Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
- Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - Hadi Hassankhani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Independent Consultant, Tabriz, Iran
| | - Hamid Yimam Hassen
- Department of Public Health, Mizan-Tepi University, Teppi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Rasmus Havmoeller
- Clinical Sciences, Karolinska University Hospital, Stockholm, Sweden
| | - Delia Hendrie
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Andualem Henok
- Department of Public Health, Mizan-Tepi University, Teppi, Ethiopia
| | - Martha Híjar
- Research Coordination, AC Environments Foundation, Cuernavaca, Mexico
- CISS, National Institute of Public Health, Cuernavaca, Mexico
| | - Michael K Hole
- Department of Pediatrics, Dell Medical School, University of Texas Austin, Austin, Texas, USA
| | - Enayatollah Homaie Rad
- Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Naznin Hossain
- Department of Pharmacology and Therapeutics, Dhaka Medical College, Dhaka University, Dhaka, Bangladesh
- Department of Pharmacology, Bangladesh Industrial Gases Limited, Tangail, Bangladesh
| | - Sorin Hostiuc
- Faculty of Dentistry, Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Central South University, Changsha, China
| | - Ehimario U Igumbor
- School of Public Health, University of the Western Cape, Bellville, Cape Town, South Africa
- Department of Public Health, Walter Sisulu University, Mthatha, South Africa
| | | | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Q Ivers
- Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Kathryn H Jacobsen
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
| | - Nader Jahanmehr
- School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mihajlo Jakovljevic
- Department for Health Care and Public Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Achala Upendra Jayatilleke
- Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Graduate Studies, University of Colombo, Colombo, Sri Lanka
| | - Ravi Prakash Jha
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Zahra Jorjoran Shushtari
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Rizwan Kalani
- Department of Neurology, University of Washington, Seattle, Washington, USA
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Andre Pascal Kengne
- Non-communicable Diseases Research Unit, Medical Research Council South Africa, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Yousef Saleh Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Ramtha, Jordan
| | - Morteza Abdullatif Khafaie
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nauman Khalid
- School of Food and Agricultural Sciences, University of Management and Technology, Lahore, Pakistan
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Abdullah T Khoja
- Department of Public Health, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Young-Eun Kim
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Ai Koyanagi
- CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Barthelemy Kuate Defo
- Department of Demography, University of Montreal, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Burcu Kucuk Bicer
- Department of Public Health, Yuksek Ihtisas University, Ankara, Turkey
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Hilton Lam
- Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | - Van C Lansingh
- HelpMeSee, New York City, New York, USA
- International Relations Department, Mexican Institute of Ophthalmology, Queretaro, Mexico
| | - Janet L Leasher
- College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shai Linn
- School of Public Health, University of Haifa, Haifa, Israel
| | - Raimundas Lunevicius
- Department of General Surgery, Aintree University Hospital National Health Service (NHS) Foundation Trust, Liverpool, UK
- Department of Surgery, University of Liverpool, Liverpool, UK
| | - Flavia R Machado
- Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, Sao Paulo, Brazil
| | | | | | | | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Manzoor Ahmad Malik
- Department of Humanities and Social Sciences, Indian Institute of Technology, Roorkee, Haridwar, India
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ana-Laura Manda
- Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Pallab K Maulik
- Research Department, The George Institute for Global Health, New Delhi, India
- School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Hailemariam Abiy Alemu Meheretu
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
- School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
| | - Man Mohan Mehndiratta
- Neurology Department, Janakpuri Super Specialty Hospital Society, New Delhi, India
- Neurology Department, Govind Ballabh Institute of Medical Education and Research, New Delhi, India
| | - Addisu Melese
- Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
| | | | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Atte Meretoja
- Neurocenter, Helsinki University Hospital, Helsinki, Finland
- School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Ted R Miller
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- Pacific Institute for Research & Evaluation, Calverton, Maryland, USA
| | - G K Mini
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Global Institute of Public Health (GIPH), Ananthapuri Hospitals and Research Centre, Trivandrum, India
| | - Erkin M Mirrakhimov
- Faculty of Internal Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
- Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
| | | | | | - Shafiu Mohammed
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
- Department of Neurology, Oasi Research Institute, Troina, Italy
| | - Pablo A Montero-Zamora
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Yoshan Moodley
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Marilita M Moschos
- 1st Department of Ophthalmology, University of Athens, Athens, Greece
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Seyyed Meysam Mousavi
- Health Management Reserach Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran, Iran
| | - Srinivas Murthy
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kamarul Imran Musa
- School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia
| | - Gurudatta Naik
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Farid Najafi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Bruno Ramos Nascimento
- Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- General Surgery Department, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Trang Huyen Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Son Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | | | - Dina Nur Anggraini Ningrum
- Public Health Department, Universitas Negeri Semarang, Kota Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | | | - Richard Ofori-Asenso
- Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, Australia
- Independent Consultant, Accra, Ghana
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea
| | - Olanrewaju Oladimeji
- HAST, Human Sciences Research Council, Durban, South Africa
- School of Public Health, Faculty of Health Sciences, University of Namibia, Osakhati, Namibia
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Pedro R Olivares
- Institute of Physical Activity and Health, Autonomous University of Chile, Talca, Chile
| | - Heather M Orpana
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Stanislav S Otstavnov
- Analytical Center, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Committee for the Comprehensive Assessment of Medical Devices and Information Technology, Health Technology Assessment Association, Moscow, Russia
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | - Smita Pakhale
- Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | - George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Population Health Department, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Konrad Pesudovs
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
- Department of Psychiatry, Department of Epidemiology, Columbia University, New York City, New York, USA
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Swayam Prakash
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando, Florida, USA
- College of Graduate Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Anwar Rafay
- Department of Epidemiology & Biostatistics, Contech School of Public Health, Lahore, Pakistan
| | - Alireza Rafiei
- Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavash Rahimi
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University, Heidelberg, Victoria, Australia
- National Centre for Farmer Health, Deakin University, Waurn Ponds, Victoria, Australia
| | - Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, India
- Department of Economics, University of Göttingen, Göttingen, Germany
| | - Kiana Ramezanzadeh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Academic Public Health Department, Public Health England, London, UK
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK
- University College London Hospitals, London, UK
| | - Andre M N Renzaho
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- Organization for the Prevention of Blindness, Paris, France
| | | | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Yogesh Damodar Sabde
- National Institute for Research in Environmental Health, Indian Council of Medical Research, Bhopal, India
| | - Basema Saddik
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yahya Salimi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Inbal Salz
- Health and Disability Intelligence Group, Ministry of Health, Wellington, New Zealand
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, West Virginia, USA
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Lidia Sanchez Riera
- Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Institute of Bone and Joint Research, University of Sydney, Syndey, New South Wales, Australia
| | - Milena M Santric Milicevic
- Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
- Centre-School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Maheswar Satpathy
- UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
- Udyam-Global Association for Sustainable Development, Bhubaneswar, India
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Susan M Sawyer
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Sonia Saxena
- School of Public Health, Imperial College London, London, UK
| | - Mete Saylan
- Market Access Department, Bayer, Istanbul, Turkey
| | - Ione J C Schneider
- School of Health Sciences, Federal University of Santa Catarina, Ararangua, Brazil
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mehran Shams-Beyranvand
- School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
- School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Morteza Shamsizadeh
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
- Division of General Internal Medicine and Primary Care, Harvard University, Boston, Massachusetts, USA
| | - Jiabin Shen
- Center for Pediatric Trauma Research, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ivy Shiue
- Institute of Medical Epidemiology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | | | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Medicine Service, US Department of Veteran Affairs, Birmingham, Alabama, USA
| | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Adauto Martins Soares Filho
- Department of Diseases and Noncommunicable Diseases and Health Promotion, Federal Ministry of Health, Brasilia, Brazil
| | - Joan B Soriano
- Hospital Universitario de la Princesa, Autonomous University of Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Sergey Soshnikov
- Department of Research Development, Federal Research Institute for Health Organization and Informatics of the Ministry of Health (FRIHOI), Moscow, Russia
| | - Ireneous N Soyiri
- Hull York Medical School, University of Hull, Hull City, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Vladimir I Starodubov
- Federal Research Institute for Health Organization and Informatics of the Ministry of Health (FRIHOI), Moscow, Russia
| | - Dan J Stein
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Mark A Stokes
- Department of Psychology, Deakin University, Burwood, Victoria, Australia
| | | | - Jacob E Sunshine
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington, USA
| | - Bryan L Sykes
- Department of Criminology, Law and Society, University of California Irvine, Irvine, California, USA
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Karen M Tabb
- School of Social Work, University of Illinois, Urbana, Illinois, USA
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Gizachew Assefa Tessema
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Jarnail Singh Thakur
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Khanh Bao Tran
- Molecular Medicine and Pathology Department, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Military Medical University, Hanoi, Vietnam
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | | | - Pascual R Valdez
- Argentine Society of Medicine, Buenos Aires, Argentina
- Velez Sarsfield Hospital, Buenos Aires, Argentina
| | - Elena Varavikova
- Central Research Institute of Cytology and Genetics, Federal Research Institute for Health Organization and Informatics of the Ministry of Health (FRIHOI), Moscow, Russia
| | - Ana Maria Nogales Vasconcelos
- Department of Statistics, University of Brasília, Brasília, Brazil
- Directorate of Social Studies and Policies, Federal District Planning Company, Brasília, Brazil
| | - Narayanaswamy Venketasubramanian
- Raffles Neuroscience Centre, Raffles Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yasir Waheed
- Foundation University Medical College, Foundation University, Islamabad, Pakistan
| | - Yuan-Pang Wang
- Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Tissa Wijeratne
- Department of Psychology and Counselling, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, St Albans, Victoria, Australia
| | - Andrea Sylvia Winkler
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - Priyanka Yadav
- Centre for the Study of Regional Development, Jawahar Lal Nehru University, New Delhi, India
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
| | | | - Paul Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Engida Yisma
- School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Naohiro Yonemoto
- Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mustafa Z Younis
- Health Economics & Finance, Jackson State University, Jackson, Mississippi, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Shamsa Zafar
- Department of Obstetrics & Gynaecology, A.C.S. Medical College and Hospital, Islamabad, Pakistan
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
| | - Sojib Bin Zaman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Sanjay Zodpey
- Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- University of Melbourne, Melbourne, Queensland, Australia
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
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James SL, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Liu Z, S Roberts NL, Sylte DO, Henry NJ, LeGrand KE, Abdelalim A, Abdoli A, Abdollahpour I, Abdulkader RS, Abedi A, Abosetugn AE, Abushouk AI, Adebayo OM, Agudelo-Botero M, Ahmad T, Ahmed R, Ahmed MB, Eddine Aichour MT, Alahdab F, Alamene GM, Alanezi FM, Alebel A, Alema NM, Alghnam SA, Al-Hajj S, Ali BA, Ali S, Alikhani M, Alinia C, Alipour V, Aljunid SM, Almasi-Hashiani A, Almasri NA, Altirkawi K, Abdeldayem Amer YS, Amini S, Loreche Amit AM, Andrei CL, Ansari-Moghaddam A, T Antonio CA, Yaw Appiah SC, Arabloo J, Arab-Zozani M, Arefi Z, Aremu O, Ariani F, Arora A, Asaad M, Asghari B, Awoke N, Ayala Quintanilla BP, Ayano G, Ayanore MA, Azari S, Azarian G, Badawi A, Badiye AD, Bagli E, Baig AA, Bairwa M, Bakhtiari A, Balachandran A, Banach M, Banerjee SK, Banik PC, Banstola A, Barker-Collo SL, Bärnighausen TW, Barrero LH, Barzegar A, Bayati M, Baye BA, Bedi N, Behzadifar M, Bekuma TT, Belete H, Benjet C, Bennett DA, Bensenor IM, Berhe K, Bhardwaj P, Bhat AG, Bhattacharyya K, Bibi S, Bijani A, Bin Sayeed MS, Borges G, Borzì AM, Boufous S, Brazinova A, Briko NI, Budhathoki SS, Car J, Cárdenas R, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Cerin E, Chandan JS, Chanie WF, Chattu SK, Chattu VK, Chatziralli I, Chaudhary N, Cho DY, Kabir Chowdhury MA, Chu DT, Colquhoun SM, Constantin MM, Costa VM, Damiani G, Daryani A, Dávila-Cervantes CA, Demeke FM, Demis AB, Demoz GT, Demsie DG, Derakhshani A, Deribe K, Desai R, Nasab MD, da Silva DD, Dibaji Forooshani ZS, Doyle KE, Driscoll TR, Dubljanin E, Adema BD, Eagan AW, Eftekhari A, Ehsani-Chimeh E, Sayed Zaki ME, Elemineh DA, El-Jaafary SI, El-Khatib Z, Ellingsen CL, Emamian MH, Endalew DA, Eskandarieh S, Faris PS, Faro A, Farzadfar F, Fatahi Y, Fekadu W, Ferede TY, Fereshtehnejad SM, Fernandes E, Ferrara P, Feyissa GT, Filip I, Fischer F, Folayan MO, Foroutan M, Francis JM, Franklin RC, Fukumoto T, Geberemariyam BS, Gebre AK, 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Y, Zodpey S, Dandona L, Dandona R, Degenhardt L, Dharmaratne SD, Hay SI, Mokdad AH, Reiner RC, Sartorius B, Vos T. Global injury morbidity and mortality from 1990 to 2017: results from the Global Burden of Disease Study 2017. Inj Prev 2020; 26:i96-i114. [PMID: 32332142 PMCID: PMC7571366 DOI: 10.1136/injuryprev-2019-043494] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/29/2019] [Accepted: 12/06/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. METHODS We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). FINDINGS In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). INTERPRETATION Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
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Affiliation(s)
- Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nathaniel J Henry
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kate E LeGrand
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Amir Abdoli
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ibrahim Abdollahpour
- Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Aidin Abedi
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA
| | | | | | - Oladimeji M Adebayo
- Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Marcela Agudelo-Botero
- School of Medicine Center for Politics, Population and Health Research, National Autonomous University of Mexico, Mexico City, Mexico
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, Southeast University Nanjing, Nanjing, China
- Department of Microbiology, Hazara University Mansehra, Mansehra, Pakistan
| | - Rushdia Ahmed
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | | | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA
| | | | - Fahad Mashhour Alanezi
- Department of Computer Sciences, Imam Abdulrehman Bin Faisal University, Dammam, Saudi Arabia
| | - Animut Alebel
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
| | | | - Suliman A Alghnam
- Department of Population Health Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Samar Al-Hajj
- Faculty of Health Sciences - Health Management and Policy, American University of Beirut, Beirut, Lebanon
- British Columbia Injury Research Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Beriwan Abdulqadir Ali
- Medical Technical Institute, Erbil Polytechnic University, Erbil, Iraq
- Faculty of Pharmacy, Ishik University, Erbil, Iraq
| | - Saqib Ali
- Department of Information Systems, College of Economics and Political Science, Sultan Qaboos University, Muscat, Oman
| | - Mahtab Alikhani
- School of Health Management and Information Sciences, Department of Health Services Management, Iran University of Medical Sciences, Tehran, Iran
| | - Cyrus Alinia
- Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | - Nihad A Almasri
- Physiotherapy Department, The University of Jordan, Amman, Jordan
| | | | - Yasser Sami Abdeldayem Amer
- Clinical Practice Guidelines Unit, King Saud University, Riyadh, Saudi Arabia
- Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt
| | - Saeed Amini
- Health Services Management Department, Arak University of Medical Sciences, Arak, Iran
| | - Arianna Maever Loreche Amit
- Department of Epidemiology and Biostatistics, University of the Philippines Manila, Manila, Philippines
- Online Programs for Applied Learning, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Carl Abelardo T Antonio
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for International Health, Ludwig Maximilians University, Munich, Germany
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Zohreh Arefi
- Department of Health Promotion and Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Filippo Ariani
- Regional Centre for the Analysis of Data on Occupational and Work-related Injuries and Diseases, Local Health Unit Tuscany Centre, Florence, Italy
| | - Amit Arora
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
- Oral Health Services, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Malke Asaad
- Department of Plastic Surgery, University of Texas, Houston, TX, USA
| | - Babak Asghari
- Department of Microbiology, Hamedan University of Medical Sciences, Azad Tabriz University, Iran
| | - Nefsu Awoke
- Department of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Beatriz Paulina Ayala Quintanilla
- The Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
- General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, Peru
| | - Getinet Ayano
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Martin Amogre Ayanore
- Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana
| | - Samad Azari
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ghasem Azarian
- Department of Environmental Health Engineering, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ashish D Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Eleni Bagli
- Department of Ophthalmology, University Hospital of Ioannina, Ioannina, Greece
- Institute of Molecular Biology & Biotechnology, Foundation for Research & Technology, Ioannina, Greece
| | - Atif Amin Baig
- Biochemistry Unit, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
- School of Health Sciences, Univeristi Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Mohan Bairwa
- Institute of Health Management Research, Indian Institute of Health Management Research University, Jaipur, India
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Ahad Bakhtiari
- Health Policy And Management Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Arun Balachandran
- Department of Demography, University of Groningen, Groningen, Netherlands
- Population Research Centre, Institute for Social and Economic Change, Bengaluru, India
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | | | - Palash Chandra Banik
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Amrit Banstola
- Department of Research, Public Health Perspective Nepal, Pokhara-Lekhnath Metropolitan City, Nepal
| | | | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Lope H Barrero
- Department of Industrial Engineering, Pontifical Javeriana University, Bogota, Colombia
| | - Akbar Barzegar
- Occupational Health Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Neeraj Bedi
- Department of Community Medicine, Gandhi Medical College Bhopal, Bhopal, India
- Jazan University, Jazan, Saudi Arabia
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Tariku Tesfaye Bekuma
- Institute of Health Sciences, School of Public Health, Wollega University, Nekemte, Ethiopia
| | - Habte Belete
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia
| | - Corina Benjet
- Department of Epidemiology and Psychosocial Reseach, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Derrick A Bennett
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Isabela M Bensenor
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
| | - Kidanemaryam Berhe
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Anusha Ganapati Bhat
- Department of Internal Medicine, University of Massachusetts Medical School, Springfield, MA, USA
| | - Krittika Bhattacharyya
- Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
- Department of Statistics, University of Calcutta, Kolkata, India
| | - Sadia Bibi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Muhammad Shahdaat Bin Sayeed
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
- Department of Clinical Pharmacy and Pharmacology, University of Dhaka, Dhaka, Bangladesh
| | - Guilherme Borges
- Department of Epidemiology and Psychosocial Reseach, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Antonio Maria Borzì
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research Department, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Nikolay Ivanovich Briko
- Department of Epidemiology and Evidence Based Medicine, I M Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Josip Car
- Centre for Population Health Sciences, Nanyang Technological University, Singapore
- Global eHealth Unit, Imperial College London, London, UK
| | - Rosario Cárdenas
- Department of Population and Health, Metropolitan Autonomous University, Mexico City, Mexico
| | - Félix Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | | | - Carlos A Castañeda-Orjuela
- Colombian National Health Observatory, National Institute of Health, Bogota, Colombia
- Epidemiology and Public Health Evaluation Group, National University of Colombia, Bogota, Colombia
| | - Giulio Castelpietra
- Primary Care Services Area, Central Health Directorate, Region Friuli Venezia Giulia, Trieste, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Ferrán Catalá-López
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Joht S Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | | | | | - Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Haidari, Greece
- Ophthalmology Private Practice Office, Independent Consultant, Athens, Greece
| | - Neha Chaudhary
- Department of Pediatrics, Harvard University, Boston, MA, USA
- Department of Neonatology, Beth Israel Deaconess Medical center, Boston, MA, USA
| | - Daniel Youngwhan Cho
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Mohiuddin Ahsanul Kabir Chowdhury
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
| | - Samantha M Colquhoun
- Research School of Population Health, Australian National University, Action, ACT, Australia
| | - Maria-Magdalena Constantin
- Department of Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 2nd Department of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
| | - Vera M Costa
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Giovanni Damiani
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
- Department of Dermatology, University of Milan, Milan, Italy
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | | | - Asmamaw Bizuneh Demis
- Department of Nursing, Woldia University, Woldia, Ethiopia
- School of Nursing, Jimma University, Jimma, Ethiopia
| | - Gebre Teklemariam Demoz
- School of Pharmacy, Aksum University, Aksum, Ethiopia
- Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rupak Desai
- Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | | | | | | | - Kerrie E Doyle
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Bundoora, VIC, Australia
| | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | | | - Bereket Duko Adema
- Public Health Department, Hawassa University, Hawassa, Ethiopia
- Curtin University, Perth, WA, Australia
| | - Arielle Wilder Eagan
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
- Department of Social Services, Tufts Medical Center, Boston, MA, USA
| | - Aziz Eftekhari
- Department of Pharmacology and Toxicology, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Pharmacology and Toxicology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Ehsani-Chimeh
- National Institute for Health Researches, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
| | - Christian Lycke Ellingsen
- Department of Pathology, Stavanger University Hospital, Stavanger, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Pawan Sirwan Faris
- Biology Department, Salahaddin University-Erbil, Erbil, Iraq
- Biology and Biotechnolaniogy"L Spallanzani", University of Pavia, Pavia, Italy
| | - Andre Faro
- Department of Psychology, Federal University of Sergipe, Sao Cristovao, Brazil
| | - Farshad Farzadfar
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Fatahi
- Pharmaceutical Nanotechnology, Tehran University of Medical Sciences, Tehran, Iran
| | - Wubalem Fekadu
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tomas Y Ferede
- Nursing Department, Hawassa University, Hawassa, Ethiopia
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurobiology, Karolinska Institutet, Stockholm, Sweden
- Division of Neurology, University of Ottawa, Ottawa, ON, Canada
| | | | - Pietro Ferrara
- Research Centre on Public Health (CESP), University of Milan Bicocca, Monza, Italy
| | - Garumma Tolu Feyissa
- Department of Health Education & Behavioral Sciences, Jimma University, Jimma, Ethiopia
| | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, CA, USA
- School of Health Sciences, A T Still University, Mesa, AZ, USA
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | | | - Masoud Foroutan
- Abadan School of Medical Sciences, Abadan University of Medical Sciences, Abadan, Iran
| | - Joel Msafiri Francis
- Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Charles Franklin
- College of Public Health, Medical and Veterinary Science, James Cook University, Douglas, QLD, Australia
- Royal Life Saving Society, Sydney, NSW, Australia
| | - Takeshi Fukumoto
- Department of Dermatology, Kobe University, Kobe, Japan
- Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, PA, USA
| | | | | | | | | | | | - Getnet Azeze Gedefaw
- Bahir Dar University, Bahir Dar, Ethiopia
- Haramaya University, Dire Dawa, Ethiopia
| | - Birhanu Geta
- Department of Pharmacy, Wollo University, Dessie, Ethiopia
| | - Mansour Ghafourifard
- Department of Medical Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Ghamari
- Occupational Health Department, Arak University of Medical Sciences, Arak, Iran
| | - Ahmad Ghashghaee
- Department of Health Services Management, Iran University of Medical Sciences, Tehran, Iran
| | - Asadollah Gholamian
- Science and Research Branch, Islamic Azad University, Tehran, Iran
- Young Researchers and Elite Club, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Alessandra C Goulart
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
- Center for Clinical and Epidemiological Research, University of São Paulo, Sao Paulo, Brazil
| | - Ayman Grada
- Department of Dermatology, Boston University, Boston, MA, USA
| | - Michal Grivna
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Rafael Alves Guimarães
- Instituto de Patologia Tropical e Saúde Pública, Federal University of Goias, Goiânia, Brazil
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Epidemiology and Biostatistics, Zhengzhou University, Zhengzhou, China
| | - Gaurav Gupta
- Non-Communicable Diseases (NCD), World Health Organization (WHO), New Delhi, India
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Nima Hafezi-Nejad
- Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, USA
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Brian James Hall
- Global and Community Mental Health Research Group, University of Macau, Macao, China
| | - Randah R Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
- Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - Md Mehedi Hasan
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD, Australia
| | - Amir Hasanzadeh
- Department of Microbiology, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Microbiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hadi Hassankhani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Independent Consultant, Tabriz, Iran
| | - Hamid Yimam Hassen
- Department of Public Health, Mizan-Tepi University, Tepi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Rasmus Havmoeller
- Department of Clinical Sciences, Karolinska University Hospital, Stockholm, Sweden
| | - Khezar Hayat
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
| | - Delia Hendrie
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Fatemeh Heydarpour
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Martha Híjar
- Research Coordination, AC Environments Foundation, Cuernavaca, Mexico
- CISS, National Institute of Public Health, Cuernavaca, Mexico
| | - Hung Chak Ho
- Department of Urban Planning and Design, University of Hong Kong, Hong Kong, China
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Michael K Hole
- Department of Pediatrics, Dell Medical School, University of Texas Austin, Austin, TX, USA
| | - Ramesh Holla
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Naznin Hossain
- Department of Pharmacology and Therapeutics, Dhaka Medical College, Dhaka, Bangladesh
- Department of Pharmacology, Bangladesh Industrial Gases Limited, Tangail, Bangladesh
| | - Mehdi Hosseinzadeh
- Department of Computer Engineering, Islamic Azad University, Tehran, Iran
- Computer Science Department, University of Human Development, Sulaymaniyah, Iraq
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Central South University, Changsha, China
| | | | | | - Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena D Ilic
- Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | | | - Endang Indriasih
- Center for Health Resource and Services Research and Development, National Institute of Health Research & Development, Jakarta, Indonesia
| | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - M Mofizul Islam
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC, Australia
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Kathryn H Jacobsen
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA
| | | | - Nader Jahanmehr
- School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mihajlo Jakovljevic
- Department for Health Care and Public Health, I M Sechenov First Moscow State Medical University, Moscow, Russia
| | - Farzad Jalilian
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sudha Jayaraman
- Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Achala Upendra Jayatilleke
- Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Graduate Studies, University of Colombo, Colombo, Sri Lanka
| | - Ravi Prakash Jha
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Beijing Ophthalmology & Visual Science Key Laboratory, Beijing Tongren Hospital, Beijing, China
| | - Nitin Joseph
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Farahnaz Joukar
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | | | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Rajendra Kadel
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Amaha Kahsay
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
| | - Leila R Kalankesh
- Department of Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Kalhor
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Teshome Abegaz Kamil
- School of Public Health, Department of Health Informatics and Health Innovation, A C S Medical College and Hospital, Mekelle, Ethiopia
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Manoochehr Karami
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Taras Kavetskyy
- Department of Applied Physics, The John Paul II Catholic University of Lublin, Lublin Voivodeship, Poland
- Department of Biology and Chemistry, Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
| | | | | | | | - Bayew Kelkay
- Department of Midwifery, University of Gondar, Gondar, Ethiopia
| | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Morteza Abdullatif Khafaie
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nauman Khalid
- School of Food and Agricultural Sciences, University of Management and Technology, Lahore, Pakistan
| | - Ibrahim A Khalil
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Rovshan Khalilov
- Department of Physiology, Baku State University, Baku, Azerbaijan
| | - Mohammad Khammarnia
- Health Care Management, Zahedan University of Medical Sciences, zahedan, Iran
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Maseer Khan
- Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Tripti Khanna
- Department of Health Research, Indian Council of Medical Research, New Delhi, India
- Centre for Ethics, Jawahar Lal Nehru University, New Delhi, India
| | - Habibolah Khazaie
- Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Roba Khundkar
- Nuffield Department of Surgical Sciences, Oxford University Global Surgery Group, University of Oxford, Oxford, UK
| | | | - Young-Eun Kim
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, MA, USA
| | - Yun Jin Kim
- School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Hamidreza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Brain Engineering Research Center, Institute for Research in Fundamental Sciences, Tehran, Iran
| | | | - Vladimir Andreevich Korshunov
- Department of Epidemiology and Evidence Based Medicine, I M Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ai Koyanagi
- CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Kewal Krishan
- Department of Anthropology, Panjab University, Chandigarh, India
| | - Burcu Kucuk Bicer
- Department of Public Health, Yuksek Ihtisas University, Ankara, Turkey
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Nuworza Kugbey
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
- Department of Psychology and Health Promotion, University of KwaZulu-Natal, Durban, South Africa
| | - Vivek Kumar
- Department of Medicine, Brigham and Women's Hospital, Harvard University, Boston, MA, USA
| | - Nithin Kumar
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - G Anil Kumar
- Public Health Foundation of India, Gurugram, India
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
| | - Girikumar Kumaresh
- Mechanical and Industrial Engineering, Indian Institute of Technology, Roorkee, Roorkee, India
| | - Om P Kurmi
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Oluwatosin Kuti
- Health and Nutrition Section, United Nations Childrens' Fund (UNICEF), Accra, Ghana
| | - Carlo La Vecchia
- Department of Clinical Medicine and Community Health, University of Milan, Milano, Italy
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | | | - Justin J Lang
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Van C Lansingh
- HelpMeSee, New York, NY, USA
- International Relations, Mexican Institute of Ophthalmology, Queretaro, Mexico
| | | | - Savita Lasrado
- Department of Otorhinolaryngology (ENT), Father Muller Medical College, Mangalore, India
| | - Arman Latifi
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Paolo Lauriola
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
| | - Janet L Leasher
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | | | - Miriam Levi
- Regional Centre for the Analysis of Data on Occupational and Work-related Injuries and Diseases, Local Health Unit Tuscany Centre, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shai Linn
- School of Public Health, University of Haifa, Haifa, Israel
| | - Xuefeng Liu
- Department of Systems, Populations and Leadership, University of Michigan, Ann Arbor, MI, USA
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Paulo A Lotufo
- Department of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Raimundas Lunevicius
- Department of General Surgery, Aintree University Hospital National Health Service (NHS) Foundation Trust, Liverpool, UK
- Department of Surgery, University of Liverpool, Liverpool, UK
| | - Ronan A Lyons
- Health Data Research UK, Swansea University, Swansea, UK
| | - Mohammed Madadin
- College of Medicine, Pathology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Jeadran N Malagon-Rojas
- Public Health Research Department, National Health Institute Colombia, Bogota, Colombia
- Faculty of Medicine, El Bosque University, Bogota, Colombia
| | - Venkatesh Maled
- Health Education and Research Department, SDM College of Medical Sciences & Hospital, Dharwad, India
- Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Navid Manafi
- Department of Ophthalmology, Iran University of Medical Sciences, Tehran, Iran
- Ophthalmology Department, University of Manitoba, Winnipeg, MB, Canada
| | - Amir Manafi
- Department of Surgery, University of Virginia, Charlottesville, VA, USA
| | - Ana-Laura Manda
- Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Borhan Mansouri
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Joemer C Maravilla
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
| | - Lyn M March
- Institute of Bone and Joint Research, University of Sydney, St Leonards, NSW, Australia
| | | | - Seyedeh Zahra Masoumi
- Department of Midwifery-Reproductive Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Benjamin Ballard Massenburg
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | - Pallab K Maulik
- Research Department, The George Institute for Global Health, New Delhi, India
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Addisu Melese
- Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Peter T N Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Baltimore, MD, USA
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
| | - Ritesh G Menezes
- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Meresa Berwo Mengesha
- College of Health Science, Department of Midwifery, Adigrat University, Adigrat, Ethiopia
| | | | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Atte Meretoja
- Neurocenter, Helsinki University Hospital, Helsinki, Finland
- School of Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | | | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, ZoraProfozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Ted R Miller
- School of Public Health, Curtin University, Perth, WA, Australia
- Pacific Institute for Research & Evaluation, Calverton, MD, USA
| | - G K Mini
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Global Institute of Public Health (GIPH), Ananthapuri Hospitals and Research Centre, Trivandrum, India
| | - Andreea Mirica
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- President's Office, National Institute of Statistics Romania, Bucharest, Romania
| | - Erkin M Mirrakhimov
- Faculty of Internal Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
- Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
| | - Mehdi Mirzaei-Alavijeh
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Masoud Moghadaszadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Efat Mohamadi
- Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | | | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | | | | | - Milad Mohammadoo-Khorasani
- Department of Clinical Biochemistry, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | | | - Shafiu Mohammed
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | | | - Farnam Mohebi
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Iran National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Yoshan Moodley
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Moradi
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Setagaya, Japan
| | - Shane Douglas Morrison
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, USA
| | | | - Atalay Goshu Muluneh
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Srinivas Murthy
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Kamarul Imran Musa
- School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia
| | - Ghulam Mustafa
- Department of Pediatric Medicine, Nishtar Medical University, Multan, Pakistan
- Department of Pediatrics & Pediatric Pulmonology, Institute of Mother & Child Care, Multan, Pakistan
| | - Ashraf F Nabhan
- Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt
- Knowledge Translation and Utilization, Egyptian Center for Evidence Based Medicine, Egypt
| | - Ahamarshan Jayaraman Nagarajan
- Research and Analytics, Initiative for Financing Health and Human Development, Chennai, India
- Research and Analytics, Bioinsilico Technologies, Chennai, India
| | - Gurudatta Naik
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russia
| | - Farid Najafi
- Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Bruno Ramos Nascimento
- Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Morteza Naserbakht
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Vinod Nayak
- Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Manipal, India
| | | | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | - Rajan Nikbakhsh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Heidelberg University Hospital, Heidelberg, Germany
| | - Dina Nur Anggraini Ningrum
- Public Health Department, Universitas Negeri Semarang, Kota Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | - Chukwudi A Nnaji
- Cochrane Unit, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Peter S Nyasulu
- Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Felix Akpojene Ogbo
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Onome Bright Oghenetega
- Reproductive Health Sciences, Department Obstetrics and Gynecology, University of Ibadan, Ibadan, Nigeria
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea
| | | | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaimaniyah, Iraq
| | - Obinna E Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
| | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Accra, Ghana
- Discipline of Psychology, University of KwaZulu-Natal, Durban, South Africa
| | - Heather M Orpana
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Erika Ota
- Department of Global Health Nursing, St Luke's International University, Chuo-ku, Japan
| | - Nikita Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Academic department, Unium Ltd, Moscow, Russia
| | - Stanislav S Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | | | - Smita Pakhale
- Department of Medicine, Ottawa Hospital Research Institute, Ottawa ON, Canada
| | - Keyvan Pakshir
- Parasitology and Mycology, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | - Sangram Kishor Patel
- Research and Evaluation, Population Council, New Delhi, India
- Indian Institute of Health Management Research University Delhi, Jaipur, India
| | - Ashish Pathak
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatircs, RD Gardi Medical College, Ujjain, India
| | - Sanghamitra Pati
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India
| | - George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Population Health Theme, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - Kebreab Paulos
- Department of Midwifery, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amy E Peden
- Royal Life Saving Society, Sydney, NSW, Australia
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Jeevan Pereira
- Department of Orthopedics, Yenepoya Medical College, Mangalore, India
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
- Department of Psychiatry, Department of Epidemiology, Columbia University, New York City, NY, USA
| | - Marina Pinheiro
- Department of Chemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Roman V Polibin
- Department of Epidemiology and Evidence-Based Medicine, Sechenon University, Moscow, Russia
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Hossein Poustchi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Swayam Prakash
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Parul Puri
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Zahiruddin Quazi Syed
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando, FL, USA
- College of Graduate Health Sciences, A T Still University, Mesa, AZ, USA
| | - Anwar Rafay
- Department of Epidemiology & Biostatistics, Contech School of Public Health, Lahore, Pakistan
| | - Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Alireza Rafiei
- Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fakher Rahim
- Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Siavash Rahimi
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, VIC, Australia
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
| | | | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ivo Rakovac
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization (WHO), Moscow, Russia
| | | | - Sowmya J Rao
- Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Tehran, Iran
| | - Prateek Rastogi
- Forensic Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Priya Rathi
- Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Academic Public Health Department, Public Health England, London, UK
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, CQ University, Sydney, NSW, Australia
| | - Reza Rawassizadeh
- Department of Computer Science, Metropolitan College, Boston University, Boston, USA
| | - Vishnu Renjith
- Neurology Department, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Andre M N Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | | | - Aziz Rezapour
- Organization for the Prevention of Blindness, Paris, France
| | - Ana Isabel Ribeiro
- EPIUnit - Public Health Institute University Porto (ISPUP), University of Porto, Porto, Portugal
| | - Jennifer Rickard
- Surgery Department, University of Minnesota, Minneapolis, MN, USA
- Surgery Department, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Carlos Miguel Rios González
- Research Directorate, Nihon Gakko University, Fernando de la Mora, Paraguay
- Research Direction, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Anas M Saad
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Yogesh Damodar Sabde
- National Institute for Research in Environmental Health, Indian Council of Medical Research, Bhopal, India
| | - Siamak Sabour
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Basema Saddik
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Saeed Safari
- Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Safari-Faramani
- Faculty of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Safarpour
- Department of Health in Disasters and Emergencies, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Safdarian
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
| | | | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farkhonde Salehi
- Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saleh Salehi Zahabi
- Radiology and Nuclear Medicine Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Research Deputy, Taleghani Hospital, Kermanshah, Iran
| | | | - Hosni Salem
- Department of Urology, Cairo University, Cairo, Egypt
| | - Omar Salman
- Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Inbal Salz
- Health and Disability Intelligence Group, Ministry of Health, Wellington, New Zealand
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, WV, USA
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Lidia Sanchez Riera
- Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Institute of Bone and Joint Research, University of Sydney, Syndey, NSW, Australia
| | - Milena M Santric Milicevic
- Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
- Centre-School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Abdur Razzaque Sarker
- Health Economics, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Brijesh Sathian
- Surgery Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Susan M Sawyer
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia
| | - Sonia Saxena
- School of Public Health, Imperial College London, London, UK
| | - Mehdi Sayyah
- Faculty member of Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Feng Sha
- Center for Biomedical Information Technology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Faramarz Shaahmadi
- Department of Health Promotion and Education, Alborz University of Medical Sciences, Karaj, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Morteza Shamsizadeh
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
- Division of General Internal Medicine, Harvard University, Boston, MA, USA
| | | | - Jae Il Shin
- College of Medicine, Yonsei University, Seodaemun-gu, South Korea
- Division of Cardiology, Emory University, Atlanta, GA, USA
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Soraya Siabani
- Department of Health Education & Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
- School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Health and Behavior Studies, Columbia University, New York, NY, USA
| | | | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Medicine Service, US Department of Veterans Affairs (VA), Birmingham, AL, USA
| | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Catalin-Gabriel Smarandache
- 2nd Department of Surgery-SUUB, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 2nd Surgery Department, Bucharest Emergency Hospital, Bucharest, Romania
| | - Emma U R Smith
- Pain Management Research Institute (PMRI), Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
- Michael J Cousins Pain Management & Research Centre, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Amin Soheili
- Department of Medical Surgical Nursing, Urmia University of Medical Science, Urmia, Iran
- Emergency Nursing Department, Semnan University of Medical Sciences, Semnan, Iran
| | - Bija Soleymani
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Reza Soltanian
- Department of Biostatistics, Hamedan University of Medical Sciences, Hamadan, Iran
| | - Joan B Soriano
- Hospital Universitario de la Princesa, Autonomous University of Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | | | - Ireneous N Soyiri
- Hull York Medical School, University of Hull, Hull City, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council, Cape Town, South Africa
| | - Mark A Stokes
- Department of Psychology, Deakin University, Burwood, VIC, Australia
| | | | | | - Bryan L Sykes
- Department of Criminology, Law and Society, University of California Irvine, Irvine, CA, USA
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Karen M Tabb
- School of Social Work, University of Illinois, Urbana, IL, USA
| | - Biruk Wogayehu Taddele
- Department of Public Health, Arbaminch College of Health Sciences, Arbaminch town sikela, Ethiopia
| | - Degena Bahrey Tadesse
- Department of Nursing, Aksum University, Aksum, Ethiopia
- Axum College of Health Science, mekelle, Ethiopia
| | | | - Ingan Ukur Tarigan
- Center for Health Resource and Services Research and Development, National Institute of Health Research & Development, Jakarta, Indonesia
| | - Yonatal Mesfin Tefera
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | - Rekha Thapar
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | | | | | - Hamid Reza Tohidinik
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Roman Topor-Madry
- Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
- The Agency for Health Technology Assessment and Tariff System, Warszawa, Poland
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Military Medical University, Hanoi, Vietnam
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Alexander C Tsai
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Saif Ullah
- Institute of Soil and Environmental Sciences, A T Still University, Faisalabad, Pakistan
| | - Irfan Ullah
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
- TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan
| | - Maida Umar
- Research Department, National Institute of Population Studies (NIPS), Islamabad, Pakistan
| | - Bhaskaran Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Era Upadhyay
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | | | - Pascual R Valdez
- Argentine Society of Medicine, Buenos Aires, Argentina
- Velez Sarsfield Hospital, Buenos Aires, Argentina
| | | | - Narayanaswamy Venketasubramanian
- Raffles Neuroscience Centre, Raffles Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yasir Waheed
- Foundation University Medical College, Foundation University, Islamabad, Pakistan
| | | | - Andrea Werdecker
- Demographic Change and Ageing Research Area, Federal Institute for Population Research, Wiesbaden, Germany
- Center of Population and Health, Wiesbaden, Germany
| | - Taweewat Wiangkham
- Department of Physical Therapy, Naresuan University, Meung District, Thailand
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Dawit Habte Woldeyes
- Department of Human Anatomy, Histology, Embryology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Dawit Zewdu Wondafrash
- Department of Pharmacology and Toxicology, Mekelle University, Mekelle, Ethiopia
- Department of Pharmacology, Addis Ababa University, Addis ababa, Ethiopia
| | | | - Adam Belay Wondmieneh
- Department of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Nursing, Wollo University, Dessie, Ethiopia
| | - Ai-Min Wu
- Department of Orthopaedics, Wenzhou Medical University, Wenzhou, China
| | - Rajaram Yadav
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Ali Yadollahpour
- Medical Physics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa ON, Canada
| | - Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Health Management, Policy and Economics, Kerman University of Medical Sciences, Kerman, Iran
| | - Paul Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Engida Yisma
- School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Naohiro Yonemoto
- Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, South Korea
| | - Mustafa Z Younis
- Department of Health Policy & Management, Jackson State University, Jackson, MS, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Zabihollah Yousefi
- Department of Environmental Health, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Environmental Health, Academy of Medical Science, Sari, Iran
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Hasan Yusefzadeh
- Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
| | - Telma Zahirian Moghadam
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
| | - Sojib Bin Zaman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Zamanian
- Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
- Department of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran
| | - Ahmad Zarei
- Department of Environment Health Engineering, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Fatemeh Zare
- Faculty of Medical Sciences, Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, Wuhan University, Wuhan, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Sanjay Zodpey
- Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Public Health Foundation of India, Gurugram, India
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Public Health Foundation of India, Gurugram, India
| | - Louisa Degenhardt
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Benn Sartorius
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Lalloo R, Lucchesi LR, Bisignano C, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Liu Z, Roberts NLS, Sylte DO, Alahdab F, Alipour V, Alsharif U, Arabloo J, Bagherzadeh M, Banach M, Bijani A, Crowe CS, Daryani A, Do HP, Doan LP, Fischer F, Gebremeskel GG, Haagsma JA, Haj-Mirzaian A, Haj-Mirzaian A, Hamidi S, Hoang CL, Irvani SSN, Kasaeian A, Khader YS, Khalilov R, Khoja AT, Kiadaliri AA, Majdan M, Manaf N, Manafi A, Massenburg BB, Mohammadian-Hafshejani A, Morrison SD, Nguyen TH, Nguyen SH, Nguyen CT, Olagunju TO, Otstavnov N, Polinder S, Rabiee N, Rabiee M, Ramezanzadeh K, Ranganathan K, Rezapour A, Safari S, Samy AM, Sanchez Riera L, Shaikh MA, Tran BX, Vahedi P, Vahedian-Azimi A, Zhang ZJ, Pigott DM, Hay SI, Mokdad AH, James SL. Epidemiology of facial fractures: incidence, prevalence and years lived with disability estimates from the Global Burden of Disease 2017 study. Inj Prev 2020; 26:i27-i35. [PMID: 31915268 PMCID: PMC7571355 DOI: 10.1136/injuryprev-2019-043297] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/07/2019] [Accepted: 08/12/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND The Global Burden of Disease Study (GBD) has historically produced estimates of causes of injury such as falls but not the resulting types of injuries that occur. The objective of this study was to estimate the global incidence, prevalence and years lived with disability (YLDs) due to facial fractures and to estimate the leading injurious causes of facial fracture. METHODS We obtained results from GBD 2017. First, the study estimated the incidence from each injury cause (eg, falls), and then the proportion of each cause that would result in facial fracture being the most disabling injury. Incidence, prevalence and YLDs of facial fractures are then calculated across causes. RESULTS Globally, in 2017, there were 7 538 663 (95% uncertainty interval 6 116 489 to 9 493 113) new cases, 1 819 732 (1 609 419 to 2 091 618) prevalent cases, and 117 402 (73 266 to 169 689) YLDs due to facial fractures. In terms of age-standardised incidence, prevalence and YLDs, the global rates were 98 (80 to 123) per 100 000, 23 (20 to 27) per 100 000, and 2 (1 to 2) per 100 000, respectively. Facial fractures were most concentrated in Central Europe. Falls were the predominant cause in most regions. CONCLUSIONS Facial fractures are predominantly caused by falls and occur worldwide. Healthcare systems and public health agencies should investigate methods of all injury prevention. It is important for healthcare systems in every part of the world to ensure access to treatment resources.
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Affiliation(s)
- Ratilal Lalloo
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Lydia R Lucchesi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota, USA
| | - Vahid Alipour
- Health Management and Economics Research Center, Tehran, Iran
- Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Ubai Alsharif
- Department of Oral and Maxillofacial Surgery, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | | | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Huyen Phuc Do
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Linh Phuong Doan
- Center of Excellence in Health Service Management, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Florian Fischer
- School of Public Health Medicine, Bielefeld University, Bielefeld, Germany
| | - Gebreamlak Gebremedhn Gebremeskel
- Nursing Department, College of Health Science, Aksum University, Aksum, Ethiopia
- Nursing Department, Mekelle University, Mekelle, Ethiopia
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Arvin Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arya Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Saleh Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Ramtha, Jordan
| | - Rovshan Khalilov
- Department of Physiology, Baku State University, Baku, Azerbaijan
| | - Abdullah T Khoja
- Department of Public Health, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Navid Manaf
- Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran
- Ophthalmology Department, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ali Manafi
- Plastic Surgery Department, Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Trang Huyen Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Son Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Nikita Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Academic Department, Unium Ltd, Moscow, Russia
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Navid Rabiee
- Chemistry Department, Sharif University of Technology, Tehran, Iran
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Kiana Ramezanzadeh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Safari
- Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Lidia Sanchez Riera
- Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Institute of Bone and Joint Research, University of Sydney, Syndey, New South Wales, Australia
| | | | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Parviz Vahedi
- Assistant Professor of Anatomical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, Wuhan University, Wuhan, China
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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27
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Crowe CS, Massenburg BB, Morrison SD, Chang J, Friedrich JB, Abady GG, Alahdab F, Alipour V, Arabloo J, Asaad M, Banach M, Bijani A, Borzì AM, Briko NI, Castle CD, Cho DY, Chung MT, Daryani A, Demoz GT, Dingels ZV, Do HT, Fischer F, Fox JT, Fukumoto T, Gebre AK, Gebremichael B, Haagsma JA, Haj-Mirzaian A, Handiso DW, Hay SI, Hoang CL, Irvani SSN, Jozwiak JJ, Kalhor R, Kasaeian A, Khader YS, Khalilov R, Khan EA, Khundkar R, Kisa S, Kisa A, Liu Z, Majdan M, Manafi N, Manafi A, Manda AL, Meretoja TJ, Miller TR, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohseni Bandpei MA, Mokdad AH, Naimzada MD, Ndwandwe DE, Nguyen CT, Nguyen HLT, Olagunju AT, Olagunju TO, Pham HQ, Pribadi DRA, Rabiee N, Ramezanzadeh K, Ranganathan K, Roberts NLS, Roever L, Safari S, Samy AM, Sanchez Riera L, Shahabi S, Smarandache CG, Sylte DO, Tesfay BE, Tran BX, Ullah I, Vahedi P, Vahedian-Azimi A, Vos T, Woldeyes DH, Wondmieneh AB, Zhang ZJ, James SL. Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study. Inj Prev 2020; 26:i115-i124. [PMID: 32169973 PMCID: PMC7571361 DOI: 10.1136/injuryprev-2019-043495] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/26/2019] [Accepted: 12/28/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017. Individual injuries included hand and wrist fractures, thumb amputations and non-thumb digit amputations. RESULTS The global incidence of hand trauma has only modestly decreased since 1990. In 2017, the age-standardised incidence of hand and wrist fractures was 179 per 100 000 (95% uncertainty interval (UI) 146 to 217), whereas the less common injuries of thumb and non-thumb digit amputation were 24 (95% UI 17 to 34) and 56 (95% UI 43 to 74) per 100 000, respectively. Rates of injury vary greatly by region, and improvements have not been equally distributed. The highest burden of hand trauma is currently reported in high SDI countries. However, low-middle and middle SDI countries have increasing rates of hand trauma by as much at 25%. CONCLUSIONS Certain regions are noted to have high rates of hand trauma over the study period. Low-middle and middle SDI countries, however, have demonstrated increasing rates of fracture and amputation over the last 27 years. This trend is concerning as access to quality and subspecialised surgical hand care is often limiting in these resource-limited regions.
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Affiliation(s)
- Christopher Stephen Crowe
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA
| | - Benjamin Ballard Massenburg
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA
| | - Shane Douglas Morrison
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA
| | - James Chang
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California, USA
| | - Jeffrey Barton Friedrich
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA
| | - Gdiom Gebreheat Abady
- College of Medicine and Health Sciences, Department of Nursing, Adigrat University, Adigrat, Ethiopia
| | - Fares Alahdab
- Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota, USA
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Malke Asaad
- Plastic Surgery Department, University of Texas, Houston, Texas, USA
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland.,Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Antonio Maria Borzì
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Nikolay Ivanovich Briko
- Epidemiology and Evidence Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Chris D Castle
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Daniel Youngwhan Cho
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA
| | - Michael T Chung
- Department of Otolaryngology - Head & Neck Surgery, Wayne State University, Detroit, Michigan, USA
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Gebre Teklemariam Demoz
- School of Pharmacy, Aksum University, Aksum, Ethiopia.,Addis Ababa University, Addis Ababa, Ethiopia
| | - Zachary V Dingels
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Hoa Thi Do
- Center of Excellence in Public Health Nutrition, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Florian Fischer
- Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany
| | - Jack T Fox
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Takeshi Fukumoto
- Department of Dermatology, Kobe University, Kobe, Japan.,Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, Pennsylvania, USA
| | | | | | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Arvin Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran.,Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Seyed Sina Naghibi Irvani
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | - Rohollah Kalhor
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Rovshan Khalilov
- Department of Physiology, Baku State University, Baku, Azerbaijan
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Roba Khundkar
- Nuffield Department of Surgical Sciences, Oxford University Global Surgery Group, University of Oxford, Oxford, UK
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Zichen Liu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Marek Majdan
- Department of Public Health, Trnava University, Trnava, Slovakia
| | - Navid Manafi
- Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran.,Ophthalmology Department, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ali Manafi
- Plastic Surgery Department, Iran University of Medical Sciences, Tehran, Iran
| | - Ana-Laura Manda
- Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
| | - Ted R Miller
- Pacific Institute for Research & Evaluation, Calverton, Maryland, USA.,School of Public Health, Curtin University, Perth, Western Australia, Australia
| | | | | | - Mohammad A Mohseni Bandpei
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia.,Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russia
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
| | - Kiana Ramezanzadeh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Nicholas L S Roberts
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil
| | - Saeed Safari
- Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Lidia Sanchez Riera
- Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.,Institute of Bone and Joint Research, University of Sydney, Syndey, New South Wales, Australia
| | - Saeed Shahabi
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Catalin-Gabriel Smarandache
- Surgery 2nd Department - SUUB, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Surgery 2nd Department, Bucharest Emergency Hospital, Bucharest, Romania
| | - Dillon O Sylte
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Irfan Ullah
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan.,TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan
| | - Parviz Vahedi
- Department of Anatomical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Facility, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Dawit Habte Woldeyes
- Department of Human Anatomy, Histology, and Embryology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Adam Belay Wondmieneh
- Department of Nursing, Wollo University, Dessie, Ethiopia.,Department of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, Wuhan University, Wuhan, China
| | - Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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28
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Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, Abdel-Rahman O, Abdelalim A, Abdoli A, Abdollahpour I, Abdulle ASM, Abebe ND, Abraha HN, Abu-Raddad LJ, Abualhasan A, Adedeji IA, Advani SM, Afarideh M, Afshari M, Aghaali M, Agius D, Agrawal S, Ahmadi A, Ahmadian E, Ahmadpour E, Ahmed MB, Akbari ME, Akinyemiju T, Al-Aly Z, AlAbdulKader AM, Alahdab F, Alam T, Alamene GM, Alemnew BTT, Alene KA, Alinia C, Alipour V, Aljunid SM, Bakeshei FA, Almadi MAH, Almasi-Hashiani A, Alsharif U, Alsowaidi S, Alvis-Guzman N, Amini E, Amini S, Amoako YA, Anbari Z, Anber NH, Andrei CL, Anjomshoa M, Ansari F, Ansariadi A, Appiah SCY, Arab-Zozani M, Arabloo J, Arefi Z, Aremu O, Areri HA, Artaman A, Asayesh H, Asfaw ET, Ashagre AF, Assadi R, Ataeinia B, Atalay HT, Ataro Z, Atique S, Ausloos M, Avila-Burgos L, Avokpaho EFGA, Awasthi A, Awoke N, Ayala Quintanilla BP, Ayanore MA, Ayele HT, Babaee E, Bacha U, Badawi A, Bagherzadeh M, Bagli E, Balakrishnan S, Balouchi A, Bärnighausen TW, Battista RJ, Behzadifar M, Behzadifar M, Bekele BB, Belay YB, Belayneh YM, Berfield KKS, Berhane A, Bernabe E, Beuran M, Bhakta N, Bhattacharyya K, Biadgo B, Bijani A, Bin Sayeed MS, Birungi C, Bisignano C, Bitew H, Bjørge T, Bleyer A, Bogale KA, Bojia HA, Borzì AM, Bosetti C, Bou-Orm IR, Brenner H, Brewer JD, Briko AN, Briko NI, Bustamante-Teixeira MT, Butt ZA, Carreras G, Carrero JJ, Carvalho F, Castro C, Castro F, Catalá-López F, Cerin E, Chaiah Y, Chanie WF, Chattu VK, Chaturvedi P, Chauhan NS, Chehrazi M, Chiang PPC, Chichiabellu TY, Chido-Amajuoyi OG, Chimed-Ochir O, Choi JYJ, Christopher DJ, Chu DT, Constantin MM, Costa VM, Crocetti E, Crowe CS, Curado MP, Dahlawi SMA, Damiani G, Darwish AH, Daryani A, das Neves J, Demeke FM, Demis AB, Demissie BW, Demoz GT, Denova-Gutiérrez E, Derakhshani A, Deribe KS, Desai R, Desalegn BB, Desta M, Dey S, Dharmaratne SD, Dhimal M, Diaz D, Dinberu MTT, Djalalinia S, Doku DT, Drake TM, Dubey M, Dubljanin E, Duken EE, Ebrahimi H, Effiong A, Eftekhari A, El Sayed I, Zaki MES, El-Jaafary SI, El-Khatib Z, Elemineh DA, Elkout H, Ellenbogen RG, Elsharkawy A, Emamian MH, Endalew DA, Endries AY, Eshrati B, Fadhil I, Fallah Omrani V, Faramarzi M, Farhangi MA, Farioli A, Farzadfar F, Fentahun N, Fernandes E, Feyissa GT, Filip I, Fischer F, Fisher JL, Force LM, Foroutan M, Freitas M, Fukumoto T, Futran ND, Gallus S, Gankpe FG, Gayesa RT, Gebrehiwot TT, Gebremeskel GG, Gedefaw GA, Gelaw BK, Geta B, Getachew S, Gezae KE, Ghafourifard M, Ghajar A, Ghashghaee A, Gholamian A, Gill PS, Ginindza TTG, Girmay A, Gizaw M, Gomez RS, Gopalani SV, Gorini G, Goulart BNG, Grada A, Ribeiro Guerra M, Guimaraes ALS, Gupta PC, Gupta R, Hadkhale K, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Hanfore LK, Haro JM, Hasankhani M, Hasanzadeh A, Hassen HY, Hay RJ, Hay SI, Henok A, Henry NJ, Herteliu C, Hidru HD, Hoang CL, Hole MK, Hoogar P, Horita N, Hosgood HD, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hussen MM, Ileanu B, Ilic MD, Innos K, Irvani SSN, Iseh KR, Islam SMS, Islami F, Jafari Balalami N, Jafarinia M, Jahangiry L, Jahani MA, Jahanmehr N, Jakovljevic M, James SL, Javanbakht M, Jayaraman S, Jee SH, Jenabi E, Jha RP, Jonas JB, Jonnagaddala J, Joo T, Jungari SB, Jürisson M, Kabir A, Kamangar F, Karch A, Karimi N, Karimian A, Kasaeian A, Kasahun GG, Kassa B, Kassa TD, Kassaw MW, Kaul A, Keiyoro PN, Kelbore AG, Kerbo AA, Khader YS, Khalilarjmandi M, Khan EA, Khan G, Khang YH, Khatab K, Khater A, Khayamzadeh M, Khazaee-Pool M, Khazaei S, Khoja AT, Khosravi MH, Khubchandani J, Kianipour N, Kim D, Kim YJ, Kisa A, Kisa S, Kissimova-Skarbek K, Komaki H, Koyanagi A, Krohn KJ, Bicer BK, Kugbey N, Kumar V, Kuupiel D, La Vecchia C, Lad DP, Lake EA, Lakew AM, Lal DK, Lami FH, Lan Q, Lasrado S, Lauriola P, Lazarus JV, Leigh J, Leshargie CT, Liao Y, Limenih MA, Listl S, Lopez AD, Lopukhov PD, Lunevicius R, Madadin M, Magdeldin S, El Razek HMA, Majeed A, Maleki A, Malekzadeh R, Manafi A, Manafi N, Manamo WA, Mansourian M, Mansournia MA, Mantovani LG, Maroufizadeh S, Martini SMS, Mashamba-Thompson TP, Massenburg BB, Maswabi MT, Mathur MR, McAlinden C, McKee M, Meheretu HAA, Mehrotra R, Mehta V, Meier T, Melaku YA, Meles GG, Meles HG, Melese A, Melku M, Memiah PTN, Mendoza W, Menezes RG, Merat S, Meretoja TJ, Mestrovic T, Miazgowski B, Miazgowski T, Mihretie KMM, Miller TR, Mills EJ, Mir SM, Mirzaei H, Mirzaei HR, Mishra R, Moazen B, Mohammad DK, Mohammad KA, Mohammad Y, Darwesh AM, Mohammadbeigi A, Mohammadi H, Mohammadi M, Mohammadian M, Mohammadian-Hafshejani A, Mohammadoo-Khorasani M, Mohammadpourhodki R, Mohammed AS, Mohammed JA, Mohammed S, Mohebi F, Mokdad AH, Monasta L, Moodley Y, Moosazadeh M, Moossavi M, Moradi G, Moradi-Joo M, Moradi-Lakeh M, Moradpour F, Morawska L, Morgado-da-Costa J, Morisaki N, Morrison SD, Mosapour A, Mousavi SM, Muche AA, Muhammed OSS, Musa J, Nabhan AF, Naderi M, Nagarajan AJ, Nagel G, Nahvijou A, Naik G, Najafi F, Naldi L, Nam HS, Nasiri N, Nazari J, Negoi I, Neupane S, Newcomb PA, Nggada HA, Ngunjiri JW, Nguyen CT, Nikniaz L, Ningrum DNA, Nirayo YL, Nixon MR, Nnaji CA, Nojomi M, Nosratnejad S, Shiadeh MN, Obsa MS, Ofori-Asenso R, Ogbo FA, Oh IH, Olagunju AT, Olagunju TO, Oluwasanu MM, Omonisi AE, Onwujekwe OE, Oommen AM, Oren E, Ortega-Altamirano DDV, Ota E, Otstavnov SS, Owolabi MO, P A M, Padubidri JR, Pakhale S, Pakpour AH, Pana A, Park EK, Parsian H, Pashaei T, Patel S, Patil ST, Pennini A, Pereira DM, Piccinelli C, Pillay JD, Pirestani M, Pishgar F, Postma MJ, Pourjafar H, Pourmalek F, Pourshams A, Prakash S, Prasad N, Qorbani M, Rabiee M, Rabiee N, Radfar A, Rafiei A, Rahim F, Rahimi M, Rahman MA, Rajati F, Rana SM, Raoofi S, Rath GK, Rawaf DL, Rawaf S, Reiner RC, Renzaho AMN, Rezaei N, Rezapour A, Ribeiro AI, Ribeiro D, Ronfani L, Roro EM, Roshandel G, Rostami A, Saad RS, Sabbagh P, Sabour S, Saddik B, Safiri S, Sahebkar A, Salahshoor MR, Salehi F, Salem H, Salem MR, Salimzadeh H, Salomon JA, Samy AM, Sanabria J, Santric Milicevic MM, Sartorius B, Sarveazad A, Sathian B, Satpathy M, Savic M, Sawhney M, Sayyah M, Schneider IJC, Schöttker B, Sekerija M, Sepanlou SG, Sepehrimanesh M, Seyedmousavi S, Shaahmadi F, Shabaninejad H, Shahbaz M, Shaikh MA, Shamshirian A, Shamsizadeh M, Sharafi H, Sharafi Z, Sharif M, Sharifi A, Sharifi H, Sharma R, Sheikh A, Shirkoohi R, Shukla SR, Si S, Siabani S, Silva DAS, Silveira DGA, Singh A, Singh JA, Sisay S, Sitas F, Sobngwi E, Soofi M, Soriano JB, Stathopoulou V, Sufiyan MB, Tabarés-Seisdedos R, Tabuchi T, Takahashi K, Tamtaji OR, Tarawneh MR, Tassew SG, Taymoori P, Tehrani-Banihashemi A, Temsah MH, Temsah O, Tesfay BE, Tesfay FH, Teshale MY, Tessema GA, Thapa S, Tlaye KG, Topor-Madry R, Tovani-Palone MR, Traini E, Tran BX, Tran KB, Tsadik AG, Ullah I, Uthman OA, Vacante M, Vaezi M, Varona Pérez P, Veisani Y, Vidale S, Violante FS, Vlassov V, Vollset SE, Vos T, Vosoughi K, Vu GT, Vujcic IS, Wabinga H, Wachamo TM, Wagnew FS, Waheed Y, Weldegebreal F, Weldesamuel GT, Wijeratne T, Wondafrash DZ, Wonde TE, Wondmieneh AB, Workie HM, Yadav R, Yadegar A, Yadollahpour A, Yaseri M, Yazdi-Feyzabadi V, Yeshaneh A, Yimam MA, Yimer EM, Yisma E, Yonemoto N, Younis MZ, Yousefi B, Yousefifard M, Yu C, Zabeh E, Zadnik V, Moghadam TZ, Zaidi Z, Zamani M, Zandian H, Zangeneh A, Zaki L, Zendehdel K, Zenebe ZM, Zewale TA, Ziapour A, Zodpey S, Murray CJL. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol 2019; 5:1749-1768. [PMID: 31560378 PMCID: PMC6777271 DOI: 10.1001/jamaoncol.2019.2996] [Citation(s) in RCA: 1447] [Impact Index Per Article: 289.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Importance Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs). Conclusions and Relevance The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.
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Affiliation(s)
| | - Christina Fitzmaurice
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Division of Hematology, University of Washington, Seattle
| | | | - Naghmeh Abbasi
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
| | - Hedayat Abbastabar
- Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Omar Abdel-Rahman
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, Ain Shams University, Cairo, Egypt
| | | | - Amir Abdoli
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
- Research Center for Non-communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ibrahim Abdollahpour
- Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
- Multiple Sclerosis Research Center, Tehran, Iran
| | - Abdishakur S M Abdulle
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Nebiyu Dereje Abebe
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, Wachemo University, Hossana, Ethiopia
| | | | - Laith Jamal Abu-Raddad
- Department of Healthcare Policy and Research, Weill Cornell Medical College in Qatar, Doha, Qatar
| | | | | | - Shailesh M Advani
- Social Behavioral Research Branch, National Institutes of Health, Bethesda, Maryland
- Cancer Prevention and Control Program, Georgetown University, Washington, DC
| | - Mohsen Afarideh
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Aghaali
- Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
| | - Dominic Agius
- Department of Health, Directorate for Health Information and Research, Pieta, Malta
| | - Sutapa Agrawal
- Public Health Foundation of India, Gurugram, India
- Vital Strategies, Gurugram, India
| | - Ayat Ahmadi
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ahmadian
- Department of Pharmacology and Toxicology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Ahmadpour
- Department of Parasitology and Mycology, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Tomi Akinyemiju
- Department of Population Health Sciences, Duke University, Durham, North Carolina
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Ziyad Al-Aly
- John T. Milliken Department of Internal Medicine, Washington University in St. Louis, St Louis, Missouri
- Clinical Epidemiology Center, VA Saint Louis Health Care System, Department of Veterans Affairs, St Louis, Missouri
| | - Assim M AlAbdulKader
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio
| | - Fares Alahdab
- Evidence-Based Practice Research Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota
| | - Tahiya Alam
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Birhan Tamene T Alemnew
- Department of Health Sciences, Woldia University, Woldia, Ethiopia
- Department of Microbiology, Immunology, and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kefyalew Addis Alene
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Research School of Population Health, Australian National University, Canberra, Australian Capitol Territory, Australia
| | - Cyrus Alinia
- Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | - Majid Abdulrahman Hamad Almadi
- Department of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Gastroenterology and Hepatology, McGill University, Montreal, Québec, Canada
| | | | - Ubai Alsharif
- Department of Oral and Maxillofacial Surgery, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
| | - Shirina Alsowaidi
- College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Nelson Alvis-Guzman
- Research Group in Health Economics, Universidad de Cartagena, Cartagena, Colombia
- Research Group in Hospital Management and Health Policies, Universidad de la Costa, Barranquilla, Colombia
| | - Erfan Amini
- Department of Urology, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Amini
- Department of Health Services Management, Arak University of Medical Sciences, Arak, Iran
| | - Yaw Ampem Amoako
- Department of Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Zohreh Anbari
- Department of Health Services Management, Arak University of Medical Sciences, Arak, Iran
| | | | | | - Mina Anjomshoa
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fereshteh Ansari
- Research Center for Evidence Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for International Health, Ludwig Maximilians University, Munich, Germany
| | - Morteza Arab-Zozani
- Department of Healthcare Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zohreh Arefi
- Department of Health Education and Health Promotion, Tehran University of Medical Sciences, Tehran, Iran
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, England, United Kingdom
| | - Habtamu Abera Areri
- School of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Al Artaman
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | | | - Reza Assadi
- Education Development Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bahar Ataeinia
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zerihun Ataro
- Department of Medical Laboratory Science, Haramaya University, Harar, Ethiopia
| | - Suleman Atique
- University Institute of Public Health, The University of Lahore, Lahore, Pakistan
- College ofPublic Health, University of Hail, Hail, Saudi Arabia
| | - Marcel Ausloos
- School of Business, University of Leicester, Leicester, England, United Kingdom
| | - Leticia Avila-Burgos
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Euripide F G A Avokpaho
- Bénin Clinical Research Institute, Abomey-Calavi, Benin
- Contrôle des Maladies Infectieuses, Laboratory of Studies and Research-Action in Health, Porto Novo, Benin
| | - Ashish Awasthi
- Public Health Foundation of India, Gurugram, India
- Indian Institute of Public Health, Gandhinagar, India
| | - Nefsu Awoke
- Department of Nursing, Wolaita Sodo University, Sodo, Ethiopia
| | - Beatriz Paulina Ayala Quintanilla
- The Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, Peru
| | - Martin Amogre Ayanore
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Henok Tadesse Ayele
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
- Public Health Department, Dilla University, Dilla, Ethiopia
| | - Ebrahim Babaee
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Umar Bacha
- School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | | | - Eleni Bagli
- Department of Ophthalmology, University Hospital of Ioannina, Ioannina, Greece
- Institute of Molecular Biology & Biotechnology, Foundation for Research & Technology, Ioannina, Greece
| | | | - Abbas Balouchi
- School of Nursing and Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Masoud Behzadifar
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | - Bayu Begashaw Bekele
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Public Health Department, Mizan-Tepi University, Teppi, Ethiopia
| | - Yared Belete Belay
- Department of Pharmacoepidemiology and Social Pharmacy, Mekelle University, Mekelle, Ethiopia
- AC Environments Foundation, Cuernavaca, Mexico
| | | | | | - Adugnaw Berhane
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eduardo Bernabe
- Dental Institute, King's College London, London, England, United Kingdom
| | - Mircea Beuran
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Nickhill Bhakta
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Krittika Bhattacharyya
- Department of Biostatistics and Bioinformatics, National Institute of Biomedical Genomics, Kalyani, India
| | - Belete Biadgo
- Department of Clinical Chemistry, University of Gondar, Gondar, Ethiopia
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Muhammad Shahdaat Bin Sayeed
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- Department of Clinical Pharmacy and Pharmacology, University of Dhaka, Ramna, Bangladesh
| | - Charles Birungi
- The UCL Centre for Global Health Economics, University College London, London, England, United Kingdom
- Fast-Track Implementation Department, United Nations Programme on HIV/AIDS, Gaborone, Botswana
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Helen Bitew
- School of Pharmacy, Mekelle University, Mekelle, Ethiopia
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Archie Bleyer
- Department of Radiation Medicine, Oregon Health and Science University, Portland
- Department of Pediatrics, The University of Texas, Houston
| | | | - Hunduma Amensisa Bojia
- School of Pharmacy, College of Medicine and Health Science, Haramaya University, Harar, Ethiopia
| | - Antonio M Borzì
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - Cristina Bosetti
- Department of Oncology, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Jerry D Brewer
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | | | - Nikolay Ivanovich Briko
- Department of Epidemiology and Evidence-Based Medicine, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Zahid A Butt
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Juan J Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Félix Carvalho
- Applied Molecular Biosciences Unit, University of Porto, Porto, Portugal
- Institute of Public Health, University of Porto, Porto, Portugal
| | - Clara Castro
- Department of Epidemiology, Portuguese Oncology Institute of Porto, Porto, Portugal
- EpiUnit, Instituto de Saúde Pública, University of Cartagena, Cartagena, Colombia
| | - Franz Castro
- Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Ferrán Catalá-López
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Yazan Chaiah
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Vijay Kumar Chattu
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- China Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Pankaj Chaturvedi
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Neelima Singh Chauhan
- Department of Obstetrics and Gynecology, People's College of Medical Sciences and Research Centre, Bhopal, India
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, Iran
- Epidemiology Research Center, Royan Institute, Tehran, Iran
| | | | | | - Onyema Greg Chido-Amajuoyi
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas, Houston
| | - Odgerel Chimed-Ochir
- Institute of Industrial Ecological Science, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Jee-Young J Choi
- Departments ofBiochemistry and Biomedical Science, Seoul National University Hospital, Seoul, South Korea
| | | | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
- Department of Cancer Immunology, Oslo University Hospital, Oslo, Norway
| | - Maria-Magdalena Constantin
- Department of Dermatology, 2nd Clinic of Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 2nd Department of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
| | - Vera M Costa
- UCIBIO/REQUIMTE, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Emanuele Crocetti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Maria Paula Curado
- Department of Epidemiology, A. C. Camargo Cancer Center, Sao Paulo, Brazil
| | - Saad M A Dahlawi
- Department of Environmental Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Giovanni Damiani
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | | | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - José das Neves
- Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal
- Institute of Biomedical Engineering (INEB), University of Porto, Porto, Portugal
| | - Feleke Mekonnen Demeke
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Asmamaw Bizuneh Demis
- Nursing Department, Woldia University, Woldia, Ethiopia
- Department of Nursing, Jimma University, Jimma, Ethiopia
| | | | - Gebre Teklemariam Demoz
- School of Pharmacy, Aksum University, Aksum, Ethiopia
- Addis Ababa University, Addis Ababa, Ethiopia
| | - Edgar Denova-Gutiérrez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Afshin Derakhshani
- Department of Immunology, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Rupak Desai
- Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia
| | | | - Melaku Desta
- Department of Midwifery, Debre Berhan University, Debre Berhan, Ethiopia
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
| | | | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Meghnath Dhimal
- Health Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Daniel Diaz
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
- Center of Complexity Sciences, National Autonomous University of Mexico, Mexico City, Mexico
| | | | - Shirin Djalalinia
- Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - David Teye Doku
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Thomas M Drake
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Manisha Dubey
- United Nations World Food Programme, New Delhi, India
| | | | - Eyasu Ejeta Duken
- College of Health Sciences, Wollega University, Nekemte, Ethiopia
- Mycobacteriology Research Center, Jimma University, Jimma, Ethiopia
| | - Hedyeh Ebrahimi
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobiliary Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Andem Effiong
- Department of Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, New South Wales, Australia
| | - Aziz Eftekhari
- Department of Pharmacology and Toxicology, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Basic Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Iman El Sayed
- Medical Research Institute, Alexandria University, Alexandria, Egypt
| | | | | | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Hajer Elkout
- Department of Community Medicine, Tripoli University, Tripoli, Libya
- Department of Health Information, World Health Organization, Tripoli, Libya
| | - Richard G Ellenbogen
- Department of Neurology, University of Washington, Seattle
- Department of Surgery, Seattle Children's Hospital, Seattle, Washington
| | - Aisha Elsharkawy
- Endemic Medicine and Hepatogastroenterology Department, Cairo University, Cairo, Egypt
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Aman Yesuf Endries
- Public Health Department, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Babak Eshrati
- Center of Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
- School of Public Health, Arak University of Medical Sciences, Arak, Iran
| | - Ibtihal Fadhil
- Department of Non-communicable Diseases, Ministry of Public Health, Dubai, United Arab Emirates
| | | | | | | | - Andrea Farioli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Farshad Farzadfar
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Netsanet Fentahun
- Department of Public Health Nutrition, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Garumma Tolu Feyissa
- Department of Health Education and Behavioral Sciences, Jimma University, Jimma, Ethiopia
- Jimma University, Jimma, Ethiopia
| | - Irina Filip
- Department of Psychiatry, Kaiser Permanente, Fontana, California
- School of Health Sciences, A.T. Still University, Mesa, Arizona
| | - Florian Fischer
- School of Public Health Medicine, Bielefeld University, Bielefeld, Germany
| | - James L Fisher
- James Cancer Hospital, Ohio State University, Columbus, Ohio
| | - Lisa M Force
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Marisa Freitas
- Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Takeshi Fukumoto
- Gene Expression and Regulation Program, Cancer Institute, Philadelphia, Pennsylvania
- Department of Dermatology, Kobe University, Kobe, Japan
| | - Neal D Futran
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle
| | - Silvano Gallus
- Department of Environmental Health Science, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Fortune Gbetoho Gankpe
- Faculty of Medicine and Pharmacy of Fez, University Sidi Mohammed Ben Abdellah, Fez, Morocco
- Non-communicable Disease Department, Laboratory of Studies and Research-Action in Health, Porto Novo, Benin
| | | | | | | | - Getnet Azeze Gedefaw
- Bahir Dar University, Bahir Dar, Ethiopia
- Haramaya University, Dire Dawa, Ethiopia
| | | | - Birhanu Geta
- Department of Pharmacy, Wollo University, Dessie, Ethiopia
| | - Sefonias Getachew
- Department of Preventive Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle, Germany
| | | | - Mansour Ghafourifard
- Medical Surgical Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ghajar
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Medicine, Massachusetts General Hospital, Boston
| | - Ahmad Ghashghaee
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Asadollah Gholamian
- Physiology Department, Iran University of Medical Sciences, Tehran, Iran
- Medical Department, Islamic Azad University, Rasht, Iran
| | - Paramjit Singh Gill
- Unit of Academic Primary Care, University of Warwick, Coventry, England, United Kingdom
| | - Themba T G Ginindza
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
- University of KwaZulu-Natal, Durban, South Africa
| | - Alem Girmay
- Department of Nursing, A.C.S. Medical College and Hospital, Aksum, Ethiopia
| | - Muluken Gizaw
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Sameer Vali Gopalani
- Department of Biostatistics and Epidemiology, University of Oklahoma, Oklahoma City
- Department of Health and Social Affairs, Government of the Federated States of Micronesia, Palikir, Federated States of Micronesia
| | - Giuseppe Gorini
- Occupational and Environmental Epidemiology Section, Cancer Prevention and Research Institute, Florence, Italy
| | | | - Ayman Grada
- School of Medicine, Boston University, Boston, Massachusetts
| | | | | | - Prakash C Gupta
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Rahul Gupta
- West Virginia Bureau for Public Health, Charleston
- Department of Health Policy, Management & Leadership, West Virginia University, Morgantown
| | | | - Arvin Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arya Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland
| | - Randah R Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | | | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network, Madrid, Spain
- Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - Milad Hasankhani
- School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Hasanzadeh
- Department of Microbiology, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Microbiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Yimam Hassen
- Public Health Department, Mizan-Tepi University, Teppi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Roderick J Hay
- International Foundation for Dermatology, London, England, United Kingdom
- St John's Institute of Dermatology, King's College London, London, England, United Kingdom
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | | | - Nathaniel J Henry
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Claudiu Herteliu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Hagos D Hidru
- Department of Epidemiology, Adigrat University, Adigrat, Ethiopia
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | | | - Praveen Hoogar
- Transdisciplinary Centre for Qualitative Methods, Manipal University, Manipal, India
| | - Nobuyuki Horita
- Department of Pulmonology, Yokohama City University, Kanazawa-ku, Yokohama, Japan
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hosseinzadeh
- Department of Computer Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Department of Computer Science, University of Human Development, Sulaimaniyah, Iraq
| | - Mihaela Hostiuc
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Internal Medicine, Bucharest Emergency Hospital, Bucharest, Romania
| | - Sorin Hostiuc
- Faculty of Dentistry, Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Clinical Legal Medicine, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
- Qatar Foundation, Doha, Qatar
| | | | - Bogdan Ileanu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- Center for Health Outcomes & Evaluation, Bucharest, Romania
| | - Milena D Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Seyed Sina Naghibi Irvani
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kufre Robert Iseh
- Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | | | - Morteza Jafarinia
- ,Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Jahangiry
- Health Education and Health Promotion Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Nader Jahanmehr
- School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Sudha Jayaraman
- Department of Surgery, Virginia Commonwealth University, Richmond
| | - Sun Ha Jee
- Department of Public Health, Yonsei University, Seoul, South Korea
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Ensiyeh Jenabi
- Faculty of Nursing & Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ravi Prakash Jha
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Jitendra Jonnagaddala
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
- NSW Health, Sydney, New South Wales, Australia
| | - Tamas Joo
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | | | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farin Kamangar
- Department of Biology, Morgan State University, Baltimore, Maryland
| | - André Karch
- Institute for Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Narges Karimi
- Immunogenetics Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Neurology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ansar Karimian
- Cellular and Molecular Biology Research Center, Babol University of Medical Sciences, Babol, Iran
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Belete Kassa
- Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, Dessie, Ethiopia
| | | | - Mesfin Wudu Kassaw
- Nursing Department, Woldia University, Woldia, Ethiopia
- Department of Public Health, Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Anil Kaul
- School of Health Care Administration, Oklahoma State University, Tulsa
- Health Care Delivery Sciences, University of Tulsa, Tulsa, Oklahoma
| | | | | | - Amene Abebe Kerbo
- Department of Public Health, Madda Walabu University, Goba, Ethiopia
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yousef Saleh Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Ramtha, Jordan
| | - Maryam Khalilarjmandi
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Gulfaraz Khan
- Department of Medical Microbiology & Immunology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Young-Ho Khang
- Division of Health Policy and Management, Seoul National University, Seoul, South Korea
| | - Khaled Khatab
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, United Kingdom
- College of Arts and Sciences, Ohio University, Zanesville
| | - Amir Khater
- Internal Medicine and Gastroenterology Department, National Hepatology and Tropical Research Institute, Cairo, Egypt
| | - Maryam Khayamzadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Academy of Medical Sciences, Tehran, Iran
| | - Maryam Khazaee-Pool
- Department of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Salman Khazaei
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abdullah T Khoja
- Department of Public Health, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland
| | - Mohammad Hossein Khosravi
- Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran
- International Otorhinolaryngology Research Association, Tehran, Iran
| | - Jagdish Khubchandani
- Department of Nutrition and Health Science, Ball State University, Muncie, Indiana
| | - Neda Kianipour
- Department of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Yun Jin Kim
- School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Adnan Kisa
- Department of Health Management and Health Economics, Kristiania University College, Oslo, Norway
- Department of Health Services Policy & Management, University of South Carolina, Columbia
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Hamidreza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Brain Engineering Research Center, Institute for Research in Fundamental Sciences, Tehran, Iran
| | - Ai Koyanagi
- Networking Center for Mental Health Network, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | - Kristopher J Krohn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Burcu Kucuk Bicer
- Department of Public Health, Yüksek Ihtisas University, Ankara, Turkey
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Nuworza Kugbey
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
- Department of Psychology and Health Promotion, University of KwaZulu-Natal, Durban, South Africa
| | - Vivek Kumar
- Department of Medicine Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Desmond Kuupiel
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Nursing, St. John of God Hospital, Duayaw Nkwanta, Ghana
| | - Carlo La Vecchia
- Clinical Medicine and Community Health, A.C.S. Medical College and Hospital, Milan, Italy
| | - Deepesh P Lad
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Eyasu Alem Lake
- Department of Nursing, Wolaita Sodo University, Sodo, Ethiopia
| | - Ayenew Molla Lakew
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | | | - Faris Hasan Lami
- Department of Community and Family Medicine, Academy of Medical Science, Baghdad, Iraq
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Savita Lasrado
- Department of Otorhinolaryngology-Head and Neck Surgery, Father Muller Medical College, Mangalore, India
| | - Paolo Lauriola
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
| | | | - James Leigh
- Asbestos Diseases Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | | | - Yu Liao
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou, China
- Alliance for Improving Health Outcomes, Inc, Quezon City, Philippines
| | | | - Stefan Listl
- Department of Dentistry, Radboud University, Nijmegen, Netherlands
- Section for Translational Health Economics, Heidelberg University Hospital, Heidelberg, Germany
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- University of Melbourne, Melbourne, Queensland, Australia
| | - Platon D Lopukhov
- Department of Epidemiology and Evidence-Based Medicine, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Raimundas Lunevicius
- Department of General Surgery, Aintree University Hospital National Health Service Foundation Trust, Liverpool, England, United Kingdom
- Department of Surgery, University of Liverpool, Liverpool, England, United Kingdom
| | - Mohammed Madadin
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sameh Magdeldin
- Proteomics and Metabolomics Unit, Suez Canal University, Cairo, Egypt
- Department of Physiology, Suez Canal University, Ismailia, Egypt
| | | | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, England, United Kingdom
| | - Afshin Maleki
- Department of Environmental Health, Tehran University of Medical Sciences, Tehran, Iran
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Manafi
- Department of Plastic Surgery, Iran University of Medical Sciences, Tehran, Iran
| | - Navid Manafi
- Department of Ophthalmology, Iran University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Morteza Mansourian
- Department of Health Education and Promotion, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Saman Maroufizadeh
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Santi Martini S Martini
- Department of Epidemiology, Airlangga University, Surabaya, Indonesia
- Indonesian Public Health Association, Surabaya, Indonesia
| | | | | | | | - Manu Raj Mathur
- Public Health Foundation of India, Gurugram, India
- Department of Epidemiology and Public Health, University College London, London, England, United Kingdom
| | - Colm McAlinden
- Department of Ophthalmology, Hywel Dda University Health Board, Carmarthen, Wales, United Kingdom
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, England, United Kingdom
| | - Hailemariam Abiy Alemu Meheretu
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
- School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ravi Mehrotra
- Department of Preventive Oncology, National Institute of Cancer Prevention and Research, Noida, India
| | - Varshil Mehta
- Department of Internal Medicine, SevenHills Hospital, Mumbai, India
| | - Toni Meier
- Institute for Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle, Germany
- Innovation Office, Competence Cluster for Nutrition and Cardiovascular Health, Halle, Germany
| | - Yohannes A Melaku
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | | | | | - Addisu Melese
- Department of Medical Laboratory Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mulugeta Melku
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Peter T N Memiah
- Department of Public Health, University of West Florida, Pensacola, Florida
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund, Lima, Peru
| | - Ritesh G Menezes
- Forensic Medicine Division, Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shahin Merat
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
- Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Hypertension, Pomeranian Medical University, Szczecin, Poland
| | | | - Ted R Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Edward J Mills
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Seyed Mostafa Mir
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
- Golestan University of Medical Sciences, Golestan, Iran
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Mirzaei
- Department of Medical Immunology, Tehran University of Medical Sciences, Tehran, Iran
| | - Rashmi Mishra
- Department of Oral Medicine, University of Washington, Seattle
| | - Babak Moazen
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research, Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Dara K Mohammad
- Department of Biology, Salahaddin University, Erbil, Iraq
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | | | - Yousef Mohammad
- Department of Internal Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | - Abolfazl Mohammadbeigi
- Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
| | - Hiwa Mohammadi
- Department of Neurology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moslem Mohammadi
- Department of Physiology and Pharmacology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Mohammadian
- Department of Epidemiology and Biostatistics, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | | | | | - Ammas Siraj Mohammed
- School of Pharmacy, College of Medicine and Health Science, Haramaya University, Harar, Ethiopia
| | | | - Shafiu Mohammed
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | - Farnam Mohebi
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Iran National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Yoshan Moodley
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Moossavi
- Department of Molecular Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Moradi-Joo
- Department of Economics and Management Sciences for Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Setagaya, Japan
| | | | - Abbas Mosapour
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
- Department of Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
| | - Seyyed Meysam Mousavi
- Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Oumer Sada S Muhammed
- Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jonah Musa
- Department of Obstetrics and Gynecology, University of Jos, Jos, Nigeria
- Center for Global Health, Northwestern University, Chicago, Illinois
| | - Ashraf F Nabhan
- Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt
- Knowledge Translation and Utilization, Egyptian Center for Evidence Based Medicine, Cairo, Egypt
| | - Mehdi Naderi
- School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ahamarshan Jayaraman Nagarajan
- Department of Research and Analytics, Initiative for Financing Health and Human Development, Chennai, India
- Department of Research and Analytics, Bioinsilico Technologies, Chennai, India
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Azin Nahvijou
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gurudatta Naik
- O'NealComprehensive Cancer Center, University of Alabama at Birmingham
| | - Farid Najafi
- Department of Epidemiology and Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Luigi Naldi
- Department of Dermatology, San Bortolo Hospital, Vicenza, Italy
- GISED Study Center, Bergamo, Italy
| | - Hae Sung Nam
- Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon, South Korea
- Daejeon Regional Cancer Center, Chungnam National University Hospital, Daejeon, South Korea
| | - Naser Nasiri
- Department of Public Health, School of Public Health, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Javad Nazari
- Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran
- Ministry of Health and Medical Education, Tehran, Iran
| | - Ionut Negoi
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Subas Neupane
- Faculty of Health Sciences, University of Tampere, Tampere, Finland
| | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle
| | - Haruna Asura Nggada
- Department of Histopathology, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
- Department of Human Pathology, University of Maiduguri, Maiduguri, Nigeria
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dina Nur Anggraini Ningrum
- Department of Public Health Sciences, State University of Semarang, Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | | | - Molly R Nixon
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Chukwudi A Nnaji
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Marzieh Nojomi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shirin Nosratnejad
- Department of Health Economics, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Richard Ofori-Asenso
- Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, Australia
- Independent consultant, Accra, Ghana
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mojisola Morenike Oluwasanu
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Abidemi E Omonisi
- Department of Anatomic Pathology, Ekiti State University, Ado- Ekiti, Nigeria
- Department of Anatomic Pathology, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Obinna E Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Anu Mary Oommen
- Department of Community Health, Christian Medical College, Vellore, India
| | - Eyal Oren
- Department of Epidemiology, University of Washington, Seattle
- Graduate School of Public Health, San Diego State University, San Diego, California
| | | | - Erika Ota
- Department of Global Health Nursing, St. Luke's International University, Chuo-ku, Japan
| | | | - Mayowa Ojo Owolabi
- Institute for Advanced Medical Research and Training, University of Ibadan, Ibadan, Nigeria
| | - Mahesh P A
- Department of TB & Respiratory Medicine, Jagadguru Sri Shivarathreeswara University, Mysore, India
| | | | - Smita Pakhale
- Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Amir H Pakpour
- Department of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, Jönköping University, Jönköping, Sweden
| | - Adrian Pana
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- Center for Health Outcomes & Evaluation, Bucharest, Romania
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | - Hadi Parsian
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
| | - Tahereh Pashaei
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Shanti Patel
- Department of Medicine, Maimonides Medical Center, Brooklyn, New York
| | - Snehal T Patil
- Krishna Institute of Medical Sciences, Deemed University, Karad, India
| | - Alyssa Pennini
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - David M Pereira
- Requimte/LAQV, University of Porto, Porto, Portugal
- University of Cartagena, Cartagena, Colombia
| | - Cristiano Piccinelli
- ReferenceCenter for Epidemiology and Cancer Prevention, CPO Piedmont, Torino, Italy
| | - Julian David Pillay
- Basic Medical Sciences Department, Durban University of Technology, Durban, South Africa
| | - Majid Pirestani
- Departments of Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farhad Pishgar
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maarten J Postma
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Hadi Pourjafar
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Farshad Pourmalek
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Akram Pourshams
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Swayam Prakash
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Narayan Prasad
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Rabiee
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
- Divisions of Chemistry and Diseases, Advanced Technologies Research Group, Tehran, Iran
| | | | - Alireza Rafiei
- Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fakher Rahim
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahdi Rahimi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Muhammad Aziz Rahman
- Austin Health Clinical School of Nursing, La Trobe University, Heidelberg, Victoria, Australia
- National Centre for Farmer Health, Deakin University, Waurn Ponds, Victoria, Australia
| | - Fatemeh Rajati
- Department of Health Education and Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saleem M Rana
- Department of Public Health, Contech School of Public Health, Lahore, Pakistan
- Public Health Department, University of Health Sciences, Lahore, Pakistan
| | - Samira Raoofi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Goura Kishor Rath
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, England, United Kingdom
- University College London Hospitals, London, England, United Kingdom
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, England, United Kingdom
- Academic Public Health, Public Health England, London, England, United Kingdom
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Andre M N Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy, and Autoimmunity, Universal Scientific Education and Research Network, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ana Isabel Ribeiro
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
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- Department of Applied Chemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Elias Merdassa Roro
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, Wollega University, Nekemte, Ethiopia
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- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
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- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
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- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
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- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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- Medical Department, University of Sharjah, Sharjah, United Arab Emirates
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- Managerial Epidemiology Research Center, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Farkhonde Salehi
- Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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- Department of Urology, Cairo University, Cairo, Egypt
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- Public Health and Community Medicine Department, Cairo University, Giza, Egypt
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- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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- Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University, Stanford, California
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- Department of Entomology, Ain Shams University, Cairo, Egypt
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- Department of Surgery, Marshall University, Huntington, West Virginia
- Departments of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, Ohio
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- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, England, United Kingdom
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- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
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- Surgery Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, England, United Kingdom
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- UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
- Udyam-Global Association for Sustainable Development, Bhubaneswar, India
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- Department of Public Health Sciences, University of North Carolina at Charlotte
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- Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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- School of Health Sciences, Federal University of Santa Catarina, Ararangua, Brazil
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- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
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- Department of Medical Statistics, Epidemiology and Medical Informatics, University of Zagreb, Zagreb, Croatia
- Division of Epidemiology and Prevention of Chronic Noncommunicable Diseases, Croatian Institute of Public Health, Zagreb, Croatia
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- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
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- Center of Expertise in Microbiology, Tehran University of Medical Sciences, Tehran, Iran
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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- Department of Health Promotion and Education, Alborz University of Medical Sciences, Karaj, Iran
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- Department of Health Policy, Iran University of Medical Sciences, Tehran, Iran
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- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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- Department of Medical Laboratory Sciences, Mazandaran University of Medical Sciences, Sari, Iran
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- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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- Department of Molecular Hepatology, Middle East Liver Disease Center, Tehran, Iran
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- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
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- Department of Basic Sciences, Islamic Azad University, Sari, Iran
- Department of Laboratory Sciences, Islamic Azad University, Sari, Iran
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- Department of Ophthalmology, Kerman University of Medical Sciences, Kerman, Iran
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- HIV/STI Surveillance Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
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- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
- Division of General Internal Medicine and Primary Care, Harvard University, Boston, Massachusetts
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- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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- Symbiosis Institute of Health Sciences, Symbiosis International University, Pune, Maharashtra, India
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- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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- Imam Ali Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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- University of Brasília, Brasília, Brazil
- Department of the Health Industrial Complex and Innovation in Health, Ministry of Health, Brasília, Brazil
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- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Global Patient Outcome and Real World Evidence, Eli Lilly and Company, Indianapolis, Indiana
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- Department of Medicine, University of Alabama at Birmingham
- Department of Epidemiology, University of Alabama at Birmingham
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- Medical Department, German Leprosy and TB Relief Association, Addis Ababa, Ethiopia
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- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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- Department of Internal Medicine and Specialties, University of Yaoundé I, Yaoundé, Cameroon
- Department of Endocrinology and Diabetes, Central Hospital of Yaoundé, Yaoundé, Cameroon
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- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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- Hospital Universitario de la Princesa, Autonomous University of Madrid, Madrid, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias, Institute of Health Carlos III, Madrid, Spain
| | - Vasiliki Stathopoulou
- Department of Occupational Therapy, Athens University of Applied Sciences, Athens, Greece
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- Department of Medicine, University of Valencia, Valencia, Spain
- Biomedical Research Networking Center for Mental Health Network, Carlos III Health Institute, Madrid, Spain
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Ken Takahashi
- Asbestos Diseases Research Institute, University of Sydney, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
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- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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- Department of Public Health, Kurdistan University of Medical Sciences, Sanandaj, Iran
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- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
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- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
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- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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- Mekelle University, Mekelle, Ethiopia
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, South Australia, Australia
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- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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- Department of Public Health, University of Southern Denmark, Odense, Denmark
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- Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- The Agency for Health Technology Assessment and Tariff System, Warsaw, Poland
| | | | - Eugenio Traini
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, The University of Auckland, Auckland, New Zealand
- Department of Clinical Hematology and Toxicology, Military Medical University, Hanoi, Vietnam
| | | | - Irfan Ullah
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
| | - Olalekan A Uthman
- Division of Health Sciences, University of Warwick, Coventry, England, United Kingdom
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Maryam Vaezi
- Women's Reproductive Health Research Center, A.C.S. Medical College and Hospital, Tabriz, Iran
- Alzahra Teaching Hospital, Tabriz, Iran
| | - Patricia Varona Pérez
- Department for International Development, Health Network of Cuba, Havana, Cuba
- Centre of Research in Environmental Epidemiology, Barcelona Institute for Global Health, Barcelona, Spain
| | - Yousef Veisani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Simone Vidale
- Department of Neurology & Stroke Unit, Sant'Anna Hospital, Como, Italy
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economy, National Research University Higher School of Economics, Moscow, Russia
| | - Stein Emil Vollset
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Kia Vosoughi
- Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland
| | - Giang Thu Vu
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | | | - Henry Wabinga
- Department of Pathology, Makerere University, Kampala, Uganda
| | | | | | - Yasir Waheed
- Foundation University Medical College, Foundation University, Rawalpindi, Pakistan
| | - Fitsum Weldegebreal
- Department of Medical Laboratory Science, Haramaya University, Harar, Ethiopia
| | | | - Tissa Wijeratne
- Department of Psychology and Counselling, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, St Albans, Victoria, Australia
| | - Dawit Zewdu Wondafrash
- Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmacology and Toxicology, Mekelle University, Mekelle, Ethiopia
| | | | - Adam Belay Wondmieneh
- Department of Nursing, Wollo University, Dessie, Ethiopia
- Department of Nursing, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Rajaram Yadav
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Abbas Yadegar
- Foodborne and Waterborne Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Yadollahpour
- Department of Medical Physics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Yazdi-Feyzabadi
- Department of Health Management, Policy, and Economics, Kerman University of Medical Sciences, Kerman, Iran
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | | | | | - Engida Yisma
- School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mustafa Z Younis
- Health Economics & Finance, Global Health, Jackson State University, Jackson, Mississippi
- Department of Public Health, Tsinghua University, Beijing, China
| | - Bahman Yousefi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Clinical Biochemistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmoud Yousefifard
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Erfan Zabeh
- Department of Electrical Engineering, Institute for Research in Fundamental Sciences, Tehran, Iran
- Department of Electrical Engineering, Bioelectric Group, Sharif University of Technology, Tehran, Iran
| | - Vesna Zadnik
- Epidemiology and Cancer Registry Sector, Institute of Oncology, Ljubljana, Slovenia
| | - Telma Zahirian Moghadam
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
| | - Alireza Zangeneh
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Leila Zaki
- Department of Parasitology, Tarbiat Modares University, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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- Department of Epidemiology and Biostatistics, Bahir Dar University, Bahir Dar, Ethiopia
| | - Arash Ziapour
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
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Chang AY, Cowling K, Micah AE, Chapin A, Chen CS, Ikilezi G, Sadat N, Tsakalos G, Wu J, Younker T, Zhao Y, Zlavog BS, Abbafati C, Ahmed AE, Alam K, Alipour V, Aljunid SM, Almalki MJ, Alvis-Guzman N, Ammar W, Andrei CL, Anjomshoa M, Antonio CAT, Arabloo J, Aremu O, Ausloos M, Avila-Burgos L, Awasthi A, Ayanore MA, Azari S, Azzopardi-Muscat N, Bagherzadeh M, Bärnighausen TW, Baune BT, Bayati M, Belay YB, Belay YA, Belete H, Berbada DA, Berman AE, Beuran M, Bijani A, Busse R, Cahuana-Hurtado L, Cámera LA, Catalá-López F, Chauhan BG, Constantin MM, Crowe CS, Cucu A, Dalal K, De Neve JW, Deiparine S, Demeke FM, Do HP, Dubey M, El Tantawi M, Eskandarieh S, Esmaeili R, Fakhar M, Fazaeli AA, Fischer F, Foigt NA, Fukumoto T, Fullman N, Galan A, Gamkrelidze A, Gezae KE, Ghajar A, Ghashghaee A, Goginashvili K, Haakenstad A, Haghparast Bidgoli H, Hamidi S, Harb HL, Hasanpoor E, Hassen HY, Hay SI, Hendrie D, Henok A, Heredia-Pi I, Herteliu C, Hoang CL, Hole MK, Homaie Rad E, Hossain N, Hosseinzadeh M, Hostiuc S, Ilesanmi OS, Irvani SSN, Jakovljevic M, Jalali A, James SL, Jonas JB, Jürisson M, Kadel R, Karami Matin B, Kasaeian A, Kasaye HK, Kassaw MW, Kazemi Karyani A, Khabiri R, Khan J, Khan MN, Khang YH, Kisa A, Kissimova-Skarbek K, Kohler S, Koyanagi A, Krohn KJ, Leung R, Lim LL, Lorkowski S, Majeed A, Malekzadeh R, Mansourian M, Mantovani LG, Massenburg BB, McKee M, Mehta V, Meretoja A, Meretoja TJ, Milevska Kostova N, Miller TR, Mirrakhimov EM, Mohajer B, Mohammad Darwesh A, Mohammed S, Mohebi F, Mokdad AH, Morrison SD, Mousavi SM, Muthupandian S, Nagarajan AJ, Nangia V, Negoi I, Nguyen CT, Nguyen HLT, Nguyen SH, Nosratnejad S, Oladimeji O, Olgiati S, Olusanya JO, Onwujekwe OE, Otstavnov SS, Pana A, Pereira DM, Piroozi B, Prada SI, Qorbani M, Rabiee M, Rabiee N, Rafiei A, Rahim F, Rahimi-Movaghar V, Ram U, Ranabhat CL, Ranta A, Rawaf DL, Rawaf S, Rezaei S, Roro EM, Rostami A, Rubino S, Salahshoor M, Samy AM, Sanabria J, Santos JV, Santric Milicevic MM, Sao Jose BP, Savic M, Schwendicke F, Sepanlou SG, Sepehrimanesh M, Sheikh A, Shrime MG, Sisay S, Soltani S, Soofi M, Soofi M, Srinivasan V, Tabarés-Seisdedos R, Torre A, Tovani-Palone MR, Tran BX, Tran KB, Undurraga EA, Valdez PR, van Boven JFM, Vargas V, Veisani Y, Violante FS, Vladimirov SK, Vlassov V, Vollmer S, Vu GT, Wolfe CDA, Yonemoto N, Younis MZ, Yousefifard M, Zaman SB, Zangeneh A, Zegeye EA, Ziapour A, Chew A, Murray CJL, Dieleman JL. Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050. Lancet 2019; 393:2233-2260. [PMID: 31030984 PMCID: PMC6548764 DOI: 10.1016/s0140-6736(19)30841-4] [Citation(s) in RCA: 213] [Impact Index Per Article: 42.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/22/2019] [Accepted: 03/27/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. METHODS We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories-government, out-of-pocket, and prepaid private health spending-and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health. FINDINGS Between 1995 and 2016, health spending grew at a rate of 4·00% (95% uncertainty interval 3·89-4·12) annually, although it grew slower in per capita terms (2·72% [2·61-2·84]) and increased by less than $1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5·55% [5·18-5·95]), mainly due to growth in government health spending, and in lower-middle-income countries (3·71% [3·10-4·34]), mainly from DAH. Health spending globally reached $8·0 trillion (7·8-8·1) in 2016 (comprising 8·6% [8·4-8·7] of the global economy and $10·3 trillion [10·1-10·6] in purchasing-power parity-adjusted dollars), with a per capita spending of US$5252 (5184-5319) in high-income countries, $491 (461-524) in upper-middle-income countries, $81 (74-89) in lower-middle-income countries, and $40 (38-43) in low-income countries. In 2016, 0·4% (0·3-0·4) of health spending globally was in low-income countries, despite these countries comprising 10·0% of the global population. In 2018, the largest proportion of DAH targeted HIV/AIDS ($9·5 billion, 24·3% of total DAH), although spending on other infectious diseases (excluding tuberculosis and malaria) grew fastest from 2010 to 2018 (6·27% per year). The leading sources of DAH were the USA and private philanthropy (excluding corporate donations and the Bill & Melinda Gates Foundation). For the first time, we included estimates of China's contribution to DAH ($644·7 million in 2018). Globally, health spending is projected to increase to $15·0 trillion (14·0-16·0) by 2050 (reaching 9·4% [7·6-11·3] of the global economy and $21·3 trillion [19·8-23·1] in purchasing-power parity-adjusted dollars), but at a lower growth rate of 1·84% (1·68-2·02) annually, and with continuing disparities in spending between countries. In 2050, we estimate that 0·6% (0·6-0·7) of health spending will occur in currently low-income countries, despite these countries comprising an estimated 15·7% of the global population by 2050. The ratio between per capita health spending in high-income and low-income countries was 130·2 (122·9-136·9) in 2016 and is projected to remain at similar levels in 2050 (125·9 [113·7-138·1]). The decomposition analysis identified governments' increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending. INTERPRETATION Financing for global health has increased steadily over the past two decades and is projected to continue increasing in the future, although at a slower pace of growth and with persistent disparities in per-capita health spending between countries. Out-of-pocket spending is projected to remain substantial outside of high-income countries. Many low-income countries are expected to remain dependent on development assistance, although with greater government spending, larger investments in health are feasible. In the absence of sustained new investments in health, increasing efficiency in health spending is essential to meet global health targets. FUNDING Bill & Melinda Gates Foundation.
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James SL, Theadom A, Ellenbogen RG, Bannick MS, Montjoy-Venning W, Lucchesi LR, Abbasi N, Abdulkader R, Abraha HN, Adsuar JC, Afarideh M, Agrawal S, Ahmadi A, Ahmed MB, Aichour AN, Aichour I, Aichour MTE, Akinyemi RO, Akseer N, Alahdab F, Alebel A, Alghnam SA, Ali BA, Alsharif U, Altirkawi K, Andrei CL, Anjomshoa M, Ansari H, Ansha MG, Antonio CAT, Appiah SCY, Ariani F, Asefa NG, Asgedom SW, Atique S, Awasthi A, Ayala Quintanilla BP, Ayuk TB, Azzopardi PS, Badali H, Badawi A, Balalla S, Banstola A, Barker-Collo SL, Bärnighausen TW, Bedi N, Behzadifar M, Behzadifar M, Bekele BB, Belachew AB, Belay YA, Bennett DA, Bensenor IM, Berhane A, Beuran M, Bhalla A, Bhaumik S, Bhutta ZA, Biadgo B, Biffino M, Bijani A, Bililign N, Birungi C, Boufous S, Brazinova A, Brown AW, Car M, Cárdenas R, Carrero JJ, Carvalho F, Castañeda-Orjuela CA, Catalá-López F, Chaiah Y, Champs AP, Chang JC, Choi JYJ, Christopher DJ, Cooper C, Crowe CS, Dandona L, Dandona R, Daryani A, Davitoiu DV, Degefa MG, Demoz GT, Deribe K, Djalalinia S, Do HP, Doku DT, Drake TM, Dubey M, Dubljanin E, El-Khatib Z, Ofori-Asenso R, Eskandarieh S, Esteghamati A, Esteghamati S, Faro A, Farzadfar F, Farzaei MH, Fereshtehnejad SM, Fernandes E, Feyissa GT, Filip I, Fischer F, Fukumoto T, Ganji M, Gankpe FG, Gebre AK, Gebrehiwot TT, Gezae KE, Gopalkrishna G, Goulart AC, Haagsma JA, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Haro JM, Hassankhani H, Hassen HY, Havmoeller R, Hawley C, Hay SI, Hegazy MI, Hendrie D, Henok A, Hibstu DT, Hoffman HJ, Hole MK, Homaie Rad E, Hosseini SM, Hostiuc S, Hu G, Hussen MA, Ilesanmi OS, Irvani SSN, Jakovljevic M, Jayaraman S, Jha RP, Jonas JB, Jones KM, Jorjoran Shushtari Z, Jozwiak JJ, Jürisson M, Kabir A, Kahsay A, Kahssay M, Kalani R, Karch A, Kasaeian A, Kassa GM, Kassa TD, Kassa ZY, Kengne AP, Khader YS, Khafaie MA, Khalid N, Khalil I, Khan EA, Khan MS, Khang YH, Khazaie H, Khoja AT, Khubchandani J, Kiadaliri AA, Kim D, Kim YE, Kisa A, Koyanagi A, Krohn KJ, Kuate Defo B, Kucuk Bicer B, Kumar GA, Kumar M, Lalloo R, Lami FH, Lansingh VC, Laryea DO, Latifi A, Leshargie CT, Levi M, Li S, Liben ML, Lotufo PA, Lunevicius R, Mahotra NB, Majdan M, Majeed A, Malekzadeh R, Manda AL, Mansournia MA, Massenburg BB, Mate KKV, Mehndiratta MM, Mehta V, Meles H, Melese A, Memiah PTN, Mendoza W, Mengistu G, Meretoja A, Meretoja TJ, Mestrovic T, Miazgowski T, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Moazen B, Mohammadi M, Mohammed S, Mokdad AH, Molokhia M, Monasta L, Mondello S, Moosazadeh M, Moradi G, Moradi M, Moradi-Lakeh M, Moradinazar M, Morrison SD, Moschos MM, Mousavi SM, Murthy S, Musa KI, Mustafa G, Naghavi M, Naik G, Najafi F, Nangia V, Nascimento BR, Negoi I, Nguyen TH, Nichols E, Ningrum DNA, Nirayo YL, Nyasulu PS, Ogbo FA, Oh IH, Okoro A, Olagunju AT, Olagunju TO, Olivares PR, Otstavnov SS, Owolabi MO, P A M, Pakhale S, Pandey AR, Pesudovs K, Pinilla-Monsalve GD, Polinder S, Poustchi H, Prakash S, Qorbani M, Radfar A, Rafay A, Rafiei A, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman M, Rahman MA, Rai RK, Rajati F, Ram U, Rawaf DL, Rawaf S, Reiner RC, Reis C, Renzaho AMN, Resnikoff S, Rezaei S, Rezaeian S, Roever L, Ronfani L, Roshandel G, Roy N, Ruhago GM, Saddik B, Safari H, Safiri S, Sahraian MA, Salamati P, Saldanha RDF, Samy AM, Sanabria J, Santos JV, Santric Milicevic MMM, Sartorius B, Satpathy M, Savuon K, Schneider IJC, Schwebel DC, Sepanlou SG, Shabaninejad H, Shaikh MAA, Shams-Beyranvand M, Sharif M, Sharif-Alhoseini M, Shariful Islam SM, She J, Sheikh A, Shen J, Sheth KN, Shibuya K, Shiferaw MS, Shigematsu M, Shiri R, Shiue I, Shoman H, Siabani S, Siddiqi TJ, Silva JP, Silveira DGA, Sinha DN, Smith M, Soares Filho AM, Sobhani S, Soofi M, Soriano JB, Soyiri IN, Stein DJ, Stokes MA, Sufiyan MB, Sunguya BF, Sunshine JE, Sykes BL, Szoeke CEI, Tabarés-Seisdedos R, Te Ao BJ, Tehrani-Banihashemi A, Tekle MG, Temsah MH, Temsah O, Topor-Madry R, Tortajada-Girbés M, Tran BX, Tran KB, Tudor Car L, Ukwaja KN, Ullah I, Usman MS, Uthman OA, Valdez PR, Vasankari TJ, Venketasubramanian N, Violante FS, Wagnew FWS, Waheed Y, Wang YP, Weldegwergs KG, Werdecker A, Wijeratne T, Winkler AS, Wyper GMA, Yano Y, Yaseri M, Yasin YJ, Ye P, Yimer EM, Yip P, Yisma E, Yonemoto N, Yoon SJ, Yost MG, Younis MZ, Yousefifard M, Yu C, Zaidi Z, Zaman SB, Zamani M, Zenebe ZM, Zodpey S, Feigin VL, Vos T, Murray CJL. Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18:56-87. [PMID: 30497965 PMCID: PMC6291456 DOI: 10.1016/s1474-4422(18)30415-0] [Citation(s) in RCA: 917] [Impact Index Per Article: 183.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/02/2018] [Accepted: 10/30/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. METHODS We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. FINDINGS In 2016, there were 27·08 million (95% uncertainty interval [UI] 24·30-30·30 million) new cases of TBI and 0·93 million (0·78-1·16 million) new cases of SCI, with age-standardised incidence rates of 369 (331-412) per 100 000 population for TBI and 13 (11-16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55·50 million (53·40-57·62 million) and of SCI was 27·04 million (24·98-30·15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8·4% (95% UI 7·7 to 9·2), whereas that of SCI did not change significantly (-0·2% [-2·1 to 2·7]). Age-standardised incidence rates increased by 3·6% (1·8 to 5·5) for TBI, but did not change significantly for SCI (-3·6% [-7·4 to 4·0]). TBI caused 8·1 million (95% UI 6·0-10·4 million) YLDs and SCI caused 9·5 million (6·7-12·4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82-141) per 100 000 for TBI and 130 (90-170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. INTERPRETATION TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments. FUNDING Bill & Melinda Gates Foundation.
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Dicker D, Nguyen G, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, Abbastabar H, Abd-Allah F, Abdela J, Abdelalim A, Abdel-Rahman O, Abdi A, Abdollahpour I, Abdulkader RS, Abdurahman AA, Abebe HT, Abebe M, Abebe Z, Abebo TA, Aboyans V, Abraha HN, Abrham AR, Abu-Raddad LJ, Abu-Rmeileh NME, Accrombessi MMK, Acharya P, Adebayo OM, Adedeji IA, Adedoyin RA, Adekanmbi V, Adetokunboh OO, Adhena BM, Adhikari TB, Adib MG, Adou AK, Adsuar JC, Afarideh M, Afshin A, Agarwal G, Aggarwal R, Aghayan SA, Agrawal S, Agrawal A, Ahmadi M, Ahmadi A, Ahmadieh H, Ahmed MLCB, Ahmed S, Ahmed MB, Aichour AN, Aichour I, Aichour MTE, Akanda AS, Akbari ME, Akibu M, Akinyemi RO, Akinyemiju T, Akseer N, Alahdab F, Al-Aly Z, Alam K, Alebel A, Aleman AV, Alene KA, Al-Eyadhy A, Ali R, Alijanzadeh M, Alizadeh-Navaei R, Aljunid SM, Alkerwi A, Alla F, Allebeck P, Allen CA, Alonso J, Al-Raddadi RM, Alsharif U, Altirkawi K, Alvis-Guzman N, Amare AT, Amini E, Ammar W, Amoako YA, Anber NH, Andrei CL, Androudi S, Animut MD, Anjomshoa M, Anlay DZ, Ansari H, Ansariadi A, Ansha MG, Antonio CAT, Appiah SCY, Aremu O, Areri HA, Ärnlöv J, Arora M, Artaman A, Aryal KK, Asadi-Lari M, Asayesh H, Asfaw ET, Asgedom SW, Assadi R, Ataro Z, Atey TMM, Athari SS, Atique S, Atre SR, Atteraya MS, Attia EF, Ausloos M, Avila-Burgos L, Avokpaho EFGA, Awasthi A, Awuah B, Ayala Quintanilla BP, Ayele HT, Ayele Y, Ayer R, Ayuk TB, Azzopardi PS, Azzopardi-Muscat N, Badali H, Badawi A, Balakrishnan K, Bali AG, Banach M, Banstola A, Barac A, Barboza MA, Barquera S, Barrero LH, Basaleem H, Bassat Q, Basu A, Basu S, Baune BT, Bazargan-Hejazi S, Bedi N, Beghi E, Behzadifar M, Behzadifar M, Béjot Y, Bekele BB, Belachew AB, Belay AG, Belay E, Belay SA, Belay YA, Bell ML, Bello AK, Bennett DA, Bensenor IM, Berhane A, Berman AE, Bernabe E, Bernstein RS, Bertolacci GJ, Beuran M, Beyranvand T, Bhala N, Bhatia E, Bhatt S, Bhattarai S, Bhaumik S, Bhutta ZA, Biadgo B, Bijani A, Bikbov B, Bililign N, Bin Sayeed MS, Birlik SM, Birungi C, Bisanzio D, Biswas T, Bjørge T, Bleyer A, Basara BB, Bose D, Bosetti C, Boufous S, Bourne R, Brady OJ, Bragazzi NL, Brant LC, Brazinova A, Breitborde NJK, Brenner H, Britton G, Brugha T, Burke KE, Busse R, Butt ZA, Cahuana-Hurtado L, Callender CSKH, Campos-Nonato IR, Campuzano Rincon JC, Cano J, Car M, Cárdenas R, Carreras G, Carrero JJ, Carter A, Carvalho F, Castañeda-Orjuela CA, Castillo Rivas J, Castro F, Catalá-López F, Çavlin A, Cerin E, Chaiah Y, Champs AP, Chang HY, Chang JC, Chattopadhyay A, Chaturvedi P, Chen W, Chiang PPC, Chimed-Ochir O, Chin KL, Chisumpa VH, Chitheer A, Choi JYJ, Christensen H, Christopher DJ, Chung SC, Cicuttini FM, Ciobanu LG, Cirillo M, Claro RM, Cohen AJ, Collado-Mateo D, Constantin MM, Conti S, Cooper C, Cooper LT, Cortesi PA, Cortinovis M, Cousin E, Criqui MH, Cromwell EA, Crowe CS, Crump JA, Cucu A, Cunningham M, Daba AK, Dachew BA, Dadi AF, Dandona L, Dandona R, Dang AK, Dargan PI, Daryani A, Das SK, Das Gupta R, das Neves J, Dasa TT, Dash AP, Weaver ND, Davitoiu DV, Davletov K, Dayama A, Courten BD, De la Hoz FP, De leo D, De Neve JW, Degefa MG, Degenhardt L, Degfie TT, Deiparine S, Dellavalle RP, Demoz GT, Demtsu BB, Denova-Gutiérrez E, Deribe K, Dervenis N, Des Jarlais DC, Dessie GA, Dey S, Dharmaratne SD, Dhimal M, Ding EL, Djalalinia S, Doku DT, Dolan KA, Donnelly CA, Dorsey ER, Douwes-Schultz D, Doyle KE, Drake TM, Driscoll TR, Dubey M, Dubljanin E, Duken EE, Duncan BB, Duraes AR, Ebrahimi H, Ebrahimpour S, Edessa D, Edvardsson D, Eggen AE, El Bcheraoui C, El Sayed Zaki M, Elfaramawi M, El-Khatib Z, Ellingsen CL, Elyazar IRF, Enayati A, Endries AYY, Er B, Ermakov SP, Eshrati B, Eskandarieh S, Esmaeili R, Esteghamati A, Esteghamati S, Fakhar M, Fakhim H, Farag T, Faramarzi M, Fareed M, Farhadi F, Farid TA, Farinha CSES, Farioli A, Faro A, Farvid MS, Farzadfar F, Farzaei MH, Fazeli MS, Feigin VL, Feigl AB, Feizy F, Fentahun N, Fereshtehnejad SM, Fernandes E, Fernandes JC, Feyissa GT, Fijabi DO, Filip I, Finegold S, Fischer F, Flor LS, Foigt NA, Ford JA, Foreman KJ, Fornari C, Frank TD, Franklin RC, Fukumoto T, Fuller JE, Fullman N, Fürst T, Furtado JM, Futran ND, Galan A, Gallus S, Gambashidze K, Gamkrelidze A, Gankpe FG, Garcia-Basteiro AL, Garcia-Gordillo MA, Gebre T, Gebre AK, Gebregergs GB, Gebrehiwot TT, Gebremedhin AT, Gelano TF, Gelaw YA, Geleijnse JM, Genova-Maleras R, Gessner BD, Getachew S, Gething PW, Gezae KE, Ghadami MR, Ghadimi R, Ghasemi Falavarjani K, Ghasemi-Kasman M, Ghiasvand H, Ghimire M, Ghoshal AG, Gill PS, Gill TK, Gillum RF, Giussani G, Goenka S, Goli S, Gomez RS, Gomez-Cabrera MC, Gómez-Dantés H, Gona PN, Goodridge A, Gopalani SV, Goto A, Goulart AC, Goulart BNG, Grada A, Grosso G, Gugnani HC, Guimaraes ALS, Guo Y, Gupta PC, Gupta R, Gupta R, Gupta T, Gyawali B, Haagsma JA, Hachinski V, Hafezi-Nejad N, Hagos TB, Hailegiyorgis TT, Hailu GB, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Handal AJ, Hankey GJ, Harb HL, Harikrishnan S, Haririan H, Haro JM, Hasan M, 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Kazemeini H, Kazemi Z, Karyani AK, K C P, Kebede S, Keiyoro PN, Kemp GR, Kengne AP, Keren A, Kereselidze M, Khader YS, Khafaie MA, Khajavi A, Khalid N, Khalil IA, Khan EA, Khan G, Khan MS, Khan MA, Khang YH, Khanna T, Khater MM, Khatony A, Khazaie H, Khoja AT, Khosravi A, Khosravi MH, Khubchandani J, Kiadaliri AA, Kibret GDD, Kim CI, Kim D, Kim JY, Kim YE, Kimokoti RW, Kinfu Y, Kinra S, Kisa A, Kissimova-Skarbek K, Kissoon N, Kivimäki M, Kleber ME, Knibbs LD, Knudsen AKS, Kochhar S, Kokubo Y, Kolola T, Kopec JA, Kosek MN, Kosen S, Koul PA, Koyanagi A, Kravchenko MA, Krishan K, Krishnaswami S, Kuate Defo B, Kucuk Bicer B, Kudom AA, Kuipers EJ, Kulikoff XR, Kumar GA, Kumar M, Kumar P, Kumsa FA, Kutz MJ, Lad SD, Lafranconi A, Lal DK, Lalloo R, Lam H, Lami FH, Lan Q, Langan SM, Lansingh VC, Lansky S, Larson HJ, Laryea DO, Lassi ZS, Latifi A, Lavados PM, Laxmaiah A, Lazarus JV, Lebedev G, Lee PH, Leigh J, Leshargie CT, Leta S, Levi M, Li S, Li Y, Li X, Liang J, Liang X, Liben ML, Lim LL, Lim SS, Limenih MA, Linn S, Liu S, Liu Y, Lodha R, Logroscino G, Lonsdale C, Lorch SA, Lorkowski S, Lotufo PA, Lozano R, Lucas TCD, Lunevicius R, Lyons RA, Ma S, Mabika C, Macarayan ERK, Mackay MT, Maddison ER, Maddison R, Madotto F, Magdy Abd El Razek H, Magdy Abd El Razek M, Maghavani DP, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malik MA, Malta DC, Mamun AA, Manamo WA, Manda AL, Mansournia MA, Mantovani LG, Mapoma CC, Marami D, Maravilla JC, Marcenes W, Marina S, Martinez-Raga J, Martins SCO, Martins-Melo FR, März W, Marzan MB, Mashamba-Thompson TP, Masiye F, Massenburg BB, Maulik PK, Mazidi M, McGrath JJ, McKee M, Mehata S, Mehendale SM, Mehndiratta MM, Mehrotra R, Mehta KM, Mehta V, Mekonen T, Mekonnen TC, Meles HG, Meles KG, Melese A, Melku M, Memiah PTN, Memish ZA, Mendoza W, Mengistu DT, Mengistu G, Mensah GA, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Mezgebe HB, Miangotar Y, Miazgowski B, Miazgowski T, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Misganaw AT, Moazen B, Moges NA, Mohammad KA, Mohammadi M, Mohammadifard N, Mohammadi-Khanaposhtani M, Mohammadnia-Afrouzi M, Mohammed S, Mohammed MA, Mohan V, Mokdad AH, Molokhia M, Monasta L, Moradi G, Moradi M, Moradi-Lakeh M, Moradinazar M, Moraga P, Morawska L, Moreno Velásquez I, Morgado-da-Costa J, Morrison SD, Mosapour A, Moschos MM, Mousavi SM, Muche AA, Muchie KF, Mueller UO, Mukhopadhyay S, Mullany EC, Muller K, Murhekar M, Murphy TB, Murthy GVS, Murthy S, Musa J, Musa KI, Mustafa G, Muthupandian S, Nachega JB, Nagel G, Naghavi M, Naheed A, Nahvijou A, Naik G, Nair S, Najafi F, Nangia V, Nansseu JR, Nascimento BR, Nawaz H, Ncama BP, Neamati N, Negoi I, Negoi RI, Neupane S, Newton CRJ, Ngalesoni FN, Ngunjiri JW, Nguyen HT, Nguyen HT, Nguyen LH, Nguyen M, Nguyen TH, Ningrum DNA, Nirayo YL, Nisar MI, Nixon MR, Nolutshungu N, Nomura S, Norheim OF, Noroozi M, Norrving B, Noubiap JJ, Nouri HR, Nourollahpour Shiadeh M, Nowroozi MR, Nsoesie EO, Nyasulu PS, Ofori-Asenso R, Ogah OS, Ogbo FA, Oh IH, Okoro A, Oladimeji O, Olagunju AT, Olagunju TO, Olivares PR, Olusanya BO, Olusanya JO, Ong SK, Opio JN, Oren E, Ortiz JR, Ortiz A, Ota E, Otstavnov SS, Øverland S, Owolabi MO, Oyekale AS, P A M, Pacella R, Pakhale S, Pakhare AP, Pana A, Panda BK, Panda-Jonas S, Pandey AR, Pandian JD, Parisi A, Park EK, Parry CDH, Parsian H, Patel S, Patle A, Patten SB, Patton GC, Paudel D, Pearce N, Peprah EK, Pereira A, Pereira DM, Perez KM, Perico N, Pervaiz A, Pesudovs K, Petri WA, Petzold M, Phillips MR, Pigott DM, Pillay JD, Pirsaheb M, Pishgar F, Plass D, Polinder S, Pond CD, Popova S, Postma MJ, Pourmalek F, Pourshams A, Poustchi H, Prabhakaran D, Prakash V, Prakash S, Prasad N, Qorbani M, Quistberg DA, Radfar A, Rafay A, Rafiei A, Rahim F, Rahimi K, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman M, Rahman MHU, Rahman MA, Rahman SU, Rai RK, Rajati F, Rajsic S, Raju SB, Ram U, Ranabhat CL, Ranjan P, Ranta A, Rasella D, Rawaf DL, Rawaf S, Ray SE, Razo-García C, Rego MAS, Rehm J, Reiner RC, Reinig N, Reis C, Remuzzi G, Renzaho AMN, Resnikoff S, Rezaei S, Rezaeian S, Rezai MS, Riahi SM, Ribeiro ALP, Riojas H, Rios-Blancas MJ, Roba KT, Robinson SR, Roever L, Ronfani L, Roshandel G, Roshchin DO, Rostami A, Rothenbacher D, Rubagotti E, Ruhago GM, Saadat S, Sabde YD, Sachdev PS, Saddik B, Sadeghi E, Moghaddam SS, Safari H, Safari Y, Safari-Faramani R, Safdarian M, Safi S, Safiri S, Sagar R, Sahebkar A, Sahraian MA, Sajadi HS, Salahshoor MR, Salam N, Salama JS, Salamati P, Saldanha RDF, Salimi Y, Salimzadeh H, Salz I, Sambala EZ, Samy AM, Sanabria J, Sanchez-Niño MD, Santos IS, Santos JV, Santric Milicevic MM, Sao Jose BP, Sardana M, Sarker AR, Sarrafzadegan N, Sartorius B, Sarvi S, Sathian B, Satpathy M, Savic M, Sawant AR, Sawhney M, Saxena S, Sayyah M, Scaria V, Schaeffner E, Schelonka K, Schmidt MI, Schneider IJC, Schöttker B, Schutte AE, Schwebel DC, Schwendicke F, Scott JG, Sekerija M, Sepanlou SG, Serván-Mori E, Shabaninejad H, Shackelford KA, Shafieesabet A, Shaheen AA, Shaikh MA, Shakir RA, Shams-Beyranvand M, Shamsi M, Shamsizadeh M, Sharafi H, Sharafi K, Sharif M, Sharif-Alhoseini M, Sharma M, Sharma J, Sharma R, She J, Sheikh A, Sheth KN, Shi P, Shibuya K, Shifa GT, Shiferaw MS, Shigematsu M, Shiri R, Shirkoohi R, Shiue I, Shokraneh F, Shrime MG, Shukla SR, Si S, Siabani S, Siddiqi TJ, Sigfusdottir ID, Sigurvinsdottir R, Silpakit N, Silva DAS, Silva JP, Silveira DGA, Singam NSV, Singh JA, Singh V, Sinha AP, Sinha DN, Sitas F, Skirbekk V, Sliwa K, Soares Filho AM, Sobaih BH, Sobhani S, Soofi M, Soriano JB, Soyiri IN, Sposato LA, Sreeramareddy CT, Srinivasan V, Srivastava RK, Starodubov VI, Stathopoulou V, Steel N, Stein DJ, Steiner C, Stewart LG, Stokes MA, Sudaryanto A, Sufiyan MB, Sulo G, Sunguya BF, Sur PJ, Sutradhar I, Sykes BL, Sylaja PN, Sylte DO, Szoeke CEI, Tabarés-Seisdedos R, Tabuchi T, Tadakamadla SK, Takahashi K, Tandon N, Tassew AA, Tassew SG, Tavakkoli M, Taveira N, Tawye NY, Tehrani-Banihashemi A, Tekalign TG, Tekle MG, Temesgen H, Temsah MH, Temsah O, Terkawi AS, Teshale MY, Tessema B, Teweldemedhin M, Thakur JS, Thankappan KR, Thirunavukkarasu S, Thomas LA, Thomas N, Thrift AG, Tilahun B, To QG, Tobe-Gai R, Tonelli M, Topor-Madry R, Topouzis F, Torre AE, Tortajada-Girbés M, Tovani-Palone MR, Towbin JA, Tran BX, Tran KB, Tripathi S, Tripathy SP, Truelsen TC, Truong NT, Tsadik AG, Tsilimparis N, Tudor Car L, Tuzcu EM, Tyrovolas S, Ukwaja KN, Ullah I, Usman MS, Uthman OA, Uzun SB, Vaduganathan M, Vaezi A, Vaidya G, Valdez PR, Varavikova E, Varughese S, Vasankari TJ, Vasconcelos AMN, Venketasubramanian N, Vidavalur R, Villafaina S, Violante FS, Vladimirov SK, Vlassov V, Vollset SE, Vos T, Vosoughi K, Vujcic IS, Wagner GR, Wagnew FWS, Waheed Y, Wang Y, Wang YP, Wassie MM, Weiderpass E, Weintraub RG, Weiss DJ, Weiss J, Weldegebreal F, Weldegwergs KG, Werdecker A, Westerman R, Whiteford HA, Widecka J, Widecka K, Wijeratne T, Winkler AS, Wiysonge CS, Wolfe CDA, Wondemagegn SA, Wu S, Wyper GMA, Xu G, Yadav R, Yakob B, Yamada T, Yan LL, Yano Y, Yaseri M, Yasin YJ, Ye P, Yearwood JA, Yentür GK, Yeshaneh A, Yimer EM, Yip P, Yisma E, Yonemoto N, Yoon SJ, York HW, Yotebieng M, Younis MZ, Yousefifard M, Yu C, Zachariah G, Zadnik V, Zafar S, Zaidi Z, Zaman SB, Zamani M, Zare Z, Zeeb H, Zeleke MM, Zenebe ZM, Zerfu TA, Zhang K, Zhang X, Zhou M, Zhu J, Zodpey S, Zucker I, Zuhlke LJJ, Lopez AD, Gakidou E, Murray CJL. Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1684-1735. [PMID: 30496102 PMCID: PMC6227504 DOI: 10.1016/s0140-6736(18)31891-9] [Citation(s) in RCA: 575] [Impact Index Per Article: 95.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/14/2018] [Accepted: 08/08/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. METHODS The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. FINDINGS Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. INTERPRETATION This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. FUNDING Bill & Melinda Gates Foundation.
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Roth GA, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, Abbastabar H, Abd-Allah F, Abdela J, Abdelalim A, Abdollahpour I, Abdulkader RS, Abebe HT, Abebe M, Abebe Z, Abejie AN, Abera SF, Abil OZ, Abraha HN, Abrham AR, Abu-Raddad LJ, Accrombessi MMK, Acharya D, Adamu AA, Adebayo OM, Adedoyin RA, Adekanmbi V, Adetokunboh OO, Adhena BM, Adib MG, Admasie A, Afshin A, Agarwal G, Agesa KM, Agrawal A, Agrawal S, Ahmadi A, Ahmadi M, Ahmed MB, Ahmed S, Aichour AN, Aichour I, Aichour MTE, Akbari ME, Akinyemi RO, Akseer N, Al-Aly Z, Al-Eyadhy A, Al-Raddadi RM, Alahdab F, Alam K, Alam T, Alebel A, Alene KA, Alijanzadeh M, Alizadeh-Navaei R, Aljunid SM, Alkerwi A, Alla F, Allebeck P, Alonso J, Altirkawi K, Alvis-Guzman N, Amare AT, Aminde LN, Amini E, Ammar W, Amoako YA, Anber NH, Andrei CL, Androudi S, Animut MD, Anjomshoa M, Ansari H, Ansha MG, Antonio CAT, Anwari P, Aremu O, Ärnlöv J, Arora A, Arora M, Artaman A, Aryal KK, Asayesh H, Asfaw ET, Ataro Z, Atique S, Atre SR, Ausloos M, Avokpaho EFGA, Awasthi A, Quintanilla BPA, Ayele Y, Ayer R, Azzopardi PS, Babazadeh A, Bacha U, Badali H, Badawi A, Bali AG, Ballesteros KE, Banach M, Banerjee K, Bannick MS, Banoub JAM, Barboza MA, Barker-Collo SL, Bärnighausen TW, Barquera S, Barrero LH, Bassat Q, Basu S, Baune BT, Baynes HW, Bazargan-Hejazi S, Bedi N, Beghi E, Behzadifar M, Behzadifar M, Béjot Y, Bekele BB, Belachew AB, Belay E, Belay YA, Bell ML, Bello AK, Bennett DA, Bensenor IM, Berman AE, Bernabe E, Bernstein RS, Bertolacci GJ, Beuran M, Beyranvand T, Bhalla A, Bhattarai S, Bhaumik S, Bhutta ZA, Biadgo B, Biehl MH, Bijani A, Bikbov B, Bilano V, Bililign N, Bin Sayeed MS, Bisanzio D, Biswas T, Blacker BF, Basara BB, Borschmann R, Bosetti C, Bozorgmehr K, Brady OJ, Brant LC, Brayne C, Brazinova A, Breitborde NJK, Brenner H, Briant PS, Britton G, Brugha T, Busse R, Butt ZA, Callender CSKH, Campos-Nonato IR, Campuzano Rincon JC, Cano J, Car M, Cárdenas R, Carreras G, Carrero JJ, Carter A, Carvalho F, Castañeda-Orjuela CA, Castillo Rivas J, Castle CD, Castro C, Castro F, Catalá-López F, Cerin E, Chaiah Y, Chang JC, Charlson FJ, Chaturvedi P, Chiang PPC, Chimed-Ochir O, Chisumpa VH, Chitheer A, Chowdhury R, Christensen H, Christopher DJ, Chung SC, Cicuttini FM, Ciobanu LG, Cirillo M, Cohen AJ, Cooper LT, Cortesi PA, Cortinovis M, Cousin E, Cowie BC, Criqui MH, Cromwell EA, Crowe CS, Crump JA, Cunningham M, Daba AK, Dadi AF, Dandona L, Dandona R, Dang AK, Dargan PI, Daryani A, Das SK, Gupta RD, Neves JD, Dasa TT, Dash AP, Davis AC, Davis Weaver N, Davitoiu DV, Davletov K, De La Hoz FP, De Neve JW, Degefa MG, Degenhardt L, Degfie TT, Deiparine S, Demoz GT, Demtsu BB, Denova-Gutiérrez E, Deribe K, Dervenis N, Des Jarlais DC, Dessie GA, Dey S, Dharmaratne SD, Dicker D, Dinberu MT, Ding EL, Dirac MA, Djalalinia S, Dokova K, Doku DT, Donnelly CA, Dorsey ER, Doshi PP, Douwes-Schultz D, Doyle KE, Driscoll TR, Dubey M, Dubljanin E, Duken EE, Duncan BB, Duraes AR, Ebrahimi H, Ebrahimpour S, Edessa D, Edvardsson D, Eggen AE, El Bcheraoui C, El Sayed Zaki M, El-Khatib Z, Elkout H, Ellingsen CL, Endres M, Endries AY, Er B, Erskine HE, Eshrati B, Eskandarieh S, Esmaeili R, Esteghamati A, Fakhar M, Fakhim H, Faramarzi M, Fareed M, Farhadi F, Farinha CSES, Faro A, Farvid MS, Farzadfar F, Farzaei MH, Feigin VL, Feigl AB, Fentahun N, Fereshtehnejad SM, Fernandes E, Fernandes JC, Ferrari AJ, Feyissa GT, Filip I, Finegold S, Fischer F, Fitzmaurice C, Foigt NA, Foreman KJ, Fornari C, Frank TD, Fukumoto T, Fuller JE, Fullman N, Fürst T, Furtado JM, Futran ND, Gallus S, Garcia-Basteiro AL, Garcia-Gordillo MA, Gardner WM, Gebre AK, Gebrehiwot TT, Gebremedhin AT, Gebremichael B, Gebremichael TG, Gelano TF, Geleijnse JM, Genova-Maleras R, Geramo YCD, Gething PW, Gezae KE, Ghadami MR, Ghadimi R, Ghasemi Falavarjani K, Ghasemi-Kasman M, Ghimire M, Gibney KB, Gill PS, Gill TK, Gillum RF, Ginawi IA, Giroud M, Giussani G, Goenka S, Goldberg EM, Goli S, Gómez-Dantés H, Gona PN, Gopalani SV, Gorman TM, Goto A, Goulart AC, Gnedovskaya EV, Grada A, Grosso G, Gugnani HC, Guimaraes ALS, Guo Y, Gupta PC, Gupta R, Gupta R, Gupta T, Gutiérrez RA, Gyawali B, Haagsma JA, Hafezi-Nejad N, Hagos TB, Hailegiyorgis TT, Hailu GB, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Handal AJ, Hankey GJ, Harb HL, Harikrishnan S, Haro JM, Hasan M, Hassankhani H, Hassen HY, Havmoeller R, Hay RJ, Hay SI, He Y, Hedayatizadeh-Omran A, Hegazy MI, Heibati B, Heidari M, Hendrie D, Henok A, Henry NJ, Herteliu C, Heydarpour F, Heydarpour P, Heydarpour S, Hibstu DT, Hoek HW, Hole MK, Homaie Rad E, Hoogar P, Hosgood HD, Hosseini SM, Hosseinzadeh M, Hostiuc M, Hostiuc S, Hotez PJ, Hoy DG, Hsiao T, Hu G, Huang JJ, Husseini A, Hussen MM, Hutfless S, Idrisov B, Ilesanmi OS, Iqbal U, Irvani SSN, Irvine CMS, Islam N, Islam SMS, Islami F, Jacobsen KH, Jahangiry L, Jahanmehr N, Jain SK, Jakovljevic M, Jalu MT, James SL, Javanbakht M, Jayatilleke AU, Jeemon P, Jenkins KJ, Jha RP, Jha V, Johnson CO, Johnson SC, Jonas JB, Joshi A, Jozwiak JJ, Jungari SB, Jürisson M, Kabir Z, Kadel R, Kahsay A, Kalani R, Karami M, Karami Matin B, Karch A, Karema C, Karimi-Sari H, Kasaeian A, Kassa DH, Kassa GM, Kassa TD, Kassebaum NJ, Katikireddi SV, Kaul A, Kazemi Z, Karyani AK, Kazi DS, Kefale AT, Keiyoro PN, Kemp GR, Kengne AP, Keren A, Kesavachandran CN, Khader YS, Khafaei B, Khafaie MA, Khajavi A, Khalid N, Khalil IA, Khan EA, Khan MS, Khan MA, Khang YH, Khater MM, Khoja AT, Khosravi A, Khosravi MH, Khubchandani J, Kiadaliri AA, Kibret GD, Kidanemariam ZT, Kiirithio DN, Kim D, Kim YE, Kim YJ, Kimokoti RW, Kinfu Y, Kisa A, Kissimova-Skarbek K, Kivimäki M, Knudsen AKS, Kocarnik JM, Kochhar S, Kokubo Y, Kolola T, Kopec JA, Koul PA, Koyanagi A, Kravchenko MA, Krishan K, Kuate Defo B, Kucuk Bicer B, Kumar GA, Kumar M, Kumar P, Kutz MJ, Kuzin I, Kyu HH, Lad DP, Lad SD, Lafranconi A, Lal DK, Lalloo R, Lallukka T, Lam JO, Lami FH, Lansingh VC, Lansky S, Larson HJ, Latifi A, Lau KMM, Lazarus JV, Lebedev G, Lee PH, Leigh J, Leili M, Leshargie CT, Li S, Li Y, Liang J, Lim LL, Lim SS, Limenih MA, Linn S, Liu S, Liu Y, Lodha R, Lonsdale C, Lopez AD, Lorkowski S, Lotufo PA, Lozano R, Lunevicius R, Ma S, Macarayan ERK, Mackay MT, MacLachlan JH, Maddison ER, Madotto F, Magdy Abd El Razek H, Magdy Abd El Razek M, Maghavani DP, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malta DC, Manda AL, Mandarano-Filho LG, Manguerra H, Mansournia MA, Mapoma CC, Marami D, Maravilla JC, Marcenes W, Marczak L, Marks A, Marks GB, Martinez G, Martins-Melo FR, Martopullo I, März W, Marzan MB, Masci JR, Massenburg BB, Mathur MR, Mathur P, Matzopoulos R, Maulik PK, Mazidi M, McAlinden C, McGrath JJ, McKee M, McMahon BJ, Mehata S, Mehndiratta MM, Mehrotra R, Mehta KM, Mehta V, Mekonnen TC, Melese A, Melku M, Memiah PTN, Memish ZA, Mendoza W, Mengistu DT, Mengistu G, Mensah GA, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Mezgebe HB, Miazgowski B, Miazgowski T, Millear AI, Miller TR, Miller-Petrie MK, Mini GK, Mirabi P, Mirarefin M, Mirica A, Mirrakhimov EM, Misganaw AT, Mitiku H, Moazen B, Mohammad KA, Mohammadi M, Mohammadifard N, Mohammed MA, Mohammed S, Mohan V, Mokdad AH, Molokhia M, Monasta L, Moradi G, Moradi-Lakeh M, Moradinazar M, Moraga P, Morawska L, Moreno Velásquez I, Morgado-Da-Costa J, Morrison SD, Moschos MM, Mouodi S, Mousavi SM, Muchie KF, Mueller UO, Mukhopadhyay S, Muller K, Mumford JE, Musa J, Musa KI, Mustafa G, Muthupandian S, Nachega JB, Nagel G, Naheed A, Nahvijou A, Naik G, Nair S, Najafi F, Naldi L, Nam HS, Nangia V, Nansseu JR, Nascimento BR, Natarajan G, Neamati N, Negoi I, Negoi RI, Neupane S, Newton CRJ, Ngalesoni FN, Ngunjiri JW, Nguyen AQ, Nguyen G, Nguyen HT, Nguyen HT, Nguyen LH, Nguyen M, Nguyen TH, Nichols E, Ningrum DNA, Nirayo YL, Nixon MR, Nolutshungu N, Nomura S, Norheim OF, Noroozi M, Norrving B, Noubiap JJ, Nouri HR, Nourollahpour Shiadeh M, Nowroozi MR, Nyasulu PS, Odell CM, Ofori-Asenso R, Ogbo FA, Oh IH, Oladimeji O, Olagunju AT, Olivares PR, Olsen HE, Olusanya BO, Olusanya JO, Ong KL, Ong SKS, Oren E, Orpana HM, Ortiz A, Ortiz JR, Otstavnov SS, Øverland S, Owolabi MO, Özdemir R, P A M, Pacella R, Pakhale S, Pakhare AP, Pakpour AH, Pana A, Panda-Jonas S, Pandian JD, Parisi A, Park EK, Parry CDH, Parsian H, Patel S, Pati S, Patton GC, Paturi VR, Paulson KR, Pereira A, Pereira DM, Perico N, Pesudovs K, Petzold M, Phillips MR, Piel FB, Pigott DM, Pillay JD, Pirsaheb M, Pishgar F, Polinder S, Postma MJ, Pourshams A, Poustchi H, Pujar A, Prakash S, Prasad N, Purcell CA, Qorbani M, Quintana H, Quistberg DA, Rade KW, Radfar A, Rafay A, Rafiei A, Rahim F, Rahimi K, Rahimi-Movaghar A, Rahman M, Rahman MHU, Rahman MA, Rai RK, Rajsic S, Ram U, Ranabhat CL, Ranjan P, Rao PC, Rawaf DL, Rawaf S, Razo-García C, Reddy KS, Reiner RC, Reitsma MB, Remuzzi G, Renzaho AMN, Resnikoff S, Rezaei S, Rezaeian S, Rezai MS, Riahi SM, Ribeiro ALP, Rios-Blancas MJ, Roba KT, Roberts NLS, Robinson SR, Roever L, Ronfani L, Roshandel G, Rostami A, Rothenbacher D, Roy A, Rubagotti E, Sachdev PS, Saddik B, Sadeghi E, Safari H, Safdarian M, Safi S, Safiri S, Sagar R, Sahebkar A, Sahraian MA, Salam N, Salama JS, Salamati P, Saldanha RDF, Saleem Z, Salimi Y, Salvi SS, Salz I, Sambala EZ, Samy AM, Sanabria J, Sanchez-Niño MD, Santomauro DF, Santos IS, Santos JV, Milicevic MMS, Sao Jose BP, Sarker AR, Sarmiento-Suárez R, Sarrafzadegan N, Sartorius B, Sarvi S, Sathian B, Satpathy M, Sawant AR, Sawhney M, Saxena S, Sayyah M, Schaeffner E, Schmidt MI, Schneider IJC, Schöttker B, Schutte AE, Schwebel DC, Schwendicke F, Scott JG, Sekerija M, Sepanlou SG, Serván-Mori E, Seyedmousavi S, Shabaninejad H, Shackelford KA, Shafieesabet A, Shahbazi M, Shaheen AA, Shaikh MA, Shams-Beyranvand M, Shamsi M, Shamsizadeh M, Sharafi K, Sharif M, Sharif-Alhoseini M, Sharma R, She J, Sheikh A, Shi P, Shiferaw MS, Shigematsu M, Shiri R, Shirkoohi R, Shiue I, Shokraneh F, Shrime MG, Si S, Siabani S, Siddiqi TJ, Sigfusdottir ID, Sigurvinsdottir R, Silberberg DH, Silva DAS, Silva JP, Silva NTD, Silveira DGA, Singh JA, Singh NP, Singh PK, Singh V, Sinha DN, Sliwa K, Smith M, Sobaih BH, Sobhani S, Sobngwi E, Soneji SS, Soofi M, Sorensen RJD, Soriano JB, Soyiri IN, Sposato LA, Sreeramareddy CT, Srinivasan V, Stanaway JD, Starodubov VI, Stathopoulou V, Stein DJ, Steiner C, Stewart LG, Stokes MA, Subart ML, Sudaryanto A, Sufiyan MB, Sur PJ, Sutradhar I, Sykes BL, Sylaja PN, Sylte DO, Szoeke CEI, Tabarés-Seisdedos R, Tabuchi T, Tadakamadla SK, Takahashi K, Tandon N, Tassew SG, Taveira N, Tehrani-Banihashemi A, Tekalign TG, Tekle MG, Temsah MH, Temsah O, Terkawi AS, Teshale MY, Tessema B, Tessema GA, Thankappan KR, Thirunavukkarasu S, Thomas N, Thrift AG, Thurston GD, Tilahun B, To QG, Tobe-Gai R, Tonelli M, Topor-Madry R, Torre AE, Tortajada-Girbés M, Touvier M, Tovani-Palone MR, Tran BX, Tran KB, Tripathi S, Troeger CE, Truelsen TC, Truong NT, Tsadik AG, Tsoi D, Tudor Car L, Tuzcu EM, Tyrovolas S, Ukwaja KN, Ullah I, Undurraga EA, Updike RL, Usman MS, Uthman OA, Uzun SB, Vaduganathan M, Vaezi A, Vaidya G, Valdez PR, Varavikova E, Vasankari TJ, Venketasubramanian N, Villafaina S, Violante FS, Vladimirov SK, Vlassov V, Vollset SE, Vos T, Wagner GR, Wagnew FS, Waheed Y, Wallin MT, Walson JL, Wang Y, Wang YP, Wassie MM, Weiderpass E, Weintraub RG, Weldegebreal F, Weldegwergs KG, Werdecker A, Werkneh AA, West TE, Westerman R, Whiteford HA, Widecka J, Wilner LB, Wilson S, Winkler AS, Wiysonge CS, Wolfe CDA, Wu S, Wu YC, Wyper GMA, Xavier D, Xu G, Yadgir S, Yadollahpour A, Yahyazadeh Jabbari SH, Yakob B, Yan LL, Yano Y, Yaseri M, Yasin YJ, Yentür GK, Yeshaneh A, Yimer EM, Yip P, Yirsaw BD, Yisma E, Yonemoto N, Yonga G, Yoon SJ, Yotebieng M, Younis MZ, Yousefifard M, Yu C, Zadnik V, Zaidi Z, Zaman SB, Zamani M, Zare Z, Zeleke AJ, Zenebe ZM, Zhang AL, Zhang K, Zhou M, Zodpey S, Zuhlke LJ, Naghavi M, Murray CJL. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1736-1788. [PMID: 30496103 PMCID: PMC6227606 DOI: 10.1016/s0140-6736%2818%2932203-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 01/19/2024]
Abstract
BACKGROUND Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. METHODS The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries-Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. FINDINGS At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5-74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9-19·6), and injuries 8·0% (7·7-8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5-23·9), representing an additional 7·61 million (7·20-8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0-8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0-24·0) and the death rate by 31·8% (30·1-33·3). Total deaths from injuries increased by 2·3% (0·5-4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2-15·1) to 57·9 deaths (55·9-59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000-289 000) globally in 2007 to 352 000 (334 000-363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8-148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2-40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2-36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990-neonatal disorders, lower respiratory infections, and diarrhoeal diseases-were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. INTERPRETATION Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. FUNDING Bill & Melinda Gates Foundation.
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Lozano R, Fullman N, Abate D, Abay SM, Abbafati C, Abbasi N, Abbastabar H, Abd-Allah F, Abdela J, Abdelalim A, Abdel-Rahman O, Abdi A, Abdollahpour I, Abdulkader RS, Abebe ND, Abebe Z, Abejie AN, Abera SF, Abil OZ, Aboyans V, Abraha HN, Abrham AR, Abu-Raddad LJ, Abu-Rmeileh NM, Abyu GY, Accrombessi MMK, Acharya D, Acharya P, Adamu AA, Adebayo OM, Adedeji IA, Adedoyin RA, Adekanmbi V, Adetokunboh OO, Adhena BM, Adhikari TB, Adib MG, Adou AK, Adsuar JC, Afarideh M, Afshari M, Afshin A, Agarwal G, Aghayan SA, Agius D, Agrawal A, Agrawal S, Ahmadi A, Ahmadi M, Ahmadieh H, Ahmed MB, Ahmed S, Akalu TY, Akanda AS, Akbari ME, Akibu M, Akinyemi RO, Akinyemiju T, Akseer N, Alahdab F, Al-Aly Z, Alam K, Alam T, Albujeer A, Alebel A, Alene KA, Al-Eyadhy A, Alhabib S, Ali R, Alijanzadeh M, Alizadeh-Navaei R, Aljunid SM, Alkerwi A, Alla F, Allebeck P, Allen CA, Almasi A, Al-Maskari F, Al-Mekhlafi HM, Alonso J, Al-Raddadi RM, Alsharif U, Altirkawi K, Alvis-Guzman N, Amare AT, Amenu K, Amini E, Ammar 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Zucker I, Zuhlke LJJ, Lim SS, Murray CJL. Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:2091-2138. [PMID: 30496107 PMCID: PMC6227911 DOI: 10.1016/s0140-6736(18)32281-5] [Citation(s) in RCA: 264] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/06/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of "leaving no one behind", it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment. METHODS We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. FINDINGS The global median health-related SDG index in 2017 was 59·4 (IQR 35·4-67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6-14·0) to a high of 84·9 (83·1-86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. INTERPRETATION The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains-curative interventions in the case of NCDs-towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions-or inaction-today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. FUNDING Bill & Melinda Gates Foundation.
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Stanaway JD, Afshin A, Gakidou E, Lim SS, Abate D, Abate KH, Abbafati C, Abbasi N, Abbastabar H, Abd-Allah F, Abdela J, Abdelalim A, Abdollahpour I, Abdulkader RS, Abebe M, Abebe Z, Abera SF, Abil OZ, Abraha HN, Abrham AR, Abu-Raddad LJ, Abu-Rmeileh NME, Accrombessi MMK, Acharya D, Acharya P, Adamu AA, Adane AA, Adebayo OM, Adedoyin RA, Adekanmbi V, Ademi Z, Adetokunboh OO, Adib MG, Admasie A, Adsuar JC, Afanvi KA, Afarideh M, Agarwal G, Aggarwal A, Aghayan SA, Agrawal A, Agrawal S, Ahmadi A, Ahmadi M, Ahmadieh H, Ahmed MB, Aichour AN, Aichour I, Aichour MTE, Akbari ME, Akinyemiju T, Akseer N, Al-Aly Z, Al-Eyadhy A, Al-Mekhlafi HM, Alahdab F, Alam K, Alam S, Alam T, Alashi A, Alavian SM, Alene KA, Ali K, Ali SM, Alijanzadeh M, Alizadeh-Navaei R, Aljunid SM, Alkerwi A, Alla F, Alsharif U, Altirkawi K, Alvis-Guzman N, Amare AT, Ammar W, Anber NH, Anderson JA, Andrei CL, Androudi S, Animut MD, Anjomshoa M, Ansha MG, Antó JM, Antonio CAT, Anwari P, Appiah LT, Appiah SCY, Arabloo J, Aremu O, Ärnlöv J, Artaman A, Aryal KK, Asayesh H, Ataro Z, Ausloos M, Avokpaho EFGA, Awasthi A, Ayala Quintanilla BP, Ayer R, Ayuk TB, Azzopardi PS, Babazadeh A, Badali H, Badawi A, Balakrishnan K, Bali AG, Ball K, Ballew SH, Banach M, Banoub JAM, Barac A, Barker-Collo SL, Bärnighausen TW, Barrero LH, Basu S, Baune BT, Bazargan-Hejazi S, Bedi N, Beghi E, Behzadifar M, Behzadifar M, Béjot Y, Bekele BB, Bekru ET, Belay E, Belay YA, Bell ML, Bello AK, Bennett DA, Bensenor IM, Bergeron G, Berhane A, Bernabe E, Bernstein RS, Beuran M, Beyranvand T, Bhala N, Bhalla A, Bhattarai S, Bhutta ZA, Biadgo B, Bijani A, Bikbov B, Bilano V, Bililign N, Bin Sayeed MS, Bisanzio D, Biswas T, Bjørge T, Blacker BF, Bleyer A, Borschmann R, Bou-Orm IR, Boufous S, Bourne R, Brady OJ, Brauer M, Brazinova A, Breitborde NJK, Brenner H, Briko AN, Britton G, Brugha T, Buchbinder R, Burnett RT, Busse R, Butt ZA, Cahill LE, Cahuana-Hurtado L, Campos-Nonato IR, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castañeda-Orjuela CA, Castillo Rivas J, Castro F, Catalá-López F, Causey K, Cercy KM, Cerin E, Chaiah Y, Chang HY, Chang JC, Chang KL, Charlson FJ, Chattopadhyay A, Chattu VK, Chee ML, Cheng CY, Chew A, Chiang PPC, Chimed-Ochir O, Chin KL, Chitheer A, Choi JYJ, Chowdhury R, Christensen H, Christopher DJ, Chung SC, Cicuttini FM, Cirillo M, Cohen AJ, Collado-Mateo D, Cooper C, Cooper OR, Coresh J, Cornaby L, Cortesi PA, Cortinovis M, Costa M, Cousin E, Criqui MH, Cromwell EA, Cundiff DK, Daba AK, Dachew BA, Dadi AF, Damasceno AAM, Dandona L, Dandona R, Darby SC, Dargan PI, Daryani A, Das Gupta R, Das Neves J, Dasa TT, Dash AP, Davitoiu DV, Davletov K, De la Cruz-Góngora V, De La Hoz FP, De Leo D, De Neve JW, Degenhardt L, Deiparine S, Dellavalle RP, Demoz GT, Denova-Gutiérrez E, Deribe K, Dervenis N, Deshpande A, Des Jarlais DC, Dessie GA, Deveber GA, Dey S, Dharmaratne SD, Dhimal M, Dinberu MT, Ding EL, Diro HD, Djalalinia S, Do HP, Dokova K, Doku DT, Doyle KE, Driscoll TR, Dubey M, Dubljanin E, Duken EE, Duncan BB, Duraes AR, Ebert N, Ebrahimi H, Ebrahimpour S, Edvardsson D, Effiong A, Eggen AE, El Bcheraoui C, El-Khatib Z, Elyazar IR, Enayati A, Endries AY, Er B, Erskine HE, Eskandarieh S, Esteghamati A, Estep K, Fakhim H, Faramarzi M, Fareed M, Farid TA, Farinha CSES, Farioli A, Faro A, Farvid MS, Farzaei MH, Fatima B, Fay KA, Fazaeli AA, Feigin VL, Feigl AB, Fereshtehnejad SM, Fernandes E, Fernandes JC, Ferrara G, Ferrari AJ, Ferreira ML, Filip I, Finger JD, Fischer F, Foigt NA, Foreman KJ, Fukumoto T, Fullman N, Fürst T, Furtado JM, Futran ND, Gall S, Gallus S, Gamkrelidze A, Ganji M, Garcia-Basteiro AL, Gardner WM, Gebre AK, Gebremedhin AT, Gebremichael TG, Gelano TF, Geleijnse JM, Geramo YCD, Gething PW, Gezae KE, Ghadimi R, Ghadiri K, Ghasemi Falavarjani K, Ghasemi-Kasman M, Ghimire M, Ghosh R, Ghoshal AG, Giampaoli S, Gill PS, Gill TK, Gillum RF, Ginawi IA, Giussani G, Gnedovskaya EV, Godwin WW, Goli S, Gómez-Dantés H, Gona PN, Gopalani SV, Goulart AC, Grada A, Grams ME, Grosso G, Gugnani HC, Guo Y, Gupta R, Gupta R, Gupta T, Gutiérrez RA, Gutiérrez-Torres DS, Haagsma JA, Habtewold TD, Hachinski V, Hafezi-Nejad N, Hagos TB, Hailegiyorgis TT, Hailu GB, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Handal AJ, Hankey GJ, Hao Y, Harb HL, Harikrishnan S, Haro JM, Hassankhani H, Hassen HY, Havmoeller R, Hawley CN, Hay SI, Hedayatizadeh-Omran A, Heibati B, Heidari B, Heidari M, Hendrie D, Henok A, Heredia-Pi I, Herteliu C, Heydarpour F, Heydarpour S, Hibstu DT, Higazi TB, Hilawe EH, Hoek HW, Hoffman HJ, Hole MK, Homaie Rad E, Hoogar P, Hosgood HD, Hosseini SM, Hosseinzadeh M, Hostiuc M, Hostiuc S, Hoy DG, Hsairi M, Hsiao T, Hu G, Hu H, Huang JJ, Hussen MA, Huynh CK, Iburg KM, Ikeda N, Ilesanmi OS, Iqbal U, Irvani SSN, Irvine CMS, Islam SMS, Islami F, Jackson MD, Jacobsen KH, Jahangiry L, Jahanmehr N, Jain SK, Jakovljevic M, James SL, Jassal SK, Jayatilleke AU, Jeemon P, Jha RP, Jha V, Ji JS, Jonas JB, Jonnagaddala J, Jorjoran Shushtari Z, Joshi A, Jozwiak JJ, Jürisson M, Kabir Z, Kahsay A, Kalani R, Kanchan T, Kant S, Kar C, Karami M, Karami Matin B, Karch A, Karema C, Karimi N, Karimi SM, Kasaeian A, Kassa DH, Kassa GM, Kassa TD, Kassebaum NJ, Katikireddi SV, Kaul A, Kawakami N, Kazemi Z, Karyani AK, Kefale AT, Keiyoro PN, Kemp GR, Kengne AP, Keren A, Kesavachandran CN, Khader YS, Khafaei B, Khafaie MA, Khajavi A, Khalid N, Khalil IA, Khan G, Khan MS, Khan MA, Khang YH, Khater MM, Khazaei M, Khazaie H, Khoja AT, Khosravi A, Khosravi MH, Kiadaliri AA, Kiirithio DN, Kim CI, Kim D, Kim YE, Kim YJ, Kimokoti RW, Kinfu Y, Kisa A, Kissimova-Skarbek K, Kivimäki M, Knibbs LD, Knudsen AKS, Kochhar S, Kokubo Y, Kolola T, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kravchenko MA, Krishan K, Krohn KJ, Kromhout H, Kuate Defo B, Kucuk Bicer B, Kumar GA, Kumar M, Kuzin I, Kyu HH, Lachat C, Lad DP, Lad SD, Lafranconi A, Lalloo R, Lallukka T, Lami FH, Lang JJ, Lansingh VC, Larson SL, Latifi A, Lazarus JV, Lee PH, Leigh J, Leili M, Leshargie CT, Leung J, Levi M, Lewycka S, Li S, Li Y, Liang J, Liang X, Liao Y, Liben ML, Lim LL, Linn S, Liu S, Lodha R, Logroscino G, Lopez AD, Lorkowski S, Lotufo PA, Lozano R, Lucas TCD, Lunevicius R, Ma S, Macarayan ERK, Machado ÍE, Madotto F, Mai HT, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malta DC, Mamun AA, Manda AL, Manguerra H, Mansournia MA, Mantovani LG, Maravilla JC, Marcenes W, Marks A, Martin RV, Martins SCO, Martins-Melo FR, März W, Marzan MB, Massenburg BB, Mathur MR, Mathur P, Matsushita K, Maulik PK, Mazidi M, McAlinden C, McGrath JJ, McKee M, Mehrotra R, Mehta KM, Mehta V, Meier T, Mekonnen FA, Melaku YA, Melese A, Melku M, Memiah PTN, Memish ZA, Mendoza W, Mengistu DT, Mensah GA, Mensink GBM, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Mezgebe HB, Miazgowski B, Miazgowski T, Millear AI, Miller TR, Miller-Petrie MK, Mini GK, Mirarefin M, Mirica A, Mirrakhimov EM, Misganaw AT, Mitiku H, Moazen B, Mohajer B, Mohammad KA, Mohammadi M, Mohammadifard N, Mohammadnia-Afrouzi M, Mohammed S, Mohebi F, Mokdad AH, Molokhia M, Momeniha F, Monasta L, Moodley Y, Moradi G, Moradi-Lakeh M, Moradinazar M, Moraga P, Morawska L, Morgado-Da-Costa J, Morrison SD, Moschos MM, Mouodi S, Mousavi SM, Mozaffarian D, Mruts KB, Muche AA, Muchie KF, Mueller UO, Muhammed OS, Mukhopadhyay S, Muller K, Musa KI, Mustafa G, Nabhan AF, Naghavi M, Naheed A, Nahvijou A, Naik G, Naik N, Najafi F, Nangia V, Nansseu JR, Nascimento BR, Neal B, Neamati N, Negoi I, Negoi RI, Neupane S, Newton CRJ, Ngunjiri JW, Nguyen AQ, Nguyen G, Nguyen HT, Nguyen HLT, Nguyen HT, Nguyen M, Nguyen NB, Nichols E, Nie J, Ningrum DNA, Nirayo YL, Nishi N, Nixon MR, Nojomi M, Nomura S, Norheim OF, Noroozi M, Norrving B, Noubiap JJ, Nouri HR, Nourollahpour Shiadeh M, Nowroozi MR, Nsoesie EO, Nyasulu PS, Obermeyer CM, Odell CM, Ofori-Asenso R, Ogbo FA, Oh IH, Oladimeji O, Olagunju AT, Olagunju TO, Olivares PR, Olsen HE, Olusanya BO, Olusanya JO, Ong KL, Ong SK, Oren E, Orpana HM, Ortiz A, Ota E, Otstavnov SS, Øverland S, Owolabi MO, P A M, Pacella R, Pakhare AP, Pakpour AH, Pana A, Panda-Jonas S, Park EK, Parry CDH, Parsian H, Patel S, Pati S, Patil ST, Patle A, Patton GC, Paudel D, Paulson KR, Paz Ballesteros WC, Pearce N, Pereira A, Pereira DM, Perico N, Pesudovs K, Petzold M, Pham HQ, Phillips MR, Pillay JD, Piradov MA, Pirsaheb M, Pischon T, Pishgar F, Plana-Ripoll O, Plass D, Polinder S, Polkinghorne KR, Postma MJ, Poulton R, Pourshams A, Poustchi H, Prabhakaran D, Prakash S, Prasad N, Purcell CA, Purwar MB, Qorbani M, Radfar A, Rafay A, Rafiei A, Rahim F, Rahimi Z, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman M, Rahman MHU, Rahman MA, Rai RK, Rajati F, Rajsic S, Raju SB, Ram U, Ranabhat CL, Ranjan P, Rath GK, Rawaf DL, Rawaf S, Reddy KS, Rehm CD, Rehm J, Reiner RC, Reitsma MB, Remuzzi G, Renzaho AMN, Resnikoff S, Reynales-Shigematsu LM, Rezaei S, Ribeiro ALP, Rivera JA, Roba KT, Rodríguez-Ramírez S, Roever L, Román Y, Ronfani L, Roshandel G, Rostami A, Roth GA, Rothenbacher D, Roy A, Rubagotti E, Rushton L, Sabanayagam C, Sachdev PS, Saddik B, Sadeghi E, Saeedi Moghaddam S, Safari H, Safari Y, Safari-Faramani R, Safdarian M, Safi S, Safiri S, Sagar R, Sahebkar A, Sahraian MA, Sajadi HS, Salam N, Salamati P, Saleem Z, Salimi Y, Salimzadeh H, Salomon JA, Salvi DD, Salz I, Samy AM, Sanabria J, Sanchez-Niño MD, Sánchez-Pimienta TG, Sanders T, Sang Y, Santomauro DF, Santos IS, Santos JV, Santric Milicevic MM, Sao Jose BP, Sardana M, Sarker AR, Sarmiento-Suárez R, Sarrafzadegan N, Sartorius B, Sarvi S, Sathian B, Satpathy M, Sawant AR, Sawhney M, Saylan M, Sayyah M, Schaeffner E, Schmidt MI, Schneider IJC, Schöttker B, Schutte AE, Schwebel DC, Schwendicke F, Scott JG, Seedat S, Sekerija M, Sepanlou SG, Serre ML, Serván-Mori E, Seyedmousavi S, Shabaninejad H, Shaddick G, Shafieesabet A, Shahbazi M, Shaheen AA, Shaikh MA, Shamah Levy T, Shams-Beyranvand M, Shamsi M, Sharafi H, Sharafi K, Sharif M, Sharif-Alhoseini M, Sharifi H, Sharma J, Sharma M, Sharma R, She J, Sheikh A, Shi P, Shibuya K, Shiferaw MS, Shigematsu M, Shin MJ, Shiri R, Shirkoohi R, Shiue I, Shokraneh F, Shoman H, Shrime MG, Shupler MS, Si S, Siabani S, Sibai AM, Siddiqi TJ, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Silva JP, Silveira DGA, Singh JA, Singh NP, Singh V, Sinha DN, Skiadaresi E, Skirbekk V, Smith DL, Smith M, Sobaih BH, Sobhani S, Somayaji R, Soofi M, Sorensen RJD, Soriano JB, Soyiri IN, Spinelli A, Sposato LA, Sreeramareddy CT, Srinivasan V, Starodubov VI, Steckling N, Stein DJ, Stein MB, Stevanovic G, Stockfelt L, Stokes MA, Sturua L, Subart ML, Sudaryanto A, Sufiyan MB, Sulo G, Sunguya BF, Sur PJ, Sykes BL, Szoeke CEI, Tabarés-Seisdedos R, Tabuchi T, Tadakamadla SK, Takahashi K, Tandon N, Tassew SG, Tavakkoli M, Taveira N, Tehrani-Banihashemi A, Tekalign TG, Tekelemedhin SW, Tekle MG, Temesgen H, Temsah MH, Temsah O, Terkawi AS, Tessema B, Teweldemedhin M, Thankappan KR, Theis A, Thirunavukkarasu S, Thomas HJ, Thomas ML, Thomas N, Thurston GD, Tilahun B, Tillmann T, To QG, Tobollik M, Tonelli M, Topor-Madry R, Torre AE, Tortajada-Girbés M, Touvier M, Tovani-Palone MR, Towbin JA, Tran BX, Tran KB, Truelsen TC, Truong NT, Tsadik AG, Tudor Car L, Tuzcu EM, Tymeson HD, Tyrovolas S, Ukwaja KN, Ullah I, Updike RL, Usman MS, Uthman OA, Vaduganathan M, Vaezi A, Valdez PR, Van Donkelaar A, Varavikova E, Varughese S, Vasankari TJ, Venkateswaran V, Venketasubramanian N, Villafaina S, Violante FS, Vladimirov SK, Vlassov V, Vollset SE, Vos T, Vosoughi K, Vu GT, Vujcic IS, Wagnew FS, Waheed Y, Waller SG, Walson JL, Wang Y, Wang Y, Wang YP, Weiderpass E, Weintraub RG, Weldegebreal F, Werdecker A, Werkneh AA, West JJ, Westerman R, Whiteford HA, Widecka J, Wijeratne T, Winkler AS, Wiyeh AB, Wiysonge CS, Wolfe CDA, Wong TY, Wu S, Xavier D, Xu G, Yadgir S, Yadollahpour A, Yahyazadeh Jabbari SH, Yamada T, Yan LL, Yano Y, Yaseri M, Yasin YJ, Yeshaneh A, Yimer EM, Yip P, Yisma E, Yonemoto N, Yoon SJ, Yotebieng M, Younis MZ, Yousefifard M, Yu C, Zaidi Z, Zaman SB, Zamani M, Zavala-Arciniega L, Zhang AL, Zhang H, Zhang K, Zhou M, Zimsen SRM, Zodpey S, Murray CJL. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1923-1994. [PMID: 30496105 PMCID: PMC6227755 DOI: 10.1016/s0140-6736(18)32225-6] [Citation(s) in RCA: 2618] [Impact Index Per Article: 436.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 08/31/2018] [Accepted: 09/05/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk-outcome associations. METHODS We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. FINDINGS In 2017, 34·1 million (95% uncertainty interval [UI] 33·3-35·0) deaths and 1·21 billion (1·14-1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6-62·4) of deaths and 48·3% (46·3-50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39-11·5) deaths and 218 million (198-237) DALYs, followed by smoking (7·10 million [6·83-7·37] deaths and 182 million [173-193] DALYs), high fasting plasma glucose (6·53 million [5·23-8·23] deaths and 171 million [144-201] DALYs), high body-mass index (BMI; 4·72 million [2·99-6·70] deaths and 148 million [98·6-202] DALYs), and short gestation for birthweight (1·43 million [1·36-1·51] deaths and 139 million [131-147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3-6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. INTERPRETATION By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning. FUNDING Bill & Melinda Gates Foundation.
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James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, Abbastabar H, Abd-Allah F, Abdela J, Abdelalim A, Abdollahpour I, Abdulkader RS, Abebe Z, Abera SF, Abil OZ, Abraha HN, Abu-Raddad LJ, Abu-Rmeileh NME, Accrombessi MMK, Acharya D, Acharya P, Ackerman IN, Adamu AA, Adebayo OM, Adekanmbi V, Adetokunboh OO, Adib MG, Adsuar JC, Afanvi KA, Afarideh M, Afshin A, Agarwal G, Agesa KM, Aggarwal R, Aghayan SA, Agrawal S, Ahmadi A, Ahmadi M, Ahmadieh H, Ahmed MB, Aichour AN, Aichour I, Aichour MTE, Akinyemiju T, Akseer N, Al-Aly Z, Al-Eyadhy A, Al-Mekhlafi HM, Al-Raddadi RM, Alahdab F, Alam K, Alam T, Alashi A, Alavian SM, Alene KA, Alijanzadeh M, Alizadeh-Navaei R, Aljunid SM, Alkerwi A, Alla F, Allebeck P, Alouani MML, Altirkawi K, Alvis-Guzman N, Amare AT, Aminde LN, Ammar W, Amoako YA, Anber NH, Andrei CL, Androudi S, Animut MD, Anjomshoa M, Ansha MG, Antonio CAT, Anwari P, Arabloo J, Arauz A, Aremu O, Ariani F, Armoon B, Ärnlöv J, Arora A, Artaman A, Aryal KK, Asayesh H, Asghar RJ, Ataro Z, Atre SR, Ausloos M, Avila-Burgos L, Avokpaho EFGA, Awasthi A, Ayala Quintanilla BP, Ayer R, Azzopardi PS, Babazadeh A, Badali H, Badawi A, Bali AG, Ballesteros KE, Ballew SH, Banach M, Banoub JAM, Banstola A, Barac A, Barboza MA, Barker-Collo SL, Bärnighausen TW, Barrero LH, Baune BT, Bazargan-Hejazi S, Bedi N, Beghi E, Behzadifar M, Behzadifar M, Béjot Y, Belachew AB, Belay YA, Bell ML, Bello AK, Bensenor IM, Bernabe E, Bernstein RS, Beuran M, Beyranvand T, Bhala N, Bhattarai S, Bhaumik S, Bhutta ZA, Biadgo B, Bijani A, Bikbov B, Bilano V, Bililign N, Bin Sayeed MS, Bisanzio D, Blacker BF, Blyth FM, Bou-Orm IR, Boufous S, Bourne R, Brady OJ, Brainin M, Brant LC, Brazinova A, Breitborde NJK, Brenner H, Briant PS, Briggs AM, Briko AN, Britton G, Brugha T, Buchbinder R, Busse R, Butt ZA, Cahuana-Hurtado L, Cano J, Cárdenas R, Carrero JJ, Carter A, Carvalho F, Castañeda-Orjuela CA, Castillo Rivas J, Castro F, Catalá-López F, Cercy KM, Cerin E, Chaiah Y, Chang AR, Chang HY, Chang JC, Charlson FJ, Chattopadhyay A, Chattu VK, Chaturvedi P, Chiang PPC, Chin KL, Chitheer A, Choi JYJ, Chowdhury R, Christensen H, Christopher DJ, Cicuttini FM, Ciobanu LG, Cirillo M, Claro RM, Collado-Mateo D, Cooper C, Coresh J, Cortesi PA, Cortinovis M, Costa M, Cousin E, Criqui MH, Cromwell EA, Cross M, Crump JA, Dadi AF, Dandona L, Dandona R, Dargan PI, Daryani A, Das Gupta R, Das Neves J, Dasa TT, Davey G, Davis AC, Davitoiu DV, De Courten B, De La Hoz FP, De Leo D, De Neve JW, Degefa MG, Degenhardt L, Deiparine S, Dellavalle RP, Demoz GT, Deribe K, Dervenis N, Des Jarlais DC, Dessie GA, Dey S, Dharmaratne SD, Dinberu MT, Dirac MA, Djalalinia S, Doan L, Dokova K, Doku DT, Dorsey ER, Doyle KE, Driscoll TR, Dubey M, Dubljanin E, Duken EE, Duncan BB, Duraes AR, Ebrahimi H, Ebrahimpour S, Echko MM, Edvardsson D, Effiong A, Ehrlich JR, El Bcheraoui C, El Sayed Zaki M, El-Khatib Z, Elkout H, Elyazar IRF, Enayati A, Endries AY, Er B, Erskine HE, Eshrati B, Eskandarieh S, Esteghamati A, Esteghamati S, Fakhim H, Fallah Omrani V, Faramarzi M, Fareed M, Farhadi F, Farid TA, Farinha CSES, Farioli A, Faro A, Farvid MS, Farzadfar F, Feigin VL, Fentahun N, Fereshtehnejad SM, Fernandes E, Fernandes JC, Ferrari AJ, Feyissa GT, Filip I, Fischer F, Fitzmaurice C, Foigt NA, Foreman KJ, Fox J, Frank TD, Fukumoto T, Fullman N, Fürst T, Furtado JM, Futran ND, Gall S, Ganji M, Gankpe FG, Garcia-Basteiro AL, Gardner WM, Gebre AK, Gebremedhin AT, Gebremichael TG, Gelano TF, Geleijnse JM, Genova-Maleras R, Geramo YCD, Gething PW, Gezae KE, Ghadiri K, Ghasemi Falavarjani K, Ghasemi-Kasman M, Ghimire M, Ghosh R, Ghoshal AG, Giampaoli S, Gill PS, Gill TK, Ginawi IA, Giussani G, Gnedovskaya EV, Goldberg EM, Goli S, Gómez-Dantés H, Gona PN, Gopalani SV, Gorman TM, Goulart AC, Goulart BNG, Grada A, Grams ME, Grosso G, Gugnani HC, Guo Y, Gupta PC, Gupta R, Gupta R, Gupta T, Gyawali B, Haagsma JA, Hachinski V, Hafezi-Nejad N, Haghparast Bidgoli H, Hagos TB, Hailu GB, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Handal AJ, Hankey GJ, Hao Y, Harb HL, Harikrishnan S, Haro JM, Hasan M, Hassankhani H, Hassen HY, Havmoeller R, Hawley CN, Hay RJ, Hay SI, Hedayatizadeh-Omran A, Heibati B, Hendrie D, Henok A, Herteliu C, Heydarpour S, Hibstu DT, Hoang HT, Hoek HW, Hoffman HJ, Hole MK, Homaie Rad E, Hoogar P, Hosgood HD, Hosseini SM, Hosseinzadeh M, Hostiuc M, Hostiuc S, Hotez PJ, Hoy DG, Hsairi M, Htet AS, Hu G, Huang JJ, Huynh CK, Iburg KM, Ikeda CT, Ileanu B, Ilesanmi OS, Iqbal U, Irvani SSN, Irvine CMS, Islam SMS, Islami F, Jacobsen KH, Jahangiry L, Jahanmehr N, Jain SK, Jakovljevic M, Javanbakht M, Jayatilleke AU, Jeemon P, Jha RP, Jha V, Ji JS, Johnson CO, Jonas JB, Jozwiak JJ, Jungari SB, Jürisson M, Kabir Z, Kadel R, Kahsay A, Kalani R, Kanchan T, Karami M, Karami Matin B, Karch A, Karema C, Karimi N, Karimi SM, Kasaeian A, Kassa DH, Kassa GM, Kassa TD, Kassebaum NJ, Katikireddi SV, Kawakami N, Karyani AK, Keighobadi MM, Keiyoro PN, Kemmer L, Kemp GR, Kengne AP, Keren A, Khader YS, Khafaei B, Khafaie MA, Khajavi A, Khalil IA, Khan EA, Khan MS, Khan MA, Khang YH, Khazaei M, Khoja AT, Khosravi A, Khosravi MH, Kiadaliri AA, Kiirithio DN, Kim CI, Kim D, Kim P, Kim YE, Kim YJ, Kimokoti RW, Kinfu Y, Kisa A, Kissimova-Skarbek K, Kivimäki M, Knudsen AKS, Kocarnik JM, Kochhar S, Kokubo Y, Kolola T, Kopec JA, Kosen S, Kotsakis GA, Koul PA, Koyanagi A, Kravchenko MA, Krishan K, Krohn KJ, Kuate Defo B, Kucuk Bicer B, Kumar GA, Kumar M, Kyu HH, Lad DP, Lad SD, Lafranconi A, Lalloo R, Lallukka T, Lami FH, Lansingh VC, Latifi A, Lau KMM, Lazarus JV, Leasher JL, Ledesma JR, Lee PH, Leigh J, Leung J, Levi M, Lewycka S, Li S, Li Y, Liao Y, Liben ML, Lim LL, Lim SS, Liu S, Lodha R, Looker KJ, Lopez AD, Lorkowski S, Lotufo PA, Low N, Lozano R, Lucas TCD, Lucchesi LR, Lunevicius R, Lyons RA, Ma S, Macarayan ERK, Mackay MT, Madotto F, Magdy Abd El Razek H, Magdy Abd El Razek M, Maghavani DP, Mahotra NB, Mai HT, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malta DC, Mamun AA, Manda AL, Manguerra H, Manhertz T, Mansournia MA, Mantovani LG, Mapoma CC, Maravilla JC, Marcenes W, Marks A, Martins-Melo FR, Martopullo I, März W, Marzan MB, Mashamba-Thompson TP, Massenburg BB, Mathur MR, Matsushita K, Maulik PK, Mazidi M, McAlinden C, McGrath JJ, McKee M, Mehndiratta MM, Mehrotra R, Mehta KM, Mehta V, Mejia-Rodriguez F, Mekonen T, Melese A, Melku M, Meltzer M, Memiah PTN, Memish ZA, Mendoza W, Mengistu DT, Mengistu G, Mensah GA, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Mezerji NMG, Miazgowski B, Miazgowski T, Millear AI, Miller TR, Miltz B, Mini GK, Mirarefin M, Mirrakhimov EM, Misganaw AT, Mitchell PB, Mitiku H, Moazen B, Mohajer B, Mohammad KA, Mohammadifard N, Mohammadnia-Afrouzi M, Mohammed MA, Mohammed S, Mohebi F, Moitra M, Mokdad AH, Molokhia M, Monasta L, Moodley Y, Moosazadeh M, Moradi G, Moradi-Lakeh M, Moradinazar M, Moraga P, Morawska L, Moreno Velásquez I, Morgado-Da-Costa J, Morrison SD, Moschos MM, Mountjoy-Venning WC, Mousavi SM, Mruts KB, Muche AA, Muchie KF, Mueller UO, Muhammed OS, Mukhopadhyay S, Muller K, Mumford JE, Murhekar M, Musa J, Musa KI, Mustafa G, Nabhan AF, Nagata C, Naghavi M, Naheed A, Nahvijou A, Naik G, Naik N, Najafi F, Naldi L, Nam HS, Nangia V, Nansseu JR, Nascimento BR, Natarajan G, Neamati N, Negoi I, Negoi RI, Neupane S, Newton CRJ, Ngunjiri JW, Nguyen AQ, Nguyen HT, Nguyen HLT, Nguyen HT, Nguyen LH, Nguyen M, Nguyen NB, Nguyen SH, Nichols E, Ningrum DNA, Nixon MR, Nolutshungu N, Nomura S, Norheim OF, Noroozi M, Norrving B, Noubiap JJ, Nouri HR, Nourollahpour Shiadeh M, Nowroozi MR, Nsoesie EO, Nyasulu PS, Odell CM, Ofori-Asenso R, Ogbo FA, Oh IH, Oladimeji O, Olagunju AT, Olagunju TO, Olivares PR, Olsen HE, Olusanya BO, Ong KL, Ong SK, Oren E, Ortiz A, Ota E, Otstavnov SS, Øverland S, Owolabi MO, P A M, Pacella R, Pakpour AH, Pana A, Panda-Jonas S, Parisi A, Park EK, Parry CDH, Patel S, Pati S, Patil ST, Patle A, Patton GC, Paturi VR, Paulson KR, Pearce N, Pereira DM, 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Werdecker A, West TE, Whiteford HA, Widecka J, Wijeratne T, Wilner LB, Wilson S, Winkler AS, Wiyeh AB, Wiysonge CS, Wolfe CDA, Woolf AD, Wu S, Wu YC, Wyper GMA, Xavier D, Xu G, Yadgir S, Yadollahpour A, Yahyazadeh Jabbari SH, Yamada T, Yan LL, Yano Y, Yaseri M, Yasin YJ, Yeshaneh A, Yimer EM, Yip P, Yisma E, Yonemoto N, Yoon SJ, Yotebieng M, Younis MZ, Yousefifard M, Yu C, Zadnik V, Zaidi Z, Zaman SB, Zamani M, Zare Z, Zeleke AJ, Zenebe ZM, Zhang K, Zhao Z, Zhou M, Zodpey S, Zucker I, Vos T, Murray CJL. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1789-1858. [PMID: 30496104 PMCID: PMC6227754 DOI: 10.1016/s0140-6736(18)32279-7#] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/30/2018] [Accepted: 09/12/2018] [Indexed: 08/12/2023]
Abstract
BACKGROUND The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. METHODS We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. FINDINGS Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs s1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). INTERPRETATION Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. FUNDING Bill & Melinda Gates Foundation.
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Murray CJL, Callender CSKH, Kulikoff XR, Srinivasan V, Abate D, Abate KH, Abay SM, Abbasi N, Abbastabar H, Abdela J, Abdelalim A, Abdel-Rahman O, Abdi A, Abdoli N, Abdollahpour I, Abdulkader RS, Abebe HT, Abebe M, Abebe Z, Abebo TA, Abejie AN, Aboyans V, Abraha HN, Abreu DMX, Abrham AR, Abu-Raddad LJ, Abu-Rmeileh NME, Accrombessi MMK, Acharya P, Adamu AA, Adebayo OM, Adedeji IA, Adekanmbi V, Adetokunboh OO, Adhena BM, Adhikari TB, Adib MG, Adou AK, Adsuar JC, Afarideh M, Afshin A, Agarwal G, Agesa KM, Aghayan SA, Agrawal S, Ahmadi A, Ahmadi M, Ahmed MB, Ahmed S, Aichour AN, Aichour I, Aichour MTE, Akanda AS, Akbari ME, Akibu M, Akinyemi RO, Akinyemiju T, Akseer N, Alahdab F, Al-Aly Z, Alam K, Alebel A, Aleman AV, Alene KA, Al-Eyadhy A, Ali R, Alijanzadeh M, Alizadeh-Navaei R, Aljunid SM, Alkerwi A, Alla F, Allebeck P, Almasi A, Alonso J, Al-Raddadi RM, Alsharif U, Altirkawi K, Alvis-Guzman N, Amare AT, Ammar W, Anber NH, Andrei CL, Androudi S, Animut MD, Ansari H, Ansha MG, Antonio CAT, Appiah SCY, Aremu O, Areri HA, Arian N, Ärnlöv J, Artaman A, Aryal KK, Asayesh H, Asfaw ET, Asgedom SW, Assadi R, Atey TMM, Atique S, Atteraya MS, Ausloos M, Avokpaho EFGA, Awasthi A, Ayala Quintanilla BP, Ayele Y, Ayer R, Ayuk TB, Azzopardi PS, Babalola TK, Babazadeh A, Badali H, Badawi A, Bali AG, Banach M, Barker-Collo SL, Bärnighausen TW, Barrero LH, Basaleem H, Bassat Q, Basu A, Baune BT, Baynes HW, Beghi E, Behzadifar M, Behzadifar M, Bekele BB, Belachew AB, Belay AG, Belay E, Belay SA, Belay YA, Bell ML, Bello AK, Bennett DA, Bensenor IM, Bergeron G, Berhane A, Berman AE, Bernabe E, Bernstein RS, Bertolacci GJ, Beuran M, Bhattarai S, Bhaumik S, Bhutta ZA, Biadgo B, Bijani A, Bikbov B, Bililign N, Bin Sayeed MS, Birlik SM, Birungi C, Biswas T, Bizuneh H, Bleyer A, Basara BB, Bosetti C, Boufous S, Brady OJ, Bragazzi NL, Brainin M, Brazinova A, Breitborde NJK, Brenner H, Brewer JD, Briant PS, Britton G, Burstein R, Busse R, Butt ZA, Cahuana-Hurtado L, Campos-Nonato IR, Campuzano Rincon JC, Cano J, Car M, Cárdenas R, Carrero JJ, Carvalho F, Castañeda-Orjuela CA, Castillo Rivas J, Castro F, Catalá-López F, Çavlin A, Cerin E, Chalek J, Chang HY, Chang JC, Chattopadhyay A, Chaturvedi P, Chiang PPC, Chin KL, Chisumpa VH, Chitheer A, Choi JYJ, Chowdhury R, Christopher DJ, Cicuttini FM, Ciobanu LG, Cirillo M, Claro RM, Collado-Mateo D, Comfort H, Constantin MM, Conti S, Cooper C, Cooper LT, Cornaby L, Cortesi PA, Cortinovis M, Costa M, Cromwell E, Crowe CS, Cukelj P, Cunningham M, Daba AK, Dachew BA, Dandona L, Dandona R, Dargan PI, Daryani A, Das Gupta R, Das Neves J, Dasa TT, Dash AP, Weaver ND, Davitoiu DV, Davletov K, De Leo D, De Neve JW, Degefa MG, Degenhardt L, Degfie TT, Deiparine S, Demoz GT, Demtsu B, Denova-Gutiérrez E, Deribe K, Dervenis N, Des Jarlais DC, Dessie GA, Dharmaratne SD, Dhimal M, Dicker D, Ding EL, Dinsa GD, Djalalinia S, Do HP, Dokova K, Doku DT, Dolan KA, Doyle KE, Driscoll TR, Dubey M, Dubljanin E, Duken EE, Duraes AR, Ebrahimpour S, Edvardsson D, El Bcheraoui C, El-Khatib Z, Elyazar IR, Enayati A, Endries AY, Ermakov SP, Eshrati B, Eskandarieh S, Esmaeili R, Esteghamati A, Esteghamati S, Estep K, Fakhim H, Farag T, Faramarzi M, Fareed M, Farinha CSES, Faro A, Farvid MS, Farzadfar F, Farzaei MH, Fay KA, Fazeli MS, Feigin VL, Feigl AB, Feizy F, Fenny AP, Fentahun N, Fereshtehnejad SM, Fernandes E, Feyissa GT, Filip I, Finegold S, Fischer F, Flor LS, Foigt NA, Foreman KJ, Fornari C, Fürst T, Fukumoto T, Fuller JE, Fullman N, Gakidou E, Gallus S, Gamkrelidze A, Ganji M, Gankpe FG, Garcia GM, Garcia-Gordillo MÁ, Gebre AK, Gebre T, Gebregergs GB, Gebrehiwot TT, Gebremedhin AT, Gelano TF, Gelaw YA, Geleijnse JM, Genova-Maleras R, Gething P, Gezae KE, Ghadami MR, Ghadimi R, Ghadiri K, Ghasemi Falavarjani K, Ghasemi-Kasman M, Ghiasvand H, Ghimire M, Ghoshal AG, Gill PS, Gill TK, Giussani G, Gnedovskaya EV, Goli S, Gomez RS, Gómez-Dantés H, Gona PN, Goodridge A, Gopalani SV, Goulart AC, Goulart BNG, Grada A, Grosso G, Gugnani HCC, Guo J, Guo Y, Gupta PC, Gupta R, Gupta R, Gupta T, Haagsma JA, Hachinski V, Hafezi-Nejad N, Hagos TB, Hailegiyorgis TT, Hailu GB, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Handal AJ, Hankey GJ, Hao Y, Harb HL, Haririan H, Haro JM, Hasan M, Hassankhani H, Hassen HY, Havmoeller R, Hay SI, He Y, Hedayatizadeh-Omran A, Hegazy MI, Heibati B, Heidari B, Hendrie D, Henok A, Henry NJ, Herteliu C, Heydarpour F, Hibstu DT, Hole MK, Homaie Rad E, Hoogar P, Hosgood HD, Hosseini SM, Hosseini Chavoshi MM, Hosseinzadeh M, Hostiuc M, Hostiuc S, Hsairi M, Hsiao T, Hu G, Huang JJ, Iburg KM, Igumbor EU, Ikeda CT, Ilesanmi OS, Iqbal U, Irenso AA, Irvani SSN, Isehunwa OO, Islam SMS, Jahangiry L, Jahanmehr N, Jain SK, Jakovljevic M, Jalu MT, James SL, Jassal SK, Javanbakht M, Jayatilleke AU, Jeemon P, Jha RP, Jha V, Ji JS, Jonas JB, Jozwiak JJ, Jungari SB, Jürisson M, Kabir Z, Kadel R, Kahsay A, Kalani R, Kapil U, Karami M, Matin BK, Karch A, Karema C, Karimi SM, Kasaeian A, Kassa DH, Kassa GM, Kassa TD, Kassa ZY, Kassebaum NJ, Kastor A, Katikireddi SV, Kaul A, Kawakami N, Karyani AK, Kebede S, Keiyoro PN, Kemp GR, Kengne AP, Keren A, Kereselidze M, Khader YS, Khafaie MA, Khajavi A, Khalid N, Khalil IA, Khan EA, Khan MS, Khang YH, Khanna T, Khater MM, Khatony A, Khazaeipour Z, Khazaie H, Khoja AT, Khosravi A, Khosravi MH, Kibret GD, Kidanemariam ZT, Kiirithio DN, Kilgore PE, Kim D, Kim JY, Kim YE, Kim YJ, Kimokoti RW, Kinfu Y, Kinra S, Kisa A, Kivimäki M, Kochhar S, Kokubo Y, Kolola T, Kopec JA, Kosek MN, Kosen S, Koul PA, Koyanagi A, Krishan K, Krishnaswami S, Krohn KJ, Defo BK, Bicer BK, Kumar GA, Kumar M, Kumar P, Kumsa FA, Kutz MJ, Lad SD, Lafranconi A, Lal DK, Lalloo R, Lam H, Lami FH, Lang JJ, Lanksy S, Lansingh VC, Laryea DO, Lassi ZS, Latifi A, Laxmaiah A, Lazarus JV, Lee JB, Lee PH, Leigh J, Leshargie CT, Leta S, Levi M, Li S, Li X, Li Y, Liang J, Liang X, Liben ML, Lim LL, Limenih MA, Linn S, Liu S, Lorkowski S, Lotufo PA, Lozano R, Lunevicius R, Mabika CM, Macarayan ERK, Mackay MT, Madotto F, Mahmood TAE, Mahotra NB, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malik MA, Mamun AA, Manamo WA, Manda AL, Mangalam S, Mansournia MA, Mantovani LG, Mapoma CC, Marami D, Maravilla JC, Marcenes W, Marina S, Martins-Melo FR, März W, Marzan MB, Mashamba-Thompson TP, Masiye F, Mason-Jones AJ, Massenburg BB, Mathur MR, Maulik PK, Mazidi M, McGrath JJ, Mehata S, Mehendale SM, Mehndiratta MM, Mehrotra R, Mehrzadi S, Mehta KM, Mehta V, Mekonnen TC, Meles HG, Meles KG, Melese A, Melku M, Memiah PTN, Memish ZA, Mendoza W, Mengesha MM, Mengistu DT, Mengistu G, Mensah GA, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Mezgebe HB, Miangotar Y, Miazgowski B, Miazgowski T, Miller TR, Miller-Petrie MK, Mini GK, Mirabi P, Mirica A, Mirrakhimov EM, Misganaw AT, Moazen B, Mohammad KA, Mohammadi M, Mohammadifard N, Mohammadi-Khanaposhtani M, Mohammed MA, Mohammed S, Mokdad AH, Mola GD, Molokhia M, Monasta L, Montañez JC, Moradi G, Moradi M, Moradi-Lakeh M, Moradinazar M, Moraga P, Morgado-Da-Costa J, Mori R, Morrison SD, Mosapour A, Moschos MM, Mousavi SM, Muche AA, Muchie KF, Mueller UO, Mukhopadhyay S, Muller K, Murphy TB, Murthy GVS, Musa J, Musa KI, Mustafa G, Muthupandian S, Nachega JB, Nagel G, Naghavi M, Naheed A, Nahvijou A, Naik G, Naik P, Najafi F, Naldi L, Nangia V, Nansseu JR, Nascimento BR, Nawaz H, Ncama BP, Neamati N, Negoi I, Negoi RI, Neupane S, Newton CRJ, Ngalesoni FN, Ngunjiri JW, Nguyen G, Nguyen LH, Nguyen TH, Ningrum DNA, Nirayo YL, Nisar MI, Nixon MR, Nomura S, Noroozi M, Noubiap JJ, Nouri HR, Shiadeh MN, Nowroozi MR, Nyandwi A, Nyasulu PS, Odell CM, Ofori-Asenso R, Ogah OS, Ogbo FA, Oh IH, Okoro A, Oladimeji O, Olagunju AT, Olagunju TO, Olivares PR, Olusanya BO, Olusanya JO, Ong SK, Ortiz A, Osgood-Zimmerman A, Ota E, Otieno BA, Otstavnov SS, Owolabi MO, Oyekale AS, P A M, Pakhale S, Pakhare AP, Pana A, Panda BK, Panda-Jonas S, Pandey AR, Park EK, Parsian H, Patel S, Patil ST, Patle A, Patton GC, Paturi VR, Paudel D, Pedroso MM, Peprah EK, Pereira DM, Perico N, Pesudovs K, Petri WA, Petzold M, Pierce M, Pigott DM, Pillay JD, Pirsaheb M, Polanczyk GV, Postma MJ, Pourmalek F, Pourshams A, Poustchi H, Prakash S, Prasad N, Purcell CA, Purwar MB, Qorbani M, Quansah R, Radfar A, Rafay A, Rafiei A, Rahim F, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman M, Rahman MS, Rahman MHU, Rahman MA, Rahman SU, Rai RK, Rajati F, Rajsic S, Ram U, Ranabhat CL, Ranjan P, Rawaf DL, Rawaf S, Ray SE, Razo-García C, Reiner RC, Reis C, Remuzzi G, Renzaho AMN, Resnikoff S, Rezaei S, Rezaeian S, Rezai MS, Riahi SM, Rios-Blancas MJ, Roba KT, Roberts NLS, Roever L, Ronfani L, Roshandel G, Rostami A, Rubagotti E, Ruhago GM, Sabde YD, Sachdev PS, Saddik B, Saeedi Moghaddam S, Safari H, Safari Y, Safari-Faramani R, Safdarian M, Safi S, Safiri S, Sagar R, Sahebkar A, Sahraian MA, Sajadi HS, Salahshoor MR, Salam N, Salama JS, Salamati P, Saldanha RDF, Saleem Z, Salimi Y, Salimzadeh H, Salomon JA, Salvi SS, Salz I, Sambala EZ, Samy AM, Sanabria J, Sanchez-Niño MD, Santos IS, Santric Milicevic MM, Sao Jose BP, Sardana M, Sarker AR, Sarmiento-Suárez R, Saroshe S, Sarrafzadegan N, Sartorius B, Sarvi S, Sathian B, Satpathy M, Sawant AR, Sawhney M, Saxena S, Schaeffner E, Schelonka K, Schneider IJC, Schwebel DC, Schwendicke F, Seedat S, Sekerija M, Sepanlou SG, Serván-Mori E, Shabaninejad H, Shackelford KA, Shafieesabet A, Shaheen AA, Shaikh MA, Shakir RA, Shams-Beyranvand M, Shamsi M, Shamsizadeh M, Sharafi H, Sharafi K, Sharif M, Sharif-Alhoseini M, Sharma J, Sharma R, She J, Sheikh A, Shi P, Shibuya K, Shigematsu M, Shiri R, Shirkoohi R, Shiue I, Shokraneh F, Shukla SR, Si S, Siabani S, Sibai AM, Siddiqi TJ, Sigfusdottir ID, Sigurvinsdottir R, Silpakit N, Silva DAS, Silva JP, Silveira DGA, Singam NSV, Singh JA, Singh NP, Singh V, Sinha DN, Sliwa K, Soares Filho AM, Sobaih BH, Sobhani S, Soofi M, Soriano JB, Soyiri IN, Sreeramareddy CT, Starodubov VI, Steiner C, Stewart LG, Stokes MA, Strong M, Subart ML, Sufiyan MB, Sulo G, Sunguya BF, Sur PJ, Sutradhar I, Sykes BL, Sylaja PN, Sylte DO, Szoeke CEI, Tabarés-Seisdedos R, Tabb KM, Tadakamadla SK, Tandon N, Tassew AA, Tassew SG, Taveira N, Tawye NY, Tehrani-Banihashemi A, Tekalign TG, Tekle MG, Temsah MH, Terkawi AS, Teshale MY, Tessema B, Teweldemedhin M, Thakur JS, Thankappan KR, Thirunavukkarasu S, Thomas N, Thomson AJ, Tilahun B, To QG, Tonelli M, Topor-Madry R, Torre AE, Tortajada-Girbés M, Tovani-Palone MR, Toyoshima H, Tran BX, Tran KB, Tripathy SP, Truelsen TC, Truong NT, Tsadik AG, Tsegay A, Tsilimparis N, Tudor Car L, Ukwaja KN, Ullah I, Usman MS, Uthman OA, Uzun SB, Vaduganathan M, Vaezi A, Vaidya G, Valdez PR, Varavikova E, Varughese S, Vasankari TJ, Vasconcelos AMN, Venketasubramanian N, Villafaina S, Violante FS, Vladimirov SK, Vlassov V, Vollset SE, Vos T, Vosoughi K, Vujcic IS, Wagnew FS, Waheed Y, Walson JL, Wang Y, Wang YP, Weiderpass E, Weintraub RG, Weldegwergs KG, Werdecker A, Westerman R, Whiteford H, Widecka J, Widecka K, Wijeratne T, Winkler AS, Wiysonge CS, Wolfe CDA, Wu S, Wyper GMA, Xu G, Yamada T, Yano Y, Yaseri M, Yasin YJ, Ye P, Yentür GK, Yeshaneh A, Yimer EM, Yip P, Yisma E, Yonemoto N, Yoon SJ, Yotebieng M, Younis MZ, Yousefifard M, Yu C, Zadnik V, Zaidi Z, Zaman SB, Zamani M, Zare Z, Zeleke MM, Zenebe ZM, Zerfu TA, Zhang X, Zhao XJ, Zhou M, Zhu J, Zimsen SRM, Zodpey S, Zoeckler L, Lopez AD, Lim SS. Population and fertility by age and sex for 195 countries and territories, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1995-2051. [PMID: 30496106 PMCID: PMC6227915 DOI: 10.1016/s0140-6736(18)32278-5] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. METHODS We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10-54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10-14 years and 50-54 years was estimated from data on fertility in women aged 15-19 years and 45-49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. FINDINGS From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4-52·0). The TFR decreased from 4·7 livebirths (4·5-4·9) to 2·4 livebirths (2·2-2·5), and the ASFR of mothers aged 10-19 years decreased from 37 livebirths (34-40) to 22 livebirths (19-24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3-200·8) since 1950, from 2·6 billion (2·5-2·6) to 7·6 billion (7·4-7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15-64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9-1·2) in Cyprus to a high of 7·1 livebirths (6·8-7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07-0·09) in South Korea to 2·4 livebirths (2·2-2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3-0·4) in Puerto Rico to a high of 3·1 livebirths (3·0-3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. INTERPRETATION Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. FUNDING Bill & Melinda Gates Foundation.
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Rahnemai-Azar AA, Perkins JD, Leca N, Blosser CD, Johnson CK, Morrison SD, Bakthavatsalam R, Limaye AP, Sibulesky L. Unintended Consequences in Use of Increased Risk Donor Kidneys in the New Kidney Allocation Era. Transplant Proc 2018; 50:14-19. [PMID: 29407297 DOI: 10.1016/j.transproceed.2017.11.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/09/2017] [Accepted: 11/03/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND The new kidney allocation system (KAS) intends to allocate the top 20% of kidneys to younger recipients with longer life expectancy. We hypothesized that the new KAS would lead to greater allocation of Public Health Service (PHS) increased-risk donor organs to younger recipients. METHODS Analyses of the Organ Procurement and Transplantation Network data of patients who underwent primary deceased kidney transplantation were performed in pre- and post-KAS periods. RESULTS The allocation of PHS increased-risk kidney allografts in various age groups changed significantly after implementation of the new KAS, with an increased proportion of younger individuals receiving increased-risk kidneys (7% vs 10% in age group 20-29 y and 13% vs 18% in age group 30-39 y before and after KAS, respectively; P < .0001). This trend was reversed in recipients 50-59 years old, with 31% in the pre-KAS period compared with 26% after KAS (P < .0001). CONCLUSIONS The new KAS resulted in a substantial increase in allocation of PHS increased-risk kidneys to candidates in younger age groups. Because increased-risk kidneys are generally underutilized, future efforts to optimize the utilization of these organs should target younger recipients and their providers.
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Affiliation(s)
- A A Rahnemai-Azar
- Division of Transplant Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington
| | - J D Perkins
- Division of Transplant Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington
| | - N Leca
- Division of Nephrology, Department of Medicine, University of Washington Medical Center, Seattle, Washington
| | - C D Blosser
- Division of Nephrology, Department of Medicine, University of Washington Medical Center, Seattle, Washington
| | - C K Johnson
- Division of Nephrology, Department of Medicine, University of Washington Medical Center, Seattle, Washington
| | - S D Morrison
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington
| | - R Bakthavatsalam
- Division of Transplant Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington
| | - A P Limaye
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington Medical Center, Seattle, Washington
| | - L Sibulesky
- Division of Transplant Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington.
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Rahnemai-Azar AA, Penna M, Morrison SD, Rayhill SC, Sibulesky L, Muczynski KA, Bakthavatsalam R. Coloduodenovesical Fistula After Simultaneous Pancreas-Kidney Transplant: Case Report and Review of the Literature. Transplant Proc 2017; 49:1960-1962. [PMID: 28923655 DOI: 10.1016/j.transproceed.2017.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/31/2017] [Accepted: 04/27/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Complicated diverticulitis after transplantation occurs in as many as 3.5% of cases and carries a 25% mortality rate. Diagnosis of complicated diverticulitis in this population can be challenging because of abnormal presentations caused by immunosuppression. Only 4 cases of fistulization after kidney transplantation are described in the literature; none occurred after simultaneous pancreas-kidney transplant. METHODS We present a first case of a coloduodenovesical fistula in a patient 9 years after simultaneous pancreas-kidney transplant. The patient presented with intermittent episodes of elevated creatinine and recurrent urinary tract infection. The presence of fistula was strongly suspected in cystoscopy, but, despite extensive investigation, a fistula tract could not be identified. RESULTS The patient ultimately underwent surgical exploration for positive cystoscopy examination, continuation of urinary complaints, and presence of multiple colonic diverticula in computed tomography scan. At surgical exploration, a fistula track was identified between the sigmoid colon and duodenal stump of the pancreas allograft. Subsequently, sigmoidectomy, bladder repair, and enteric conversion of the pancreas transplant were performed. CONCLUSIONS Complications of diverticulitis should be considered in organ transplant recipients presenting with recurrent urinary infection and elevated creatinine, and surgical exploration might be indicated even if unable to well-define the fistula tract.
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Affiliation(s)
- A A Rahnemai-Azar
- Department of Surgery, University of Washington Medical Center, University of Washington, Seattle, Washington
| | - M Penna
- Department of Surgery, University of Washington Medical Center, University of Washington, Seattle, Washington
| | - S D Morrison
- Department of Surgery, University of Washington Medical Center, University of Washington, Seattle, Washington
| | - S C Rayhill
- Department of Surgery, University of Washington Medical Center, University of Washington, Seattle, Washington
| | - L Sibulesky
- Department of Surgery, University of Washington Medical Center, University of Washington, Seattle, Washington
| | - K A Muczynski
- Department of Medicine, University of Washington Medical Center, University of Washington, Seattle, Washington
| | - R Bakthavatsalam
- Department of Surgery, University of Washington Medical Center, University of Washington, Seattle, Washington.
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Abstract
The psychostimulants methylphenidate, dextroamphetamine, and pemoline are among the most common medications used in child and adolescent psychiatry. Often, these agents are used in combination with other medications. This review summarizes reported drug interactions and assesses both causality and clinical significance. A computerized search was undertaken using MEDLINE (1966 to 1998) to obtain all pertinent reports of adverse events associated with the coadministration of psychostimulants and other drugs. A total of 38 reports involving 25 different drugs from various classes were systematically evaluated along with research studies conducted to specifically assess drug interactions. Methylphenidate appeared to be involved primarily in pharmacokinetic interactions suggestive of cytochrome P450 inhibition while dextroamphetamine and pemoline were more often involved in apparent pharmacodynamic interactions. The published data support the safe use of psychostimulants with most classes of medications with few absolute contraindications.
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Affiliation(s)
- J S Markowitz
- The Institute of Psychiatry, Medical University of South Carolina, Charleston 29425-0742, USA.
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Jones SK, Hall JE, Allen MA, Morrison SD, Ohemeng KA, Reddy VV, Geratz JD, Tidwell RR. Novel pentamidine analogs in the treatment of experimental Pneumocystis carinii pneumonia. Antimicrob Agents Chemother 1990; 34:1026-30. [PMID: 2393262 PMCID: PMC171751 DOI: 10.1128/aac.34.6.1026] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
We have recently demonstrated that substitution of imidazoline moieties for the amidine groups of pentamidine produces a molecule that is effective against rat Pneumocystis carinii pneumonia and that is apparently less toxic than pentamidine. For this reason, 10 novel imidazoline substituted compounds were evaluated for their effect against rat P. carinii pneumonia. While several of the new compounds were observed to have advantages over pentamidine in the treatment of disease in the rat model, only one compound stood out as a potential new clinical agent. Treatment for 2 weeks with intravenous (i.v.) doses of 1,3-di(4-imidazolino-2-methoxyphenoxy)propane (DIMP) at 1 mg/kg per day produced an anti-P. carinii pneumonia effect equivalent to i.v. doses of pentamidine at 10 mg/kg per day. Although pentamidine and one of the test drugs, 1,3-di(4-imidazolinophenoxy)propane, showed no activity against P. carinii pneumonia when administered per os, DIMP exhibited potent anti-P. carinii pneumonia activity when given by daily gavage doses of 40 and 25 mg/kg. DIMP retained significant activity when given every other day by a gavage dose of 25 mg/kg. No toxicity was observed with the drug at any of the dose levels or by either of the routes of administration. However, the low solubility of the drug prevented testing at higher i.v. doses. Our conclusion is that DIMP has the potential of providing a safer and more effective alternative to pentamidine for the treatment of P. carinii pneumonia.
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Affiliation(s)
- S K Jones
- Department of Pediatric Infectious Disease, School of Medicine, University of North Carolina, Chapel Hill 27599
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Moley JF, Morrison SD, Gorschboth CM, Norton JA. Body composition changes in rats with experimental cancer cachexia: improvement with exogenous insulin. Cancer Res 1988; 48:2784-7. [PMID: 3282649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Exogenous insulin treatment has been shown to improve food intake and host weight of cachectic tumor-bearing (TB) rats, but the composition of the host weight gain has not been quantitated. Sixty-six Fischer 344 rats were randomized to seven groups: early nontumor-bearing (NTB) (n = 10) who underwent compositional analysis (CA) on the day the methylcholanthrene sarcoma was implanted in TB rats; pretreatment-NTB (n = 10) and pretreatment-TB (n = 10) who underwent CA 25 days later when rats began treatment with saline or insulin; and finally saline-treated NTB (n = 9), saline-treated TB (n = 9), insulin-treated NTB (n = 9), and insulin-treated TB (n = 9), who underwent CA following 5 days of treatment with daily saline or neutral protamine hagedorn insulin 2 units/100 g. Body weight and food intake were measured daily. For compositional analysis, the tumor was separated from the host in TB rats and the entire rat in NTB animals was homogenized, lyophilized and analyzed for fat, water, protein, potassium, chloride, and sodium. The tumor was processed in a similar fashion. In response to insulin, NTB rats ate significantly more food, and had an increase in body weight gain. Compositional analysis of insulin-treated NTB rats indicated a slight, but insignificant, increase in body fat and a similar insignificant decrease in body protein. TB rats ate significantly less than NTB rats during the 5-day experimental period, and insulin treatment significantly increased food intake to levels similar to NTB animals. Compositional analysis indicated that the tumor-bearing state resulted in a significant decrease in total host water, protein, fat, potassium, sodium, and chloride. Insulin administration resulted in preservation of host nitrogen, fat, potassium, sodium, and chloride in cachectic tumor-bearing rats. Insulin treatment did not affect tumor dry weight or composition. The results suggest that exogenous insulin, can preserve normal host composition of TB rats during cachectic decline.
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Affiliation(s)
- J F Moley
- Surgical Metabolism Section, National Cancer Institute, Bethesda, Maryland 20892
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Abstract
As a model of surgical stress in the cancer-bearing animal, we resected large flank sarcomas from cachectic rats under ether anesthesia and closed wounds primarily. The metabolic cost of tumor resection was measured using a long-term continuous indirect calorimeter. In the immediate postresection period energy balance decreased and host energy expenditure increased significantly (P less than 0.005). In animals with similar tumor weights, mortality following resection was determined by the degree of cachectic depletion. We then considered whether improvement of preoperative host nutritional status with insulin treatment might improve a subsequent surgical outcome. Insulin, when administered exogenously to cachectic tumor-bearing rats, has been shown to stimulate food intake and preserve host weight and does not stimulate tumor growth. When individual rats bearing a cachexia-producing flank sarcoma demonstrated a decline in food intake to less than 75% of predicted (approximately 25 days after tumor implantation), they were randomized to receive either daily injections of NPH insulin (2 units/100 g/day) for 5 days or no treatment for 5 days. Animals then underwent tumor resection and 14-day survival was measured. All resections were performed in an unbiased manner without the surgeon's knowledge of each rat's treatment status. In an experiment using 59 rats, insulin-treated rats had a threefold higher 5-day preoperative food intake and did not lose weight in the preoperative period, while untreated rats lost 17 g (P less than 0.001). Mortality in the insulin-treated group was 10% versus 28% in the untreated group.(ABSTRACT TRUNCATED AT 250 WORDS)
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Abstract
Rats with intravascular catheters connected to infusion systems are frequently used in the investigation of nutritional and metabolic problems. Although the animal is often referred to as "unrestrained," there is no information on the effect of the catheter assembly or total parenteral nutrition (TPN) on total (TEE), activity (AEE), and resting (REE) energy expenditure (TEE = REE + AEE). Male Fischer 344 rats were studied in an analytical respiration calorimeter. Normal unoperated rats, aseptically catheterized orally fed rats from postoperative day 1 to 7, and TPN rats were studied. Orally fed catheterized rats had weight loss, negative nitrogen balance, negative energy balance, elevated REE, and normal AEE during the first 4 postoperative days. Their weight gain, positive nitrogen balance, AEE, and REE were almost identical to those of normal rats over postoperative days 5 through 7. REE and AEE in TPN rats were similar to values in normal rats. These data indicate that catheter operation and TPN cause no abnormality in AEE and REE if adequate time is allowed for recovery from catheter operation and strict attention is given to asepsis.
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Abstract
Cancer cachexia is a complex syndrome that includes host tissue wasting, anorexia, asthenia, and abnormal host intermediary metabolism. It is present in approximately 50% of cancer patients during treatment and nearly 100% of treated cancer patients at death. Cachexia has a detrimental impact on cancer therapy. The central problem of cancer cachexia is that energy balance is not maintained, and the host has a relative hypophagia which results in host tissue wasting. The tumor by its nature and obligate growth can continue to consume glucose, amino acids, and lipids at the expense of the host. This produces abnormal host intermediary metabolism including elevated glucose production and recycling, decreased muscle protein synthesis, and increased muscle and fat breakdown. The exact mechanisms of cancer cachexia have been only partially elucidated. The identification of signal molecules like cachectin which mediate these changes may be on the horizon. Nutritional support can reverse some of the derangements seen with cachexia, and there is evidence that functional lean body mass or body cell mass can be restored in some (but not all) patients. However, nutritional support has not yet improved response to chemotherapy or radiation therapy, nor has it improved host tolerance of chemotherapy. It has improved operative mortality and morbidity in cachectic cancer patients undergoing major surgical procedures. Optimum host nutritional support appears to be dependent on high insulin concentrations in both humans and rats. Insulin and exercise may be methods to preserve host lean tissue and feed the host rather than the tumor. Future studies depend on better definition of tumor-bearing host metabolism, altering the relationship between neoplasm and host to preferentially feed the host, and making the neoplasm more susceptible to effective treatment.
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Affiliation(s)
- J A Norton
- Surgery Branch, National Cancer Institute, Bethesda, Maryland
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Cowen AR, Haywood JM, Morrison SD. Field coverage in digital grey-scale fluorography of the chest. Br J Radiol 1986; 59:426-7. [PMID: 3697625 DOI: 10.1259/0007-1285-59-700-426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Norton JA, Moley JF, Green MV, Carson RE, Morrison SD. Parabiotic transfer of cancer anorexia/cachexia in male rats. Cancer Res 1985; 45:5547-52. [PMID: 3863707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
To demonstrate that the anorexia and depletion of cachexia reverses on tumor removal, F344 rats underwent sarcoma resection when their food intake fell to 0 g/day. In survivors of surgery, reversal in food intake was apparent within 3 days postoperatively, followed after 2 days by gain in host weight. To detect whether the transmission of anorexia/cachexia in these tumor-bearing (TB) rats was via the circulation, four groups were studied: single non-tumor bearing (NTB); single TB; parabiotic NTB; and parabiotic TB. The measured blood exchange rate between parabiotic halves was 1.2-1.5%/min. No cachectic effect was detected in either half of the NTB parabionts. There was no evidence of sarcoma metastases in the tumor-free half of the parabiotic TB pair. All the rats associated with the presence of tumor showed cachectic effects but the degree and timing of effect varied among the three conditions, single TB, parabiotic TB half, and parabiotic tumor-free half. In all variables examined (fall in food intake, time of first fall in food intake, host weight loss, elevation of blood urea nitrogen) the severities were always in the same sequence: single TB greater than parabiotic TB half greater than parabiotic tumor-free half greater than NTB. In addition, the TB parabiotic pair had a significantly longer survival time and grew a significantly larger tumor than did the single TB animal. The parabiotic tumor had a slower initial growth rate and a slower deceleration rate than the singlet tumor. These results provide evidence for the humoral mediation of cancer-associated cachexia.
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Moley JF, Morrison SD, Norton JA. Insulin reversal of cancer cachexia in rats. Cancer Res 1985; 45:4925-31. [PMID: 3896470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The anabolic effects of exogenous neutral protamine hagedorn insulin on tumor-bearing (TB) and non-tumor-bearing (NTB) rats were examined. Exogenous insulin (2 units/100 g/day) produced similar hypoglycemia in TB and NTB rats. Food intake and body weight gain were significantly increased by insulin in NTB rats. In TB rats in an early stage of cachexia, insulin increased food intake and host weight (total body weight minus tumor weight). In TB rats with severe cachexia, insulin increased food intake and stabilized host weight when untreated TB controls were not eating and were losing weight. When daily insulin administration was started at an early stage of tumor growth and continued until death, there was again significant enhancement of host weight and food intake. Heart and adrenal weights were significantly reduced in insulin-treated TB animals. Tumor growth was not stimulated by insulin treatment. Survival time was slightly reduced in TB rats treated with long-term insulin. Survival time in TB rats randomized to insulin during late cachectic decline was not different from untreated TB controls. Insulin did not have any measurable effect on energy expenditure or the motor activity compartment of energy expenditure in either TB or NTB rats. Insulin treatment can reverse experimental cancer cachexia. It is a nutritional therapy which preferentially feeds the host over the tumor. As yet, its beneficial effects have not prolonged survival of tumor-bearing animals.
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Deuster PA, Morrison SD, Ahrens RA. Endurance exercise modifies cachexia of tumor growth in rats. Med Sci Sports Exerc 1985; 17:385-92. [PMID: 4021782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Food intakes, body composition, skeletal muscle mass, muscle protein synthesis, and myofibrillar protein degradation were studied in normal, food-restricted (FR), and Walker 256 tumor-bearing (TB) male Sprague-Dawley rats which were exercised (E) or maintained in a sedentary state. Exercise was enforced 3 times per wk for 100 min X session-1 at 20 m X min-1 on a 13% incline for 7 wk. Tumors were transplanted 3 wk after beginning the exercise program and were allowed to grow for 29 d. Food restriction was initiated during the last 2 wk of tumor growth. Food intakes and body lipid stores were reduced in all E groups, whereas body nitrogen was reduced only in the TBS animals. All E animals had significantly higher gastrocnemius muscle/body weight ratios than their sedentary counterparts, with the greatest ratio noted for the TBE animals. Muscle protein synthesis, measured by incorporation of [3H]tyrosine into gastrocnemius muscle, was significantly depressed in both FR and TB animals. Muscle protein breakdown, estimated by urinary 3-methylhistidine excretion, was significantly elevated in TB animals and slightly increased in FR animals. The results suggest that tumor presence significantly alters protein turnover to a greater extent than elicited by food restriction alone. Additionally, although exercise may have initially protected the animal by retarding tumor growth and muscle mass depletion, in the end, the energy costs of exercise accelerated the catabolic state.
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Morrison SD, Moley JF, Norton JA. Contribution of inert mass to experimental cancer cachexia in rats. J Natl Cancer Inst 1984; 73:991-8. [PMID: 6592392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
An inert artificial tumor (AFT) was inflated in male F344 rats to simulate, experimentally, the growth in mass of large transplantable tumors that produce cachexia. The AFT depressed host weight gain and skeletal muscle mass up to 30% and food intake up to 20% of the depression induced by tumors of comparable size. When the growth rate of the AFT was low, there was no depression of food intake. Work-induced hypertrophy of skeletal muscles, as assessed by a gastrocnemius tenotomy model, was approximately equal to that of normal, tumor-bearing, and AFT-bearing animals. The AFT elevated host total energy expenditure by 12.5% and compartment-of-energy expenditure attributable to motor activity by 10.5%. The elevation of energy expenditure accounted for most of the depression of weight gain of AFT-bearing animals below that of intact animals. The large mass of most transplantable tumors leads to an overestimate of the malignant tissue-depletive effects of tumor and an under-estimate of the asthenic effects.
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Abstract
Insulin administered to rats during simultaneous exposure to cold increases food intake by more than the sum of the separate feeding responses and prevents the normal cold-induced loss of body weight. On withdrawal of insulin with cold maintained, all the body weight maintained by insulin is immediately lost and body weight thereafter is identical to that of rats exposed to cold only. Accumulated food intake for the joint treatment and after withdrawal of insulin with cold maintained is greater than for cold exposure only. There is no increase in metabolic cost due to insulin. Energy density of weight gain during insulin treatment is high and of weight loss on withdrawal of insulin with cold maintained is very low. These responses do not conform with commonly proposed models of feeding control.
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