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1. Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000–17

Author

Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. Bennett, Habib Benzian, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Krittika Bhattacharyya, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Muhammad Shahdaat Bin Sayeed, Raaj Kishore Biswas, Somayeh Bohlouli, Soufiane Boufous, Oliver J Brady, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Alexandria Brown, Sharath Burugina Nagaraja, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Carlos A Castañeda-Orjuela, Franz Castro, Ester Cerin, Binaya Chalise, Vijay Kumar Chattu, Ken Lee Chin, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Elizabeth A Cromwell, Abel Fekadu Fekadu Dadi, Tukur Dahiru, Saad M A Dahlawi, Rakhi Dandona, Lalit Dandona, Anh Kim Dang, Farah Daoud, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Nicole Davis Weaver, Fernando Pio De la Hoz, Jan-Walter De Neve, Dereje Bayissa Demissie, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Hoa Thi Do, Christiane Dolecek, Kerrie E Doyle, Eleonora Dubljanin, Andre Rodrigues Duraes, Hisham Atan Edinur, Andem Effiong, Aziz Eftekhari, Nevine El Nahas, Maysaa El Sayed Zaki, Maha El Tantawi, Hala Rashad Elhabashy, Shaimaa I. El-Jaafary, Ziad El-Khatib, Hajer Elkout, Aisha Elsharkawy, Shymaa Enany, Daniel Adane Endalew, Babak Eshrati, Sharareh Eskandarieh, Arash Etemadi, Oluchi Ezekannagha, Emerito Jose A. Faraon, Mohammad Fareed, Andre Faro, Farshad Farzadfar, Alebachew Fasil Fasil, Mehdi Fazlzadeh, Valery L. Feigin, Wubalem Fekadu, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Carsten Flohr, Nataliya A. Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Mohamed M Gad, Gregory M Garcia, Augustine Mwangi Gatotoh, Reta Tsegaye Gayesa, Ketema Bizuwork Gebremedhin, Yilma Chisha Dea Geramo, Hailay Abrha Gesesew, Kebede Embaye Gezae, Ahmad Ghashghaee, Farzaneh Ghazi Sherbaf, Tiffany K Gill, Paramjit Singh Gill, Themba G Ginindza, Alem Girmay, Zemichael Gizaw, Amador Goodridge, Sameer Vali Gopalani, Bárbara Niegia Garcia Goulart, Alessandra C Goulart, Ayman Grada, Manfred S Green, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Rajeev Gupta, Rahul Gupta, Giang Hai Ha, Juanita A. Haagsma, Nima Hafezi-Nejad, Dessalegn H Haile, Michael Tamene Haile, Brian J. Hall, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Hamid Yimam Hassen, Desta Haftu Hayelom, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru, Thomas R Hird, Chi Linh Hoang, Gillian I Hollerich, Praveen Hoogar, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Mamusha Aman A Hussen, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Milena D. Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Rebecca Q Ivers, Chinwe Juliana Iwu, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Tanuj Kanchan, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A. Kayode, Mihiretu M Kebede, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Junaid Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Amir M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Sonali Kochhar, Tufa Kolola, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, Nuworza Kugbey, Pushpendra Kumar, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Hilton Lam, Faris Hasan Lami, Van Charles Lansingh, Savita Lasrado, Georgy Lebedev, Paul H Lee, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Aubrey J Levine, Sonia Lewycka, Shanshan Li, Shai Linn, Shiwei Liu, Jaifred Christian F Lopez, Platon D Lopukhov, Muhammed Magdy Abd El Razek, D.R. Mahadeshwara Prasad, Phetole Walter Mahasha, Narayan B. Mahotra, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Navid Manafi, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Gabriel Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Kala M Mehta, Teferi Mekonnen, Tefera Chane Mekonnen, Gebrekiros Gebremichael Meles, Hagazi Gebre Meles, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Tomislav Mestrovic, Workua Mekonnen Metekiya, Bartosz Miazgowski, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Yousef Mohammad, Dara K. Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Shafiu Mohammed, Jemal Abdu Mohammed, Hassen Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Paula Moraga, Linda Morales, Abbas Mosapour, Jonathan F. Mosser, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor, Sandra B Munro, Moses K. Muriithi, Christopher J L Murray, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Gurudatta Naik, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Duduzile Edith Ndwandwe, Ionut Negoi, Henok Biresaw Netsere, Josephine W. Ngunjiri, Cuong Tat Nguyen, Huong Lan Thi Nguyen, QuynhAnh P Nguyen, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Ole F Norheim, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Jacob Olusegun Olusanya, Bolajoko Olubukunola Olusanya, Obinna E Onwujekwe, Doris V. Ortega-Altamirano, Osayomwanbo Osarenotor, Frank B Osei, Mayowa O Owolabi, Mahesh P A, Jagadish Rao. Padubidri, Smita Pakhale, Adrian Pana, Eun-Kee Park, Sangram Kishor Patel, Ashish Pathak, Ajay Patle, Kebreab Paulos, Veincent Christian Filipino Pepito, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Konrad Pesudovs, Hai Quang Pham, David M Pigott, Thomas Pilgrim, Meghdad Pirsaheb, Mario Poljak, Ian Pollock, Maarten J Postma, Farshad Pourmalek, Akram Pourshams, Sergio I Prada, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Siavash Rahimi, Vafa Rahimi-Movaghar, Muhammad Aziz Rahman, Mohammad Hifz Ur Rahman, Fatemeh Rajati, Chhabi Lal Ranabhat, Puja C Rao, Davide Rasella, Goura Kishor Rath, Salman Rawaf, Lal Rawal, Wasiq Faraz Rawasia, Giuseppe Remuzzi, Vishnu Renjith, Andre M.N. Renzaho, Serge Resnikoff, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Siamak Sabour, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Yahya Safari, Rajesh Sagar, Mohammad Ali Sahraian, S. Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Ahsan Saleem, Hosni Salem, Marwa Rashad Salem, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Itamar S Santos, Milena M. Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Nizal Sarrafzadegan, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Maheswar Satpathy, Monika Sawhney, Mehdi Sayyah, Alyssa N Sbarra, Lauren E Schaeffer, David C Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Azadeh Shafieesabet, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Rajesh Sharma, Aziz Sheikh, B Suresh Kumar Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Si Si, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Virendra Singh, Narinder Pal Singh, Balbir Bagicha Singh Singh, Jasvinder A. Singh, Ambrish Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L Smith, Adauto Martins Soares Filho, Mohammad Reza Sobhiyeh, Anton Sokhan, Joan B Soriano, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Ingan Ukur Tarigan, Bineyam Taye, Yonatal Mesfin Tefera, Arash Tehrani-Banihashemi, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Akhil Soman ThekkePurakkal, Nihal Thomas, Robert L Thompson, Alan J Thomson, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Olalekan A Uthman, Benjamin S. Chudi Uzochukwu, Pascual R Valdez, Santosh Varughese, Yousef Veisani, Francesco S Violante, Sebastian Vollmer, Feleke Gebremeskel W/hawariat, Yasir Waheed, Mitchell Taylor Wallin, Yuan-Pang Wang, Yafeng Wang, Kinley Wangdi, Daniel J Weiss, Girmay Teklay Weldesamuel, Adhena Ayaliew Werkneh, Ronny Westerman, Taweewat Wiangkham, Kirsten E Wiens, Tissa Wijeratne, Charles Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Getasew Taddesse Worku, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Hiroshi Yatsuya, Alex Yeshaneh, Mekdes Tigistu Yilma, Paul Yip, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Telma Zahirian Moghadam, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Taddese Alemu Zerfu, Yunquan Zhang, Arash Ziapour, Sanjay Zodpey, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr

Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. Funding: Bill & Melinda Gates Foundation.

Published
2020
Full Text
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2. The global distribution of lymphatic filariasis, 2000–18: a geospatial analysis

Author

Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. Bennett, Habib Benzian, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Krittika Bhattacharyya, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Muhammad Shahdaat Bin Sayeed, Raaj Kishore Biswas, Somayeh Bohlouli, Soufiane Boufous, Oliver J Brady, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Alexandria Brown, Sharath Burugina Nagaraja, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Carlos A Castañeda-Orjuela, Franz Castro, Ester Cerin, Binaya Chalise, Vijay Kumar Chattu, Ken Lee Chin, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Elizabeth A Cromwell, Abel Fekadu Fekadu Dadi, Tukur Dahiru, Saad M A Dahlawi, Rakhi Dandona, Lalit Dandona, Anh Kim Dang, Farah Daoud, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Nicole Davis Weaver, Fernando Pio De la Hoz, Jan-Walter De Neve, Dereje Bayissa Demissie, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Hoa Thi Do, Christiane Dolecek, Kerrie E Doyle, Eleonora Dubljanin, Andre Rodrigues Duraes, Hisham Atan Edinur, Andem Effiong, Aziz Eftekhari, Nevine El Nahas, Maysaa El Sayed Zaki, Maha El Tantawi, Hala Rashad Elhabashy, Shaimaa I. El-Jaafary, Ziad El-Khatib, Hajer Elkout, Aisha Elsharkawy, Shymaa Enany, Daniel Adane Endalew, Babak Eshrati, Sharareh Eskandarieh, Arash Etemadi, Oluchi Ezekannagha, Emerito Jose A. Faraon, Mohammad Fareed, Andre Faro, Farshad Farzadfar, Alebachew Fasil Fasil, Mehdi Fazlzadeh, Valery L. Feigin, Wubalem Fekadu, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Carsten Flohr, Nataliya A. Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Mohamed M Gad, Gregory M Garcia, Augustine Mwangi Gatotoh, Reta Tsegaye Gayesa, Ketema Bizuwork Gebremedhin, Yilma Chisha Dea Geramo, Hailay Abrha Gesesew, Kebede Embaye Gezae, Ahmad Ghashghaee, Farzaneh Ghazi Sherbaf, Tiffany K Gill, Paramjit Singh Gill, Themba G Ginindza, Alem Girmay, Zemichael Gizaw, Amador Goodridge, Sameer Vali Gopalani, Bárbara Niegia Garcia Goulart, Alessandra C Goulart, Ayman Grada, Manfred S Green, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Rajeev Gupta, Rahul Gupta, Giang Hai Ha, Juanita A. Haagsma, Nima Hafezi-Nejad, Dessalegn H Haile, Michael Tamene Haile, Brian J. Hall, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Hamid Yimam Hassen, Desta Haftu Hayelom, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru, Thomas R Hird, Chi Linh Hoang, Gillian I Hollerich, Praveen Hoogar, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Mamusha Aman A Hussen, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Milena D. Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Rebecca Q Ivers, Chinwe Juliana Iwu, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Tanuj Kanchan, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A. Kayode, Mihiretu M Kebede, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Junaid Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Amir M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Sonali Kochhar, Tufa Kolola, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, Nuworza Kugbey, Pushpendra Kumar, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Hilton Lam, Faris Hasan Lami, Van Charles Lansingh, Savita Lasrado, Georgy Lebedev, Paul H Lee, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Aubrey J Levine, Sonia Lewycka, Shanshan Li, Shai Linn, Shiwei Liu, Jaifred Christian F Lopez, Platon D Lopukhov, Muhammed Magdy Abd El Razek, D.R. Mahadeshwara Prasad, Phetole Walter Mahasha, Narayan B. Mahotra, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Navid Manafi, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Gabriel Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Kala M Mehta, Teferi Mekonnen, Tefera Chane Mekonnen, Gebrekiros Gebremichael Meles, Hagazi Gebre Meles, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Tomislav Mestrovic, Workua Mekonnen Metekiya, Bartosz Miazgowski, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Yousef Mohammad, Dara K. Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Shafiu Mohammed, Jemal Abdu Mohammed, Hassen Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Paula Moraga, Linda Morales, Abbas Mosapour, Jonathan F. Mosser, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor, Sandra B Munro, Moses K. Muriithi, Christopher J L Murray, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Gurudatta Naik, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Duduzile Edith Ndwandwe, Ionut Negoi, Henok Biresaw Netsere, Josephine W. Ngunjiri, Cuong Tat Nguyen, Huong Lan Thi Nguyen, QuynhAnh P Nguyen, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Ole F Norheim, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Jacob Olusegun Olusanya, Bolajoko Olubukunola Olusanya, Obinna E Onwujekwe, Doris V. Ortega-Altamirano, Osayomwanbo Osarenotor, Frank B Osei, Mayowa O Owolabi, Mahesh P A, Jagadish Rao. Padubidri, Smita Pakhale, Adrian Pana, Eun-Kee Park, Sangram Kishor Patel, Ashish Pathak, Ajay Patle, Kebreab Paulos, Veincent Christian Filipino Pepito, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Konrad Pesudovs, Hai Quang Pham, David M Pigott, Thomas Pilgrim, Meghdad Pirsaheb, Mario Poljak, Ian Pollock, Maarten J Postma, Farshad Pourmalek, Akram Pourshams, Sergio I Prada, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Siavash Rahimi, Vafa Rahimi-Movaghar, Muhammad Aziz Rahman, Mohammad Hifz Ur Rahman, Fatemeh Rajati, Chhabi Lal Ranabhat, Puja C Rao, Davide Rasella, Goura Kishor Rath, Salman Rawaf, Lal Rawal, Wasiq Faraz Rawasia, Giuseppe Remuzzi, Vishnu Renjith, Andre M.N. Renzaho, Serge Resnikoff, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Siamak Sabour, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Yahya Safari, Rajesh Sagar, Mohammad Ali Sahraian, S. Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Ahsan Saleem, Hosni Salem, Marwa Rashad Salem, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Itamar S Santos, Milena M. Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Nizal Sarrafzadegan, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Maheswar Satpathy, Monika Sawhney, Mehdi Sayyah, Alyssa N Sbarra, Lauren E Schaeffer, David C Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Azadeh Shafieesabet, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Rajesh Sharma, Aziz Sheikh, B Suresh Kumar Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Si Si, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Virendra Singh, Narinder Pal Singh, Balbir Bagicha Singh Singh, Jasvinder A. Singh, Ambrish Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L Smith, Adauto Martins Soares Filho, Mohammad Reza Sobhiyeh, Anton Sokhan, Joan B Soriano, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Ingan Ukur Tarigan, Bineyam Taye, Yonatal Mesfin Tefera, Arash Tehrani-Banihashemi, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Akhil Soman ThekkePurakkal, Nihal Thomas, Robert L Thompson, Alan J Thomson, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Olalekan A Uthman, Benjamin S. Chudi Uzochukwu, Pascual R Valdez, Santosh Varughese, Yousef Veisani, Francesco S Violante, Sebastian Vollmer, Feleke Gebremeskel W/hawariat, Yasir Waheed, Mitchell Taylor Wallin, Yuan-Pang Wang, Yafeng Wang, Kinley Wangdi, Daniel J Weiss, Girmay Teklay Weldesamuel, Adhena Ayaliew Werkneh, Ronny Westerman, Taweewat Wiangkham, Kirsten E Wiens, Tissa Wijeratne, Charles Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Getasew Taddesse Worku, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Hiroshi Yatsuya, Alex Yeshaneh, Mekdes Tigistu Yilma, Paul Yip, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Telma Zahirian Moghadam, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Taddese Alemu Zerfu, Yunquan Zhang, Arash Ziapour, Sanjay Zodpey, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr

Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection. Methods: A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000–18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected. Findings: We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174–234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6–5·7 million) in the region of the Americas to 107 million (91–134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43–63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination. Interpretation: Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease. Funding: Bill & Melinda Gates Foundation.

Published
2020
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3. Corrigendum: Direct oral anticoagulants for the treatment of cerebral venous thrombosis – a protocol of an international phase IV study

Author

Anita van de Munckhof, Mayte Sánchez van Kammen, Katarzyna Krzywicka, Sanjith Aaron, Diana Aguiar de Sousa, Florina Antochi, Antonio Arauz, Miguel A. Barboza, Adriana B. Conforto, Francesco Dentali, Daniel Galdames Contreras, Xunming Ji, Katarina Jood, Mirjam R. Heldner, María Hernández-Pérez, Wayneho Kam, Timothy J. Kleinig, Espen S. Kristoffersen, Ronen R. Leker, Robin Lemmens, Sven Poli, Nilüfer Yeşilot, Mohammad Wasay, Teddy Y. Wu, Marcel Arnold, Lia Lucas-Neto, Saskia Middeldorp, Jukka Putaala, Turgut Tatlisumak, José M. Ferro, and Jonathan M. Coutinho

Subjects
cerebral venous thrombosis, anticoagulants, DOAC, vitamin K antagonist, treatment, Neurology. Diseases of the nervous system, RC346-429
Published
2024
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4. Comparison of Functional Outcome and Stroke Recurrence in Patients with Embolic Stroke of Undetermined Source (ESUS) vs. Cardioembolic Stroke Patients.

Author

Antonio Arauz, Eugenia Morelos, Jonathan Colín, Javier Roldán, and Miguel A Barboza

Subjects
Medicine, Science
Abstract

Embolic stroke of undetermined source (ESUS) recurrence and functional outcome from long-term follow-up is not well delineated. The purpose of this study is to compare these functional variables between ESUS vs. cardioembolic stroke (CS) patients.We analyzed data of consecutive ESUS and CS patients from our institutional database, from January 2003 until April 2015. The endpoints were stroke recurrence, mortality and poor clinical outcome (Modified Rankin Score 3-6), at discharge, 6 months and final follow-up. Adjusted multivariate Cox analysis and Kaplan-Meier curves were used to estimate the probability of recurrence and death.149 ESUS (median age 44 years) and 235 CS (median age 66 years) consecutive patients were included in the study. Median follow-up period for the entire sample was 19 months (interquartile range 6.0-45.0 months). Stroke recurrence was similar between ESUS and CS patients (5.4% vs. 9.8% respectively, p = 0.12). Death occurred in 30 CS cases (12.8%), with a cumulative probability of survival of 77%. Poor functional outcome was present in 58.3%, 54.0% and 54.9% at discharge, 6 months and final follow-up respectively in CS patients, significantly worst compared to ESUS cases (HR 3.1; CI 95% 1.96-4.68). Oral anticoagulation presents with a HR 8.01 for recurrence, and antiplatelet therapy had the highest risk for recurrence for both groups (HR 24.3).ESUS patients are substantially younger than CS patients but have a stroke recurrence rate similar to CS patients, with a lower mortality rate, and better functional outcome on long-term follow-up.

Published
2016
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5. Direct oral anticoagulants for the treatment of cerebral venous thrombosis – a protocol of an international phase IV study

Author

Anita van de Munckhof, Mayte Sánchez van Kammen, Katarzyna Krzywicka, Sanjith Aaron, Diana Aguiar de Sousa, Florina Antochi, Antonio Arauz, Miguel A. Barboza, Adriana B. Conforto, Francesco Dentali, Daniel Galdames Contreras, Xunming Ji, Katarina Jood, Mirjam R. Heldner, María Hernández-Pérez, Wayneho Kam, Timothy J. Kleinig, Espen S. Kristoffersen, Ronen R. Leker, Robin Lemmens, Sven Poli, Nilüfer Yeşilot, Mohammad Wasay, Teddy Y. Wu, Marcel Arnold, Lia Lucas-Neto, Saskia Middeldorp, Jukka Putaala, Turgut Tatlisumak, José M. Ferro, and Jonathan M. Coutinho

Subjects
cerebral venous thrombosis, anticoagulants, DOAC, vitamin K antagonist, treatment, Neurology. Diseases of the nervous system, RC346-429
Abstract

IntroductionCurrent guidelines recommend that patients with cerebral venous thrombosis (CVT) should be treated with vitamin K antagonists (VKAs) for 3–12 months. Direct oral anticoagulants (DOACs), however, are increasingly used in clinical practice. An exploratory randomized controlled trial including 120 patients with CVT suggested that the efficacy and safety profile of dabigatran (a DOAC) is similar to VKAs for the treatment of CVT, but large-scale prospective studies from a real-world setting are lacking.MethodsDOAC-CVT is an international, prospective, observational cohort study comparing DOACs to VKAs for the prevention of recurrent venous thrombotic events after acute CVT. Patients are eligible if they are 18 years or older, have a radiologically confirmed CVT, and have started oral anticoagulant treatment (DOAC or VKA) within 30 days of CVT diagnosis. Patients with an absolute contra-indication for DOACs, such as pregnancy or severe renal insufficiency, are excluded from the study. We aim to recruit at least 500 patients within a three-year recruitment period. The primary endpoint is a composite of recurrent venous thrombosis and major bleeding at 6 months of follow-up. We will calculate an adjusted odds ratio for the primary endpoint using propensity score inverse probability treatment weighting.DiscussionDOAC-CVT will provide real-world data on the comparative efficacy and safety of DOACs versus VKAs for the treatment of CVT.Clinical trial registrationClinicalTrials.gov, NCT04660747.

Published
2023
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6. Clinical markers of functional outcomes in cognition

Author

Miguel A. Barboza

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Detection of pre-clinical markers and predictors of cognitive behavior has become an area of research, mainly to establish those individuals with higher risk of cognitive decline.

Published
2023
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7. [Untitled]

Author

Fabiola Serrano, Miguel A. Barboza, Sebastian F. Ameriso, Virginia Pujol-Lereis, Alan Flores, Hernan Bayona, Huberth Fernández, Alejandro Castillo, Rosa Ecos, Jorge Vazquez, Pablo Amaya, Angélica Ruiz, Minerva López, Carlos Zapata, Luis Roa, Juan M. Marquez-Romero, Marco A. Ochoa, Eugenia Morelos, Carolina León, Felipe Romero, José L. Ruiz-Sandoval, Abraham Reyes, and Antonio Arauz

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Published
2023

8. Work performance questionnaire after returning to work in ischemic stroke survivors: the WPQ-INNN survey

Author

Miguel A. Barboza, Luis Becerra, Fabiola Serrano, Eduardo Soriano, Rodrigo Uribe, and Antonio Arauz

Subjects
Ischemic stroke. Employment. Disability. Work satisfaction. Quality of life., Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Objective: Quality of performance after stroke in working-active survivors has been poorly studied. The aim of this study is to analyze work performance after stroke not only by the probability of being active in daily job activities but also by the survivor’s ability to recover capability in different cognitive and motor areas. Material and methods: We developed a 15-item survey for stroke who had returned to their work activity. The survey evaluated 11 different domains (language, memory, attention, planning, calculating, writing, motor skills, gait, visual, mood, and self-perception). Internal consistency, test-retest reliability, item-scale correlation, and factor analysis were conducted. Results: A total of 100 ischemic stroke survivors were recruited (51 [51.0%] female patients, median age 42 years [interquartile range = 34.5-54.5 years]); median time to return to work was 4 months. Work performance after stroke was high in 16% of cases, good in 58% of cases, moderate in 24%, and low in 2%. Chronbach’s alpha coefficient was 0.75 for the scale. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.72 (p < 0.001). The test-retest reliability, as estimated by the intraclass correlation coefficients, was good. Memory, language, and attention explained 59.7% of the variance of the questionnaire in the extraction analysis. Conclusion: The WPQ-INNN is a reliable and valid tool for the assessment of performance quality in stroke survivors who returned to work.

Published
2023
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10. Fighting Against Stroke in Latin America: A Joint Effort of Medical Professional Societies and Governments

Author

Sheila Cristina Ouriques Martins, Pablo Lavados, Thaís Leite Secchi, Michael Brainin, Sebastian Ameriso, Fernando Gongora-Rivera, Claudio Sacks, Carlos Cantú-Brito, Tony Fabian Alvarez Guzman, Germán Enrique Pérez-Romero, Mario Muñoz Collazos, Miguel A. Barboza, Antonio Arauz, Carlos Abanto Argomedo, Nelson Novarro-Escudero, Hector Ignacio Amorin Costabile, Roberto Crosa, Claudia Camejo, Ricardo Mernes, Nelson Maldonado, Daissy Liliana Mora Cuervo, Octávio Marques Pontes Neto, Gisele Sampaio Silva, Leonardo Augusto Carbonera, Ana Claudia de Souza, Eduardo David Gomes de Sousa, Alan Flores, Donoban Melgarejo, Irving R. Santos Carquin, Arnold Hoppe, João José Freitas de Carvalho, Francisco Mont'Alverne, Pablo Amaya, Hernan Bayona, Victor Hugo Navia González, Juan Carlos Duran, Victor C. Urrutia, Denizar Vianna Araujo, Valery L. Feigin, and Raul G. Nogueira

Subjects
stroke, Latin America, stroke units, stroke centers, stroke system of care, Neurology. Diseases of the nervous system, RC346-429
Abstract

Introduction: Stroke is one of the leading causes of death in Latin America, a region with countless gaps to be addressed to decrease its burden. In 2018, at the first Latin American Stroke Ministerial Meeting, stroke physician and healthcare manager representatives from 13 countries signed the Declaration of Gramado with the priorities to improve the region, with the commitment to implement all evidence-based strategies for stroke care. The second meeting in March 2020 reviewed the achievements in 2 years and discussed new objectives. This paper will review the 2-year advances and future plans of the Latin American alliance for stroke.Method: In March 2020, a survey based on the Declaration of Gramado items was sent to the neurologists participants of the Stroke Ministerial Meetings. The results were confirmed with representatives of the Ministries of Health and leaders from the countries at the second Latin American Stroke Ministerial Meeting.Results: In 2 years, public stroke awareness initiatives increased from 25 to 75% of countries. All countries have started programs to encourage physical activity, and there has been an increase in the number of countries that implement, at least partially, strategies to identify and treat hypertension, diabetes, and lifestyle risk factors. Programs to identify and treat dyslipidemia and atrial fibrillation still remained poor. The number of stroke centers increased from 322 to 448, all of them providing intravenous thrombolysis, with an increase in countries with stroke units. All countries have mechanical thrombectomy, but mostly restricted to a few private hospitals. Pre-hospital organization remains limited. The utilization of telemedicine has increased but is restricted to a few hospitals and is not widely available throughout the country. Patients have late, if any, access to rehabilitation after hospital discharge.Conclusion: The initiative to collaborate, exchange experiences, and unite societies and governments to improve stroke care in Latin America has yielded good results. Important advances have been made in the region in terms of increasing the number of acute stroke care services, implementing reperfusion treatments and creating programs for the detection and treatment of risk factors. We hope that this approach can reduce inequalities in stroke care in Latin America and serves as a model for other under-resourced environments.

Published
2021
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11. Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

Author

Simachew Animen Bante, Carlo Eduardo Medina-Solís, Rodrigo Sarmiento-Suárez, Deniz Yuce, Ninuk Hariyani, Virginia Núñez-Samudio, Zhi-Jiang Zhang, Lucas Guimarães Abreu, Sindhura Lakshmi Koulmane Laxminarayana, Ejaz Ahmad Khan, Natalie Maria Cormier, Ghulam Mustafa, Arielle Wilder Eagan, Shirin Djalalinia, Jalal Arabloo, Bay Vo, Mukhammad David Naimzada, Farahnaz Joukar, Arvin Haj-Mirzaian, Julia Moreira Pescarini, Getinet Kassahun, Robert Ancuceanu, Mohammad Ali Mansournia, Amin Soheili, Félix Carvalho, Edgar Denova-Gutiérrez, Aubrey J. Cook, Jasvinder A. Singh, Maysaa El Sayed Zaki, Sergio I. Prada, Seyedeh Zahra Masoumi, Rajesh Sagar, Emmanuel Peprah, Fenta Hun Y. Beyene, Mikhail Sergeevich Zastrozhin, Dimas Ria Angga Pribadi, Yun Jin Kim, Maryam Adabi, Feleke Mekonnen Demeke, Valentin Yurievich Skryabin, Mathew M. Baumann, Bárbara Niegia Garcia de Goulart, Ali Kazemi Karyani, Nooshin Abbasi, Eyayou Girma Tadesse, Sanjay Basu, Hadi Hassankhani, Keyghobad Ghadiri, Keshab Deuba, Dilshad Manzar, Robert L. Thompson, Keivan Ahmadi, Rahmatollah Moradzadeh, Shaimaa I. El-Jaafary, Alessandra C. Goulart, Diana Fernanda Bejarano Ramirez, Samata Nepal, Marcos Roberto Tovani-Palone, Gebiyaw Wudie Tsegaye, Irina Filip, Ian D. Letourneau, Ramesh Holla, Neda Kianipour, Maha El Tantawi, Lucas Earl, Paul S. F. Yip, Miguel A Barboza, Rajan Nikbakhsh, Nauman Khalid, Kimberly B. Johnson, Iván Landires, Manasi Kumar, Babak Moazen, Rohol Lah Kalhor, Dinh-Toi Chu, Lauren E. Schaeffer, Nima Rezaei, Alexandre C. Pereira, Susan F. Rumisha, Mehdi Hosseinzadeh, Xuefeng Liu, Feng Sha, Mahaveer Golechha, Davood Anvari, Urvish K Patel, Bing-Fang Hwang, Samath D Dharmaratne, Muhammad Aqeel, Kebede Deribe, Nelsensius Klau Fauk, Lillian Mwanri, Nuruzzaman Khan, Yunquan Zhang, Paula Moraga, Ai Koyanagi, Abdallah M. Samy, Nithin Kumar, Rahul Gupta, Samad Azari, Soheil Hassanipour, Archith Boloor, Kiana Ramezanzadeh, Andrew J. Croneberger, Enrico Rubagotti, Jaykaran Charan, Khezar Hayat, Amir Masoud Rahmani, Kio Mars Sharafi, Ionut Negoi, Simon I. Hay, Deborah Carvalho Malta, Yasser Vasseghian, Yihienew M. Bezabih, Jean Jacques Noubiap, Nazir Fattahi, Adnan Kisa, Alok Atreya, Devasahayam J. Christopher, Ayenew Kassie Tesema, Nuwan Darshana Wickramasinghe, Jaffar Abbas, Daniel Diaz, Desta Debalkie Atnafu, Malke Asaad, Arief Hargono, Zahid A Butt, Dharmesh Kumar Lal, Pankaj Bhardwaj, Amir Radfar, Salman Rawaf, Vardhmaan Jain, Amir Almasi-Hashiani, Krittika Bhattacharyya, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Mohammad Rifat Haider, Emily Haeuser, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Jagadish Rao Padubidri, Carlos Alberto Marrugo Arnedo, Beatriz Paulina Ayala Quintanilla, Tomislav Mestrovic, Hawraz Ibrahim M. Amin, Bhaskaran Unnikrishnan, Seithikurippu R. Pandi-Perumal, Arash Ziapour, Samantha Perkins, Deepa Jahagirdar, Akshaya Srikanth Bhagavathula, Eduarda Fernandes, Nataliya Foigt, Audrey L. Serfes, Fissaha Tekulu Welay, Savita Lasrado, Saad M.A. Dahlawi, Segun Emmanuel Ibitoye, Hedayat Abbastabar, Om P Kurmi, Hung Chak Ho, Faheem Hyder Pottoo, Priya Rathi, Chukwuma David Umeokonkwo, Ali Bijani, Shanshan Li, Reza Rawassizadeh, Vishnu Renjith, Barthelemy Kuate Defo, Giang Thu Vu, Farah Daoud, Tudorel Andrei, Ricardo de Souza Kuchenbecker, Fakher Rahim, Adeyinka Emmanuel Adegbosin, Sezer Kisa, Rajesh Elayedath, Shafiu Mohammed, Vinod C. Nayak, Fisaha Haile Tesfay, Cuong Tat Nguyen, Masoud Foroutan, Mingyou Yang, Yousef Mohammad, Abdul-Aziz Seidu, Benjamin K. Mayala, Diego Augusto Santos Silva, Amin Mousavi Khaneghah, Nikha Bhardwaj, Masoud Moradi, Charles Ugochukwu Ibeneme, Olatunji O. Adetokunboh, Carlo La Vecchia, Tesfay B.B. Gebremariam, Ritesh G. Menezes, Olatunde Aremu, Bogdan Oancea, Mohiuddin Ahsanul Kabir Chowdhury, Stefanie Watson, Yousef Moradi, Souranshu Chatterjee, Ugo Gori, Isabela M. Benseñor, Khem Narayan Pokhrel, Hailay Abrha Gesesew, Paul Ward, Carlos A Castañeda-Orjuela, Usman Iqbal, Rekha Thapar, Naser Mohammad Gholi Mezerji, Yasir Waheed, Ziad A. Memish, Vijay Kumar Chattu, Daiane Borges Machado, Shrikant Pawar, Soosanna Kumary Chattu, Sanni Yaya, Ketema Bizuwork Gebremedhin, Naohiro Yonemoto, Ahmad Ghashghaee, Marcela Agudelo-Botero, Amber Sligar, Nicole Davis Weaver, Kenji Shibuya, Claudiu Herteliu, Andreea Mirica, André Karch, Asif Hanif, Atif Amin Baig, Salah Eddin Karimi, Gulfaraz Khan, David Laith Rawaf, Andrew T Olagunju, Chuanhua Yu, Darshan B B, Olayinka Stephen Ilesanmi, Takeshi Fukumoto, Neeraj Bedi, Claudio Alberto Dávila-Cervantes, Muktar Beshir Ahmed, Deepak Madi, Ione Jayce Ceola Schneider, Masood Ali Shaikh, Juwel Rana, Tanuj Kanchan, Mohamed M. Gad, Syed Amir Gilani, Victor Adekanmbi, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Tadele G. Adal, Mohammad Hifz Ur Rahman, Leila R Kalankesh, Gbenga A. Kayode, Bach Xuan Tran, Ana Isabel Ribeiro, Basavaprabhu Achappa, Andem Effiong, André Faro, Javad Nazari, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Vahid Alipour, Sowmya J. Rao, Rosario Cárdenas, Milena Ilic, Ravi Prakash Jha, Zebenay Workneh Bitew, Nelson Alvis-Guzman, Dian Kusuma, Yum Ing Guo, Mowafa Househ, Arya Haj-Mirzaian, Krista M. Steuben, Hadush Negash, Ahamarshan Jayaraman Nagarajan, Irena Ilic, Laura Dwyer-Lindgren, Godfrey Mutashambara Rwegerera, Florian Fischer, Gebreamlak Gebremedhn Gebremeskel, Kate E. LeGrand, Ravishankar Nagaraja, Reza Mohammadpourhodki, Mark Drew Crosland Guimarães, Kewal Krishan, Maryam Zamanian, Paul H. Lee, Emerito Jose A. Faraon, Rafael Alves Guimarães, Aziz Sheikh, Marwa Rashad Salem, Michael A. Cork, Francesco Saverio Violante, Bright Opoku Ahinkorah, Liliana Preotescu, Somayeh Bohlouli, Aziz Rezapour, Ana Melisa Pardo-Montaño, Huong Lan Thi Nguyen, Khaled Khatab, Teklehaimanot Gereziher Haile, Mohammad Ali Moni, Govinda Prasad Dhungana, Leonardo Roever, Carlos Magis-Rodriguez, Andre R. Brunoni, Nathaniel J. Henry, Brijesh Sathian, Bingyu Li, Maciej Banach, Hasan Yusefzadeh, Nikita Otstavnov, Bruno Ramos Nascimento, Fernando de la Hoz, Georges Nguefack-Tsague, Zulfiqar A Bhutta, Robert Kaba Alhassan, Jae Il Shin, Andre Rodrigues Duraes, Yuan-Pang Wang, Felix Akpojene Ogbo, Mihajlo Jakovljevic, Eman Abu-Gharbieh, Vaman Kulkarni, Anna Aleksandrovna Skryabina, Sait Mentes Birlik, Maarten J. Postma, Chhabi Lal Ranabhat, Walter Mendoza, Yanzhong Wang, Maryam Keramati, Mahesh P A, Ali H. Mokdad, Muhammad Naveed, Nitin Joseph, Ronny Westerman, Bill & Melinda Gates Foundation, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Cork M.A., Henry N.J., Watson S., Croneberger A.J., Baumann M., Letourneau I.D., Yang M., Serfes A.L., Abbas J., Abbasi N., Abbastabar H., Abreu L.G., Abu-Gharbieh E., Achappa B., Adabi M., Adal T.G., Adegbosin A.E., Adekanmbi V., Adetokunboh O.O., Agudelo-Botero M., Ahinkorah B.O., Ahmadi K., Ahmed M.B., Alhassan R.K., Alipour V., Almasi-Hashiani A., Alvis-Guzman N., Ancuceanu R., Andrei T., Anvari D., Aqeel M., Arabloo J., Aremu O., Asaad M., Atnafu D.D., Atreya A., Quintanilla B.P.A., Azari S., B D.B., Baig A.A., Banach M., Bante S.A., Barboza M.A., Basu S., Bedi N., Ramirez D.F.B., Bensenor I.M., Beyene F.-H.Y., Bezabih Y.M., Bhagavathula A.S., Bhardwaj N., Bhardwaj P., Bhattacharyya K., Bhutta Z.A., Bijani A., Birlik S.M., Bitew Z.W., Bohlouli S., Boloor A., Brunoni A.R., Butt Z.A., Cardenas R., Carvalho F., Castaldelli-Maia J.M., Casta-neda-orjuela C.A., Charan J., Chatterjee S., Chattu V.K., Chattu S.K., Chowdhury M.A.K., Christopher D.J., Chu D.-T., Cook A.J., Cormier N.M., Dahlawi S.M.A., Daoud F., Davila-Cervantes C.A., Weaver N.D., De la Hoz F.P., Demeke F.M., Denova-Gutierrez E., Deribe K., Deuba K., Dharmaratne S.D., Dhungana G.P., Diaz D., Djalalinia S., Duraes A.R., Eagan A.W., Earl L., Effiong A., Zaki M.E.S., Tantawi M.E., Elayedath R., El-Jaafary S.I., Faraon E.J.A., Faro A., Fattahi N., Fauk N.K., Fernandes E., Filip I., Fischer F., Foigt N.A., Foroutan M., Fukumoto T., Gad M.M., Gebremariam T.B.B., Gebremed-Hin K.B., Gebremeskel G.G., Gesesew H.A., Ghadiri K., Ghashghaee A., Gilani S.A., Golechha M., Gori U., Goulart A.C., Goulart B.N.G., Gugnani H.C., Guimaraes M.D.C., Guimaraes R.A., Guo Y.-I., Gupta R., Haeuser E., Haider M.R., Haile T.G., Haj-Mirzaian A., Hanif A., Hargono A., Hariyani N., Hassanipour S., Hassankhani H., Hayat K., Herteliu C., Ho H.C., Holla R., Hosseinzadeh M., Househ M., Hwang B.-F., Ibeneme C.U., Ibitoye S.E., Ile-Sanmi O.S., Ilic M.D., Ilic I.M., Iqbal U., Jahagir-Dar D., Jain V., Jakovljevic M., Jha R.P., Johnson K.B., Joseph N., Joukar F., Kalankesh L.R., Kalhor R.-L., Kanchan T., Matin B.K., Karch A., Karimi S.E., Kassahun G., Kayode G.A., Karyani A.K., Keramati M., Khalid N., Khan E.A., Khan G., Khan M.N.N., Khatab K., Kianipour N., Kim Y.J., Kisa S., Kisa A., Kosen S., Laxminarayana S.L.K., Koyanagi A., Krishan K., Defo B.K., Kuchenbecker R.S., Kulkarni V., Kumar N., Kumar M., Kurmi O.P., Kusuma D., Vecchia C.L., Lal D.K., Landires I., Lasrado S., Lee P.H., Legrand K.E., Li B., Li S., Liu X., Amin H.I.M., Machado D.B., Madi D., Magis-Rodriguez C., Malta D.C., Mansournia M.A., Manzar M.D., Arnedo C.A.M., Martins-Melo F.R., Masoumi S.Z., Mayala B.K., Medina-Solis C.E., Memish Z.A., Mendoza W., Menezes R.G., Mestrovic T., Mirica A., Moazen B., Mohammad Y., Mezerji N.M.G., Mohammadian-Hafshejani A., Mohammadpourhodki R., Mohammed S., Mokdad A.H., Moni M.A., Moradi M., Moradi Y., Moradzadeh R., Moraga P., Khaneghah A.M.-S., Mustafa G., Mwanri L., Nagaraja R., Nagarajan A.J., Naim-Zada M.D., Nascimento B.R., Naveed D.M., Nayak V.C., Nazari J., Negash H., Negoi I., Nepal S., Nguefack-Tsague G., Nguyen C.T., Nguyen H.L.T., Nikbakhsh R., Noubiap J.J., Nunez-Samudio V., Oancea B., Ogbo F.A., Olagunju A.T., Otstav-Nov N., A M.P., Padubidri J.R., Pandi-Perumal S.R., Pardo-Montano A.M., Patel U.K., Pawar S., Peprah E.K., Pereira A., Perkins S., Pescarini J.M., Pokhrel K.N., Postma M.J., Pot-Too F.H., Prada S.I., Preotescu L., Pribadi D.R.A., Radfar A., Rahim F., Rahman M.H.U., Rahmani A.M., Ramezanzadeh K., Rana J., Ranabhat C.L., Rao S.J., Rathi P., Rawaf S., Rawaf D.L., Rawassizadeh R., Renjith V., Rezaei N., Rezapour A., Ribeiro A.I., Roever L., Rubagotti E., Rumisha S.F., Rwegerera G.M., Sagar R., Sajadi S.M., Salem M.R., Samy A.M., Sarmiento-Suarez R., Sathian B., Schaeffer L.E., Schneider I.J.C., Seidu A.-A., Sha F., Shaikh M.A., Sharafi K.-M., Sheikh A., Shibuya K., Shin J.I., Silva D.A.S., Singh J.A., Skryabin V.Y., Skryabina A.A., Sligar A., Soheili A., Steuben K.M., Sufiyan M.B., Tadesse E.G., Tesema A.K.T., Tesfay F.H., Thapar R., Thompson R.L., Tovani-Palone M.R., Tran B.X., Tsegaye G.W., Umeokonkwo C.D., Unnikrish-Nan B., Vasseghian Y., Violante F.S., Vo B., Vu G.T., Waheed Y., Wang Y.-P., Wang Y., Ward P., Welay F.T., Westerman R., Wickramasinghe N.D., Yaya S., Yip P., Yonemoto N., Yu C., Yuce D., Yusefzadeh H., Zamanian M., Zastroz-Hin M.S., Zhang Z.-J., Zhang Y., Ziapour A., Hay S.I., Dwyer-Lindgren L., Local Burden of Disease HIV Collaborators, Clinicum, HUS Comprehensive Cancer Center, Cork, Michael A, Henry, Nathaniel J, Watson, Stefanie, Croneberger, Andrew J, Ahmed, Muktar B, Dwyer-Lindgren, Laura, Instituto de Saúde Pública da Universidade do Porto, and Collaborators, Local Burden of Disease HIV

Subjects
Male, Latin Americans, lcsh:Medicine, LOW-INCOME, HIV Infections, HIV mortality, HIV/AIDS, Latin America, Mapping, Small area estimation, Spatial statistics, Vital registration, Vital registrations, 0302 clinical medicine, ANTIRETROVIRAL THERAPY, Medicine, 030212 general & internal medicine, Registries, 11 Medical and Health Sciences, media_common, Mortality rate, 1. No poverty, DEATH, Regression analysis, General Medicine, Middle Aged, BRAZIL, Local Burden of Disease HIV Collaborators, 3. Good health, AIDS, SEX, A990 Medicine and Dentistry not elsewhere classified, Female, HEALTH, 0305 other medical science, Life Sciences & Biomedicine, Research Article, Adult, medicine.medical_specialty, Inequality, Adolescent, media_common.quotation_subject, TUBERCULOSIS, Small area estimations, 03 medical and health sciences, Medicine, General & Internal, Sex Factors, Acquired immunodeficiency syndrome (AIDS), HIV mortalities, General & Internal Medicine, Humans, Aged, Science & Technology, 030505 public health, business.industry, Public health, lcsh:R, Ecological study, HIV, Bayes Theorem, GLOBAL BURDEN, medicine.disease, TRENDS, Vital Statistics, Spatial statistic, 3121 General medicine, internal medicine and other clinical medicine, Human medicine, business, Demography
Abstract

Background Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. Methods We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. Results All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Conclusions Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.

Published
2021

13. Sex Differences Among Participants in the Latin American Stroke Registry

Author

Antonio Arauz, Fabiola Serrano, Sebastián F. Ameriso, Virginia Pujol‐Lereis, Alan Flores, Hernán Bayona, Huberth Fernández, Alejandro Castillo, Rosa Ecos, Jorge Vazquez, Pablo Amaya, Angélica Ruíz, Minerva López, Carlos Zapata, Luis Roa, Juan Manuel Marquez‐Romero, Eugenia Morelos, Marco A. Ochoa, Carolina Leon, Felipe Romero, José Luis Ruíz‐Sandoval, Abraham Reyes, and Miguel A. Barboza

Subjects
Latin America, sex, stroke outcome, stroke registry, vascular risk factors, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Reports on sex differences in stroke outcome and risk factors are scarce in Latin America. Our objective was to analyze clinical and prognostic differences according to sex among participants in the LASE (Latin American Stroke Registry). Methods and Results Nineteen centers across Central and South America compiled data on demographics, vascular risk factors, clinical stroke description, ancillary tests, and functional outcomes at short‐term follow‐up of patients included from January 2012 to January 2017. For the present study, all these variables were analyzed according to sex at hospital discharge. We included 4788 patients with a median in‐hospital stay of 8 days (interquartile range, 5–8); 2677 were male (median age, 66 years) and 2111 female (median age, 60 years). Ischemic stroke occurred in 4293: 3686 as cerebral infarction (77%) and 607 as transient ischemic attack cases (12.7%); 495 patients (10.3%) corresponded to intracerebral hemorrhage. Poor functional outcome (modified Rankin scale, 3–6) was present in 1662 (34.7%) patients and 38.2% of women (P

Published
2020
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14. Expression of Olig2, Nestin, NogoA and AQP4 have no impact on overall survival in IDH-wildtype glioblastoma.

Author

Felix Behling, Alonso Barrantes-Freer, Carl Ludwig Behnes, Florian Stockhammer, Veit Rohde, Antonia Adel-Horowski, Odir Antonio Rodríguez-Villagra, Miguel Angel Barboza, Wolfgang Brück, Ulrich Lehmann, Christine Stadelmann, and Christian Hartmann

Subjects
Medicine, Science
Abstract

Despite many years of research efforts and clinical trials the prognosis of patients diagnosed with glioblastoma remains very poor. The oligodendrocyte transcription factor 2 (Olig2) was identified as a marker for glioma stem cells, which are believed to be responsible for glioma recurrence and therapy resistance. In this retrospective analysis we assessed the prognostic value of oligodendroglial and glioma stem cell markers in 113 IDH-wildtype glioblastomas. Immunohistochemical staining for Olig2, NogoA, AQP4 and Nestin was performed in combination with sequencing of IDH1 and IDH2 as well as promotor methylation analysis of the MGMT gene. Even though differences in overall survival according to Olig2 expression were observed, univariate and multivariate survival analysis did not reveal a firm significant prognostic impact of Olig2, NogoA, AQP4 or Nestin expression. Additionally, no differences in the expression of these markers depending on clinical status, age or gender were found. The established independent prognostic factors age = 70 and methylated MGMT gene promoter were significant in the multivariate analysis. In conclusion expression of oligodendroglial and glioma stem cell markers do not have an independent prognostic effect in IDH-wildtype glioblastoma.

Published
2020
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15. Factors related to time of stroke onset versus time of hospital arrival: A SITS registry-based study in an Egyptian stroke center

Author

Hossam M. Shokri, Nevine M. El Nahas, Hany M. Aref, Noha L. Dawood, Eman M. Abushady, Eman H. Abd Eldayem, Shady S. Georgy, Amr S. Zaki, Rady Y. Bedros, Mona M. Wahid El Din, Tamer M. Roushdy, and Miguel A. Barboza

Subjects
Medicine, Science
Abstract

Background High-quality data on time of stroke onset and time of hospital arrival is required for proper evaluation of points of delay that might hinder access to medical care after the onset of stroke symptoms. Purpose Based on (SITS Dataset) in Egyptian stroke patients, we aimed to explore factors related to time of onset versus time of hospital arrival for acute ischemic stroke (AIS). Material and methods We included 1,450 AIS patients from two stroke centers of Ain Shams University, Cairo, Egypt. We divided the day to four quarters and evaluated relationship between different factors and time of stroke onset and time of hospital arrival. The factors included: age, sex, duration from stroke onset to hospital arrival, type of management, type of stroke (TOAST classification), National Institute of Health Stroke Scale (NIHSS) on admission and favorable outcome modified Rankin Scale (mRS ≤2). Results Pre-hospital: highest stroke incidence was in the first and fourth quarters. There was no significant difference in the mean age, sex, type of stroke in relation to time of onset. NIHSS was significantly less in onset in third quarter of the day. Percentage of patients who received thrombolytic therapy was higher with onset in the first 2 quarters of the day (p =

Published
2020

16. A Practical Score for Prediction of Outcome After Cerebral Venous Thrombosis

Author

Miguel A. Barboza, Erwin Chiquete, Antonio Arauz, Marlon Merlos-Benitez, Alejandro Quiroz-Compeán, Fernando Barinagarrementería, and Carlos Cantú-Brito

Subjects
cerebral venous thrombosis, mortality, scale, stroke, outcome, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background: Most patients with cerebral venous thrombosis (CVT) have independent survival in the short term. However, identification of high-risk individuals with an unfavorable outcome is a challenging task. We aimed to develop a CVT grading scale (CVT-GS) to aid in the short-term clinical decision-making.Methods: We included 467 consecutive patients with CVT who were hospitalized from 1981 to 2015 in two third-level referral hospitals. Factors associated with 30-day mortality were selected with bivariate analyses to integrate a Cox proportional-hazards model to determine components of the final scoring. After the scale was configured, the prognostic performance was tested for prediction of short-term death or moderately impaired to death [modified Rankin scale (mRS) > 2]. CVT-GS was categorized as mild, moderate or severe for the prediction of 30-day fatality rate and a probability of mRS > 2.Results: The 30-day case fatality rate was 9.0%. The CVT-GS (0–13 points; more points predicting poorer outcomes) was composed of parenchymal lesion size > 6 cm (3 points), bilateral Babinski signs (3 points), male sex (2 points), parenchymal hemorrhage (2 points), and level of consciousness (coma: 3 points, stupor: 2, somnolence: 1, and alert: 0). CVT was categorized as mild (0–2 points, 0.4% fatality rate), moderate (3–7 points, 9.9% fatality rate), or severe (8–13 points, 61.4% fatality rate). The CVT-GS had an accuracy of 91.6% for the prediction of 30-day mortality and 85.3% for mRS > 2.Conclusions: CVT-GS is a practical clinical tool for prediction of outcome after CVT. This score may aid in clinical decision-making and could serve to stratify patients enrolled in clinical trials.

Published
2018
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17. Mexican-National Institute of Neurology and Neurosurgery-Stroke Registry: Results of a 25-Year Hospital-Based Study

Author

Antonio Arauz, Juan Manuel Marquez-Romero, Miguel A. Barboza, Fabiola Serrano, Carol Artigas, Luis Manuel Murillo-Bonilla, Carlos Cantú-Brito, José Luis Ruiz-Sandoval, and Fernando Barinagarrementeria

Subjects
stroke classification, vascular risk factors, stroke outcome, stroke registry, Mexico, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background and purposeStroke has been scarcely studied in Latin America (LA). The Mexican Institute of Neurology Stroke Registry was established in 1990 as a prospective computer-based database to register data obtained from patients admitted with stroke. Using this data, we attempted to define the profile of risk factors and outcomes.MethodsThe demographic data, stroke description, ancillary tests, vascular risk factors, and modified Rankin scale (mRs) were registered. Ischemic stroke subtyping was based on the Trial of Org 10,172 of the Acute Stroke Treatment classification. We followed-up patients using multiple overlapping methods. Primary outcomes included mRs, recurrence, and death at 30 days and at the end of follow-up.ResultsWe included 4,481 patients with a median follow-up of 27 months, (17,281 person-years follow-up). The mean age was 52.8 ± 18 years. There were 2,229 males (50%) included in the study. CI was present in 64.9%, intracerebral hemorrhage (ICH) in 25.6%, and cerebral venous thrombosis (CVT) in 6.3%. Hypertension was the major risk factor (46.5%). The most common cause of CI was atherosclerosis (27%). ICH was mainly hypertensive (58%), and 60% of CVT were puerperal. Overall, the mortality rate was 24.5%. The recurrence rate was 16.9%. Poor outcome (mRs ≥ 3) was found in 56.2% of patients. The best outcomes were observed in CVT patients (74.5% mRs ≤ 2), whereas 72.1% ICH patients had mRs ≥3.ConclusionThis is one of the largest hospital-based registries in LA and shows significant differences with other previously published registries, including a younger age, relatively less hypertension, and larger proportion of CVT. Poor functional outcome was common. This study adds to the understanding of geographic differences in stroke characteristics and outcomes.

Published
2018
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