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1. Injury-related gaining momentum as external causes of deaths in Ethiopian health and demographic surveillance sites: evidence from verbal autopsy study

Author: Kassahun Alemu Gelaye, Fasil Tessema, Befikadu Tariku, Semaw Ferede Abera, Alemseged Aregay Gebru, Nega Assefa, Desalew Zelalem, Melkamu Dedefo, Mekdes Kondal, Mesfin Kote, Mitike Molla Sisay, Wubegzier Mekonnen, Mamo Wubshet Terefe, Gashaw Andargie Biks, Firehywot Eshetu, Mulumebet Abera, Yoseph Fekadu, Gessessew Bugssa Hailu, Etsehiwot Tilahun, and Yihunie Lakew
Subjects: Accidents, assault, drowning, external causes, mortality, suicide, transport, verbal autopsy, Ethiopia, Public aspects of medicine, RA1-1270
Abstract: Background: In Ethiopia, though all kinds of mortality due to external causes are an important component of overall mortality often not counted or documented on an individual basis. Objective: The aim of this study was to describe the patterns of mortality from external causes using verbal autopsy (VA) method at the Ethiopian HDSS Network sites. Methods: All deaths at Ethiopian HDSS sites were routinely registered and followed up with VA interviews. The VA forms comprised deaths up to 28 days, between four weeks and 14 years and 15 years and above. The cause of a death was ascertained based on an interview with next of families or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history and circumstances preceding death after 45 days mourning period. Two physician assigned probable causes of death as underlying, immediate and contributing factors independently using information in VA forms based on the WHO ICD-10 and VA code system. Disagreed cases sent to third physician for independent review and diagnosis. The final cause of death considered when two of the three physicians assigned underlying cause of death; otherwise, labeled as undetermined. Results: In the period from 2009 to 2013, a total of 9719 deaths were registered. Of the total deaths, 623 (6.4%) were from external causes. Of these, accidental drowning and submersion, 136 (21.8%), accidental fall, 113 (18.1%) and transport-related accidents, 112 (18.0%) were the topmost three leading external causes of deaths. About 436 (70.0%) of deaths were from the age group above 15 years old. Drowning and submersion and transport-related accidents were high in age group between 5 and 14 years old. Conclusion: In this study, external causes of death are significant public health problems and require attention as one of prior health agenda.
Published: 2018
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2. Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author: Mohsen Naghavi, Maarten J. Postma, Mahesh P A, Milena Santric-Milicevic, Barbora de Courten, Parvaiz A Koul, Elias Merdassa Roro, Marek Majdan, Ali H. Mokdad, Mihaela Hostiuc, Félix Carvalho, Rufus A. Adedoyin, Miriam Levi, Ejaz Ahmad Khan, Rakhi Dandona, Mohamad-Hani Temsah, Catalina Liliana Andrei, Benn Sartorius, Gebre Teklemariam Demoz, Derrick A Bennett, Ahmad Daryani, Paulo A. Lotufo, Fereshteh Ansari, Elissa M. Abrams, Luke D. Knibbs, Seyyed Meysam Mousavi, Azeem Majeed, Tomislav Mestrovic, Rajeev Gupta, Irina Filip, Leonardo Roever, G.K. Mini, Lorainne Tudor Car, Ghulam Mustafa, Josip Car, Lalit Dandona, Masoud Moradi, Molly R Nixon, Mohammad Zamani, Babak Moazen, Devasahayam J. Christopher, Chi Linh Hoang, Aaron J Cohen, Hossein Poustchi, Luca Ronfani, Sheikh Mohammed Shariful Islam, Nefsu Awoke, Miguel Tortajada-Girbés, Khalid A Altirkawi, Justin R. Ortiz, Adane Teshome Kefale, Shailesh Advani, Alireza Rafiei, Kristina E. Rudd, Tim Driscoll, Yousef Khader, Heather J. Zar, Josep M. Antó, Milena Ilic, Fakher Rahim, Jost B. Jonas, Trang Huyen Nguyen, Yonatal Mesfin Tefera, Simon I. Hay, Aloke Gopal Ghoshal, Adnan Kisa, Ranjani Somayaji, Gholamreza Roshandel, Smita Pakhale, Francesco Saverio Violante, Monika Sawhney, Eyal Oren, Ali Bijani, Gebrekiros Gebremichael Meles, Hajer Elkout, Shanshan Li, Michael Soljak, Masoud Foroutan, Narayan Bahadur Mahotra, Mina Anjomshoa, Jasvinder A. Singh, Mika Shigematsu, Abdel Douiri, Naohiro Yonemoto, Amir Kasaeian, Lorenzo Monasta, Hagazi Gebre Meles, Rupak Desai, Hai Quang Pham, Feleke Mekonnen Demeke, Marissa B Reitsma, Samath D Dharmaratne, Amr Jamal, Miguel Ángel García-Gordillo, Seyed Sina Naghibi Irvani, Michael K. Hole, Aman Yesuf Endries, Vinay Gupta, Mehdi Naderi, Tham Thi Le, Houman Goudarzi, Hamid Yimam Hassen, Siamak Sabour, Theo Vos, Anurag Agrawal, Ireneous N. Soyiri, Kathleen S Sachiko Berfield, Charles D.A. Wolfe, Jobert Richie Nansseu, Robert C. Reiner, Carlo La Vecchia, Michael Brauer, Jagdish Khubchandani, Alaa Badawi, Sezer Kisa, Basema Saddik, Amir Hasanzadeh, H. Dean Hosgood, Berhe Etsay Tesfay, Ibtihal Fadhil, Ketema Bizuwork Gebremedhin, Ai Koyanagi, Maheswar Satpathy, James Leigh, Si Si, Gregory R. Wagner, Eduarda Fernandes, Huong Lan Thi Nguyen, Isabela M. Benseñor, Tommi Vasankari, Gebreamlak Gebremedhn Gebremeskel, Andrew T Olagunju, Moslem Soofi, Jalal Arabloo, Muhammad Aziz Rahman, Mowafa Househ, Amir Radfar, Gebremicheal Gebreslassie Kasahun, Tara Ballav Adhikari, Songhomitra Panda-Jonas, Gessessew Bugssa Hailu, Komal Saleem, Bach Xuan Tran, Lal B. Rawal, Jee-Young Jasmine Choi, Hadi Pourjafar, Robert S. Bernstein, Ghobad Moradi, Farnam Mohebi, Mariam Molokhia, Kamarul Imran Musa, Elham Ahmadian, Pascual R. Valdez, Irfan Ullah, Ritesh G. Menezes, Dawit Zewdu Wondafrash, Olayinka Stephen Ilesanmi, Masood Ali Shaikh, Richard F. Gillum, Aziz Sheikh, Eun-Kee Park, Virendra Singh, Aziz Eftekhari, Yogesh Sabde, Florian Fischer, Krittika Bhattacharyya, Syed Mohamed Aljunid, Alemayehu Toma, Ruxandra Irina Negoi, Kebede Embaye Gezae, Abadi Kahsu Gebre, Abdullah Al Mamun, Junaid Khan, Yuming Guo, Parkes J Kendrick, Reza Malekzadeh, Bruno Piassi Sao Jose, Mohammad Hifz Ur Rahman, Lidia Morawska, Soraya Siabani, Tinuke O Olagunju, Zahid A Butt, Ronny Westerman, Eyasu Ejeta Duken, Khanh Bao Tran, Yousef Veisani, Getachew Mullu Kassa, Erkin M. Mirrakhimov, Miloje Savic, Anh Kim Dang, Vinay Nangia, Job F M van Boven, Adam Belay Wondmieneh, Alan D. Lopez, G Anil Kumar, Navid Manafi, Andre Pascal Kengne, Joan B. Soriano, Luis Camera, Seok Jun Yoon, Paramjit Gill, Yun Jin Kim, Seyyede Masoume Athari, Gurudatta Naik, Sadaf G. Sepanlou, Sanjeev Nair, Jarnail Singh Thakur, André Faro, Javad Nazari, Gene Bukhman, Nelson Alvis-Guzman, Mayowa O. Owolabi, Lorenzo G. Mantovani, Nobuyuki Horita, Zubair Kabir, Felix Akpojene Ogbo, Birhanu Geta Meharie, Daniel Diaz, Adrian Pana, Salman Rawaf, Mihajlo Jakovljevic, Ted R. Miller, Savita Lasrado, Joseph Adel Mattar Banoub, Fares Alahdab, Jan-Walter De Neve, Carlos A Castañeda-Orjuela, Saeed Safari, Farzad Manafi, Marco Vacante, Katherine R. Paulson, Hamidreza Komaki, Reza Shirkoohi, Young Eun Kim, Duduzile Ndwandwe, Nahla Anber, Ravi Prakash Jha, Farshad Farzadfar, Abdallah M. Samy, Richard Ofori-Asenso, Shafiu Mohammed, Paolo Lauriola, Fabiana Madotto, Yunquan Zhang, Qing Lan, David Laith Rawaf, Zoubida Zaidi, Karzan Abdulmuhsin Mohammad, Juan Jesus Carrero, Morteza Abdullatif Khafaie, Seyyed Shamsadin Athari, Cuong Tat Nguyen, UAM. Departamento de Medicina, Instituto de Investigación Sanitaria Hospital Universitario de La Princesa (IIS-IP), Soriano, J, Kendrick, P, Paulson, K, Gupta, V, Abrams, E, Adedoyin, R, Adhikari, T, Advani, S, Agrawal, A, Ahmadian, E, Alahdab, F, Aljunid, S, Altirkawi, K, Alvis-Guzman, N, Anber, N, Andrei, C, Anjomshoa, M, Ansari, F, Anto, J, Arabloo, J, Athari, S, Awoke, N, Badawi, A, Banoub, J, Bennett, D, Bensenor, I, Berfield, K, Bernstein, R, Bhattacharyya, K, Bijani, A, Brauer, M, Bukhman, G, Butt, Z, Camera, L, Car, J, Carrero, J, Carvalho, F, Castaneda-Orjuela, C, Choi, J, Christopher, D, Cohen, A, Dandona, L, Dandona, R, Dang, A, Daryani, A, de Courten, B, Demeke, F, Demoz, G, De Neve, J, Desai, R, Dharmaratne, S, Diaz, D, Douiri, A, Driscoll, T, Duken, E, Eftekhari, A, Elkout, H, Endries, A, Fadhil, I, Faro, A, Farzadfar, F, Fernandes, E, Filip, I, Fischer, F, Foroutan, M, Garcia-Gordillo, M, Gebre, A, Gebremedhin, K, Gebremeskel, G, Gezae, K, Ghoshal, A, Gill, P, Gillum, R, Goudarzi, H, Guo, Y, Gupta, R, Hailu, G, Hasanzadeh, A, Hassen, H, Hay, S, Hoang, C, Hole, M, Horita, N, Hosgood, H, Hostiuc, M, Househ, M, Ilesanmi, O, Ilic, M, Irvani, S, Islam, S, Jakovljevic, M, Jamal, A, Jha, R, Jonas, J, Kabir, Z, Kasaeian, A, Kasahun, G, Kassa, G, Kefale, A, Kengne, A, Khader, Y, Khafaie, M, Khan, E, Khan, J, Khubchandani, J, Kim, Y, Kisa, S, Kisa, A, Knibbs, L, Komaki, H, Koul, P, Koyanagi, A, Kumar, G, Lan, Q, Lasrado, S, Lauriola, P, La Vecchia, C, Le, T, Leigh, J, Levi, M, Li, S, Lopez, A, Lotufo, P, Madotto, F, Mahotra, N, Majdan, M, Majeed, A, Malekzadeh, R, Mamun, A, Manafi, N, Manafi, F, Mantovani, L, Meharie, B, Meles, H, Meles, G, Menezes, R, Mestrovic, T, Miller, T, Mini, G, Mirrakhimov, E, Moazen, B, Mohammad, K, Mohammed, S, Mohebi, F, Mokdad, A, Molokhia, M, Monasta, L, Moradi, M, Moradi, G, Morawska, L, Mousavi, S, Musa, K, Mustafa, G, Naderi, M, Naghavi, M, Naik, G, Nair, S, Nangia, V, Nansseu, J, Nazari, J, Ndwandwe, D, Negoi, R, Nguyen, T, Nguyen, C, Nguyen, H, Nixon, M, Ofori-Asenso, R, Ogbo, F, Olagunju, A, Olagunju, T, Oren, E, Ortiz, J, Owolabi, M, P A, M, Pakhale, S, Pana, A, Panda-Jonas, S, Park, E, Pham, H, Postma, M, Pourjafar, H, Poustchi, H, Radfar, A, Rafiei, A, Rahim, F, Rahman, M, Rawaf, S, Rawaf, D, Rawal, L, Reiner, R, Reitsma, M, Roever, L, Ronfani, L, Roro, E, Roshandel, G, Rudd, K, Sabde, Y, Sabour, S, Saddik, B, Safari, S, Saleem, K, Samy, A, Santric-Milicevic, M, Sao Jose, B, Sartorius, B, Satpathy, M, Savic, M, Sawhney, M, Sepanlou, S, Shaikh, M, Sheikh, A, Shigematsu, M, Shirkoohi, R, Si, S, Siabani, S, Singh, V, Singh, J, Soljak, M, Somayaji, R, Soofi, M, Soyiri, I, Tefera, Y, Temsah, M, Tesfay, B, Thakur, J, Toma, A, Tortajada-Girbes, M, Tran, K, Tran, B, Tudor Car, L, Ullah, I, Vacante, M, Valdez, P, van Boven, J, Vasankari, T, Veisani, Y, Violante, F, Wagner, G, Westerman, R, Wolfe, C, Wondafrash, D, Wondmieneh, A, Yonemoto, N, Yoon, S, Zaidi, Z, Zamani, M, Zar, H, Zhang, Y, Vos, T, GBD Chronic Respiratory Disease Collaborator, Violante FS, GBD Chronic Respiratory Disease Collaborators, Collaborators, GBD Chronic Respiratory Disease, Groningen Research Institute for Asthma and COPD (GRIAC), Value, Affordability and Sustainability (VALUE), and Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)
Subjects: Male, Respiratory diseases, Respiratory Tract Diseases, Disease, Chronic respiratory diseases, Global Burden of Disease, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Cost of Illness, 11. Sustainability, METABOLIC RISKS, EPIDEMIOLOGY, 030212 general & internal medicine, Child, Cause of death, Aged, 80 and over, COPD, DALY, Chronic obstructive pulmonary disease, Mortality rate, Respiratory disease, 1. No poverty, Age Factors, Middle Aged, Death causes, 3. Good health, PREVALENCE, Health risks, Child, Preschool, COMPARATIVE RISK-ASSESSMENT, Female, death and disability worldwide, Quality-Adjusted Life Years, TERRITORIES, BURDEN, growth in absolute numbers, Pulmonary and Respiratory Medicine, Adult, ADJUSTED LIFE-YEARS, Health burdens, Adolescent, Medicina, 195 COUNTRIES, chronic respiratory diseases, Article, 1117 Public Health and Health Services, 03 medical and health sciences, Young Adult, Life Expectancy, Sex Factors, Burden of Disease, Respiratory disease, Sarcoidosis, Pulmonary, Environmental health, medicine, Disability-adjusted life year, Humans, EXPOSURE, Risk factor, Mortality, Aged, per-capita basis, business.industry, DISABILITY, Infant, Newborn, Infant, 1103 Clinical Sciences, asthma, medicine.disease, Asthma, Years of potential life lost, 030228 respiratory system, Risk factors, 13. Climate action, Systematic analyses, Chronic Disease, INJURIES, Human medicine, Pneumoconiosis, Morbidity, business, Lung Diseases, Interstitial, 1199 Other Medical and Health Sciences
Abstract: Artículo con numerosos autores. Sólo se hace referencia al primero que coincide con el de la UAM y al colectivo, Background Previous attempts to characterise the burden of chronic respiratory diseases have focused only on specific disease conditions, such as chronic obstructive pulmonary disease (COPD) or asthma. In this study, we aimed to characterise the burden of chronic respiratory diseases globally, providing a comprehensive and up-to-date analysis on geographical and time trends from 1990 to 2017. Methods Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we estimated the prevalence, morbidity, and mortality attributable to chronic respiratory diseases through an analysis of deaths, disability-adjusted life-years (DALYs), and years of life lost (YLL) by GBD super-region, from 1990 to 2017, stratified by age and sex. Specific diseases analysed included asthma, COPD, interstitial lung disease and pulmonary sarcoidosis, pneumoconiosis, and other chronic respiratory diseases. We also assessed the contribution of risk factors (smoking, second-hand smoke, ambient particulate matter and ozone pollution, household air pollution from solid fuels, and occupational risks) to chronic respiratory disease-attributable DALYs. Findings In 2017, 544·9 million people (95% uncertainty interval [UI] 506·9–584·8) worldwide had a chronic respiratory disease, representing an increase of 39·8% compared with 1990. Chronic respiratory disease prevalence showed wide variability across GBD super-regions, with the highest prevalence among both males and females in high-income regions, and the lowest prevalence in sub-Saharan Africa and south Asia. The age-sex-specific prevalence of each chronic respiratory disease in 2017 was also highly variable geographically. Chronic respiratory diseases were the third leading cause of death in 2017 (7·0% [95% UI 6·8–7·2] of all deaths), behind cardiovascular diseases and neoplasms. Deaths due to chronic respiratory diseases numbered 3 914 196 (95% UI 3 790 578–4 044 819) in 2017, an increase of 18·0% since 1990, while total DALYs increased by 13·3%. However, when accounting for ageing and population growth, declines were observed in age-standardised prevalence (14·3% decrease), agestandardised death rates (42·6%), and age-standardised DALY rates (38·2%). In males and females, most chronic respiratory disease-attributable deaths and DALYs were due to COPD. In regional analyses, mortality rates from chronic respiratory diseases were greatest in south Asia and lowest in sub-Saharan Africa, also across both sexes. Notably, although absolute prevalence was lower in south Asia than in most other super-regions, YLLs due to chronic respiratory diseases across the subcontinent were the highest in the world. Death rates due to interstitial lung disease and pulmonary sarcoidosis were greater than those due to pneumoconiosis in all super-regions. Smoking was the leading risk factor for chronic respiratory disease-related disability across all regions for men. Among women, household air pollution from solid fuels was the predominant risk factor for chronic respiratory diseases in south Asia and sub-Saharan Africa, while ambient particulate matter represented the leading risk factor in southeast Asia, east Asia, and Oceania, and in the Middle East and north Africa super-region. Interpretation Our study shows that chronic respiratory diseases remain a leading cause of death and disability worldwide, with growth in absolute numbers but sharp declines in several age-standardised estimators since 1990. Premature mortality from chronic respiratory diseases seems to be highest in regions with less-resourced health systems on a per-capita basis, Bill & Melinda Gates Foundation.
Published: 2020

3. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17

Author: Ninuk Hariyani, Benjamin Uzochukwu, Anas M. Saad, Sivan Yegnanarayana Iyer Saraswathy, Amirhossein Sahebkar, Behzad Karami Matin, Abdallah M. Samy, Roman Topor-Madry, Nelson G.M. Gomes, Afsaneh Arzani, Simin Liu, Maryam Khayamzadeh, Ejaz Ahmad Khan, Asmamaw Bizuneh Demis, Anelisa Jaca, Amir Kasaeian, Fereshteh Ansari, Abdur Razzaque Sarker, Ali Kabir, Jorge Cano, Marcos Roberto Tovani-Palone, Tufa Kolola, Josephine W. Ngunjiri, Roghiyeh Faridnia, Kedir Hussein Abegaz, Hosni Salem, Sharareh Eskandarieh, Norberto Perico, Sergio I. Prada, Fisaha Haile Tesfay, Jai K Das, Ana Isabel Ribeiro, Sameer Vali Gopalani, Dessalegn Haile, Shivakumar Km Marulasiddaiah M. KMShivakumar, Narayan Prasad, Pranab Chatterjee, Shafiu Mohammed, Ravi Prakash Jha, Xiu Ju George Zhao, Farshad Farzadfar, Ahmad Daryani, Pramesh Raj Ghimire, Abbas Mosapour, Ebrahim Babaee, Rajat Das Gupta, Jean Jacques Noubiap, Daniel Bekele Ketema, Teshome Bekele Elema I, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Muktar Beshir Ahmed, Wondimeneh Shibabaw Shiferaw, Mehran Asadi-Aliabadi, Mohamed M. Gad, Eugenio Traini, Milena Santric-Milicevic, Bakhtiar Piroozi, Mohsen Afarideh, Duduzile Ndwandwe, Ibrahim Abdollahpour, Aisha Elsharkawy, Bárbara Niegia Garcia de Goulart, Soufiane Boufous, Obinna Onwujekwe, Seyyed Meysam Mousavi, Azeem Majeed, Meghnath Dhimal, Bruno F. Sunguya, Daniel Adane Endalew, Hosein Shabaninejad, Siddhesh Zadey, Takahiro Tabuchi, Gebrekiros Gebremichael Meles, Davide Guido, Trang Huyen Nguyen, Yonatal Mesfin Tefera, Hala Elhabashy, Devasahayam J. Christopher, Malede Mequanent Sisay, Davide Rasella, Hedayat Abbastabar, Maziar Moradi-Lakeh, Anthony Masaka, Wagaye Fentahun Chanie, B. Suresh Kumar Shetty, Matiwos Soboka Daba, Tesfaye Yitna Yitna Chichiabellu, Arianna Maever L. Amit, Tomohide Yamada, Alireza Rafiei, Reinhard Busse, Abdullah Al Mamun, Genet Melak Alamene, George C Patton, Andem Effiong, Rushdia Ahmed, Jagadish Rao Padubidri, Mohamad-Hani Temsah, Nizal Sarrafzadegan I, Francesco Saverio Violante, Monika Sawhney, Eyal Oren, Kimberly B. Johnson, Benn Sartorius, Shirin Djalalinia, Mohsen Bayati, Merhawi Gebremedhin Tekle, Navid Rabiee, Javad Nazari, Krishna K. Aryal, Kavumpurathu Raman Thankappan, Yoshan Moodley, Anh Kim Dang, Mohammad Khazaei, Parvaiz A Koul, Edson Serván-Mori, Foad Abd-Allah, Seyed Mohammad Riahi, Nader Jahanmehr, Yuming Guo, Sonia Saxena, Bayu Begashaw Bekele, Hagos Degefa de Hidru I, Enayatollah Homaie Rad, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Oliver J. Brady, Natalie Maria Cormier, Ghulam Mustafa, Samiah Alam, Guoqing Hu, Yousef Khader, Mohsen Mazidi, Hamed Kalani, Hamideh Salimzadeh, Mayowa O. Owolabi, Ali Bijani, Getu Debalkie Demissie, Tsegaye Lolaso Lenjebo, German Martinez, Elias Merdassa Roro, Hamidreza Komaki, Giovanni Damiani, Nelson Alvis-Guzman, Reza Shirkoohi, Aditya Prasad Dash, Benny Antony, Cheru Tesema Leshargie, Josip Car, Turki Alanzi, Amir Jalali, Shahin Soltani, Arvin Haj-Mirzaian, John S. Ji, Nima Hafezi-Nejad, S. Mohammad Sajadi, Khalid A Altirkawi, Shanshan Li, Hunduma Amensisa Amensisa Bojia I, Estifanos Baye, Hany Aref, Kebreab Paulos, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Felix Lam, Themba G.G. Ginindza, Behnam Heidari, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Mostafa Leili, Sohail Ahmad, Babak Moazen, Samad Azari, Feleke Gebremeskel W, Jacqueline Elizabeth Alcalde-Rabanal, Khanh Bao Tran, Okechukwu S Ogah, Bruno Ramos Nascimento, Tefera Chane Mekonnen, Irina Filip, Bogdan Oancea, Lalit Dandona, Desalegn Markos Shifti, Nasir Salam, Binyam Minuye Birihane, Mohammad Ali Mansournia, Mohammad Ebrahimi Kalan, Sheetal D. Lad, Michael R.M. Abrigo, Ken Lee Chin, Masoud Moradi, Temesgen Yihunie Akalu, Behzad Heibati, Ole Frithjof Norheim, Man Mohan Mehndiratta, Mahya Beheshti, Ali Yadollahpour, Gelin Xu, Siamak Sabour, Neda Izadi, Carlos Culquichicón, Tuomo J. Meretoja, Ireneous N. Soyiri, Jacob Olusegun Olusanya, Félix Carvalho, Hamid Yimam Hassen, Dereje Bayissa Demissie, Yun Jin Kim, Rajesh Sagar, Fakher Rahim, Catrin E. Moore, Thomas R. Hird, Amjad Mohamadi-Bolbanabad, Naser Mohammad Gholi Mezerji, Ahamarshan Jayaraman Nagarajan, Anton Sokhan, Faris Lami, Masoud Behzadifar, Ritesh G. Menezes, Amira Hamed Darwish, Mohammad Zamani, Tesleem Kayode Babalola, Navid Manafi, Charles Shey Wiysonge, Diego Augusto Santos Silva, Daniel Diaz, Eleonora Dubljanin, Soraya Nouraei Motlagh, Suraj Bhattarai, Getasew Taddesse Worku, Noore Alam, Jasvinder A. Singh, Catalina Liliana Andrei, Ali Kazemi Karyani, Robert C. Reiner, Mohammedaman Mama Hussen, Fatemeh Heydarpour, Nuruzzaman Khan I, Bach Xuan Tran, Lal B. Rawal, Bereket Duko, Joemer C. Maravilla, Rakhi Dandona, Sandra B. Munro, Jae Il Shin, Julia Moreira Pescarini, Claudiu Herteliu, Ahmed Abdelalim, Manasi Kumar, Pushpendra Kumar, Saleem Muhammad Rana, Hedley Quintana, Akram Pourshams, Franz Castro, Muhammad Aziz Rahman, Beyene Meressa Adhena, Aberash Abay Tasew, Linda Morales, Dawit Zewdu Wondafrash, Wasiq Faraz Rawasia, David Laith Rawaf, Zoubida Zaidi, Tomislav Mestrovic, Rajeev Gupta, Seyyede Masoume Athari, Peter Njenga Keiyoro, Andrea Werdecker, Santi Martini, Fatemeh Rajati, Andre Pascal Kengne, Victor Adekanmbi, Seid Tiku Mereta, Yared Asmare Aynalem, Kewal Krishan, Marzieh Nojomi, Yves Miel H Zuniga, Mohammad Reza Sobhiyeh, Frank B. Osei, Nefsu Awoke, Randah R. Hamadeh, G. K. Mini, Edris Hasanpoor, Ayele Geleto Bali, Moslem Soofi, Prabhat Lamichhane, Peter Azzopardi, Amir Khater, G Anil Kumar, Catherine A. Welgan, Abraham Getachew Kelbore, Jaifred Christian F. Lopez, Senthilkumar Balakrishnan, Mohammad Ali Sahraian, Ahmed I. Hasaballah, Virendra Singh, Arash Ziapour, Zahid A Butt, Hebat Allah Salah A. Yousof, Tewodros Eshete Wonde, Sanjay Zodpey, Amaha Kahsay, Achala Upendra Jayatilleke, Segun Emmanuel Ibitoye, Beriwan Abdulqadir Ali, Simin Mouodi, Salman Rawaf, Iqbal R. F. Elyazar, Ai-Min Wu, Seyed Sina Naghibi Irvani, Yasir Waheed, Delia Hendrie, Hadi Pourjafar, Farnam Mohebi, Naohiro Yonemoto, Ahmad Ghashghaee, Veincent Christian Filipino Pepito, Paulina A. Lindstedt, Nauman Khalid, Sezer Kisa, Chi Linh Hoang, Niranjan Kissoon, Kindie Fentahun Muchie, Valery L. Feigin, Mathew M. Baumann, Alemayehu Toma, Andre Rodrigues Duraes, Benjamin B. Massenburg, Santosh Varughese, Yuan-Pang Wang, Ingan Ukur Tarigan, Ali Kiadaliri, Hamed Zandian, Demelash Woldeyohannes Handiso, Hassan Magdy Abd El Razek, Ketema Bizuwork Gebremedhin, Hafiz Ansar Rasul Suleria, Oluchi Ezekannagha, Getinet Ayano, Bolajoko O. Olusanya, Manu Raj Mathur, Manfred Accrombessi, Christopher J L Murray, Moritz U. G. Kraemer, Saeed Amini, Ziad A. Memish, Yousef Mohammad, Luis Camera, Ernoiz Antriyandarti, Ronny Westerman, Meghdad Pirsaheb, Negar Rezaei, Ted R. Miller, Aziz Eftekhari, Nevine El Nahas, Sebastian Vollmer, Sanjay Basu, Hesham M. Al-Mekhlafi, D. R. Mahadeshwara Prasad, Rufus A. Adedoyin, Miliva Mozaffor I, Mihiretu Kebede, Preeti Dhillon, Dilaram Acharya, Iman El Sayed, Narendar Manohar, Paul S. F. Yip, Ben Lacey, Felix Akpojene Ogbo, Adrian Davis, Dinh-Toi Chu, Ranjani Somayaji, Raaj Kishore Biswas, Taddese Alemu Zerfu, Claudio Alberto Dávila-Cervantes, Sharath Burugina Nagaraja, Getachew Mullu Kassa, Mohan Bairwa, Gurudatta Naik, André Karch, Gudlavalleti V S Murthy, Avula Laxmaiah, Farid Najafi, Birhanu Geta Meharie, Lorenzo Monasta, Amit Arora, Christopher S Yilgwan, Samer Hamidi, Keivan Ahmadi, Kebede Deribe, Ehimario U. Igumbor, Engida Yisma, Henok Biresaw Netsere, Mihajlo Jakovljevic, Ali S. Shalash, Thirunavukkarasu Sathish, Sachin R Atre, Mohamed I Hegazy, Mehedi Hasan, Hamidreza Haririan, Lucas Guimarães Abreu, Nejimu Biza Zepro, Surendra Karki, Krittika Bhattacharyya, Hiroshi Yatsuya, Gbenga A. Kayode, Osayomwanbo Osarenotor, Paul H. Lee, Deepak Paudel, Hagos Tasew Atalay, Hatem S Shehata, Mohammad Fareed, Adnan Kisa, Hisham Atan Edinur, Mehran Alijanzadeh, Shafiur Rahman, Mohammad Hossein Khosravi, Anusha Ganapati Bhat, Bahram Mohajer, Narinder Pal Singh, Shai Linn, Savita Lasrado, Joseph Adel Mattar Banoub, Amir Almasi-Hashiani, Mohd Anisul Karim, Praveen Hoogar, Kerrie E. Doyle, Bedilu Girma Weji, Juan Sanabria, Olatunji O. Adetokunboh, Mohamed Hsairi, Alireza Esteghamati, Seok Jun Yoon, Paramjit Gill, Dabere Nigatu, Tariq Jamal Siddiqi, Muhammad Usman, Rafael Alves Guimarães, Zemenu Tadesse Tessema, Aziz Sheikh, Florian Fischer, Peter Memiah, Rakesh Lodha, Nihal Thomas, Karzan Abdulmuhsin Mohammad, Mohammad Sadegh Rezai, Tanuj Kanchan, Vinay Nangia, Ashraf Nabhan, Gebre Teklemariam Demoz, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Sadaf G. Sepanlou, Michellr L. Bell, Nicola Luigi Bragazzi, Aklilu Endalamaw, Vishnu Renjith, Chinwe Juliana Iwu, Gabrielle B. Britton, Colm McAlinden, Ayenew Negesse Abejie, Smita Pakhale, Doris V.V. Ortega-Altamirano, Noushin Mohammadifard, Deborah Carvalho Malta, Vo Dinh Bay, Kirsten E. Wiens, Hamidreza Karimi-Sari, Mustafa Z. Younis, Shaimaa I. El-Jaafary, Morenike Oluwatoyin Folayan, Phetole Walter Mahasha, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Mohammad Hifz Ur Rahman, Sheikh Mohammed Shariful Islam, Maarten J. Postma, Usman Iqbal, Abdu A. Adamu, Marwa R.Rashad Salem I, Fares Alahdab, Vafa Rahimi-Movaghar, Zulfiqar A. Bhutta, Masoud Foroutan, Muhammad Shahzeb Khan, In-Hwan Oh, Yahya Salimi, Takeshi Fukumoto, Chhabi Lal Ranabhat, Tiffany K. Gill, Angel Paternina-Caicedo, Walter Mendoza, Sojib Bin Zaman, Olayinka Stephen Ilesanmi, Brigette F. Blacker, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Ambrish Singh, Mehdi Fazlzadeh, Mahesh P A, Carlo La Vecchia, Alex Yeshaneh, Benjamin K. Mayala, Aniruddha Deshpande, Agus Sudaryanto, Neeraj Bedi, Morteza Shamsizadeh, Jemal Abdu Mohammed, Vahid Alipour, Haileab Fekadu Wolde, Boris Bikbov, Ahmed Abualhasan, Ali H. Mokdad, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Jacek Jerzy Jozwiak, Alessandra C. Goulart, Mahmoud Yousefifard, Masood Ali Shaikh, Roya Safari-Faramani, MohammadBagher Shamsi, Aso Mohammad Darwesh, Amir Anoushiravani, Kebede Embaye Gezae, Degena Bahrey Tadesse, Paula Moraga, Maha El Tantawi, Rosario Cárdenas, Assefa Desalew, Vivek Kumar, Mina Anjomshoa, Junaid Khan, Jagdish Khubchandani, Marcel Ausloos, Soraya Siabani, Anwar E. Ahmed, Mohammed Ibrahim Mohialdeen Gubari, Andre M. N. Renzaho, Vuong Minh Nong, Kaushik Sarkar, Bruno Piassi Sao Jose, Yafeng Wang, Mitchell T. Wallin, Edgar Denova-Gutiérrez, Mohammad Hasan Imani-Nasab, Melese Abate Reta, Kala M. Mehta, Yahya Safari, Marufa Sultana, David C. Schwebel, Roghayeh Mohammadibakhsh, Samath D Dharmaratne, Maysaa El Sayed Zaki, Shiwei Liu, Gail Davey, Milena Ilic, Yunquan Zhang, Bahram Armoon, Seyed-Mohammad Fereshtehnejad, Jost B. Jonas, Dian Kusuma, Yawukal chane Kasahun, Beatriz Paulina Ayala Quintanilla, Mohammad Moradi-Joo, Gebrehiwot G. Kassa, Maria Jesus Rios-Blancas, Serge Resnikoff, Seifadin Ahmed Shallo, Bartosz Miazgowski, Huda Basaleem, Jobert Richie Nansseu, Enrico Rubagotti, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Maryam Adabi, Saravanan Muthupandian, Soumyadeep Bhaumik, hawariat, Carlos A Castañeda-Orjuela, Bhaskaran Unnikrishnan, Martin Amogre Ayanore, Dragos Virgil Davitoiu, Hossein Poustchi, Moses K. Muriithi, Dharmesh Kumar Lal, Ayman Grada, Rafael Tabarés-Seisdedos, Seyyed Shamsadin Athari, Ashish Pathak, Salvatore Rubino, Kenji Shibuya, Ana Laura Manda, Muluken Bekele Sorrie, Vivekanand Jha, Habtamu Kebebe Kasaye, Mohammad Hoseini, Sonali Kochhar, Van C. Lansingh, Ali Almasi, Amir Radfar, Till Bärnighausen, Marcia R. Weaver, Mowafa Househ, Arya Haj-Mirzaian, Gebremicheal Gebreslassie Kasahun, Arash Etemadi, Getahun Fentaw Mulaw, Zubair Kabir, Cuong Tat Nguyen, Chabila C Mapoma, Aubrey J. Levine, Solomon Gedlu Nigatu, Aslam Pervaiz, Muhammed Magdy Abd El Razek, Nataliya A. Foigt, Andrey Nikolaevich Briko, Sadaf Esteghamati, Chuanhua Yu, Pascual R. Valdez, Jennifer Rickard, Jennifer M. Ross, Ionut Negoi, Hailay Abrha Gesesew, Kamarul Imran Musa, Farshad Pourmalek, Kiomars Sharafi, Sangram Kishor Patel, Vera Marisa Costa, Mostafa Hosseini, Hajer Elkout, Mika Shigematsu, Bryan L. Sykes, Afarin Rahimi-Movaghar, Nuworza Kugbey, Vijay Kumar Chattu, Payman Salamati, Mona M. Khater, Reta Tsegaye Gayesa, Ehsan Sadeghi, Andrew T Olagunju, Govinda Prasad Dhungana, Dina Nur Anggraini Ningrum, Yaschilal Muche Belayneh, Leonardo Roever, Luca Ronfani, Nathaniel J. Henry, Brijesh Sathian, Hamid Sharifi, Liliana Preotescu, Joshua Longbottom, Somayeh Bohlouli, Huong Lan Thi Nguyen, Khaled Khatab, Ziyad Al-Aly, Ghobad Moradi, Ruth W Kimokoti, Jalal Arabloo, Mariam Molokhia, Maciej Banach, Hasan Yusefzadeh, Rahman Shiri, Girmay Teklay Weldesamuel, Mekdes Tigistu Yilma, Taweewat Wiangkham, Soewarta Kosen, Kovin Naidoo, Fernando de la Hoz, Mohammed Shannawaz, Berhe Etsay Tesfay I, Yogesh Sabde, Syed Mohamed Aljunid, Belay Tessema, Reza Malekzadeh, Tinuke O Olagunju, Olatunde Aremu, Mohammad Reza Salahshoor, Derrick A Bennett, Oladimeji M. Adebayo, Teshome Gebre, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Mehdi Hosseinzadeh, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Rovshan Khalilov, Ai Koyanagi, Salman Khazaei, Ismael R. Campos-Nonato, Alaa Badawi, Amir Hasanzadeh, Gebreamlak Gebremedhn Gebremeskel, Gessessew Bugssa Hailu, Dessalegn Ajema Berbada, Kate E. LeGrand, Azadeh Shafieesabet, Nikolay Ivanovich Briko, Robert S. Bernstein, Irfan Ullah, Isaac Oluwafemi Dipeolu, Hadi Hassankhani, Keyghobad Ghadiri, Local Burden of Disease Diarrhoea Collaborator, Violante FS, Wiens, KE, Lindstedt, PA, Blacker, BF, Johnson, KB, Yisma, E, Ahmed, Muktar Beshir, Reiner, Robert C, Duko, Bereket, Local Burden of Disease Diarrhoea Collaborators, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Local Burden Dis Diarrhoea, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, HUS Comprehensive Cancer Center, Clinicum, Institute for Molecular Medicine Finland, Department of Oncology, University of Helsinki, and Instituto de Saúde Pública da Universidade do Porto
Subjects: RJ101, medicine.medical_treatment, CHILDREN, ZINC, 0302 clinical medicine, 030212 general & internal medicine, media_common, Geography, lcsh:Public aspects of medicine, 1. No poverty, Low income and middle income countries, General Medicine, 3142 Public health care science, environmental and occupational health, 3. Good health, Child, Preschool, A990 Medicine and Dentistry not elsewhere classified, Geographical inequalities, 0605 Microbiology, Diarrhea, AFRICA, Inequality, DEATHS, media_common.quotation_subject, 030231 tropical medicine, Developing country, Article, RS, 1117 Public Health and Health Services, 03 medical and health sciences, MORBIDITY, Environmental health, DIARRHEAL DISEASE, medicine, Humans, Oral rehydration therapy, Healthcare Disparities, Developing Countries, Models, Statistical, CHOLERA, MORTALITY, Infant, Newborn, Infant, lcsh:RA1-1270, Bayes Theorem, Middle income, GLOBAL BURDEN, Child mortality, 0605 Microbiology, 1117 Public Health and Health Services, Health Care Surveys, ITC-ISI-JOURNAL-ARTICLE, Fluid Therapy, NA, Human medicine, ITC-GOLD
Abstract: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000-17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000-7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910-68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). L G Abreu has received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance Code 001), Conselho Nacional de Desenvolvimento Científico e Tecnológico and Fundação de Amparo à Pesquisa do Estado de Minas Gerais. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. H T Atalay acknowledges Aksum University. M Ausloos and C Herteliu are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. P S Azzopardi was supported by an Australian National Health and Medical Research Council (NHMRC) early career fellowship. A Badawi is supported by the Public Health Agency of Canada. T W Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research; the EU; the Wellcome Trust; and from National Institute of Child Health and Human Development of National Institutes of Health (NIH; R01-HD084233), National Institute on Aging of NIH (P01-AG041710), National Institute of Allergy and Infectious Diseases of NIH (R01-AI124389 and R01-AI112339), as well as Fogarty International Center of NIH (D43-TW009775). G B Britton is supported by Sistema Nacional de Investigación (SNI) de la Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) of Panamá. A Barac is funded by the Project of Ministry of Education, Science and Technology of the Republic of Serbia (number III45005). D A Bennett was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the UK Department of Health and Social Care. V M Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/Ministério da Ciência, Tecnologia e Ensino Superior through national funds. K Deribe is supported by a Wellcome Trust grant (number 201900/Z/16/Z) as part of his International Intermediate Fellowship. C Herteliu is partially supported by a grant co-funded by European Fund for Regional Development through the Operational Program for Competitiveness (project ID P_40_382). P Hoogar thanks Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education, Manipal and Centre for Holistic Development and Research, Kalaghatgi-Karnataka. S M S Islam is funded by a Fellowship from National Heart Foundation of Australia and Deakin University. M Jakovljevic and the Serbian part of this GBD contribution was co-funded through grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. A P Kengne is supported by the South African Medical Research Council. Y J Kim's work was supported by the Research Management Centre, Xiamen University Malaysia, grants number XMUMRF/2018-C2/ITCM/0001. K Krishan is supported by a DST PURSE grant and UGC Center of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar acknowledges K43 TW010716-03. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence, Oxford. P T N Memiah acknowledges the Council for the Development of Social Science Research in Africa. M Molokhia is supported by the NIHR Biomedical Research Center at Guy's and St Thomas' National Health Service Foundation Trust and King's College London. I Moreno Velásquez is supported by the Sistema Nacional de Investigación (SENACYT, Panamá). G C Patton is funded by an NHMRC Fellowship. A M Samy received a fellowship from the Egyptian Fulbright Mission programme. M M Santric-Milicevic acknowledges the support of the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). A Sheikh acknowledges the support of Health Data Research UK. M R Sobhiyeh acknowledges the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences for their wise advice. R Tabarés-Seisdedos was supported in part by grant PI17/00719 from Instituto de Salud Carlos III–FEDER. B Unnikrishnan acknowledges Manipal Academy of Higher Education, Manipal. M R Weaver was supported by the Bill & Melinda Gates Foundation grant OPP1127433. C S Wiysonge was supported by the South African Medical Research Council.
Published: 2020

4. Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years : an analysis of the Global Burden of Disease Study 2017

Author: Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Yuming Guo, Soewarta Kosen, Irfan Ullah, Khanh Bao Tran, Joan B. Soriano, Carl Abelardo T. Antonio, Teklay G E Teklu, Smita Pakhale, Dietrich Rothenbacher, Christopher Troeger, Eyasu Ejeta Duken, Erkin M. Mirrakhimov, Helena Manguerra, Cuong Tat Nguyen, Chalachew Genet Akal, Rakhi Dandona, Alaa Badawi, Barthelemy Kuate Defo, Sonali Kochhar, Javad Nazari, Evanson Z. Sambala, Nelson Alvis-Guzman, G Anil Kumar, Niranjan Kissoon, Yousef Veisani, Ai Koyanagi, Lalit Dandona, Molly R Nixon, David L. Smith, Samah Awad, Seyyed Meysam Mousavi, Rachel L Updike, Rajesh Kumar Rai, Hagos Tasew Atalay, Giuseppe Gorini, Charles Shey Wiysonge, Molly H Biehl, Zoubida Zaidi, Ahmad Daryani, Bach Xuan Tran, André Karch, Mostafa Qorbani, Zikria Saleem, Addisu Melese, Devasahayam J. Christopher, Adane Teshome Kefale, Félix Carvalho, Stephen S Lim, Birhanu Geta, Aziz Sheikh, Reginald Quansah, Andrew T Olagunju, Jalal Arabloo, Karzan Abdulmuhsin Mohammad, Fiseha Wadilo Wada, Amir Kasaeian, Maarten J. Postma, Abdullah T Khoja, Ravi Prakash Jha, Syed Mohamed Aljunid, Yousef Khader, Heather J. Zar, Ali Bijani, Ibrahim A Khalil, William M. Gardner, Marcia R. Weaver, Ebrahim M Yimer, Srinivas Murthy, Quique Bassat, Mu'awiyyah Babale Sufiyan, Kirsten E. Wiens, Saeed Amini, Ziad A. Memish, Samer Hamidi, Shanshan Li, Belay Tessema, Erlyn Rachelle King Macarayan, Tinuke O Olagunju, Alessandra C. Goulart, Seyed Sina Naghibi Irvani, Mahesh P A, Olatunde Aremu, Spencer L. James, Derrick A Bennett, Sezer Kisa, Keyghobad Ghadiri, Alireza Ahmadi, Theo Vos, Tuomo J. Meretoja, Mika Shigematsu, Naohiro Yonemoto, Shirin Djalalinia, Rakesh Lodha, Anselm Okoro, Adnan Kisa, Ali H. Mokdad, Aman Yesuf Endries, Josip Car, Fakher Rahim, Cheru Tesema Leshargie, Babak Moazen, Hamid Yimam Hassen, Lorenzo Monasta, Abdullah Al Mamun, Young-Ho Khang, Yasir Waheed, Mohamad-Hani Temsah, Zakir Hussain, Milena M Santric Milicevic, Abdallah M. Samy, Ejaz Ahmad Khan, Hmwe H Kyu, Afshin Zarghi, Monika Sawhney, Ghulam Mustafa, Samuel B. Albertson, Tomislav Mestrovic, Long Hoang Nguyen, Marek Majdan, Maysaa El Sayed Zaki, Mihaela Hostiuc, Desalegn Tadese Mengistu, Chi Linh Hoang, Christopher J L Murray, Nahla Anber, Seyedmojtaba Seyedmousavi, Maria Jesus Rios-Blancas, Mohammad Sadegh Rezai, Ashish Awasthi, Robert Reiner, Carlos A Castañeda-Orjuela, Shafiu Mohammed, Saeed Safari, Catrin E. Moore, Mina Anjomshoa, Joseph Adel Mattar Banoub, Fares Alahdab, Vafa Rahimi-Movaghar, Aniruddha Deshpande, Nicholas J Kassebaum, Kefyalew Addis Alene, Rajaa Al-Raddadi, Nancy Fullman, Benn Sartorius, Nuruzzaman Khan, Manisha Dubey, Eleonora Dubljanin, Stephanie R M Zimsen, Jost B. Jonas, Dharmesh Kumar Lal, Feleke Mekonnen Demeke, Jeffrey D. Stanaway, Euripide Frinel G Arthur Avokpaho, Tommi Vasankari, Florian Fischer, Krittika Bhattacharyya, Aleksandra Barac, Simon I. Hay, Kalpana Balakrishnan, Brigette F. Blacker, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Puja C Rao, Neeraj Bedi, Masood Ali Shaikh, Bartosz Miazgowski, Arya Haj-Mirzaian, Mohamed Lemine Cheikh brahim Ahmed, Vahid Alipour, Tesfaye Dessale Kassa, Luca Ronfani, Suleman Atique, Muhammad Imran Nisar, Alireza Rafiei, Aziz Rezapour, Ruth W Kimokoti, Noore Alam, Zulfiqar A Bhutta, Katherine Rosettie, Jonathan F. Mosser, Felix Akpojene Ogbo, Degu Abate, Clinicum, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, Department of Oncology, Public Health, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Collaborators, GBD 2017 Diarrhoeal Disease, and GBD 2017 Diarrhoeal Dis
Subjects: Male, Diarrhea, AFRICA, 030231 tropical medicine, Developing country, Global Health, Risk Assessment, Global Burden of Disease, 03 medical and health sciences, MORBIDITY, Life Expectancy, 0302 clinical medicine, SDG 3 - Good Health and Well-being, SANITATION, NUTRITIONAL INTERVENTIONS, Environmental health, Prevalence, Global health, Humans, Medicine, 030212 general & internal medicine, Risk factor, Child, Developing Countries, Wasting, Children, Models, Statistical, business.industry, Mortality rate, MORTALITY, 1. No poverty, Infant, Verbal autopsy, 3. Good health, Infectious Diseases, Socioeconomic Factors, WATER-QUALITY, Child, Preschool, Relative risk, 3121 General medicine, internal medicine and other clinical medicine, Child Mortality, GROWTH, Female, Human medicine, medicine.symptom, business, Risk assessment, Diarrea, Infants
Abstract: Background Many countries have shown marked declines in diarrhoeal disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. Methods This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. Findings Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162–593 145) among children younger than 5 years globally in 2017, a rate of 78·4 deaths (70·1–87·1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69·6% (63·1–74·6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13·3% decrease, 11·2–15·5), childhood wasting (9·9% decrease, 9·6–10·2), and low use of oral rehydration solution (6·9% decrease, 4·8–8·4). Interpretation Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors—particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution—appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness. Funding Bill & Melinda Gates Foundation.
Published: 2020

5. Global Mortality From Firearms, 1990-2016

Author: Leticia Avila-Burgos, Mahdi Safdarian, Devina Nand, Tim Driscoll, David C. Schwebel, Andrew T Olagunju, Saeid Safiri, Vasily Vlassov, Dina Nur Anggraini Ningrum, Jost B. Jonas, Reyna A Gutiérrez, Delia Hendrie, Fentaw Tadese, Jagdish Khubchandani, Gessessew Bugssa Hailu, Bach Xuan Tran, Mekonnen Sisay, Amanda J. Mason-Jones, Mu'awiyyah Babale Sufiyan, Tommi Vasankari, Kyle J Foreman, Kristopher J. Krohn, Haftay Berhane Mezgebe, Christian Kieling, Nadia Akseer, Maheswar Satpathy, Reza Assadi, Christopher J L Murray, Tsegaye Tewelde Gebrehiwot, Ali Rowhani-Rahbar, Rakhi Dandona, Sudha Jayaraman, Rintaro Mori, Mustafa Z. Younis, Tesfay Mehari Atey, Ashish Awasthi, Amit Arora, Rodrigo Sarmiento-Suarez, Kingsley N. Ukwaja, Alan D. Lopez, Masoud Behzadifar, Ibrahim A Khalil, G Anil Kumar, George C Patton, Nancy Fullman, Nigussie Tadesse Sharew, André Faro, Guoqing Hu, Yousef Khader, Benn Sartorius, Suzanne Barker-Collo, Young-Ho Khang, Rajesh Sagar, Martha Híjar, Florian Fischer, Suliman Alghnam, Michael Kutz, Valery L. Feigin, Raimundas Lunevicius, Suzanne Polinder, Bryan L. Sykes, Van C. Lansingh, Adauto Martins Soares Filho, Mamta Swaroop, Jasvinder A. Singh, Mohsen Asadi-Lari, Afarin Rahimi-Movaghar, Spencer L. James, Alireza Esteghamati, Theo Vos, Tuomo J. Meretoja, Soewarta Kosen, Kerrie E. Doyle, Michael R. Phillips, Amaha Kahsay, Miloud Taki Eddine Aichour, Samath D Dharmaratne, James R. Bennett, Rohan Borschmann, Muhammed Magdy Abd El Razek, Rafael Tabarés-Seisdedos, Joseph S Salama, Salman Rawaf, Hamid Yimam Hassen, Heidi J. Larson, Ted R. Miller, Caitlin Hawley, Beatriz Paulina Ayala Quintanilla, Katya Anne Shackelford, Lalit Dandona, Vafa Rahimi-Movaghar, Aman Yesuf Endries, Guilherme Borges, Carlos A Castañeda-Orjuela, Shahrzad Bazargan-Hejazi, Soraya Seedat, Paul S. F. Yip, Juan Sanabria, Maziar Moradi-Lakeh, Farshad Pourmalek, Olayinka Stephen Ilesanmi, Masood Ali Shaikh, Mahfuzar Rahman, Richard Matzopoulos, Richard C. Franklin, Huyen Phuc Do, Mostafa Qorbani, Eric L. Ding, Mark A. Stokes, Rajaa Al-Raddadi, Stephen S Lim, Tung Thanh Tran, Dan J. Stein, Naohiro Yonemoto, Mohsen Naghavi, Vegard Skirbekk, Chhabi Lal Ranabhat, Walter Mendoza, Arebu Issa Bilal, Pengpeng Ye, Shai Linn, Ali H. Mokdad, Alexandra Brazinova, Nima Hafezi-Nejad, Julio Cesar Campuzano Rincon, Ashish Bhalla, Simon I. Hay, Deborah Carvalho Malta, David Teye Doku, Ivy Shiue, Farshad Farzadfar, Shafiu Mohammed, Aliasghar Ahmad Kiadaliri, Molly K. Miller-Petrie, Khurshid Alam, Milena M Santric Milicevic, Dumessa Edessa, Quyen Nguyen, Rajesh Kumar Rai, Paul I. Dargan, Reza Malekzadeh, Olatunde Aremu, David Laith Rawaf, Zoubida Zaidi, Hassan Magdy Abd El Razek, Carl Abelardo T. Antonio, Meysam Behzadifar, Josep Maria Haro, Ziad El-Khatib, Cuong Tat Nguyen, Laurie B. Marczak, Peter Njenga Keiyoro, Andrea Werdecker, Megha Arora, Neal D. Futran, Maysaa El Sayed Zaki, Diego De Leo, Faris Lami, Hassan Haghparast Bidgoli, Amir Kasaeian, Peter Memiah, Zulfiqar A Bhutta, Till Bärnighausen, Sadaf G. Sepanlou, Felix Akpojene Ogbo, Mihajlo Jakovljevic, Félix Carvalho, Yun Jin Kim, Global Burden Dis 2016 Injury Col, Universitat de Barcelona, and Public Health
Subjects: Male, Global Health, 01 natural sciences, 0302 clinical medicine, Firearm injury, Armas de Fuego, Homicide, Global health, Medicine, 030212 general & internal medicine, Young adult, Child, Aged, 80 and over, Mortality rate, Armes de foc, 11 Medical And Health Sciences, General Medicine, Middle Aged, 16. Peace & justice, Firearm suicide, Suicide, Gun ownership, Child, Preschool, Violencia, Female, Adult, Firearms, Adolescent, Uncertainty interval, Violence, Young Adult, 03 medical and health sciences, Age Distribution, General & Internal Medicine, Mortalitat, Humans, Vital registration, Suicidio, Sex Distribution, 0101 mathematics, Mortality, Aged, business.industry, 010102 general mathematics, Infant, Newborn, Infant, Heridas por Arma de Fuego, Homicidio, Mortalidad, Wounds, Gunshot, Human medicine, business, Demography
Abstract: IMPORTANCE: Understanding global variation in firearm mortality rates could guide prevention policies and interventions. OBJECTIVE: To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories. DESIGN, SETTING, AND PARTICIPANTS: This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths. EXPOSURES: Firearm ownership and access. MAIN OUTCOMES AND MEASURES: Cause-specific deaths by age, sex, location, and year. RESULTS: Worldwide, it was estimated that 251 000 (95% uncertainty interval [UI], 195 000-276 000) people died from firearm injuries in 2016, with 6 countries (Brazil, United States, Mexico, Colombia, Venezuela, and Guatemala) accounting for 50.5% (95% UI, 42.2%-54.8%) of those deaths. In 1990, there were an estimated 209 000 (95% UI, 172 000 to 235 000) deaths from firearm injuries. Globally, the majority of firearm injury deaths in 2016 were homicides (64.0% [95% UI, 54.2%-68.0%]; absolute value, 161 000 deaths [95% UI, 107 000-182 000]); additionally, 27% were firearm suicide deaths (67 500 [95% UI, 55 400-84 100]) and 9% were unintentional firearm deaths (23 000 [95% UI, 18 200-24 800]). From 1990 to 2016, there was no significant decrease in the estimated global age-standardized firearm homicide rate (-0.2% [95% UI, -0.8% to 0.2%]). Firearm suicide rates decreased globally at an annualized rate of 1.6% (95% UI, 1.1-2.0), but in 124 of 195 countries and territories included in this study, these levels were either constant or significant increases were estimated. There was an annualized decrease of 0.9% (95% UI, 0.5%-1.3%) in the global rate of age-standardized firearm deaths from 1990 to 2016. Aggregate firearm injury deaths in 2016 were highest among persons aged 20 to 24 years (for men, an estimated 34 700 deaths [95% UI, 24 900-39 700] and for women, an estimated 3580 deaths [95% UI, 2810-4210]). Estimates of the number of firearms by country were associated with higher rates of firearm suicide (P
Published: 2018

6. Global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

Author: Ephrem Tsegay Asfaw, Irina Filip, Maciej Banach, Amjad Mohamadi-Bolbanabad, Girmay Teklay Weldesamuel, Joshua A. Salomon, Anemaw A Asrat, Zahra Jorjoran Shushtari, Hamidreza Komaki, Mekdes Tigistu Yilma, Reza Shirkoohi, Mostafa Qorbani, Ahamarshan Jayaraman Nagarajan, Don C. Des Jarlais, Adnan Kisa, Gebreamlak Gebremedhn Gebremeskel, Kidu Gidey Weldegwergs, Amir Kasaeian, Peter Memiah, Son Hoang Nguyen, Segun Emmanuel Ibitoye, Ali Kabir, Subash Thapa, Diego Augusto Santos Silva, Kefyalew Addis Alene, Alireza Rafiei, Huong Lan Thi Nguyen, Erlyn Rachelle King Macarayan, Kelali Kalaye Gebreyohannes, Khaled Khatab, Ghobad Moradi, Noore Alam, Aletta E. Schutte, Sharareh Eskandarieh, H. Dean Hosgood, Rakhi Dandona, Taye Abuhay Zewale, Sezer Kisa, Gessessew Bugssa Hailu, Hedayat Abbastabar, Ketema Bizuwork Gebremedhin, Smita Pakhale, Govinda Prasad Dhungana, Dina Nur Anggraini Ningrum, Bakhtiar Piroozi, Yaschilal Muche Belayneh, Tesfaye Dessale Kassa, Irfan Ullah, Sahar Saeedi Moghaddam, Jean Jacques Noubiap, Mojtaba Bagherzadeh, Akram Pourshams, Alberto L. García-Basteiro, Helen Bitew, Kindie Fentahun Muchie, Mehdi Sayyah, Kevin S Ikuta, Moses K. Muriithi, Aliasghar Ahmad Kiadaliri, Zerihun Menlkalew Zenebe, Cesar Reis, Themba G. Ginindza, Jagadish Rao Padubidri, Yoosik Youm, Saba Abraham Belay, Olayinka Stephen Ilesanmi, Neeraj Bedi, Maziar Moradi-Lakeh, Hamid Sharifi, Nefsu Awoke, Manasi Kumar, Carlos Magis-Rodriguez, Muhammad Shahdaat Bin Sayeed, Maheswar Satpathy, Andrew Blinov, Fiseha Wadilo Wada, Babak Moazen, Hadi Hassankhani, Jae Il Shin, Sanjay Basu, Aziz Eftekhari, Masood Ali Shaikh, Arya Haj-Mirzaian, Laura Dwyer-Lindgren, Haileab Fekadu Wolde, Habtamu Abera Areri, Krista M. Steuben, Lalit Dandona, Keivan Ahmadi, Aso Mohammad Darwesh, Belete Kassa, Keyghobad Ghadiri, Arash Ziapour, Raquel Crider, Alaa Badawi, Tahvi Frank, Amir Hasanzadeh, Marcel Yotebieng, Jemal Abdu Mohammed, Marcos Roberto Tovani-Palone, Emmanuel Peprah, Mekonnen Sisay, Ghulam Mustafa, Oghenowede Eyawo, Seyed Sina Naghibi Irvani, Vahid Alipour, Reza Malekzadeh, Bereket Duko Adema, Direslgne Misker Abyu, Tinuke O Olagunju, Olatunde Aremu, Roghayeh Mohammadibakhsh, Linh Phuong Doan, Mihiretu Kebede, Aman Yesuf Endries, Amira Shaheen, Belete Biadgo, Ali Rostami, Marwa Rashad Salem, Getnet Gedefaw, Stein Emil Vollset, Gurudatta Naik, Veincent Christian Filipino Pepito, Duduzile Ndwandwe, Melese Abate Reta, Aleksandra Barac, Simon I. Hay, Vishnu Renjith, Seifadin Ahmed Shallo, Kebede Deribe, Malihe Nourollahpour Shiadeh, Tewodros Eshete Wonde, Nuno Taveira, Mohammad Ali Sahraian, Marilita M Moschos, Masoud Foroutan, Alebachew Fasil Ashagre, Félix Carvalho, Yun Jin Kim, Farid Najafi, Tukur Dahiru, Chinwe Juliana Iwu, Dharmesh Kumar Lal, Varshil Mehta, Molly R Nixon, Nahla Anber, Seyedmojtaba Seyedmousavi, Mohammad Rabiee, Nauman Khalid, Felix Akpojene Ogbo, Anselm Okoro, Sanjay Zodpey, Birhanu Geta, Kebede Embaye Gezae, Shirin Djalalinia, Amanda E. Smith, Naser Mohammad Gholi Mezerji, Arvin Haj-Mirzaian, Birkneh Tilahun Tadesse, Yared Belete Belay, Saeed Amini, Ziad A. Memish, Stephanie M. Topp, Eduarda Fernandes, Mohammed Suleiman Obsa, Junaid Khan, Andem Effiong, Jane Jean-Hee Lee, Emmanuel Ngassa Laurent Mayenga, Abdallah M. Samy, Anton Sokhan, Rajesh Sagar, Dawit Zewdu Wondafrash, Atalay Goshu Muluneh, Birhan Alemnew, Asmamaw Demis, Samer Hamidi, Getnet Mengistu, Michael Tamene Haile, Gbenga A. Kayode, Huyen Phuc Do, Yoshan Moodley, Mehdi Hosseinzadeh, Moslem Mohammadi, Dayane Gabriele Alves Silveira, Samad Azari, Gulfaraz Khan, Maysaa El Sayed Zaki, Emmanuel Ankrah Odame, Anusha Ganapati Bhat, Louisa Degenhardt, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Sadaf G. Sepanlou, Ai Koyanagi, Ebrahim M Yimer, Maryam Adabi, Javad Nazari, Saravanan Muthupandian, Evanson Z. Sambala, Salman Khazaei, Nelson Alvis-Guzman, Hunduma Amensisa Bojia, Anwar Rafay, Richard Ofori-Asenso, Ehsan Ahmadpour, José Neves, Desalegn Tadese Mengistu, Shafiu Mohammed, Hamid Yimam Hassen, Navid Rabiee, Dinh-Toi Chu, Zoubida Zaidi, Sajjad Ur Rahman, Tilahun Belete Mossie, Olanrewaju Oladimeji, Krittika Bhattacharyya, Gebrekiros Gebremichael Meles, Hassan Magdy Abd El Razek, Stanislav S. Otstavnov, Shaimaa I. El-Jaafary, Habtamu Temesgen, Lolemo Kelbiso Hanfore, Milad Mohammadoo-Khorasani, Muktar Beshir Ahmed, Karzan Abdulmuhsin Mohammad, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Spencer L. James, Bhaskaran Unnikrishnan, Morteza Shamsizadeh, Kenean Getaneh Tlaye, Ziad El-Khatib, Zohreh Anbari, Aisha Elsharkawy, Nancy Fullman, Cuong Tat Nguyen, Chalachew Genet Akal, Chabila C Mapoma, Amir H. Pakpour, Rafael Alves Guimarães, Jalal Arabloo, Eyasu Ejeta Duken, Hailay Abrha Gesesew, Koku Sisay Tamirat, Batool Fatima, Tissa Wijeratne, Addisu Gize Yeshanew, Benn Sartorius, Kathryn H. Jacobsen, Abdullah T Khoja, Morenike Oluwatoyin Folayan, Phetole Walter Mahasha, Takeshi Fukumoto, Maryam Moossavi, Bahram Mohajer, Ravi Prakash Jha, Oladimeji Adebayo, Farshad Farzadfar, Francisco Rogerlândio Martins-Melo, Solomon Sisay, Ensiyeh Jenabi, Bach Xuan Tran, Eleonora Dubljanin, Farnam Mohebi, Jasvinder A. Singh, Barthelemy Kuate Defo, Masoud Behzadifar, Yousef Mohammad, Feleke Mekonnen Demeke, G Anil Kumar, Jan-Walter De Neve, Afshin Zarghi, Hosein Shabaninejad, Trang Huyen Nguyen, Degena Bahrey Tadesse, Monika Sawhney, Eyal Oren, Bayu Begashaw Bekele, Saeed Safari, Salvatore Rubino, Kenji Shibuya, Daniel Diaz, Salman Rawaf, Demelash Woldeyohannes Handiso, Ted R. Miller, Fares Alahdab, Vafa Rahimi-Movaghar, Seyyed Meysam Mousavi, Sonali Kochhar, Azeem Majeed, Till Bärnighausen, Zubair Kabir, Devasahayam J. Christopher, Malede Mequanent Sisay, Adane Teshome Kefale, Shishay Wahdey Tekelemedhin, Tsegaye Lolaso Lenjebo, Yousef Khader, Ali Bijani, Kebreab Paulos, Hagazi Gebre Meles, Euripide Frinel G Arthur Avokpaho, Alireza Ahmadi, Tuomo J. Meretoja, Padukudru Anand Mahesh, Florian Fischer, Mulugeta Melku, Fakher Rahim, Manisha Dubey, Cheru Tesema Leshargie, Vijay Kumar Chattu, Yasir Waheed, Mehdi Noroozi, Austin Carter, Chuanhua Yu, Ronny Westerman, Andualem Henok, Yousef Veisani, Sharath Burugina Nagaraja, Reta Tsegaye Gayesa, Mina Anjomshoa, Andrew T Olagunju, Getachew Mullu Kassa, Belayneh K Gelaw, Jost B. Jonas, Ejaz Ahmad Khan, Adugnaw Berhane, Chukwudi A Nnaji, Daniel Asmelash, Tomislav Mestrovic, Addisu Melese, Stephen S Lim, Yahya Salimi, Chi Linh Hoang, Christopher J L Murray, Mohammad Sadegh Rezai, Bruno F. Sunguya, Herbert C. Duber, Senad Handanagic, Ashish Awasthi, Anthony Masaka, Megha Arora, Sergey Soshnikov, Sangram Kishor Patel, Kwaku Oppong Asante, Haidong Wang, Rajendra Kadel, Bryan L. Sykes, Lucero Cahuana-Hurtado, Afarin Rahimi-Movaghar, Deepa Jahagirdar, Manaye Yihune Teshale, Samantha Leigh Larson, Martin Amogre Ayanore, Sergey K Vladimirov, Gebre Teklemariam Demoz, Fisaha Haile Tesfay, Mohsen Naghavi, Chhabi Lal Ranabhat, Walter Mendoza, Kassawmar Angaw Bogale, Khanh Bao Tran, Berhanu Yazew Wondmagegn, Carlos Miguel Rios González, Ahmad Daryani, Ali H. Mokdad, Julio Cesar Campuzano Rincon, Alemayehu Toma Mena, Navid Manafi, Andre Pascal Kengne, Victor Adekanmbi, Netsanet Fentahun, Olalekan A. Uthman, Desmond Kuupiel, Olatunji O. Adetokunboh, Zahid A Butt, Mohamed Hsairi, Bulat Idrisov, Ranjani Somayaji, Dan J. Stein, Molly H Biehl, Samuel B. Albertson, Laith J. Abu-Raddad, Parvaiz A Koul, Elias Merdassa Roro, Marek Majdan, Dereje Bayissa Demissie, Emilie R Maddison, Naohiro Yonemoto, Ahmad Ghashghaee, Young-Ho Khang, Solomon Olum, Hmwe H Kyu, Amir Radfar, Dirk Douwes-Schultz, Elham Ahmadian, Graduate School, AII - Infectious diseases, APH - Global Health, APH - Methodology, GBD 2017 HIV Collaborators, Clinicum, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, Department of Oncology, Adema, Bereket Duko, GBD 2017 HIV collaborators, and Public Health
Subjects: 0301 basic medicine, A300 Clinical Medicine, Epidemiology, CITIES, HIV Infections, Mortalities, Global Burden of Disease, 0302 clinical medicine, Risk Factors, Seroepidemiologic Studies, Cause of Death, Prevalences, Prevalence, Global health, LIFE EXPECTANCY, 030212 general & internal medicine, 10. No inequality, education.field_of_study, CHALLENGES, Incidence, Incidence (epidemiology), Incidences, 1. No poverty, MEN, 3. Good health, AIDS, Infectious Diseases, Life Sciences & Biomedicine, GBD 2017 HIV collaborators, medicine.medical_specialty, Forecasts, Immunology, Population, Cause of Death/trends, UNITED-STATES, Context (language use), History, 21st Century, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Acquired immunodeficiency syndrome (AIDS), Virology, Environmental health, medicine, Humans, education, Global Burden of Disease/trends, Estimation, Science & Technology, SEX-SPECIFIC MORTALITY, business.industry, DISABILITY, Public health, HIV, coverage of antiretroviral therapy, History, 20th Century, medicine.disease, mortality, R1, PREVENTION, TRENDS, 030112 virology, HIV Infections/mortality, 3121 General medicine, internal medicine and other clinical medicine, Life expectancy, Human medicine, business, Forecasting
Abstract: BACKGROUND: Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories.METHODS: We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package-a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections.FINDINGS: Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87-2·04) and has since decreased to 0·95 million deaths (0·91-1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79-3·67) and since then have gradually decreased to 1·94 million (1·63-2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8-39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets.INTERPRETATION: Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact.FUNDING: Bill & Melinda Gates Foundation, National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH.
Published: 2019

7. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015

Author: Haidong, Wang, Mohsen, Naghavi, Christine, Allen, Ryan M, Barber Zulfi, qar A, Bhutta, Austin, Carter, Daniel C, Casey Fiona, J Charlson, Alan Zian, Chen Matthew, M Coates, Megan, Coggeshall, Lalit, Dandona, Daniel J, Dicker Holly, E Erskine, Alize J, Ferrari, Christina, Fitzmaurice, Kyle, Foreman, Mohammad H, Forouzanfar Maya, S Fraser, Nancy, Fullman, Peter W, Gething Ellen, M Goldberg, Nicholas, Graetz, Juanita A, Haagsma Simon, I Hay, Chantal, Huynh, Catherine O, Johnson Nicholas, J Kassebaum, Yohannes, Kinfu, Xie Rachel, Kulikoff, Michael, Kutz, Hmwe H, Kyu Heidi, J Larson, Janni, Leung, Xiaofeng, Liang, Stephen S, Lim, Margaret, Lind, Rafael, Lozano, Neal, Marquez, George A, Mensah, Joe, Mikesell, Ali H, Mokdad Meghan, D Mooney, Grant, Nguyen, Elaine, Nsoesie, David M, Pigott, Christine, Pinho, Gregory A, Roth Joshua, A Salomon, Logan, Sandar, Naris, Silpakit, Amber, Sligar, Reed J, D Sorensen, Jeff rey, Stanaway, Caitlyn, Steiner, Stephanie, Teeple, Bernadette A, Thomas, Christopher, Troeger, Amelia, VanderZanden, Stein Emil, Vollset, Valentine, Wanga, Harvey A, Whiteford, Timothy, Wolock, Leo, Zoeckler, Kalkidan Hassen, Abate, Cristiana, Abbafati, Kaja M, Abbas, Foad, Abd-Allah, Semaw Ferede, Abera Daisy, M X, Abreu Laith, J Abu-Raddad, Gebre Yitayih, Abyu, Tom, Achoki, Ademola Lukman, Adelekan Zanfi, na Ademi, Arsène Kouablan, Adou José, C Adsuar, Kossivi Agbelenko, Afanvi, Ashkan, Afshin, Emilie Elisabet, Agardh, Arnav, Agarwal, Anurag, Agrawal, Aliasghar Ahmad, Kiadaliri Oluremi, N Ajala, Ali Shafqat, Akanda Rufus, Olusola Akinyemi, Tomi F, Akinyemiju, Nadia, Akseer, Faris Hasan, Al Lami, Samer, Alabed, Ziyad, Al-Aly, Khurshid, Alam, Noore K, M Alam, Deena, Alasfoor, Saleh Fahed, Aldhahri Robert, William Aldridge, Miguel Angel, Alegretti Alicia, V Aleman, Zewdie Aderaw, Alemu Lily, T Alexander, Samia, Alhabib, Raghib, Ali, Ala’a, Alkerwi, François, Alla, Peter, Allebeck, Rajaa, Al-Raddadi, Ubai, Alsharif, Khalid A, Altirkawi Elena, Alvarez Martin, Nelson, Alvis-Guzman, Azmeraw T, Amare Adeladza, Kofi Amegah, Emmanuel A, Ameh, Heresh, Amini, Walid, Ammar, Stephen Marc, Amrock Hjalte, H Andersen, Benjamin O, Anderson Gregory, M Anderson, Carl Abelardo, T Antonio, Atsede Fantahun, Aregay, Johan, Ärnlöv, Valentina S, Arsic Arsenijevic, Al, Artaman, Hamid, Asayesh, Rana Jawad, Asghar, Suleman, Atique, Euripide Frinel, G Arthur, Avokpaho, Ashish, Awasthi, Peter, Azzopardi, Umar, Bacha, Alaa, Badawi, Maria C, Bahit, Kalpana, Balakrishnan, Amitava, Banerjee, Aleksandra, Barac, Suzanne L, Barker-Collo, Till, Bärnighausen, Lars, Barregard, Lope H, Barrero, Arindam, Basu, Sanjay, Basu, Yibeltal Tebekaw, Bayou, Shahrzad, Bazargan-Hejazi, Justin, Beardsley, Neeraj, Bedi, Ettore, Beghi, Haileeyesus Adamu, Belay, Brent, Bell, Michelle L, Bell Aminu, K Bello, Derrick A, Bennett Isabela, M Bensenor, Adugnaw, Berhane, Eduardo, Bernabé, Balem Demtsu, Betsu Addisu, Shunu Beyene, Neeraj, Bhala, Ashish, Bhalla, Sibhatu, Biadgilign, Boris, Bikbov, Aref A, Bin Abdulhak, Brian J, Biroscak, Stan, Biryukov, Espen, Bjertness, Jed D, Blore Christopher, D Blosser, Megan A, Bohensky, Rohan, Borschmann, Dipan, Bose, Rupert R, A Bourne, Michael, Brainin, Carol E, G Brayne, Alexandra, Brazinova, Nicholas J, K Breitborde, Hermann, Brenner, Jerry D, Brewer, Alexandria, Brown, Jonathan, Brown, Traolach S, Brugha Geoff, rey Colin, Buckle Zahid, A Butt, Bianca, Calabria, Ismael Ricardo, Campos-Nonato Julio, Cesar Campuzano, Jonathan R, Carapetis, Rosario, Cárdenas, David O, Carpenter Juan, Jesus Carrero, Carlos A, Castañeda-Orjuela Jacqueline, Castillo Rivas, Ferrán, Catalá-López, Fiorella, Cavalleri, Kelly, Cercy, Jorge, Cerda, Wanqing, Chen, Adrienne, Chew, Peggy Pei-Chia, Chiang, Mirriam, Chibalabala, Chioma Ezinne, Chibueze, Odgerel, Chimed-Ochir, Vesper Hichilombwe, Chisumpa Jee-Young, Jasmine Choi, Rajiv, Chowdhury, Hanne, Christensen, Devasahayam Jesudas, Christopher Liliana, G Ciobanu, Cirillo Massimo, Aaron J, Cohen, Valentina, Colistro, Mercedes, Colomar, Samantha M, Colquhoun, Cyrus, Cooper, Leslie Trumbull, Cooper, Monica, Cortinovis, Benjamin C, Cowie John, A Crump, James, Damsere-Derry, Hadi, Danawi, Rakhi, Dandona, Farah, Daoud, Sarah C, Darby Paul, I Dargan, José das, Neves, Gail, Davey, Adrian C, Davis Dragos, V Davitoiu, E Filipa, de Castro, Pieter de, Jager Diego, De Leo, Louisa, Degenhardt, Robert P, Dellavalle, Kebede, Deribe, Amare, Deribew, Samath D, Dharmaratne Preet, K Dhillon, Cesar, Diaz-Torné, Eric L, Ding Kadine, Priscila Bender, dos Santos, Edem, Dossou, Tim R, Driscoll, Leilei, Duan, Manisha, Dubey, Bruce Bartholow, Duncan Richard, G Ellenbogen, Christian Lycke, Ellingsen, Iqbal, Elyazar, Aman Yesuf, Endries Sergey, Petrovich Ermakov, Babak, Eshrati, Alireza, Esteghamati, Kara, Estep, Imad D, A Faghmous, Saman, Fahimi, Emerito Jose, Aquino Faraon, Talha A, Farid Carla, Sofi a, e Sa, Farinha, André, Faro, Maryam S, Farvid, Farshad, Farzadfar, Valery L, Feigin, Seyed-Mohammad, 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Jae-Hyun, Parry, Charles D, Parsaeian, Mahboubeh, Caicedo, Angel J Paternina, Patten, Scott B, Patton, George C, Paul, Vinod K, Pearce, Neil, Pedro, João Mário, Stokic, Ljiljana Pejin, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Piel, Frédéric B, Pillay, Julian David, Plass, Dietrich, Platts-Mills, James A, Polinder, Suzanne, Pope, C Arden, Popova, Svetlana, Poulton, Richie G, Pourmalek, Farshad, Prabhakaran, Dorairaj, Qorbani, Mostafa, Quame-Amaglo, Justice, Quistberg, D Alex, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajavi, Zhale, Rajsic, Sasa, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M, Ranabhat, Chhabi L, Rangaswamy, Thara, Rao, Puja, Rao, Sowmya R, Refaat, Amany H, Rehm, Jürgen, Reitsma, Marissa B, Remuzzi, Giuseppe, Resnikoff, Serge, Ribeiro, Antonio L, Ricci, Stefano, Blancas, Maria Jesus Rio, Roberts, Bayard, Roca, Anna, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Rothenbacher, Dietrich, Roy, Ambuj, Roy, Nawal K, Ruhago, George Mugambage, Sagar, Rajesh, Saha, Sukanta, Sahathevan, Ramesh, Saleh, Muhammad Muhammad, Sanabria, Juan R, Sanchez-Niño, Maria Dolore, Sanchez-Riera, Lidia, Santos, Itamar S, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Schaub, Michael P, Schmidt, Maria Inê, Schneider, Ione J C, Schöttker, Ben, Schutte, Aletta E, Schwebel, David C, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya A, Shaddick, Gavin, Shaheen, Amira, Shahraz, Saeid, Shaikh, Masood Ali, Shakh-Nazarova, Marina, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Shen, Ziyan, Shepard, Donald S, Sheth, Kevin N, Shetty, Balakrishna P, Shi, Peilin, Shibuya, Kenji, Shin, Min-Jeong, Shiri, Rahman, Shiue, Ivy, Shrime, Mark G, Sigfusdottir, Inga Dora, Silberberg, Donald H, Silva, Diego Augusto Santo, Silveira, Dayane Gabriele Alve, Silverberg, Jonathan I, Simard, Edgar P, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Singh, Virendra, Soneji, Samir, Søreide, Kjetil, Soriano, Joan B, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stathopoulou, Vasiliki, Stein, Dan J, Stein, Murray B, Stranges, Saverio, Stroumpoulis, Konstantino, Sunguya, Bruno F, Sur, Patrick, Swaminathan, Soumya, Sykes, Bryan L, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tabb, Karen M, Takahashi, Ken, Takala, Jukka S, Talongwa, Roberto Tchio, Tandon, Nikhil, Tavakkoli, Mohammad, Taye, Bineyam, Taylor, Hugh R, Ao, Braden J Te, Tedla, Bemnet Amare, Tefera, Worku Mekonnen, Have, Margreet Ten, Terkawi, Abdullah Sulieman, Tesfay, Fisaha Haile, Tessema, Gizachew Assefa, Thomson, Alan J, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tirschwell, David L, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Towbin, Jeffrey Allen, Traebert, Jefferson, Tran, Bach Xuan, Truelsen, Thoma, Trujillo, Ulise, Tura, Abera Kenay, Tuzcu, Emin Murat, Uchendu, Uche S, Ukwaja, Kingsley N, Undurraga, Eduardo A, Uthman, Olalekan A, Dingenen, Rita Van, van Donkelaar, Aaron, Vasankari, Tommi, Vasconcelos, Ana Maria Nogale, Venketasubramanian, Narayanaswamy, Vidavalur, Ramesh, Vijayakumar, Lakshmi, Villalpando, Salvador, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Wagner, Joseph A, Wagner, Gregory R, Wallin, Mitchell T, Wang, Linhong, Watkins, David A, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Westerman, Ronny, White, Richard A, Wijeratne, Tissa, Wilkinson, James D, Williams, Hywel C, Wiysonge, Charles Shey, Woldeyohannes, Solomon Meseret, Wolfe, Charles D A, Won, Sungho, Wong, John Q, Woolf, Anthony D, Xavier, Deni, Xiao, Qingyang, Xu, Gelin, Yakob, Bereket, Yalew, Ayalnesh Zemene, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Ye, Pengpeng, Yebyo, Henock Gebremedhin, Yip, Paul, Yirsaw, Biruck Desalegn, Yonemoto, Naohiro, Yonga, Gerald, Younis, Mustafa Z, Yu, Shicheng, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zannad, Faiez, Zavala, Diego E, Zeeb, Hajo, Zeleke, Berihun M, Zhang, Hao, Zodpey, Sanjay, Zonies, David, Zuhlke, Liesl Joanna, Vos, Theo, Lopez, Alan D, and Murray, Christopher J L
Subjects: VITAL-STATISTICS, INTEGRATED APPROACH, ECONOMIC-DEVELOPMENT, DEVELOPMENT ASSISTANCE, UNITED-STATES, Global Health, Communicable Disease, Communicable Diseases, cause of death, Medicine, General & Internal, Life Expectancy, General & Internal Medicine, Humans, Mortality, Medicine(all), Science & Technology, Mortality, Premature, Medicine (all), EPIDEMIOLOGIC TRANSITION, GBD 2015 Mortality and Causes of Death Collaborators, CIVIL REGISTRATION, Public Health, Global Health, Social Medicine and Epidemiology, Articles, 11 Medical And Health Sciences, ROAD TRAFFIC INJURIES, ALZHEIMERS-DISEASE, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, VERBAL AUTOPSY, Life Sciences & Biomedicine, Human
Abstract: Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.
Published: 2016

8. Injury-related gaining momentum as external causes of deaths in Ethiopian health and demographic surveillance sites: evidence from verbal autopsy study

Author: Gessessew Bugssa Hailu, Nega Assefa, Kassahun Alemu Gelaye, Desalew Zelalem, Wubegzier Mekonnen, Fasil Tessema, Gashaw Andargie Biks, Semaw Ferede Abera, Mekdes Kondal, Mamo Wubshet Terefe, Firehywot Eshetu, Befikadu Tariku, Mulumebet Abera, Mitike Molla Sisay, Yoseph Fekadu, Mesfin Kote, Etsehiwot Tilahun, Alemseged Aregay Gebru, Yihunie Lakew, and Melkamu Dedefo
Subjects: Male, verbal autopsy, Poison control, Suicide prevention, Occupational safety and health, 0302 clinical medicine, Cause of Death, Medicine, 030212 general & internal medicine, Child, lcsh:Public aspects of medicine, Health Policy, Human factors and ergonomics, Middle Aged, Research Design, Child, Preschool, Population Surveillance, Female, Original Article, Autopsy, Adult, Adolescent, Injury control, Article, Young Adult, 03 medical and health sciences, Age Distribution, Momentum (finance), Environmental health, Injury prevention, Humans, assault, suicide, Aged, Drowning, business.industry, Infant, Newborn, Public Health, Environmental and Occupational Health, Infant, lcsh:RA1-1270, 030208 emergency & critical care medicine, mortality, Verbal autopsy, Socioeconomic Factors, external causes, Accidents, transport, Wounds and Injuries, Ethiopia, business
Abstract: Background: In Ethiopia, though all kinds of mortality due to external causes are an important component of overall mortality often not counted or documented on an individual basis. Objective: The aim of this study was to describe the patterns of mortality from external causes using verbal autopsy (VA) method at the Ethiopian HDSS Network sites. Methods: All deaths at Ethiopian HDSS sites were routinely registered and followed up with VA interviews. The VA forms comprised deaths up to 28 days, between four weeks and 14 years and 15 years and above. The cause of a death was ascertained based on an interview with next of families or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history and circumstances preceding death after 45 days mourning period. Two physician assigned probable causes of death as underlying, immediate and contributing factors independently using information in VA forms based on the WHO ICD-10 and VA code system. Disagreed cases sent to third physician for independent review and diagnosis. The final cause of death considered when two of the three physicians assigned underlying cause of death; otherwise, labeled as undetermined. Results: In the period from 2009 to 2013, a total of 9719 deaths were registered. Of the total deaths, 623 (6.4%) were from external causes. Of these, accidental drowning and submersion, 136 (21.8%), accidental fall, 113 (18.1%) and transport-related accidents, 112 (18.0%) were the topmost three leading external causes of deaths. About 436 (70.0%) of deaths were from the age group above 15 years old. Drowning and submersion and transport-related accidents were high in age group between 5 and 14 years old. Conclusion: In this study, external causes of death are significant public health problems and require attention as one of prior health agenda.
Published: 2018

9. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015

Author: Barber R. M. a, Fullman N. a, Sorensen R. J. D. a, Bollyky T. f, McKee M. i, Nolte E. g, Abajobir A. A. j, Abate K. H. n, Abbafati C. o, Abbas K. M. p, Abd-Allah F. q, Abdulle A. M. r, Abdurahman, A. A. ac, Abera, S. F. ad, ah Abraham, B. ai, Abreha, G. F. ad, Adane, K. af, Adelekan, A. L. aj, ak Adetifa, I. M. O. i al, Afshin A. a, Agarwal, A. ao, ap Agarwal, S. K. aq, S. ar, Agrawal, A. as, Ahmad Kiadaliri, A. au, Ahmadi, A. ax, Ahmed, K. Y. ay, Ahmed M. B. m, Akinyemi, R. O. ak, az Akinyemiju, T. F. ba, Akseer, N. am, bc Al-Aly, Z. bd, Alam, K. be, bf dn, dq Alam, N. bg, S. S. bh, Alemu, Z. A. ay, Alene, K. A. bi, Alexander L. a, Ali, R. bm, S. D. bn, bo bp, Alizadeh-Navaei, R. bq, Alkerwi, A. bs, Alla, F. bt, Allebeck, P. bu, Allen C. a, Al-Raddadi, R. cb, Alsharif, U. cd, Altirkawi, K. A. ce, Alvarez Martin, E. cf, Alvis-Guzman, N. cg, Amare, A. T. ch, cj gr, Amini E. s, t wy, Ammar, W. cl, Amo-Adjei, J. cm, cn Amoako, Y. A. co, Anderson B. O. e, Androudi, S. cq, Ansari, H. cr, Ansha, M. G. cs, Antonio, C. A. T. ct, Ärnlöv, J. bv, cv Artaman, A. cw, Asayesh, H. cx, Assadi, R. cy, Astatkie, A. cz, Atey, T. M. ag, Atique, S. da, Atnafu, N. T. dc, dd Atre, S. R. de, Avila-Burgos, L. df, Avokpaho, E. F. G. A. dg, Ayala Quintanilla, B. P. di, dj Awasthi, A. dk, Ayele, N. N. dl, Azzopardi, P. dm, dn dr, Ba Saleem, H. O. dt, Bärnighausen, T. du, dz ea, Bacha, U. eb, Badawi, A. an, ec Banerjee, A. ed, Barac, A. eg, Barboza, M. A. ej, ek Barker-Collo, S. L. el, Barrero, L. H. en, Basu, S. eo, Baune, B. T. ch, gr Baye, K. eq, Bayou, Y. T. er, Bazargan-Hejazi, S. es, et Bedi, N. eu, Beghi, E. ev, Béjot, Y. ew, Bello, A. K. ex, Bennett, D. A. bm, Bensenor, I. M. ez, Berhane, A. fa, Bernabé, E. fd, Bernal, O. A. fe, Beyene, A. S. ff, ki Beyene, T. J. eq, fi Bhutta, Z. A. bc, fj Biadgilign, S. fk, Bikbov, B. fl, Birlik, S. M. fm, Birungi, C. ef, Biryukov S. a, Bisanzio, D. bk, Bizuayehu, H. M. fn, Bose, D. fo, Brainin, M. fp, Brauer M. a, fq Brazinova, A. fr, fs Breitborde, N. J. K. fu, Brenner, H. fw, Butt, Z. A. fx, Cárdenas, R. fy, Cahuana-Hurtado, Campos-Nonato, I. R. df, dx Car, J. fz, Carrero, J. J. bw, Casey D. a, Caso, V. ga, Castañeda-Orjuela, C. A. gb, Castillo Rivas, J. gd, ge Catalá-López, F. gf, gg Cecilio, P. gh, Cercy K. a, Charlson F. J. a, j gi, Chen A. Z. a, Chew A. a, Chibalabala, M. gj, Chibueze, C. E. gk, Chisumpa, V. H. gl, gm Chitheer, A. A. gn, Chowdhury, R. go, Christensen, H. gp, Christopher, D. J. gq, Ciobanu, L. G. ci, Cirillo, M. gs, Coggeshall M. S. a, Cooper, L. T. gt, Cortinovis, M. fl, Crump, J. A. gu, Dalal, K. gv, Danawi, H. gw, Dandona L. a, gy Dandona, R. a gy, Dargan, P. I. gz, Das Neves, J. ha, hb Davey, G. hd, Davitoiu, D. V. he, Davletov, K. hf, De Leo, D. hh, Del Gobbo, L. C. eo, Del Pozo-Cruz, B. em, Dellavalle, R. P. hi, Deribe, K. ep, hj Deribew, A. al, Des Jarlais, D. C. hk, hl Dey, S. hm, Dharmaratne, S. D. hn, Dicker D. a, Ding, E. L. dx, Dokova, K. ho, Dorsey, E. R. hp, Doyle, K. E. hq, hr Dubey, M. hs, Ehrenkranz R. a, Ellingsen, C. L. hu, Elyazar, I. hv, Enayati, A. hw, Ermakov, S. P. hx, hy Eshrati, B. hz, ia Esteghamati, A. t wz, Estep K. a, Fürst T. h, ic ie, Faghmous I. D. A. i, Fanuel, F. B. B. cz, if Faraon, E. J. A. cu, ig Farid, T. A. ih, Farinha, C. S. E. S. ii, ij Faro, A. ik, Farvid, M. S. dw, il Farzadfar, F. u xa, Feigin, V. L. im, Feigl, A. B. du, Fereshtehnejad, S. -M. bx, Fernandes, J. G. in, J. C. io, Feyissa, T. R. ip, Fischer, F. iq, Fitzmaurice C. a, b ir, Fleming T. D. a, Foigt, N. is, Foreman K. J. a, ib Forouzanfar, M. H. it, Franklin, R. C. iu, Frostad J. a, Ghiwot T. T. n, Gakidou E. a, Gambashidze, K. iv, Gamkrelidze, A. iv, Gao, W. ix, Garcia-Basteiro, A. L. iy, iz Gebre, T. ja, Gebremedhin A. T. n, jb Gebremichael, M. W. ag, Gebru, A. A. ag, jc Gelaye, A. A. jd, Geleijnse, J. M. fh, Genova-Maleras, R. je, jf Gibney, K. B. jg, Giref, A. Z. eq, Gishu, M. D. fg, jh Giussani, G. ev, Godwin W. W. a, Gold A. a, Goldberg E. M. a, Gona, P. N. ji, Goodridge, A. jj, Gopalani, S. V. jk, Goto, A. jl, Graetz N. a, Greaves, F. ib, jm Griswold, M. a Guban, P. I. jn, Gugnani, H. C. jo, Gupta, P. C. jp, R. jq, R. jr, T. js, V. jt, Habtewold, T. D. fb, jv Hafezi-Nejad, N. t xb, Haile, D. eq, Hailu, A. D. ep, jx Hailu, G. B. ag, jc Hakuzimana, A. jz, ka Hamadeh, R. R. kb, Hambisa, M. T. ff, Hamidi, S. kc, Hammami, M. kd, Hankey, G. J. ke, kf kg, Hao, Y. kh, Harb, H. L. cl, Hareri, H. A. eq, Haro, J. M. mw, Hassanvand M. S. w, xc Havmoeller, R. ca, Hay, R. J. fd, kk Hay, S. I. a bl, Hendrie, D. kl, Heredia-Pi, I. B. df, Hoek, H. W. ju, km Horino, M. ko, Horita, N. kp, Hosgood, H. D. kq, Htet, A. S. kr, ks Hu, G. kt, Huang, H. ku, J. J. kv, Huntley B. M. a, Huynh C. a, Iburg, K. M. kw, Ileanu, B. V. kx, Innos, K. ky, Irenso, A. A. fg, kj Jahanmehr, N. kz, Jakovljevic, M. B. lb, James, P. dv, S. L. lc, Javanbakht, M. ld, Jayaraman, S. 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Mohammad, Yahya, Saeedi, Saeid, Safiri, Rajesh, Sagar, Mohammad, Ali, Sahraian, Muhammad, Muhammad, Saleh, Joshua, Salomon, Abdallah, Samy, Juan, Ramon, Sanabria, Maria, Dolores, Sanchez, Niño, Logan, Sandar, Itamar, Santo, João, Vasco, Santos, Milena, Santric, Milicevic, Rodrigo, Sarmiento Suarez, Benn, Sartoriu, Maheswar, Satpathy, Miloje, Savic, Monika, Sawhney, Mete, Saylan, Ben, Schöttker, Aletta, Schutte, David, Schwebel, Soraya, Seedat, Abdulbasit, Musa, Seid, Canaan, Negash, Seifu, Sadaf, Sepanlou, Berrin, Serdar, Edson, Servan Mori, Tesfaye, Setegn, Katya, Anne, Shackelford, Amira, Shaheen, Saeid, Shahraz, Masood, Ali, Shaikh, Marina, Shakh Nazarova, Mansour, Shamsipour, Sheikh, Mohammed, Shariful, Islam, Jayendra, Sharma, Rajesh, Sharma, Jun, She, Sara, Sheikhbahaei, Jiabin, Shen, Peilin, Shi, Mika, Shigematsu, Min Jeong, Shin, Rahman, Shiri, Haitham, Shoman, Mark, Shrime, Ephrem, Lejore, Sibamo, Sibamo, Inga, Dora, Sigfusdottir, Diego, Augusto, Santo, Silva, Dayane, Gabriele, Alve, Silveira, Shireen, Sindi, Abhishek, Singh, Jasvinder, Singh, Om, Prakash, Singh, Prashant, Kumar, Singh, Virendra, Singh, Abiy, Hiruye, Sinke, Aklilu, Endalamaw, Sinshaw, Vegard, Skirbekk, Karen, Sliwa, Alison, Smith, Eugene, Sobngwi, Samir, Soneji, Joan, Soriano, Tatiane, Cristina, Moraes, Sousa, Luciano, Sposato, Chandrashekhar, Sreeramareddy, Vasiliki, Stathopoulou, Nicholas, Steel, Caitlyn, Steiner, Sabine, Steinke, Mark, Andrew, Stokes, Saverio, Strange, Mark, Strong, Konstantinos, Stroumpouli, Lela, Sturua, Muawiyyah, Babale, Sufiyan, Rizwan, Abdulkader, Suliankatchi, Jiandong, Sun, Patrick, Sur, Soumya, Swaminathan, Bryan, Syke, Rafael, Tabarés Seisdedo, Karen, Tabb, Getachew, Redae, Taffere, Roberto, Tchio, Talongwa, Musharaf, Tarajia, Mohammad, Tavakkoli, Nuno, Taveira, Stephanie, Teeple, Teketo, Kassaw, Tegegne, Arash, Tehrani Banihashemi, Tesfalidet, Tekelab, Dejen, Yemane, Tekle, Girma, Temam, Shifa, Abdullah, Sulieman, Terkawi, Azeb, Gebresilassie, Tesema, Js, Thakur, Alan, Thomson, Taavi, Tillmann, Tenaw, Yimer, Tiruye, Ruoyan, Tobe Gai, Marcello, Tonelli, Roman, Topor Madry, Miguel, Tortajada, Christopher, Troeger, Thomas, Truelsen, Abera, Kenay, Tura, Uche, Uchendu, Kingsley, N, Ukwaja, Eduardo, Undurraga, Chigozie, Jesse, Uneke, Olalekan, Uthman, Job, F, Van, Boven, Rita, Van, Dingenen, Santosh, Varughese, Tommi, Vasankari, Narayanaswamy, Venketasubramanian, Francesco, Violante, Sergey, Vladimirov, Vasiliy, Victorovich, Vlassov, Stein, Emil, Vollset, Theo, Vo, Joseph, Wagner, Tolassa, Wakayo, Stephen, Waller, Judd, Walson, Haidong, Wang, Yuan Pang, Wang, David, Watkin, Elisabete, Weiderpa, Robert, Weintraub, Chi Pang, Wen, Andrea, Werdecker, Joshua, Wesana, Ronny, Westerman, Harvey, Whiteford, James, Wilkinson, Charles, Shey, Wiysonge, Belete, Getahun, Woldeye, Charles, Wolfe, Sungho, Won, Abdulhalik, Workicho, Shimelash, Bitew, Workie, Mamo, Wubshet, Denis, Xavier, Gelin, Xu, Ajit, Kumar, Yadav, Mohsen, Yaghoubi, Bereket, Yakob, Lijing, Yan, Yuichiro, Yano, Mehdi, Yaseri, Hassen, Hamid, Yimam, Paul, Yip, Naohiro, Yonemoto, Seok Jun, Yoon, Mustafa, Youni, Chuanhua, Yu, Zoubida, Zaidi, Maysaa, El, Sayed, Zaki, Carlos, Zambrana Torrelio, Tomas, Zapata, Zerihun, Menlkalew, Zenebe, Sanjay, Zodpey, Leo, Zoeckler, Liesl, Joanna, Zuhlke, Murray, Christopher, Barber, R, Fullman, N, Sorensen, R, Bollyky, T, Mckee, M, Nolte, E, Abajobir, A, Abate, K, Abbafati, C, Abbas, K, Abd-Allah, F, Abdulle, A, Abdurahman, A. 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Anselm, Oladimeji, Olanrewaju, Olagunju, Andrew Toyin, Olivares, Pedro R, Olsen, Helen E, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osborne, Richard H, Osman, Majdi, Owolabi, Mayowa O, PA, Mahesh, Pain, Amanda W, Pakhale, Smita, Castillo, Elizabeth Palomare, Pana, Adrian, Papachristou, Christina, Parsaeian, Mahboubeh, Patel, Teja, Patton, George C, Paudel, Deepak, Paul, Vinod K, Pearce, Neil, Pereira, David M, Perez-Padilla, Rogelio, Perez-Ruiz, Fernando, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pigott, David M, Pillay, Julian David, Pinho, Christine, Polinder, Suzanne, Pond, Constance D, Prakash, V., Purwar, Manorama, Qorbani, Mostafa, Quistberg, D Alex, Radfar, Amir, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rai, Rajesh Kumar, Ram, Usha, Rana, Saleem M, Rankin, Zane, Rao, Paturi Vishnupriya, Rao, Puja C, Rawaf, Salman, Rego, Maria Albertina Santiago, Reitsma, Marissa, Remuzzi, Giuseppe, Renzaho, Andre M N N, Resnikoff, Serge, Rezaei, Satar, Rezai, Mohammad Sadegh, Ribeiro, Antonio L, Roba, Hirbo Shore, Rokni, Mohammad Bagher, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Nawal K, Sachdev, Perminder S, Sackey, Ben Benasco, Saeedi, Mohammad Yahya, Safiri, Saeid, Sagar, Rajesh, Sahraian, Mohammad Ali, Saleh, Muhammad Muhammad, Salomon, Joshua A, Samy, Abdallah M, Sanabria, Juan Ramon, Sanchez-Niño, Maria Dolore, Sandar, Logan, Santos, Itamar S, Santos, João Vasco, Milicevic, Milena M Santric, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Saylan, Mete I, Schöttker, Ben, Schutte, Aletta E, Schwebel, David C, Seedat, Soraya, Seid, Abdulbasit Musa, Seifu, Canaan Negash, Sepanlou, Sadaf G, Serdar, Berrin, Servan-Mori, Edson E, Setegn, Tesfaye, Shackelford, Katya Anne, Shaheen, Amira, Shahraz, Saeid, Shaikh, Masood Ali, Shakh-Nazarova, Marina, Shamsipour, Mansour, Islam, Sheikh Mohammed Shariful, Sharma, Jayendra, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Shi, Peilin, Shigematsu, Mika, Shin, Min-Jeong, Shiri, Rahman, Shoman, Haitham, Shrime, Mark G, Sibamo, Ephrem Lejore Sibamo, Sigfusdottir, Inga Dora, Silva, Diego Augusto Santo, Silveira, Dayane Gabriele Alve, Sindi, Shireen, Singh, Abhishek, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Singh, Virendra, Sinke, Abiy Hiruye, Sinshaw, Aklilu Endalamaw, Skirbekk, Vegard, Sliwa, Karen, Smith, Alison, Sobngwi, Eugene, Soneji, Samir, Soriano, Joan B, Sousa, Tatiane Cristina Morae, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stathopoulou, Vasiliki, Steel, Nichola, Steiner, Caitlyn, Steinke, Sabine, Stokes, Mark Andrew, Stranges, Saverio, Strong, Mark, Stroumpoulis, Konstantino, Sturua, Lela, Sufiyan, Muawiyyah Babale, Suliankatchi, Rizwan Abdulkader, Sun, Jiandong, Sur, Patrick, Swaminathan, Soumya, Sykes, Bryan L, Tabarés-Seisdedos, Rafael, Tabb, Karen M, Taffere, Getachew Redae, Talongwa, Roberto Tchio, Tarajia, Musharaf, Tavakkoli, Mohammad, Taveira, Nuno, Teeple, Stephanie, Tegegne, Teketo Kassaw, Tehrani-Banihashemi, Arash, Tekelab, Tesfalidet, Tekle, Dejen Yemane, Shifa, Girma Temam, Terkawi, Abdullah Sulieman, Tesema, Azeb Gebresilassie, Thakur, J.S., Thomson, Alan J, Tillmann, Taavi, Tiruye, Tenaw Yimer, Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Tortajada, Miguel, Troeger, Christopher, Truelsen, Thoma, Tura, Abera Kenay, Uchendu, Uche S, Ukwaja, Kingsley N, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Uthman, Olalekan A, van Boven, Job F M, Van Dingenen, Rita, Varughese, Santosh, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Violante, Francesco S, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wagner, Joseph A, Wakayo, Tolassa, Waller, Stephen G, Walson, Judd L, Wang, Haidong, Wang, Yuan-Pang, Watkins, David A, Weiderpass, Elisabete, Weintraub, Robert G, Wen, Chi-Pang, Werdecker, Andrea, Wesana, Joshua, Westerman, Ronny, Whiteford, Harvey A, Wilkinson, James D, Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles D A, Won, Sungho, Workicho, Abdulhalik, Workie, Shimelash Bitew, Wubshet, Mamo, Xavier, Deni, Xu, Gelin, Yadav, Ajit Kumar, Yaghoubi, Mohsen, Yakob, Bereket, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Yimam, Hassen Hamid, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, El Sayed Zaki, Maysaa, Zambrana-Torrelio, Carlo, Zapata, Toma, Zenebe, Zerihun Menlkalew, Zodpey, Sanjay, Zoeckler, Leo, Zuhlke, Liesl Joanna, and Murray, Christopher J L
Subjects: Dánartíðni, Lífslíkur, Life expectancy, Diseases, Health insurance, Globan Burden of Disease, Healthcare Access, DEVELOPMENT GOALS, Methods, Psychology, LIFE EXPECTANCY, Risk assessment, Public health, Globan Burden of Disease, Injuries, Tölfræði, Sjúkdómar, Statistics, DEATH, Þjóðir, Staðtölur, 11 Medical And Health Sciences, Healthcare access, Health status indicators, Health policy, Global burden of disease, Gæðastjórnun, Sálfræði, COMPARATIVE RISK-ASSESSMENT, Lýðheilsa, Life Sciences & Biomedicine, Standards, UNITED-STATES, Sjúkratryggingar, Medicine, General & Internal, General & Internal Medicine, Heilbrigðisstefna, SYSTEMATIC ANALYSIS, Mortality, Public health systems, medicine (all), Áhættugreining, Science & Technology, Health services accessibility, Staðlar, TRENDS, Heilbrigðisþjónusta, MEDICAL-CARE, AVOIDABLE MORTALITY, Áverkar, Aðferðafræði, Quality of health care, EUROPEAN COUNTRIES, Heilbrigðiskerfi
Abstract: Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r= 0.88), an index of 11 universal health coverage interventions (r= 0.83), and human resources for health per 1000 (r= 0.77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28.6 to 94.6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40.7 (95% uncertainty interval, 39.0-42.8) in 1990 to 53.7 (52.2-55.4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21.2 in 1990 to 20.1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73.8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-systemcharacteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world., Bill & Melinda Gates Foundation.
Published: 2017

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9 results on '"Bugssa Hailu"'

1. Injury-related gaining momentum as external causes of deaths in Ethiopian health and demographic surveillance sites: evidence from verbal autopsy study

2. Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

3. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17

4. Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years : an analysis of the Global Burden of Disease Study 2017

5. Global Mortality From Firearms, 1990-2016

6. Global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

7. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015

8. Injury-related gaining momentum as external causes of deaths in Ethiopian health and demographic surveillance sites: evidence from verbal autopsy study

9. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015

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9 results on '"Bugssa Hailu"'

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