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1. Married Women’s Decision-Making Power in Family Planning Use and its Determinants in Basoliben, Northwest Ethiopia

Author

Alemayehu B, Kassa GM, Teka Y, Zeleke LB, Abajobir AA, and Alemu AA

Subjects
decision-making, married women, family planning, amhara, ethiopia, Gynecology and obstetrics, RG1-991
Abstract

Berhanu Alemayehu,1 Getachew Mullu Kassa,1 Yohannes Teka,1 Liknaw Bewket Zeleke,1 Amanuel Alemu Abajobir,2 Addisu Alehegn Alemu1 1College of Health Sciences, Debre Markos University, Debre Mark’os, Ethiopia; 2Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, KenyaCorrespondence: Addisu Alehegn AlemuCollege of Health Sciences, Debre Markos University, Debre Markos, EthiopiaEmail addisua4@gmail.comBackground: Women’s decision-making power influences the use of family planning. It is one of the denied fundamental rights of women, particularly in developing countries. Objective: This study was aimed to assess married women’s decision-making power in the use of family planning and its associated factors among married reproductive age women in Basoliben, Amhara, Ethiopia, 2018.Methods: A community-based cross-sectional study was conducted among married reproductive age women from March 1 to 30, 2018. A multistage simple random sampling technique was employed in selecting study participants. Data were collected using structured questionnaires and analyzed through SPSS 20 software. The binary and multiple variable logistic regression models were fitted to identify factors associated with women’s decision-making power on family planning use. Statistical significance was declared at p-value less than 0.05.Results: A total of 734 married women aged 18– 49 years are making a 98% response rate included in this study. The level of married women’s decision-making power in family planning among married women was 80%; 95% CI (76.9, 82.8). Monthly income (AOR=2.2; 95% CI: 1.1, 4.2), husband’s desired number of children of < 3 (AOR=9.9; 95% CI: 3.6), husband’s desired time for additional child after 3 years postbirth (AOR=4.0; 95% CI: 1.9, 8.5) and women’s information on any contraceptive (AOR=9.6; 95% CI: 2.4, 39.0) were factors significantly associated with married women’s decision-making power in family planning.Conclusion: Married women’s decision-making power in family planning use was optimal. Household monthly income, husband’s desired ideal number of children, husband’s desired time when to have another child and information about any contraceptive methods were predictors of their decision-making power on family planning use. There should be awareness creation of family planning methods to increase its utilization.Keywords: decision-making, married women, family planning, Amhara, Ethiopia

Published
2020

2. Early Resumption of Sexual Intercourse and Its Associated Factors Among Postpartum Women in Western Ethiopia: A Cross-Sectional Study

Author

Jambola ET, Gelagay AA, Belew AK, and Abajobir AA

Subjects
early resumption of sexual intercourse, postpartum women, ethiopia., Gynecology and obstetrics, RG1-991
Abstract

Ebisa Turi Jambola,1 Abebaw Addis Gelagay,2 Aysheshim Kassahun Belew,3 Amanuel Alemu Abajobir4 1Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia; 2Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia; 3Department of Human Nutrition, Institute of Public Health, University of Gondar, Gondar, Ethiopia; 4Maternal and Child Wellbeing Unit, African Population and Health Research Centre, Nairobi, KenyaCorrespondence: Ebisa Turi JambolaDepartment of Public Health, Institute of Health Sciences, Wollega University, Nekemte, EthiopiaTel +251917686021Fax +251576617980Email ebakoturi@gmail.comBackground: Women are often forced to recommence sexual intercourse after childbirth to maintain intimacy and fulfill their partners’ desires. Early resumption of postpartum sexual intercourse leads to sexual health problems and unwanted pregnancy if not complemented with appropriate contraceptive use. However, sexual practice during the early postpartum period has received little attention in clinical and research settings. The aim of this study was therefore to assess the early resumption of sexual intercourse and its associated factors among postpartum women attending public health institutions in Nekemte town, Western Ethiopia.Methods: An institution-based cross-sectional study was carried out from March to April 2019. A systematic random sampling technique was used to select 528 postpartum women. An interviewer-administered, pretested, and structured questionnaire was used to collect data. Data were coded and entered into Epi Info 7.2.1, and exported to SPSS version 20.0 to run bivariable and multivariable logistic regressions.Results: One in five postpartum women (20.2%, 95% CI: 17.1– 23.6) practiced an early resumption of sexual intercourse, of whom three-fifths (58%) did not use any contraceptives. Women’s secondary education (AOR=0.22, 95% CI: 0.07– 0.71), husband’s elementary (AOR=0.23, 95% CI: 0.06– 0.87) and secondary education (AOR=0.25, 95% CI: 0.07– 0.88), as well as women’s fertility status (parity of one) (AOR=3.52, 95% CI: 1.24– 10.01), normal vaginal delivery (AOR=5.44, 95% CI: 1.84– 16.12), giving birth to a male child (AOR=1.94, 95% CI: 1.05– 3.60), desire for another child (AOR=5.71, 95% CI: 1.89– 17.25), and pressure from the husband to initiate intercourse (AOR=9.89, 95% CI: 4.99– 19.58) were significantly associated with early resumption of sexual intercourse.Conclusion: A significant proportion of postpartum women who resume early sexual intercourse do not use any contraceptives. Interventions that focus on strengthening the integration of postpartum sexual health education and service use are warranted.Keywords: early resumption of sexual intercourse, postpartum women, Ethiopia

Published
2020

3. Why Too Soon? Early Initiation of Sexual Intercourse Among Adolescent Females in Ethiopia: Evidence from 2016 Ethiopian Demographic and Health Survey

Author

Turi E, Merga BT, Fekadu G, and Abajobir AA

Subjects
early initiation of sexual intercourse, female adolescents, edhs, ethiopia, Gynecology and obstetrics, RG1-991
Abstract

Ebisa Turi,1 Bedasa Taye Merga,2 Ginenus Fekadu,3 Amanuel Alemu Abajobir4 1Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia; 2School of Public Health, College of Health and Medical Sciences, Haromaya University, Harar, Ethiopia; 3Clinical Pharmacy Unit, Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia; 4Maternal and Child Wellbeing Unit, African Population and Health Research Centre, Nairobi, KenyaCorrespondence: Ginenus FekaduClinical Pharmacy Unit, Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Oromia, EthiopiaTel +251 917137145Fax +251 57 6617980Email take828pharm@gmail.comBackground: Early sexual initiation – sexual activity that begun earlier than 18 years of age – is among risky sexual behaviors which may be associated with increased risks of adverse outcomes such as sexually transmitted infections (STIs), unwanted pregnancy and unsafe abortions. However, there is no nationally representative evidence on early initiation of sexual intercourse and its determinant factors among adolescent females in Ethiopia.Methods: Data were extracted from the 2016 Ethiopian Demographic and Health Survey (EDHS) to assess early initiation of sexual intercourse and factors contributing to it in adolescent females. The analysis included a weighted sample of 3881 adolescent females aged 15– 19 years. A multivariable logistic regression analysis was conducted and the results were presented as adjusted odds ratio (AOR) at 95% confidence interval (CI), declaring statistical significance at a p-value < 0.05 in all analyses.Results: About 1 in 5 (21.9%, 95% CI: 20.5%, 23.33%) adolescent females experienced early sexual debut. Administrative regions (Amhara, AOR = 2.3, 95% CI: 1.30, 4.09 and Gambella, AOR = 4.89, CI 95%: 1.08, 22.07), religion (Muslim, AOR = 1.76, 95% CI: 1.24, 2.49), substance use (e.g., ever chewed khat, AOR = 2.02, 95% CI: 1.47, 2.77, ever drunk alcohol, AOR = 1.83, 95% CI: 1.35, 2.48) and having no knowledge on family planning (AOR = 4.47, 95% CI: 2.22, 8.99) were found to have statistically significant association with early sexual debut in adolescent females. Whereas any levels of formal education decreased the odds of early sexual debut (primary, AOR = 0.44, 95% CI: 0.35, 0.56; secondary, AOR = 0.19, 95% CI: 0.13, 0.28, and higher, AOR= 0.31, 95% CI: 0.15, 0.63). Similarly, all categories of wealth indices as compared to the poorest were protective of early sexual initiation in adolescent females (AOR = 0.40– 0.57) as was for education as compared to no education (AOR = 0.19– 0.44).Conclusion: A significant proportion of adolescent females initiate early sexual intercourse in Ethiopia and multifaceted factors appear to determine their early sexual experiences. Contextualized interventions including strengthening information, education and communication on adverse consequences of early sexual initiation in regions and improving contraceptive knowledge of teenagers will play a paramount role.Keywords: early initiation of sexual intercourse, female adolescents, EDHS, Ethiopia

Published
2020

5. Married Women's Decision-Making Power in Family Planning Use and its Determinants in Basoliben, Northwest Ethiopia.

Author

Alemayehu, B, Kassa, GM, Teka, Y, Zeleke, LB, Abajobir, AA, Alemu, AA, Alemayehu, B, Kassa, GM, Teka, Y, Zeleke, LB, Abajobir, AA, and Alemu, AA

Abstract

Background: Women's decision-making power influences the use of family planning. It is one of the denied fundamental rights of women, particularly in developing countries. Objective: This study was aimed to assess married women's decision-making power in the use of family planning and its associated factors among married reproductive age women in Basoliben, Amhara, Ethiopia, 2018. Methods: A community-based cross-sectional study was conducted among married reproductive age women from March 1 to 30, 2018. A multistage simple random sampling technique was employed in selecting study participants. Data were collected using structured questionnaires and analyzed through SPSS 20 software. The binary and multiple variable logistic regression models were fitted to identify factors associated with women's decision-making power on family planning use. Statistical significance was declared at p-value less than 0.05. Results: A total of 734 married women aged 18-49 years are making a 98% response rate included in this study. The level of married women's decision-making power in family planning among married women was 80%; 95% CI (76.9, 82.8). Monthly income (AOR=2.2; 95% CI: 1.1, 4.2), husband's desired number of children of <3 (AOR=9.9; 95% CI: 3.6), husband's desired time for additional child after 3 years postbirth (AOR=4.0; 95% CI: 1.9, 8.5) and women's information on any contraceptive (AOR=9.6; 95% CI: 2.4, 39.0) were factors significantly associated with married women's decision-making power in family planning. Conclusion: Married women's decision-making power in family planning use was optimal. Household monthly income, husband's desired ideal number of children, husband's desired time when to have another child and information about any contraceptive methods were predictors of their decision-making power on family planning use. There should be awareness creation of family planning methods to increase its utilization.

Published
2020

6. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016

Author

Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abera, SF, Aboyans, V, and Abu-Raddad, LJ

Abstract

Summary Background The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of “leaving no one behind”. Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990–2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030. Methods We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0–100, with 0 as the 2·5th percentile estimated between 1990 and 2030, and 100 as the 97·5th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment. Findings Globally, the median health-related SDG index was 56·7 (IQR 31·9–66·8) in 2016 and country-level performance markedly varied, with Singapore (86·8, 95% uncertainty interval 84·6–88·9), Iceland (86·0, 84·1–87·6), and Sweden (85·6, 81·8–87·8) having the highest levels in 2016 and Afghanistan (10·9, 9·6–11·9), the Central African Republic (11·0, 8·8–13·8), and Somalia (11·3, 9·5–13·1) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2–8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60% of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5% of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past. Interpretation GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs' broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations. Funding Bill & Melinda Gates Foundation.

Published
2017

7. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Global Burden Of Disease 2016 Dalys And Hale Collaborators, Hay, SI, Abajobir, AA, and et al

Abstract

Background: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9–78·6) for females and 72·0 years (68·8–75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0–49·5]) and for males was in Lesotho (41·5 years [39·0–44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97–6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74–6·27) for males and 6·49 years (6·08–6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61–1·93) for males and 1·96 years (1·69–2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (–2·3% [–5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support.

Published
2017

8. Erratum:Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016 (The Lancet (2017) 390(10100) (1423–1459) (S014067361732336X)(10.1016/S0140-6736(17)32336-X))

Author

Fullman, N, Barber, RM, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adetokunboh, O, Afshin, A, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Ahmadieh, H, Ahmed, MB, Aichour, MTE, Aichour, AN, Aichour, I, Aiyar, S, Akinyemi, RO, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Alene, KA, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Ansari, H, Antonio, CAT, Anwari, P, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, MS, Barac, A, Barker-Collo, SL, Bärnighausen, T, Barrero, LH, Basu, S, Battle, KE, Baune, BT, Beardsley, J, Bedi, N, Beghi, E, Béjot, Y, Bell, ML, Bennett, DA, Bennett, JR, Bensenor, IM, Berhane, A, Berhe, DF, Bernabé, E, Betsu, BD, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhatt, S, Bhutta, ZA, Bicer, BK, Bidgoli, HH, Bikbov, B, Bilal, AI, Birungi, C, Biryukov, S, Bizuayehu, HM, Blosser, CD, Boneya, DJ, Bose, D, Bou-Orm, IR, and Brauer, M

Subjects
General & Internal Medicine, 11 Medical And Health Sciences
Abstract

GBD 2016 SDG Collaborators. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016. Lancet 2017; 390: 1423–59—In figure 8B of this Article (published Online First on Sept 12, 2017), the number of indicator targets has been changed from 1 to 9 for Turkmenistan, from 0 to 1 for Afghanistan, and from 1 to 2 for Yemen. Ettore Beghi, Neeraj Bhala, Hélène Carabin, Raimundas Lunevicius, Donald H Silberberg, and Caitlyn Steiner have been added to the list of GBD 2016 SDG Collaborators. Their affiliations, along with the affiliation of Soumya Swaminathan, have been added to the Affiliations section. These corrections have been made to the online version as of Sept 18, 2017, and the printed Article is correct.

Published
2017

9. Erratum: Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016 (The Lancet (2017) 390(10100) (1423–1459) (S014067361732336X) (10.1016/S0140-6736(17)32336-X))

Author

Fullman, N, Barber, RM, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adetokunboh, O, Afshin, A, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Ahmadieh, H, Ahmed, MB, Aichour, MTE, Aichour, AN, Aichour, I, Aiyar, S, Akinyemi, RO, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Alene, KA, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Ansari, H, Antonio, CAT, Anwari, P, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, MS, Barac, A, Barker-Collo, SL, Bärnighausen, T, Barrero, LH, Basu, S, Battle, KE, Baune, BT, Beardsley, J, Bedi, N, Beghi, E, Béjot, Y, Bell, ML, Bennett, DA, Bennett, JR, Bensenor, IM, Berhane, A, Berhe, DF, Bernabé, E, Betsu, BD, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhatt, S, Bhutta, ZA, Bicer, BK, Bidgoli, HH, Bikbov, B, Bilal, AI, Birungi, C, Biryukov, S, Bizuayehu, HM, Blosser, CD, Boneya, DJ, Bose, D, Bou-Orm, IR, and Brauer, M

Subjects
General & Internal Medicine, 11 Medical And Health Sciences
Abstract

GBD 2016 SDG Collaborators. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016. Lancet 2017; 390: 1423–59—The full-text version of this Article has been updated so that the list of authors is displayed in the correct order, in line with the pdf version, rather than in alphabetical order. This correction has been made to the online version as of Oct 12, 2017.

Published
2017

10. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016

Author

Fullman, N, Barbar, RM, Abajobir, AA, Et al, Rawaf, S, Murray, CJ, and GBD 2016 SDG Collaborators

Subjects
Science & Technology, MORTALITY, DEVELOPMENT ASSISTANCE, 11 Medical And Health Sciences, PREPAID PRIVATE, CARE, COVERAGE, CHINA, MEXICO, Medicine, General & Internal, SYSTEMS, General & Internal Medicine, 40-PERCENT, Life Sciences & Biomedicine, GOVERNMENT
Abstract

Background The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of “leaving no one behind”. Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990–2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030. Methods We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0–100, with 0 as the 2·5th percentile estimated between 1990 and 2030, and 100 as the 97·5th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment. Findings Globally, the median health-related SDG index was 56·7 (IQR 31·9–66·8) in 2016 and country-level performance markedly varied, with Singapore (86·8, 95% uncertainty interval 84·6–88·9), Iceland (86·0, 84·1–87·6), and Sweden (85·6, 81·8–87·8) having the highest levels in 2016 and Afghanistan (10·9, 9·6–11·9), the Central African Republic (11·0, 8·8–13·8), and Somalia (11·3, 9·5–13·1) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2–8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60% of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5% of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past. Interpretation GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs' broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations.

Published
2017

11. Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study

Author

Global Burden of Disease Child and Adolescent Health Collaboration, Kassebaum N, Kyu HH, Zoeckler L, Olsen HE, Thomas K, Pinho C, Bhutta ZA, Dandona L, Ferrari A, Ghiwot TT, Hay SI, Kinfu Y, Liang X, Lopez A, Malta DC, Mokdad AH, Naghavi M, Patton GC, Salomon J, Sartorius B, Topor-Madry R, Vollset SE, Werdecker A, Whiteford HA, Abate KH, Abbas K, Damtew SA, Ahmed MB, Akseer N, Al-Raddadi R, Alemayohu MA, Altirkawi K, Abajobir AA, Amare AT, Antonio CAT, Arnlov J, Artaman A, Asayesh H, Avokpaho EFGA, Awasthi A, Ayala Quintanilla BP, Bacha U, Betsu BD, Barac A, Bärnighausen TW, Baye E, Bedi N, Bensenor IM, Berhane A, Bernabe E, Bernal OA, Beyene AS, Biadgilign S, Bikbov B, Boyce CA, Brazinova A, Hailu GB, Carter A, Castañeda-Orjuela CA, Catalá-López F, Charlson FJ, Chitheer AA, Choi JJ, Ciobanu LG, Crump J, Dandona R, Dellavalle RP, Deribew A, deVeber G, Dicker D, Ding EL, Dubey M, Endries AY, Erskine HE, Faraon EJA, Faro A, Farzadfar F, Fernandes JC, Fijabi DO, Fitzmaurice C, Fleming TD, Flor LS, Foreman KJ, Franklin RC, Fraser MS, Frostad JJ, Fullman N, Gebregergs GB, Gebru AA, Geleijnse JM, Gibney KB, Gidey Yihdego M, Ginawi IAM, Gishu MD, Gizachew TA, Glaser E, Gold AL, Goldberg E, Gona P, Goto A, Gugnani HC, Jiang G, Gupta R, Tesfay FH, Hankey GJ, Havmoeller R, Hijar M, Horino M, Hosgood HD, Hu G, Jacobsen KH, Jakovljevic MB, Jayaraman SP, Jha V, Jibat T, Johnson CO, Jonas J, Kasaeian A, Kawakami N, Keiyoro PN, Khalil I, Khang YH, Khubchandani J, Ahmad Kiadaliri AA, Kieling C, Kim D, Kissoon N, Knibbs LD, Koyanagi A, Krohn KJ, Kuate Defo B, Kucuk Bicer B, Kulikoff R, Kumar GA, Lal DK, Lam HY, Larson HJ, Larsson A, Laryea DO, Leung J, Lim SS, Lo LT, Lo WD, Looker KJ, Lotufo PA, Magdy Abd El Razek H, Malekzadeh R, Markos Shifti D, Mazidi M, Meaney PA, Meles KG, Memiah P, Mendoza W, Abera Mengistie M, Mengistu GW, Mensah GA, Miller TR, Mock C, Mohammadi A, Mohammed S, Monasta L, Mueller U, Nagata C, Naheed A, Nguyen G, Nguyen QL, Nsoesie E, Oh IH, Okoro A, Olusanya JO, Olusanya BO, Ortiz A, Paudel D, Pereira DM, Perico N, Petzold M, Phillips MR, Polanczyk GV, Pourmalek F, Qorbani M, Rafay A, Rahimi-Movaghar V, Rahman M, Rai RK, Ram U, Rankin Z, Remuzzi G, Renzaho AMN, Roba HS, Rojas-Rueda D, Ronfani L, Sagar R, Sanabria JR, Kedir Mohammed MS, Santos IS, Satpathy M, Sawhney M, Schöttker B, Schwebel DC, Scott JG, Sepanlou SG, Shaheen A, Shaikh MA, She J, Shiri R, Shiue I, Sigfusdottir ID, Singh J, Silpakit N, Smith A, Sreeramareddy C, Stanaway JD, Stein DJ, Steiner C, Sufiyan MB, Swaminathan S, Tabarés-Seisdedos R, Tabb KM, Tadese F, Tavakkoli M, Taye B, Teeple S, Tegegne TK, Temam Shifa G, Terkawi AS, Thomas B, Thomson AJ, Tobe-Gai R, Tonelli M, Tran BX, Troeger C, Ukwaja KN, Uthman O, Vasankari T, Venketasubramanian N, Vlassov VV, Weiderpass E, Weintraub R, Gebrehiwot SW, Westerman R, Williams HC, Wolfe CDA, Woodbrook R, Yano Y, Yonemoto N, Yoon SJ, Younis MZ, Yu C, Zaki MES, Zegeye EA, Zuhlke LJ, Murray CJL, and Vos T

Subjects
Male, Adolescent, G300, L500, Adolescent Health, Age Factors, Child Health, Correction, Global Health, Disabled Children, Global Burden of Disease, Pregnancy Complications, Sex Factors, Pregnancy, Risk Factors, Cause of Death, Child Mortality, Humans, Wounds and Injuries, Female, Child
Abstract

IMPORTANCE: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. OBJECTIVE: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion. EVIDENCE REVIEW: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss. FINDINGS: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries. CONCLUSIONS AND RELEVANCE: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.

Published
2017

12. The global burden of tuberculosis: results from the Global Burden of Disease Study 2015

Author

Kyu, HH, Maddison, ER, Henry, NJ, Mumford, JE, Barber, R, Shields, C, Brown, JC, Nguyen, G, Carter, A, Wolock, TM, Wang, H, Liu, PY, Reitsma, M, Ross, JM, Abajobir, AA, Abate, KH, Abbas, K, Abera, M, Abera, SF, Hareri, HA, Ahmed, M, Alene, KA, Alvis-Guzman, N, Amo-Adjei, J, Andrews, J, Ansari, H, Antonio, CA, Anwari, P, Asayesh, H, Atey, TM, Atre, S, Barac, A, Beardsley, J, Bedi, N, Bensenor, I, Beyene, AS, Butt, ZA, Cardona, PJ, Christopher, DJ, Dandona, L, Dandona, R, Deribe, K, Deribew, A, Ehrenkranz, R, El Sayed Zaki, M, Endries, A, Feyissa, Tesfaye, Fischer, F, Gai, R, Garcia-Basteiro, AL, Gebrehiwot, TT, Gesesew, H, Getahun, B, Gona, P, Goodridge, A, Gugnani, H, Haghparast-Bidgoli, H, Hailu, GB, Hassen, HY, Hilawe, E, Horita, N, Jacobsen, KH, Jonas, JB, Kasaeian, A, Sano Kedir, M, Kemmer, L, Khader, Y, Khan, E, Khang, YH, Khoja, AT, Kim, YJ, Koul, P, Koyanagi, A, Krohn, KJ, Anil Kumar, G, Kutz, M, Lodha, R, Magdy Abd El Razek, H, Majdzadeh, R, Manyazewal, T, Memish, Z, Mendoza, W, Mezgebe, HB, Mohammed, S, Ogbo, FA, Oh, IH, Oren, E, Osgood-Zimmerman, A, Pereira, D, Plass, D, Pourmalek, F, Qorbani, M, Rafay, A, Rahman, M, Rai, RK, Rao, PC, Ray, SE, Reiner, R, Reinig, N, Safiri, S, Kyu, HH, Maddison, ER, Henry, NJ, Mumford, JE, Barber, R, Shields, C, Brown, JC, Nguyen, G, Carter, A, Wolock, TM, Wang, H, Liu, PY, Reitsma, M, Ross, JM, Abajobir, AA, Abate, KH, Abbas, K, Abera, M, Abera, SF, Hareri, HA, Ahmed, M, Alene, KA, Alvis-Guzman, N, Amo-Adjei, J, Andrews, J, Ansari, H, Antonio, CA, Anwari, P, Asayesh, H, Atey, TM, Atre, S, Barac, A, Beardsley, J, Bedi, N, Bensenor, I, Beyene, AS, Butt, ZA, Cardona, PJ, Christopher, DJ, Dandona, L, Dandona, R, Deribe, K, Deribew, A, Ehrenkranz, R, El Sayed Zaki, M, Endries, A, Feyissa, Tesfaye, Fischer, F, Gai, R, Garcia-Basteiro, AL, Gebrehiwot, TT, Gesesew, H, Getahun, B, Gona, P, Goodridge, A, Gugnani, H, Haghparast-Bidgoli, H, Hailu, GB, Hassen, HY, Hilawe, E, Horita, N, Jacobsen, KH, Jonas, JB, Kasaeian, A, Sano Kedir, M, Kemmer, L, Khader, Y, Khan, E, Khang, YH, Khoja, AT, Kim, YJ, Koul, P, Koyanagi, A, Krohn, KJ, Anil Kumar, G, Kutz, M, Lodha, R, Magdy Abd El Razek, H, Majdzadeh, R, Manyazewal, T, Memish, Z, Mendoza, W, Mezgebe, HB, Mohammed, S, Ogbo, FA, Oh, IH, Oren, E, Osgood-Zimmerman, A, Pereira, D, Plass, D, Pourmalek, F, Qorbani, M, Rafay, A, Rahman, M, Rai, RK, Rao, PC, Ray, SE, Reiner, R, Reinig, N, and Safiri, S

Published
2018

13. Burden of cardiovascular diseases in the Eastern Mediterranean Region, 1990–2015: findings from the Global Burden of Disease 2015 study

Author

Tehrani-Banihashemi, A, Moradi-Lakeh, M, Elbcheraoui, C, Charara, R, Khalil, I, Afshin, A, Collison, M, Daoud, F, Krohn, KJ, Chew, A, Cornaby, L, Foreman, KJ, Frostad, J, Kassebaum, NJ, Kemmer, L, Kutz, M, Liu, P, Mirarefin, M, Nguyen, G, Wang, H, Zipkin, B, Abajobir, AA, Abouzeid, Marian, Abu-Rmeileh, NME, Ahmad Kiadaliri, A, Ahmed, MB, Aksut, B, Alam, K, Alasfoor, D, Ali, R, Alizadeh-Navaei, R, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Anber, N, Anwari, P, Ärnlöv, J, Asgedom, SW, Atey, TM, Awasthi, A, Bärnighausen, T, Bacha, U, Barac, A, Barker-Collo, SL, Bedi, N, Bennett, DA, Berhe, DF, Biadgilign, S, Butt, ZA, Carapetis, JR, Castro, RE, Chitheer, AA, Davletov, K, Dharmaratne, SD, Djalalinia, S, Do, HP, Dubey, M, Ebrahimi, H, Eshrati, B, Esteghamati, A, Farvid, MS, Fereshtehnejad, SM, Fischer, F, Gebrehiwot, SW, Gebrehiwot, TT, Gillum, RF, Gona, PN, Gupta, R, Hafezi-Nejad, N, Hamadeh, RR, Hamidi, S, Hsairi, M, Jee, SH, Jonas, JB, Karimkhani, C, Kasaeian, A, Khader, YS, Khan, EA, Kim, D, Lal, DK, Larson, HJ, Latif, AA, Linn, S, Lotufo, PA, Lunevicius, R, Magdyabdelrazek, H, Majeed, A, Malekzadeh, R, Malta, DC, Meier, T, Memiah, P, Memish, ZA, Mendoza, W, Mensah, GA, Meretoja, A, Miller, TR, Mirrakhimov, EM, Mohammed, S, Nguyen, QL, Tehrani-Banihashemi, A, Moradi-Lakeh, M, Elbcheraoui, C, Charara, R, Khalil, I, Afshin, A, Collison, M, Daoud, F, Krohn, KJ, Chew, A, Cornaby, L, Foreman, KJ, Frostad, J, Kassebaum, NJ, Kemmer, L, Kutz, M, Liu, P, Mirarefin, M, Nguyen, G, Wang, H, Zipkin, B, Abajobir, AA, Abouzeid, Marian, Abu-Rmeileh, NME, Ahmad Kiadaliri, A, Ahmed, MB, Aksut, B, Alam, K, Alasfoor, D, Ali, R, Alizadeh-Navaei, R, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Anber, N, Anwari, P, Ärnlöv, J, Asgedom, SW, Atey, TM, Awasthi, A, Bärnighausen, T, Bacha, U, Barac, A, Barker-Collo, SL, Bedi, N, Bennett, DA, Berhe, DF, Biadgilign, S, Butt, ZA, Carapetis, JR, Castro, RE, Chitheer, AA, Davletov, K, Dharmaratne, SD, Djalalinia, S, Do, HP, Dubey, M, Ebrahimi, H, Eshrati, B, Esteghamati, A, Farvid, MS, Fereshtehnejad, SM, Fischer, F, Gebrehiwot, SW, Gebrehiwot, TT, Gillum, RF, Gona, PN, Gupta, R, Hafezi-Nejad, N, Hamadeh, RR, Hamidi, S, Hsairi, M, Jee, SH, Jonas, JB, Karimkhani, C, Kasaeian, A, Khader, YS, Khan, EA, Kim, D, Lal, DK, Larson, HJ, Latif, AA, Linn, S, Lotufo, PA, Lunevicius, R, Magdyabdelrazek, H, Majeed, A, Malekzadeh, R, Malta, DC, Meier, T, Memiah, P, Memish, ZA, Mendoza, W, Mensah, GA, Meretoja, A, Miller, TR, Mirrakhimov, EM, Mohammed, S, and Nguyen, QL

Abstract

Objectives: To report the burden of cardiovascular diseases (CVD) in the Eastern Mediterranean Region (EMR) during 1990–2015. Methods: We used the 2015 Global Burden of Disease study for estimates of mortality and disability-adjusted life years (DALYs) of different CVD in 22 countries of EMR. Results: A total of 1.4 million CVD deaths (95% UI: 1.3–1.5) occurred in 2015 in the EMR, with the highest number of deaths in Pakistan (465,116) and the lowest number of deaths in Qatar (723). The age-standardized DALY rate per 100,000 decreased from 10,080 in 1990 to 8606 in 2015 (14.6% decrease). Afghanistan had the highest age-standardized DALY rate of CVD in both 1990 and 2015. Kuwait and Qatar had the lowest age-standardized DALY rates of CVD in 1990 and 2015, respectively. High blood pressure, high total cholesterol, and high body mass index were the leading risk factors for CVD. Conclusions: The age-standardized DALY rates in the EMR are considerably higher than the global average. These findings call for a comprehensive approach to prevent and control the burden of CVD in the region.

Published
2018

14. Maternal mortality and morbidity burden in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study

Author

Mokdad, AH, Khalil, I, Collison, M, El Bcheraoui, C, Charara, R, Moradi-Lakeh, M, Afshin, A, Chew, A, Daoud, F, Krohn, KJ, Colombara, D, Ehrenkranz, R, Kutz, M, Wang, H, Abajobir, AA, Abd-Allah, F, Abraha, HN, Abu-Raddad, LJ, Kiadaliri, AA, Ahmadi, A, Ahmed, KY, Ahmed, MB, Al Lami, FH, Alam, K, Alasfoor, D, Alizadeh-Navaei, R, Alkaabi, JM, Al-Maskari, F, Al-Raddadi, R, Altirkawi, KA, Anber, N, Ansari, H, Asayesh, H, Asghar, RJ, Atey, TM, Ayele, TA, Baernighausen, T, Bacha, U, Barac, A, Barker-Collo, SL, Baune, BT, Bazargan-Hejazi, S, Geffen, D, Bedi, N, Bensenor, IM, Berhane, A, Beyene, AS, Bhutta, ZA, Boneya, DJ, Borschmann, R, Breitborde, NJK, Butt, ZA, Catala-Lopez, F, Ciobanu, LG, Danawi, H, Deribew, A, Dharmaratne, SD, Doyle, KE, Endries, AY, Faraon, EJA, Faro, A, Farvid, MS, Fekadu, W, Fereshtehnejad, S-M, Fischer, F, Gebrehiwot, TT, Giref, AZ, Gishu, MD, Goulart, AC, Habtewold, TD, Hamadeh, RR, Hambisa, MT, Hamidi, S, Maria Haro, J, Hassanvand, MS, Horita, N, Hsairi, M, Huang, H, Husseini, A, Jakovljevic, MB, James, SL, Jonas, JB, Kasaeian, A, Khader, YS, Khan, EA, Khoja, ATA, Khosravi, A, Khubchandani, J, Kim, D, Kim, YJ, Kokubo, Y, Koyanagi, A, Defo, BK, Larson, HJ, Latif, AA, Lee, PH, Leshargie, CT, Leung, R, Lo, L-T, Lunevicius, R, Abd El Razek, HM, Abd El Razek, MM, Majdzadeh, R, Majeed, A, Malekzadeh, R, Martinez-Raga, J, Farid, HM, Mazidi, M, McGrath, JJ, Memish, ZA, Mendoza, W, Mengesha, MM, Mengistie, MA, Mensah, GA, Mezgebe, HB, Miller, TR, Mitchell, PB, Mohammadi, A, Mohammed, S, Obermeyer, CM, Ogbo, FA, Palomares Castillo, E, Papachristou, C, Patten, SB, Patton, GC, Pereira, DM, Pervaiz, A, Phillips, MR, Pourmalek, F, Qorbani, M, Radfar, A, Rafay, A, Rahimi-Movaghar, V, Rai, RK, Rawaf, DL, Rawaf, S, Refaat, AH, Rezaei, S, Rezai, MS, Roshandel, G, Safdarian, M, Safiabadi, M, Safiri, S, Sagar, R, Sahraian, MA, Salamati, P, Samy, AM, Sartorius, B, Saylan, MI, Seedat, S, Sepanlou, SG, Shaikh, MA, Shamsizadeh, M, Santos Silva, DA, Singh, JA, Sobaih, BHA, Sreeramareddy, CT, Stein, DJ, Abdulkader, RS, Sykes, BL, Tabares-Seisdedos, R, Sufiyan, M, Tabb, KM, Tehrani-Banihashemi, A, Temsah, M-H, Terkawi, AS, Topor-Madry, R, Ukwaja, KN, Uthman, OA, Vollset, SE, Wakayo, T, Wang, Y-P, Werdecker, A, Westerman, R, Workicho, A, Yaghoubi, M, Yimam, HH, Yonemoto, N, Younis, MZ, Yu, C, Zaki, MES, Jumaan, AO, Vos, T, Hay, SI, Naghavi, M, Kassebaum, NJ, Murray, CJL, Mokdad, AH, Khalil, I, Collison, M, El Bcheraoui, C, Charara, R, Moradi-Lakeh, M, Afshin, A, Chew, A, Daoud, F, Krohn, KJ, Colombara, D, Ehrenkranz, R, Kutz, M, Wang, H, Abajobir, AA, Abd-Allah, F, Abraha, HN, Abu-Raddad, LJ, Kiadaliri, AA, Ahmadi, A, Ahmed, KY, Ahmed, MB, Al Lami, FH, Alam, K, Alasfoor, D, Alizadeh-Navaei, R, Alkaabi, JM, Al-Maskari, F, Al-Raddadi, R, Altirkawi, KA, Anber, N, Ansari, H, Asayesh, H, Asghar, RJ, Atey, TM, Ayele, TA, Baernighausen, T, Bacha, U, Barac, A, Barker-Collo, SL, Baune, BT, Bazargan-Hejazi, S, Geffen, D, Bedi, N, Bensenor, IM, Berhane, A, Beyene, AS, Bhutta, ZA, Boneya, DJ, Borschmann, R, Breitborde, NJK, Butt, ZA, Catala-Lopez, F, Ciobanu, LG, Danawi, H, Deribew, A, Dharmaratne, SD, Doyle, KE, Endries, AY, Faraon, EJA, Faro, A, Farvid, MS, Fekadu, W, Fereshtehnejad, S-M, Fischer, F, Gebrehiwot, TT, Giref, AZ, Gishu, MD, Goulart, AC, Habtewold, TD, Hamadeh, RR, Hambisa, MT, Hamidi, S, Maria Haro, J, Hassanvand, MS, Horita, N, Hsairi, M, Huang, H, Husseini, A, Jakovljevic, MB, James, SL, Jonas, JB, Kasaeian, A, Khader, YS, Khan, EA, Khoja, ATA, Khosravi, A, Khubchandani, J, Kim, D, Kim, YJ, Kokubo, Y, Koyanagi, A, Defo, BK, Larson, HJ, Latif, AA, Lee, PH, Leshargie, CT, Leung, R, Lo, L-T, Lunevicius, R, Abd El Razek, HM, Abd El Razek, MM, Majdzadeh, R, Majeed, A, Malekzadeh, R, Martinez-Raga, J, Farid, HM, Mazidi, M, McGrath, JJ, Memish, ZA, Mendoza, W, Mengesha, MM, Mengistie, MA, Mensah, GA, Mezgebe, HB, Miller, TR, Mitchell, PB, Mohammadi, A, Mohammed, S, Obermeyer, CM, Ogbo, FA, Palomares Castillo, E, Papachristou, C, Patten, SB, Patton, GC, Pereira, DM, Pervaiz, A, Phillips, MR, Pourmalek, F, Qorbani, M, Radfar, A, Rafay, A, Rahimi-Movaghar, V, Rai, RK, Rawaf, DL, Rawaf, S, Refaat, AH, Rezaei, S, Rezai, MS, Roshandel, G, Safdarian, M, Safiabadi, M, Safiri, S, Sagar, R, Sahraian, MA, Salamati, P, Samy, AM, Sartorius, B, Saylan, MI, Seedat, S, Sepanlou, SG, Shaikh, MA, Shamsizadeh, M, Santos Silva, DA, Singh, JA, Sobaih, BHA, Sreeramareddy, CT, Stein, DJ, Abdulkader, RS, Sykes, BL, Tabares-Seisdedos, R, Sufiyan, M, Tabb, KM, Tehrani-Banihashemi, A, Temsah, M-H, Terkawi, AS, Topor-Madry, R, Ukwaja, KN, Uthman, OA, Vollset, SE, Wakayo, T, Wang, Y-P, Werdecker, A, Westerman, R, Workicho, A, Yaghoubi, M, Yimam, HH, Yonemoto, N, Younis, MZ, Yu, C, Zaki, MES, Jumaan, AO, Vos, T, Hay, SI, Naghavi, M, Kassebaum, NJ, and Murray, CJL

Abstract

OBJECTIVES: Assessing the burden of maternal mortality is important for tracking progress and identifying public health gaps. This paper provides an overview of the burden of maternal mortality in the Eastern Mediterranean Region (EMR) by underlying cause and age from 1990 to 2015. METHODS: We used the results of the Global Burden of Disease 2015 study to explore maternal mortality in the EMR countries. RESULTS: The maternal mortality ratio in the EMR decreased 16.3% from 283 (241-328) maternal deaths per 100,000 live births in 1990 to 237 (188-293) in 2015. Maternal mortality ratio was strongly correlated with socio-demographic status, where the lowest-income countries contributed the most to the burden of maternal mortality in the region. CONCLUSION: Progress in reducing maternal mortality in the EMR has accelerated in the past 15 years, but the burden remains high. Coordinated and rigorous efforts are needed to make sure that adequate and timely services and interventions are available for women at each stage of reproductive life.

Published
2018

15. The burden of mental disorders in the Eastern Mediterranean region, 1990-2015: findings from the global burden of disease 2015 study

Author

Mokdad, AH, Charara, R, El Bcheraoui, C, Khalil, I, Moradi-Lakeh, M, Afshin, A, Kassebaum, NJ, Collison, M, Krohn, KJ, Chew, A, Daoud, F, Charlson, FJ, Colombara, D, Degenhardt, L, Ehrenkranz, R, Erskine, HE, Ferrari, AJ, Kutz, M, Leung, J, Santomauro, D, Wang, H, Whiteford, HA, Abajobir, AA, Abd-Allah, F, Abraha, HN, Abu-Raddad, LJ, Kiadaliri, AA, Ahmadi, A, Yimam, K, Beshir, M, Al Lami, FH, Alam, K, Alasfoor, D, Alizadeh-Navaei, R, Alkaabi, JM, Al-Maskari, F, Al-Raddadi, R, Altirkawi, KA, Anber, N, Ansari, H, Asayesh, H, Asghar, RJ, Atey, TM, Ayele, TA, Baernighausen, T, Bacha, U, Barac, A, Barker-Collo, SL, Baune, BT, Bazargan-Hejazi, S, Drew, CR, Geffen, D, Bedi, N, Bensenor, IM, Berhane, A, Beyene, AS, Bhutta, ZA, Boneya, DJ, Borschmann, R, Breitborde, NJK, Butt, ZA, Catala-Lopez, F, Ciobanu, LG, Danawi, H, Deribew, A, Dharmaratne, SD, Doyle, KE, Endries, AY, Faraon, EJA, Faro, A, Farvid, MS, Fekadu, W, Fereshtehnejad, S-M, Fischer, F, Gebrehiwot, TT, Giref, AZ, Gishu, MD, Carvalho, A, Habtewold, TD, Hamadeh, RR, Hambisa, MT, Hamidi, S, Haro, JM, Hassanvand, MS, Horita, N, Hsairi, M, Huang, H, Husseini, A, Jakovljevic, MB, James, SL, Jonas, JB, Kasaeian, A, Khader, YS, Khan, EA, Khoja, ATA, Khosravi, A, Khubchandani, J, Kim, D, Kim, YJ, Kokubo, Y, Koyanagi, A, Defo, BK, Larson, HJ, Latif, AA, Lee, PH, Leshargie, CT, Leung, R, Lo, L-T, Lunevicius, R, Abd El Razek, HM, Abd El Razek, MM, Majdzadeh, R, Majeed, A, Malekzadeh, R, Martinez-Raga, J, Farid, HM, Mazidi, M, McGrath, JJ, Memish, ZA, Mendoza, W, Mengesha, MM, Mengistie, MA, Mezgebe, HB, Miller, TR, Mitchell, PB, Mohammadi, A, Mohammed, S, Obermeyer, CM, Ogbo, FA, Castillo, EP, Papachristou, C, Patten, SB, Patton, GC, Pervaiz, A, Phillips, MR, Pourmalek, F, Qorbani, M, Radfar, A, Rafay, A, Rahimi-Movaghar, V, Rai, RK, Rawaf, DL, Rawaf, S, Refaat, AH, Rezaei, S, Rezai, MS, Roshandel, G, Safdarian, M, Safiabadi, M, Safiri, S, Sagar, R, Sahraian, MA, Salamati, P, Samy, AM, Sartorius, B, Saylan, MI, Seedat, S, Sepanlou, SG, Shaikh, MA, Shamsizadeh, M, Silva, DAS, Singh, JA, Sobaih, BHA, Stein, DJ, Abdulkader, RS, Sykes, BL, Tabares-Seisdedos, R, Tabb, KM, Tehrani-Banihashemi, A, Temsah, M-H, Terkawi, AS, Topor-Madry, R, Ukwaja, KN, Uthman, OA, Vollset, SE, Wakayo, T, Wang, Y-P, Werdecker, A, Westerman, R, Workicho, A, Yaghoubi, M, Yimam, HH, Yonemoto, N, Younis, MZ, Yu, C, Zaki, MES, Zein, B, Jumaan, AO, Vos, T, Hay, SI, Naghavi, M, Murray, CJL, Mokdad, AH, Charara, R, El Bcheraoui, C, Khalil, I, Moradi-Lakeh, M, Afshin, A, Kassebaum, NJ, Collison, M, Krohn, KJ, Chew, A, Daoud, F, Charlson, FJ, Colombara, D, Degenhardt, L, Ehrenkranz, R, Erskine, HE, Ferrari, AJ, Kutz, M, Leung, J, Santomauro, D, Wang, H, Whiteford, HA, Abajobir, AA, Abd-Allah, F, Abraha, HN, Abu-Raddad, LJ, Kiadaliri, AA, Ahmadi, A, Yimam, K, Beshir, M, Al Lami, FH, Alam, K, Alasfoor, D, Alizadeh-Navaei, R, Alkaabi, JM, Al-Maskari, F, Al-Raddadi, R, Altirkawi, KA, Anber, N, Ansari, H, Asayesh, H, Asghar, RJ, Atey, TM, Ayele, TA, Baernighausen, T, Bacha, U, Barac, A, Barker-Collo, SL, Baune, BT, Bazargan-Hejazi, S, Drew, CR, Geffen, D, Bedi, N, Bensenor, IM, Berhane, A, Beyene, AS, Bhutta, ZA, Boneya, DJ, Borschmann, R, Breitborde, NJK, Butt, ZA, Catala-Lopez, F, Ciobanu, LG, Danawi, H, Deribew, A, Dharmaratne, SD, Doyle, KE, Endries, AY, Faraon, EJA, Faro, A, Farvid, MS, Fekadu, W, Fereshtehnejad, S-M, Fischer, F, Gebrehiwot, TT, Giref, AZ, Gishu, MD, Carvalho, A, Habtewold, TD, Hamadeh, RR, Hambisa, MT, Hamidi, S, Haro, JM, Hassanvand, MS, Horita, N, Hsairi, M, Huang, H, Husseini, A, Jakovljevic, MB, James, SL, Jonas, JB, Kasaeian, A, Khader, YS, Khan, EA, Khoja, ATA, Khosravi, A, Khubchandani, J, Kim, D, Kim, YJ, Kokubo, Y, Koyanagi, A, Defo, BK, Larson, HJ, Latif, AA, Lee, PH, Leshargie, CT, Leung, R, Lo, L-T, Lunevicius, R, Abd El Razek, HM, Abd El Razek, MM, Majdzadeh, R, Majeed, A, Malekzadeh, R, Martinez-Raga, J, Farid, HM, Mazidi, M, McGrath, JJ, Memish, ZA, Mendoza, W, Mengesha, MM, Mengistie, MA, Mezgebe, HB, Miller, TR, Mitchell, PB, Mohammadi, A, Mohammed, S, Obermeyer, CM, Ogbo, FA, Castillo, EP, Papachristou, C, Patten, SB, Patton, GC, Pervaiz, A, Phillips, MR, Pourmalek, F, Qorbani, M, Radfar, A, Rafay, A, Rahimi-Movaghar, V, Rai, RK, Rawaf, DL, Rawaf, S, Refaat, AH, Rezaei, S, Rezai, MS, Roshandel, G, Safdarian, M, Safiabadi, M, Safiri, S, Sagar, R, Sahraian, MA, Salamati, P, Samy, AM, Sartorius, B, Saylan, MI, Seedat, S, Sepanlou, SG, Shaikh, MA, Shamsizadeh, M, Silva, DAS, Singh, JA, Sobaih, BHA, Stein, DJ, Abdulkader, RS, Sykes, BL, Tabares-Seisdedos, R, Tabb, KM, Tehrani-Banihashemi, A, Temsah, M-H, Terkawi, AS, Topor-Madry, R, Ukwaja, KN, Uthman, OA, Vollset, SE, Wakayo, T, Wang, Y-P, Werdecker, A, Westerman, R, Workicho, A, Yaghoubi, M, Yimam, HH, Yonemoto, N, Younis, MZ, Yu, C, Zaki, MES, Zein, B, Jumaan, AO, Vos, T, Hay, SI, Naghavi, M, and Murray, CJL

Abstract

OBJECTIVES: Mental disorders are among the leading causes of nonfatal burden of disease globally. METHODS: We used the global burden of diseases, injuries, and risk factors study 2015 to examine the burden of mental disorders in the Eastern Mediterranean region (EMR). We defined mental disorders according to criteria proposed in the diagnostic and statistical manual of mental disorders IV and the 10th International Classification of Diseases. RESULTS: Mental disorders contributed to 4.7% (95% uncertainty interval (UI) 3.7-5.6%) of total disability-adjusted life-years (DALYs), ranking as the ninth leading cause of disease burden. Depressive disorders and anxiety disorders were the third and ninth leading causes of nonfatal burden, respectively. Almost all countries in the EMR had higher age-standardized mental disorder DALYs rates compared to the global level, and in half of the EMR countries, observed mental disorder rates exceeded the expected values. CONCLUSIONS: The burden of mental disorders in the EMR is higher than global levels, particularly for women. To properly address this burden, EMR governments should implement nationwide quality epidemiological surveillance of mental disorders and provide adequate prevention and treatment services.

Published
2018

16. Burden of lower respiratory infections in the Eastern Mediterranean Region between 1990 and 2015: findings from the Global Burden of Disease 2015 study

Author

Mokdad, AH, Moradi-Lakeh, M, El Bcheraoui, C, Charara, R, Khalil, I, Afshin, A, Kassebaum, NJ, Collison, M, Daoud, F, Chew, A, Krohn, KJ, Colombara, D, Ehrenkranz, R, Foreman, KJ, Frostad, J, Godwin, WW, Kutz, M, Rao, PC, Reiner, R, Troeger, C, Wang, H, Abajobir, AA, Abbas, KM, Abera, SF, Abu-Raddad, LJ, Adane, K, Kiadaliri, AA, Ahmadi, A, Beshir, M, Al-Eyadhy, A, Alam, K, Alam, N, Alasfoor, D, Alizadeh-Navaei, R, Al-Maskari, F, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Anber, N, Ansari, H, Antonio, CAT, Anwari, P, Asayesh, H, Asgedom, SW, Atey, TM, Arthur, EFG, Bacha, U, Barac, A, Bazargan-Hejazi, S, Drew, CR, Geffen, D, Bedi, N, Bhutta, ZA, Michael, B, Butt, ZA, Castaneda-Orjuela, CA, Danawi, H, Djalalinia, S, Endries, AY, Eshrati, B, Farvid, MS, Fereshtehnejad, S-M, Fischer, F, Garcia-Basteiro, AL, Gebrehiwot, KT, Gebrehiwot, TT, Hailu, GB, Hamadeh, RR, Hambisa, MT, Hamidi, S, Hassanvand, MS, Hedayati, MT, Horita, N, Husseini, A, Spencer, LJ, Javanbakht, M, Jonas, JB, Kasaeian, A, Khader, YS, Khan, EA, Khan, G, Khoja, ATA, Khubchandani, J, Kim, YJ, Kissoon, N, Larson, HJ, Latif, AA, Leshargie, CT, Lunevicius, R, Abd El Razek, HM, Abd El Razek, MM, Majdzadeh, R, Majeed, A, Malekzadeh, R, Farid, HM, Mehari, A, Memish, ZA, Mengistu, DT, Mensah, GA, Mezgebe, HB, Nakamura, S, Oren, E, Pourmalek, F, Qorbani, M, Radfar, A, Rafay, A, Vafa, R-M, Rai, RK, Rawaf, DL, Rawaf, S, Refaat, AH, Rezaei, S, Rezai, MS, Roba, HS, Roshandel, G, Safdarian, M, Safiri, S, Sahraian, MA, Salamati, P, Samy, AM, Sartorius, B, Sepanlou, SG, Shaikh, MA, Shamsizadeh, M, Shigematsu, M, Singh, JA, Sufiyan, MB, Tehrani-Banihashemi, A, Temsah, M-H, Topor-Madry, R, Uthman, OA, Vollset, SE, Wakayo, T, Werdecker, A, Wijeratne, T, Yaghoubi, M, Yimam, HH, Yonemoto, N, Younis, MZ, Zaki, MES, Jumaan, AO, Vos, T, Naghavi, M, Hay, SI, Murray, CJL, Mokdad, AH, Moradi-Lakeh, M, El Bcheraoui, C, Charara, R, Khalil, I, Afshin, A, Kassebaum, NJ, Collison, M, Daoud, F, Chew, A, Krohn, KJ, Colombara, D, Ehrenkranz, R, Foreman, KJ, Frostad, J, Godwin, WW, Kutz, M, Rao, PC, Reiner, R, Troeger, C, Wang, H, Abajobir, AA, Abbas, KM, Abera, SF, Abu-Raddad, LJ, Adane, K, Kiadaliri, AA, Ahmadi, A, Beshir, M, Al-Eyadhy, A, Alam, K, Alam, N, Alasfoor, D, Alizadeh-Navaei, R, Al-Maskari, F, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Anber, N, Ansari, H, Antonio, CAT, Anwari, P, Asayesh, H, Asgedom, SW, Atey, TM, Arthur, EFG, Bacha, U, Barac, A, Bazargan-Hejazi, S, Drew, CR, Geffen, D, Bedi, N, Bhutta, ZA, Michael, B, Butt, ZA, Castaneda-Orjuela, CA, Danawi, H, Djalalinia, S, Endries, AY, Eshrati, B, Farvid, MS, Fereshtehnejad, S-M, Fischer, F, Garcia-Basteiro, AL, Gebrehiwot, KT, Gebrehiwot, TT, Hailu, GB, Hamadeh, RR, Hambisa, MT, Hamidi, S, Hassanvand, MS, Hedayati, MT, Horita, N, Husseini, A, Spencer, LJ, Javanbakht, M, Jonas, JB, Kasaeian, A, Khader, YS, Khan, EA, Khan, G, Khoja, ATA, Khubchandani, J, Kim, YJ, Kissoon, N, Larson, HJ, Latif, AA, Leshargie, CT, Lunevicius, R, Abd El Razek, HM, Abd El Razek, MM, Majdzadeh, R, Majeed, A, Malekzadeh, R, Farid, HM, Mehari, A, Memish, ZA, Mengistu, DT, Mensah, GA, Mezgebe, HB, Nakamura, S, Oren, E, Pourmalek, F, Qorbani, M, Radfar, A, Rafay, A, Vafa, R-M, Rai, RK, Rawaf, DL, Rawaf, S, Refaat, AH, Rezaei, S, Rezai, MS, Roba, HS, Roshandel, G, Safdarian, M, Safiri, S, Sahraian, MA, Salamati, P, Samy, AM, Sartorius, B, Sepanlou, SG, Shaikh, MA, Shamsizadeh, M, Shigematsu, M, Singh, JA, Sufiyan, MB, Tehrani-Banihashemi, A, Temsah, M-H, Topor-Madry, R, Uthman, OA, Vollset, SE, Wakayo, T, Werdecker, A, Wijeratne, T, Yaghoubi, M, Yimam, HH, Yonemoto, N, Younis, MZ, Zaki, MES, Jumaan, AO, Vos, T, Naghavi, M, Hay, SI, and Murray, CJL

Abstract

OBJECTIVES: We used data from the Global Burden of Disease 2015 study (GBD) to calculate the burden of lower respiratory infections (LRIs) in the 22 countries of the Eastern Mediterranean Region (EMR) from 1990 to 2015. METHODS: We conducted a systematic analysis of mortality and morbidity data for LRI and its specific etiologic factors, including pneumococcus, Haemophilus influenzae type b, Respiratory syncytial virus, and influenza virus. We used modeling methods to estimate incidence, deaths, and disability-adjusted life-years (DALYs). We calculated burden attributable to known risk factors for LRI. RESULTS: In 2015, LRIs were the fourth-leading cause of DALYs, causing 11,098,243 (95% UI 9,857,095-12,396,566) DALYs and 191,114 (95% UI 170,934-210,705) deaths. The LRI DALY rates were higher than global estimates in 2015. The highest and lowest age-standardized rates of DALYs were observed in Somalia and Lebanon, respectively. Undernutrition in childhood and ambient particulate matter air pollution in the elderly were the main risk factors. CONCLUSIONS: Our findings call for public health strategies to reduce the level of risk factors in each age group, especially vulnerable child and elderly populations.

Published
2018

17. Burden of cardiovascular diseases in the Eastern Mediterranean Region, 1990-2015: findings from the Global Burden of Disease 2015 study

Author

Mokdad, AH, Tehrani-Banihashemi, A, Moradi-Lakeh, M, El Bcheraoui, C, Charara, R, Khalil, I, Afshin, A, Collison, M, Daoud, F, Krohn, KJ, Chew, A, Cornaby, L, Foreman, KJ, Frostad, J, Kassebaum, NJ, Kemmer, L, Kutz, M, Liu, P, Mirarefin, M, Nguyen, G, Wang, H, Zipkin, B, Abajobir, AA, Abouzeid, M, Abu-Rmeileh, NME, Kiadaliri, AA, Ahmed, MB, Aksut, B, Alam, K, Alasfoor, D, Ali, R, Alizadeh-Navaei, R, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Anber, N, Anwari, P, Arnlov, J, Asgedom, SW, Atey, TM, Awasthi, A, Baernighausen, T, Bacha, U, Barac, A, Barker-Collo, SL, Bedi, N, Bennett, DA, Berhe, DF, Biadgilign, S, Butt, ZA, Carapetis, JR, Estanislao Castro, R, Chitheer, AA, Davletov, K, Dharmaratne, SD, Djalalinia, S, Huyen, PD, Dubey, M, Ebrahimi, H, Eshrati, B, Esteghamati, A, Farvid, MS, Fereshtehnejad, S-M, Fischer, F, Gebrehiwot, SW, Gebrehiwot, TT, Gillum, RF, Gona, PN, Gupta, R, Hafezi-Nejad, N, Hamadeh, RR, Hamidi, S, Hsairi, M, Jee, SH, Jonas, JB, Karimkhani, C, Kasaeian, A, Khader, YS, Khan, EA, Kim, D, Lal, DK, Larson, HJ, Latif, AA, Linn, S, Lotufo, PA, Lunevicius, R, Abd El Razek, HM, Majeed, A, Malekzadeh, R, Malta, DC, Meier, T, Memiah, P, Memish, ZA, Mendoza, W, Mensah, GA, Meretoja, A, Miller, TR, Mirrakhimov, EM, Mohammed, S, Quyen, LN, Vuong, MN, Pearson-Stuttard, J, Pishgar, F, Pourmalek, F, Qorbani, M, Radfar, A, Rafay, A, Rahimi-Movaghar, V, Rai, RK, Rana, SM, Rawaf, DL, Rawaf, S, Renzaho, AMN, Rezaei, S, Roba, KT, Roshandel, G, Safdarian, M, Safi, S, Safiri, S, Sahraian, MA, Salamati, P, Samy, AM, Milicevic, MMS, Sartorius, B, Sepanlou, SG, Shaikh, MA, Santos Silva, DA, Singh, JA, Sobaih, BHA, Stroumpoulis, K, Abdulkader, RS, Szoeke, CEI, Temsah, M-H, Tran, BX, Ukwaja, KN, Uthman, OA, Vasankari, T, Vlassov, VV, Vollset, SE, Wakayo, T, Weintraub, RG, Wessly, PR, Wijeratne, T, Wolfe, CDA, Workicho, A, Yaghoubi, M, Yano, Y, Yaseri, M, Yonemoto, N, Younis, MZ, Yu, C, Zaki, MES, Jumaan, AO, Vos, T, Roth, GA, Hay, SI, Naghavi, M, Murray, CJL, Mokdad, AH, Tehrani-Banihashemi, A, Moradi-Lakeh, M, El Bcheraoui, C, Charara, R, Khalil, I, Afshin, A, Collison, M, Daoud, F, Krohn, KJ, Chew, A, Cornaby, L, Foreman, KJ, Frostad, J, Kassebaum, NJ, Kemmer, L, Kutz, M, Liu, P, Mirarefin, M, Nguyen, G, Wang, H, Zipkin, B, Abajobir, AA, Abouzeid, M, Abu-Rmeileh, NME, Kiadaliri, AA, Ahmed, MB, Aksut, B, Alam, K, Alasfoor, D, Ali, R, Alizadeh-Navaei, R, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Anber, N, Anwari, P, Arnlov, J, Asgedom, SW, Atey, TM, Awasthi, A, Baernighausen, T, Bacha, U, Barac, A, Barker-Collo, SL, Bedi, N, Bennett, DA, Berhe, DF, Biadgilign, S, Butt, ZA, Carapetis, JR, Estanislao Castro, R, Chitheer, AA, Davletov, K, Dharmaratne, SD, Djalalinia, S, Huyen, PD, Dubey, M, Ebrahimi, H, Eshrati, B, Esteghamati, A, Farvid, MS, Fereshtehnejad, S-M, Fischer, F, Gebrehiwot, SW, Gebrehiwot, TT, Gillum, RF, Gona, PN, Gupta, R, Hafezi-Nejad, N, Hamadeh, RR, Hamidi, S, Hsairi, M, Jee, SH, Jonas, JB, Karimkhani, C, Kasaeian, A, Khader, YS, Khan, EA, Kim, D, Lal, DK, Larson, HJ, Latif, AA, Linn, S, Lotufo, PA, Lunevicius, R, Abd El Razek, HM, Majeed, A, Malekzadeh, R, Malta, DC, Meier, T, Memiah, P, Memish, ZA, Mendoza, W, Mensah, GA, Meretoja, A, Miller, TR, Mirrakhimov, EM, Mohammed, S, Quyen, LN, Vuong, MN, Pearson-Stuttard, J, Pishgar, F, Pourmalek, F, Qorbani, M, Radfar, A, Rafay, A, Rahimi-Movaghar, V, Rai, RK, Rana, SM, Rawaf, DL, Rawaf, S, Renzaho, AMN, Rezaei, S, Roba, KT, Roshandel, G, Safdarian, M, Safi, S, Safiri, S, Sahraian, MA, Salamati, P, Samy, AM, Milicevic, MMS, Sartorius, B, Sepanlou, SG, Shaikh, MA, Santos Silva, DA, Singh, JA, Sobaih, BHA, Stroumpoulis, K, Abdulkader, RS, Szoeke, CEI, Temsah, M-H, Tran, BX, Ukwaja, KN, Uthman, OA, Vasankari, T, Vlassov, VV, Vollset, SE, Wakayo, T, Weintraub, RG, Wessly, PR, Wijeratne, T, Wolfe, CDA, Workicho, A, Yaghoubi, M, Yano, Y, Yaseri, M, Yonemoto, N, Younis, MZ, Yu, C, Zaki, MES, Jumaan, AO, Vos, T, Roth, GA, Hay, SI, Naghavi, M, and Murray, CJL

Abstract

OBJECTIVES: To report the burden of cardiovascular diseases (CVD) in the Eastern Mediterranean Region (EMR) during 1990-2015. METHODS: We used the 2015 Global Burden of Disease study for estimates of mortality and disability-adjusted life years (DALYs) of different CVD in 22 countries of EMR. RESULTS: A total of 1.4 million CVD deaths (95% UI: 1.3-1.5) occurred in 2015 in the EMR, with the highest number of deaths in Pakistan (465,116) and the lowest number of deaths in Qatar (723). The age-standardized DALY rate per 100,000 decreased from 10,080 in 1990 to 8606 in 2015 (14.6% decrease). Afghanistan had the highest age-standardized DALY rate of CVD in both 1990 and 2015. Kuwait and Qatar had the lowest age-standardized DALY rates of CVD in 1990 and 2015, respectively. High blood pressure, high total cholesterol, and high body mass index were the leading risk factors for CVD. CONCLUSIONS: The age-standardized DALY rates in the EMR are considerably higher than the global average. These findings call for a comprehensive approach to prevent and control the burden of CVD in the region.

Published
2018

18. Años de vida ajustados por discapacidad a nivel mundial, regional y nacional (dalys) para 333 enfermedades y lesiones y esperanza de vida saludable (hale) para 195 países y territorios, 1990-2016: un análisis sistemático para el estudio de la carga mundial de la enfermedad 2016

Author

Hay, SI, Abajobir, AA, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, KM, Abd-Allah, Foad, Abdulkader, Rizwan Suliankatchi, Abdulle, AM, Abebo, Teshome Abuka, Abera, SF, and Alvis Guzman, Nelson

Subjects
Research resources, Health, Salud, Epidemiological patterns, Patrones epidemiológicos, Recursos en investigación
Abstract

Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the global burden of diseases, injuries, and risk factors study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (dalys) and healthy life expectancy (hale). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the socio-demographic index (sdi) La medición de los cambios en la salud en todos los lugares es útil para comparar y contrastar los patrones epidemiológicos cambiantes con el desempeño del sistema de salud e identificar necesidades específicas para la asignación de recursos en investigación, desarrollo de políticas y toma de decisiones de programas. Usando la carga global de enfermedades, lesiones y factores de riesgo del estudio 2016, tomamos dos medidas de resumen ampliamente utilizadas para monitorear tales cambios en la salud de la población: años de vida ajustados por discapacidad (dalys) y esperanza de vida saludable (hale). Utilizamos estas medidas para rastrear las tendencias y comparar el progreso en comparación con las tendencias esperadas sobre la base del índice sociodemográfico (sdi)

Published
2017

19. Global, regional, and national burden of neurological disorders during 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Feigin, VL, Abajobir, AA, Abate, KH, Abd-Allah, F, Abdulle, AM, Abera, SF, Abyu, GY, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Akinyemi, RO, Alabed, S, Al-Raddadi, R, Alvis-Guzman, N, Amare, AT, Ansari, H, Anwari, P, Arnlov, J, Asayesh, H, Asgedom, SW, Atey, TM, Avila-Burgos, L, Avokpaho, EFGA, Azarpazhooh, MR, Barac, A, Barboza, M, Barker-Collo, SL, Baernighausen, T, Bedi, N, Beghi, E, Bennett, DA, Bensenor, IM, Berhane, A, Betsu, BD, Bhaumik, S, Birlik, SM, Biryukov, S, Boneya, DJ, Bulto, LN, Carabin, H, Casey, D, Castaneda-Orjuela, CA, Catala-Lopez, F, Chen, H, Chitheer, AA, Chowdhury, R, Christensen, H, Dandona, L, Dandona, R, deVeber, GA, Dharmaratne, SD, Do, HP, Dokova, K, Dorsey, ER, Ellenbogen, RG, Eskandarieh, S, Farvid, MS, Fereshtehnejad, S-M, Fischer, F, Foreman, KJ, Geleijnse, JM, Gillum, RF, Giussani, G, Goldberg, EM, Gona, PN, Goulart, AC, Gugnani, HC, Gupta, R, Hachinski, V, Hamadeh, RR, Hambisa, M, Hankey, GJ, Hareri, HA, Havmoeller, R, Hay, SI, Heydarpour, P, Hotez, PJ, Jakovljevic, MMB, Javanbakht, M, Jeemon, P, Jonas, JB, Kalkonde, Y, Kandel, A, Karch, A, Kasaeian, A, Kastor, A, Keiyoro, PN, Khader, YS, Khalil, IA, Khan, EA, Khang, Y-H, Khoja, AT, Khubchandani, J, Kulkarni, C, Kim, D, Kim, YJ, Kivimaki, M, Kokubo, Y, Kosen, S, Kravchenko, M, Krishnamurthi, RV, Defo, BK, Kumar, GA, Kumar, R, Kyu, HH, Larsson, A, Lavados, PM, Li, Y, Liang, X, Liben, ML, Lo, WD, Logroscino, G, Lotufo, PA, Loy, CT, Mackay, MT, Abd El Razek, HM, Abd El Razek, MM, Majeed, A, Malekzadeh, R, Manhertz, T, Mantovani, LG, Massano, J, Mazidi, M, McAlinden, C, Mehata, S, Mehndiratta, MM, Memish, ZA, Mendoza, W, Mengistie, MA, Mensah, GA, Meretoja, A, Mezgebe, HB, Miller, TR, Mishra, SR, Ibrahim, NM, Mohammadi, A, Mohammed, KE, Mohammed, S, Mokdad, AH, Moradi-Lakeh, M, Velasquez, IM, Musa, KI, Naghavi, M, Ngunjiri, JW, Nguyen, CT, Nguyen, G, Nguyen, QL, Nguyen, TH, Nichols, E, Ningrum, DN, Nong, VM, Norrving, B, Noubiap, JJN, Ogbo, FA, Owolabi, MO, Pandian, JD, Parmar, PG, Pereira, DM, Petzold, M, Phillips, MR, Piradov, MA, Poulton, RG, Pourmalek, F, Qorbani, M, Rafay, A, Rahman, M, Rahman, MH, Rai, RK, Rajsic, S, Ranta, A, Rawaf, S, Renzaho, AMN, Rezai, MS, Roth, GA, Roshandel, G, Rubagotti, E, Sachdev, P, Safiri, S, Sahathevan, R, Sahraian, MA, Samy, AM, Santalucia, P, Santos, IS, Sartorius, B, Satpathy, M, Sawhney, M, Saylan, MI, Sepanlou, SG, Shaikh, MA, Shakir, R, Shamsizadeh, M, Sheth, KN, Shigematsu, M, Shoman, H, Silva, DA, Smith, M, Sobngwi, E, Sposato, LA, Stanaway, JD, Stein, DJ, Steiner, TJ, Stovner, LJ, Abdulkader, RS, Szoeke, CEI, Tabares-Seisdedos, R, Tanne, D, Theadom, AM, Thrift, AG, Tirschwell, DL, Topor-Madry, R, Tran, BX, Truelsen, T, Tuem, KB, Ukwaja, KN, Uthman, OA, Varakin, YY, Vasankari, T, Venketasubramanian, N, Vlassov, VV, Wadilo, F, Wakayo, T, Wallin, MT, Weiderpass, E, Westerman, R, Wijeratne, T, Wiysonge, CS, Woldu, MA, Wolfe, CDA, Xavier, D, Xu, G, Yano, Y, Yimam, HH, Yonemoto, N, Yu, C, Zaidi, Z, Zaki, MES, Zunt, JR, Murray, CJL, Vos, T, Disorders, GBDN, Feigin, V, Abajobir, A, Abate, K, Abd-Allah, F, Abdulle, A, Abera, S, Abyu, G, Ahmed, M, Aichour, A, Aichour, I, Aichour, M, Akinyemi, R, Alabed, S, Al-Raddadi, R, Alvis-Guzman, N, Amare, A, Ansari, H, Anwari, P, Ärnlöv, J, Asayesh, H, Asgedom, S, Atey, T, Avila-Burgos, L, Frinel, E, Avokpaho, G, Barac, A, Barboza, M, Barker-Collo, S, Bärnighausen, T, Bedi, N, Beghi, E, Bennett, D, Bensenor, I, Berhane, A, Betsu, B, Bhaumik, S, Birlik, S, Biryukov, S, Boneya, D, Bulto, L, Carabin, H, Casey, D, Castañeda-Orjuela, C, Catalá-López, F, Chen, H, Chitheer, A, Chowdhury, R, Christensen, H, Dandona, L, Dandona, R, Veber, G, Dharmaratne, S, Do, H, Dokova, K, Dorsey, E, Ellenbogen, R, Eskandarieh, S, Farvid, M, Fereshtehnejad, S, Fischer, F, Foreman, K, Geleijnse, J, Gillum, R, Giussani, G, Gona, P, Goulart, A, Gugnani, H, Gupta, R, Hamadeh, R, Hambisa, M, Hankey, G, Hareri, H, Havmoeller, R, Hay, S, Heydarpour, P, Hotez, P, Jakovljevic, M, Javanbakht, M, Jeemon, P, Jonas, J, Kalkonde, Y, Kandel, A, Karch, A, Kasaeian, A, Kastor, A, Keiyoro, P, Khader, Y, Khalil, I, Khan, E, Khang, Y, Tawfih, A, Khoja, A, Khubchandani, J, Kim, D, Kim, Y, Kivimaki, M, Kokubo, Y, Kosen, S, Kravchenko, M, Krishnamurthi, R, Defo, B, Kumar, G, Kumar, R, Kyu, H, Larsson, A, Lavados, P, Li, Y, Liang, X, Liben, M, Lo, W, Logroscino, G, Lotufo, P, Loy, C, Mackay, M, El Razek, H, El Razek, M, Majeed, A, Malekzadeh, R, Manhertz, T, Mantovani, L, Massano, J, Mazidi, M, Mcalinden, C, Mehata, S, Mehndiratta, M, Memish, Z, Mendoza, W, Mengistie, M, Mensah, G, Meretoja, A, Mezgebe, H, Miller, T, Mishra, S, Ibrahim, N, Mohammadi, A, Mohammed, K, Mohammed, S, Mokdad, A, Moradi-Lakeh, M, Velasquez, I, Musa, K, Naghavi, M, Ngunjiri, J, Nguyen, C, Nguyen, G, Le Nguyen, Q, Nguyen, T, Nichols, E, Ningrum, D, Nong, V, Norrving, B, Noubiap, J, Ogbo, F, Owolabi, M, Pandian, J, Petzold, M, Phillips, M, Piradov, M, Poulton, R, Pourmalek, F, Qorbani, M, Rafay, A, Rahman, M, Rai, R, Rajsic, S, Ranta, A, Rawaf, S, Renzaho, A, Rezai, M, Roshandel, G, Rubagotti, E, Sachdev, P, Safiri, S, Sahathevan, R, Sahraian, M, Samy, A, Santalucia, P, Santos, I, Sartorius, B, Satpathy, M, Sawhney, M, Saylan, M, Sepanlou, S, Shaikh, M, Shakir, R, Shamsizadeh, M, Sheth, K, Shigematsu, M, Shoman, H, Silva, D, Smith, M, Sobngwi, E, Sposato, L, Stein, D, Steiner, T, Stovner, L, Abdulkader, R, EI Szoeke, C, Tabarés-Seisdedos, R, Tanne, D, Theadom, A, Thrift, A, Tirschwell, D, Topor-Madry, R, Tran, B, Truelsen, T, Tuem, K, Ukwaja, K, Uthman, O, Varakin, Y, Vasankari, T, Venketasubramanian, N, Vlassov, V, Wadilo, F, Wakayo, T, Wallin, M, Weiderpass, E, Westerman, R, Wijeratne, T, Wiysonge, C, Woldu, M, Wolfe, C, Xavier, D, Xu, G, Yano, Y, Yimam, H, Yonemoto, N, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zunt, J, Murray, C, and Vos, T

Subjects
Cost of Illness, Nutrition and Disease, GBD, Voeding en Ziekte, Humans, Life Science, Quality-Adjusted Life Years, Nervous System Diseases, Global Health, Article, Global Burden of Disease, VLAG
Abstract

Background Comparable data on the global and country-specific burden of neurological disorders and their trends are\ud crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors\ud (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians\ud specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to\ud neurological disorders in 2015 and its relationship with country development level.\ud \ud Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years\ud of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification\ud have been previously spread across multiple disease groupings. The more inclusive grouping of neurological\ud disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer’s disease and other dementias, Parkinson’s\ud disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse\ud headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed\ud results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and\ud fertility, to identify patterns associated with development and how countries fare against expected outcomes relative\ud to their level of development.\ud \ud Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval\ud (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4\ud [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tensiontype\ud headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication\ud overuse headache (58·5 [50·8 to 67·4 million]), and Alzheimer’s disease and other dementias (46·0\ud [40·2 to 52·7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by\ud 36·7%, and the number of DALYs by 7·4%. These increases occurred despite decreases in age-standardised rates of\ud death and DALYs of 26·1% and 29·7%, respectively; stroke and communicable neurological disorders were\ud responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in\ud countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the\ud changes in DALY rates of neurological disorders with development were driven by changes in YLLs.\ud \ud Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden\ud of neurological disorders has increased substantially over the past 25 years because of expanding population numbers\ud and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders.\ud The number of patients who will need care by clinicians with expertise in neurological conditions will continue to\ud grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate\ud services.\ud \ud Funding Bill & Melinda Gates Foundation.

Published
2017

20. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Author

Hay, SI, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abebo, TA, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Ärnlöv, Johan, Larsson, Anders, Zaki, MES, Zegeye, EA, Zenebe, ZM, Zhang, X, Zheng, Y, Zhou, M, Zipkin, B, Zodpey, S, Zoeckler, L, Zuhlke, LJ, and Murray, CJL

Subjects
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Public Health, Global Health, Social Medicine and Epidemiology
Abstract

BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. FUNDING: Bill & Melinda Gates Foundation.

Published
2017

21. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Author

Gakidou, E, Afshin, A, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, A, Abdulle, AM, Abera, F, Aboyans, v, Abu-Raddad, LJ, Abu-Rmeileh, NME, Abyu, GY, Ärnlöv, Johan, Larsson, Anders, Artaman, A, Aryal, KK, Asayesh, H, Zhang, X, Zimsen, SRM, Zipkin, B, Zodpey, S, Lim, SS, and Murray, CJL

Subjects
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Public Health, Global Health, Social Medicine and Epidemiology
Abstract

BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. METHODS: We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. FINDINGS: Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9-11·6) decline in deaths and a 10·8% (8·3-13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7-17·5) of deaths and 6·2% (3·9-8·7) of DALYs, and population growth for 12·4% (10·1-14·9) of deaths and 12·4% (10·1-14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9-29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. INTERPRETATION: Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. For a complete list of authors see: https://doi.org/10.1016/S0140-6736(17)32366-8

Published
2017

22. Correction to Lancet HIV 2016; 3: e361-87

Author

Wang, H, Wolock, TM, Carter, A, Nguyen, G, Kyu, HH, Gakidou, E, Hay, SI, Mills, EJ, Trickey, A, Msemburi, W, Coates, MM, Mooney, MD, Fraser, MS, Sligar, A, Salomon, J, Larson, HJ, Friedman, J, Abajobir, AA, Abate, KH, Abbas, KM, Razek, MMAE, Abd-Allah, F, Abdulle, AM, Abera, SF, Abubakar, I, Abu-Raddad, LJ, Abu-Rmeileh, NME, Abyu, GY, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adofo, K, Adou, AK, Ajala, ON, Akinyemiju, TF, Akseer, N, Lami, FHA, Al-Aly, Z, Alam, K, Alam, NKM, Alasfoor, D, Aldhahri, SFS, Aldridge, RW, Alegretti, MA, Aleman, AV, Alemu, ZA, Alfonso-Cristancho, R, Ali, R, Alkerwi, A, Alla, F, Mohammad, R, Al-Raddadi, S, Alsharif, U, Alvarez, E, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Antonio, CAT, Anwari, P, Ärnlöv, J, Artaman, A, Asayesh, H, Asghar, RJ, Assadi, R, Atique, S, Atkins, LS, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Bacha, U, Badawi, A, Barac, A, Bärnighausen, T, Basu, A, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, N, Bennett, DA, Bensenor, IM, Betsu, BD, Beyene, AS, Bhatia, E, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Bisanzio, D, Brainin, M, Brazinova, A, Breitborde, NJK, Brown, A, Burch, M, Butt, ZA, Campuzano, JC, and Cárdenas, R

Abstract

GBD 2015 HIV Collaborators. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015. Lancet HIV 2016; 3: e361–87—In this Article, Kerrie E Doyle and David M Pereira have been added to the list of collaborators and Claudia C Pereira has been removed. These corrections have been made as of Aug 22, 2016.

Published
2016

23. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015 : the Global Burden of Disease Study 2015

Author

GBD 2015 HIV Collaborators, Wang, H, Wolock, TM, Carter, A, Nguyen, G, Kyu, HH, Gakidou, E, Hay, SI, Mills, EJ, Trickey, A, Msemburi, W, Coates, MM, Mooney, MD, Fraser, MS, Sligar, A, Salomon, J, Larson, HJ, Friedman, J, Abajobir, AA, Abate, KH, Abbas, KM, Razek, MM, Abd-Allah, F, Abdulle, AM, Abera, SF, Abubakar, I, Abu-Raddad, LJ, Abu-Rmeileh, NM, Abyu, GY, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adofo, K, Adou, AK, Ajala, ON, Akinyemiju, TF, Akseer, N, Lami, FH, Al-Aly, Z, Alam, K, Alam, NK, Alasfoor, D, Aldhahri, SF, Aldridge, RW, Alegretti, MA, Aleman, AV, Alemu, ZA, Alfonso-Cristancho, R, Ali, R, Alkerwi, A, Alla, F, Mohammad, R, Al-Raddadi, S, Alsharif, U, Alvarez, E, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Antonio, CA, Anwari, P, Ärnlöv, J, Artaman, A, Asayesh, H, Asghar, RJ, Assadi, R, Atique, S, Atkins, LS, Avokpaho, EF, Awasthi, A, Quintanilla, BP, Bacha, U, Badawi, A, Barac, A, Bärnighausen, T, Basu, A, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, N, Bennett, DA, Bensenor, IM, Betsu, BD, Beyene, AS, Bhatia, E, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Bisanzio, D, Brainin, M, Brazinova, A, Breitborde, NJ, Brown, A, Burch, M, Butt, ZA, Campuzano, JC, Cárdenas, R, Carrero, JJ, Castañeda-Orjuela, CA, Rivas, JC, Catalá-López, F, Chang, HY, Chang, JC, Chavan, L, Chen, W, Chiang, PP, Chibalabala, M, Chisumpa, VH, Choi, JY, Christopher, DJ, Ciobanu, LG, Cooper, C, Dahiru, T, Damtew, SA, Dandona, L, Dandona, R, Das Neves, J, De Jager, P, De Leo, D, Degenhardt, L, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dharmaratne, SD, Ding, EL, Doshi, PP, Driscoll, TR, Dubey, M, Elshrek, YM, Elyazar, I, Endries, AY, Ermakov, SP, Eshrati, B, Esteghamati, A, Faghmous, ID, Farinha, CS, Faro, A, Farvid, MS, Farzadfar, F, Fereshtehnejad, SM, Fernandes, JC, Fischer, F, Fitchett, JR, Foigt, N, Fullman, N, Fürst, T, Gankpé, FG, Gebre, T, Gebremedhin, AT, Gebru, AA, Geleijnse, JM, Gessner, BD, Gething, PW, Ghiwot, TT, Giroud, M, Gishu, MD, Glaser, E, Goenka, S, Goodridge, A, Gopalani, SV, Goto, A, Gugnani, HC, Guimaraes, MD, Gupta, R, Gupta, V, Haagsma, J, Hafezi-Nejad, N, Hagan, H, Hailu, GB, Hamadeh, RR, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Harikrishnan, S, Haro, JM, Harun, KM, Havmoeller, R, Hedayati, MT, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Hoy, DG, Hsairi, M, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Idrisov, BT, Innos, K, Iyer, VJ, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jha, V, Jiang, G, Jiang, Y, Jibat, T, Jonas, JB, Kabir, Z, Kamal, R, Kan, H, Karch, A, Karema, CK, Karletsos, D, Kasaeian, A, Kaul, A, Kawakami, N, Kayibanda, JF, Keiyoro, PN, Kemp, AH, Kengne, AP, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khang, YH, Khubchandani, J, Kim, YJ, Kinfu, Y, Kivipelto, M, Kokubo, Y, Kosen, S, Koul, PA, Koyanagi, A, Defo, BK, Bicer, BK, Kulkarni, VS, Kumar, GA, Lal, DK, Lam, H, Lam, JO, Langan, SM, Lansingh, VC, Larsson, A, Leigh, J, Leung, R, Li, Y, Lim, SS, Lipshultz, SE, Liu, S, Lloyd, BK, Logroscino, G, Lotufo, PA, Lunevicius, R, Razek, HM, Mahdavi, M, Majdan, M, Majeed, A, Makhlouf, C, Malekzadeh, R, Mapoma, CC, Marcenes, W, Martinez-Raga, J, Marzan, MB, Masiye, F, Mason-Jones, AJ, Mayosi, BM, McKee, M, Meaney, PA, Mehndiratta, MM, Mekonnen, AB, Melaku, YA, Memiah, P, Memish, ZA, Mendoza, W, Meretoja, A, Meretoja, TJ, Mhimbira, FA, Miller, TR, Mikesell, J, Mirarefin, M, Mohammad, KA, Mohammed, S, Mokdad, AH, Monasta, L, Moradi-Lakeh, M, Mori, R, Mueller, UO, Murimira, B, Murthy, GV, Naheed, A, Naldi, L, Nangia, V, Nash, D, Nawaz, H, Nejjari, C, Ngalesoni, FN, De Dieu Ngirabega, J, Nguyen, QL, Nisar, MI, Norheim, OF, Norman, RE, Nyakarahuka, L, Ogbo, FA, Oh, IH, Ojelabi, FA, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ota, E, Padukudru, MA, Park, HY, Park, JH, Patil, ST, Patten, SB, Paul, VK, Pearson, K, Peprah, EK, Pereira, CC, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pillay, JD, Plass, D, Polinder, S, Pourmalek, F, Prokop, DM, Qorbani, M, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MH, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Rao, PV, Remuzzi, G, Rojas-Rueda, D, Ronfani, L, Roshandel, G, Roy, A, Ruhago, GM, Saeedi, MY, Sagar, R, Saleh, MM, Sanabria, JR, Santos, IS, Sarmiento-Suarez, R, Sartorius, B, Sawhney, M, Schutte, AE, Schwebel, DC, Seedat, S, Sepanlou, SG, Servan-Mori, EE, Shaikh, MA, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shibuya, K, Shin, HH, Sigfusdottir, ID, Silpakit, N, Silva, DA, Silveira, DG, Simard, EP, Sindi, S, Singh, JA, Singh, OP, Singh, PK, Skirbekk, V, Sliwa, K, Soneji, S, Sorensen, RJ, Soriano, JB, Soti, DO, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Sunguya, BF, Swaminathan, S, Sykes, BL, Tabarés-Seisdedos, R, Talongwa, RT, Tavakkoli, M, Taye, B, Tedla, BA, Tekle, T, Shifa, GT, Temesgen, AM, Terkawi, AS, Tesfay, FH, Tessema, GA, Thapa, K, Thomson, AJ, Thorne-Lyman, AL, Tobe-Gai, R, Topor-Madry, R, Towbin, JA, Tran, BX, Dimbuene, ZT, Tsilimparis, N, Tura, AK, Ukwaja, KN, Uneke, CJ, Uthman, OA, Venketasubramanian, N, Vladimirov, SK, Vlassov, VV, Vollset, SE, Wang, L, Weiderpass, E, Weintraub, RG, Werdecker, A, Westerman, R, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Wolfe, CD, Won, S, Wong, JQ, Xu, G, Yadav, AK, Yakob, B, Yalew, AZ, Yano, Y, Yaseri, M, Yebyo, HG, Yip, P, Yonemoto, N, Yoon, SJ, Younis, MZ, Yu, C, Yu, S, Zaidi, Z, Zaki, MELS, Zeeb, H, Zhang, H, Zhao, Y, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Lopez, AD, and Murray, CJ

Subjects
GBD 2015 HIV Collaborators
Abstract

BACKGROUND: Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. METHODS: For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. FINDINGS: Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1-3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5-2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6-40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7-1·9 million) in 2005, to 1·2 million deaths (1·1-1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. INTERPRETATION: Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030. Funding: We thank the countless individuals who have contributed to the Global Burden of Disease (GBD) Study 2015 in various capacities. We specifically thank Jeffrey Eaton and John Stover. HW and CJLM received funding for this study from the Bill & Melinda Gates Foundation; the National Institute of Mental Health, National Institutes of Health (NIH; R01MH110163); and the National Institute on Aging, NIH (P30AG047845). LJAR acknowledges the support of Qatar National Research Fund (NPRP 04-924-3-251) who provided the main funding for generating the data provided to the GBD-Institute for Health Metrics and Evaluation effort. BPAQ acknowledges institutional support from PRONABEC (National Program of Scholarship and Educational Loan), provided by the Peruvian government. DB is supported by the Bill & Melinda Gates Foundation (grant number OPP1068048). JDN was supported in his contribution to this work by a Fellowship from Fundacao para a Ciencia e a Tecnologia, Portugal (SFRH/BPD/92934/2013). KD is supported by a Wellcome Trust Fellowship in Public Health and Tropical Medicine (grant number 099876). TF received financial support from the Swiss National Science Foundation (SNSF; project number P300P3-154634). AG acknowledges funding from Sistema Nacional de Investigadores de Panama-SNI. PJ is supported by Wellcome Trust-DBT India Alliance Clinical and Public Health Intermediate Fellowship. MK receives research support from the Academy of Finland, the Swedish Research Council, Alzheimerfonden, Alzheimer's Research & Prevention Foundation, Center for Innovative Medicine (CIMED) at Karolinska Institutet South Campus, AXA Research Fund, Wallenberg Clinical Scholars Award from the Knut och Alice Wallenbergs Foundation, and the Sheika Salama Bint Hamdan Al Nahyan Foundation. AK's work was supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R&D&I and funded by the ISCIII (General Branch Evaluation and Promotion of Health Research), and the European Regional Development Fund (ERDF-FEDER). SML is funded by a National Institute for Health Research (NIHR) Clinician Scientist Fellowship (grant number NIHR/CS/010/014). HJL reports grants from the NIHR, EU Innovative Medicines Initiative, Centre for Strategic & International Studies, and WHO. WM is Program analyst, Population and Development, in the Peru Country Office of the United Nations Population Fund, which does not necessarily endorse this study. For UOM, funding from the German National Cohort Consortium (O1ER1511D) is gratefully acknowledged. KR reports grants from NIHR Oxford Biomedical Research Centre, NIHR Career Development Fellowship, and Oxford Martin School during the conduct of the study. GR acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group supported by the International Society of Nephrology (ISN). ISS reports grants from FAPESP (Brazilian public agency). RSS receives institutional support from Universidad de Ciencias Aplicadas y Ambientales, UDCA, Bogota Colombia. SS receives postdoctoral funding from the Fonds de la recherche en sante du Quebec (FRSQ), including its renewal. RTS was supported in part by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI14/00894 from ISCIII-FEDER. PY acknowledges support from Strategic Public Policy Research (HKU7003-SPPR-12).

Published
2016

24. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016 : a systematic analysis for the Global Burden of Disease Study 2016.

Author

Naghavi, M, Abajobir, AA, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Aboyans, V, Adetokunboh, O, Afshin, A, Agrawal, A, Ahmadi, A, Ahmed, MB, Ärnlöv, Johan, Larsson, Anders, Zaidi, Z, Zaki, MES, Zegeye, EA, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zipkin, B, Zodpey, S, Lopez, AD, Murray, CJL, Naghavi, M, Abajobir, AA, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Aboyans, V, Adetokunboh, O, Afshin, A, Agrawal, A, Ahmadi, A, Ahmed, MB, Ärnlöv, Johan, Larsson, Anders, Zaidi, Z, Zaki, MES, Zegeye, EA, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zipkin, B, Zodpey, S, Lopez, AD, and Murray, CJL

Abstract

BACKGROUND: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. METHODS: We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year. YLLs were calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage coding; and other sources including surveys and surveillance systems for specific causes such as maternal mortality. To facilitate assessment of quality, we reported on the fraction of deaths assigned to GBD Level 1 or Level 2 causes that cannot be underlying causes of death (major garbage codes) by location and year. Based on completeness, garbage coding, cause list detail, and time periods covered, we provided an overall data quality rating for each location with scores ranging from 0 stars (worst) to 5 stars (best). We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to generate estimates for each location, year, age, and sex. We assessed observed and expected levels and trends of cause-specific deaths in relation to the Socio-demographic Index (SDI), a summary indicator derived from measures of average income per capita, educational attainment, and total fertility, with locations grouped into quintiles by SDI. Relative to GBD 2015, we expanded the GBD cause hierarchy by 18 causes of death for GBD 2016. FINDINGS: The quality of available data vari, For a complete list of authors see: https://doi.org/10.1016/S0140-6736(17)32152-9

Published
2017
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25. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016.

Author

Vos, T, Abajobir, AA, Abate, KH, Abbafati, c, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abebo, TA, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Ackerman, IN, Adamu, AA, Adetokunboh, O, Afarideh, M, Afshin, A, Ärnlöv, Johan, Larsson, Anders, Zhang, X, Zhou, M, Zipkin, B, Zodpey, S, Zuhlke, LJ, Murray, CJL, Vos, T, Abajobir, AA, Abate, KH, Abbafati, c, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abebo, TA, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Ackerman, IN, Adamu, AA, Adetokunboh, O, Afarideh, M, Afshin, A, Ärnlöv, Johan, Larsson, Anders, Zhang, X, Zhou, M, Zipkin, B, Zodpey, S, Zuhlke, LJ, and Murray, CJL

Abstract

BACKGROUND: As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016. METHODS: We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). FINDINGS: Globally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57·6 million (95% uncertainty interval [UI] 40·8-75·9 million [7·2%, 6·0-8·3]), 45·1 million (29·0-62·8 million [5·6%, 4·0-7·2]), 36·3 million (25·3-50·9 million [4·5%, 3·8-5·3]), 34·7 million (23·0-49·6 million [4·3%, 3·5-5·2]), and 34·1 million (23·5-46·0 million [4·2%, 3·2-5·3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2·7% (95% UI 2·3-3·1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from no, For a complete list of authors see: https://doi.org/10.1016/S0140-6736(17)32154-2

Published
2017
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26. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016 : a systematic analysis for the Global Burden of Disease Study 2016.

Author

Wang, H, Abajobir, AA, Abate, KH, Abbafati, C, Abbas ,, KM, Abd-Allah, F, Abera, sf, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adedoyin, RA, Adetifa, IMO, Adetokunboh, O, Afshin, A, Larsson, Anders, Zeeb, H, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zodpey, S, Zuhlke, LJ, Lopez, AD, Murray, CJL, Wang, H, Abajobir, AA, Abate, KH, Abbafati, C, Abbas ,, KM, Abd-Allah, F, Abera, sf, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adedoyin, RA, Adetifa, IMO, Adetokunboh, O, Afshin, A, Larsson, Anders, Zeeb, H, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zodpey, S, Zuhlke, LJ, Lopez, AD, and Murray, CJL

Abstract

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to

Published
2017
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27. 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, RM, Fullman, N, Sorensen, RJD, Bollyky, T, McKee, M, Nolte, E, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulle, AM, Ärnlöv, Johan, Larsson, Anders, Younis, MZ, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zambrana-Torrelio, C, Zapata, T, Zenebe, ZM, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Murray, CJL, Barber, RM, Fullman, N, Sorensen, RJD, Bollyky, T, McKee, M, Nolte, E, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulle, AM, Ärnlöv, Johan, Larsson, Anders, Younis, MZ, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zambrana-Torrelio, C, Zapata, T, Zenebe, ZM, Zodpey, S, Zoeckler, L, Zuhlke, LJ, and Murray, CJL

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 fertil, For a complete list of authors, see https://doi.org/10.1016/S0140-6736(17)30818-8

Published
2017
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28. Global, regional, and national burden of neurological disorders during 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Feigin, V, Abajobir, A, Abate, K, Abd-Allah, F, Abdulle, A, Abera, S, Abyu, G, Ahmed, M, Aichour, A, Aichour, I, Aichour, M, Akinyemi, R, Alabed, S, Al-Raddadi, R, Alvis-Guzman, N, Amare, A, Ansari, H, Anwari, P, Ärnlöv, J, Asayesh, H, Asgedom, S, Atey, T, Avila-Burgos, L, Frinel, E, Avokpaho, G, Barac, A, Barboza, M, Barker-Collo, S, Bärnighausen, T, Bedi, N, Beghi, E, Bennett, D, Bensenor, I, Berhane, A, Betsu, B, Bhaumik, S, Birlik, S, Biryukov, S, Boneya, D, Bulto, L, Carabin, H, Casey, D, Castañeda-Orjuela, C, Catalá-López, F, Chen, H, Chitheer, A, Chowdhury, R, Christensen, H, Dandona, L, Dandona, R, Veber, G, Dharmaratne, S, Do, H, Dokova, K, Dorsey, E, Ellenbogen, R, Eskandarieh, S, Farvid, M, Fereshtehnejad, S, Fischer, F, Foreman, K, Geleijnse, J, Gillum, R, Giussani, G, Gona, P, Goulart, A, Gugnani, H, Gupta, R, Hamadeh, R, Hambisa, M, Hankey, G, Hareri, H, Havmoeller, R, Hay, S, Heydarpour, P, Hotez, P, Jakovljevic, M, Javanbakht, M, Jeemon, P, Jonas, J, Kalkonde, Y, Kandel, A, Karch, A, Kasaeian, A, Kastor, A, Keiyoro, P, Khader, Y, Khalil, I, Khan, E, Khang, Y, Tawfih, A, Khoja, A, Khubchandani, J, Kim, D, Kim, Y, Kivimaki, M, Kokubo, Y, Kosen, S, Kravchenko, M, Krishnamurthi, R, Defo, B, Kumar, G, Kumar, R, Kyu, H, Larsson, A, Lavados, P, Li, Y, Liang, X, Liben, M, Lo, W, Logroscino, G, Lotufo, P, Loy, C, Mackay, M, El Razek, H, El Razek, M, Majeed, A, Malekzadeh, R, Manhertz, T, Mantovani, L, Massano, J, Mazidi, M, Mcalinden, C, Mehata, S, Mehndiratta, M, Memish, Z, Mendoza, W, Mengistie, M, Mensah, G, Meretoja, A, Mezgebe, H, Miller, T, Mishra, S, Ibrahim, N, Mohammadi, A, Mohammed, K, Mohammed, S, Mokdad, A, Moradi-Lakeh, M, Velasquez, I, Musa, K, Naghavi, M, Ngunjiri, J, Nguyen, C, Nguyen, G, Le Nguyen, Q, Nguyen, T, Nichols, E, Ningrum, D, Nong, V, Norrving, B, Noubiap, J, Ogbo, F, Owolabi, M, Pandian, J, Petzold, M, Phillips, M, Piradov, M, Poulton, R, Pourmalek, F, Qorbani, M, Rafay, A, Rahman, M, Rai, R, Rajsic, S, Ranta, A, Rawaf, S, Renzaho, A, Rezai, M, Roshandel, G, Rubagotti, E, Sachdev, P, Safiri, S, Sahathevan, R, Sahraian, M, Samy, A, Santalucia, P, Santos, I, Sartorius, B, Satpathy, M, Sawhney, M, Saylan, M, Sepanlou, S, Shaikh, M, Shakir, R, Shamsizadeh, M, Sheth, K, Shigematsu, M, Shoman, H, Silva, D, Smith, M, Sobngwi, E, Sposato, L, Stein, D, Steiner, T, Stovner, L, Abdulkader, R, EI Szoeke, C, Tabarés-Seisdedos, R, Tanne, D, Theadom, A, Thrift, A, Tirschwell, D, Topor-Madry, R, Tran, B, Truelsen, T, Tuem, K, Ukwaja, K, Uthman, O, Varakin, Y, Vasankari, T, Venketasubramanian, N, Vlassov, V, Wadilo, F, Wakayo, T, Wallin, M, Weiderpass, E, Westerman, R, Wijeratne, T, Wiysonge, C, Woldu, M, Wolfe, C, Xavier, D, Xu, G, Yano, Y, Yimam, H, Yonemoto, N, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zunt, J, Murray, C, Vos, T, Feigin, VL, Abajobir, AA, Abate, KH, Abdulle, AM, Abera, SF, Abyu, GY, Ahmed, MB, Aichour, AN, Aichour, MTE, Akinyemi, RO, Amare, AT, Asgedom, SW, Atey, TM, Avokpaho, GA, Barker-Collo, SL, Bennett, DA, Bensenor, IM, Betsu, BD, Birlik, SM, Boneya, DJ, Bulto, LNB, Castañeda-Orjuela, CA, Chitheer, AA, Veber, GA, Dharmaratne, SD, Do, HP, Dorsey, ER, Ellenbogen, RG, Farvid, MS, Fereshtehnejad, SM, Foreman, KJ, Geleijnse, JM, Gillum, RF, Gona, PN, Goulart, AC, Gugnani, HC, Hamadeh, RR, Hankey, GJ, Hareri, HA, Hay, SI, Hotez, PJ, Jakovljevic, MMB, Jonas, JB, Keiyoro, PN, Khader, YS, Khalil, IA, Khan, EA, Khang, YH, Kim, YJ, Krishnamurthi, RV, Defo, BK, Kumar, GA, Kyu, HH, Lavados, PM, Liben, ML, Lo, WD, Lotufo, PA, Loy, CT, Mackay, MT, El Razek, HMA, El Razek, MMA, Mantovani, LG, McAlinden, C, Mehndiratta, MM, Memish, ZA, Mengistie, MA, Mensah, GA, Mezgebe, HB, Miller, TR, Mishra, SR, Ibrahim, NM, Mohammed, KE, Mokdad, AH, Velasquez, IM, Musa, KI, Ngunjiri, JW, Nguyen, CT, Nguyen, TH, Ningrum, DNA, Nong, VM, Noubiap, JJN, Ogbo, FA, Owolabi, MO, Pandian, JD, Phillips, MR, Piradov, MA, Poulton, RG, Rahman, MH, Rai, RK, Renzaho, AMN, Rezai, MS, Sahraian, MA, Samy, AM, Santos, IS, Saylan, MI, Sepanlou, SG, Shaikh, MA, Sheth, KN, Silva, DAS, Sposato, LA, Stein, DJ, Steiner, TJ, Stovner, LJ, Abdulkader, RS, Theadom, AM, Thrift, AG, Tirschwell, DL, Tran, BX, Tuem, KB, Ukwaja, KN, Uthman, OA, Varakin, YY, Vlassov, VV, Wallin, MT, Wiysonge, CS, Woldu, MA, Wolfe, CDA, Yimam, HH, Zunt, JR, Murray, CJL, Feigin, V, Abajobir, A, Abate, K, Abd-Allah, F, Abdulle, A, Abera, S, Abyu, G, Ahmed, M, Aichour, A, Aichour, I, Aichour, M, Akinyemi, R, Alabed, S, Al-Raddadi, R, Alvis-Guzman, N, Amare, A, Ansari, H, Anwari, P, Ärnlöv, J, Asayesh, H, Asgedom, S, Atey, T, Avila-Burgos, L, Frinel, E, Avokpaho, G, Barac, A, Barboza, M, Barker-Collo, S, Bärnighausen, T, Bedi, N, Beghi, E, Bennett, D, Bensenor, I, Berhane, A, Betsu, B, Bhaumik, S, Birlik, S, Biryukov, S, Boneya, D, Bulto, L, Carabin, H, Casey, D, Castañeda-Orjuela, C, Catalá-López, F, Chen, H, Chitheer, A, Chowdhury, R, Christensen, H, Dandona, L, Dandona, R, Veber, G, Dharmaratne, S, Do, H, Dokova, K, Dorsey, E, Ellenbogen, R, Eskandarieh, S, Farvid, M, Fereshtehnejad, S, Fischer, F, Foreman, K, Geleijnse, J, Gillum, R, Giussani, G, Gona, P, Goulart, A, Gugnani, H, Gupta, R, Hamadeh, R, Hambisa, M, Hankey, G, Hareri, H, Havmoeller, R, Hay, S, Heydarpour, P, Hotez, P, Jakovljevic, M, Javanbakht, M, Jeemon, P, Jonas, J, Kalkonde, Y, Kandel, A, Karch, A, Kasaeian, A, Kastor, A, Keiyoro, P, Khader, Y, Khalil, I, Khan, E, Khang, Y, Tawfih, A, Khoja, A, Khubchandani, J, Kim, D, Kim, Y, Kivimaki, M, Kokubo, Y, Kosen, S, Kravchenko, M, Krishnamurthi, R, Defo, B, Kumar, G, Kumar, R, Kyu, H, Larsson, A, Lavados, P, Li, Y, Liang, X, Liben, M, Lo, W, Logroscino, G, Lotufo, P, Loy, C, Mackay, M, El Razek, H, El Razek, M, Majeed, A, Malekzadeh, R, Manhertz, T, Mantovani, L, Massano, J, Mazidi, M, Mcalinden, C, Mehata, S, Mehndiratta, M, Memish, Z, Mendoza, W, Mengistie, M, Mensah, G, Meretoja, A, Mezgebe, H, Miller, T, Mishra, S, Ibrahim, N, Mohammadi, A, Mohammed, K, Mohammed, S, Mokdad, A, Moradi-Lakeh, M, Velasquez, I, Musa, K, Naghavi, M, Ngunjiri, J, Nguyen, C, Nguyen, G, Le Nguyen, Q, Nguyen, T, Nichols, E, Ningrum, D, Nong, V, Norrving, B, Noubiap, J, Ogbo, F, Owolabi, M, Pandian, J, Petzold, M, Phillips, M, Piradov, M, Poulton, R, Pourmalek, F, Qorbani, M, Rafay, A, Rahman, M, Rai, R, Rajsic, S, Ranta, A, Rawaf, S, Renzaho, A, Rezai, M, Roshandel, G, Rubagotti, E, Sachdev, P, Safiri, S, Sahathevan, R, Sahraian, M, Samy, A, Santalucia, P, Santos, I, Sartorius, B, Satpathy, M, Sawhney, M, Saylan, M, Sepanlou, S, Shaikh, M, Shakir, R, Shamsizadeh, M, Sheth, K, Shigematsu, M, Shoman, H, Silva, D, Smith, M, Sobngwi, E, Sposato, L, Stein, D, Steiner, T, Stovner, L, Abdulkader, R, EI Szoeke, C, Tabarés-Seisdedos, R, Tanne, D, Theadom, A, Thrift, A, Tirschwell, D, Topor-Madry, R, Tran, B, Truelsen, T, Tuem, K, Ukwaja, K, Uthman, O, Varakin, Y, Vasankari, T, Venketasubramanian, N, Vlassov, V, Wadilo, F, Wakayo, T, Wallin, M, Weiderpass, E, Westerman, R, Wijeratne, T, Wiysonge, C, Woldu, M, Wolfe, C, Xavier, D, Xu, G, Yano, Y, Yimam, H, Yonemoto, N, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zunt, J, Murray, C, Vos, T, Feigin, VL, Abajobir, AA, Abate, KH, Abdulle, AM, Abera, SF, Abyu, GY, Ahmed, MB, Aichour, AN, Aichour, MTE, Akinyemi, RO, Amare, AT, Asgedom, SW, Atey, TM, Avokpaho, GA, Barker-Collo, SL, Bennett, DA, Bensenor, IM, Betsu, BD, Birlik, SM, Boneya, DJ, Bulto, LNB, Castañeda-Orjuela, CA, Chitheer, AA, Veber, GA, Dharmaratne, SD, Do, HP, Dorsey, ER, Ellenbogen, RG, Farvid, MS, Fereshtehnejad, SM, Foreman, KJ, Geleijnse, JM, Gillum, RF, Gona, PN, Goulart, AC, Gugnani, HC, Hamadeh, RR, Hankey, GJ, Hareri, HA, Hay, SI, Hotez, PJ, Jakovljevic, MMB, Jonas, JB, Keiyoro, PN, Khader, YS, Khalil, IA, Khan, EA, Khang, YH, Kim, YJ, Krishnamurthi, RV, Defo, BK, Kumar, GA, Kyu, HH, Lavados, PM, Liben, ML, Lo, WD, Lotufo, PA, Loy, CT, Mackay, MT, El Razek, HMA, El Razek, MMA, Mantovani, LG, McAlinden, C, Mehndiratta, MM, Memish, ZA, Mengistie, MA, Mensah, GA, Mezgebe, HB, Miller, TR, Mishra, SR, Ibrahim, NM, Mohammed, KE, Mokdad, AH, Velasquez, IM, Musa, KI, Ngunjiri, JW, Nguyen, CT, Nguyen, TH, Ningrum, DNA, Nong, VM, Noubiap, JJN, Ogbo, FA, Owolabi, MO, Pandian, JD, Phillips, MR, Piradov, MA, Poulton, RG, Rahman, MH, Rai, RK, Renzaho, AMN, Rezai, MS, Sahraian, MA, Samy, AM, Santos, IS, Saylan, MI, Sepanlou, SG, Shaikh, MA, Sheth, KN, Silva, DAS, Sposato, LA, Stein, DJ, Steiner, TJ, Stovner, LJ, Abdulkader, RS, Theadom, AM, Thrift, AG, Tirschwell, DL, Tran, BX, Tuem, KB, Ukwaja, KN, Uthman, OA, Varakin, YY, Vlassov, VV, Wallin, MT, Wiysonge, CS, Woldu, MA, Wolfe, CDA, Yimam, HH, Zunt, JR, and Murray, CJL

Abstract

Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4 [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tension-type headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication overuse headache (58·5 [50·8 to 67·4 mil

Published
2017

29. Child and adolescent health from 1990 to 2015: findings from the Global Burden of Diseases, Injuries, and Risk Factors 2015 study

Author

Kassebaum, N, Kyu, HH, Zoeckler, L, Olsen, HE, Thomas, K, Pinho, C, Bhutta, ZA, Dandona, L, Ferrari, A, Ghiwot, TT, Hay, SI, Kinfu, Y, Liang, X, Lopez, A, Malta, DC, Mokdad, AH, Naghavi, M, Patton, GC, Salomon, J, Sartorius, B, Topor-Madry, R, Vollset, SE, Werdecker, A, Whiteford, HA, Abate, KH, Abbas, K, Damtew, SA, Ahmed, MB, Akseer, N, Al-Raddadi, R, Alemayohu, MA, Altirkawi, K, Abajobir, AA, Amare, AT, Antonio, CAT, Arnlov, J, Artaman, A, Asayesh, H, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Bacha, U, Betsu, BD, Barac, A, Barnighausen, TW, Baye, E, Bedi, N, Bensenor, IM, Berhane, A, Bernabe, E, Bernal, OA, Beyene, AS, Biadgilign, S, Bikbov, B, Boyce, CA, Brazinova, A, Hailu, GB, Carter, A, Castaneda-Orjuela, CA, Catala-Lopez, F, Charlson, FJ, Chitheer, AA, Choi, JYJ, Ciobanu, LG, Crump, J, Dandona, R, Dellavalle, RP, Deribew, A, DeVeber, G, Dicker, D, Ding, EL, Dubey, M, Endries, AY, Erskine, HE, Faraon, EJA, Faro, A, Farzadfar, F, Fernandes, JC, Fijabi, DO, Fitzmaurice, C, Fleming, TD, Flor, LS, Foreman, KJ, Franklin, RC, Fraser, MS, Frostad, JJ, Fullman, N, Gebregergs, GB, Gebru, AA, Geleijnse, JM, Gibney, KB, Yihdego, MG, Ginawi, IAM, Gishu, MD, Gizachew, TA, Glaser, E, Gold, AL, Goldberg, E, Gona, P, Goto, A, Tesfay, Fisaha, Kassebaum, N, Kyu, HH, Zoeckler, L, Olsen, HE, Thomas, K, Pinho, C, Bhutta, ZA, Dandona, L, Ferrari, A, Ghiwot, TT, Hay, SI, Kinfu, Y, Liang, X, Lopez, A, Malta, DC, Mokdad, AH, Naghavi, M, Patton, GC, Salomon, J, Sartorius, B, Topor-Madry, R, Vollset, SE, Werdecker, A, Whiteford, HA, Abate, KH, Abbas, K, Damtew, SA, Ahmed, MB, Akseer, N, Al-Raddadi, R, Alemayohu, MA, Altirkawi, K, Abajobir, AA, Amare, AT, Antonio, CAT, Arnlov, J, Artaman, A, Asayesh, H, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Bacha, U, Betsu, BD, Barac, A, Barnighausen, TW, Baye, E, Bedi, N, Bensenor, IM, Berhane, A, Bernabe, E, Bernal, OA, Beyene, AS, Biadgilign, S, Bikbov, B, Boyce, CA, Brazinova, A, Hailu, GB, Carter, A, Castaneda-Orjuela, CA, Catala-Lopez, F, Charlson, FJ, Chitheer, AA, Choi, JYJ, Ciobanu, LG, Crump, J, Dandona, R, Dellavalle, RP, Deribew, A, DeVeber, G, Dicker, D, Ding, EL, Dubey, M, Endries, AY, Erskine, HE, Faraon, EJA, Faro, A, Farzadfar, F, Fernandes, JC, Fijabi, DO, Fitzmaurice, C, Fleming, TD, Flor, LS, Foreman, KJ, Franklin, RC, Fraser, MS, Frostad, JJ, Fullman, N, Gebregergs, GB, Gebru, AA, Geleijnse, JM, Gibney, KB, Yihdego, MG, Ginawi, IAM, Gishu, MD, Gizachew, TA, Glaser, E, Gold, AL, Goldberg, E, Gona, P, Goto, A, and Tesfay, Fisaha

Published
2017

30. Erratum: Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016 (The Lancet (2017) 390(10100) (1423–1459) (S

Author

Fullman, N, Barber, RM, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adetokunboh, O, Afshin, A, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Ahmadieh, H, Ahmed, MB, Aichour, MTE, Aichour, AN, Aichour, I, Aiyar, S, Akinyemi, RO, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Alene, KA, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Ansari, H, Antonio, CAT, Anwari, P, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, MS, Barac, A, Barker-Collo, SL, Bärnighausen, T, Barrero, LH, Basu, S, Battle, KE, Baune, BT, Beardsley, J, Bedi, N, Beghi, E, Béjot, Y, Bell, ML, Bennett, DA, Bennett, JR, Bensenor, IM, Berhane, A, Berhe, DF, Bernabé, E, Betsu, BD, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhatt, S, Bhutta, ZA, Bicer, BK, Bidgoli, HH, Bikbov, B, Bilal, AI, Birungi, C, Biryukov, S, Bizuayehu, HM, Blosser, CD, Boneya, DJ, Bose, D, Bou-Orm, IR, Brauer, M, Stokes, Mark, Fullman, N, Barber, RM, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adetokunboh, O, Afshin, A, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Ahmadieh, H, Ahmed, MB, Aichour, MTE, Aichour, AN, Aichour, I, Aiyar, S, Akinyemi, RO, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Alene, KA, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Ansari, H, Antonio, CAT, Anwari, P, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, MS, Barac, A, Barker-Collo, SL, Bärnighausen, T, Barrero, LH, Basu, S, Battle, KE, Baune, BT, Beardsley, J, Bedi, N, Beghi, E, Béjot, Y, Bell, ML, Bennett, DA, Bennett, JR, Bensenor, IM, Berhane, A, Berhe, DF, Bernabé, E, Betsu, BD, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhatt, S, Bhutta, ZA, Bicer, BK, Bidgoli, HH, Bikbov, B, Bilal, AI, Birungi, C, Biryukov, S, Bizuayehu, HM, Blosser, CD, Boneya, DJ, Bose, D, Bou-Orm, IR, Brauer, M, and Stokes, Mark

Published
2017

31. Erratum:Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016 (The Lancet (2017) 390(10100) (1423–1459) (S0

Author

Fullman, N, Barber, RM, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adetokunboh, O, Afshin, A, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Ahmadieh, H, Ahmed, MB, Aichour, MTE, Aichour, AN, Aichour, I, Aiyar, S, Akinyemi, RO, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Alene, KA, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Ansari, H, Antonio, CAT, Anwari, P, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, MS, Barac, A, Barker-Collo, SL, Bärnighausen, T, Barrero, LH, Basu, S, Battle, KE, Baune, BT, Beardsley, J, Bedi, N, Beghi, E, Béjot, Y, Bell, ML, Bennett, DA, Bennett, JR, Bensenor, IM, Berhane, A, Berhe, DF, Bernabé, E, Betsu, BD, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhatt, S, Bhutta, ZA, Bicer, BK, Bidgoli, HH, Bikbov, B, Bilal, AI, Birungi, C, Biryukov, S, Bizuayehu, HM, Blosser, CD, Boneya, DJ, Bose, D, Bou-Orm, IR, Brauer, M, Stokes, Mark, Fullman, N, Barber, RM, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adetokunboh, O, Afshin, A, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Ahmadieh, H, Ahmed, MB, Aichour, MTE, Aichour, AN, Aichour, I, Aiyar, S, Akinyemi, RO, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Alene, KA, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Ansari, H, Antonio, CAT, Anwari, P, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, MS, Barac, A, Barker-Collo, SL, Bärnighausen, T, Barrero, LH, Basu, S, Battle, KE, Baune, BT, Beardsley, J, Bedi, N, Beghi, E, Béjot, Y, Bell, ML, Bennett, DA, Bennett, JR, Bensenor, IM, Berhane, A, Berhe, DF, Bernabé, E, Betsu, BD, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhatt, S, Bhutta, ZA, Bicer, BK, Bidgoli, HH, Bikbov, B, Bilal, AI, Birungi, C, Biryukov, S, Bizuayehu, HM, Blosser, CD, Boneya, DJ, Bose, D, Bou-Orm, IR, Brauer, M, and Stokes, Mark

Published
2017

32. Department of Error.

Author

Fullman, N, Barber, RM, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adetokunboh, O, Afshin, A, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Ahmadieh, H, Ahmed, MB, Aichour, MTE, Aichour, AN, Aichour, I, Aiyar, S, Akinyemi, RO, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Alene, KA, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Ansari, H, Antonio, CAT, Anwari, P, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, MS, Barac, A, Barker-Collo, SL, Bärnighausen, T, Barrero, LH, Basu, S, Battle, KE, Baune, BT, Beardsley, J, Bedi, N, Beghi, E, Béjot, Y, Bell, ML, Bennett, DA, Bennett, JR, Bensenor, IM, Berhane, A, Berhe, DF, Bernabé, E, Betsu, BD, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhatt, S, Bhutta, ZA, Bicer, BK, Bidgoli, HH, Bikbov, B, Bilal, AI, Birungi, C, Biryukov, S, Bizuayehu, HM, Blosser, CD, Boneya, DJ, Bose, D, Bou-Orm, IR, Brauer, M, Fullman, N, Barber, RM, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adetokunboh, O, Afshin, A, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Ahmadieh, H, Ahmed, MB, Aichour, MTE, Aichour, AN, Aichour, I, Aiyar, S, Akinyemi, RO, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Alene, KA, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Ansari, H, Antonio, CAT, Anwari, P, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, MS, Barac, A, Barker-Collo, SL, Bärnighausen, T, Barrero, LH, Basu, S, Battle, KE, Baune, BT, Beardsley, J, Bedi, N, Beghi, E, Béjot, Y, Bell, ML, Bennett, DA, Bennett, JR, Bensenor, IM, Berhane, A, Berhe, DF, Bernabé, E, Betsu, BD, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhatt, S, Bhutta, ZA, Bicer, BK, Bidgoli, HH, Bikbov, B, Bilal, AI, Birungi, C, Biryukov, S, Bizuayehu, HM, Blosser, CD, Boneya, DJ, Bose, D, Bou-Orm, IR, and Brauer, M

Published
2017

33. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Soriano, JB, Abajobir, AA, Abate, KH, Abera, SF, Agrawal, A, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Alam, K, Alam, N, Alkaabi, JM, Al-Maskari, F, Alvis-Guzman, N, Amberbir, A, Amoako, YA, Ansha, MG, Anto, JM, Asayesh, H, Atey, TM, Avokpaho, EFGA, Barac, A, Basu, S, Bedi, N, Bensenor, IM, Berhane, A, Beyene, AS, Bhutta, ZA, Biryukov, S, Boneya, DJ, Brauer, M, Carpenter, DO, Casey, D, Christopher, DJ, Dandona, L, Dandona, R, Dharmaratne, SD, Huyen, PD, Fischer, F, Geleto, A, Ghoshal, AG, Gillum, RF, Ginawi, IAM, Gupta, V, Hay, SI, Hedayati, MT, Horita, N, Hosgood, HD, Jakovljevic, MMB, James, SL, Jonas, JB, Kasaeian, A, Khader, YS, Khalil, IA, Khan, EA, Khang, Y-H, Khubchandani, J, Knibbs, LD, Kosen, S, Koul, PA, Kumar, GA, Leshargie, CT, Liang, X, Abd El Razek, HM, Majeed, A, Malta, DC, Manhertz, T, Marquez, N, Mehari, A, Mensah, GA, Miller, TR, Mohammad, KA, Mohammed, KE, Mohammed, S, Mokdad, AH, Naghavi, M, Cuong, TN, Nguyen, G, Quyen, LN, Trang, HN, Ningrum, DNA, Vuong, MN, Obi, JI, Odeyemi, YE, Ogbo, FA, Oren, E, Mahesh, PA, Park, E-K, Patton, GC, Paulson, K, Qorbani, M, Quansah, R, Rafay, A, Rahman, MHU, Rai, RK, Rawaf, S, Reinig, N, Safiri, S, Sarmiento-Suarez, R, Sartorius, B, Savic, M, Sawhney, M, Shigematsu, M, Smith, M, Tadese, F, Thurston, GD, Topor-Madry, R, Tran, BX, Ukwaja, KN, van Boven, JFM, Vlassov, VV, Vollset, SE, Wan, X, Werdecker, A, Hanson, SW, Yano, Y, Yimam, HH, Yonemoto, N, Yu, C, Zaidi, Z, Zaki, MES, Murray, CJL, Vos, T, Soriano, JB, Abajobir, AA, Abate, KH, Abera, SF, Agrawal, A, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Alam, K, Alam, N, Alkaabi, JM, Al-Maskari, F, Alvis-Guzman, N, Amberbir, A, Amoako, YA, Ansha, MG, Anto, JM, Asayesh, H, Atey, TM, Avokpaho, EFGA, Barac, A, Basu, S, Bedi, N, Bensenor, IM, Berhane, A, Beyene, AS, Bhutta, ZA, Biryukov, S, Boneya, DJ, Brauer, M, Carpenter, DO, Casey, D, Christopher, DJ, Dandona, L, Dandona, R, Dharmaratne, SD, Huyen, PD, Fischer, F, Geleto, A, Ghoshal, AG, Gillum, RF, Ginawi, IAM, Gupta, V, Hay, SI, Hedayati, MT, Horita, N, Hosgood, HD, Jakovljevic, MMB, James, SL, Jonas, JB, Kasaeian, A, Khader, YS, Khalil, IA, Khan, EA, Khang, Y-H, Khubchandani, J, Knibbs, LD, Kosen, S, Koul, PA, Kumar, GA, Leshargie, CT, Liang, X, Abd El Razek, HM, Majeed, A, Malta, DC, Manhertz, T, Marquez, N, Mehari, A, Mensah, GA, Miller, TR, Mohammad, KA, Mohammed, KE, Mohammed, S, Mokdad, AH, Naghavi, M, Cuong, TN, Nguyen, G, Quyen, LN, Trang, HN, Ningrum, DNA, Vuong, MN, Obi, JI, Odeyemi, YE, Ogbo, FA, Oren, E, Mahesh, PA, Park, E-K, Patton, GC, Paulson, K, Qorbani, M, Quansah, R, Rafay, A, Rahman, MHU, Rai, RK, Rawaf, S, Reinig, N, Safiri, S, Sarmiento-Suarez, R, Sartorius, B, Savic, M, Sawhney, M, Shigematsu, M, Smith, M, Tadese, F, Thurston, GD, Topor-Madry, R, Tran, BX, Ukwaja, KN, van Boven, JFM, Vlassov, VV, Vollset, SE, Wan, X, Werdecker, A, Hanson, SW, Yano, Y, Yimam, HH, Yonemoto, N, Yu, C, Zaidi, Z, Zaki, MES, Murray, CJL, and Vos, T

Abstract

BACKGROUND: Chronic obstructive pulmonary disease (COPD) and asthma are common diseases with a heterogeneous distribution worldwide. Here, we present methods and disease and risk estimates for COPD and asthma from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 study. The GBD study provides annual updates on estimates of deaths, prevalence, and disability-adjusted life years (DALYs), a summary measure of fatal and non-fatal disease outcomes, for over 300 diseases and injuries, for 188 countries from 1990 to the most recent year. METHODS: We estimated numbers of deaths due to COPD and asthma using the GBD Cause of Death Ensemble modelling (CODEm) tool. First, we analysed data from vital registration and verbal autopsy for the aggregate category of all chronic respiratory diseases. Subsequently, models were run for asthma and COPD relying on covariates to predict rates in countries that have incomplete or no vital registration data. Disease estimates for COPD and asthma were based on systematic reviews of published papers, unpublished reports, surveys, and health service encounter data from the USA. We used the Global Initiative of Chronic Obstructive Lung Disease spirometry-based definition as the reference for COPD and a reported diagnosis of asthma with current wheeze as the definition of asthma. We used a Bayesian meta-regression tool, DisMod-MR 2.1, to derive estimates of prevalence and incidence. We estimated population-attributable fractions for risk factors for COPD and asthma from exposure data, relative risks, and a theoretical minimum exposure level. Results were stratified by Socio-demographic Index (SDI), a composite measure of income per capita, mean years of education over the age of 15 years, and total fertility rate. FINDINGS: In 2015, 3·2 million people (95% uncertainty interval [UI] 3·1 million to 3·3 million) died from COPD worldwide, an increase of 11·6% (95% UI 5·3 to 19·8) compared with 1990. There was a decrease in age-stan

Published
2017

34. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016 (vol 390, pg 1423, 2017)

Author

Fullman, N, Barber, RM, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adetokunboh, O, Afshin, A, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Ahmadieh, H, Ahmed, MB, Aichour, MTE, Aichour, AN, Aichour, I, Aiyar, S, Akinyemi, RO, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Alene, KA, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Ansari, H, Antonio, CAT, Anwari, P, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, MS, Barac, A, Barker-Collo, SL, Bärnighausen, T, Barrero, LH, Basu, S, Battle, KE, Baune, BT, Beardsley, J, Bedi, N, Beghi, E, Béjot, Y, Bell, ML, Bennett, DA, Bennett, JR, Bensenor, IM, Berhane, A, Berhe, DF, Bernabé, E, Betsu, BD, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhatt, S, Bhutta, ZA, Bicer, BK, Bidgoli, HH, Bikbov, B, Bilal, AI, Birungi, C, Biryukov, S, Bizuayehu, HM, Blosser, CD, Boneya, DJ, Bose, D, Bou-Orm, IR, Brauer, M, Fullman, N, Barber, RM, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulkader, RS, Abdulle, AM, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adetokunboh, O, Afshin, A, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Ahmadieh, H, Ahmed, MB, Aichour, MTE, Aichour, AN, Aichour, I, Aiyar, S, Akinyemi, RO, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Alene, KA, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Ansari, H, Antonio, CAT, Anwari, P, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, MS, Barac, A, Barker-Collo, SL, Bärnighausen, T, Barrero, LH, Basu, S, Battle, KE, Baune, BT, Beardsley, J, Bedi, N, Beghi, E, Béjot, Y, Bell, ML, Bennett, DA, Bennett, JR, Bensenor, IM, Berhane, A, Berhe, DF, Bernabé, E, Betsu, BD, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhatt, S, Bhutta, ZA, Bicer, BK, Bidgoli, HH, Bikbov, B, Bilal, AI, Birungi, C, Biryukov, S, Bizuayehu, HM, Blosser, CD, Boneya, DJ, Bose, D, Bou-Orm, IR, and Brauer, M

Published
2017

35. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Kassebaum, NJ, Arora, M, Barber, RM, Brown, J, Carter, A, Casey, DC, Charlson, FJ, Coates, MM, Coggeshall, M, Cornaby, L, Dandona, L, Dicker, DJ, Erskine, HE, Ferrari, AJ, Fitzmaurice, C, Foreman, K, Forouzanfar, MH, Fullman, N, Goldberg, EM, Graetz, N, Haagsma, JA, Hay, SI, Johnson, CO, Kemmer, L, Khalil, IA, Kinfu, Y, Kutz, MJ, Kyu, HH, Leung, J, Lim, SS, Lozano, R, Mikesell, J, Mokdad, AH, Mooney, MD, Naghavi, M, Nguyen, G, Nsoesie, E, Pigott, DM, Pinho, C, Rankin, Z, Reinig, N, Sandar, L, Smith, A, Sorensen, RJD, Stanaway, J, Steiner, C, Teeple, S, Thomas, BA, Troeger, C, VanderZanden, A, Wagner, JA, Wanga, V, Whiteford, HA, Zhou, M, Zoeckler, L, Achoki, T, Afshin, A, Alexander, LT, Allen, C, Anderson, GM, Bell, B, Bienhoff, K, Biryukov, S, Blore, JD, Estep, K, Friedman, J, Frostad, J, Godwin, WW, Liu, PY, Masiye, F, Millear, A, Mirarefin, M, Moradi-Lakeh, M, Mumford, JE, Ng, M, Reitsma, MB, Reynolds, A, Roth, GA, Sur, PJ, Vollset, SE, Vos, T, Lopez, AD, Murray, CJL, Ellenbogen, RG, Mock, CN, Anderson, BO, Futran, ND, Bhutta, ZA, Nisar, MI, Akseer, N, deVeber, GA, Abajobir, AA, Knibbs, LD, Lalloo, R, Alam, NKM, Gouda, HN, Guo, Y, McGrath, JJ, Jeemon, P, Kassebaum, NJ, Arora, M, Barber, RM, Brown, J, Carter, A, Casey, DC, Charlson, FJ, Coates, MM, Coggeshall, M, Cornaby, L, Dandona, L, Dicker, DJ, Erskine, HE, Ferrari, AJ, Fitzmaurice, C, Foreman, K, Forouzanfar, MH, Fullman, N, Goldberg, EM, Graetz, N, Haagsma, JA, Hay, SI, Johnson, CO, Kemmer, L, Khalil, IA, Kinfu, Y, Kutz, MJ, Kyu, HH, Leung, J, Lim, SS, Lozano, R, Mikesell, J, Mokdad, AH, Mooney, MD, Naghavi, M, Nguyen, G, Nsoesie, E, Pigott, DM, Pinho, C, Rankin, Z, Reinig, N, Sandar, L, Smith, A, Sorensen, RJD, Stanaway, J, Steiner, C, Teeple, S, Thomas, BA, Troeger, C, VanderZanden, A, Wagner, JA, Wanga, V, Whiteford, HA, Zhou, M, Zoeckler, L, Achoki, T, Afshin, A, Alexander, LT, Allen, C, Anderson, GM, Bell, B, Bienhoff, K, Biryukov, S, Blore, JD, Estep, K, Friedman, J, Frostad, J, Godwin, WW, Liu, PY, Masiye, F, Millear, A, Mirarefin, M, Moradi-Lakeh, M, Mumford, JE, Ng, M, Reitsma, MB, Reynolds, A, Roth, GA, Sur, PJ, Vollset, SE, Vos, T, Lopez, AD, Murray, CJL, Ellenbogen, RG, Mock, CN, Anderson, BO, Futran, ND, Bhutta, ZA, Nisar, MI, Akseer, N, deVeber, GA, Abajobir, AA, Knibbs, LD, Lalloo, R, Alam, NKM, Gouda, HN, Guo, Y, McGrath, JJ, and Jeemon, P

Published
2016

36. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Forouzanfar, MH, Afshin, A, Alexander, LT, Biryukov, S, Brauer, M, Cercy, K, Charlson, FJ, Cohen, AJ, Dandona, L, Estep, K, Ferrari, AJ, Frostad, JJ, Fullman, N, Godwin, WW, Griswold, M, Hay, SI, Kyu, HH, Larson, HJ, Lim, SS, Liu, PY, Lopez, AD, Lozano, R, Marczak, L, Mokdad, AH, Moradi-Lakeh, M, Naghavi, M, Reitsma, MB, Roth, GA, Sur, PJ, Vos, T, Wagner, JA, Wang, H, Zhao, Y, Zhou, M, Barber, RM, Bell, B, Blore, JD, Casey, DC, Coates, MM, Cooperrider, K, Cornaby, L, Dicker, D, Erskine, HE, Fleming, T, Foreman, K, Gakidou, E, Haagsma, JA, Johnson, CO, Kemmer, L, Ku, T, Leung, J, Masiye, F, Millear, A, Mirarefin, M, Misganaw, A, Mullany, E, Mumford, JE, Ng, M, Olsen, H, Rao, P, Reinig, N, Roman, Y, Sandar, L, Santomauro, DF, Slepak, EL, Sorensen, RJD, Thomas, BA, Vollset, SE, Whiteford, HA, Zipkin, B, Murray, CJL, Mock, CN, Anderson, BO, Futran, ND, Anderson, HR, Bhutta, ZA, Nisar, MI, Akseer, N, Krueger, H, Gotay, CC, Kissoon, N, Kopec, JA, Pourmalek, F, Burnett, R, Abajobir, AA, Knibbs, LD, Veerman, JL, Lalloo, R, Scott, JG, Alam, NKM, Gouda, HN, Guo, Y, McGrath, JJ, Jeemon, P, Dandona, R, Goenka, S, Kumar, GA, Gething, PW, Bisanzio, D, Deribew, A, Mekonnen, A, Forouzanfar, MH, Afshin, A, Alexander, LT, Biryukov, S, Brauer, M, Cercy, K, Charlson, FJ, Cohen, AJ, Dandona, L, Estep, K, Ferrari, AJ, Frostad, JJ, Fullman, N, Godwin, WW, Griswold, M, Hay, SI, Kyu, HH, Larson, HJ, Lim, SS, Liu, PY, Lopez, AD, Lozano, R, Marczak, L, Mokdad, AH, Moradi-Lakeh, M, Naghavi, M, Reitsma, MB, Roth, GA, Sur, PJ, Vos, T, Wagner, JA, Wang, H, Zhao, Y, Zhou, M, Barber, RM, Bell, B, Blore, JD, Casey, DC, Coates, MM, Cooperrider, K, Cornaby, L, Dicker, D, Erskine, HE, Fleming, T, Foreman, K, Gakidou, E, Haagsma, JA, Johnson, CO, Kemmer, L, Ku, T, Leung, J, Masiye, F, Millear, A, Mirarefin, M, Misganaw, A, Mullany, E, Mumford, JE, Ng, M, Olsen, H, Rao, P, Reinig, N, Roman, Y, Sandar, L, Santomauro, DF, Slepak, EL, Sorensen, RJD, Thomas, BA, Vollset, SE, Whiteford, HA, Zipkin, B, Murray, CJL, Mock, CN, Anderson, BO, Futran, ND, Anderson, HR, Bhutta, ZA, Nisar, MI, Akseer, N, Krueger, H, Gotay, CC, Kissoon, N, Kopec, JA, Pourmalek, F, Burnett, R, Abajobir, AA, Knibbs, LD, Veerman, JL, Lalloo, R, Scott, JG, Alam, NKM, Gouda, HN, Guo, Y, McGrath, JJ, Jeemon, P, Dandona, R, Goenka, S, Kumar, GA, Gething, PW, Bisanzio, D, Deribew, A, and Mekonnen, A

Abstract

Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015

Published
2016

37. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015

Author

Wang, H, Wolock, TM, Carter, A, Nguyen, G, Kyu, HH, Gakidou, E, Hay, SI, Msemburi, W, Coates, MM, Mooney, MD, Fraser, MS, Sligar, A, Larson, HJ, Friedman, J, Brown, A, Dandona, L, Fullman, N, Haagsma, J, Khalil, I, Lim, SS, Mikesell, J, Mokdad, AH, Moradi-Lakeh, M, Pearson, K, Silpakit, B, Sorensen, MJD, Temesgen, AM, Vollset, SE, Zoeckler, L, Murray, CJL, Alfonso-Cristancho, R, Harun, KM, Prokop, DM, Mills, EJ, Trickey, A, Ajala, ON, Bärnighausen, T, Ding, EL, Farvid, MS, Thorne-Lyman, AL, Won, S, Fitchett, JRA, Salomon, J, Abajobir, AA, Hoy, DG, Alam, NKM, Abate, KH, Ghiwot, TT, Gebremedhin, AT, Abbas, KM, Abd El Razek, MM, Abd-Allah, F, Abdulle, AM, Abera, SF, Melaku, YA, Tesfay, Fisaha, Abyu, GY, Bayou, TA, Betsu, BD, Gebru, AA, Hailu, GB, Tekle, T, Yalew, AZ, Yebyo, HG, Abubakar, I, Aldridge, RW, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Ojelabi, FA, Adofo, K, Adou, AK, Akinyemiju, TF, Schwebel, DC, Singh, JA, Akseer, N, Al Lami, FH, Al-Aly, Z, Alam, K, Weintraub, RG, Chiang, PP, Meretoja, A, Lopez, AD, Wijeratne, T, Driscoll, TR, Kemp, AH, Leigh, J, Mekonnen, Alemayehu, Karema, CK, Alasfoor, D, Aldhahri, SFS, Terkawi, AS, Alegretti, MA, Aleman, AV, Alemu, ZA, Cooper, C, Deribew, A, Wang, H, Wolock, TM, Carter, A, Nguyen, G, Kyu, HH, Gakidou, E, Hay, SI, Msemburi, W, Coates, MM, Mooney, MD, Fraser, MS, Sligar, A, Larson, HJ, Friedman, J, Brown, A, Dandona, L, Fullman, N, Haagsma, J, Khalil, I, Lim, SS, Mikesell, J, Mokdad, AH, Moradi-Lakeh, M, Pearson, K, Silpakit, B, Sorensen, MJD, Temesgen, AM, Vollset, SE, Zoeckler, L, Murray, CJL, Alfonso-Cristancho, R, Harun, KM, Prokop, DM, Mills, EJ, Trickey, A, Ajala, ON, Bärnighausen, T, Ding, EL, Farvid, MS, Thorne-Lyman, AL, Won, S, Fitchett, JRA, Salomon, J, Abajobir, AA, Hoy, DG, Alam, NKM, Abate, KH, Ghiwot, TT, Gebremedhin, AT, Abbas, KM, Abd El Razek, MM, Abd-Allah, F, Abdulle, AM, Abera, SF, Melaku, YA, Tesfay, Fisaha, Abyu, GY, Bayou, TA, Betsu, BD, Gebru, AA, Hailu, GB, Tekle, T, Yalew, AZ, Yebyo, HG, Abubakar, I, Aldridge, RW, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Ojelabi, FA, Adofo, K, Adou, AK, Akinyemiju, TF, Schwebel, DC, Singh, JA, Akseer, N, Al Lami, FH, Al-Aly, Z, Alam, K, Weintraub, RG, Chiang, PP, Meretoja, A, Lopez, AD, Wijeratne, T, Driscoll, TR, Kemp, AH, Leigh, J, Mekonnen, Alemayehu, Karema, CK, Alasfoor, D, Aldhahri, SFS, Terkawi, AS, Alegretti, MA, Aleman, AV, Alemu, ZA, Cooper, C, and Deribew, A

Abstract

Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. Methods For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. Findings Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1–3·4 million). Annual incidence has stayed relatively constant at about 2·6 mil

Published
2016

38. Global, regional, and national levels of maternal mortality, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Kassebaum, NJ, Barber, RM, Bhutta, ZA, Dandona, L, Gething, PW, Hay, SI, Kinfu, Y, Larson, HJ, Liang, X, Lim, SS, Lopez, AD, Lozano, R, Mensah, GA, Mokdad, AH, Naghavi, M, Pinho, C, Salomon, JA, Steiner, C, Vos, T, Wang, H, Abajobir, AA, Abate, KH, Abbas, KM, Abd-Allah, F, Abdallat, MA, Abdulle, AM, Abera, SF, Aboyans, V, Abubakar, I, Abu-Rmeileh, NME, Achoki, T, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adou, AK, Afanvi, KA, Agarwal, A, Kiadaliri, AA, Ajala, ON, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, NKM, Alasfoor, D, Aldhahri, SF, Aldridge, RW, Alhabib, S, Ali, R, Alkerwi, A, Alla, F, Al-Raddadi, R, Alsharif, U, Martin, EA, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Andersen, HH, Anderson, GM, Antoine, RM, Antonio, CAT, Aregay, AF, Arnlov, J, Arora, M, Arsenijevic, VSA, Al, A, Asayesh, H, Atique, S, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Azzopardi, P, Bacha, U, Badawi, A, Bahit, MC, Balakrishnan, K, Banerjee, A, Barac, A, Barker-Collo, SL, Barnighausen, T, Basu, S, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, NW, Bekele, T, Bell, ML, Bennett, DA, Bensenor, IM, Berhane, A, Bernabe, E, Betsu, BD, Beyene, AS, Biadgilign, S, Bikbov, B, Bin Abdulhak, AA, Biroscak, BJ, Biryukov, S, Bisanzio, D, Bjertness, E, Blore, JD, Brainin, M, Brazinova, A, Breitborde, NJK, Brugha, TS, Butt, ZA, Campos-Nonato, IR, Campuzano, JC, Cardenas, R, Carrero, JJ, Carter, A, Casey, DC, Castaneda-Oquela, CA, Castro, RE, Catala-Lopez, F, Cavalleri, F, Chang, H-Y, Chang, J-C, Chavan, L, Chibueze, CE, Chisumpa, VH, Choi, J-YJ, Chowdhury, R, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coates, MM, Coggeshall, M, Colistro, V, Colquhoun, SM, Cooper, C, Cooper, LT, Cortinovis, M, Dahiru, T, Damasceno, A, Danawi, H, Dandona, R, Das Neves, J, De Leo, D, Dellavalle, RP, Deribe, K, Deribew, A, Jarlais, DCD, Dharmaratne, SD, Dicker, DJ, Ding, EL, Dossou, E, Dubey, M, Ebel, BE, Ellingsen, CL, Elyazar, I, Endries, AY, Ermakov, SP, Eshrati, B, Esteghamati, A, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Fereshtehnejad, S-M, Fernandes, JC, Fischer, F, Fitchett, JRA, Fleming, T, Gt, NF, Franca, EB, Franklin, RC, Fraser, MS, Friedman, J, Pullman, N, Furst, T, Futran, ND, Gambashidze, K, Gamkrelidze, A, Gebre, T, Gebrehiwot, TT, Gebremedhin, AT, Gebremedhin, M, Gebru, AA, Geleijnse, JM, Gibney, KB, Giref, AZ, Giroud, M, Gishu, MD, Glaser, E, Goenka, S, Gomez-Dantes, H, Gona, P, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Gugnani, HC, Guo, Y, Gupta, R, Gupta, V, Hafezi-Nejad, N, Hailu, AD, Hailu, GB, Hamadeh, RR, Hamidi, S, Hancock, J, Handal, AJ, Hankey, GJ, Harb, HL, Harikrishnan, S, Harun, KM, Havmoeller, R, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Hoy, DG, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huybrechts, I, Huynh, C, Iannarone, M, Iburg, KM, Idrisov, BT, Iyer, VJ, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jee, SH, Jeemon, P, Jha, V, Jiang, G, Jiang, Y, Jibat, T, Jonas, JB, Kabir, Z, Kamal, R, Kan, H, Karch, A, Karletsos, D, Kasaeian, A, Kaul, A, Kawakami, N, Kayibanda, JF, Kazanjan, K, Kazi, DS, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Keren, A, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khan, AR, Khan, EA, Khang, Y-H, Khonelidze, I, Khosravi, A, Khubchandani, J, Kim, YJ, Kivipelto, M, Knibbs, LD, Kokubo, Y, Kosen, S, Koul, PA, Koyanagi, A, Krishnaswami, S, Defo, BK, Bicer, BK, Kudom, AA, Kulikoff, XR, Kulkarni, C, Kumar, GA, Kutz, MJ, Lal, DK, Lalloo, R, Lam, H, Lamadrid-Figueroa, H, Lan, Q, Larsson, A, Laryea, DO, Leigh, J, Leung, R, Li, Y, Lipshultz, SE, Liu, PY, Liu, S, Liu, Y, Lloyd, BK, Lotufo, PA, Lunevicius, R, Ma, S, El Razek, HMA, El Razek, MMA, Majdan, M, Majeed, A, Malekzadeh, R, Mapoma, CC, Marcenes, W, Margolis, DJ, Marquez, N, Masiye, F, Marzan, MB, Mason-Jones, AJ, Mazorodze, TT, Meaney, PA, Mehari, A, Mehndiratta, MM, Mena-Rodriguez, F, Mekonnen, AB, Melaku, YA, Memish, ZA, Mendoza, W, Meretoja, A, Meretoja, TJ, Mhimbira, FA, Miller, TR, Mills, EJ, Mirarefin, M, Misganaw, A, Ibrahim, NM, Mohammad, KA, Mohammadi, A, Mohammed, S, Mola, GLD, Monasta, L, Monis, JDLC, Hernandez, JCM, Montero, P, Montico, M, Mooney, MD, Moore, AR, Moradi-Lakeh, M, Morawska, L, Mori, R, Mueller, U, Murthy, GVS, Murthy, S, Nachega, JB, Naheed, A, Naldi, L, Nand, D, Nangia, V, Nash, D, Neupane, S, Newton, JN, Ng, M, Ngalesoni, FN, Nguhiu, P, Nguyen, G, Le Nguyen, Q, Nisar, MI, Nomura, M, Norheim, OF, Norman, RE, Nyakarahuka, L, Obermeyer, CM, Ogbo, FA, Oh, I-H, Ojelabi, FA, Olivares, PR, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ota, E, Oyekale, AS, Pa, M, Pain, A, Papantoniou, N, Park, E-K, Park, H-Y, Caicedo, AJP, Patten, SB, Paul, VK, Pereira, DM, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pillay, JD, Pishgar, F, Polinder, S, Pope, D, Pourmalek, F, Qorbani, M, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Ram, U, Ranabhat, CL, Rangaswamy, T, Rao, PV, Refaat, AH, Remuzzi, G, Violante, FS, Kassebaum, NJ, Barber, RM, Bhutta, ZA, Dandona, L, Gething, PW, Hay, SI, Kinfu, Y, Larson, HJ, Liang, X, Lim, SS, Lopez, AD, Lozano, R, Mensah, GA, Mokdad, AH, Naghavi, M, Pinho, C, Salomon, JA, Steiner, C, Vos, T, Wang, H, Abajobir, AA, Abate, KH, Abbas, KM, Abd-Allah, F, Abdallat, MA, Abdulle, AM, Abera, SF, Aboyans, V, Abubakar, I, Abu-Rmeileh, NME, Achoki, T, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adou, AK, Afanvi, KA, Agarwal, A, Kiadaliri, AA, Ajala, ON, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, NKM, Alasfoor, D, Aldhahri, SF, Aldridge, RW, Alhabib, S, Ali, R, Alkerwi, A, Alla, F, Al-Raddadi, R, Alsharif, U, Martin, EA, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Andersen, HH, Anderson, GM, Antoine, RM, Antonio, CAT, Aregay, AF, Arnlov, J, Arora, M, Arsenijevic, VSA, Al, A, Asayesh, H, Atique, S, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Azzopardi, P, Bacha, U, Badawi, A, Bahit, MC, Balakrishnan, K, Banerjee, A, Barac, A, Barker-Collo, SL, Barnighausen, T, Basu, S, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, NW, Bekele, T, Bell, ML, Bennett, DA, Bensenor, IM, Berhane, A, Bernabe, E, Betsu, BD, Beyene, AS, Biadgilign, S, Bikbov, B, Bin Abdulhak, AA, Biroscak, BJ, Biryukov, S, Bisanzio, D, Bjertness, E, Blore, JD, Brainin, M, Brazinova, A, Breitborde, NJK, Brugha, TS, Butt, ZA, Campos-Nonato, IR, Campuzano, JC, Cardenas, R, Carrero, JJ, Carter, A, Casey, DC, Castaneda-Oquela, CA, Castro, RE, Catala-Lopez, F, Cavalleri, F, Chang, H-Y, Chang, J-C, Chavan, L, Chibueze, CE, Chisumpa, VH, Choi, J-YJ, Chowdhury, R, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coates, MM, Coggeshall, M, Colistro, V, Colquhoun, SM, Cooper, C, Cooper, LT, Cortinovis, M, Dahiru, T, Damasceno, A, Danawi, H, Dandona, R, Das Neves, J, De Leo, D, Dellavalle, RP, Deribe, K, Deribew, A, Jarlais, DCD, Dharmaratne, SD, Dicker, DJ, Ding, EL, Dossou, E, Dubey, M, Ebel, BE, Ellingsen, CL, Elyazar, I, Endries, AY, Ermakov, SP, Eshrati, B, Esteghamati, A, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Fereshtehnejad, S-M, Fernandes, JC, Fischer, F, Fitchett, JRA, Fleming, T, Gt, NF, Franca, EB, Franklin, RC, Fraser, MS, Friedman, J, Pullman, N, Furst, T, Futran, ND, Gambashidze, K, Gamkrelidze, A, Gebre, T, Gebrehiwot, TT, Gebremedhin, AT, Gebremedhin, M, Gebru, AA, Geleijnse, JM, Gibney, KB, Giref, AZ, Giroud, M, Gishu, MD, Glaser, E, Goenka, S, Gomez-Dantes, H, Gona, P, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Gugnani, HC, Guo, Y, Gupta, R, Gupta, V, Hafezi-Nejad, N, Hailu, AD, Hailu, GB, Hamadeh, RR, Hamidi, S, Hancock, J, Handal, AJ, Hankey, GJ, Harb, HL, Harikrishnan, S, Harun, KM, Havmoeller, R, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Hoy, DG, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huybrechts, I, Huynh, C, Iannarone, M, Iburg, KM, Idrisov, BT, Iyer, VJ, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jee, SH, Jeemon, P, Jha, V, Jiang, G, Jiang, Y, Jibat, T, Jonas, JB, Kabir, Z, Kamal, R, Kan, H, Karch, A, Karletsos, D, Kasaeian, A, Kaul, A, Kawakami, N, Kayibanda, JF, Kazanjan, K, Kazi, DS, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Keren, A, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khan, AR, Khan, EA, Khang, Y-H, Khonelidze, I, Khosravi, A, Khubchandani, J, Kim, YJ, Kivipelto, M, Knibbs, LD, Kokubo, Y, Kosen, S, Koul, PA, Koyanagi, A, Krishnaswami, S, Defo, BK, Bicer, BK, Kudom, AA, Kulikoff, XR, Kulkarni, C, Kumar, GA, Kutz, MJ, Lal, DK, Lalloo, R, Lam, H, Lamadrid-Figueroa, H, Lan, Q, Larsson, A, Laryea, DO, Leigh, J, Leung, R, Li, Y, Lipshultz, SE, Liu, PY, Liu, S, Liu, Y, Lloyd, BK, Lotufo, PA, Lunevicius, R, Ma, S, El Razek, HMA, El Razek, MMA, Majdan, M, Majeed, A, Malekzadeh, R, Mapoma, CC, Marcenes, W, Margolis, DJ, Marquez, N, Masiye, F, Marzan, MB, Mason-Jones, AJ, Mazorodze, TT, Meaney, PA, Mehari, A, Mehndiratta, MM, Mena-Rodriguez, F, Mekonnen, AB, Melaku, YA, Memish, ZA, Mendoza, W, Meretoja, A, Meretoja, TJ, Mhimbira, FA, Miller, TR, Mills, EJ, Mirarefin, M, Misganaw, A, Ibrahim, NM, Mohammad, KA, Mohammadi, A, Mohammed, S, Mola, GLD, Monasta, L, Monis, JDLC, Hernandez, JCM, Montero, P, Montico, M, Mooney, MD, Moore, AR, Moradi-Lakeh, M, Morawska, L, Mori, R, Mueller, U, Murthy, GVS, Murthy, S, Nachega, JB, Naheed, A, Naldi, L, Nand, D, Nangia, V, Nash, D, Neupane, S, Newton, JN, Ng, M, Ngalesoni, FN, Nguhiu, P, Nguyen, G, Le Nguyen, Q, Nisar, MI, Nomura, M, Norheim, OF, Norman, RE, Nyakarahuka, L, Obermeyer, CM, Ogbo, FA, Oh, I-H, Ojelabi, FA, Olivares, PR, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ota, E, Oyekale, AS, Pa, M, Pain, A, Papantoniou, N, Park, E-K, Park, H-Y, Caicedo, AJP, Patten, SB, Paul, VK, Pereira, DM, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pillay, JD, Pishgar, F, Polinder, S, Pope, D, Pourmalek, F, Qorbani, M, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Ram, U, Ranabhat, CL, Rangaswamy, T, Rao, PV, Refaat, AH, Remuzzi, G, and Violante, FS

Abstract

BACKGROUND: In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. METHODS: We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10-54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. FINDINGS: Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy

Published
2016

39. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Vos, Theo, Allen, Christine, Arora, Megha, Barber, Ryan M, Bhutta, Zulfiqar A, Brown, Alexandria, Carter, Austin, Casey, Daniel C, Charlson, Fiona J, Chen, Alan Z, Coggeshall, Megan, Cornaby, Leslie, Dandona, Lalit, Dicker, Daniel J, Dilegge, Tina, Erskine, Holly E, Ferrari, Alize J, Fitzmaurice, Christina, Fleming, Tom, Forouzanfar, Mohammad H, Fullman, Nancy, Gething, Peter W, Goldberg, Ellen M, Graetz, Nicholas, Haagsma, Juanita A, Hay, Simon I, Johnson, Catherine O, Kassebaum, Nicholas J, Kawashima, Toana, Kemmer, Laura, Khalil, Ibrahim A, Kinfu, Yohannes, Kyu, Hmwe H, Leung, Janni, Liang, Xiaofeng, Lim, Stephen S, Lopez, Alan D, Lozano, Rafael, Marczak, Laurie, Mensah, George A, Mokdad, Ali H, Naghavi, Mohsen, Nguyen, Grant, Nsoesie, Elaine, Olsen, Helen, Pigott, David M, Pinho, Christine, Rankin, Zane, Reinig, Nikolas, Salomon, Joshua A, Sandar, Logan, Smith, Alison, Stanaway, Jeffrey, Steiner, Caitlyn, Teeple, Stephanie, Thomas, Bernadette A, Troeger, Christopher, Wagner, Joseph A, Wang, Haidong, Wanga, Valentine, Whiteford, Harvey A, Zoeckler, Leo, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abraham, Biju, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen M E, Ackerman, Ilana N, Adebiyi, Akindele Olupelumi, Ademi, Zanfina, Adou, Arsène Kouablan, Afanvi, Kossivi Agbelenko, Agardh, Emilie Elisabet, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ahmadieh, Hamid, Ajala, Oluremi N, Akinyemi, Rufus Olusola, Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K M, Aldhahri, Saleh Fahed, Alegretti, Miguel Angel, Alemu, Zewdie Aderaw, Alexander, Lily T, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amberbir, Alemayehu, Amini, Heresh, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H, Anderson, Gregory M, Anderson, Benjamin O, Antonio, Carl Abelardo T, Aregay, Atsede Fantahun, Ärnlöv, Johan, Artaman, Al, Asayesh, Hamid, Assadi, Reza, Atique, Suleman, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L, Bärnighausen, Till, Barregard, Lars, Barrero, Lope H, Basu, Arindam, Bazargan-Hejazi, Shahrzad, Beghi, Ettore, Bell, Brent, Bell, Michelle L, Bennett, Derrick A, Bensenor, Isabela M, Benzian, Habib, Berhane, Adugnaw, Bernabé, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Bhala, Neeraj, Bhatt, Samir, Biadgilign, Sibhatu, Bienhoff, Kelly, Bikbov, Boris, Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed, Borschmann, Rohan, Boufous, Soufiane, Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Brown, Jonathan, Buchbinder, Rachelle, Buckle, Geoffrey Colin, Butt, Zahid A, Calabria, Bianca, Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Carabin, Hélène, Cárdenas, Rosario, Carpenter, David O, Carrero, Juan Jesus, Castañeda-Orjuela, Carlos A, Rivas, Jacqueline Castillo, Catalá-López, Ferrán, Chang, Jung-Chen, Chiang, Peggy Pei-Chia, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christensen, Hanne, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G, Cirillo, Massimo, Coates, Matthew M, Colquhoun, Samantha M, Cooper, Cyrus, Cortinovis, Monica, Crump, John A, Damtew, Solomon Abrha, Dandona, Rakhi, Daoud, Farah, Dargan, Paul I, das Neves, José, Davey, Gail, Davis, Adrian C, Leo, Diego De, Degenhardt, Louisa, Gobbo, Liana C Del, Dellavalle, Robert P, Deribe, Kebede, Deribew, Amare, Derrett, Sarah, Jarlais, Don C Des, Dharmaratne, Samath D, Dhillon, Preet K, Diaz-Torné, Cesar, Ding, Eric L, Driscoll, Tim R, Duan, Leilei, Dubey, Manisha, Duncan, Bruce Bartholow, Ebrahimi, Hedyeh, Ellenbogen, Richard G, Elyazar, Iqbal, Endres, Matthias, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Estep, Kara, Farid, Talha A, Farinha, Carla Sofia e Sa, Faro, André, Farvid, Maryam S, Farzadfar, Farshad, Feigin, Valery L, Felson, David T, Fereshtehnejad, Seyed-Mohammad, Fernandes, Jefferson G, Fernandes, Joao C, Fischer, Florian, Fitchett, Joseph R A, Foreman, Kyle, Fowkes, F Gerry R, Fox, Jordan, Franklin, Richard C, Friedman, Joseph, Frostad, Joseph, Fürst, Thomas, Futran, Neal D, Gabbe, Belinda, Ganguly, Parthasarathi, Gankpé, Fortuné Gbètoho, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Geleijnse, Johanna M, Gessner, Bradford D, Gibney, Katherine B, Ginawi, Ibrahim Abdelmageem Mohamed, Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Giussani, Giorgia, Glaser, Elizabeth, Godwin, William W, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Grainger, Rebecca, Greaves, Felix, Guillemin, Francis, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Gutiérrez, Reyna A, Haile, Demewoz, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Halasa, Yara A, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Hancock, Jamie, Handal, Alexis J, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Harikrishnan, Sivadasanpillai, Haro, Josep Maria, Havmoeller, Rasmus, Hay, Roderick J, Heredia-Pi, Ileana Beatriz, Heydarpour, Pouria, Hoek, Hans W, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hoy, Damian G, Htet, Aung Soe, Huang, Hsiang, Huang, John J, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Innos, Kaire, Inoue, Manami, Iyer, Veena J, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, Javanbakht, Mehdi, Jayaraman, Sudha P, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jensen, Paul N, Jiang, Ying, Jibat, Tariku, Jimenez-Corona, Aida, Jin, Ye, Jonas, Jost B, Kabir, Zubair, Kalkonde, Yogeshwar, Kamal, Ritul, Kan, Haidong, Karch, André, Karema, Corine Kakizi, Karimkhani, Chante, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Keiyoro, Peter Njenga, Kemp, Andrew Haddon, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khera, Sahil, Khoja, Tawfik Ahmed Muthafer, Khubchandani, Jagdish, Kieling, Christian, Kim, Pauline, Kim, Cho-il, Kim, Daniel, Kim, Yun Jin, Kissoon, Niranjan, Knibbs, Luke D, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek A, Kosen, Soewarta, Kotsakis, Georgios A, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A, Kuipers, Ernst J, Kumar, G Anil, Kutz, Michael, Kwan, Gene F, Lal, Aparna, Lalloo, Ratilal, Lallukka, Tea, Lam, Hilton, Lam, Jennifer O, Langan, Sinead M, Larsson, Anders, Lavados, Pablo M, Leasher, Janet L, Leigh, James, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Juan, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Lo, Warren D, Logroscino, Giancarlo, Looker, Katharine J, Lotufo, Paulo A, Lunevicius, Raimundas, Lyons, Ronan A, Mackay, Mark T, Magdy, Mohammed, Razek, Abd El, Mahdavi, Mahdi, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Marcenes, Wagner, Margolis, David Joel, Martinez-Raga, Jose, Masiye, Felix, Massano, João, McGarvey, Stephen Theodore, McGrath, John J, McKee, Martin, McMahon, Brian J, Meaney, Peter A, Mehari, Alem, Mejia-Rodriguez, Fabiola, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J, Mhimbira, Francis Apolinary, Millear, Anoushka, Miller, Ted R, Mills, Edward J, Mirarefin, Mojde, Mitchell, Philip B, Mock, Charles N, Mohammadi, Alireza, Mohammed, Shafiu, Monasta, Lorenzo, Hernandez, Julio Cesar Montañez, Montico, Marcella, Mooney, Meghan D, Moradi-Lakeh, Maziar, Morawska, Lidia, Mueller, Ulrich O, Mullany, Erin, Mumford, John Everett, Murdoch, Michele E, Nachega, Jean B, Nagel, Gabriele, Naheed, Aliya, Naldi, Luigi, Nangia, Vinay, Newton, John N, Ng, Marie, Ngalesoni, Frida Namnyak, Nguyen, Quyen Le, Nisar, Muhammad Imran, Pete, Patrick Martial Nkamedjie, Nolla, Joan M, Norheim, Ole F, Norman, Rosana E, Norrving, Bo, Nunes, Bruno P, Ogbo, Felix Akpojene, Oh, In-Hwan, Ohkubo, Takayoshi, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ortiz, Alberto, Osman, Majdi, Ota, Erika, PA, Mahesh, Park, Eun-Kee, Parsaeian, Mahboubeh, de Azeredo Passos, Valéria Maria, Caicedo, Angel J Paternina, Patten, Scott B, Patton, George C, Pereira, David M, Perez-Padilla, Rogelio, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Piel, Frédéric B, Pillay, Julian David, Pishgar, Farhad, Plass, Dietrich, Platts-Mills, James A, Polinder, Suzanne, Pond, Constance D, Popova, Svetlana, Poulton, Richie G, Pourmalek, Farshad, Prabhakaran, Dorairaj, Prasad, Noela M, Qorbani, Mostafa, Rabiee, Rynaz H S, Radfar, Amir, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajsic, Sasa, Ram, Usha, Rao, Puja, Refaat, Amany H, Reitsma, Marissa B, Remuzzi, Giuseppe, Resnikoff, Serge, Reynolds, Alex, Ribeiro, Antonio L, Blancas, Maria Jesus Rios, Roba, Hirbo Shore, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Sagar, Rajesh, Sahathevan, Ramesh, Sanabria, Juan R, Sanchez-Niño, Maria Dolores, Santos, Itamar S, Santos, João Vasco, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Schaub, Michael P, Schmidt, Maria Inês, Schneider, Ione J C, Schöttker, Ben, Schwebel, David C, Scott, James G, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya A, Shaheen, Amira, Shaikh, Masood Ali, Sharma, Rajesh, Sharma, Upasana, Shen, Jiabin, Shepard, Donald S, Sheth, Kevin N, Shibuya, Kenji, Shin, Min-Jeong, Shiri, Rahman, Shiue, Ivy, Shrime, Mark G, Sigfusdottir, Inga Dora, Silva, Diego Augusto Santos, Silveira, Dayane Gabriele Alves, Singh, Abhishek, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Sivonda, Anna, Skirbekk, Vegard, Skogen, Jens Christoffer, Sligar, Amber, Sliwa, Karen, Soljak, Michael, Søreide, Kjetil, Sorensen, Reed J D, Soriano, Joan B, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stathopoulou, Vasiliki, Steel, Nicholas, Stein, Dan J, Steiner, Timothy J, Steinke, Sabine, Stovner, Lars, Stroumpoulis, Konstantinos, Sunguya, Bruno F, Sur, Patrick, Swaminathan, Soumya, Sykes, Bryan L, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Takala, Jukka S, Tandon, Nikhil, Tanne, David, Tavakkoli, Mohammad, Taye, Bineyam, Taylor, Hugh R, Ao, Braden J Te, Tedla, Bemnet Amare, Terkawi, Abdullah Sulieman, Thomson, Alan J, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Fotis, Tran, Bach Xuan, Truelsen, Thomas, Dimbuene, Zacharie Tsala, Tsilimbaris, Miltiadis, Tura, Abera Kenay, Tuzcu, Emin Murat, Tyrovolas, Stefanos, Ukwaja, Kingsley N, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Uthman, Olalekan A, van Gool, Coen H, Varakin, Yuri Y, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Verma, Raj Kumar, Violante, Francesco S, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wagner, Gregory R, Waller, Stephen G, Wang, Linhong, Watkins, David A, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Westerman, Ronny, White, Richard A, Williams, Hywel C, Wiysonge, Charles Shey, Wolfe, Charles D A, Won, Sungho, Woodbrook, Rachel, Wubshet, Mamo, Xavier, Denis, Xu, Gelin, Yadav, Ajit Kumar, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Ye, Pengpeng, Yebyo, Henock Gebremedhin, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zeeb, Hajo, Zhou, Maigeng, Zodpey, Sanjay, Zuhlke, Liesl Joanna, Murray, Christopher J L, Vos, T, Allen, C, Arora, M, Barber, Rm, Bhutta, Za, Brown, A, Carter, A, Casey, Dc, Charlson, Fj, Chen, Az, Coggeshall, M, Cornaby, L, Dandona, L, Dicker, Dj, Dilegge, T, Erskine, He, Ferrari, Aj, Fitzmaurice, C, Fleming, T, Forouzanfar, Mh, Fullman, N, Gething, Pw, Goldberg, Em, Graetz, N, Haagsma, Ja, Johnson, Co, Kassebaum, Nj, Kawashima, T, Kemmer, L, Khalil, Ia, Kinfu, Y, Kyu, Hh, Leung, J, Liang, X, Lim, S, Lopez, Ad, Lozano, R, Marczak, L, Mensah, Ga, Mokdad, Ah, Naghavi, M, Nguyen, G, Nsoesie, E, Olsen, H, Pigott, Dm, Pinho, C, Rankin, Z, Reinig, N, Salomon, Ja, Sandar, L, Smith, A, Stanaway, J, Steiner, C, Teeple, S, Thomas, Ba, Troeger, C, Wagner, Ja, Wang, H, Wanga, V, Whiteford, Ha, Zoeckler, L, Abajobir, Aa, Abate, Kh, Abbafati, C, Abbas, Km, Abd Allah, F, Abraham, B, Abubakar, I, Abu Raddad, Lj, Abu Rmeileh, Nm, Ackerman, In, Adebiyi, Ao, Ademi, Z, Adou, Ak, Afanvi, Ka, Agardh, Ee, Agarwal, A, Kiadaliri, Aa, Ahmadieh, H, Ajala, On, Akinyemi, Ro, Akseer, N, Al Aly, Z, Alam, K, Alam, Nk, Aldhahri, Sf, Alegretti, Ma, Alemu, Za, Alexander, Lt, Alhabib, S, Ali, R, Alkerwi, A, Alla, F, Allebeck, P, Al Raddadi, R, Alsharif, U, Altirkawi, Ka, Alvis Guzman, N, Amare, At, Amberbir, A, Amini, H, Ammar, W, Amrock, Sm, Andersen, Hh, Anderson, Gm, Anderson, Bo, Antonio, Ca, Aregay, Af, Ärnlöv, J, Artaman, A, Asayesh, H, Assadi, R, Atique, S, Avokpaho, Ef, Awasthi, A, Quintanilla, Bp, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Banerjee, A, Barac, A, Barker Collo, Sl, Bärnighausen, T, Barregard, L, Barrero, Lh, Basu, A, Bazargan Hejazi, S, Bell, B, Bell, Ml, Bennett, Da, Bensenor, Im, Benzian, H, Berhane, A, Bernabé, E, Betsu, Bd, Beyene, A, Bhala, N, Bhatt, S, Biadgilign, S, Bienhoff, K, Bikbov, B, Biryukov, S, Bisanzio, D, Bjertness, E, Blore, J, Borschmann, R, Boufous, S, Brainin, M, Brazinova, A, Breitborde, Nj, Brown, J, Buchbinder, R, Buckle, Gc, Butt, Za, Calabria, B, Campos Nonato, Ir, Campuzano, Jc, Carabin, H, Cárdenas, R, Carpenter, Do, Carrero, Jj, Castañeda Orjuela, Ca, Rivas, Jc, Catalá López, F, Chang, Jc, Chiang, Pp, Chibueze, Ce, Chisumpa, Vh, Choi, Jj, Chowdhury, R, Christensen, H, Christopher, Dj, Ciobanu, Lg, Cirillo, Massimo, Coates, Mm, Colquhoun, Sm, Cooper, C, Cortinovis, M, Crump, Ja, Gastroenterology & Hepatology, Health Services Management & Organisation (HSMO), Public Health, Psychiatry, Vos, Theo, Allen, Christine, Arora, Megha, Barber, Ryan M, Bhutta, Zulfiqar A, Brown, Alexandria, Carter, Austin, Casey, Daniel C, Charlson, Fiona J, Chen, Alan Z, Coggeshall, Megan, Cornaby, Leslie, Dandona, Lalit, Dicker, Daniel J, Dilegge, Tina, Erskine, Holly E, Ferrari, Alize J, Fitzmaurice, Christina, Fleming, Tom, Forouzanfar, Mohammad H, Fullman, Nancy, Gething, Peter W, Goldberg, Ellen M, Graetz, Nichola, Haagsma, Juanita A, Johnson, Catherine O, Kassebaum, Nicholas J, Kawashima, Toana, Kemmer, Laura, Khalil, Ibrahim A, Kinfu, Yohanne, Kyu, Hmwe H, Leung, Janni, Liang, Xiaofeng, Lim, Stephen S, Lopez, Alan D, Lozano, Rafael, Marczak, Laurie, Mensah, George A, Mokdad, Ali H, Naghavi, Mohsen, Nguyen, Grant, Nsoesie, Elaine, Olsen, Helen, Pigott, David M, Pinho, Christine, Rankin, Zane, Reinig, Nikola, Salomon, Joshua A, Sandar, Logan, Smith, Alison, Stanaway, Jeffrey, Steiner, Caitlyn, Teeple, Stephanie, Thomas, Bernadette A, Troeger, Christopher, Wagner, Joseph A, Wang, Haidong, Wanga, Valentine, Whiteford, Harvey A, Zoeckler, Leo, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abraham, Biju, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen M E, Ackerman, Ilana N, Adebiyi, Akindele Olupelumi, Ademi, Zanfina, Adou, Arsène Kouablan, Afanvi, Kossivi Agbelenko, Agardh, Emilie Elisabet, Agarwal, Arnav, Kiadaliri, Aliasghar Ahmad, Ahmadieh, Hamid, Ajala, Oluremi N, Akinyemi, Rufus Olusola, Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K M, Aldhahri, Saleh Fahed, Alegretti, Miguel Angel, Alemu, Zewdie Aderaw, Alexander, Lily T, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'A, Alla, Françoi, Allebeck, Peter, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amberbir, Alemayehu, Amini, Heresh, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H, Anderson, Gregory M, Anderson, Benjamin O, Antonio, Carl Abelardo T, Aregay, Atsede Fantahun, Ärnlöv, Johan, Artaman, Al, Asayesh, Hamid, Assadi, Reza, Atique, Suleman, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L, Bärnighausen, Till, Barregard, Lar, Barrero, Lope H, Basu, Arindam, Bazargan-Hejazi, Shahrzad, Bell, Brent, Bell, Michelle L, Bennett, Derrick A, Bensenor, Isabela M, Benzian, Habib, Berhane, Adugnaw, Bernabé, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Bhala, Neeraj, Bhatt, Samir, Biadgilign, Sibhatu, Bienhoff, Kelly, Bikbov, Bori, Biryukov, Stan, Bisanzio, Donal, Bjertness, Espen, Blore, Jed, Borschmann, Rohan, Boufous, Soufiane, Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Brown, Jonathan, Buchbinder, Rachelle, Buckle, Geoffrey Colin, Butt, Zahid A, Calabria, Bianca, Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Carabin, Hélène, Cárdenas, Rosario, Carpenter, David O, Carrero, Juan Jesu, Castañeda-Orjuela, Carlos A, Rivas, Jacqueline Castillo, Catalá-López, Ferrán, Chang, Jung-Chen, Chiang, Peggy Pei-Chia, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christensen, Hanne, Christopher, Devasahayam Jesuda, Ciobanu, Liliana G, Coates, Matthew M, Colquhoun, Samantha M, Cooper, Cyru, Cortinovis, Monica, Crump, John A, Damtew, Solomon Abrha, Dandona, Rakhi, Daoud, Farah, Dargan, Paul I, das Neves, José, Davey, Gail, Davis, Adrian C, Leo, Diego De, Degenhardt, Louisa, Gobbo, Liana C Del, Dellavalle, Robert P, Deribe, Kebede, Deribew, Amare, Derrett, Sarah, Jarlais, Don C De, Dharmaratne, Samath D, Dhillon, Preet K, Diaz-Torné, Cesar, Ding, Eric L, Driscoll, Tim R, Duan, Leilei, Dubey, Manisha, Duncan, Bruce Bartholow, Ebrahimi, Hedyeh, Ellenbogen, Richard G, Elyazar, Iqbal, Endres, Matthia, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Estep, Kara, Farid, Talha A, Farinha, Carla Sofia e Sa, Faro, André, Farvid, Maryam S, Farzadfar, Farshad, Feigin, Valery L, Felson, David T, Fereshtehnejad, Seyed-Mohammad, Fernandes, Jefferson G, Fernandes, Joao C, Fischer, Florian, Fitchett, Joseph R A, Foreman, Kyle, Fowkes, F Gerry R, Fox, Jordan, Franklin, Richard C, Friedman, Joseph, Frostad, Joseph, Fürst, Thoma, Futran, Neal D, Gabbe, Belinda, Ganguly, Parthasarathi, Gankpé, Fortuné Gbètoho, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Geleijnse, Johanna M, Gessner, Bradford D, Gibney, Katherine B, Ginawi, Ibrahim Abdelmageem Mohamed, Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Glaser, Elizabeth, Godwin, William W, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Grainger, Rebecca, Greaves, Felix, Guillemin, Franci, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Gutiérrez, Reyna A, Haile, Demewoz, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Halasa, Yara A, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Hancock, Jamie, Handal, Alexis J, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Harikrishnan, Sivadasanpillai, Haro, Josep Maria, Havmoeller, Rasmu, Hay, Roderick J, Heredia-Pi, Ileana Beatriz, Heydarpour, Pouria, Hoek, Hans W, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hoy, Damian G, Htet, Aung Soe, Huang, Hsiang, Huang, John J, Huynh, Chantal, Iannarone, Marissa, Iburg, Kim Moesgaard, Innos, Kaire, Inoue, Manami, Iyer, Veena J, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jensen, Paul N, Jiang, Ying, Jibat, Tariku, Jimenez-Corona, Aida, Jin, Ye, Jonas, Jost B, Kabir, Zubair, Kalkonde, Yogeshwar, Kamal, Ritul, Kan, Haidong, Karch, André, Karema, Corine Kakizi, Karimkhani, Chante, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Keiyoro, Peter Njenga, Kemp, Andrew Haddon, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khera, Sahil, Khoja, Tawfik Ahmed Muthafer, Khubchandani, Jagdish, Kieling, Christian, Kim, Pauline, Kim, Cho-il, Kim, Daniel, Kim, Yun Jin, Kissoon, Niranjan, Knibbs, Luke D, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek A, Kosen, Soewarta, Kotsakis, Georgios A, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A, Kuipers, Ernst J, Kumar, G Anil, Kutz, Michael, Kwan, Gene F, Lal, Aparna, Lalloo, Ratilal, Lallukka, Tea, Lam, Hilton, Lam, Jennifer O, Langan, Sinead M, Larsson, Ander, Lavados, Pablo M, Leasher, Janet L, Leigh, Jame, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Juan, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Lo, Warren D, Logroscino, Giancarlo, Looker, Katharine J, Lotufo, Paulo A, Lunevicius, Raimunda, Lyons, Ronan A, Mackay, Mark T, Magdy, Mohammed, Razek, Abd El, Mahdavi, Mahdi, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Marcenes, Wagner, Margolis, David Joel, Martinez-Raga, Jose, Masiye, Felix, Massano, João, Mcgarvey, Stephen Theodore, Mcgrath, John J, Mckee, Martin, Mcmahon, Brian J, Meaney, Peter A, Mehari, Alem, Mejia-Rodriguez, Fabiola, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J, Mhimbira, Francis Apolinary, Miller, Ted R, Mills, Edward J, Mirarefin, Mojde, Mitchell, Philip B, Mock, Charles N, Mohammadi, Alireza, Mohammed, Shafiu, Monasta, Lorenzo, Hernandez, Julio Cesar Montañez, Montico, Marcella, Mooney, Meghan D, Moradi-Lakeh, Maziar, Morawska, Lidia, Mueller, Ulrich O, Mullany, Erin, Mumford, John Everett, Murdoch, Michele E, Nachega, Jean B, Nagel, Gabriele, Naheed, Aliya, Naldi, Luigi, Nangia, Vinay, Newton, John N, Ng, Marie, Ngalesoni, Frida Namnyak, Nguyen, Quyen Le, Nisar, Muhammad Imran, Pete, Patrick Martial Nkamedjie, Nolla, Joan M, Norheim, Ole F, Norman, Rosana E, Norrving, Bo, Nunes, Bruno P, Ogbo, Felix Akpojene, Oh, In-Hwan, Ohkubo, Takayoshi, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ortiz, Alberto, Osman, Majdi, Ota, Erika, Pa, Mahesh, Park, Eun-Kee, Parsaeian, Mahboubeh, de Azeredo Passos, Valéria Maria, Caicedo, Angel J Paternina, Patten, Scott B, Patton, George C, Pereira, David M, Perez-Padilla, Rogelio, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Piel, Frédéric B, Pillay, Julian David, Pishgar, Farhad, Plass, Dietrich, Platts-Mills, James A, Polinder, Suzanne, Pond, Constance D, Popova, Svetlana, Poulton, Richie G, Pourmalek, Farshad, Prabhakaran, Dorairaj, Prasad, Noela M, Qorbani, Mostafa, Rabiee, Rynaz H S, Radfar, Amir, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajsic, Sasa, Ram, Usha, Rao, Puja, Refaat, Amany H, Reitsma, Marissa B, Remuzzi, Giuseppe, Resnikoff, Serge, Reynolds, Alex, Ribeiro, Antonio L, Blancas, Maria Jesus Rio, Roba, Hirbo Shore, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Sagar, Rajesh, Sahathevan, Ramesh, Sanabria, Juan R, Sanchez-Niño, Maria Dolore, Santos, Itamar S, Santos, João Vasco, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Schaub, Michael P, Schmidt, Maria Inê, Schneider, Ione J C, Schöttker, Ben, Schwebel, David C, Scott, James G, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya A, Shaheen, Amira, Shaikh, Masood Ali, Sharma, Rajesh, Sharma, Upasana, Shen, Jiabin, Shepard, Donald S, Sheth, Kevin N, Shibuya, Kenji, Shin, Min-Jeong, Shiri, Rahman, Shiue, Ivy, Shrime, Mark G, Sigfusdottir, Inga Dora, Silva, Diego Augusto Santo, Silveira, Dayane Gabriele Alve, Singh, Abhishek, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Sivonda, Anna, Skirbekk, Vegard, Skogen, Jens Christoffer, Sligar, Amber, Sliwa, Karen, Soljak, Michael, Søreide, Kjetil, Soriano, Joan B, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stathopoulou, Vasiliki, Steel, Nichola, Stein, Dan J, Steiner, Timothy J, Steinke, Sabine, Stovner, Lar, Stroumpoulis, Konstantino, Sunguya, Bruno F, Sur, Patrick, Swaminathan, Soumya, Sykes, Bryan L, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Takala, Jukka S, Tandon, Nikhil, Tanne, David, Tavakkoli, Mohammad, Taye, Bineyam, Taylor, Hugh R, Ao, Braden J Te, Tedla, Bemnet Amare, Terkawi, Abdullah Sulieman, Thomson, Alan J, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Tran, Bach Xuan, Dimbuene, Zacharie Tsala, Tsilimbaris, Miltiadi, Tura, Abera Kenay, Tuzcu, Emin Murat, Tyrovolas, Stefano, Ukwaja, Kingsley N, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Uthman, Olalekan A, van Gool, Coen H, Varakin, Yuri Y, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Verma, Raj Kumar, Violante, Francesco S, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wagner, Gregory R, Waller, Stephen G, Wang, Linhong, Watkins, David A, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Westerman, Ronny, White, Richard A, Williams, Hywel C, Wiysonge, Charles Shey, Wolfe, Charles D A, Won, Sungho, Woodbrook, Rachel, Wubshet, Mamo, Xavier, Deni, Xu, Gelin, Yadav, Ajit Kumar, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Ye, Pengpeng, Yebyo, Henock Gebremedhin, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zeeb, Hajo, Zhou, Maigeng, Zodpey, Sanjay, Zuhlke, Liesl Joanna, and Murray, Christopher J L

Subjects
Medicine(all), VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Incidence, Medicine (all), Public Health, Global Health, Social Medicine and Epidemiology, Bayes Theorem, 11 Medical And Health Sciences, Articles, Department of Error, Global Health, Cost of Illne, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Cost of Illness, disability, General & Internal Medicine, Quality-Adjusted Life Year, Prevalence, Humans, Disabled Person, Disabled Persons, Quality-Adjusted Life Years, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, Human
Abstract

Background Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015. Methods We estimated incidence and prevalence by age, sex, cause, year, and geography with a wide range of updated and standardised analytical procedures. Improvements from GBD 2013 included the addition of new data sources, updates to literature reviews for 85 causes, and the identification and inclusion of additional studies published up to November, 2015, to expand the database used for estimation of non-fatal outcomes to 60 900 unique data sources. Prevalence and incidence by cause and sequelae were determined with DisMod-MR 2.1, an improved version of the DisMod-MR Bayesian meta-regression tool first developed for GBD 2010 and GBD 2013. For some causes, we used alternative modelling strategies where the complexity of the disease was not suited to DisMod-MR 2.1 or where incidence and prevalence needed to be determined from other data. For GBD 2015 we created a summary indicator that combines measures of income per capita, educational attainment, and fertility (the Socio-demographic Index [SDI]) and used it to compare observed patterns of health loss to the expected pattern for countries or locations with similar SDI scores. Findings We generated 9·3 billion estimates from the various combinations of prevalence, incidence, and YLDs for causes, sequelae, and impairments by age, sex, geography, and year. In 2015, two causes had acute incidences in excess of 1 billion: upper respiratory infections (17·2 billion, 95% uncertainty interval [UI] 15·4–19·2 billion) and diarrhoeal diseases (2·39 billion, 2·30–2·50 billion). Eight causes of chronic disease and injury each affected more than 10% of the world's population in 2015: permanent caries, tension-type headache, iron-deficiency anaemia, age-related and other hearing loss, migraine, genital herpes, refraction and accommodation disorders, and ascariasis. The impairment that affected the greatest number of people in 2015 was anaemia, with 2·36 billion (2·35–2·37 billion) individuals affected. The second and third leading impairments by number of individuals affected were hearing loss and vision loss, respectively. Between 2005 and 2015, there was little change in the leading causes of years lived with disability (YLDs) on a global basis. NCDs accounted for 18 of the leading 20 causes of age-standardised YLDs on a global scale. Where rates were decreasing, the rate of decrease for YLDs was slower than that of years of life lost (YLLs) for nearly every cause included in our analysis. For low SDI geographies, Group 1 causes typically accounted for 20–30% of total disability, largely attributable to nutritional deficiencies, malaria, neglected tropical diseases, HIV/AIDS, and tuberculosis. Lower back and neck pain was the leading global cause of disability in 2015 in most countries. The leading cause was sense organ disorders in 22 countries in Asia and Africa and one in central Latin America; diabetes in four countries in Oceania; HIV/AIDS in three southern sub-Saharan African countries; collective violence and legal intervention in two north African and Middle Eastern countries; iron-deficiency anaemia in Somalia and Venezuela; depression in Uganda; onchoceriasis in Liberia; and other neglected tropical diseases in the Democratic Republic of the Congo. Interpretation Ageing of the world's population is increasing the number of people living with sequelae of diseases and injuries. Shifts in the epidemiological profile driven by socioeconomic change also contribute to the continued increase in years lived with disability (YLDs) as well as the rate of increase in YLDs. Despite limitations imposed by gaps in data availability and the variable quality of the data available, the standardised and comprehensive approach of the GBD study provides opportunities to examine broad trends, compare those trends between countries or subnational geographies, benchmark against locations at similar stages of development, and gauge the strength or weakness of the estimates available. Funding Bill & Melinda Gates Foundation. Open Access funded by Bill & Melinda Gates FoundationUnder a Creative Commons license Attribution 4.0 International (CC BY 4.0)

Published
2016
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40. The impact of intimate partner violence on adverse birth outcomes in 20 sub-Saharan African countries: propensity score matching analysis.

Author

Asnake AA, Seifu BL, Gebrehana AK, Gebeyehu AA, Gebrekidan AY, Lombebo AA, and Abajobir AA

Abstract

Background: Intimate partner violence (IPV) is a significant public health problem, with serious consequences on women's physical, mental, sexual, and reproductive health, as well as birth outcomes. Women who encounter IPV are more likely to experience adverse birth outcomes such as low birth weight, premature delivery, and stillbirth. Although numerous studies are exploring the association between IPV and adverse birth outcomes, they merely used classical models and could not control for potential confounders. The purpose of this study was to ascertain whether there was a causation between IPV and adverse birth outcomes in sub-Saharan Africa (SSA) using a quasi-experimental statistical technique [i.e., propensity score matching (PSM) analysis]., Method: This study used the most recent (2015-22) Demographic and Health Survey (DHS) data from 20 SSA countries. A total weighted sample of 13,727 women was included in this study. IPV (i.e., sexual, physical, emotional, and at least one form of IPV) was the exposure/treatment variable and adverse birth outcomes (preterm delivery, low birth weight, stillbirth, and macrosomia) were the outcome variables of this study. PSM was employed to estimate the impact of IPV on adverse birth outcomes., Results: The average treatment effects (ATE) of sexual, physical, emotional, and at least one form of IPV were 0.031, 0.046, 0.084, and 0.025, respectively. Sexual, physical, emotional, and at least one form of IPV increased adverse birth outcomes by 3.1%, 4.6%, 8.4%, and 2.5%, respectively. Findings from the average treatment effect on treated (ATT) showed that women who experienced sexual, physical, emotional, and at least one form of IPV had an increased risk of adverse birth outcomes by 3.6%, 3.7%, 3.3%, and 3.0%, respectively, among treated groups., Conclusion: This study demonstrates a causal relationship between IPV and adverse birth outcomes in SSA countries, indicating a need for programs and effective interventions to mitigate the impact of IPV during pregnancy to reduce related adverse pregnancy outcomes. Furthermore, we suggest further research that investigates the causal effect of IPV on adverse birth outcomes by incorporating additional proximal variables not observed in this study., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Asnake, Seifu, Gebrehana, Gebeyehu, Gebrekidan, Lombebo and Abajobir.)

Published
2024
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41. Multilevel analysis of dropout from maternal continuum of care and its associated factors: Evidence from 2022 Tanzania Demographic and Health Survey.

Author

Asnake AA, Abajobir AA, Seifu BL, Asgedom YS, Melese M, Bezie MM, and Negussie YM

Subjects
Humans, Female, Tanzania, Adult, Pregnancy, Young Adult, Adolescent, Patient Dropouts statistics & numerical data, Health Surveys, Middle Aged, Prenatal Care statistics & numerical data, Postnatal Care statistics & numerical data, Socioeconomic Factors, Multilevel Analysis, Maternal Health Services statistics & numerical data, Continuity of Patient Care statistics & numerical data
Abstract

Background: The maternal continuum of care (CoC) is a cost-effective approach to mitigate preventable maternal and neonatal deaths. Women in developing countries, including Tanzania, face an increased vulnerability to significant dropout rates from maternal CoC, and addressing dropout from the continuum remains a persistent public health challenge., Method: This study used the 2022 Tanzania Demographic and Health Survey (TDHS). A total weighted sample of 5,172 women who gave birth in the past 5 years and had first antenatal care (ANC) were included in this study. Multilevel binary logistic regression analyses were used to examine factors associated with dropout from the 3 components of maternal CoC (i.e., ANC, institutional delivery, and postnatal care (PNC))., Results: The vast majority, 83.86% (95% confidence interval (CI): 82.83%, 84.83%), of women reported dropout from the maternal CoC. The odds of dropout from the CoC was 36% (AOR = 0.64, (95% CI: 0.41, 0.98)) lower among married women compared to their divorced counterparts. Women who belonged to the richer wealth index reported a 39% (AOR = 0.61, (95% CI: 0.39, 0.95)) reduction in the odds of dropout, while those belonged to the richest wealth index demonstrated a 49% (AOR = 0.51, (95% CI: 0.31, 0.82)) reduction. The odds of dropout from CoC was 37% (AOR = 0.63, (95% CI: 0.45,0.87)) lower among women who reported the use of internet in the past 12 months compared to those who had no prior exposure to the internet. Geographical location emerged as a significant factor, with women residing in the Northern region and Southern Highland Zone, respectively, experiencing a 44% (AOR = 0.56, 95% CI: 0.35-0.89) and 58% (AOR = 0.42, 95% CI: 0.26-0.68) lower odds of dropout compared to their counterparts in the central zone., Conclusion: The dropout rate from the maternity CoC in Tanzania was high. The findings contribute to our understanding of the complex dynamics surrounding maternity care continuity and underscore the need for targeted interventions, considering factors such as marital status, socioeconomic status, internet usage, and geographical location., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Asnake et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Published
2024
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42. Reduced incidence of respiratory, gastrointestinal and malaria infections among children during the COVID-19 pandemic in Western Kenya: An analysis of facility-based and weekly diaries data.

Author

Gómez-Pérez GP, de Groot R, Abajobir AA, Wainaina CW, Rinke de Wit TF, Sidze E, Pradhan M, and Janssens W

Subjects
Adult, Humans, Child, Pandemics, Kenya epidemiology, Incidence, Longitudinal Studies, COVID-19 epidemiology, Malaria epidemiology, Malaria prevention & control
Abstract

Background: Epidemics can cause significant disruptions of essential health care services. This was evident in West-Africa during the 2014-2016 Ebola outbreak, raising concerns that COVID-19 would have similar devastating consequences for the continent. Indeed, official facility-based records show a reduction in health care visits after the onset of COVID-19 in Kenya. Our question is whether this observed reduction was caused by lower access to health care or by reduced incidence of communicable diseases resulting from reduced mobility and social contacts., Methods: We analysed monthly facility-based data from 2018 to 2020, and weekly health diaries data digitally collected by trained fieldworkers between February and November 2020 from 342 households, including 1974 individuals, in Kisumu and Kakamega Counties, Kenya. Diaries data was collected as part of an ongoing longitudinal study of a digital health insurance scheme (Kakamega), and universal health coverage implementation (Kisumu). We assessed the weekly incidence of self-reported medical symptoms, formal and informal health-seeking behaviour, and foregone care in the diaries and compared it with facility-based records. Linear probability regressions with household fixed-effects were performed to compare the weekly incidence of health outcomes before and after COVID-19., Results: Facility-based data showed a decrease in health care utilization for respiratory infections, enteric illnesses, and malaria, after start of COVID-19 measures in Kenya in March 2020. The weekly diaries confirmed this decrease in respiratory and enteric symptoms, and malaria / fever, mainly in the paediatric population. In terms of health care seeking behaviour, our diaries data find a temporary shift in consultations from health care centres to pharmacists / chemists / medicine vendors for a few weeks during the pandemic, but no increase in foregone care. According to the diaries, for adults the incidence of communicable diseases/symptoms rebounded after COVID-19 mobility restrictions were lifted, while for children the effects persisted., Conclusions: COVID-19-related containment measures in Western Kenya were accompanied by a decline in respiratory infections, enteric illnesses, and malaria / fever mainly in children. Data from a population-based survey and facility-based records aligned regarding this finding despite the temporary shift to non-facility-based consultations and confirmed that the drop in utilization of health care services was not due to decreased accessibility, but rather to a lower incidence of these infections., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and declare the following activities and relationships: AA, CW, and ES work at the African Population and Health Research Centre, Nairobi, Kenya; TRdW and GPGP work at PharmAccess Foundation, Amsterdam, The Netherlands, and WJ, RdG and MP work at the AIGHD and / or the Vrij University, Amsterdam, The Netherlands., (Copyright © 2023 by the Journal of Global Health. All rights reserved.)

Published
2023
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43. Adverse obstetric outcomes in public hospitals of southern Ethiopia: the role of parity.

Author

Yimer NB, Gedefaw A, Tenaw Z, Liben ML, Meikena HK, Amano A, and Abajobir AA

Subjects
Cross-Sectional Studies, Ethiopia epidemiology, Female, Humans, Parity, Pregnancy, Hospitals, Public, Pregnancy Outcome epidemiology
Abstract

Purpose: Direct obstetric causes have a significant contribution for severe maternal morbidities and mortalities, although the effect of grand multiparity on adverse obstetric outcomes remains controversial across studies. This study aimed to compare obstetric outcomes in grand multiparous and low multiparous women in two hospitals of southern Ethiopia., Materials and Methods: A comparative cross-sectional study was conducted in one general and one comprehensive specialized hospitals in 2018. Four hundred and sixty-one mothers were included in the study. Data were collected by structured questionnaire and extraction sheets from clinical documents, and were analyzed using STATA version 14 (StataCorp, College Station, TX, USA)., Results: About 39% of the included mothers had at least one adverse obstetric outcome. Hypertensive disorders of pregnancy, antepartum hemorrhage, and premature rupture of membrane and were higher in the grand multiparous mothers. However, obstructed labor and risk of cesarean delivery were higher in low multiparous women. History of medical illnesses, previous cesarean delivery, and high birth weight were independent predictors of adverse maternal outcomes regardless of parity. However, parity did not show statistically significant difference in obstetric outcomes., Conclusion: Parity did not show statistically significant difference in experiencing adverse obstetric outcomes in women. Early identification and treatment of high-risk mothers is recommended regardless of parity.

Published
2022
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44. Prevalence of Violence Against Women in Ethiopia: A Meta-Analysis.

Author

Kassa GM and Abajobir AA

Subjects
Adolescent, Adult, Ethiopia epidemiology, Female, Humans, Middle Aged, Prevalence, Young Adult, Crime Victims, Domestic Violence statistics & numerical data, Physical Abuse statistics & numerical data, Sex Offenses statistics & numerical data, Women
Abstract

Violence against women (VAW) is a major public health problem globally, particularly in developing countries including Ethiopia. Accordingly, sustainable development goal (SDG) 5 (by United Nation) prioritizes VAW and calls for the design and implementation of programs relevant to its elimination by 2030. However, little is known about the epidemiology of VAW as all estimates from few, cross-sectional studies so far are inconsistent and inconclusive. This study, therefore, was conducted to determine the pooled national prevalence of VAW in Ethiopia. Databases including PUBMED, MEDLINE, Cochrane review, CINAHL, African Journals Online, and Google Scholar were reviewed, using relevant search engines. The meta-analysis was conducted using STATA 14 software, and forest plots were used to present the pooled estimates of VAW. The Cochran Q , I 2 statistics, and Egger's test were used to test heterogeneity and publication bias of the included studies. A total of 36 published articles, 23,782 participants, were included in the meta-analysis. The overall pooled lifetime and the past 12 months VAW prevalence was 46.93% (95% confidence interval [CI] = [39.96, 54.00]) and 37.02% (95% CI [26.47, 47.56]), respectively. The pooled lifetime physical, sexual, and psychological violence were 38.15%, 39.33%, and 39.51%, respectively. Pooled lifetime prevalence of rape was 13.02%. Overall, nearly half of Ethiopian women experience lifetime VAW, with substantial levels of physical, sexual, or psychological violence. The country should work toward enhancing gender equality, coupled with addressing risk factors at multiple levels, using community- and institution-based approaches to prevent VAW and to specifically achieve SDG 5 of eliminating VAW by 2030.

Published
2020
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45. Child Maltreatment and Persistent Smoking From Adolescence Into Adulthood: A Birth Cohort Study.

Author

Kisely S, Abajobir AA, Mills R, Strathearn L, Clavarino A, Gartner C, and Najman JM

Subjects
Adolescent, Adult, Australia epidemiology, Child, Female, Humans, Incidence, Male, Prospective Studies, Young Adult, Child Abuse psychology, Smokers psychology, Smoking epidemiology, Tobacco Use Disorder epidemiology
Abstract

Objective: A prospective record-linkage analysis to examine whether notified and/or substantiated child maltreatment is associated with the prevalence and persistence of smoking in early adulthood., Methods: The sample consisted of 3758 participants enrolled in a population-based birth cohort study in Brisbane, Australia, who were followed up at both 14 and 21 years of age. Suspected experience of child maltreatment was measured by linkage with state child protection agency data. The two main outcomes were the prevalence and persistence of smoking at 21-year follow-up, as well as the 12-month prevalence of nicotine use disorder for participants who completed the Composite International Diagnostic Interview-Auto version., Results: Of the 3758 young people at the 21-year follow-up, 7.5% (n = 282) had a history of notified maltreatment by the age of 16 years. Of these, 167 cases were substantiated. There were 1362 (35.3%) smokers at 21-year follow-up, although only 220 (5.9%) smoked more than 20 cigarettes daily. Of the 602 participants who smoked at 14 years, 289 were still smoking 7 years later. On adjusted analyses, participants who had experienced any form of notified and/or substantiated maltreatment were approximately twice as likely to be smokers at 21 years old and persistent smokers from 14 years of age. Any form of maltreatment, except sexual abuse, was also associated with an increase in the 12-month prevalence of nicotine use disorders., Conclusions: Child maltreatment is associated with both an increased onset and persistence of smoking from adolescence into young adulthood. This may have implications for smoking cessation programs and early interventions for individuals who have experienced maltreatment., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2020
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46. A meta-analysis of inpatient treatment outcomes of severe acute malnutrition and predictors of mortality among under-five children in Ethiopia.

Author

Wagnew F, Dessie G, Takele WW, Tadesse A, Islam SMS, Mulugeta H, Haile D, Negesse A, and Abajobir AA

Subjects
Child, Preschool, Comorbidity, Ethiopia epidemiology, Hospitalization, Humans, Infant, Treatment Outcome, Severe Acute Malnutrition mortality, Severe Acute Malnutrition therapy
Abstract

Background: Severe forms of malnutrition have drastic effects on childhood morbidity and mortality in sub-Saharan countries, including Ethiopia. Although few studies have previously estimated treatment outcomes of severe acute malnutrition (SAM) in Ethiopia, the findings were widely varied and inconsistent. This study thus aimed to pool estimates of treatment outcomes and identify predictors of mortality among children with SAM in Ethiopia., Methods: A systematic review was carried out to select 21 eligible articles from identified 1013 studies (dating from 2000 to 2018) that estimated treatment outcomes and predictors of mortality among SAM children. Databases including PubMed, CINHAL, Web of Sciences; Cochrane, Psych INFO and Google Scholar were comprehensively reviewed using medical subject headings (MESH) and a priori set criteria PRISMA guideline was used to systematically review and meta-analyze eligible studies. Details of sample size, magnitude of effect sizes, including Hazard Ratio (HRs) and standard errors were extracted. Random-effects model was used to calculate pooled estimates in Stata/se version-14. Cochran's Q, I 2 , and meta-bias statistics were assessed for heterogeneity and Egger's test for publication bias., Result: Twenty-one studies were included in the final analysis, which comprised 8057 under-five children with SAM in Ethiopia. The pooled estimates of treatment outcomes, in terms of death, recovery, defaulter and transfer out and non-response rates were 10.3% (95% CI: 8.3, 12.3), 70.5% (95% CI: 65.7, 72.2), 13.8% (95% CI: 10.8, 16.9) and 5.1% (95% CI: 3.3, 6.9), respectively. Diarrhea (HR: 1.5, 95% CI: 1.1, 2.2), dehydration (HR: 3.1, 95% CI: 2.3, 4.2) and anemia (HR: 2.2, 95% CI: 1.5, 3.3) were statistically significant predictors of mortality among these children. No publication bias was detected., Conclusion: Treatment outcomes in under-five children with SAM are lower than the World Health Organization (WHO) standard, where mortality is being predicted by comorbidities at admission. Children with SAM need to be treated for diarrhea, dehydration and anemia at the primary point of care to reduce mortality.

Published
2019
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47. Treatment cure rate and its predictors among children with severe acute malnutrition in northwest Ethiopia: A retrospective record review.

Author

Wagnew F, Dejenu G, Eshetie S, Alebel A, Worku W, and Abajobir AA

Subjects
Body Weight physiology, Child, Preschool, Comorbidity, Ethiopia, Female, Hospitalization, Humans, Infant, Male, Prognosis, Proportional Hazards Models, Retrospective Studies, Weight Gain physiology, Severe Acute Malnutrition drug therapy
Abstract

Background: More than 29 million that is an estimated 5%, under-five children suffer from severe acute malnutrition (SAM) globally, with a nine times higher risk of mortality than that of well-nourished children. However, little is known regarding outcomes and predictors of SAM in Ethiopia. Therefore, this study aims to determine treatment cure rate and its predictors among children aged 6-59 months with SAM admitted to a stabilization center., Methodology: A retrospective record review was employed in SAM children at the University of Gondar Comprehensive Specialized Hospital (UOGCSH) from 2014 to 2016. SAM defined as weight for height below -3 z scores of the median World Health Organization (WHO) growth standards or presence of bilateral edema or mid upper arm circumference < 115mm for a child ≥6months age. All SAM patients with medical complication(s) or failure to pass appetite test are admitted to the malnutrition treatment center for inpatient follow-up. Data were extracted from a randomly selected records after getting ethical clearance. Data were cleaned, coded and entered to Epi-info version-7, and analyzed using STATA/se version-14. Descriptive statistics and analytic analyses schemes including bivariable and multivariable Cox proportional hazards model were conducted., Result: Among a total of 416 records recruited for this study, 288 (69.2%) SAM children were cured at the end of the follow up, with a median cure time of 11 days. Kwash-dermatosis (AHR (Adjusted Hazard Ratio): 1.48(95% CI: 1.01, 2.16)), anemia (AHR: 1.36(95% CI: 1.07, 1.74)), tuberculosis (AHR: 1.6(95% CI: 1.04, 2.43)) and altered body temperature at admission (AHR: 1.58(95% CI: 1.04, 2.4) were independent predictors of time to cure., Conclusion: The cure rate in SAM children was low relative to sphere standard guideline. Prognosis of SAM largely depends on the presence of other comorbidities at admission. Available intervention modalities need to address coexisting morbidities to achieve better outcomes in SAM children., Competing Interests: The authors have declared that no competing interests exist.

Published
2019
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48. Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016.

Author

Feigin VL, Nguyen G, Cercy K, Johnson CO, Alam T, Parmar PG, Abajobir AA, Abate KH, Abd-Allah F, Abejie AN, Abyu GY, Ademi Z, Agarwal G, Ahmed MB, Akinyemi RO, Al-Raddadi R, Aminde LN, Amlie-Lefond C, Ansari H, Asayesh H, Asgedom SW, Atey TM, Ayele HT, Banach M, Banerjee A, Barac A, Barker-Collo SL, Bärnighausen T, Barregard L, Basu S, Bedi N, Behzadifar M, Béjot Y, Bennett DA, Bensenor IM, Berhe DF, Boneya DJ, Brainin M, Campos-Nonato IR, Caso V, Castañeda-Orjuela CA, Rivas JC, Catalá-López F, Christensen H, Criqui MH, Damasceno A, Dandona L, Dandona R, Davletov K, de Courten B, deVeber G, Dokova K, Edessa D, Endres M, Faraon EJA, Farvid MS, Fischer F, Foreman K, Forouzanfar MH, Gall SL, Gebrehiwot TT, Geleijnse JM, Gillum RF, Giroud M, Goulart AC, Gupta R, Gupta R, Hachinski V, Hamadeh RR, Hankey GJ, Hareri HA, Havmoeller R, Hay SI, Hegazy MI, Hibstu DT, James SL, Jeemon P, John D, Jonas JB, Jóźwiak J, Kalani R, Kandel A, Kasaeian A, Kengne AP, Khader YS, Khan AR, Khang YH, Khubchandani J, Kim D, Kim YJ, Kivimaki M, Kokubo Y, Kolte D, Kopec JA, Kosen S, Kravchenko M, Krishnamurthi R, Kumar GA, Lafranconi A, Lavados PM, Legesse Y, Li Y, Liang X, Lo WD, Lorkowski S, Lotufo PA, Loy CT, Mackay MT, Abd El Razek HM, Mahdavi M, Majeed A, Malekzadeh R, Malta DC, Mamun AA, Mantovani LG, Martins SCO, Mate KK, Mazidi M, Mehata S, Meier T, Melaku YA, Mendoza W, Mensah GA, Meretoja A, Mezgebe HB, Miazgowski T, Miller TR, Ibrahim NM, Mohammed S, Mokdad AH, Moosazadeh M, Moran AE, Musa KI, Negoi RI, Nguyen M, Nguyen QL, Nguyen TH, Tran TT, Nguyen TT, Anggraini Ningrum DN, Norrving B, Noubiap JJ, O’Donnell MJ, Olagunju AT, Onuma OK, Owolabi MO, Parsaeian M, Patton GC, Piradov M, Pletcher MA, Pourmalek F, Prakash V, Qorbani M, Rahman M, Rahman MA, Rai RK, Ranta A, Rawaf D, Rawaf S, Renzaho AM, Robinson SR, Sahathevan R, Sahebkar A, Salomon JA, Santalucia P, Santos IS, Sartorius B, Schutte AE, Sepanlou SG, Shafieesabet A, Shaikh MA, Shamsizadeh M, Sheth KN, Sisay M, Shin MJ, Shiue I, Silva DAS, Sobngwi E, Soljak M, Sorensen RJD, Sposato LA, Stranges S, Suliankatchi RA, Tabarés-Seisdedos R, Tanne D, Nguyen CT, Thakur JS, Thrift AG, Tirschwell DL, Topor-Madry R, Tran BX, Nguyen LT, Truelsen T, Tsilimparis N, Tyrovolas S, Ukwaja KN, Uthman OA, Varakin Y, Vasankari T, Venketasubramanian N, Vlassov VV, Wang W, Werdecker A, Wolfe CDA, Xu G, Yano Y, Yonemoto N, Yu C, Zaidi Z, El Sayed Zaki M, Zhou M, Ziaeian B, Zipkin B, Vos T, Naghavi M, Murray CJL, and Roth GA

Subjects
Adult, Age Distribution, Aged, Aged, 80 and over, Cause of Death, Female, Global Burden of Disease, Global Health, Humans, Incidence, Male, Middle Aged, Risk, Sex Distribution, Socioeconomic Factors, Stroke epidemiology
Abstract

Background: The lifetime risk of stroke has been calculated in a limited number of selected populations. We sought to estimate the lifetime risk of stroke at the regional, country, and global level using data from a comprehensive study of the prevalence of major diseases., Methods: We used the Global Burden of Disease (GBD) Study 2016 estimates of stroke incidence and the competing risks of death from any cause other than stroke to calculate the cumulative lifetime risks of first stroke, ischemic stroke, or hemorrhagic stroke among adults 25 years of age or older. Estimates of the lifetime risks in the years 1990 and 2016 were compared. Countries were categorized into quintiles of the sociodemographic index (SDI) used in the GBD Study, and the risks were compared across quintiles. Comparisons were made with the use of point estimates and uncertainty intervals representing the 2.5th and 97.5th percentiles around the estimate., Results: The estimated global lifetime risk of stroke from the age of 25 years onward was 24.9% (95% uncertainty interval, 23.5 to 26.2); the risk among men was 24.7% (95% uncertainty interval, 23.3 to 26.0), and the risk among women was 25.1% (95% uncertainty interval, 23.7 to 26.5). The risk of ischemic stroke was 18.3%, and the risk of hemorrhagic stroke was 8.2%. In high-SDI, high-middle-SDI, and low-SDI countries, the estimated lifetime risk of stroke was 23.5%, 31.1% (highest risk), and 13.2% (lowest risk), respectively; the 95% uncertainty intervals did not overlap between these categories. The highest estimated lifetime risks of stroke according to GBD region were in East Asia (38.8%), Central Europe (31.7%), and Eastern Europe (31.6%), and the lowest risk was in eastern sub-Saharan Africa (11.8%). The mean global lifetime risk of stroke increased from 22.8% in 1990 to 24.9% in 2016, a relative increase of 8.9% (95% uncertainty interval, 6.2 to 11.5); the competing risk of death from any cause other than stroke was considered in this calculation., Conclusions: In 2016, the global lifetime risk of stroke from the age of 25 years onward was approximately 25% among both men and women. There was geographic variation in the lifetime risk of stroke, with the highest risks in East Asia, Central Europe, and Eastern Europe. (Funded by the Bill and Melinda Gates Foundation.).

Published
2018
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49. Child maltreatment and mental health problems in adulthood: birth cohort study.

Author

Kisely S, Abajobir AA, Mills R, Strathearn L, Clavarino A, and Najman JM

Subjects
Adolescent, Australia epidemiology, Female, Humans, Logistic Models, Longitudinal Studies, Male, Mental Health, Psychiatric Status Rating Scales, Risk Factors, Self Report, Young Adult, Adult Survivors of Child Abuse psychology, Anxiety Disorders epidemiology, Child Abuse psychology, Depressive Disorder epidemiology, Stress Disorders, Post-Traumatic epidemiology
Abstract

Background: Retrospective studies have shown a high association between child abuse and subsequent psychiatric morbidity. Prospective studies are rarer.AimsTo examine, using a prospective record-linkage analysis, whether substantiated child maltreatment is associated with adverse psychological outcomes in early adulthood., Method: The participants were 3778 mother and child pairs enrolled in a population-based birth cohort study in Brisbane, Australia. Exposure to suspected child maltreatment was measured by linkage with state child protection agency data. The primary outcomes were the internalising and externalising scales of the Youth Self-Report and the Centre for Epidemiological Studies-Depression scales (CES-D) at approximately 21 years of age. A subset completed the Composite International Diagnostic Interview-Auto version (CIDI-Auto)., Results: In total, 171 (4.5%) participants had a history of substantiated child maltreatment, most commonly emotional abuse (n = 91), followed by physical abuse (n = 78), neglect (n = 73) and sexual abuse (n = 54). After adjustment for potential confounders, depressive symptoms on the CES-D, as well as internalising and externalising behaviours were strongly associated with substantiated abuse in all forms, except sexual abuse. The results for the subset of the sample who completed the CIDI-Auto were less clear. Anxiety, especially post-traumatic stress disorder, showed the strongest association whereas the findings for depressive disorder were equivocal. However, across all diagnostic categories, emotional abuse and neglect, as well as multiple forms of abuse, showed a consistent association., Conclusions: Child maltreatment, particularly neglect and emotional abuse, has serious adverse effects on early adult mental health. These two warrant the attention given to other forms of child maltreatment. Children experiencing more than one type of maltreatment are at particular risk.Declaration of interestNone.

Published
2018
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50. Does short message service improve focused antenatal care visit and skilled birth attendance? A systematic review and meta-analysis of randomized clinical trials.

Author

Wagnew F, Dessie G, Alebel A, Mulugeta H, Belay YA, and Abajobir AA

Subjects
Female, Health Services Accessibility, Humans, Pregnancy, Randomized Controlled Trials as Topic, Cell Phone, Delivery, Obstetric, Midwifery, Prenatal Care, Text Messaging
Abstract

Background: In low resource circumstances, non-adherence for available health services is a major cause of inefficiency in health care delivery. MHealth has been projected as a possible solution to support women during pregnancy, birth and puerperium period, to increase the uptake of essential maternal services., Objectives: This systematic review and meta-analysis study was aimed to determine the effectiveness of short message services (SMS)on Focused Antenatal Care (FANC) visits and the attendance of skilled birth professionals in Low and Middle Income Countries (LMICs)., Methods: We searched a broad body of literature from electronic databases-Cochrane review, CINAHL, PsycINFO, PubMed and Google Scholar to collect comprehensive evidence on the role of SMS on FANC visits and skilled birth attendance. We extracted data from randomized clinical trials (RCTs) only. Meta-analyses were conducted using random-effects models with inverse variance method in Review Manager (RevMan) computer software. Qualities of the included studies were determined by GRADEpro, and risk of bias was assessed using Cochrane Collaboration risk of bias tool., Results: Of the 1224 non-duplicated articles screened, only 7 RCT studies representing 8324 participants met eligibility criteria and included in this synthesis. On aggregate, there were statistically significant associations in experimental group in that pregnant mothers who received text messaging had a 174% increase in FANC visits (OR = 2.74 (95% CI: 1.41, 5.32) and 82% in skilled birth attendance (OR = 1.82 (95% CI; 1.33, 2.49). The I 2 test result indicated high heterogeneity I 2  = 78% (P < .001). The overall qualities of included studies were moderate, and had low risk of bias., Conclusions: SMS has positive effects for the uptake of FANC visits and skilled birth attendance in LMICs. A short messaging service targeting pregnant woman is an invaluable, affordable intervention to improve maternal healthcare seeking behaviors.

Published
2018
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