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1. Association Between Self-Reported Polycystic Ovary Syndrome with Chronic Diseases Among Emiratis: A Cross-Sectional Analysis from the UAE Healthy Future Study

Author

Juber NF, Abdulle A, AlJunaibi A, AlNaeemi A, Ahmad A, Leinberger-Jabari A, Al Dhaheri AS, AlZaabi E, Al-Maskari F, AlAnouti F, Alsafar H, Alkaabi J, Wareth LA, Aljaber M, Kazim M, Weitzman M, Al-Houqani M, Hag-Ali M, Oumeziane N, Sherman S, Shah SM, Almahmeed W, Idaghdour Y, Loney T, El-Shahawy O, and Ali R

Subjects
polycystic ovary syndrome, self-reported diagnosis, epidemiology, women’s health, united arab emirates, uae healthy future study, Gynecology and obstetrics, RG1-991
Abstract

Nirmin F Juber,1 Abdishakur Abdulle,1 Abdulla AlJunaibi,2 Abdulla AlNaeemi,3 Amar Ahmad,1 Andrea Leinberger-Jabari,1 Ayesha S Al Dhaheri,4 Eiman AlZaabi,5 Fatma Al-Maskari,6,7 Fatme AlAnouti,8 Habiba Alsafar,9– 11 Juma Alkaabi,12 Laila Abdel Wareth,13 Mai Aljaber,14 Marina Kazim,15 Michael Weitzman,16 Mohammad Al-Houqani,17 Mohammed Hag-Ali,18 Naima Oumeziane,15 Scott Sherman,19 Syed M Shah,6 Wael Almahmeed,20 Youssef Idaghdour,1 Tom Loney,21 Omar El-Shahawy,19 Raghib Ali1,22 1Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates; 2Department of Pediatrics, Zayed Military Hospital, Abu Dhabi, United Arab Emirates; 3Department of Cardiology, Zayed Military Hospital, Abu Dhabi, United Arab Emirates; 4Department of Nutrition and Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates; 5Department of Pathology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates; 6Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates; 7Zayed Center for Health Sciences, UAE University, Al-Ain, United Arab Emirates; 8College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates; 9Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates; 10Department of Genetics and Molecular Biology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates; 11Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates; 12Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates; 13The National Reference Laboratory, Abu Dhabi, United Arab Emirates; 14Healthpoint Hospital, Abu Dhabi, United Arab Emirates; 15Abu Dhabi Blood Bank Services, SEHA, Abu Dhabi, United Arab Emirates; 16Department of Environmental Medicine, New York University of Medicine, New York, NY, USA; 17Department of Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates; 18Faculty of Health Sciences, Higher Colleges of Technology, Abu Dhabi, United Arab Emirates; 19Department of Population Health, New York University School of Medicine, New York, NY, USA; 20Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; 21College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates; 22MRC Epidemiology Unit, University of Cambridge, Cambridge, UKCorrespondence: Nirmin F Juber, Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates, Tel +971-2-6287631, Email nirmin.juber@nyu.eduPurpose: This study aimed to assess the prevalence of self-reported polycystic ovary syndrome (PCOS) among Emiratis and examine bi-directional associations of PCOS with self-reported chronic diseases, namely: diabetes, asthma, high cholesterol, and high blood pressure.Patients and Methods: A cross-sectional analysis was performed using the UAE Healthy Future Study (UAEHFS) data collected from February 2016 to April 2022 involving 1040 Emirati women aged 25– 67 years from recruitment centers in the United Arab Emirates (UAE). The bi-directional associations between self-reported PCOS and self-reported chronic diseases were evaluated by establishing temporality based on reported age-at-diagnoses. Firstly, the associations between PCOS (diagnosed at ≥ 25 years) and chronic diseases (diagnosed at < 25 years) were examined, followed by PCOS (diagnosed at < 25 years) and chronic diseases (diagnosed at ≥ 25 years). Finally, a Poisson regression under unadjusted and age-and-body mass index (BMI) adjusted models was performed to obtain the risk ratio (RR) and its 95% confidence interval (CI).Results: The prevalence of PCOS in this study was 25.9%. Those with asthma and high cholesterol diagnosed at < 25 years had increased risks of PCOS diagnosed at ≥ 25 years (RR = 1.79, 95% CI: 1.17– 2.76 for asthma; and RR = 1.61, 95% CI: 1.01– 2.59 for high cholesterol), compared to those respective healthier counterparts, after adjusting for age and BMI. No significant association was observed between PCOS diagnosed at < 25 years and respective chronic diseases diagnosed at ≥ 25 years.Conclusion: PCOS prevalence among Emirati women was high. Asthma and high cholesterol in earlier life were associated with PCOS in later life. Understanding how chronic disease conditions and PCOS are associated in bi-directional ways may improve the surveillance of chronic disease conditions among women with PCOS and may also contribute to more targeted PCOS prevention strategies.Keywords: polycystic ovary syndrome, self-reported diagnosis, epidemiology, women’s health, United Arab Emirates, UAE Healthy Future Study

Published
2023

2. Impact of Recurrent Miscarriage on Maternal Outcomes in Subsequent Pregnancy: The Mutaba’ah Study

Author

Ali N, Elbarazi I, Ghazal-Aswad S, Al-Maskari F, Al-Rifai RH, Oulhaj A, Loney T, and Ahmed LA

Subjects
cesarean section, cohort study, miscarriage, preterm delivery, recurrent miscarriage, Gynecology and obstetrics, RG1-991
Abstract

Nasloon Ali,1 Iffat Elbarazi,1 Saad Ghazal-Aswad,2 Fatima Al-Maskari,1,3 Rami H Al-Rifai,1,3 Abderrahim Oulhaj,1,3 Tom Loney,4 Luai A Ahmed1,3 1Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; 2Obstetrics and Gynecology Department, Tawam Hospital, Al Ain, United Arab Emirates; 3Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; 4College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab EmiratesCorrespondence: Luai A AhmedInstitute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab EmiratesTel +971 37137511Email luai.ahmed@uaeu.ac.aePurpose: To estimate the prevalence of recurrent miscarriage (RM) and investigate the association between RM and adverse maternal outcomes in subsequent pregnancies.Participants and Methods: This is an interim analysis of a prospective study of 1737 pregnant women with gravidity of two or more prior to the current pregnancy. These women joined the Mutaba’ah Study between May 2017 and April 2019 and were followed up until they delivered. Hospital medical records were used to extract data on past pregnancy history and the progress and outcomes of the current pregnancy, such as gestational diabetes, preeclampsia, mode of delivery, preterm delivery, and complications at birth.Results: Amongst pregnant women with at least two previous pregnancies (n=1737), there were 234 (13.5%) women with a history of two or more consecutive miscarriages. Women with RM were slightly older, more parous, and more likely to have had previous infertility treatment (all p-values < 0.05). Women with a history of RM had independently significant increased odds of cesarean section (adjusted odds ratio (aOR) 1.81, 95% CI 1.24– 2.65) and preterm (< 37 weeks, aOR: 2.52, 95% CI 1.56– 4.08) or very preterm delivery (< 32 weeks, aOR: 7.02 95% CI 2.41– 20.46) in subsequent pregnancies than women who did not have a history of RM.Conclusion: Women with a history of RM were twice as likely to undergo cesarean section and seven times more likely to deliver prior to 32 weeks of gestation than women without a history of RM. The study findings support the need for early pregnancy monitoring or assessment units to ensure better follow-up and customized care for at-risk pregnant women with a history of RM.Keywords: cesarean section, cohort study, miscarriage, preterm delivery, recurrent miscarriage

Published
2020

9. Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

Author

Lozano, R, Fullman, N, Abate, D, Abay, SM, Abbafati, C, Abbasi, N, Abbastabar, H, Abd-Allah, F, Abdela, J, Abdelalim, A, Abdel-Rahman, O, Abdi, A, Abdollahpour, I, Abdulkader, RS, Abebe, ND, Abebe, Z, Abejie, AN, Abera, SF, Abil, OZ, Aboyans, V, Abraha, HN, Abrham, AR, Abu-Raddad, LJ, Abu-Rmeileh, NM, Abyu, GY, Accrombessi, MMK, Acharya, D, Acharya, P, Adamu, AA, Adebayo, OM, Adedeji, IA, Adedoyin, RA, Adekanmbi, V, Adetokunboh, OO, Adhena, BM, Adhikari, TB, Adib, MG, Adou, AK, Adsuar, JC, Afarideh, M, Afshari, M, Afshin, A, Agarwal, G, Aghayan, SA, Agius, D, Agrawal, A, Agrawal, S, Ahmadi, A, Ahmadi, M, Ahmadieh, H, Ahmed, MB, Ahmed, S, Akalu, TY, Akanda, AS, Akbari, ME, Akibu, M, Akinyemi, RO, Akinyemiju, T, Akseer, N, Alahdab, F, Al-Aly, Z, Alam, K, Alam, T, Albujeer, A, Alebel, A, Alene, KA, Al-Eyadhy, A, Alhabib, S, Ali, R, Alijanzadeh, M, Alizadeh-Navaei, R, Aljunid, SM, Alkerwi, A, Alla, F, Allebeck, P, Allen, CA, Almasi, A, Al-Maskari, F, Al-Mekhlafi, HM, Alonso, J, Al-Raddadi, RM, Alsharif, U, Altirkawi, K, Alvis-Guzman, N, Amare, AT, Amenu, K, Amini, E, Ammar, W, Anber, NH, Anderson, JA, Andrei, CL, Androudi, S, Animut, MD, Anjomshoa, M, Ansari, H, Ansariadi, A, Ansha, MG, Antonio, CAT, Anwari, P, and Appiah, LT

Subjects
Male, United Nations, Health Status, Sex Offenses, Sustainable Development, Global Health, Global Burden of Disease, Risk Factors, General & Internal Medicine, Humans, Health Status Indicators, Female, Mortality, Goals
Abstract

© 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. Funding: Bill & Melinda Gates Foundation.

Published
2018

10. Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

Author

Lozano, R. Fullman, N. Abate, D. Abay, S.M. Abbafati, C. Abbasi, N. Abbastabar, H. Abd-Allah, F. Abdela, J. Abdelalim, A. Abdel-Rahman, O. Abdi, A. Abdollahpour, I. Abdulkader, R.S. Abebe, N.D. Abebe, Z. Abejie, A.N. Abera, S.F. Abil, O.Z. Aboyans, V. Abraha, H.N. Abrham, A.R. Abu-Raddad, L.J. Abu-Rmeileh, N.M. Abyu, G.Y. Accrombessi, M.M.K. Acharya, D. Acharya, P. Adamu, A.A. Adebayo, O.M. Adedeji, I.A. Adedoyin, R.A. Adekanmbi, V. Adetokunboh, O.O. Adhena, B.M. Adhikari, T.B. Adib, M.G. Adou, A.K. Adsuar, J.C. Afarideh, M. Afshari, M. Afshin, A. Agarwal, G. Aghayan, S.A. Agius, D. Agrawal, A. Agrawal, S. Ahmadi, A. Ahmadi, M. Ahmadieh, H. Ahmed, M.B. Ahmed, S. Akalu, T.Y. Akanda, A.S. Akbari, M.E. Akibu, M. Akinyemi, R.O. Akinyemiju, T. Akseer, N. Alahdab, F. Al-Aly, Z. Alam, K. Alam, T. Albujeer, A. Alebel, A. Alene, K.A. Al-Eyadhy, A. Alhabib, S. Ali, R. Alijanzadeh, M. Alizadeh-Navaei, R. Aljunid, S.M. Alkerwi, A. Alla, F. Allebeck, P. Allen, C.A. Almasi, A. Al-Maskari, F. Al-Mekhlafi, H.M. Alonso, J. Al-Raddadi, R.M. Alsharif, U. Altirkawi, K. Alvis-Guzman, N. Amare, A.T. Amenu, K. Amini, E. Ammar, W. Anber, N.H. Anderson, J.A. Andrei, C.L. Androudi, S. Animut, M.D. Anjomshoa, M. Ansari, H. Ansariadi, A. Ansha, M.G. Antonio, C.A.T. Anwari, P. Appiah, L.T. Aremu, O. Areri, H.A. Ärnlöv, J. Arora, M. Aryal, K.K. Asayesh, H. Asfaw, E.T. Asgedom, S.W. Asghar, R.J. Assadi, R. Ataro, Z. Atique, S. Atre, S.R. Atteraya, M.S. Ausloos, M. Avila-Burgos, L. Avokpaho, E.F.G.A. Awasthi, A. Quintanilla, B.P.A. Ayele, H.T. Ayele, Y. Ayer, R. Azarpazhooh, M.R. Azzopardi, P.S. Azzopardi-Muscat, N. Babalola, T.K. Babazadeh, A. Badali, H. Badawi, A. Balakrishnan, K. Bali, A.G. Banach, M. Banerjee, A. Banoub, J.A.M. Banstola, A. Barac, A. Barboza, M.A. Barker-Collo, S.L. Bärnighausen, T.W. Barrero, L.H. Barthelemy, C.M. Bassat, Q. Basu, A. Basu, S. Battista, R.J. Baune, B.T. Baynes, H.W. Bazargan-Hejazi, S. Bedi, N. Beghi, E. Behzadifar, M. Behzadifar, M. Béjot, Y. Bekele, B.B. Belachew, A.B. Belay, A.G. Belay, S.A. Belay, Y.A. Bell, M.L. Bello, A.K. Bennett, D.A. Bensenor, I.M. Benzian, H. Berhane, A. Berhe, A.K. Berman, A.E. Bernabe, E. Bernstein, R.S. Bertolacci, G.J. Beuran, M. Beyranvand, T. Bhala, N. Bhalla, A. Bhansali, A. Bhattarai, S. Bhaumik, S. Bhutta, Z.A. Biadgo, B. Biehl, M.H. Bijani, A. Bikbov, B. Bililign, N. Sayeed, M.S.B. Birlik, S.M. Birungi, C. Bisanzio, D. Biswas, T. Bitew, H. Bizuneh, H. Bjertness, E. Bobasa, E.M. Boufous, S. Bourne, R. Bozorgmehr, K. Bragazzi, N.L. Brainin, M. Brant, L.C. Brauer, M. Brazinova, A. Breitborde, N.J.K. Briant, P.S. Britton, G. Brugha, T. Bukhman, G. Busse, R. Butt, Z.A. Cahuana-Hurtado, L. Callender, C.S.K.H. Campos-Nonato, I.R. Rincon, J.C.C. Cano, J. Car, J. Car, M. Cárdenas, R. Carrero, J.J. Carter, A. Carvalho, F. Castañeda-Orjuela, C.A. Rivas, J.C. Castro, F. Causey, K. Çavlin, A. Cercy, K.M. Cerin, E. Chaiah, Y. Chalek, J. Chang, H.-Y. Chang, J.-C. Chattopadhyay, A. Chattu, V.K. Chaturvedi, P. Chiang, P.P.-C. Chin, K.L. Chisumpa, V.H. Chitheer, A. Choi, J.-Y.J. Chowdhury, R. Christensen, H. Christopher, D.J. Chung, S.-C. Cicuttini, F.M. Ciobanu, L.G. Cirillo, M. Claro, R.M. Claßen, T.K.D. Cohen, A.J. Collado-Mateo, D. Cooper, C. Cooper, L.T. Cornaby, L. Cortinovis, M. Costa, M. Cousin, E. Cromwell, E.A. Crowe, C.S. Cunningham, M. Daba, A.K. Dadi, A.F. Dandona, L. Dandona, R. Dang, A.K. Dargan, P.I. Daryani, A. Das, S.K. Das Gupta, R. Das Neves, J. Dasa, T.T. Dash, A.P. Davis, A.C. Davitoiu, D.V. Davletov, K. Dayama, A. De Courten, B. De Leo, D. Neve, J.W.D. De Steur, H. Degefa, M.G. Degenhardt, L. Degfie, T.T. Deiparine, S. Dellavalle, R.P. Demoz, G.T. Demtsu, B. Denova-Gutiérrez, E. Deribe, K. Dervenis, N. Dessie, G.A. Dey, S. Dharmaratne, S.D. Dhimal, M. Dicker, D. Dinberu, M.T. Ding, E.L. Djalalinia, S. Do, H.P. Dokova, K. Doku, D.T. Douwes-Schultz, D. Driscoll, T.R. Duan, L. Dubey, M. Dubljanin, E. Duken, E.E. Duncan, B.B. Duraes, A.R. Ebrahimpour, S. Edvardsson, D. El Bcheraoui, C. Eldrenkamp, E. El-Khatib, Z. Elyazar, I.R.F. Enayati, A. Endries, A.Y. Eshrati, B. Eskandarieh, S. Esteghamati, A. Esteghamati, S. Estep, K. Fakhar, M. Fakhim, H. Fanzo, J. Faramarzi, M. Fareed, M. Farhadi, F. Farid, T.A. Farinha, C.S.E.S. Farioli, A. Faro, A. Farvid, M.S. Farzadfar, F. Farzaei, M.H. Farzam, H. Fazaeli, A.A. Fazeli, M.S. Feigin, V.L. Feigl, A.B. Fekadu, W. Feldman, R. Fentahun, N. Fereshtehnejad, S.-M. Fernandes, E. Fernandes, J.C. Feyissa, G.T. Fijabi, D.O. Filip, I. Finegold, S. Finger, J.D. Fischer, F. Fitzmaurice, C. Flor, L.S. Foigt, N.A. Foreman, K.J. Frank, T.D. Franklin, R.C. Fukumoto, T. Fukutaki, K. Fuller, J.E. Fürst, T. Furtado, J.M. Gakidou, E. Gallus, S. Gankpe, F.G. Gansevoort, R.T. Garcia, A.C. Garcia-Basteiro, A.L. Garcia-Gordillo, M.A. Gardner, W.M. Gebre, A.K. Gebre, T. Gebregergs, G.B. Gebrehiwot, T.T. Gebremedhin, A.T. Gebremichael, B. Gebremichael, T.G. Gelano, T.F. Geleijnse, J.M. Geramo, Y.C.D. Getachew, S. Gething, P.W. Gezae, K.E. Ghadami, M.R. Ghadimi, R. Ghadiri, K. Ghasemi-Kasman, M. Ghiasvand, H. Ghimire, M. Ghoshal, A.G. Giampaoli, S. Gill, P.S. Gill, T.K. Giussani, G. Gnedovskaya, E.V. Goldberg, E.M. Goli, S. Gona, P.N. Goodridge, A. Gopalani, S.V. Gorman, T.M. Goto, A. Goulart, A.C. Goulart, B.N.G. Grada, A. Griswold, M.G. Grosso, G. Gugnani, H.C.C. Guillemin, F. Guimaraes, A.L.S. Guo, Y. Gupta, P.C. Gupta, R. Gupta, R. Gupta, T. Ha, G.H. Haagsma, J.A. Hachinski, V. Hafezi-Nejad, N. Bidgoli, H.H. Hagos, T.B. Haile, M.T. Hailegiyorgis, T.T. Hailu, G.B. Haj-Mirzaian, A. Haj-Mirzaian, A. Hamadeh, R.R. Hamidi, S. Hankey, G.J. Harb, H.L. Harikrishnan, S. Haririan, H. Haro, J.M. Hasan, M. Hassankhani, H. Hassen, H.Y. Havmoeller, R. Hawley, C.N. Hay, S.I. He, Y. Hedayatizadeh-Omran, A. Hegazy, M.I. Heibati, B. Heidari, B. Heidari, M. Hendrie, D. Henok, A. Heredia-Pi, I. Herteliu, C. Heydarpour, B. Heydarpour, F. Heydarpour, S. Hibstu, D.T. Híjar, M. Hoek, H.W. Hoffman, D.J. Hole, M.K. Homaie Rad, E. Hoogar, P. Horita, N. Hosgood, H.D. Hosseini, S.M. Hosseinzadeh, M. Hostiuc, M. Hostiuc, S. Hotez, P.J. Hoy, D.G. Hsairi, M. Hsiao, T. Hu, G. Huang, J.J. Hughes, C. Huynh, C.K. Igumbor, E.U. Ikeda, C.T. Ilesanmi, O.S. Iqbal, U. Irvani, S.S.N. Irvine, C.M.S. Islam, S.M.S. Islami, F. Ivers, R.Q. Izadi, N. Jacobsen, K.H. Jahangiry, L. Jahanmehr, N. Jain, S.K. Jakovljevic, M. Jalu, M.T. Jamal, A.A. James, S.L. Jassal, S.K. Javanbakht, M. Jayatilleke, A.U. Jeemon, P. Jha, R.P. Jha, V. Ji, J.S. Johnson, C.O. Johnson, S.C. Jonas, J.B. Jonnagaddala, J. Shushtari, Z.J. Joshi, A. Jozwiak, J.J. Jungari, S.B. Jürisson, M. Madhanraj, K. Kabir, Z. Kadel, R. Kahsay, A. Kahssay, M. Kalani, R. Kapil, U. Karami, M. Matin, B.K. Karanikolos, M. Karimi, N. Karimi, S.M. Karimi-Sari, H. Kasaeian, A. Kassa, D.H. Kassa, G.M. Kassa, T.D. Kassa, Z.Y. Kassebaum, N.J. Katikireddi, S.V. Kaul, A. Kawakami, N. Kazemi, Z. Karyani, A.K. Kazi, D.S. Prakash, K.C. Kebede, S. Keiyoro, P.N. Kemmer, L. 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Vujcic, I.S. Wagner, G.R. Wagnew, F.S. Waheed, Y. Walson, J.L. Wang, Y. Wang, Y.-P. Wassie, M.M. Weiderpass, E. Weintraub, R.G. Weiss, J. Weldegebreal, F. Weldegwergs, K.G. Werdecker, A. Werkneh, A.A. West, T.E. Westerman, R. Whisnant, J.L. Whiteford, H.A. Widecka, J. Widecka, K. Wijeratne, T. Wilner, L.B. Winkler, A.S. Wiyeh, A.B. Wiysonge, C.S. Wolde, H.F. Wolfe, C.D.A. Wu, S. Xavier, D. Xu, G. Xu, R. Yadollahpour, A. Jabbari, S.H.Y. Yakob, B. Yamada, T. Yan, L.L. Yano, Y. Yaseri, M. Yasin, Y.J. Ye, P. Yearwood, J.A. Yeshaneh, A. Yimer, E.M. Yip, P. Yirsaw, B.D. Yisma, E. Yonemoto, N. Yonga, G. Yoon, S.-J. Yotebieng, M. Younis, M.Z. Yousefifard, M. Yu, C. Zaman, S.B. Zamani, M. Zare, Z. Zavala-Arciniega, L. Zegeye, D.T. Zegeye, E.A. Zeleke, A.J. Zendehdel, K. Zerfu, T.A. Zhang, A.L. Zhang, X. Zhou, M. Zhu, J. Zimsen, S.R.M. Zodpey, S. Zoeckler, L. Zucker, I. Zuhlke, L.J.J. Lim, S.S. Murray, C.J.L. GBD 2017 SDG Collaborators

Abstract

Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

Published
2018

13. Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017.

Author

Servan-Mori E., Usman M.S., Uthman O.A., Vaduganathan M., Vaezi A., Vaidya G., Valdez P.R., Van Donkelaar A., Varavikova E., Vasankari T.J., Venketasubramanian N., Vidavalur R., Villafaina S., Violante F.S., Vladimirov S.K., Vlassov V., Vollmer S., Vollset S.E., Vos T., Vosoughi K., Vujcic I.S., Wagner G.R., Wagnew F.S., Waheed Y., Walson J.L., Wang Y., Wang Y.-P., Wassie M.M., Weiderpass E., Weintraub R.G., Weiss J., Weldegebreal F., Weldegwergs K.G., Werdecker A., Werkneh A.A., West T.E., Westerman R., Whisnant J.L., Whiteford H.A., Widecka J., Widecka K., Wijeratne T., Wilner L.B., Winkler A.S., Wiyeh A.B., Wiysonge C.S., Wolde H.F., Wolfe C.D.A., Wu S., Xavier D., Xu G., Xu R., Yadollahpour A., Jabbari S.H.Y., Yakob B., Yamada T., Yan L.L., Yano Y., Yaseri M., Yasin Y.J., Ye P., Yearwood J.A., Yeshaneh A., Yimer E.M., Yip P., Yirsaw B.D., Yisma E., Yonemoto N., Yonga G., Yoon S.-J., Yotebieng M., Younis M.Z., Yousefifard M., Yu C., Zaman S.B., Zamani M., Zare Z., Zavala-Arciniega L., Zegeye D.T., Zegeye E.A., Zeleke A.J., Zendehdel K., Zerfu T.A., Zhang A.L., Zhang X., Zhou M., Zhu J., Zimsen S.R.M., Zodpey S., Zoeckler L., Zucker I., Zuhlke L.J.J., Lim S.S., Murray C.J.L., De Courten B., Hughes C., Thrift A.G., Lozano R., Fullman N., Abate D., Abay S.M., Abbafati C., Abbasi N., Abbastabar H., Abd-Allah F., Abdela J., Abdelalim A., Abdel-Rahman O., Abdi A., Abdollahpour I., Abdulkader R.S., Abebe N.D., Abebe Z., Abejie A.N., Abera S.F., Abil O.Z., Aboyans V., Abraha H.N., Abrham A.R., Abu-Raddad L.J., Abu-Rmeileh N.M., Abyu G.Y., Accrombessi M.M.K., Acharya D., Acharya P., Adamu A.A., Adebayo O.M., Adedeji I.A., Adedoyin R.A., Adekanmbi V., Adetokunboh O.O., Adhena B.M., Adhikari T.B., Adib M.G., Adou A.K., Adsuar J.C., Afarideh M., Afshari M., Afshin A., Agarwal G., Aghayan S.A., Agius D., Agrawal A., Agrawal S., Ahmadi A., Ahmadi M., Ahmadieh H., Ahmed M.B., Ahmed S., Akalu T.Y., Akanda A.S., Akbari M.E., Akibu M., Akinyemi R.O., Akinyemiju T., Akseer N., 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J.R., Lee J.B., Lee P.H., Leever A.T., Leigh J., Leinsalu M., Leshargie C.T., Leung J., Lewycka S., Li S., Li X., Li Y., Liang J., Liang X., Liben M.L., Lim L.-L., Limenih M.A., Linn S., Liu S., Liu Y., Lodha R., Logroscino G., Lopez A.D., Lorkowski S., Lotufo P.A., Lucchesi L.R., Lyons R.A., Macarayan E.R.K., Mackay M.T., Maddison E.R., Madotto F., Maghavani D.P., Magis-Rodriguez C., Mahotra N.B., Majdan M., Majdzadeh R., Majeed A., Malekzadeh R., Malta D.C., Mamun A.A., Manda A.-L., Mandarano-Filho L.G., Mangalam S., Manguerra H., Mansournia M.A., Mapoma C.C., Maravilla J.C., Marcenes W., Marks A., Martin R.V., Martins S.C.O., Martins-Melo F.R., Martopullo I., Mashamba-Thompson T.P., Massenburg B.B., Mathur M.R., Maulik P.K., Mazidi M., McAlinden C., McGrath J.J., McKee M., McMahon B.J., Mehata S., Mehndiratta M.M., Mehrotra R., Mehta K.M., Mehta V., Mejia-Rodriguez F., Mekonen T., Mekonnen T.C.C., Meles H.G., Melese A., Melku M., Memiah P.T.N., Memish Z.A., Mendoza W., Mengistu 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Abstract

Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of "leaving no one behind", it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment. Method(s): We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2.5th percentile and 100 as the 97.5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the prob

Published
2018

14. Trends in HIV/AIDS morbidity and mortality in Eastern Mediterranean countries, 1990–2015: findings from the Global Burden of Disease 2015 study

Author

Mokdad, Ali H., El Bcheraoui, Charbel, Wang, Haidong, Charara, Raghid, Khalil, Ibrahim, Moradi-Lakeh, Maziar, Afshin, Ashkan, Collison, Michael, Daoud, Farah, Chew, Adrienne, Krohn, Kristopher J., Carter, Austin, Foreman, Kyle J., He, Fei, Kassebaum, Nicholas J., Kutz, Michael, Mirarefin, Mojde, Nguyen, Grant, Silpakit, Naris, Sligar, Amber, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abera, Semaw Ferede, Adane, K, Agarwal, A, Ahmadkiadaliri, A, Ahmadi, A, Ahmed, MB, Al Lami, FH, Alam, K, Alasfoor, D, Alizadeh-Navaei, R, Al-Maskari, F, Al-Raddadi, R, Altirkawi, KA, Alvis-Guzman, N, Ammar, W, Anber, N, Antonio, CAT, Anwari, P, Asayesh, H, Asghar, RJ, Atey, TM, Avokpaho, EFGA, Awokeayele, T, Azzopardi, P, Bacha, U, Barac, A, Bärnighausen, T, Bazargan-Hejazi, S, Bedi, N, Bensenor, IM, Berhane, A, Bessong, PO, Beyene, AS, Bhutta, ZA, Birungi, C, Butt, ZA, Cahuana-Hurtado, L, Danawi, H, Dasneves, J, Deribe, K, Deribew, A, Des Jarlais, DC, Dharmaratne, SD, Djalalinia, S, Doyle, KE, Endries, AY, Eshrati, B, Faraon, EJA, Farvid, MS, Fereshtehnejad, SM, Feyissa, TR, Fischer, F, Garcia-Basteiro, AL, Gebrehiwot, TT, Gesesew, HA, Gishu, MD, Glaser, E, Gona, PN, Gugnani, HC, Gupta, R, Haghparastbidgoli, H, Hailu, GB, Hamadeh, RR, Hambisa, MT, Hamidi, S, Harb, HL, Hareri, HA, Horita, N, Husseini, A, Ibrahim, A, James, SL, Jonas, JB, Kasaeian, A, Kassaw, NA, Khader, YS, Khan, EA, Khan, G, Mekonnen, Alemayehu, Mokdad, Ali H., El Bcheraoui, Charbel, Wang, Haidong, Charara, Raghid, Khalil, Ibrahim, Moradi-Lakeh, Maziar, Afshin, Ashkan, Collison, Michael, Daoud, Farah, Chew, Adrienne, Krohn, Kristopher J., Carter, Austin, Foreman, Kyle J., He, Fei, Kassebaum, Nicholas J., Kutz, Michael, Mirarefin, Mojde, Nguyen, Grant, Silpakit, Naris, Sligar, Amber, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M., Abd-Allah, Foad, Abera, Semaw Ferede, Adane, K, Agarwal, A, Ahmadkiadaliri, A, Ahmadi, A, Ahmed, MB, Al Lami, FH, Alam, K, Alasfoor, D, Alizadeh-Navaei, R, Al-Maskari, F, Al-Raddadi, R, Altirkawi, KA, Alvis-Guzman, N, Ammar, W, Anber, N, Antonio, CAT, Anwari, P, Asayesh, H, Asghar, RJ, Atey, TM, Avokpaho, EFGA, Awokeayele, T, Azzopardi, P, Bacha, U, Barac, A, Bärnighausen, T, Bazargan-Hejazi, S, Bedi, N, Bensenor, IM, Berhane, A, Bessong, PO, Beyene, AS, Bhutta, ZA, Birungi, C, Butt, ZA, Cahuana-Hurtado, L, Danawi, H, Dasneves, J, Deribe, K, Deribew, A, Des Jarlais, DC, Dharmaratne, SD, Djalalinia, S, Doyle, KE, Endries, AY, Eshrati, B, Faraon, EJA, Farvid, MS, Fereshtehnejad, SM, Feyissa, TR, Fischer, F, Garcia-Basteiro, AL, Gebrehiwot, TT, Gesesew, HA, Gishu, MD, Glaser, E, Gona, PN, Gugnani, HC, Gupta, R, Haghparastbidgoli, H, Hailu, GB, Hamadeh, RR, Hambisa, MT, Hamidi, S, Harb, HL, Hareri, HA, Horita, N, Husseini, A, Ibrahim, A, James, SL, Jonas, JB, Kasaeian, A, Kassaw, NA, Khader, YS, Khan, EA, Khan, G, and Mekonnen, Alemayehu

Published
2018

15. 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

16. 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

17. 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

18. Genomic Medicine Without Borders: Which Strategies Should Developing Countries Employ to Invest in Precision Medicine? A New Fast-Second Winner Strategy

Author

Mitropoulos, K. Cooper, D.N. Mitropoulou, C. Agathos, S. Reichardt, J.K.V. Al-Maskari, F. Chantratita, W. Wonkam, A. Dandara, C. Katsila, T. Lopez-Correa, C. Ali, B.R. Patrinos, G.P.

Abstract

Genomic medicine has greatly matured in terms of its technical capabilities, but the diffusion of genomic innovations worldwide faces significant barriers beyond mere access to technology. New global development strategies are sorely needed for biotechnologies such as genomics and their applications toward precision medicine without borders. Moreover, diffusion of genomic medicine globally cannot adhere to a "one-size-fits-all-countries" development strategy, in the same way that drug treatments should be customized. This begs a timely, difficult but crucial question: How should developing countries, and the resource-limited regions of developed countries, invest in genomic medicine? Although a full-scale investment in infrastructure from discovery to the translational implementation of genomic science is ideal, this may not always be feasible in all countries at all times. A simple "transplantation of genomics" from developed to developing countries is unlikely to be feasible. Nor should developing countries be seen as simple recipients and beneficiaries of genomic medicine developed elsewhere because important advances in genomic medicine have materialized in developing countries as well. There are several noteworthy examples of genomic medicine success stories involving resource-limited settings that are contextualized and described in this global genomic medicine innovation analysis. In addition, we outline here a new long-term development strategy for global genomic medicine in a way that recognizes the individual country's pressing public health priorities and disease burdens. We term this approach the "Fast-Second Winner" model of innovation that supports innovation commencing not only "upstream" of discovery science but also "mid-stream," building on emerging highly promising biomarker and diagnostic candidates from the global science discovery pipeline, based on the unique needs of each country. A mid-stream entry into innovation can enhance collective learning from other innovators' mistakes upstream in discovery science and boost the probability of success for translation and implementation when resources are limited. This à la carte model of global innovation and development strategy offers multiple entry points into the global genomics innovation ecosystem for developing countries, whether or not extensive and expensive discovery infrastructures are already in place. Ultimately, broadening our thinking beyond the linear model of innovation will help us to enable the vision and practice of genomics without borders in both developed and resource-limited settings. © 2017, Mary Ann Liebert, Inc.

Published
2017

19. 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

Kaul A., Bhutta Z.A., Hailu G.B., Hamadeh R.R., Hamidi S., Hammami M., Handal A.J., Hankey G.J., Hao Y., Harb H.L., Hareri H.A., Haro J.M., Harun K.M., Harvey J., Hassanvand M.S., Havmoeller R., Hay R.J., Hedayati M.T., Hendrie D., Henry N.J., Heredia-Pi I.B., Heydarpour P., Hoek H.W., Hofman H.J., Horino M., Horita N., Hosgood H.D., Hostiuc S., Hotez P.J., Hoy D.G., Htet A.S., Hu G., Huang J.J., Huynh C., Iburg K.M., Igumbor E.U., Ikeda C., Irvine C.M.S., Jacobsen K.H., Jahanmehr N., Jakovljevic M.B., James P., Jassal S.K., Javanbakht M., Jayaraman S.P., Jeemon P., Jensen P.N., Jha V., Jiang G., John D., Johnson C.O., Johnson S.C., Jonas J.B., Jurisson M., Kabir Z., Kadel R., Kahsay A., Kamal R., Kar C., Karam N.E., Karch A., Karema C.K., Karimi S.M., Karimkhani C., Kasaeian A., Kassa G.M., Kassebaum N.J., Kassaw N.A., Kastor A., Katikireddi S.V., Kawakami N., Keiyoro P.N., Kemmer L., Kengne A.P., Keren A., Kesavachandran C.N., Khader Y.S., Khalil I.A., Khan E.A., Khang Y.-H., Khoja A.T., Khosravi A., Khubchandani J., Kieling C., Kim Y.J., Kim D., Kimokoti R.W., Kinfu Y., Kisa A., Kissimova-Skarbek K.A., Kissoon N., Kivimaki M., Knudsen A.K., Kokubo Y., Kolte D., Kopec J.A., Kosen S., Kotsakis G.A., Koul P.A., Koyanagi A., Kravchenko M., Krohn K.J., Defo B.K., Bicer B.K., Kumar G.A., Kumar P., Kyu H.H., Lager A.C.J., Lal D.K., Lalloo R., Lallukka T., Lambert N., Lan Q., Lansingh V.C., Larsson A., Leasher J.L., Lee P.H., Leigh J., Leshargie C.T., Leung J., Leung R., Levi M., Li Y., Liang X., Liben M.L., Lim S.S., Linn S., Liu A., Liu P.Y., Liu S., Liu Y., Lodha R., Logroscino G., Looker K.J., Lopez A.D., Lorkowski S., Lotufo P.A., Lozano R., Lucas T.C.D., Lunevicius R., Lyons R.A., Macarayan E.R.K., Maddison E.R., Magdy Abd El Razek H., Magdy Abd El Razek M., Magis-Rodriguez C., Mahdavi M., Majdan M., Majdzadeh R., Majeed A., Malekzadeh R., Malhotra R., Malta D.C., Mamun A.A., Manguerra H., Manhertz T., Mantovani L.G., Mapoma C.C., March L.M., Marczak L.B., Martinez-Raga J., Martins P.H.V., Martins-Melo F.R., Martopullo I., Marz W., Mathur M.R., Mazidi M., McAlinden C., McGaughey M., McGrath J.J., McKee M., Mehata S., Meier T., Meles K.G., Memiah P., Memish Z.A., Mendoza W., Mengesha M.M., Mengistie M.A., Mengistu D.T., Mensah G.A., Meretoja A., Meretoja T.J., Mezgebe H.B., Micha R., Millear A., Miller T.R., Minnig S., Mirarefn M., Mirrakhimov E.M., Misganaw A., Mishra S.R., Mitchell P.B., Mohammad K.A., Mohammadi A., Mohammed S., Mohammed K.E., Mohammed M.S.K., Mohan M.B.V., Mokdad A.H., Mollenkopf S.K., Monasta L., Montanez Hernandez J.C., Montico M., Moradi-Lakeh M., Moraga P., Morawska L., Mori R., Morrison S.D., Moses M., Mountjoy-Venning C., Mruts K.B., Mueller U.O., Muller K., Mudoch M.E., Murthy S., Murthy G.V.S., Musa K.I., Nachega J.B., Nagel G., Naghavi M., Naheed A., Naidoo K.S., Nangia V., Nasher J.T., Natarajan G., Negasa D.E., Negoi I., Negoi R.I., Newton C.R., Ngunjiri J.W., Nguyen C.T., Nguyen Q.L., Nguyen G., Nguyen T.H., Nguyen M., Nichols E., Ningrum D.N.A., Nong V.M., Norheim O.F., Norrving B., Noubiap J.J.N., Nyandwi A., Obermeyer C.M., O'Donnell M.J., Ogbo F.A., Oh I.-H., Okoro A., Oladimeji O., Olagunju A.T., Olagunju T.O., Olsen H.E., Olusanya B.O., Olusanya J.O., Ong K., Opio J.N., Oren E., Ortiz A., Osborne R.H., Osgood-Zimmerman A., Osman M., Ota E., Owolabi M.O., Pa M., Pacella R.E., Panda B.K., Pandian J.D., Papachristou C., Park E.-K., Parry C.D., Parsaeian M., Patil S.T., Patten S.B., Patton G.C., Paudel D., Paulson K., Pearce N., Pereira D.M., Perez K.M., Perico N., Pesudovs K., Peterson C.B., Petri W.A., Petzold M., Phillips M.R., Phipps G., Pigott D.M., Pillay J.D., Pinho C., Piradov M.A., Plass D., Pletcher M.A., Popova S., Poulton R.G., Pourmalek F., Prabhakaran D., Prasad N., Purcell C., Purwar M., Qorbani M., Rabiee R.H.S., Radfar A., Rafay A., Rahimi K., Rahimi-Movaghar A., Rahimi-Movaghar V., Rahman M., Rahman M.A., Rahman M.H.U., Rai R.K., Rajsic S., Ram U., Ranabhat C.L., Rangaswamy T., Rankin Z., Rao P.V., Rao P.C., Rawaf S., Ray S.E., Reiner R.C., Reinig N., Reitsma M., Remuzzi G., Renzaho A.M.N., Resnikof S., Rezaei S., Ribeiro A.L., Roba H.S., Robinson S.R., Rojas-Rueda D., Rokni M.B., Ronfani L., Roshandel G., Roth G.A., Rothenbacher D., Roy A., Rubagotti E., Ruhago G.M., Saadat S., Safdarian M., Safri S., Sagar R., Sahathevan R., Sahraian M.A., Salama J., Saleh M.M., Salomon J.A., Salvi S.S., Samy A.M., Sanabria J.R., Sanchez-Nino M.D., Santomauro D., Santos J.V., Santos I.S., Santric Milicevic M.M., Sartorius B., Satpathy M., Sawhney M., Saxena S., Schelonka K., Schmidt M.I., Schneider I.J.C., Schottker B., Schutte A.E., Schwebel D.C., Schwendicke F., Seedat S., Sepanlou S.G., Servan-Mori E.E., Shaheen A., Shaikh M.A., Shamsipour M., Shariful Islam S.M., Sharma R., Sharma J., She J., Shi P., Shibuya K., Shields C., Shiferaw M.S., Shigematsu M., Shiri R., Shirkoohi R., Shirude S., Shishani K., Shoman H., Siabani S., Sibai A.M., Sigfusdottir I.D., Silberberg D.H., Silva J.P., Silva D.A.S., Silveira D.G.A., Singh J.A., Singh V., Singh O.P., Singh N.P., Sinha D.N., Skiadaresi E., Skirbekk V., Slepak E.L., Smith D.L., Smith M., Sobaih B.H.A., Sobngwi E., Soljak M., Sorensen R.J.D., Sousa T.C.M., Sposato L.A., Sreeramareddy C.T., Srinivasan V., Stanaway J.D., Stathopoulou V., Steel N., Stein D.J., Steiner C., Steinke S., Stokes M.A., Stovner L.J., Strub B., Subart M., Sufyan M.B., Abdulkader R.S., Sunguya B.F., Sur P.J., Swaminathan S., Sykes B.L., Sylte D., Szoeke C.E.I., Tabares-Seisdedos R., Tadakamadla S.K., Tafere G.R., Takala J.S., Tandon N., Tanne D., Tarekegn Y.L., Tavakkoli M., Taveira N., Taylor H.R., Tegegne T.K., Tehrani-Banihashemi A., Tekelab T., Temam Shifa G., Terkawi A.S., Tesfaye D.J., Tesssema B., Thakur J.S., Thamsuwan O., Theadom A.M., Theis A.M., Thomas K.E., Thomas N., Thompson R., Tobe-Gai R., Tobollik M., Tonelli M., Topor-Madry R., Tortajada M., Touvier M., Traebert J., Tran B.X., Troeger C., Truelsen T., Tsoi D., Tuzcu E.M., Tymeson H., Tyrovolas S., Ukwaja K.N., Undurraga E.A., Uneke C.J., Updike R., Uthman O.A., Uzochukwu B.S.C., Van Boven J.F.M., Varughese S., Vasankari T., Veerman L.J., Venkatesh S., Venketasubramanian N., Vidavalur R., Vijayakumar L., Violante F.S., Vishnu A., Vladimirov S.K., Vlassov V.V., Vollset S.E., Vos T., Wadilo F., Wakayo T., Wallin M.T., Wang Y.-P., Weichenthal S., Weiderpass E., Weintraub R.G., Weiss D.J., Werdecker A., Westerman R., Whiteford H.A., Wijeratne T., Williams H.C., Wiysonge C.S., Woldeyes B.G., Wolfe C.D.A., Woodbrook R., Woolf A.D., Workicho A., Xavier D., Xu G., Yadgir S., Yaghoubi M., Yakob B., Yan L.L., Yano Y., Ye P., Yihdego M.G., Yimam H.H., Yip P., Yonemoto N., Yoon S.-J., Yotebieng M., Younis M.Z., Yu C., Zaidi Z., Zaki M.E.S., Zegeye E.A., Zenebe Z.M., Zhang X., Zheng Y., Zhou M., Zipkin B., Zodpey S., Zoeckler L., Zuhlke L.J., Murray C.J.L., Adedji I.A., Murdoch M.E., Bryane C.E.G., De Courten B., Thrift A.G., Biadgilign S., Hay S.I., Abajobir A.A., Abate K.H., Abbafati C., Abbas K.M., Abd-Allah F., Abdulle A.M., Abebo T.A., Abera S.F., Aboyans V., Abu-Raddad L.J., Ackerman I.N., Adedeji I.A., Adetokunboh O., Afshin A., Aggarwal R., Agrawal S., Agrawal A., Kiadaliri A.A., Ahmed M.B., Aichour A.N., Aichour I., Aichour M.T.E., Aiyar S., Akinyemiju T.F., Akseer N., Al Lami F.H., Alahdab F., Al-Aly Z., Alam K., Alam N., Alam T., Alasfoor D., Alene K.A., Ali R., Alizadeh-Navaei R., Alkaabi J.M., Alkerwi A., Alla F., Allebeck P., Allen C., Al-Maskari F., Almazroa M.A., Al-Raddadi R., Alsharif U., Alsowaidi S., Althouse B.M., Altirkawi K.A., Alvis-Guzman N., Amare A.T., Amini E., Ammar W., Amoako Y.A., Ansha M.G., Antonio C.A.T., Anwari P., Arnlov J., Arora M., Artaman A., Aryal K.K., Asgedom S.W., Atey T.M., Atnafu N.T., Avila-Burgos L., Arthur Avokpaho E.F.G., Awasthi A., Awasthi S., Quintanilla B.P.A., Azarpazhooh M.R., Azzopardi P., Babalola T.K., Bacha U., Badawi A., Balakrishnan K., Bannick M.S., Barac A., Barker-Collo S.L., Barnighausen T., Barquera S., Barrero L.H., Basu S., Battista R., Battle K.E., Baune B.T., Bazargan-Hejazi S., Beardsley J., Bedi N., Bejot Y., Bekele B.B., Bell M.L., Bennett D.A., Bennett J.R., Bensenor I.M., Benson J., Berhane A., Berhe D.F., Bernabe E., Betsu B.D., Beuran M., Beyene A.S., Bhansali A., Bhatt S., Bienhof K., Bikbov B., Birungi C., Biryukov S., Bisanzio D., Bizuayehu H.M., Blyth F.M., Boneya D.J., Bose D., Bou-Orm I.R., Bourne R.R.A., Brainin M., Brayne C.E.G., Brazinova A., Breitborde N.J.K., Briant P.S., Britton G., Brugha T.S., Buchbinder R., Bulto L.N.B., Bumgarner B., Butt Z.A., Cahuana-Hurtado L., Cameron E., Campos-Nonato I.R., Carabin H., Cardenas R., Carpenter D.O., Carrero J.J., Carter A., Carvalho F., Casey D., Castaneda-Orjuela C.A., Rivas J.C., Castle C.D., Catala-Lopez F., Chang J.-C., Charlson F.J., Chaturvedi P., Chen H., Chibalabala M., Chibueze C.E., Chisumpa V.H., Chitheer A.A., Chowdhury R., Christopher D.J., Ciobanu L.G., Cirillo M., Colombara D., Cooper L.T., Cooper C., Cortesi P.A., Cortinovis M., Criqui M.H., Cromwell E.A., Cross M., Crump J.A., Dadi A.F., Dalal K., Damasceno A., Dandona L., Dandona R., Das Neves J., Davitoiu D.V., Davletov K., De Leo D., De Steur H., Degenhardt L., Deiparine S., Dellavalle R.P., Deribe K., Deribew A., Das Jarlais D.C., Dey S., Dharmaratne S.D., Dhillon P.K., Dicker D., Djalalinia S., Do H.P., Dokova K., Doku D.T., Dorsey E.R., Dos Santos K.P.B., Driscoll T.R., Dubey M., Duncan B.B., Ebel B.E., Echko M., El-Khatib Z.Z., Enayati A., Endries A.Y., Ermakov S.P., Erskine H.E., Eshetie S., Eshrati B., Esteghamati A., Estep K., Fanuel F.B.B., Farag T., Farinha C.S.E.S., Faro A., Farzadfar F., Fazeli M.S., Feigin V.L., Feigl A.B., Fereshtehnejad S.-M., Fernandes J.C., Ferrari A.J., Feyissa T.R., Filip I., Fischer F., Fitzmaurice C., Flaxman A.D., Foigt N., Foreman K.J., Franklin R.C., Frostad J.J., Fullman N., Furst T., Furtado J.M., Futran N.D., Gakidou E., Garcia-Basteiro A.L., Gebre T., Gebregergs G.B., Gebrehiwot T.T., Geleijnse J.M., Geleto A., Gemechu B.L., Gesesew H.A., Gething P.W., Ghajar A., Gibney K.B., Gillum R.F., Ginawi I.A.M., Gishu M.D., Giussani G., Godwin W.W., Goel K., Goenka S., Goldberg E.M., Gona P.N., Goodridge A., Gopalani S.V., Gosselin R.A., Gotay C.C., Goto A., Goulart A.C., Graetz N., Gugnani H.C., Gupta P.C., Gupta T., Gupta V., Gupta R., Gutierrez R.A., Hachinski V., Hafezi-Nejad N., Hailu A.D., Kaul A., Bhutta Z.A., Hailu G.B., Hamadeh R.R., Hamidi S., Hammami M., Handal A.J., Hankey G.J., Hao Y., Harb H.L., Hareri H.A., Haro J.M., Harun K.M., Harvey J., Hassanvand M.S., Havmoeller R., Hay R.J., Hedayati M.T., Hendrie D., Henry N.J., Heredia-Pi I.B., Heydarpour P., Hoek H.W., Hofman H.J., Horino M., Horita N., Hosgood H.D., Hostiuc S., Hotez P.J., Hoy D.G., Htet A.S., Hu G., Huang J.J., Huynh C., Iburg K.M., Igumbor E.U., Ikeda C., Irvine C.M.S., Jacobsen K.H., Jahanmehr N., Jakovljevic M.B., James P., Jassal S.K., Javanbakht M., Jayaraman S.P., Jeemon P., Jensen P.N., Jha V., Jiang G., John D., Johnson C.O., Johnson S.C., Jonas J.B., Jurisson M., Kabir Z., Kadel R., Kahsay A., Kamal R., Kar C., Karam N.E., Karch A., Karema C.K., Karimi S.M., Karimkhani C., Kasaeian A., Kassa G.M., Kassebaum N.J., Kassaw N.A., Kastor A., Katikireddi S.V., Kawakami N., Keiyoro P.N., Kemmer L., Kengne A.P., Keren A., Kesavachandran C.N., Khader Y.S., Khalil I.A., Khan E.A., Khang Y.-H., Khoja A.T., Khosravi A., Khubchandani J., Kieling C., Kim Y.J., Kim D., Kimokoti R.W., Kinfu Y., Kisa A., Kissimova-Skarbek K.A., Kissoon N., Kivimaki M., Knudsen A.K., Kokubo Y., Kolte D., Kopec J.A., Kosen S., Kotsakis G.A., Koul P.A., Koyanagi A., Kravchenko M., Krohn K.J., Defo B.K., Bicer B.K., Kumar G.A., Kumar P., Kyu H.H., Lager A.C.J., Lal D.K., Lalloo R., Lallukka T., Lambert N., Lan Q., Lansingh V.C., Larsson A., Leasher J.L., Lee P.H., Leigh J., Leshargie C.T., Leung J., Leung R., Levi M., Li Y., Liang X., Liben M.L., Lim S.S., Linn S., Liu A., Liu P.Y., Liu S., Liu Y., Lodha R., Logroscino G., Looker K.J., Lopez A.D., Lorkowski S., Lotufo P.A., Lozano R., Lucas T.C.D., Lunevicius R., Lyons R.A., Macarayan E.R.K., Maddison E.R., Magdy Abd El Razek H., Magdy Abd El Razek M., Magis-Rodriguez C., Mahdavi M., Majdan M., Majdzadeh R., Majeed A., Malekzadeh R., Malhotra R., Malta D.C., Mamun A.A., Manguerra H., Manhertz T., Mantovani L.G., Mapoma C.C., March L.M., Marczak L.B., Martinez-Raga J., Martins P.H.V., Martins-Melo F.R., Martopullo I., Marz W., Mathur M.R., Mazidi M., McAlinden C., McGaughey M., McGrath J.J., McKee M., Mehata S., Meier T., Meles K.G., Memiah P., Memish Z.A., Mendoza W., Mengesha M.M., Mengistie M.A., Mengistu D.T., Mensah G.A., Meretoja A., Meretoja T.J., Mezgebe H.B., Micha R., Millear A., Miller T.R., Minnig S., Mirarefn M., Mirrakhimov E.M., Misganaw A., Mishra S.R., Mitchell P.B., Mohammad K.A., Mohammadi A., Mohammed S., Mohammed K.E., Mohammed M.S.K., Mohan M.B.V., Mokdad A.H., Mollenkopf S.K., Monasta L., Montanez Hernandez J.C., Montico M., Moradi-Lakeh M., Moraga P., Morawska L., Mori R., Morrison S.D., Moses M., Mountjoy-Venning C., Mruts K.B., Mueller U.O., Muller K., Mudoch M.E., Murthy S., Murthy G.V.S., Musa K.I., Nachega J.B., Nagel G., Naghavi M., Naheed A., Naidoo K.S., Nangia V., Nasher J.T., Natarajan G., Negasa D.E., Negoi I., Negoi R.I., Newton C.R., Ngunjiri J.W., Nguyen C.T., Nguyen Q.L., Nguyen G., Nguyen T.H., Nguyen M., Nichols E., Ningrum D.N.A., Nong V.M., Norheim O.F., Norrving B., Noubiap J.J.N., Nyandwi A., Obermeyer C.M., O'Donnell M.J., Ogbo F.A., Oh I.-H., Okoro A., Oladimeji O., Olagunju A.T., Olagunju T.O., Olsen H.E., Olusanya B.O., Olusanya J.O., Ong K., Opio J.N., Oren E., Ortiz A., Osborne R.H., Osgood-Zimmerman A., Osman M., Ota E., Owolabi M.O., Pa M., Pacella R.E., Panda B.K., Pandian J.D., Papachristou C., Park E.-K., Parry C.D., Parsaeian M., Patil S.T., Patten S.B., Patton G.C., Paudel D., Paulson K., Pearce N., Pereira D.M., Perez K.M., Perico N., Pesudovs K., Peterson C.B., Petri W.A., Petzold M., Phillips M.R., Phipps G., Pigott D.M., Pillay J.D., Pinho C., Piradov M.A., Plass D., Pletcher M.A., Popova S., Poulton R.G., Pourmalek F., Prabhakaran D., Prasad N., Purcell C., Purwar M., Qorbani M., Rabiee R.H.S., Radfar A., Rafay A., Rahimi K., Rahimi-Movaghar A., Rahimi-Movaghar V., Rahman M., Rahman M.A., Rahman M.H.U., Rai R.K., Rajsic S., Ram U., Ranabhat C.L., Rangaswamy T., Rankin Z., Rao P.V., Rao P.C., Rawaf S., Ray S.E., Reiner R.C., Reinig N., Reitsma M., Remuzzi G., Renzaho A.M.N., Resnikof S., Rezaei S., Ribeiro A.L., Roba H.S., Robinson S.R., Rojas-Rueda D., Rokni M.B., Ronfani L., Roshandel G., Roth G.A., Rothenbacher D., Roy A., Rubagotti E., Ruhago G.M., Saadat S., Safdarian M., Safri S., Sagar R., Sahathevan R., Sahraian M.A., Salama J., Saleh M.M., Salomon J.A., Salvi S.S., Samy A.M., Sanabria J.R., Sanchez-Nino M.D., Santomauro D., Santos J.V., Santos I.S., Santric Milicevic M.M., Sartorius B., Satpathy M., Sawhney M., Saxena S., Schelonka K., Schmidt M.I., Schneider I.J.C., Schottker B., Schutte A.E., Schwebel D.C., Schwendicke F., Seedat S., Sepanlou S.G., Servan-Mori E.E., Shaheen A., Shaikh M.A., Shamsipour M., Shariful Islam S.M., Sharma R., Sharma J., She J., Shi P., Shibuya K., Shields C., Shiferaw M.S., Shigematsu M., Shiri R., Shirkoohi R., Shirude S., Shishani K., Shoman H., Siabani S., Sibai A.M., Sigfusdottir I.D., Silberberg D.H., Silva J.P., Silva D.A.S., Silveira D.G.A., Singh J.A., Singh V., Singh O.P., Singh N.P., Sinha D.N., Skiadaresi E., Skirbekk V., Slepak E.L., Smith D.L., Smith M., Sobaih B.H.A., Sobngwi E., Soljak M., Sorensen R.J.D., Sousa T.C.M., Sposato L.A., Sreeramareddy C.T., Srinivasan V., Stanaway J.D., Stathopoulou V., Steel N., Stein D.J., Steiner C., Steinke S., Stokes M.A., Stovner L.J., Strub B., Subart M., Sufyan M.B., Abdulkader R.S., Sunguya B.F., Sur P.J., Swaminathan S., Sykes B.L., Sylte D., Szoeke C.E.I., Tabares-Seisdedos R., Tadakamadla S.K., Tafere G.R., Takala J.S., Tandon N., Tanne D., Tarekegn Y.L., Tavakkoli M., Taveira N., Taylor H.R., Tegegne T.K., Tehrani-Banihashemi A., Tekelab T., Temam Shifa G., Terkawi A.S., Tesfaye D.J., Tesssema B., Thakur J.S., Thamsuwan O., Theadom A.M., Theis A.M., Thomas K.E., Thomas N., Thompson R., Tobe-Gai R., Tobollik M., Tonelli M., Topor-Madry R., Tortajada M., Touvier M., Traebert J., Tran B.X., Troeger C., Truelsen T., Tsoi D., Tuzcu E.M., Tymeson H., Tyrovolas S., Ukwaja K.N., Undurraga E.A., Uneke C.J., Updike R., Uthman O.A., Uzochukwu B.S.C., Van Boven J.F.M., Varughese S., Vasankari T., Veerman L.J., Venkatesh S., Venketasubramanian N., Vidavalur R., Vijayakumar L., Violante F.S., Vishnu A., Vladimirov S.K., Vlassov V.V., Vollset S.E., Vos T., Wadilo F., Wakayo T., Wallin M.T., Wang Y.-P., Weichenthal S., Weiderpass E., Weintraub R.G., Weiss D.J., Werdecker A., Westerman R., Whiteford H.A., Wijeratne T., Williams H.C., Wiysonge C.S., Woldeyes B.G., Wolfe C.D.A., Woodbrook R., Woolf A.D., Workicho A., Xavier D., Xu G., Yadgir S., Yaghoubi M., Yakob B., Yan L.L., Yano Y., Ye P., Yihdego M.G., Yimam H.H., Yip P., Yonemoto N., Yoon S.-J., Yotebieng M., Younis M.Z., Yu C., Zaidi Z., Zaki M.E.S., Zegeye E.A., Zenebe Z.M., Zhang X., Zheng Y., Zhou M., Zipkin B., Zodpey S., Zoeckler L., Zuhlke L.J., Murray C.J.L., Adedji I.A., Murdoch M.E., Bryane C.E.G., De Courten B., Thrift A.G., Biadgilign S., Hay S.I., Abajobir A.A., Abate K.H., Abbafati C., Abbas K.M., Abd-Allah F., Abdulle A.M., Abebo T.A., Abera S.F., Aboyans V., Abu-Raddad L.J., Ackerman I.N., Adedeji I.A., Adetokunboh O., Afshin A., Aggarwal R., Agrawal S., Agrawal A., Kiadaliri A.A., Ahmed M.B., Aichour A.N., Aichour I., Aichour M.T.E., Aiyar S., Akinyemiju T.F., Akseer N., Al Lami F.H., Alahdab F., Al-Aly Z., Alam K., Alam N., Alam T., Alasfoor D., Alene K.A., Ali R., Alizadeh-Navaei R., Alkaabi J.M., Alkerwi A., Alla F., Allebeck P., Allen C., Al-Maskari F., Almazroa M.A., Al-Raddadi R., Alsharif U., Alsowaidi S., Althouse B.M., Altirkawi K.A., Alvis-Guzman N., Amare A.T., Amini E., Ammar W., Amoako Y.A., Ansha M.G., Antonio C.A.T., Anwari P., Arnlov J., Arora M., Artaman A., Aryal K.K., Asgedom S.W., Atey T.M., Atnafu N.T., Avila-Burgos L., Arthur Avokpaho E.F.G., Awasthi A., Awasthi S., Quintanilla B.P.A., Azarpazhooh M.R., Azzopardi P., Babalola T.K., Bacha U., Badawi A., Balakrishnan K., Bannick M.S., Barac A., Barker-Collo S.L., Barnighausen T., Barquera S., Barrero L.H., Basu S., Battista R., Battle K.E., Baune B.T., Bazargan-Hejazi S., Beardsley J., Bedi N., Bejot Y., Bekele B.B., Bell M.L., Bennett D.A., Bennett J.R., Bensenor I.M., Benson J., Berhane A., Berhe D.F., Bernabe E., Betsu B.D., Beuran M., Beyene A.S., Bhansali A., Bhatt S., Bienhof K., Bikbov B., Birungi C., Biryukov S., Bisanzio D., Bizuayehu H.M., Blyth F.M., Boneya D.J., Bose D., Bou-Orm I.R., Bourne R.R.A., Brainin M., Brayne C.E.G., Brazinova A., Breitborde N.J.K., Briant P.S., Britton G., Brugha T.S., Buchbinder R., Bulto L.N.B., Bumgarner B., Butt Z.A., Cahuana-Hurtado L., Cameron E., Campos-Nonato I.R., Carabin H., Cardenas R., Carpenter D.O., Carrero J.J., Carter A., Carvalho F., Casey D., Castaneda-Orjuela C.A., Rivas J.C., Castle C.D., Catala-Lopez F., Chang J.-C., Charlson F.J., Chaturvedi P., Chen H., Chibalabala M., Chibueze C.E., Chisumpa V.H., Chitheer A.A., Chowdhury R., Christopher D.J., Ciobanu L.G., Cirillo M., Colombara D., Cooper L.T., Cooper C., Cortesi P.A., Cortinovis M., Criqui M.H., Cromwell E.A., Cross M., Crump J.A., Dadi A.F., Dalal K., Damasceno A., Dandona L., Dandona R., Das Neves J., Davitoiu D.V., Davletov K., De Leo D., De Steur H., Degenhardt L., Deiparine S., Dellavalle R.P., Deribe K., Deribew A., Das Jarlais D.C., Dey S., Dharmaratne S.D., Dhillon P.K., Dicker D., Djalalinia S., Do H.P., Dokova K., Doku D.T., Dorsey E.R., Dos Santos K.P.B., Driscoll T.R., Dubey M., Duncan B.B., Ebel B.E., Echko M., El-Khatib Z.Z., Enayati A., Endries A.Y., Ermakov S.P., Erskine H.E., Eshetie S., Eshrati B., Esteghamati A., Estep K., Fanuel F.B.B., Farag T., Farinha C.S.E.S., Faro A., Farzadfar F., Fazeli M.S., Feigin V.L., Feigl A.B., Fereshtehnejad S.-M., Fernandes J.C., Ferrari A.J., Feyissa T.R., Filip I., Fischer F., Fitzmaurice C., Flaxman A.D., Foigt N., Foreman K.J., Franklin R.C., Frostad J.J., Fullman N., Furst T., Furtado J.M., Futran N.D., Gakidou E., Garcia-Basteiro A.L., Gebre T., Gebregergs G.B., Gebrehiwot T.T., Geleijnse J.M., Geleto A., Gemechu B.L., Gesesew H.A., Gething P.W., Ghajar A., Gibney K.B., Gillum R.F., Ginawi I.A.M., Gishu M.D., Giussani G., Godwin W.W., Goel K., Goenka S., Goldberg E.M., Gona P.N., Goodridge A., Gopalani S.V., Gosselin R.A., Gotay C.C., Goto A., Goulart A.C., Graetz N., Gugnani H.C., Gupta P.C., Gupta T., Gupta V., Gupta R., Gutierrez R.A., Hachinski V., Hafezi-Nejad N., and Hailu A.D.

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). Method(s): 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 difered 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. Finding(s): 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 m

Published
2017

20. 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

Larsson A., Arnlov J., Artaman A., Aryal K.K., Asayesh H., Asgedom S.W., Assadi R., Atey T.M., Atnafu N.T., Atre S.R., Avila-Burgos L., Avokpaho E.F.G.A., Awasthi A., Ayala Quintanilla B.P., Ba Saleem H.O., Bacha U., Badawi A., Balakrishnan K., Banerjee A., Bannick M.S., Barac A., Barber R.M., Barker-Collo S.L., Barnighausen T., Barquera S., Barregard L., Barrero L.H., Basu S., Battista B., Battle K.E., Baune B.T., Bazargan-Hejazi S., Beardsley J., Bedi N., Beghi E., Bejot Y., Bekele B.B., Bell M.L., Bennett D.A., Bensenor I.M., Benson J., Berhane A., Berhe D.F., Bernabe E., Betsu B.D., Beuran M., Beyene A.S., Bhala N., Bhansali A., Bhatt S., Bhutta Z.A., Biadgilign S., Bienhoff K., Bikbov B., Birungi C., Biryukov S., Bisanzio D., Bizuayehu H.M., Boneya D.J., Boufous S., Bourne R.R.A., Brazinova A., Brugha T.S., Buchbinder R., Bulto L.N.B., Bumgarner B.R., Butt Z.A., Cahuana-Hurtado L., Cameron E., Car M., Carabin H., Carapetis J.R., Cardenas R., Carpenter D.O., Carrero J.J., Carter A., Carvalho F., Casey D.C., Caso V., Castaneda-Orjuela C.A., Castle C.D., Catala-Lopez F., Chang H.-Y., Chang J.-C., Charlson F.J., Chen H., Chibalabala M., Chibueze C.E., Chisumpa V.H., Chitheer A.A., Christopher D.J., Ciobanu L.G., Cirillo M., Colombara D., Cooper C., Cortesi P.A., Criqui M.H., Crump J.A., Dadi A.F., Dalal K., Dandona L., Dandona R., Das Neves J., Davitoiu D.V., De Leo D., Degenhardt L., Deiparine S., Dellavalle R.P., Deribe K., Des Jarlais D.C., Dey S., Dharmaratne S.D., Dhillon P.K., Dicker D., Ding E.L., Djalalinia S., Do H.P., Dorsey E.R., Dos Santos K.P.B., Douwes-Schultz D., Doyle K.E., Driscoll T.R., Dubey M., Duncan B.B., El-Khatib Z.Z., Ellerstrand J., Enayati A., Endries A.Y., Ermakov S.P., Erskine H.E., Eshrati B., Eskandarieh S., Esteghamati A., Estep K., Fanuel F.B.B., Farinha C.S.E.S., Faro A., Farzadfar F., Fazeli M.S., Feigin V.L., Fereshtehnejad S.-M., Fernandes J.C., Ferrari A.J., Feyissa T.R., Filip I., Fischer F., Fitzmaurice C., Flaxman A.D., Flor L.S., Foigt N., Foreman K.J., Franklin R.C., Fullman N., Furst T., Furtado J.M., Futran N.D., Gakidou E., Ganji M., Garcia-Basteiro A.L., Gebre T., Gebrehiwot T.T., Geleto A., Gemechu B.L., Gesesew H.A., Gething P.W., Ghajar A., Gibney K.B., Gill P.S., Gillum R.F., Ginawi I.A.M., Giref A.Z., Gishu M.D., Giussani G., Godwin W.W., Gold A.L., Goldberg E.M., Gona P.N., Goodridge A., Gopalani S.V., Goto A., Goulart A.C., Griswold M., Gugnani H.C., Gupta R., Gupta T., Gupta V., Hafezi-Nejad N., Hailu A.D., Hailu G.B., Hamadeh R.R., Hamidi S., Handal A.J., Hankey G.J., Hao Y., Harb H.L., Hareri H.A., Haro J.M., Harvey J., Hassanvand M.S., Havmoeller R., Hawley C., Hay R.J., Hay S.I., Henry N.J., Heredia-Pi I.B., Heydarpour P., Hoek H.W., Hoffman H.J., Horita N., Hosgood H.D., Hostiuc S., Hotez P.J., Hoy D.G., Htet A.S., Hu G., Huang H., Huynh C., Iburg K.M., Igumbor E.U., Ikeda C., Irvine C.M.S., Jacobsen K.H., Jahanmehr N., Jakovljevic M.B., Jassal S.K., Javanbakht M., Jayaraman S.P., Jeemon P., Jensen P.N., Jha V., Jiang G., John D., Johnson C.O., Johnson S.C., Jonas J.B., Jurisson M., Kabir Z., Kadel R., Kahsay A., Kamal R., Kan H., Karam N.E., Karch A., Karema C.K., Kasaeian A., Kassa G.M., Kassaw N.A., Kassebaum N.J., Kastor A., Katikireddi S.V., Kaul A., Kawakami N., Keiyoro P.N., Kengne A.P., Keren A., Khader Y.S., Khalil I.A., Khan E.A., Khang Y.-H., Khosravi A., Khubchandani J., Kieling C., Kim D., Kim P., Kim Y.J., Kimokoti R.W., Kinfu Y., Kisa A., Kissimova-Skarbek K.A., Kivimaki M., Knudsen A.K., Kokubo Y., Kolte D., Kopec J.A., Kosen S., Koul P.A., Koyanagi A., Kravchenko M., Krishnaswami S., Krohn K.J., Kuate Defo B., Kucuk Bicer B., Kumar G.A., Kumar P., Kumar S., Kyu H.H., Lal D.K., Lalloo R., Lambert N., Lan Q., Lavados P.M., Leasher J.L., Lee J.-T., Lee P.H., Leigh J., Leshargie C.T., Leung J., Leung R., Levi M., Li Y., Li Kappe D., Liang X., Liben M.L., Lim S.S., Linn S., Liu A., Liu P.Y., Liu S., Liu Y., Lodha R., Logroscino G., London S.J., Looker K.J., Lopez A.D., Lorkowski S., Lotufo P.A., Low N., Lozano R., Lucas T.C.D., Macarayan E.R.K., Magdy Abd El Razek H., Magdy Abd El Razek M., Mahdavi M., Majdan M., Majdzadeh R., Majeed A., Malekzadeh R., Malhotra R., Malta D.C., Mamun A.A., Manguerra H., Manhertz T., Mantilla A., Mantovani L.G., Mapoma C.C., Marczak L.B., Martinez-Raga J., Martins-Melo F.R., Martopullo I., Marz W., Mathur M.R., Mazidi M., McAlinden C., McGaughey M., McGrath J.J., McKee M., McNellan C., Mehata S., Mehndiratta M.M., Mekonnen T.C., Memiah P., Memish Z.A., Mendoza W., Mengistie M.A., Mengistu D.T., Mensah G.A., Meretoja A., Meretoja T.J., Mezgebe H.B., Micha R., Millear A., Miller T.R., Mills E.J., Mirarefin M., Mirrakhimov E.M., Misganaw A., Mishra S.R., Mitchell P.B., Mohammad K.A., Mohammadi A., Mohammed K.E., Mohammed S., Mohanty S.K., Mokdad A.H., Mollenkopf S.K., Monasta L., Hernandez J.M., Montico M., Moradi-Lakeh M., Moraga P., Mori R., Morozoff C., Morrison S.D., Moses M., Mountjoy-Venning C., Mruts K.B., Mueller U.O., Muller K., Murdoch M.E., Murthy G.V.S., Musa K.I., Nachega J.B., Nagel G., Naghavi M., Naheed A., Naidoo K.S., Naldi L., Nangia V., Natarajan G., Negasa D.E., Negoi I., Negoi R.I., Newton C.R., Ngunjiri J.W., Nguyen C.T., Nguyen G., Nguyen M., Nguyen Q.L., Nguyen T.H., Nichols E., Ningrum D.N.A., Nolte S., Nong V.M., Norrving B., Noubiap J.J.N., O'Donnell M.J., Ogbo F.A., Oh I.-H., Okoro A., Oladimeji O., Olagunju A.T., Olagunju T.O., Olsen H.E., Olusanya B.O., Olusanya J.O., Ong K., Opio J.N., Oren E., Ortiz A., Osgood-Zimmerman A., Osman M., Owolabi M.O., Pa M., Pacella R.E., Pana A., Panda B.K., Papachristou C., Park E.-K., Parry C.D., Parsaeian M., Patten S.B., Patton G.C., Paulson K., Pearce N., Pereira D.M., Perico N., Pesudovs K., Peterson C.B., Petzold M., Phillips M.R., Pigott D.M., Pillay J.D., Pinho C., Plass D., Pletcher M.A., Popova S., Poulton R.G., Pourmalek F., Prabhakaran D., Prasad N., Prasad N.M., Purcell C., Qorbani M., Quansah R., Rabiee R.H.S., Radfar A., Rafay A., Rahimi K., Rahimi-Movaghar A., Rahimi-Movaghar V., Rahman M., Rahman M.H.U., Rai R.K., Rajsic S., Ram U., Ranabhat C.L., Rankin Z., Rao P.V., Rao P.C., Rawaf S., Ray S.E., Reiner R.C., Reinig N., Reitsma M.B., Remuzzi G., Renzaho A.M.N., Resnikoff S., Rezaei S., Ribeiro A.L., Ronfani L., Roshandel G., Roth G.A., Roy A., Rubagotti E., Ruhago G.M., Saadat S., Sadat N., Safdarian M., Safi S., Safiri S., Sagar R., Sahathevan R., Salama J., Salomon J.A., Salvi S.S., Samy A.M., Sanabria J.R., Santomauro D., Santos I.S., Santos J.V., Santric Milicevic M.M., Sartorius B., Satpathy M., Sawhney M., Saxena S., Schmidt M.I., Schneider I.J.C., Schottker B., Schwebel D.C., Schwendicke F., Seedat S., Sepanlou S.G., Servan-Mori E.E., Setegn T., Shackelford K.A., Shaheen A., Shaikh M.A., Shamsipour M., Shariful Islam S.M., Sharma J., Sharma R., She J., Shi P., Shields C., Shigematsu M., Shinohara Y., Shiri R., Shirkoohi R., Shirude S., Shishani K., Shrime M.G., Sibai A.M., Sigfusdottir I.D., Silva D.A.S., Silva J.P., Silveira D.G.A., Singh J.A., Singh N.P., Sinha D.N., Skiadaresi E., Skirbekk V., Slepak E.L., Sligar A., Smith D.L., Smith M., Sobaih B.H.A., Sobngwi E., Sorensen R.J.D., Sousa T.C.M., Sposato L.A., Sreeramareddy C.T., Srinivasan V., Stanaway J.D., Stathopoulou V., Steel N., Stein D.J., Stein M.B., Steiner C., Steiner T.J., Steinke S., Stokes M.A., Stovner L.J., Strub B., Subart M., Sufiyan M.B., Suliankatchi Abdulkader R., Sunguya B.F., Sur P.J., Swaminathan S., Sykes B.L., Sylte D.O., Tabares-Seisdedos R., Taffere G.R., Takala J.S., Tandon N., Tavakkoli M., Taveira N., Taylor H.R., Tehrani-Banihashemi A., Tekelab T., Temam Shifa G., Terkawi A.S., Tesfaye D.J., Tesssema B., Thamsuwan O., Thomas K.E., Tiruye T.Y., Tobe-Gai R., Tollanes M.C., Tonelli M., Topor-Madry R., Tortajada M., Touvier M., Tran B.X., Tripathi S., Troeger C., Truelsen T., Tsoi D., Tuem K.B., Tuzcu E.M., Tyrovolas S., Ukwaja K.N., Undurraga E.A., Uneke C.J., Updike R., Uthman O.A., Uzochukwu B.S.C., Van Boven J.F.M., Varughese S., Vasankari T., Venkatesh S., Venketasubramanian N., Vidavalur R., Violante F.S., Vladimirov S.K., Vlassov V.V., Vollset S.E., Wadilo F., Wakayo T., Wang Y.-P., Weaver M., Weichenthal S., Weiderpass E., Weintraub R.G., Werdecker A., Westerman R., Whiteford H.A., Wijeratne T., Wiysonge C.S., Wolfe C.D.A., Woodbrook R., Woolf A.D., Workicho A., Wulf Hanson S., Xavier D., Xu G., Yadgir S., Yaghoubi M., Yakob B., Yan L.L., Yano Y., Ye P., Yimam H.H., Yip P., Yonemoto N., Yoon S.-J., Yotebieng M., Younis M.Z., Zaidi Z., Zaki M.E.S., Zegeye E.A., Zenebe Z.M., Zhang X., Zhou M., Zipkin B., Zodpey S., Zuhlke L.J., Murray C.J.L., De Courten B., Thrift A.G., Vos T., Abajobir A.A., Abbafati C., Abbas K.M., Abate K.H., Abd-Allah F., Abdulle A.M., Abebo T.A., Abera S.F., Aboyans V., Abu-Raddad L.J., Ackerman I.N., Adamu A.A., Adetokunboh O., Afarideh M., Afshin A., Agarwal S.K., Aggarwal R., Agrawal A., Agrawal S., Ahmad Kiadaliri A., Ahmadieh H., Ahmed M.B., Aichour A.N., Aichour I., Aichour M.T.E., Aiyar S., Akinyemi R.O., Akseer N., Al Lami F.H., Alahdab F., Al-Aly Z., Alam K., Alam N., Alam T., Alasfoor D., Alene K.A., Ali R., Alizadeh-Navaei R., Alkerwi A., Alla F., Allebeck P., Allen C., Al-Maskari F., Al-Raddadi R., Alsharif U., Alsowaidi S., Altirkawi K.A., Amare A.T., Amini E., Ammar W., Amoako Y.A., Andersen H.H., Antonio C.A.T., Anwari P., Larsson A., Arnlov J., Artaman A., Aryal K.K., Asayesh H., Asgedom S.W., Assadi R., Atey T.M., Atnafu N.T., Atre S.R., Avila-Burgos L., Avokpaho E.F.G.A., Awasthi A., Ayala Quintanilla B.P., Ba Saleem H.O., Bacha U., Badawi A., Balakrishnan K., Banerjee A., Bannick M.S., Barac A., Barber R.M., Barker-Collo S.L., Barnighausen T., Barquera S., Barregard L., Barrero L.H., Basu S., Battista B., Battle K.E., Baune B.T., Bazargan-Hejazi S., Beardsley J., Bedi N., Beghi E., Bejot Y., Bekele B.B., Bell M.L., Bennett D.A., Bensenor I.M., Benson J., Berhane A., Berhe D.F., Bernabe E., Betsu B.D., Beuran M., Beyene A.S., Bhala N., Bhansali A., Bhatt S., Bhutta Z.A., Biadgilign S., Bienhoff K., Bikbov B., Birungi C., Biryukov S., Bisanzio D., Bizuayehu H.M., Boneya D.J., Boufous S., Bourne R.R.A., Brazinova A., Brugha T.S., Buchbinder R., Bulto L.N.B., Bumgarner B.R., Butt Z.A., Cahuana-Hurtado L., Cameron E., Car M., Carabin H., Carapetis J.R., Cardenas R., Carpenter D.O., Carrero J.J., Carter A., Carvalho F., Casey D.C., Caso V., Castaneda-Orjuela C.A., Castle C.D., Catala-Lopez F., Chang H.-Y., Chang J.-C., Charlson F.J., Chen H., Chibalabala M., Chibueze C.E., Chisumpa V.H., Chitheer A.A., Christopher D.J., Ciobanu L.G., Cirillo M., Colombara D., Cooper C., Cortesi P.A., Criqui M.H., Crump J.A., Dadi A.F., Dalal K., Dandona L., Dandona R., Das Neves J., Davitoiu D.V., De Leo D., Degenhardt L., Deiparine S., Dellavalle R.P., Deribe K., Des Jarlais D.C., Dey S., Dharmaratne S.D., Dhillon P.K., Dicker D., Ding E.L., Djalalinia S., Do H.P., Dorsey E.R., Dos Santos K.P.B., Douwes-Schultz D., Doyle K.E., Driscoll T.R., Dubey M., Duncan B.B., El-Khatib Z.Z., Ellerstrand J., Enayati A., Endries A.Y., Ermakov S.P., Erskine H.E., Eshrati B., Eskandarieh S., Esteghamati A., Estep K., Fanuel F.B.B., Farinha C.S.E.S., Faro A., Farzadfar F., Fazeli M.S., Feigin V.L., Fereshtehnejad S.-M., Fernandes J.C., Ferrari A.J., Feyissa T.R., Filip I., Fischer F., Fitzmaurice C., Flaxman A.D., Flor L.S., Foigt N., Foreman K.J., Franklin R.C., Fullman N., Furst T., Furtado J.M., Futran N.D., Gakidou E., Ganji M., Garcia-Basteiro A.L., Gebre T., Gebrehiwot T.T., Geleto A., Gemechu B.L., Gesesew H.A., Gething P.W., Ghajar A., Gibney K.B., Gill P.S., Gillum R.F., Ginawi I.A.M., Giref A.Z., Gishu M.D., Giussani G., Godwin W.W., Gold A.L., Goldberg E.M., Gona P.N., Goodridge A., Gopalani S.V., Goto A., Goulart A.C., Griswold M., Gugnani H.C., Gupta R., Gupta T., Gupta V., Hafezi-Nejad N., Hailu A.D., Hailu G.B., Hamadeh R.R., Hamidi S., Handal A.J., Hankey G.J., Hao Y., Harb H.L., Hareri H.A., Haro J.M., Harvey J., Hassanvand M.S., Havmoeller R., Hawley C., Hay R.J., Hay S.I., Henry N.J., Heredia-Pi I.B., Heydarpour P., Hoek H.W., Hoffman H.J., Horita N., Hosgood H.D., Hostiuc S., Hotez P.J., Hoy D.G., Htet A.S., Hu G., Huang H., Huynh C., Iburg K.M., Igumbor E.U., Ikeda C., Irvine C.M.S., Jacobsen K.H., Jahanmehr N., Jakovljevic M.B., Jassal S.K., Javanbakht M., Jayaraman S.P., Jeemon P., Jensen P.N., Jha V., Jiang G., John D., Johnson C.O., Johnson S.C., Jonas J.B., Jurisson M., Kabir Z., Kadel R., Kahsay A., Kamal R., Kan H., Karam N.E., Karch A., Karema C.K., Kasaeian A., Kassa G.M., Kassaw N.A., Kassebaum N.J., Kastor A., Katikireddi S.V., Kaul A., Kawakami N., Keiyoro P.N., Kengne A.P., Keren A., Khader Y.S., Khalil I.A., Khan E.A., Khang Y.-H., Khosravi A., Khubchandani J., Kieling C., Kim D., Kim P., Kim Y.J., Kimokoti R.W., Kinfu Y., Kisa A., Kissimova-Skarbek K.A., Kivimaki M., Knudsen A.K., Kokubo Y., Kolte D., Kopec J.A., Kosen S., Koul P.A., Koyanagi A., Kravchenko M., Krishnaswami S., Krohn K.J., Kuate Defo B., Kucuk Bicer B., Kumar G.A., Kumar P., Kumar S., Kyu H.H., Lal D.K., Lalloo R., Lambert N., Lan Q., Lavados P.M., Leasher J.L., Lee J.-T., Lee P.H., Leigh J., Leshargie C.T., Leung J., Leung R., Levi M., Li Y., Li Kappe D., Liang X., Liben M.L., Lim S.S., Linn S., Liu A., Liu P.Y., Liu S., Liu Y., Lodha R., Logroscino G., London S.J., Looker K.J., Lopez A.D., Lorkowski S., Lotufo P.A., Low N., Lozano R., Lucas T.C.D., Macarayan E.R.K., Magdy Abd El Razek H., Magdy Abd El Razek M., Mahdavi M., Majdan M., Majdzadeh R., Majeed A., Malekzadeh R., Malhotra R., Malta D.C., Mamun A.A., Manguerra H., Manhertz T., Mantilla A., Mantovani L.G., Mapoma C.C., Marczak L.B., Martinez-Raga J., Martins-Melo F.R., Martopullo I., Marz W., Mathur M.R., Mazidi M., McAlinden C., McGaughey M., McGrath J.J., McKee M., McNellan C., Mehata S., Mehndiratta M.M., Mekonnen T.C., Memiah P., Memish Z.A., Mendoza W., Mengistie M.A., Mengistu D.T., Mensah G.A., Meretoja A., Meretoja T.J., Mezgebe H.B., Micha R., Millear A., Miller T.R., Mills E.J., Mirarefin M., Mirrakhimov E.M., Misganaw A., Mishra S.R., Mitchell P.B., Mohammad K.A., Mohammadi A., Mohammed K.E., Mohammed S., Mohanty S.K., Mokdad A.H., Mollenkopf S.K., Monasta L., Hernandez J.M., Montico M., Moradi-Lakeh M., Moraga P., Mori R., Morozoff C., Morrison S.D., Moses M., Mountjoy-Venning C., Mruts K.B., Mueller U.O., Muller K., Murdoch M.E., Murthy G.V.S., Musa K.I., Nachega J.B., Nagel G., Naghavi M., Naheed A., Naidoo K.S., Naldi L., Nangia V., Natarajan G., Negasa D.E., Negoi I., Negoi R.I., Newton C.R., Ngunjiri J.W., Nguyen C.T., Nguyen G., Nguyen M., Nguyen Q.L., Nguyen T.H., Nichols E., Ningrum D.N.A., Nolte S., Nong V.M., Norrving B., Noubiap J.J.N., O'Donnell M.J., Ogbo F.A., Oh I.-H., Okoro A., Oladimeji O., Olagunju A.T., Olagunju T.O., Olsen H.E., Olusanya B.O., Olusanya J.O., Ong K., Opio J.N., Oren E., Ortiz A., Osgood-Zimmerman A., Osman M., Owolabi M.O., Pa M., Pacella R.E., Pana A., Panda B.K., Papachristou C., Park E.-K., Parry C.D., Parsaeian M., Patten S.B., Patton G.C., Paulson K., Pearce N., Pereira D.M., Perico N., Pesudovs K., Peterson C.B., Petzold M., Phillips M.R., Pigott D.M., Pillay J.D., Pinho C., Plass D., Pletcher M.A., Popova S., Poulton R.G., Pourmalek F., Prabhakaran D., Prasad N., Prasad N.M., Purcell C., Qorbani M., Quansah R., Rabiee R.H.S., Radfar A., Rafay A., Rahimi K., Rahimi-Movaghar A., Rahimi-Movaghar V., Rahman M., Rahman M.H.U., Rai R.K., Rajsic S., Ram U., Ranabhat C.L., Rankin Z., Rao P.V., Rao P.C., Rawaf S., Ray S.E., Reiner R.C., Reinig N., Reitsma M.B., Remuzzi G., Renzaho A.M.N., Resnikoff S., Rezaei S., Ribeiro A.L., Ronfani L., Roshandel G., Roth G.A., Roy A., Rubagotti E., Ruhago G.M., Saadat S., Sadat N., Safdarian M., Safi S., Safiri S., Sagar R., Sahathevan R., Salama J., Salomon J.A., Salvi S.S., Samy A.M., Sanabria J.R., Santomauro D., Santos I.S., Santos J.V., Santric Milicevic M.M., Sartorius B., Satpathy M., Sawhney M., Saxena S., Schmidt M.I., Schneider I.J.C., Schottker B., Schwebel D.C., Schwendicke F., Seedat S., Sepanlou S.G., Servan-Mori E.E., Setegn T., Shackelford K.A., Shaheen A., Shaikh M.A., Shamsipour M., Shariful Islam S.M., Sharma J., Sharma R., She J., Shi P., Shields C., Shigematsu M., Shinohara Y., Shiri R., Shirkoohi R., Shirude S., Shishani K., Shrime M.G., Sibai A.M., Sigfusdottir I.D., Silva D.A.S., Silva J.P., Silveira D.G.A., Singh J.A., Singh N.P., Sinha D.N., Skiadaresi E., Skirbekk V., Slepak E.L., Sligar A., Smith D.L., Smith M., Sobaih B.H.A., Sobngwi E., Sorensen R.J.D., Sousa T.C.M., Sposato L.A., Sreeramareddy C.T., Srinivasan V., Stanaway J.D., Stathopoulou V., Steel N., Stein D.J., Stein M.B., Steiner C., Steiner T.J., Steinke S., Stokes M.A., Stovner L.J., Strub B., Subart M., Sufiyan M.B., Suliankatchi Abdulkader R., Sunguya B.F., Sur P.J., Swaminathan S., Sykes B.L., Sylte D.O., Tabares-Seisdedos R., Taffere G.R., Takala J.S., Tandon N., Tavakkoli M., Taveira N., Taylor H.R., Tehrani-Banihashemi A., Tekelab T., Temam Shifa G., Terkawi A.S., Tesfaye D.J., Tesssema B., Thamsuwan O., Thomas K.E., Tiruye T.Y., Tobe-Gai R., Tollanes M.C., Tonelli M., Topor-Madry R., Tortajada M., Touvier M., Tran B.X., Tripathi S., Troeger C., Truelsen T., Tsoi D., Tuem K.B., Tuzcu E.M., Tyrovolas S., Ukwaja K.N., Undurraga E.A., Uneke C.J., Updike R., Uthman O.A., Uzochukwu B.S.C., Van Boven J.F.M., Varughese S., Vasankari T., Venkatesh S., Venketasubramanian N., Vidavalur R., Violante F.S., Vladimirov S.K., Vlassov V.V., Vollset S.E., Wadilo F., Wakayo T., Wang Y.-P., Weaver M., Weichenthal S., Weiderpass E., Weintraub R.G., Werdecker A., Westerman R., Whiteford H.A., Wijeratne T., Wiysonge C.S., Wolfe C.D.A., Woodbrook R., Woolf A.D., Workicho A., Wulf Hanson S., Xavier D., Xu G., Yadgir S., Yaghoubi M., Yakob B., Yan L.L., Yano Y., Ye P., Yimam H.H., Yip P., Yonemoto N., Yoon S.-J., Yotebieng M., Younis M.Z., Zaidi Z., Zaki M.E.S., Zegeye E.A., Zenebe Z.M., Zhang X., Zhou M., Zipkin B., Zodpey S., Zuhlke L.J., Murray C.J.L., De Courten B., Thrift A.G., Vos T., Abajobir A.A., Abbafati C., Abbas K.M., Abate K.H., Abd-Allah F., Abdulle A.M., Abebo T.A., Abera S.F., Aboyans V., Abu-Raddad L.J., Ackerman I.N., Adamu A.A., Adetokunboh O., Afarideh M., Afshin A., Agarwal S.K., Aggarwal R., Agrawal A., Agrawal S., Ahmad Kiadaliri A., Ahmadieh H., Ahmed M.B., Aichour A.N., Aichour I., Aichour M.T.E., Aiyar S., Akinyemi R.O., Akseer N., Al Lami F.H., Alahdab F., Al-Aly Z., Alam K., Alam N., Alam T., Alasfoor D., Alene K.A., Ali R., Alizadeh-Navaei R., Alkerwi A., Alla F., Allebeck P., Allen C., Al-Maskari F., Al-Raddadi R., Alsharif U., Alsowaidi S., Altirkawi K.A., Amare A.T., Amini E., Ammar W., Amoako Y.A., Andersen H.H., Antonio C.A.T., and Anwari P.

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 non-c

Published
2017

21. 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

Abajobir, A, Abate, K, Abbafati, C, Abbas, K, Abd-Allah, F, Abdulkader, R, Abdulle, A, Abebo, T, Abera, S, Aboyans, V, Abu-Raddad, L, Ackerman, I, Adedeji, I, Adetokunboh, O, Afshin, A, Aggarwal, R, Agrawal, S, Agrawal, A, Ahmed, M, Aichour, M, Aichour, A, Aichour, I, Aiyar, S, Akinyemiju, T, Akseer, N, Al Lami, F, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alam, T, Alasfoor, D, Alene, K, Ali, R, Alizadeh-Navaei, R, Alkaabi, J, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Maskari, F, Almazroa, M, Al-Raddadi, R, Alsharif, U, Alsowaidi, S, Althouse, B, Altirkawi, K, Alvis-Guzman, N, Amare, A, Amini, E, Ammar, W, Amoako, Y, Ansha, M, Antonio, C, Anwari, P, Ärnlöv, J, Arora, M, Artaman, A, Aryal, K, Asgedom, S, Atey, T, Atnafu, N, Avila-Burgos, L, Avokpaho, E, Awasthi, A, Awasthi, S, Azarpazhooh, M, Azzopardi, P, Babalola, T, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, M, Barac, A, Barker-Collo, S, Bärnighausen, T, Barquera, S, Barrero, L, Basu, S, Battista, R, Battle, K, Baune, B, 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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 difered 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

Published
2017

22. 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

23. 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, S. I., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulle, A. M., Abebo, T. A., Abera, S. F., Aboyans, V., Abu-Raddad, L. J., Ackerman, I. N., Adedeji, I. A., Adetokunboh, O., Afshin, A., Aggarwal, R., Agrawal, S., Agrawal, A., Kiadaliri, A. A., Ahmed, M. B., Aichour, A. N., Aichour, I., Aichour, M. T. E., Aiyar, S., Akinyemiju, T. F., Akseer, N., Al Lami, F. H., Alahdab, F., Al-Aly, Z., Alam, K., Alam, N., Alam, T., Alasfoor, D., Alene, K. A., Ali, R., Alizadeh-Navaei, R., Alkaabi, J. M., Alkerwi, A., Alla, F., Allebeck, P., Allen, C., Al-Maskari, F., Almazroa, M. A., Al-Raddadi, R., Alsharif, U., Alsowaidi, S., Althouse, B. M., Altirkawi, K. A., Alvis-Guzman, N., Amare, A. T., Amini, E., Ammar, W., Amoako, Y. A., Ansha, M. G., Antonio, C. A. T., Anwari, P., Ärnlöv, J., Arora, M., Artaman, A., Aryal, K. K., Asgedom, S. W., Atey, T. M., Atnafu, N. T., Avila-Burgos, L., Arthur Avokpaho, E. F. G., Awasthi, A., Awasthi, S., Quintanilla, B. P. A., Azarpazhooh, M. R., Azzopardi, P., Babalola, T. K., Bacha, U., Badawi, A., Balakrishnan, K., Bannick, M. S., Barac, A., Barker-Collo, S. L., BÀrnighausen, T., Barquera, S., Barrero, L. H., Basu, S., Battista, R., Battle, K. E., Baune, B. T., Bazargan-Hejazi, S., Beardsley, J., Bedi, N., Béjot, Y., Bekele, B. B., Bell, M. L., Bennett, D. A., Bennett, J. R., Bensenor, I. M., Benson, J., Berhane, A., Berhe, D. F., Bernabé, E., Betsu, B. D., Beuran, M., Beyene, A. S., Bhansali, A., Bhatt, S., Bhutta, Z. A., Biadgilign, S., Bienhof, K., Bikbov, B., Birungi, C., Biryukov, S., Bisanzio, D., Bizuayehu, H. M., Blyth, F. M., Boneya, D. J., Bose, D., Bou-Orm, I. R., Bourne, R. R. A., Brainin, M., Brayne, C. E. G., Brazinova, A., Breitborde, N. J. K., Briant, P. S., Britton, G., Brugha, T. S., Buchbinder, R., Bulto, L. N. B., Bumgarner, B., Butt, Z. A., Cahuana-Hurtado, L., Cameron, E., Campos-Nonato, I. R., Carabin, H., Cárdenas, R., Carpenter, D. O., Carrero, J. J., Carter, A., Carvalho, F., Casey, D., Castañeda-Orjuela, C. A., Rivas, J. C., Castle, C. D., Catalá-López, F., Chang, J. -C, Charlson, F. J., Chaturvedi, P., Chen, H., Chibalabala, M., Chibueze, C. E., Chisumpa, V. H., Chitheer, A. A., Chowdhury, R., Christopher, D. J., Ciobanu, L. G., Cirillo, M., Colombara, D., Cooper, L. T., Cooper, C., Cortesi, P. A., Cortinovis, M., Criqui, M. H., Cromwell, E. A., Cross, M., Crump, J. A., Dadi, A. F., Dalal, Koustuv, Damasceno, A., Dandona, L., Dandona, R., Das Neves, J., Davitoiu, D. V., Davletov, K., De Courten, B., De Leo, D., De Steur, H., Degenhardt, L., Deiparine, S., Dellavalle, R. P., Deribe, K., Deribew, A., Das Jarlais, D. C., Dey, S., Dharmaratne, S. D., Dhillon, P. K., Dicker, D., Djalalinia, S., Do, H. P., Dokova, K., Doku, D. T., Dorsey, E. R., Dos Santos, K. P. B., Driscoll, T. R., Dubey, M., Duncan, B. B., Ebel, B. E., Echko, M., El-Khatib, Z. Z., Enayati, A., Endries, A. Y., Ermakov, S. P., Erskine, H. E., Eshetie, S., Eshrati, B., Esteghamati, A., Estep, K., Fanuel, F. B. B., Farag, T., Farinha, C. S. E. S., Faro, A., Farzadfar, F., Fazeli, M. S., Feigin, V. L., Feigl, A. B., Fereshtehnejad, S. -M, Fernandes, J. C., Ferrari, A. J., Feyissa, T. R., Filip, I., Fischer, F., Fitzmaurice, C., Flaxman, A. D., Foigt, N., Foreman, K. J., Franklin, R. C., Frostad, J. J., Fullman, N., FÃŒrst, T., Furtado, J. M., Futran, N. D., Gakidou, E., Garcia-Basteiro, A. L., Gebre, T., Gebregergs, G. B., Gebrehiwot, T. T., Geleijnse, J. M., Geleto, A., Gemechu, B. L., Gesesew, H. A., Gething, P. W., Ghajar, A., Gibney, K. B., Gillum, R. F., Ginawi, I. A. M., Gishu, M. D., Giussani, G., Godwin, W. W., Goel, K., Goenka, S., Goldberg, E. M., Gona, P. N., Goodridge, A., Gopalani, S. V., Gosselin, R. A., Gotay, C. C., Goto, A., Goulart, A. C., Graetz, N., Gugnani, H. C., Gupta, R., Gupta, P. C., Gupta, T., Gupta, V., Gutiérrez, R. A., Hachinski, V., Hafezi-Nejad, N., Hailu, A. D., Hailu, G. B., Hamadeh, R. R., Hamidi, S., Hammami, M., Handal, A. J., Hankey, G. J., Hao, Y., Harb, H. L., Hareri, H. A., Haro, J. M., Harun, K. M., Harvey, J., Hassanvand, M. S., Havmoeller, R., Hay, R. J., Hedayati, M. T., Hendrie, D., Henry, N. J., Heredia-Pi, I. B., Heydarpour, P., Hoek, H. W., Hofman, H. J., Horino, M., Horita, N., Hosgood, H. D., Hostiuc, S., Hotez, P. J., Hoy, D. G., Htet, A. S., Hu, G., Huang, J. J., Huynh, C., Iburg, K. M., Igumbor, E. U., Ikeda, C., Irvine, C. M. S., Jacobsen, K. H., Jahanmehr, N., Jakovljevic, M. B., James, P., Jassal, S. K., Javanbakht, M., Jayaraman, S. P., Jeemon, P., Jensen, P. N., Jha, V., Jiang, G., John, D., Johnson, C. O., Johnson, S. C., Jonas, J. B., JÃŒrisson, M., Kabir, Z., Kadel, R., Kahsay, A., Kamal, R., Kar, C., Karam, N. E., Karch, A., Karema, C. K., Karimi, S. M., Karimkhani, C., Kasaeian, A., Kassa, G. M., Kassebaum, N. J., Kassaw, N. A., Kastor, A., Katikireddi, S. V., Kaul, A., Kawakami, N., Keiyoro, P. N., Kemmer, L., Kengne, A. P., Keren, A., Kesavachandran, C. N., Khader, Y. S., Khalil, I. A., Khan, E. A., Khang, Y. -H, Khoja, A. T., Khosravi, A., Khubchandani, J., Kieling, C., Kim, Y. J., Kim, D., Kimokoti, R. W., Kinfu, Y., Kisa, A., Kissimova-Skarbek, K. A., Kissoon, N., Kivimaki, M., Knudsen, A. K., Kokubo, Y., Kolte, D., Kopec, J. A., Kosen, S., Kotsakis, G. A., Koul, P. A., Koyanagi, A., Kravchenko, M., Krohn, K. J., Defo, B. K., Bicer, B. K., Kumar, G. A., Kumar, P., Kyu, H. H., Lager, A. C. J., Lal, D. K., Lalloo, R., Lallukka, T., Lambert, N., Lan, Q., Lansingh, V. C., Larsson, A., Leasher, J. L., Lee, P. H., Leigh, J., Leshargie, C. T., Leung, J., Leung, R., Levi, M., Li, Y., Liang, X., Liben, M. L., Lim, S. S., Linn, S., Liu, A., Liu, P. Y., Liu, S., Liu, Y., Lodha, R., Logroscino, G., Looker, K. J., Lopez, A. D., Lorkowski, S., Lotufo, P. A., Lozano, R., Lucas, T. C. D., Lunevicius, R., Lyons, R. A., Macarayan, E. R. K., Maddison, E. R., Magdy Abd El Razek, H., Magdy Abd El Razek, M., Magis-Rodriguez, C., Mahdavi, M., Majdan, M., Majdzadeh, R., Majeed, A., Malekzadeh, R., Malhotra, R., Malta, D. C., Mamun, A. A., Manguerra, H., Manhertz, T., Mantovani, L. G., Mapoma, C. C., March, L. M., Marczak, L. B., Martinez-Raga, J., Martins, P. H. V., Martins-Melo, F. R., Martopullo, I., MÀrz, W., Mathur, M. R., Mazidi, M., McAlinden, C., McGaughey, M., McGrath, J. J., McKee, M., Mehata, S., Meier, T., Meles, K. G., Memiah, P., Memish, Z. A., Mendoza, W., Mengesha, M. M., Mengistie, M. A., Mengistu, D. T., Mensah, G. A., Meretoja, A., Meretoja, T. J., Mezgebe, H. B., Micha, R., Millear, A., Miller, T. R., Minnig, S., Mirarefn, M., Mirrakhimov, E. M., Misganaw, A., Mishra, S. R., Mitchell, P. B., Mohammad, K. A., Mohammadi, A., Mohammed, S., Mohammed, K. E., Mohammed, M. S. K., Mohan, M. B. V., Mokdad, A. H., Mollenkopf, S. K., Monasta, L., Montañez Hernandez, J. C., Montico, M., Moradi-Lakeh, M., Moraga, P., Morawska, L., Mori, R., Morrison, S. D., Moses, M., Mountjoy-Venning, C., Mruts, K. B., Mueller, U. O., Muller, K., Mudoch, M. E., Murthy, S., Murthy, G. V. S., Musa, K. I., Nachega, J. B., Nagel, G., Naghavi, M., Naheed, A., Naidoo, K. S., Nangia, V., Nasher, J. T., Natarajan, G., Negasa, D. E., Negoi, I., Negoi, R. I., Newton, C. R., Ngunjiri, J. W., Nguyen, C. T., Nguyen, Q. L., Nguyen, G., Nguyen, T. H., Nguyen, M., Nichols, E., Ningrum, D. N. A., Nong, V. M., Norheim, O. F., Norrving, B., Noubiap, J. J. N., Nyandwi, A., Obermeyer, C. M., O’Donnell, M. J., Ogbo, F. A., Oh, I. -H, Okoro, A., Oladimeji, O., Olagunju, A. T., Olagunju, T. O., Olsen, H. E., Olusanya, B. O., Olusanya, J. O., Ong, K., Opio, J. N., Oren, E., Ortiz, A., Osborne, R. H., Osgood-Zimmerman, A., Osman, M., Ota, E., Owolabi, M. O., Pa, M., Pacella, R. E., Panda, B. K., Pandian, J. D., Papachristou, C., Park, E. -K, Parry, C. D., Parsaeian, M., Patil, S. T., Patten, S. B., Patton, G. C., Paudel, D., Paulson, K., Pearce, N., Pereira, D. M., Perez, K. M., Perico, N., Pesudovs, K., Peterson, C. B., Petri, W. A., Petzold, M., Phillips, M. R., Phipps, G., Pigott, D. M., Pillay, J. D., Pinho, C., Piradov, M. A., Plass, D., Pletcher, M. A., Popova, S., Poulton, R. G., Pourmalek, F., Prabhakaran, D., Prasad, N., Purcell, C., Purwar, M., Qorbani, M., Rabiee, R. H. S., Radfar, A., Rafay, A., Rahimi, K., Rahimi-Movaghar, A., Rahimi-Movaghar, V., Rahman, M., Rahman, M. A., Rahman, M. H. U., Rai, R. K., Rajsic, S., Ram, U., Ranabhat, C. L., Rangaswamy, T., Rankin, Z., Rao, P. V., Rao, P. C., Rawaf, S., Ray, S. E., Reiner, R. C., Reinig, N., Reitsma, M., Remuzzi, G., Renzaho, A. M. N., Resnikof, S., Rezaei, S., Ribeiro, A. L., Roba, H. S., Robinson, S. R., Rojas-Rueda, D., Rokni, M. B., Ronfani, L., Roshandel, G., Roth, G. A., Rothenbacher, D., Roy, A., Rubagotti, E., Ruhago, G. M., Saadat, S., Safdarian, M., Safri, S., Sagar, R., Sahathevan, R., Sahraian, M. A., Salama, J., Saleh, M. M., Salomon, J. A., Salvi, S. S., Samy, A. M., Sanabria, J. R., Sanchez-Niño, M. D., Santomauro, D., Santos, J. V., Santos, I. S., Santric Milicevic, M. M., Sartorius, B., Satpathy, M., Sawhney, M., Saxena, S., Schelonka, K., Schmidt, M. I., Schneider, I. J. C., Schöttker, B., Schutte, A. E., Schwebel, D. C., Schwendicke, F., Seedat, S., Sepanlou, S. G., Servan-Mori, E. E., Shaheen, A., Shaikh, M. A., Shamsipour, M., Shariful Islam, S. M., Sharma, R., Sharma, J., She, J., Shi, P., Shibuya, K., Shields, C., Shiferaw, M. S., Shigematsu, M., Shiri, R., Shirkoohi, R., Shirude, S., Shishani, K., Shoman, H., Siabani, S., Sibai, A. M., Sigfusdottir, I. D., Silberberg, D. H., Silva, J. P., Silva, D. A. S., Silveira, D. G. A., Singh, J. A., Singh, V., Singh, O. P., Singh, N. P., Sinha, D. N., Skiadaresi, E., Skirbekk, V., Slepak, E. L., Smith, D. L., Smith, M., Sobaih, B. H. A., Sobngwi, E., Soljak, M., Sorensen, R. J. D., Sousa, T. C. M., Sposato, L. A., Sreeramareddy, C. T., Srinivasan, V., Stanaway, J. D., Stathopoulou, V., Steel, N., Stein, D. J., Steiner, C., Steinke, S., Stokes, M. A., Stovner, L. J., Strub, B., Subart, M., Sufyan, M. B., Abdulkader, R. S., Sunguya, B. F., Sur, P. J., Swaminathan, S., Sykes, B. L., Sylte, D., Szoeke, C. E. I., Tabarés-Seisdedos, R., Tadakamadla, S. K., Tafere, G. R., Takala, J. S., Tandon, N., Tanne, D., Tarekegn, Y. L., Tavakkoli, M., Taveira, N., Taylor, H. R., Tegegne, T. K., Tehrani-Banihashemi, A., Tekelab, T., Temam Shifa, G., Terkawi, A. S., Tesfaye, D. J., Tesssema, B., Thakur, J. S., Thamsuwan, O., Theadom, A. M., Theis, A. M., Thomas, K. E., Thomas, N., Thompson, R., Thrift, A. G., Tobe-Gai, R., Tobollik, M., Tonelli, M., Topor-Madry, R., Tortajada, M., Touvier, M., Traebert, J., Tran, B. X., Troeger, C., Truelsen, T., Tsoi, D., Tuzcu, E. M., Tymeson, H., Tyrovolas, S., Ukwaja, K. N., Undurraga, E. A., Uneke, C. J., Updike, R., Uthman, O. A., Uzochukwu, B. S. C., Van Boven, J. F. M., Varughese, S., Vasankari, T., Veerman, L. J., Venkatesh, S., Venketasubramanian, N., Vidavalur, R., Vijayakumar, L., Violante, F. S., Vishnu, A., Vladimirov, S. K., Vlassov, V. V., Vollset, S. E., Vos, T., Wadilo, F., Wakayo, T., Wallin, M. T., Wang, Y. -P, Weichenthal, S., Weiderpass, E., Weintraub, R. G., Weiss, D. J., Werdecker, A., Westerman, R., Whiteford, H. A., Wijeratne, T., Williams, H. C., Wiysonge, C. S., Woldeyes, B. G., Wolfe, C. D. A., Woodbrook, R., Woolf, A. D., Workicho, A., Xavier, D., Xu, G., Yadgir, S., Yaghoubi, M., Yakob, B., Yan, L. L., Yano, Y., Ye, P., Yihdego, M. G., Yimam, H. H., Yip, P., Yonemoto, N., Yoon, S. -J, Yotebieng, M., Younis, M. Z., Yu, C., Zaidi, Z., Zaki, M. E. S., Zegeye, E. A., Zenebe, Z. M., Zhang, X., Zheng, Y., Zhou, M., Zipkin, B., Zodpey, S., Zoeckler, L., Zuhlke, L. J., Murray, C. J. L., Adedji, I. A., Murdoch, M. E., Bryane, C. E. G., DALYs, G B D 2 0 1 6, Collaborators, H A L E, Hay, S. I., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulle, A. M., Abebo, T. A., Abera, S. F., Aboyans, V., Abu-Raddad, L. J., Ackerman, I. N., Adedeji, I. A., Adetokunboh, O., Afshin, A., Aggarwal, R., Agrawal, S., Agrawal, A., Kiadaliri, A. A., Ahmed, M. B., Aichour, A. N., Aichour, I., Aichour, M. T. E., Aiyar, S., Akinyemiju, T. F., Akseer, N., Al Lami, F. H., Alahdab, F., Al-Aly, Z., Alam, K., Alam, N., Alam, T., Alasfoor, D., Alene, K. A., Ali, R., Alizadeh-Navaei, R., Alkaabi, J. M., Alkerwi, A., Alla, F., Allebeck, P., Allen, C., Al-Maskari, F., Almazroa, M. A., Al-Raddadi, R., Alsharif, U., Alsowaidi, S., Althouse, B. M., Altirkawi, K. A., Alvis-Guzman, N., Amare, A. T., Amini, E., Ammar, W., Amoako, Y. A., Ansha, M. G., Antonio, C. A. T., Anwari, P., Ärnlöv, J., Arora, M., Artaman, A., Aryal, K. K., Asgedom, S. W., Atey, T. M., Atnafu, N. T., Avila-Burgos, L., Arthur Avokpaho, E. F. 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G., DALYs, G B D 2 0 1 6, and Collaborators, H A L E

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 difered 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, cited By 723

Published
2017
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24. 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, A. A., Abbafati, C., Abbas, K. M., Abate, K. H., Abd-Allah, F., Abdulle, A. M., Abebo, T. A., Abera, S. F., Aboyans, V., Abu-Raddad, L. J., Ackerman, I. N., Adamu, A. A., Adetokunboh, O., Afarideh, M., Afshin, A., Agarwal, S. K., Aggarwal, R., Agrawal, A., Agrawal, S., Ahmad Kiadaliri, A., Ahmadieh, H., Ahmed, M. B., Aichour, A. N., Aichour, I., Aichour, M. T. E., Aiyar, S., Akinyemi, R. O., Akseer, N., Al Lami, F. H., Alahdab, F., Al-Aly, Z., Alam, K., Alam, N., Alam, T., Alasfoor, D., Alene, K. A., Ali, R., Alizadeh-Navaei, R., Alkerwi, A., Alla, F., Allebeck, P., Allen, C., Al-Maskari, F., Al-Raddadi, R., Alsharif, U., Alsowaidi, S., Altirkawi, K. A., Amare, A. T., Amini, E., Ammar, W., Amoako, Y. A., Andersen, H. H., Antonio, C. A. T., Anwari, P., Ärnlöv, J., Artaman, A., Aryal, K. K., Asayesh, H., Asgedom, S. W., Assadi, R., Atey, T. M., Atnafu, N. T., Atre, S. R., Avila-Burgos, L., Avokpaho, E. F. G. A., Awasthi, A., Ayala Quintanilla, B. P., Ba Saleem, H. O., Bacha, U., Badawi, A., Balakrishnan, K., Banerjee, A., Bannick, M. S., Barac, A., Barber, R. M., Barker-Collo, S. L., BÀrnighausen, T., Barquera, S., Barregard, L., Barrero, L. H., Basu, S., Battista, B., Battle, K. E., Baune, B. T., Bazargan-Hejazi, S., Beardsley, J., Bedi, N., Beghi, E., Béjot, Y., Bekele, B. B., Bell, M. L., Bennett, D. A., Bensenor, I. M., Benson, J., Berhane, A., Berhe, D. F., Bernabé, E., Betsu, B. D., Beuran, M., Beyene, A. S., Bhala, N., Bhansali, A., Bhatt, S., Bhutta, Z. A., Biadgilign, S., Bienhoff, K., Bikbov, B., Birungi, C., Biryukov, S., Bisanzio, D., Bizuayehu, H. M., Boneya, D. J., Boufous, S., Bourne, R. R. A., Brazinova, A., Brugha, T. S., Buchbinder, R., Bulto, L. N. B., Bumgarner, B. R., Butt, Z. A., Cahuana-Hurtado, L., Cameron, E., Car, M., Carabin, H., Carapetis, J. R., Cárdenas, R., Carpenter, D. O., Carrero, J. J., Carter, A., Carvalho, F., Casey, D. C., Caso, V., Castañeda-Orjuela, C. A., Castle, C. D., Catalá-López, F., Chang, H. -Y, Chang, J. -C, Charlson, F. J., Chen, H., Chibalabala, M., Chibueze, C. E., Chisumpa, V. H., Chitheer, A. A., Christopher, D. J., Ciobanu, L. G., Cirillo, M., Colombara, D., Cooper, C., Cortesi, P. A., Criqui, M. H., Crump, J. A., Dadi, A. F., Dalal, Koustuv, Dandona, L., Dandona, R., Das Neves, J., Davitoiu, D. V., De Courten, B., De Leo, D., Degenhardt, L., Deiparine, S., Dellavalle, R. P., Deribe, K., Des Jarlais, D. C., Dey, S., Dharmaratne, S. D., Dhillon, P. K., Dicker, D., Ding, E. L., Djalalinia, S., Do, H. P., Dorsey, E. R., Dos Santos, K. P. B., Douwes-Schultz, D., Doyle, K. E., Driscoll, T. R., Dubey, M., Duncan, B. B., El-Khatib, Z. Z., Ellerstrand, J., Enayati, A., Endries, A. Y., Ermakov, S. P., Erskine, H. E., Eshrati, B., Eskandarieh, S., Esteghamati, A., Estep, K., Fanuel, F. B. B., Farinha, C. S. E. S., Faro, A., Farzadfar, F., Fazeli, M. S., Feigin, V. L., Fereshtehnejad, S. -M, Fernandes, J. C., Ferrari, A. J., Feyissa, T. R., Filip, I., Fischer, F., Fitzmaurice, C., Flaxman, A. D., Flor, L. S., Foigt, N., Foreman, K. J., Franklin, R. C., Fullman, N., FÃŒrst, T., Furtado, J. M., Futran, N. D., Gakidou, E., Ganji, M., Garcia-Basteiro, A. L., Gebre, T., Gebrehiwot, T. T., Geleto, A., Gemechu, B. L., Gesesew, H. A., Gething, P. W., Ghajar, A., Gibney, K. B., Gill, P. S., Gillum, R. F., Ginawi, I. A. M., Giref, A. Z., Gishu, M. D., Giussani, G., Godwin, W. W., Gold, A. L., Goldberg, E. M., Gona, P. N., Goodridge, A., Gopalani, S. V., Goto, A., Goulart, A. C., Griswold, M., Gugnani, H. C., Gupta, R., Gupta, T., Gupta, V., Hafezi-Nejad, N., Hailu, A. D., Hailu, G. B., Hamadeh, R. R., Hamidi, S., Handal, A. J., Hankey, G. J., Hao, Y., Harb, H. L., Hareri, H. A., Haro, J. M., Harvey, J., Hassanvand, M. S., Havmoeller, R., Hawley, C., Hay, R. J., Hay, S. I., Henry, N. J., Heredia-Pi, I. B., Heydarpour, P., Hoek, H. W., Hoffman, H. J., Horita, N., Hosgood, H. D., Hostiuc, S., Hotez, P. J., Hoy, D. G., Htet, A. S., Hu, G., Huang, H., Huynh, C., Iburg, K. M., Igumbor, E. U., Ikeda, C., Irvine, C. M. S., Jacobsen, K. H., Jahanmehr, N., Jakovljevic, M. B., Jassal, S. K., Javanbakht, M., Jayaraman, S. P., Jeemon, P., Jensen, P. N., Jha, V., Jiang, G., John, D., Johnson, C. O., Johnson, S. C., Jonas, J. B., JÃŒrisson, M., Kabir, Z., Kadel, R., Kahsay, A., Kamal, R., Kan, H., Karam, N. E., Karch, A., Karema, C. K., Kasaeian, A., Kassa, G. M., Kassaw, N. A., Kassebaum, N. J., Kastor, A., Katikireddi, S. V., Kaul, A., Kawakami, N., Keiyoro, P. N., Kengne, A. P., Keren, A., Khader, Y. S., Khalil, I. A., Khan, E. A., Khang, Y. -H, Khosravi, A., Khubchandani, J., Kieling, C., Kim, D., Kim, P., Kim, Y. J., Kimokoti, R. W., Kinfu, Y., Kisa, A., Kissimova-Skarbek, K. A., Kivimaki, M., Knudsen, A. K., Kokubo, Y., Kolte, D., Kopec, J. A., Kosen, S., Koul, P. A., Koyanagi, A., Kravchenko, M., Krishnaswami, S., Krohn, K. J., Kuate Defo, B., Kucuk Bicer, B., Kumar, G. A., Kumar, P., Kumar, S., Kyu, H. 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L., Lim, S. S., Linn, S., Liu, A., Liu, P. Y., Liu, S., Liu, Y., Lodha, R., Logroscino, G., London, S. J., Looker, K. J., Lopez, A. D., Lorkowski, S., Lotufo, P. A., Low, N., Lozano, R., Lucas, T. C. D., Macarayan, E. R. K., Magdy Abd El Razek, H., Magdy Abd El Razek, M., Mahdavi, M., Majdan, M., Majdzadeh, R., Majeed, A., Malekzadeh, R., Malhotra, R., Malta, D. C., Mamun, A. A., Manguerra, H., Manhertz, T., Mantilla, A., Mantovani, L. G., Mapoma, C. C., Marczak, L. B., Martinez-Raga, J., Martins-Melo, F. R., Martopullo, I., MÀrz, W., Mathur, M. R., Mazidi, M., McAlinden, C., McGaughey, M., McGrath, J. J., McKee, M., McNellan, C., Mehata, S., Mehndiratta, M. M., Mekonnen, T. C., Memiah, P., Memish, Z. A., Mendoza, W., Mengistie, M. A., Mengistu, D. T., Mensah, G. A., Meretoja, A., Meretoja, T. J., Mezgebe, H. B., Micha, R., Millear, A., Miller, T. R., Mills, E. J., Mirarefin, M., Mirrakhimov, E. M., Misganaw, A., Mishra, S. R., Mitchell, P. B., Mohammad, K. A., Mohammadi, A., Mohammed, K. E., Mohammed, S., Mohanty, S. K., Mokdad, A. H., Mollenkopf, S. K., Monasta, L., Hernandez, J. M., Montico, M., Moradi-Lakeh, M., Moraga, P., Mori, R., Morozoff, C., Morrison, S. D., Moses, M., Mountjoy-Venning, C., Mruts, K. B., Mueller, U. O., Muller, K., Murdoch, M. E., Murthy, G. V. S., Musa, K. I., Nachega, J. B., Nagel, G., Naghavi, M., Naheed, A., Naidoo, K. S., Naldi, L., Nangia, V., Natarajan, G., Negasa, D. E., Negoi, I., Negoi, R. I., Newton, C. R., Ngunjiri, J. W., Nguyen, C. T., Nguyen, G., Nguyen, M., Nguyen, Q. L., Nguyen, T. H., Nichols, E., Ningrum, D. N. A., Nolte, S., Nong, V. M., Norrving, B., Noubiap, J. J. N., O’Donnell, M. J., Ogbo, F. A., Oh, I. -H, Okoro, A., Oladimeji, O., Olagunju, A. T., Olagunju, T. O., Olsen, H. E., Olusanya, B. O., Olusanya, J. O., Ong, K., Opio, J. N., Oren, E., Ortiz, A., Osgood-Zimmerman, A., Osman, M., Owolabi, M. O., Pa, M., Pacella, R. E., Pana, A., Panda, B. K., Papachristou, C., Park, E. -K, Parry, C. D., Parsaeian, M., Patten, S. B., Patton, G. C., Paulson, K., Pearce, N., Pereira, D. M., Perico, N., Pesudovs, K., Peterson, C. B., Petzold, M., Phillips, M. R., Pigott, D. M., Pillay, J. D., Pinho, C., Plass, D., Pletcher, M. A., Popova, S., Poulton, R. G., Pourmalek, F., Prabhakaran, D., Prasad, N., Prasad, N. M., Purcell, C., Qorbani, M., Quansah, R., Rabiee, R. H. S., Radfar, A., Rafay, A., Rahimi, K., Rahimi-Movaghar, A., Rahimi-Movaghar, V., Rahman, M., Rahman, M. H. U., Rai, R. K., Rajsic, S., Ram, U., Ranabhat, C. L., Rankin, Z., Rao, P. V., Rao, P. C., Rawaf, S., Ray, S. E., Reiner, R. C., Reinig, N., Reitsma, M. B., Remuzzi, G., Renzaho, A. M. N., Resnikoff, S., Rezaei, S., Ribeiro, A. L., Ronfani, L., Roshandel, G., Roth, G. A., Roy, A., Rubagotti, E., Ruhago, G. M., Saadat, S., Sadat, N., Safdarian, M., Safi, S., Safiri, S., Sagar, R., Sahathevan, R., Salama, J., Salomon, J. A., Salvi, S. S., Samy, A. M., Sanabria, J. 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J., Strub, B., Subart, M., Sufiyan, M. B., Suliankatchi Abdulkader, R., Sunguya, B. F., Sur, P. J., Swaminathan, S., Sykes, B. L., Sylte, D. O., Tabarés-Seisdedos, R., Taffere, G. R., Takala, J. S., Tandon, N., Tavakkoli, M., Taveira, N., Taylor, H. R., Tehrani-Banihashemi, A., Tekelab, T., Temam Shifa, G., Terkawi, A. S., Tesfaye, D. J., Tesssema, B., Thamsuwan, O., Thomas, K. E., Thrift, A. G., Tiruye, T. Y., Tobe-Gai, R., Tollanes, M. C., Tonelli, M., Topor-Madry, R., Tortajada, M., Touvier, M., Tran, B. X., Tripathi, S., Troeger, C., Truelsen, T., Tsoi, D., Tuem, K. B., Tuzcu, E. M., Tyrovolas, S., Ukwaja, K. N., Undurraga, E. A., Uneke, C. J., Updike, R., Uthman, O. A., Uzochukwu, B. S. C., Van Boven, J. F. M., Varughese, S., Vasankari, T., Venkatesh, S., Venketasubramanian, N., Vidavalur, R., Violante, F. S., Vladimirov, S. K., Vlassov, V. V., Vollset, S. E., Wadilo, F., Wakayo, T., Wang, Y. -P, Weaver, M., Weichenthal, S., Weiderpass, E., Weintraub, R. G., Werdecker, A., Westerman, R., Whiteford, H. A., Wijeratne, T., Wiysonge, C. S., Wolfe, C. D. A., Woodbrook, R., Woolf, A. D., Workicho, A., Wulf Hanson, S., Xavier, D., Xu, G., Yadgir, S., Yaghoubi, M., Yakob, B., Yan, L. L., Yano, Y., Ye, P., Yimam, H. H., Yip, P., Yonemoto, N., Yoon, S. -J, Yotebieng, M., Younis, M. Z., Zaidi, Z., Zaki, M. E. S., Zegeye, E. A., Zenebe, Z. M., Zhang, X., Zhou, M., Zipkin, B., Zodpey, S., Zuhlke, L. J., Murray, C. J. L., Disease, G B D 2 0 1 6, Incidence, Injury, and Collaborators, Prevalence

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 a

Published
2017
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26. Prevalence and correlates of conduct disorder among inmates of juvenile detention centres, United Arab Emirates

Author

Al-Banna, A., Al-Bedwawi, S., Al-Saadi, A., Al-Maskari, F., and Valsamma Eapen

Subjects
Conduct Disorder, Male, Parents, Chi-Square Distribution, Adolescent, Prisoners, Psychology, Adolescent, United Arab Emirates, Age Distribution, Cross-Sectional Studies, Residence Characteristics, Risk Factors, Population Surveillance, Surveys and Questionnaires, Juvenile Delinquency, Prevalence, Educational Status, Humans, Female, Occupations, Sex Distribution, Child
Abstract

The prevalence of conduct disorder was assessed in 77 young people in 4 juvenile detention centres in the United Arab Emirates (UAE). The prevalence of conduct disorder was 24.7%, and recidivism, as indicated by repeat admissions to the centres, was found to be associated with conduct disorder. Having a diagnosis of conduct disorder was associated with a lower educational and occupational level of the father, as well as living with a single parent or relatives. Among UAE nationals, conduct disorder was also associated with having a mother who was a non-UAE national.

Published
2009

29. Prevalence of Food Allergy among Children in Al-Ain City, United Arab Emirates.

Author

Al-Hammadi, S., Al-Maskari, F., and Bernsen, R.

Subjects
*FOOD allergy in children, *ALLERGENS, *HEALTH of school children, *ALLERGIES, *EGGS
Abstract

Background: Food allergy (FA) in children is an important health problem. However, the prevalence of FA in the United Arab Emirates (UAE) has not yet been determined. This cross-sectional study was carried out to assess the prevalence of FA among school children aged 6–9 years in Al-Ain city, UAE. Methods: We used multistage random sampling in order to get a sample of 397 school children whose parents completed a self-administered questionnaire designed to assess the presence or absence of physician diagnosis of FA and other allergic diseases. Results: The study showed that the prevalence of physician-diagnosed FA in children was 8% (95% CI 5.4–10.8%). Eggs, fruits and fish were the main allergies reported. FA was independently related to a family history of FA, to a small sibship size and to a personal history of other atopic diseases. Conclusions: The prevalence of FA in Al-Ain city was 8%. A history of FA in first-degree family members and a small sibship size were associated with a higher risk of FA in children. FA was related to a personal history of other atopic diseases. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2010
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30. Prevalence and correlates of conduct disorder among inmates of juvenile detention centres, United Arab Emirates.

Author

Al-Banna A, Al-Bedwawi S, Al-Saadi A, Al-Maskari F, and Eapen V

Abstract

The prevalence of conduct disorder was assessed in 77 young people in 4 juvenile detention centres in the United Arab Emirates (UAE). The prevalence of conduct disorder was 24.7%, and recidivism, as indicated by repeat admissions to the centres, was found to be associated with conduct disorder. Having a diagnosis of conduct disorder was associated with a lower educational and occupational level of the father, as well as living with a single parent or relatives. Among UAE nationals, conduct disorder was also associated with having a mother who was a non-UAE national. [ABSTRACT FROM AUTHOR]

Published
2008

31. Prevalence of risk factors for diabetic foot complications.

Author

Al-Maskari F and El-Sadig M

Abstract

BACKGROUND: Foot complications are common in diabetic patients and are considered one of the most expensive diabetes (DM) complications to treat. The aim of this study was to determine the prevalence and risk factors for foot complications among diabetic patients in Al-Ain district, United Arab Emirates (UAE). METHODS: The study was part of a general cross-sectional survey carried out to assess the prevalence of DM complications in Al-Ain district, UAE. A sample of 513 diabetic patients with a mean age of 53 years (SD: +/- 13) were randomly selected during 2003/2004. All completed an interviewer-administered questionnaire and underwent medical assessment including foot examination and assessment of presence of peripheral neuropathy (PN) and peripheral vascular disease (PVD). RESULTS: Forty nine percent of the study populations were diagnosed to have DM without presenting with symptoms of diabetes and 35% had hypertension. The majority (86%) had type 2 DM. Of the total sample, 39% (95% CI: 35.1-43.7%) had PN and 12% (95% CI: 8.8-14.4%) had PVD. There were no cases of amputation and only one case had previous history of lower extremity ulceration. Significant risk factors for PN and PVD were: male gender, poor level of education, UAE nationality, increased duration of diabetes, type 2 DM, presence of hypertension and microalbuminuria (MA). CONCLUSION: Despite the low prevalence of foot ulceration and amputation among the study population, nevertheless, a substantial proportion had potential risk factors for foot complications. [ABSTRACT FROM AUTHOR]

Published
2007

33. Assessment of the direct medical costs of diabetes mellitus and its complications in the United Arab Emirates

Author

Nagelkerke Nicholas, El-Sadig Mohammed, and Al-Maskari Fatma

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Diabetes mellitus (DM) is a major health problem in the United Arab Emirates (UAE) and is well recognized as a major and increasing burden to the country's resources due to its severe, long term debilitating effects on individuals, families and the society at large. The aim of the study was to estimate the direct annual treatment costs of DM and its related complications among patients in Al-Ain city, UAE. Methods A sample of 150 DM patients were enrolled during 2004-2005, and their medical costs over the ensuing 12 months was measured, quantified, analyzed and extrapolated to the population in Al-Ain and UAE, using conventional and inference statistics. The costs were converted from UAE Dirhams to US Dollar, using the official conversion rate of US$ (1 USD = 3.68 AED). Results The total annual direct treatment costs of DM among patients without complications in Al Ain-UAE, was US $1,605 (SD = 1,206) which is 3.2 times higher than the per capita expenditure for health care in the UAE (US$ 497) during 2004 (WHO, 2004). However, this cost increased 2.2 times with the presence of DM related complications for patients with microvascular complications, by 6.4 times for patients with macrovascular complications and 9.4 times for patients with both micro and macrovascular complications. Likewise, the annual direct hospitalization costs of DM patients increased by 3.7 times for patients with microvascular complications, by 6.6 times for patients with macrovascular complications and by 5 times for patients with both micro and macrovascualr complications. Overall, costs increased with age, diabetes duration and were higher for patients treated with insulin compared to those treated with oral hypoglycemic agents or with diet control only. Conclusions DM direct treatment costs increased with the presence and progression of chronic DM related complications. Hospitalisation costs constituted a large proportion and were increasingly higher with the presence and progression of DM related complications. To reduce the impact on healthcare resources, efforts should be made to prevent progression to DM complications, by implementing guidelines for diabetes care, screening for complications and better management.

Published
2010
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34. Prevalence and determinants of microalbuminuria among diabetic patients in the United Arab Emirates

Author

Obineche Enyioma, El-Sadig Mohammed, and Al-Maskari Fatma

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Abstract

Abstract Background Microalbuminuria (MA) represents the earliest clinical evidence of diabetic nephropathy and is a predictor of increased cardiovascular morbidity and mortality. The aim of this study was to determine the prevalence of MA among diabetic patients in the Al-Ain district of the United Arab Emirates (UAE). Methods The study was part of a general cross-sectional survey carried out to assess the prevalence of diabetes mellitus (DM) complications in Al-Ain district, UAE and was the first to assess the prevalence of MA among diabetic patients. A sample of 513 diabetic patients with a mean age of 53 years (SD: ± 13) was randomly selected during 2003/2004. All patients completed an interviewer-administered questionnaire and underwent medical assessment. First morning urine collections were obtained and were tested for clinical proteinuria using urine dipsticks and for MA using the single Micral-Test II strips. Results MA was found in 61% (95% CI: 56.7–65.7) of the sample and the rate was significantly higher among males, positively related to body mass index (BMI), type 2 DM and presence of other DM complications such as diabetic retinopathy and neuropathy. Of the total sample population, 12.5% (95% CI: 8.1-14.1) had clinical proteinuria. Conclusion The prevalence rate of MA was considerably high ( 61%) among diabetic patients in the UAE. Therefore, regular screening for MA is recommended for all diabetic patients, as early treatment is critical for reducing cardiovascular risks and slowing the progression to late stages of diabetic nephropathy (overt proteinuria and end-stage renal disease).

Published
2008
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35. Prevalence of risk factors for diabetic foot complications

Author

El-Sadig Mohammed and Al-Maskari Fatma

Subjects
Medicine (General), R5-920
Abstract

Abstract Background Foot complications are common in diabetic patients and are considered one of the most expensive diabetes (DM) complications to treat. The aim of this study was to determine the prevalence and risk factors for foot complications among diabetic patients in Al-Ain district, United Arab Emirates (UAE). Methods The study was part of a general cross-sectional survey carried out to assess the prevalence of DM complications in Al-Ain district, UAE. A sample of 513 diabetic patients with a mean age of 53 years (SD: ± 13) were randomly selected during 2003/2004. All completed an interviewer-administered questionnaire and underwent medical assessment including foot examination and assessment of presence of peripheral neuropathy (PN) and peripheral vascular disease (PVD). Results Forty nine percent of the study populations were diagnosed to have DM without presenting with symptoms of diabetes and 35% had hypertension. The majority (86%) had type 2 DM. Of the total sample, 39% (95% CI: 35.1-43.7%) had PN and 12% (95% CI: 8.8–14.4%) had PVD. There were no cases of amputation and only one case had previous history of lower extremity ulceration. Significant risk factors for PN and PVD were: male gender, poor level of education, UAE nationality, increased duration of diabetes, type 2 DM, presence of hypertension and microalbuminuria (MA). Conclusion Despite the low prevalence of foot ulceration and amputation among the study population, nevertheless, a substantial proportion had potential risk factors for foot complications.

Published
2007
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36. The prevalence of macrovascular complications among diabetic patients in the United Arab Emirates

Author

Norman John N, El-Sadig Mohammed, and Al-Maskari Fatma

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Diabetes Mellitus (DM) is a major public health problem in the UAE with a prevalence rate reaching 24% in national citizens and 17.4% in expatriates. The aim of this study was to determine the prevalence and risk factors of macrovascular complications among diabetic patients in the Al-Ain district of the United Arab Emirates (UAE). Methods The study was part of a general cross-sectional survey carried out to assess the prevalence of diabetes (DM) complications among known diabetic patients in Al-Ain District, UAE. Patients were randomly selected during 2003/2004. Patients completed an interviewer-administered questionnaire carried out by treating doctors and underwent a complete medical assessment including measurement of height, weight, blood pressure and examination for evidence of macrovascular complications. A standard ECG was recorded and blood samples were taken to document fasting blood sugar, glycosylated haemoglobin (HbA1C) and lipid profile. Results A sample of 513 diabetic patients was selected with a mean age of 53 years (SD ± 13.01). Overall, 29.5% of DM patients had evidence of macrovascular complications: 11.6% (95% CI: 8.8–14.4) of patients had peripheral vascular disease (PVD), 14.4% (95% CI: 11.3–17.5) had a history of coronary artery disease (CAD) and 3.5% (95% CI: 1.9–5.1%) had cerebrovascular disease (CVD). Of the total population surveyed 35% (95%CI: 30.8–39) had hypertension. The analysis showed that macrovascular complications in diabetic patients were more common among males, increased with age, were more common among hypertensive patients and its prevalence increased steadily with duration of DM. Conclusion Our data revealed a significant association between hypertension and presence of macrovascular disease among diabetic patients. However, the risk of CAD in the UAE was relatively low compared to that seen in patients in other geographical settings. In addition, a lack of correlation between macrovascular disease and glycemic control among patients with DM was observed.

Published
2007
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37. Prevalence of diabetic retinopathy in the United Arab Emirates: a cross-sectional survey

Author

El-Sadig Mohammed and Al-Maskari Fatma

Subjects
Ophthalmology, RE1-994
Abstract

Abstract Background Diabetic retinopathy (DR) is one of the leading causes of blindness. The aim of this study was to estimate the prevalence and determinants of retinopathy among diabetics in Al-Ain city, United Arab Emirates (UAE). Methods The study was part of a general cross-sectional survey carried out to assess the prevalence of diabetes (DM) complications including retinopathy among known diabetic patients in Al-Ain District, UAE. Patients were randomly selected during 2003/2004. Patients completed an interviewer-administered questionnaire carried out by treating doctors and underwent a complete medical assessment. All patients were examined for evidence of diabetic retinopathy by ophthalmologist and their fundi were examined using slit lamp examination and fundus photography of each eye through dilated pupils. Results A sample of 513 diabetic patients was selected with a mean age of 53 years (SD ± 13.01). Retinopathy was present in 19% (95% CI: 15.1–23.5%) of the study population. Most patients (74%) were not aware of their condition. The disease was more common among males (24.2 vs. 13.9%; p = 0.016), increased with increasing age (p = 0.004) and disease duration (p = 0.0001). Type I DM was a highly significantly contributing risk factor (38.3% for type 1, vs. 16.4% for type 2; p < 0.0001). Retinopathy was higher among patients with hypertension, microalbuminuria, peripheral vascular disease, coronary artery disease and neuropathy. Conclusion The prevalence of DR in the UAE was (19%) and significantly affected elderly males. Regular screening to detect DR is highly recommended as with the early detection of proliferative retinopathy and timely laser photocoagulation which are known to prevent most of the diabetes related blindness.

Published
2007
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38. Prevalence and determinants of microalbuminuria among diabetic patients in the United Arab Emirates.

Author

Al-Maskari F, El-Sadig M, Obineche E, Al-Maskari, Fatma, El-Sadig, Mohammed, and Obineche, Enyioma

Abstract

Background: Microalbuminuria (MA) represents the earliest clinical evidence of diabetic nephropathy and is a predictor of increased cardiovascular morbidity and mortality. The aim of this study was to determine the prevalence of MA among diabetic patients in the Al-Ain district of the United Arab Emirates (UAE).Methods: The study was part of a general cross-sectional survey carried out to assess the prevalence of diabetes mellitus (DM) complications in Al-Ain district, UAE and was the first to assess the prevalence of MA among diabetic patients. A sample of 513 diabetic patients with a mean age of 53 years (SD: +/- 13) was randomly selected during 2003/2004. All patients completed an interviewer-administered questionnaire and underwent medical assessment. First morning urine collections were obtained and were tested for clinical proteinuria using urine dipsticks and for MA using the single Micral-Test II strips.Results: MA was found in 61% (95% CI: 56.7-65.7) of the sample and the rate was significantly higher among males, positively related to body mass index (BMI), type 2 DM and presence of other DM complications such as diabetic retinopathy and neuropathy. Of the total sample population, 12.5% (95% CI: 8.1-14.1) had clinical proteinuria.Conclusion: The prevalence rate of MA was considerably high ( 61%) among diabetic patients in the UAE. Therefore, regular screening for MA is recommended for all diabetic patients, as early treatment is critical for reducing cardiovascular risks and slowing the progression to late stages of diabetic nephropathy (overt proteinuria and end-stage renal disease). [ABSTRACT FROM AUTHOR]

Published
2008
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39. Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

Author

Lozano, Rafael, Fullman, Nancy, Abate, Degu, Abay, Solomon M, Abbafati, Cristiana, Abbasi, Nooshin, Abbastabar, Hedayat, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abdel-Rahman, Omar, Abdi, Alireza, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abebe, Nebiyu Dereje, Abebe, Zegeye, Abejie, Ayenew Negesse, Abera, Semaw F, Abil, Olifan Zewdie, Aboyans, Victor, Abraha, Haftom Niguse, Abrham, Aklilu Roba, Abu-Raddad, Laith Jamal, Abu-Rmeileh, Niveen Me, Abyu, Gebre Y, Accrombessi, Manfred Mario Kokou, Acharya, Dilaram, Acharya, Pawan, Adamu, Abdu A, Adebayo, Oladimeji M, Adedeji, Isaac Akinkunmi, Adedoyin, Rufus Adesoji, Adekanmbi, Victor, Adetokunboh, Olatunji O, Adhena, Beyene Meressa, Adhikari, Tara Ballav, Adib, Mina G, Adou, Arsène Kouablan, Adsuar, Jose C, Afarideh, Mohsen, Afshari, Mahdi, Afshin, Ashkan, Agarwal, Gina, Aghayan, Sargis Aghasi, Agius, Dominic, Agrawal, Anurag, Agrawal, Sutapa, Ahmadi, Alireza, Ahmadi, Mehdi, Ahmadieh, Hamid, Ahmed, Muktar Beshir, Ahmed, Sayem, Akalu, Temesgen Yihunie, Akanda, Ali S, Akbari, Mohammad Esmaeil, Akibu, Mohammed, Akinyemi, Rufus Olusola, Akinyemiju, Tomi, Akseer, Nadia, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Tahiya, Albujeer, Ammar, Alebel, Animut, Alene, Kefyalew Addis, Al-Eyadhy, Ayman, Alhabib, Samia, Ali, Raghib, Alijanzadeh, Mehran, Alizadeh-Navaei, Reza, Aljunid, Syed Mohamed, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine A, Almasi, Ali, Al-Maskari, Fatma, Al-Mekhlafi, Hesham M, Alonso, Jordi, Al-Raddadi, Rajaa M, Alsharif, Ubai, Altirkawi, Khalid, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amenu, Kebede, Amini, Erfan, Ammar, Walid, Anber, Nahla Hamed, Anderson, Jason A, Andrei, Catalina Liliana, Androudi, Sofia, Animut, Megbaru Debalkie, Anjomshoa, Mina, Ansari, Hossein, Ansariadi, Ansariadi, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Anwari, Palwasha, Appiah, Lambert Tetteh, Aremu, Olatunde, Areri, Habtamu Abera, Ärnlöv, Johan, Arora, Monika, Aryal, 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Subjects
GENDER-DIFFERENCES, SUICIDE, Medicine (all), Burden of Disease Study 2017, SDG, CONSUMPTION, 11 Medical And Health Sciences, GBD, Sustainable Development Goals, PREVENTION, ALCOHOL-USE, CARDIOVASCULAR-DISEASE, SMOKING PREVALENCE, General & Internal Medicine, factors risk, Medicine and Health Sciences, Human medicine, CESSATION, PERSPECTIVE, TRANSITION
Abstract

Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of "leaving no one behind", it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health -related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment. Methods We measured progress on 41 health-related S DG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health related SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2.5th percentile and 100 as the 97.5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings The global median health-related SDG index in 2017 was 59.4 (IQR 35.4-67.3), ranging from a low of 11.6 (95% uncertainty interval 9.6-14.0) to a high of 84.9 (83.1-86.7). SDG index values in countries assessed at the subnational level varied substantially particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attaimnent by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation The GBD study offers a unique, robust platform for monitoring the health -related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health -related SDG indicators, NCDs, NCD-related risks, and violence -related indicators will require a concerted shift away from what might have driven past gains curative interventions in the case of NCDs towards multisectoral, prevention -oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the S DGs. What is clear is that our actions or inaction today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Published
2018

40. 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

Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulkader, Rizwan Suliankatchi, Abdulle, Abdishakur M, Abebo, Teshome Abuka, Abera, Semaw Ferede, Aboyans, Victor, Abu-Raddad, Laith J, Ackerman, Ilana N, Adedeji, Isaac A, Adetokunboh, Olatunji, Afshin, Ashkan, Aggarwal, Rakesh, Agrawal, Sutapa, Agrawal, Anurag, Ahmed, Muktar Beshir, Aichour, Miloud Taki Eddine, Aichour, Amani Nidhal, Aichour, Ibtihel, Aiyar, Sneha, Akinyemiju, Tomi F, Akseer, Nadia, Al Lami, Faris Hasan, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Tahiya, Alasfoor, Deena, Alene, Kefyalew Addis, Ali, Raghib, Alizadeh-Navaei, Reza, Alkaabi, Juma M, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine, Al-Maskari, Fatma, AlMazroa, Mohammad AbdulAziz, Al-Raddadi, Rajaa, Alsharif, Ubai, Alsowaidi, Shirina, Althouse, Benjamin M, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Anwari, Palwasha, Ärnlöv, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asgedom, Solomon W, Atey, Tesfay Mehari, Atnafu, Niguse Tadele, Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Awasthi, Shally, Azarpazhooh, Mahmoud Reza, Azzopardi, Peter, Babalola, Tesleem Kayode, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Bannick, Marlena S, Barac, Aleksandra, Barker-Collo, Suzanne L, Bärnighausen, Till, Barquera, Simon, Barrero, Lope H, Basu, Sanjay, Battista, Robert, Battle, Katherine E, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Béjot, Yannick, Bekele, Bayu Begashaw, Bell, Michelle L, Bennett, Derrick A, Bennett, James R, Bensenor, Isabela M, Benson, Jennifer, Berhane, Adugnaw, Berhe, Derbew Fikadu, Bernabé, Eduardo, Betsu, Balem Demtsu, Beuran, Mircea, Beyene, Addisu Shunu, Bhansali, Anil, Bhatt, Samir, Bhutta, Zulfiqar A, Biadgilign, Sibhatu, Bicer, Burcu Kucuk, 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Lyons, R, Macarayan, E, Maddison, E, Magdy Abd El Razek, H, Magdy Abd El Razek, M, Magis-Rodriguez, C, Mahdavi, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, D, Mamun, A, Manguerra, H, Manhertz, T, Mantovani, L, Mapoma, C, March, L, Marczak, L, Martinez-Raga, J, Martins, P, Martins-Melo, F, Martopullo, I, März, W, Mathur, M, Mazidi, M, Mcalinden, C, Mcgaughey, M, Mcgrath, J, Mckee, M, Mehata, S, Meier, T, Meles, K, Memiah, P, Memish, Z, Mendoza, W, Mengesha, M, Mengistie, M, Mengistu, D, Mensah, G, Meretoja, T, Meretoja, A, Mezgebe, H, Micha, R, Millear, A, Miller, T, Minnig, S, Mirarefin, M, Mirrakhimov, E, Misganaw, A, Mishra, S, Mitchell, P, Mohammad, K, Mohammadi, A, Mohammed, M, Mohammed, K, Mohammed, S, Mohan, M, Mokdad, A, Mollenkopf, S, Monasta, L, Montañez Hernandez, J, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Mori, R, Morrison, S, Moses, M, Mountjoy-Venning, C, Mruts, K, Mueller, U, Muller, K, Murdoch, M, Murray, C, Murthy, G, Murthy, S, Musa, K, Nachega, J, Nagel, G, Naghavi, M, Naheed, A, Naidoo, K, Nangia, V, Nasher, J, Natarajan, G, Negasa, D, Negoi, R, Negoi, I, Newton, C, Ngunjiri, J, Nguyen, C, Nguyen, Q, Nguyen, T, Nguyen, G, Nguyen, M, Nichols, E, Ningrum, D, Nong, V, Norheim, O, Norrving, B, Noubiap, J, Nyandwi, A, Obermeyer, C, O'Donnell, M, Ogbo, F, Oh, I, Okoro, A, Oladimeji, O, Olagunju, A, Olagunju, T, Olsen, H, Olusanya, B, Olusanya, J, Ong, K, Opio, J, Oren, E, Ortiz, A, Osborne, R, Osgood-Zimmerman, A, Osman, M, Ota, E, Owolabi, M, Pa, M, Pacella, R, Panda, B, Pandian, J, Papachristou, C, Park, E, Parry, C, Parsaeian, M, Patil, S, Patten, S, Patton, G, Paudel, D, Paulson, K, Pearce, N, Pereira, D, Perez, K, Perico, N, Pesudovs, K, Peterson, C, Petri, W, Petzold, M, Phillips, M, Phipps, G, Pigott, D, Pillay, J, Pinho, C, Piradov, M, Plass, D, Pletcher, M, Popova, S, Poulton, R, Pourmalek, F, Prabhakaran, D, Prasad, N, Purcell, C, Purwar, M, Qorbani, M, Quintanilla, B, Rabiee, R, Radfar, A, Rafay, A, Rahimi, K, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, M, Rai, R, Rajsic, S, Ram, U, Ranabhat, C, Rangaswamy, T, Rankin, Z, Rao, P, Rawaf, S, Ray, S, Reiner, R, Reinig, N, Reitsma, M, Remuzzi, G, Renzaho, A, Resnikoff, S, Rezaei, S, Ribeiro, A, Rivas, J, Roba, H, Robinson, S, Rojas-Rueda, D, Rokni, M, Ronfani, L, Roshandel, G, Roth, G, Rothenbacher, D, Roy, A, Rubagotti, E, Ruhago, G, Saadat, S, Safdarian, M, Safiri, S, Sagar, R, Sahathevan, R, Sahraian, M, Salama, J, Saleh, M, Salomon, J, Salvi, S, Samy, A, Sanabria, J, Sanchez-Niño, M, Santomauro, D, Santos, J, Santos, I, Santric Milicevic, M, Sartorius, B, Satpathy, M, Sawhney, M, Saxena, S, Schelonka, K, Schmidt, M, Schneider, I, Schöttker, B, Schutte, A, Schwebel, D, Schwendicke, F, Seedat, S, Sepanlou, S, Servan-Mori, E, Shaheen, A, Shaikh, M, Shamsipour, M, Sharma, R, Sharma, J, She, J, Shi, P, Shibuya, K, Shields, C, Shifa, G, Shiferaw, M, Shigematsu, M, Shiri, R, Shirkoohi, R, Shirude, S, Shishani, K, Shoman, H, Siabani, S, Sibai, A, Sigfusdottir, I, Silberberg, D, Silva, D, Silva, J, Silveira, D, Singh, J, Singh, O, Singh, N, Singh, V, Sinha, D, Skiadaresi, E, Slepak, E, Smith, D, Smith, M, Sobaih, B, Sobngwi, E, Soljak, M, Sorensen, R, Sousa, T, Sposato, L, Sreeramareddy, C, Srinivasan, V, Stanaway, J, Stathopoulou, V, Steel, N, Stein, D, Steiner, C, Steinke, S, Stokes, M, Stovner, L, Strub, B, Subart, M, Sufiyan, M, Sunguya, B, Sur, P, Swaminathan, S, Sykes, B, Sylte, D, Szoeke, C, Tabarés-Seisdedos, R, Tadakamadla, S, Taffere, G, Takala, J, Tandon, N, Tanne, D, Tarekegn, Y, Tavakkoli, M, Taveira, N, Taylor, H, Tegegne, T, Tehrani-Banihashemi, A, Tekelab, T, Terkawi, A, Tesfaye, D, Tesssema, B, Thakur, J, Thamsuwan, O, Theadom, A, Theis, A, Thomas, K, Thomas, N, Thompson, R, Thrift, A, Tobe-Gai, R, Tobollik, M, Tonelli, M, Topor-Madry, R, Tortajada, M, Touvier, M, Traebert, J, Tran, B, Troeger, C, Truelsen, T, Tsoi, D, Tuzcu, E, Tymeson, H, Tyrovolas, S, Ukwaja, K, Undurraga, E, Uneke, C, Updike, R, Uthman, O, Uzochukwu, B, van Boven, J, Varughese, S, Vasankari, T, Veerman, L, Venkatesh, S, Venketasubramanian, N, Vidavalur, R, Vijayakumar, L, Violante, F, Vishnu, A, Vladimirov, S, Vlassov, V, Vollset, S, Vos, T, Wadilo, F, Wakayo, T, Wallin, M, Wang, Y, Weichenthal, S, Weiderpass, E, Weintraub, R, Weiss, D, Werdecker, A, Westerman, R, Whiteford, H, Wijeratne, T, Williams, H, Wiysonge, C, Woldeyes, B, Wolfe, C, Woodbrook, R, Woolf, A, Workicho, A, Xavier, D, Xu, G, Yadgir, S, Yaghoubi, M, Yakob, B, Yan, L, Yano, Y, Ye, P, Yihdego, M, Yimam, H, Yip, P, Yonemoto, N, Yoon, S, Yotebieng, M, Younis, M, Yu, C, Zaidi, Z, Zaki, M, Zegeye, E, Zenebe, Z, Zhang, X, Zheng, Y, Zhou, M, Zipkin, B, Zodpey, S, Zoeckler, L, Zuhlke, L, Brayne, Carol [0000-0001-5307-663X], Chowdhury, Rajiv [0000-0003-4881-5690], and Apollo - University of Cambridge Repository

Subjects
Male, Dánarmein, AUSTRALIA, GBD, disability-adjusted life-years (DALYs), Heilsufar, Lífslíkur, Epidemiology, Life expectancy, Diseases, Global Health, THERAPY, Global Burden of Disease, Residence Characteristics, Fullorðnir, Cause of Death, Medicine and Health Sciences, Psychology, Konur, Aged, 80 and over, Tölfræði, PLASMODIUM-FALCIPARUM, Aldraðir, Sjúkdómar, Medicine (all), Fatlaðir, Men, Þjóðir, 11 Medical And Health Sciences, ASSOCIATION, Middle Aged, Health policy, PREVALENCE, Sálfræði, disability-adjusted life-years (DALYs), Female, Lýðheilsa, Quality-Adjusted Life Years, Life Sciences & Biomedicine, Global Health Metrics, Adult, AFRICA, Quality of life, People with disabilities, GBD, WEIGHTS, Social ecology, Lífsgæði, Communicable Diseases, World health/statistics, Age Distribution, Life Expectancy, Medicine, General & Internal, SDG 3 - Good Health and Well-being, General & Internal Medicine, Heilbrigðisstefna, Humans, Adults, Disabled Persons, Women, Sex Distribution, Mortality, Noncommunicable Diseases, Aged, Science & Technology, Faraldsfræði, MORTALITY, Wounds and injuries, EPIDEMIOLOGIC TRANSITION, HIV, Áverkar, Karlar, Wounds and Injuries, Félagshagfræði, Older people
Abstract

Correction in: LANCET Volume: 390 Issue: 10106 Pages: E38-E38 Published: OCT 28 2017, 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., Bill & Melinda Gates Foundation

Published
2017

41. Sociodemographic predictors of the association between self-reported sleep duration and depression.

Author

Al Balushi M, Ahmad A, Al Balushi S, Javaid S, Al-Maskari F, Abdulle A, and Ali R

Abstract

A growing interest has been recently reported in exploring sleep duration within psychology context in particular to its relation to some mental chronic diseases such as depression. The aim of this study is to investigate the association between self-reported sleep hours as an outcome and self-perceived depression among Emirati adults, after adjusting for sociodemographic factors such as age, gender, marital status, and employment status. We performed a cross-sectional analysis using 11,455 participants baseline data of the UAE Healthy Future Study (UAEHFS). Univariate and multivariate logistic regression models were performed with self-reported sleep hours as an outcome. The predictors were the self-reported depression by measuring the PHQ-8 score, sociodemographic factors (age, gender, marital status, and employment status) Odds ratios with 95% confidence intervals (CI) were reported. In a sensitivity analysis, a multivariate imputation by chained equations (MICE) procedure was applied with classification and Regression Trees (CART) to impute missing values. Overall, 11,455 participants were included in the final analysis of this study. Participants' median age was 32.0 years (Interquartile-Range: 24.0, 39.0). There were 6,217 (54.3%) males included in this study. In total, 4,488 (63.6%) of the participants reported sleep duration of more than 7 hours. Statistically significant negative association was observed between the total PHQ-8 score as a measure for depression and binarized self-reported sleep, OR = 0.961 (95% CI: 0.948, 0.974). For one unit increase in age and BMI, the odds ratio of reporting shorter sleep was 0.979 (95% CI: 0.969, 0.990) and 0.987 (95% CI: 0.977, 0.998), respectively. The study findings indicate a correlation between self-reported depression and an increased probability of individuals reporting shorter self-perceived sleep durations especially when considering the sociodemographic factors as predictors. There was a variation in the effect of depression on sleep duration among different study groups. In particular, the association between reported sleep duration and reported depression, students and unemployed individuals have reported longer sleep hours as compared to employed participants. Also, married individuals reported a higher percentage of longer sleep duration as compared to single and unmarried ones when examined reported depression as a predictor to sleep duration. However, there was no gender differences in self-perceived sleep duration when associated with reported depression., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Al Balushi 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. Correction: The interrelationship and accumulation of cardiometabolic risk factors amongst young adults in the United Arab Emirates: The UAE Healthy Future Study.

Author

Mezhal F, Oulhaj A, Abdulle A, AlJunaibi A, Alnaeemi A, Ahmad A, Leinberger-Jabari A, Al Dhaheri AS, Tuzcu EM, AlZaabi E, Al-Maskari F, Alanouti F, Alameri F, Alsafar H, Alblooshi H, Alkaabi J, Wareth LA, Aljaber M, Kazim M, Weitzman M, Al-Houqani M, Ali MH, Oumeziane N, El-Shahawy O, Al-Rifai RH, Scherman S, Shah SM, Loney T, Almahmeed W, Idaghdour Y, Ahmed LA, and Ali R

Published
2024
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43. Cancer Health Literacy and Its Correlated Factors in the United Arab Emirates-A Cross Sectional Study.

Author

Elbarazi I, Aziz F, Ahmed LA, Abdullahi AS, and Al-Maskari F

Subjects
Humans, United Arab Emirates epidemiology, Female, Male, Cross-Sectional Studies, Adult, Middle Aged, Surveys and Questionnaires, Health Knowledge, Attitudes, Practice, Early Detection of Cancer statistics & numerical data, Young Adult, Health Literacy statistics & numerical data, Neoplasms epidemiology, Neoplasms prevention & control
Abstract

Introduction: Cancer Health literacy (CHL) is the health literacy related to cancer knowledge, prevention, treatment, screening, and access to services. It is an important indicator of people's adherence to screening and preventive measures, which helps to reduce the incidence and prevalence of cancer. The study assessed the CHL level and its association with relevant socio-demographic characteristics and sources of information among primary health care patients and visitors in the United Arab Emirates (UAE)., Methods: A cross-sectional study recruited survey participants who consented to respond to an interviewer-administered questionnaire. The assessment of CHL was done by using 15 questions. CHL level was measured as a median score and also categorized as poor/inadequate, moderate, good/excellent. Nominal logistic regression was used to analyze the relationship between CHL categories and participants' sociodemographic characteristics and CHL sources of information., Results: Of the total 492 participants, 45.5% were young adults (30-39 years old), 32.9% were males, and 70.8% were UAE nationals. The overall median CHL score was 8.0 (IQR = 5.0-10). 33.7% of the participants had a poor/inadequate level of CHL, 49.6% had a moderate level and 16.7% had a good to excellent level of CHL. 76.9% of the participants knew the importance of early cancer screening tests, 72.7% acknowledged the metastatic capacity of cancer, and the protective factors of cancer, especially, in colon cancer (71.7%). A high proportion of participants received health information about cancer via the internet (50.7%), television (45.3%), social media (40.2%), and doctors (43.6%). Nationality other than UAE (aOR = 1.62, 95% CI = 1.03-2.56, P = .038), having university education (aOR = 2.20, 95% CI = 1.21-3.99, P = .010) compared to those with lower than high school, and having a family history of cancer (aOR = 2.42, 95% CI = 1.33-4.41, P = .004) were positively associated with CHL. Older age (aOR = .36, 95% CI = .17-.75, P = .007 for 50-59 years, and aOR = .29, 95% CI = .11-.82, P = .019) for 60-69 years, higher-income (aOR = .57, 95% CI = .33-.99, P = .047 for 10,000-19,999 AED; aOR = .53, 95% CI = .33-.88, P = .013 for ≥20,000) compared with those earning <10,000 AED were negatively associated with CHL., Conclusions: CHL among the resident UAE population was moderately adequate, therefore implementation of awareness campaigns seems to be warranted. Moreover, evaluation research targeting the CHL impact on cancer prevention practices and screening is also advocated., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2024
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44. Health literacy among pregnant women in the United Arab Emirates: The Mutaba'ah study.

Author

Elbarazi I, Alam Z, Ali N, Loney T, Al-Rifai RH, Al-Maskari F, and Ahmed LA

Subjects
Child, Female, Humans, Pregnancy, United Arab Emirates, Cross-Sectional Studies, Prospective Studies, Surveys and Questionnaires, Pregnant Women, Health Literacy
Abstract

Background: Health literacy is the degree to which individuals can obtain, process, understand, and communicate health-related information. Health literacy among pregnant women, in particular, may have a significant impact on maternal and child health. In the United Arab Emirates, no previous studies have been carried out to investigate the health literacy levels of pregnant women., Objective: This study aimed to investigate antenatal health literacy levels and identify associated factors among pregnant Emirati women in the United Arab Emirates., Design: This analysis was based on the baseline cross-sectional data for pregnant women participating in the prospective cohort Mutaba'ah Study, recruited between May 2017 and August 2022., Methods: Participants completed a self-administered questionnaire during their antenatal visits that collected sociodemographic and pregnancy-related information. Adequacy of health literacy was assessed using the BRIEF health literacy screening tool with adequate health literacy defined as a score ⩾ 17. Regression modeling investigated the association between the pregnant women characteristics with having adequate health literacy level (ability to read and comprehend most patient education materials)., Results: A total of 2694 responses to the BRIEF health literacy screening tool were analyzed. Approximately, three-quarters (71.6%) of respondents showed adequate health literacy, followed by marginal (22.8%), and limited (5.6%) health literacy levels, respectively. Higher education levels (adjusted odds ratio (aOR) = 1.74, 95% confidence interval = 1.46-2.08), employment (adjusted odds ratio = 1.35, 95% confidence interval = 1.10-1.65), and adequate social support (adjusted odds ratio = 1.69, 95% confidence interval = 1.26-2.28) were associated with adequate health literacy levels. Participants who expressed worry about birth were less likely to have adequate literacy levels (adjusted odds ratio = 0.70, 95% confidence interval = 0.58-0.85)., Conclusion: Nearly three-quarters of pregnant women have adequate health literacy. Nevertheless, measures including policies to sustain and enhance health literacy levels among all expectant mothers are required, with a specific focus on those having limited health literacy.

Published
2024
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45. Temporal trends of hemoglobin among pregnant women: The Mutaba'ah study.

Author

Abdullahi AS, Suliman A, Khan MA, Khair H, Ghazal-Aswad S, Elbarazi I, Al-Maskari F, Loney T, Al-Rifai RH, and Ahmed LA

Subjects
Child, Pregnancy, Female, Humans, Cohort Studies, Hemoglobins analysis, Iron, Parity, Pregnant Women, Diabetes Mellitus, Type 1
Abstract

Background: Low hemoglobin (Hb) level is a leading cause of many adverse pregnancy outcomes. Patterns of changes in Hb levels during pregnancy are not well understood., Aim: This study estimated Hb levels, described its changing patterns across gestational trimesters, and identified factors associated with these changes among pregnant women., Materials and Methods: Data from the ongoing maternal and child health cohort study-The Mutaba'ah Study, was used (N = 1,120). KML machine learning algorithm was applied to identify three distinct cluster trajectories of Hb levels between the first and the third trimesters. Descriptive statistics were used to profile the study participants. Multinomial multivariable logistic regression was employed to identify factors associated with change patterns in Hb levels., Results: The three identified clusters-A, B and C-had, respectively, median Hb levels (g/L) of 123, 118, and 104 in the first trimester and 119, 100, and 108 in the third trimester. Cluster 'A' maintained average normal Hb levels in both trimesters. Cluster 'B', on average, experienced a decrease in Hb levels below the normal range during the third trimester. Cluster 'C' showed increased Hb levels in the third trimester but remained, on average, below the normal range in both trimesters. Pregnant women with higher gravida, diabetes mellitus (type 1 or 2), nulliparity or lower level of education were more likely to be in cluster 'B' than the normal cluster 'A'. Pregnant women who reported using iron supplements before pregnancy or those with low levels of education. were more likely to be in cluster 'C' than the normal cluster 'A'., Conclusion: The majority of pregnant women experienced low Hb levels during pregnancy. Changes in Hb levels during pregnancy were associated with parity, gravida, use of iron before pregnancy, and the presence of diabetes mellitus (type 1 or 2)., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Abdullahi 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
2023
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46. Associations between Birth Weight and Adult Sleep Characteristics: A Cross-Sectional Analysis from the UAEHFS.

Author

Juber NF, Abdulle A, Ahmad A, Leinberger-Jabari A, Dhaheri ASA, Al-Maskari F, AlAnouti F, Al-Houqani M, Ali MH, El-Shahawy O, Sherman S, Shah SM, Loney T, Idaghdour Y, and Ali R

Abstract

Abnormal birth weight, particularly low birth weight (LBW), is known to have long-term adverse health consequences in adulthood, with disrupted sleep being suggested as a mediator or modifier of this link. We thus aimed to assess the associations between birth weight and self-reported adult sleep characteristics: sleep duration, difficulty waking up in the morning, daily nap frequency, sleep problems at night, snoring, daytime tiredness or sleepiness, and ever-stop breathing during sleep. This cross-sectional analysis used the United Arab Emirates Healthy Future Study data collected from February 2016 to March 2023 involving 2124 Emiratis aged 18-61 years. We performed a Poisson regression under unadjusted and age-sex-and-BMI-adjusted models to obtain the risk ratio and its 95% confidence interval for our analysis of the association between birth weight and each adult sleep characteristics, compared to individuals with normal birth weight (≥2.5 kg). Those with LBW had significantly a 17% increased risk of difficulty waking up in the morning, compared to those with normal birth weight. In addition, females with LBW history were also at an increased risk of reporting difficulty waking up in the morning. Studies with objective sleep assessments that include measurements of more confounding factors are recommended to confirm these risks., Competing Interests: The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Published
2023
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47. Knowledge, attitudes, and perceptions of the multi-ethnic population of the United Arab Emirates on genomic medicine and genetic testing.

Author

Rahma AT, Ali BR, Patrinos GP, Ahmed LA, Elbarazi I, Abdullahi AS, Elsheik M, Abbas M, Afandi F, Alnaqbi A, and Al Maskari F

Subjects
Humans, United Arab Emirates epidemiology, Cross-Sectional Studies, Surveys and Questionnaires, Health Knowledge, Attitudes, Practice, Genomic Medicine
Abstract

Introduction: The adoption and implementation of genomic medicine and pharmacogenomics (PGx) in healthcare systems have been very slow and limited worldwide. Major barriers to knowledge translation into clinical practice lie in the level of literacy of the public of genetics and genomics. The aim of this study was to assess the knowledge, attitudes, and perceptions of the United Arab Emirates (UAE) multi-ethnic communities toward genomic medicine and genetic testing., Method: A cross-sectional study using validated questionnaires was distributed to the participants. Descriptive statistics were performed, and multivariable logistic regression models were used to identify factors associated with knowledge of genomics., Results: 757 individuals completed the survey. Only 7% of the participants had a good knowledge level in genetics and genomics (95% CI 5.3-9.0%). However, 76.9% of the participants were willing to take a genetic test if their relatives had a genetic disease. In addition, the majority indicated that they would disclose their genetic test results to their spouses (61.5%) and siblings (53.4%)., Conclusions: This study sets the stage for the stakeholders to plan health promotion and educational campaigns to improve the genomic literacy of the community of the UAE as part of their efforts for implementing precision and personalized medicine in the country., (© 2023. The Author(s).)

Published
2023
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48. Association between pediatric asthma and adult polycystic ovarian syndrome (PCOS): a cross-sectional analysis of the UAE healthy future Study (UAEHFS).

Author

Juber NF, Abdulle A, AlJunaibi A, AlNaeemi A, Ahmad A, Leinberger-Jabari A, Al Dhaheri AS, AlZaabi E, Mezhal F, Al-Maskari F, Alanouti F, Alsafar H, Alkaabi J, Wareth LA, Aljaber M, Kazim M, Weitzman M, Al-Houqani M, Hag-Ali M, Oumeziane N, El-Shahawy O, Sherman S, Shah SM, Loney T, Almahmeed W, Idaghdour Y, and Ali R

Subjects
Female, Humans, Cross-Sectional Studies, Retrospective Studies, Risk Factors, Polycystic Ovary Syndrome complications, Polycystic Ovary Syndrome epidemiology, Polycystic Ovary Syndrome diagnosis, Asthma epidemiology, Asthma etiology
Abstract

Introduction: Asthma and polycystic ovarian syndrome (PCOS) are linked in several possible ways. To date, there has been no study evaluating whether pediatric asthma is an independent risk factor for adult PCOS. Our study aimed to examine the association between pediatric asthma (diagnosed at 0-19 years) and adult PCOS (diagnosed at ≥20 years). We further assessed whether the aforementioned association differed in two phenotypes of adult PCOS which were diagnosed at 20-25 years (young adult PCOS), and at >25 years (older adult PCOS). We also evaluated whether the age of asthma diagnosis (0-10 vs 11-19 years) modified the association between pediatric asthma and adult PCOS., Material and Methods: This is a retrospective cross-sectional analysis using the United Arab Emirates Healthy Future Study (UAEHFS) collected from February 2016 to April 2022 involving 1334 Emirati females aged 18-49 years. We fitted a Poisson regression model to estimate the risk ratio (RR) and its 95% confidence interval (95% CI) to assess the association between pediatric asthma and adult PCOS adjusting for age, urbanicity at birth, and parental smoking at birth., Results: After adjusting for confounding factors and comparing to non-asthmatic counterparts, we found that females with pediatric asthma had a statistically significant association with adult PCOS diagnosed at ≥20 years (RR=1.56, 95% CI: 1.02-2.41), with a stronger magnitude of the association found in the older adult PCOS phenotype diagnosed at >25 years (RR=2.06, 95% CI: 1.16-3.65). Further, we also found females reported thinner childhood body size had a two-fold to three-fold increased risk of adult PCOS diagnosed at ≥20 years in main analysis and stratified analyses by age of asthma and PCOS diagnoses (RR=2.06, 95% CI: 1.08-3.93 in main analysis; RR=2.74, 95% CI: 1.22-6.15 among those diagnosed with PCOS > 25 years; and RR=3.50, 95% CI: 1.38-8.43 among those diagnosed with asthma at 11-19 years)., Conclusions: Pediatric asthma was found to be an independent risk factor for adult PCOS. More targeted surveillance for those at risk of adult PCOS among pediatric asthmatics may prevent or delay PCOS in this at-risk group. Future studies with robust longitudinal designs aimed to elucidate the exact mechanism between pediatric asthma and PCOS are warranted., 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., (Copyright © 2023 Juber, Abdulle, AlJunaibi, AlNaeemi, Ahmad, Leinberger-Jabari, Al Dhaheri, AlZaabi, Mezhal, Al-Maskari, Alanouti, Alsafar, Alkaabi, Wareth, Aljaber, Kazim, Weitzman, Al-Houqani, Hag-Ali, Oumeziane, El-Shahawy, Sherman, Shah, Loney, Almahmeed, Idaghdour and Ali.)

Published
2023
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49. High prevalence of cardiometabolic risk factors amongst young adults in the United Arab Emirates: the UAE Healthy Future Study.

Author

Mezhal F, Oulhaj A, Abdulle A, AlJunaibi A, Alnaeemi A, Ahmad A, Leinberger-Jabari A, Al Dhaheri AS, AlZaabi E, Al-Maskari F, Alanouti F, Alameri F, Alsafar H, Alblooshi H, Alkaabi J, Wareth LA, Aljaber M, Kazim M, Weitzman M, Al-Houqani M, Ali MH, Tuzcu EM, Oumeziane N, El-Shahawy O, Al-Rifai RH, Sherman S, Shah SM, Alzaabi T, Loney T, Almahmeed W, Idaghdour Y, Ahmed LA, and Ali R

Subjects
Male, Humans, Female, Young Adult, Adult, United Arab Emirates epidemiology, Obesity, Abdominal diagnosis, Obesity, Abdominal epidemiology, Obesity, Abdominal complications, Cardiometabolic Risk Factors, Prevalence, Obesity epidemiology, Risk Factors, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases etiology, Hypertension diagnosis, Hypertension epidemiology, Hypertension complications, Dyslipidemias diagnosis, Dyslipidemias epidemiology, Dyslipidemias complications
Abstract

Background: Cardiovascular disease (CVD) is the leading cause of death in the world. In the United Arab Emirates (UAE), it accounts for 40% of mortality. CVD is caused by multiple cardiometabolic risk factors (CRFs) including obesity, dysglycemia, dyslipidemia, hypertension and central obesity. However, there are limited studies focusing on the CVD risk burden among young Emirati adults. This study investigates the burden of CRFs in a sample of young Emiratis, and estimates the distribution in relation to sociodemographic and behavioral determinants., Methods: Data was used from the baseline data of the UAE Healthy Future Study volunteers. The study participants were aged 18 to 40 years. The study analysis was based on self-reported questionnaires, anthropometric and blood pressure measurements, as well as blood analysis., Results: A total of 5167 participants were included in the analysis; 62% were males and the mean age of the sample was 25.7 years. The age-adjusted prevalence was 26.5% for obesity, 11.7% for dysglycemia, 62.7% for dyslipidemia, 22.4% for hypertension and 22.5% for central obesity. The CRFs were distributed differently when compared within social and behavioral groups. For example, obesity, dyslipidemia and central obesity in men were found higher among smokers than non-smokers (p < 0.05). And among women with lower education, all CRFs were reported significantly higher than those with higher education, except for hypertension. Most CRFs were significantly higher among men and women with positive family history of common non-communicable diseases., Conclusions: CRFs are highly prevalent in the young Emirati adults of the UAE Healthy Future Study. The difference in CRF distribution among social and behavioral groups can be taken into account to target group-specific prevention measures., (© 2023. The Author(s).)

Published
2023
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50. Happiness and associated factors amongst pregnant women in the United Arab Emirates: The Mutaba'ah Study.

Author

Ali N, Elbarazi I, Al-Maskari F, Loney T, and Ahmed LA

Subjects
Humans, Female, Pregnancy, Prospective Studies, United Arab Emirates, Cross-Sectional Studies, Parturition, Pregnant Women, Happiness
Abstract

Objective: Prenatal happiness and life satisfaction research are often over-shadowed by other pregnancy and birth outcomes. This analysis investigated the level of, and factors associated with happiness amongst pregnant women in the United Arab Emirates., Methods: Baseline cross-sectional data was analyzed from the Mutaba'ah Study, a large population-based prospective cohort study in the UAE. This analysis included all expectant mothers who completed the baseline self-administered questionnaire about sociodemographic and pregnancy-related information between May 2017 and July 2021. Happiness was assessed on a 10-point scale (1 = very unhappy; 10 = very happy). Regression models were used to evaluate the association between various factors and happiness., Results: Overall, 9,350 pregnant women were included, and the majority (60.9%) reported a happiness score of ≥8 (median). Higher levels of social support, planned pregnancies and primi-gravidity were independently associated with higher odds of being happier; adjusted odds ratio (aOR (95% CI): 2.02 (1.71-2.38), 1.34 (1.22-1.47), and 1.41 (1.23-1.60), respectively. Women anxious about childbirth had lower odds of being happier (aOR: 0.58 (0.52-0.64)., Conclusion: Self-reported happiness levels were high among pregnant women in the UAE. Health services enhancing social support and promoting well-being during pregnancy and childbirth may ensure continued happiness during pregnancy in the UAE., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ali 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
2023
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