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1. The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013.

Author

Raghid Charara, Mohammad Forouzanfar, Mohsen Naghavi, Maziar Moradi-Lakeh, Ashkan Afshin, Theo Vos, Farah Daoud, Haidong Wang, Charbel El Bcheraoui, Ibrahim Khalil, Randah R Hamadeh, Ardeshir Khosravi, Vafa Rahimi-Movaghar, Yousef Khader, Nawal Al-Hamad, Carla Makhlouf Obermeyer, Anwar Rafay, Rana Asghar, Saleem M Rana, Amira Shaheen, Niveen M E Abu-Rmeileh, Abdullatif Husseini, Laith J Abu-Raddad, Tawfik Khoja, Zulfa A Al Rayess, Fadia S AlBuhairan, Mohamed Hsairi, Mahmoud A Alomari, Raghib Ali, Gholamreza Roshandel, Abdullah Sulieman Terkawi, Samer Hamidi, Amany H Refaat, Ronny Westerman, Aliasghar Ahmad Kiadaliri, Ali S Akanda, Syed Danish Ali, Umar Bacha, Alaa Badawi, Shahrzad Bazargan-Hejazi, Imad A D Faghmous, Seyed-Mohammad Fereshtehnejad, Florian Fischer, Jost B Jonas, Barthelemy Kuate Defo, Alem Mehari, Saad B Omer, Farshad Pourmalek, Olalekan A Uthman, Ali A Mokdad, Fadi T Maalouf, Foad Abd-Allah, Nadia Akseer, Dinesh Arya, Rohan Borschmann, Alexandra Brazinova, Traolach S Brugha, Ferrán Catalá-López, Louisa Degenhardt, Alize Ferrari, Josep Maria Haro, Masako Horino, John C Hornberger, Hsiang Huang, Christian Kieling, Daniel Kim, Yunjin Kim, Ann Kristin Knudsen, Philip B Mitchell, George Patton, Rajesh Sagar, Maheswar Satpathy, Kim Savuon, Soraya Seedat, Ivy Shiue, Jens Christoffer Skogen, Dan J Stein, Karen M Tabb, Harvey A Whiteford, Paul Yip, Naohiro Yonemoto, Christopher J L Murray, and Ali H Mokdad

Subjects
Medicine, Science
Abstract

The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost-YLLs) and nonfatal outcomes (years lived with disability-YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25-49 age group, with a peak in the 35-39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of diseases in the region.

Published
2017
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2. Satellite Based Assessment of Hydroclimatic Conditions Related to Cholera in Zimbabwe

Author

Antarpreet Jutla, Haidar Aldaach, Hannah Billian, Rita R. Colwell, Anwar Huq, and Ali S. Akanda

Subjects
Satellite Imagery, Zimbabwe, Climatic Processes, Science, Rain, Population, medicine.disease_cause, Models, Biological, Disease Outbreaks, Cholera, Tropical climate, medicine, Humans, education, Epidemics, Vibrio cholerae, education.field_of_study, Spatial Analysis, Tropical Climate, Multidisciplinary, Outbreak, medicine.disease, Geography, Climatology, Early warning system, Medicine, Seasons, Environmental epidemiology, Research Article
Abstract

IntroductionCholera, an infectious diarrheal disease, has been shown to be associated with large scale hydroclimatic processes. The sudden and sporadic occurrence of epidemic cholera is linked with high mortality rates, in part, due to uncertainty in timing and location of outbreaks. Improved understanding of the relationship between pathogenic abundance and climatic processes allows prediction of disease outbreak to be an achievable goal. In this study, we show association of large scale hydroclimatic processes with the cholera epidemic in Zimbabwe reported to have begun in Chitungwiza, a city in Mashonaland East province, in August, 2008.Principal findingsClimatic factors in the region were found to be associated with triggering cholera outbreak and are shown to be related to anomalies of temperature and precipitation, validating the hypothesis that poor conditions of sanitation, coupled with elevated temperatures, and followed by heavy rainfall can initiate outbreaks of cholera. Spatial estimation by satellite of precipitation and global gridded air temperature captured sensitivities in hydroclimatic conditions that permitted identification of the location in the region where the disease outbreak began.DiscussionSatellite derived hydroclimatic processes can be used to capture environmental conditions related to epidemic cholera, as occurred in Zimbabwe, thereby providing an early warning system. Since cholera cannot be eradicated because the causative agent, Vibrio cholerae, is autochthonous to the aquatic environment, prediction of conditions favorable for its growth and estimation of risks of triggering the disease in a given population can be used to alert responders, potentially decreasing infection and saving lives.

Published
2015

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