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1. Urinary tract infection among people living with human immunodeficiency virus attending selected hospitals in Addis Ababa and Adama, central Ethiopia

Author

Ketema Bizuwork Gebremedhin, Engida Yisma, Haile Alemayehu, Girmay Medhin, Girma Belay, Shubhada Bopegamage, Wondwosson Amogne, and Tadesse Eguale

Subjects
human immunodeficiency virus (HIV), urinary tract infections (UTIs), antibacterial resistance, bacterial uropathogens, Ethiopia, Public aspects of medicine, RA1-1270
Abstract

BackgroundUrinary tract infections (UTIs) and antibacterial resistance (ABR) are important public health problems, but they are not well-studied among people living with human immunodeficiency virus (PLHIV) globally, especially in low-income countries. Therefore, it is important to regularly measure the extent of UTIs and ABR in the most susceptible populations. This study aimed to investigate the prevalence of UTIs, associated factors, bacterial causal agents, and their antibiotic susceptibility profile among PLHIV in central Ethiopia.MethodsA hospital-based cross-sectional study was conducted to recruit 688 PLHIV by a simple random sampling method. Background information was gathered through interviews, while clinical information was gathered from recent information sheets of patient charts using organized, pretested, and validated study tools. Midstream urine was collected aseptically and transported to the Microbiology Laboratory of Aklilu Lemma Institute of Pathobiology within 4 h of collection, maintaining its cold chain. Standard conventional microbial culture methods and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry were used to identify the bacterial isolates at the species level. Kirby Bauer’s disk diffusion method was used to determine the antibiotic susceptibility profile of the bacterial isolates based on the interpretation guidelines of the Clinical Laboratory Standard Institute. Logistic regression models were used to examine factors associated with the occurrence of UTIs among PLHIV attending selected hospitals in Addis Ababa, and Adama.ResultsOut of 688 PLHIVs involved in the current study, 144 (20.9%) were positive for UTIs, whereas the majority were asymptomatic for UTIs. In the multivariable logistic regression analysis, only HIV RNA ≥ 200 copies/ml [AOR = 12.24 (95% CI, 3.24, 46.20), p

Published
2024
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2. Effect of behavioural activation for individuals with post-stroke depression: systematic review and meta-analysis

Author

Engida Yisma, Sandra Walsh, Susan Hillier, Marianne Gillam, Richard Gray, and Martin Jones

Subjects
Behavioural activation, post-stroke depression, efficacy, systematic review, meta-analysis, Psychiatry, RC435-571
Abstract

Background Previous research showed that behavioural activation is as effective as cognitive–behavioural therapy for general depression. However, it remains unclear if it leads to greater improvement in depressive symptoms when compared with standard treatment for post-stroke depression. Aims To compare the effectiveness of behavioural activation against control conditions in reducing depression symptoms in individuals with post-stroke depression. Method This review searched five databases from inception until 13 July 2021 (updated 15 September 2023) for randomised controlled trials comparing behavioural activation and any control conditions for post-stroke depression. Risk of bias was assessed with the Cochrane Collaboration's Risk-of-Bias 2 tool. The primary outcome was improvement in depressive symptoms in individuals with post-stroke depression. We calculated a random-effects, inverse variance weighting meta-analysis. Results Of 922 initial studies, five randomised controlled trials with 425 participants met the inclusion criteria. Meta-analysis showed that behavioural activation was associated with reduced depressive symptoms in individuals with post-stroke depression at 6-month follow-up (Hedges’ g −0.39; 95% CI −0.64 to −0.14). The risk of bias was low for two (40%) of five trials, and the remaining three (60%) trials were rated as having a high risk of bias. Heterogeneity was low, with no indication of inconsistency. Conclusions Evidence from this review was too little to confirm the effectiveness of behavioural activation as a useful treatment for post-stroke depression when compared with control conditions. Further high-quality studies are needed to conclusively establish the efficacy of behavioural activation as a treatment option for post-stroke depression.

Published
2024
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3. Effect of Behavioral Activation for Women with Postnatal Depression: A Systematic Review and Meta-Analysis

Author

Engida Yisma, Sandra Walsh, Mary Steen, Richard Gray, Shaun Dennis, Marianne Gillam, Nayana Parange, and Martin Jones

Subjects
behavioral activation, postnatal depression, women, systematic review, meta-analysis, Nursing, RT1-120
Abstract

Evidence shows that behavioral activation (BA), a simple form of psychological therapy, is as effective as the more complex psychological therapy—cognitive behavioral therapy (CBT)—in treating general depression. However, it remains unclear whether BA when compared with treatment-as-usual (TAU) has greater contributions in reducing postnatal depression. This systematic review compared the effect of BA versus TAU in reducing depression symptoms among postnatal women. Five databases (MEDLINE, Embase, Emcare, Cochrane Library, and PsycINFO) were searched. Risk of bias was assessed using the Cochrane Collaboration’s ‘risk-of-bias 2 tool’. A random-effects meta-analysis was conducted to examine the effect of BA on postnatal depression. Of 2844 initial studies, only two randomized control trials (RCTs) met the inclusion criteria. The overall quality of evidence of these two RCTs was low. When compared to TAU, meta-analysis showed that BA was associated with reduced depression symptoms in postnatal women (standard mean difference −0.56; 95% confidence interval −0.76 to −0.37). This review suggests that BA might be more effective than TAU for alleviating postnatal depression. However, due to concerns about evidence quality, these findings should be interpreted cautiously.

Published
2024
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4. Aeromedical retrieval services characteristics globally: a scoping review

Author

Kuda Muyambi, Fergus Gardiner, Stephen Sollid, Per Kristian Hyldmo, Engida Yisma, Breeanna Spring, Per Bredmose, Martin Jones, Sandra Walsh, Zoe Schofield, and Marianne Gillam

Subjects
Aeromedical retrieval services, Fixed-wing aircraft, OECD countries, Trauma and emergency retrieval, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Aeromedical emergency retrieval services play an important role in supporting patients with critical and often life-threatening clinical conditions. Aeromedical retrieval services help to provide fast access to definitive care for critically ill patients in under-served regions. Typically, fixed-wing aeromedical retrieval becomes the most viable transport option compared with rotary-wing aircraft when distances away from centres of definitive care extend beyond 200 kms. To our knowledge, there are no studies that have investigated fixed-wing aeromedical services in the member countries of the organisation for economic cooperation and development (OECD). A description of the global characteristics of aeromedical services will inform international collaboration to optimise clinical outcomes for patients. Aim In this scoping review, we aimed to describe the features of government- and not-for-profit organisation-owned fixed-wing aeromedical retrieval services in some of the member countries of the OECD. Methods We followed scoping review methodology based on the grey literature search strategy identified in earlier studies. This mostly involved internet-based searches of the websites of fixed-wing aeromedical emergency retrieval services affiliated with the OECD member countries. Results We identified 460 potentially relevant records after searching Google Scholar (n = 24) and Google search engines (n = 436). After removing ineligible and duplicate information, this scoping review identified 86 government-and not-for-profit-operated fixed-wing aeromedical retrieval services as existing in 17 OECD countries. Concentrations of the services were greatest in the USA followed by Australia, Canada, and the UK. The most prevalent business models used across the identified OECD member countries comprised the government, not-for-profit, and hybrid models. Three-quarters of the not-for-profit and two-fifths of the hybrid business models were in the USA compared to other countries studied. The government or state-funded business model was most common in Australia (11/24, 46%), Canada (4/24, 17%), and the UK (4/24, 17%). The frequently used service delivery models adopted for patients of all ages included primary/secondary retrievals, secondary retrievals only, and service specialisation models. Of these service models, primary/secondary retrieval involving the transportation of adults and children from community clinics and primary health care facilities to centres of definitive care comprised the core tasks performed by most of the aeromedical retrieval services studied. The service specialisation model provided an extra layer of specialist health care dedicated to the transportation of neonates and paediatrics. At least eight aeromedical retrieval services catered solely for children from birth to 16 years of age. One aeromedical service, the royal flying doctor service in Australia also provided primary health care and telehealth services in addition to primary retrieval and interhospital transfer of patients. The doctor and registered nurse/paramedic (Franco-German model) and the nurse and/or paramedic (Anglo-American model) configurations were the most common staffing models used across the aeromedical services studied. Conclusions The development and composition of fixed-wing aeromedical emergency retrieval services operated by not-for-profit organisations and governments in the OECD countries showed diversity in terms of governance arrangements, services provided, and staffing models used. We do not fully understand the impact of these differences on the quality of service provision, including equitable service access, highlighting a need for further research.

Published
2022
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5. The distribution of registered occupational therapists, physiotherapists, and podiatrists in Australia.

Author

Engida Yisma, Vincent L Versace, Martin Jones, Sandra Walsh, Sara Jones, Esther May, Lee San Puah, and Marianne Gillam

Subjects
Medicine, Science
Abstract

BackgroundIn Australia, the distribution of occupational therapists, physiotherapists, and podiatrists density (per 10,000 population) by measure of location/rurality, usual resident population, and area-level socioeconomic status has not been described.ObjectiveTo describe the national as well as states-and territories-wide distribution of registered allied health workforce-occupational therapists, physiotherapists, and podiatrists-by measures of rurality and area-level socioeconomic position in Australia.MethodsA linked data study that brings together (1) the location of health practitioners' principal place of practice from the Australian Health Practitioner Regulation Agency, (2) a measure of location/rurality-Modified Monash Model (MMM), and (3) an area-level measure of socioeconomic status-Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD). The provider-to-population ratio (i.e., density) of three Australia's allied health workforce (occupational therapists, physiotherapists, and podiatrists) was calculated according to the MMM classifications (i.e., Modified Monash 1-7) and IRSAD quintiles at state and national level.ResultsNationwide, the density of occupational therapists and physiotherapists was highest in metropolitan areas (Modified Monash 1) and decreased with the increasing levels of the MMM categories. The national density of podiatrists was highest in Modified Monash 3 areas. The density of occupational therapists, physiotherapists, and podiatrists was highest in areas with IRSAD quintile 5 (i.e., the highest socioeconomic position) and decreased with the declining levels of the IRSAD quintiles nationwide. Moreover, there were notable disparities in the density of occupational therapists, physiotherapists, and podiatrists across each state and territory in Australia when stratified by the MMM classifications and IRSAD quintiles.ConclusionsThere was uneven distribution of registered occupational therapists, physiotherapists, and podiatrists when stratified by measures of location/rurality and area-level socioeconomic status across Australian jurisdictions. The density of these three groups of allied health workforce tended to be more concentrated in metropolitan and most advantaged areas while remote and most disadvantaged areas exhibited less allied health workforce distribution across each state and territory.

Published
2023
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6. Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000–17

Author

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

Subjects
Public aspects of medicine, RA1-1270
Abstract

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

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

Author

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

Subjects
Public aspects of medicine, RA1-1270
Abstract

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

Published
2020
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8. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Author

Kirsten E Wiens, Paulina A Lindstedt, Brigette F Blacker, Kimberly B Johnson, Mathew M Baumann, Lauren E Schaeffer, Hedayat Abbastabar, Sr, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R M Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Maryam Adabi, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Sr, Victor Adekanmbi, Olatunji O Adetokunboh, Sr, Beyene Meressa Adhena, Mohsen Afarideh, Sohail Ahmad, Keivan Ahmadi, Anwar E Ahmed, Muktar Beshir Ahmed, Rushdia Ahmed, Temesgen Yihunie Akalu, Fares Alahdab, Ziyad Al-Aly, Noore Alam, Sr, Samiah Alam, Genet Melak Alamene, Turki M Alanzi, Jacqueline Elizabeth Alcalde-Rabanal, Beriwan Abdulqadir Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Sr, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Saeed Amini, Sr, Arianna Maever L Amit, Sr, Catalina Liliana Andrei, Sr, Mina Anjomshoa, Amir Anoushiravani, Sr, Fereshteh Ansari, Carl Abelardo T Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Sr, Olatunde Aremu, Bahram Armoon, Amit Arora, Sr, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Hagos Tasew Atalay, Seyyed Shamsadin Athari, Sr, Seyyede Masoume Athari, Sachin R Atre, Marcel Ausloos, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Sr, Yared Asmare Aynalem IV, Samad Azari, Peter S Azzopardi, Ebrahim Babaee, Tesleem Kayode Babalola, Alaa Badawi, Sr, Mohan Bairwa, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Ayele Geleto Bali, Maciej Banach, Sr, Joseph Adel Mattar Banoub, Sr, Aleksandra Barac, Till Winfried Bärnighausen, Huda Basaleem, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Estifanos Baye, Neeraj Bedi, Mahya Mahya Beheshti Beheshti, Masoud Behzadifar, Meysam Behzadifar, Bayu Begashaw Bekele, Yaschilal Muche Belayneh, Michellr L Bell, Sr, Derrick A Bennett, Sr, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Sr, Krittika Bhattacharyya, Sr, Suraj Bhattarai, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Binyam Minuye Birihane IV, Raaj Kishore Biswas, Somayeh Bohlouli, Hunduma Amensisa Amensisa Bojia I, Soufiane Boufous, Oliver J Brady, Nicola Luigi Bragazzi, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Sharath Burugina Nagaraja, Sr, Reinhard Busse, Sr, Zahid A Butt, Luis LA Alberto Cámera, Sr, Ismael R Campos-Nonato, Sr, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Sr, Carlos A Castañeda-Orjuela, Sr, Franz Castro, Wagaye Fentahun Chanie, Sr, Pranab Chatterjee, Vijay Kumar Chattu, Tesfaye Yitna Yitna Chichiabellu, Jr, Ken Lee Chin, Sr, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Carlos Culquichicon, Matiwos Soboka Daba, Giovanni Damiani, Sr, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Sr, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Gail Davey, Claudio Alberto Dávila-Cervantes, Adrian C Davis, Sr, Dragos Virgil Davitoiu, Fernando Pio De la Hoz, Asmamaw Bizuneh Demis, Dereje Bayissa Demissie, Getu Debalkie Demissie, Gebre Teklemariam Demoz, Sr, Edgar Denova-Gutiérrez, Sr, Kebede Deribe, Sr, Assefa Desalew, Aniruddha Deshpande, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Sr, Isaac Oluwafemi Dipeolu, Shirin Djalalinia, Kerrie E Doyle, Eleonora Dubljanin, Bereket Duko, Andre Rodrigues Duraes, Mohammad Ebrahimi Kalan, Hisham Atan Edinur, Sr, Andem Effiong, Sr, Aziz Eftekhari, Nevine El Nahas, Iman El Sayed, Maysaa El Sayed Zaki, Maha El Tantawi, Teshome Bekele Elema I, Hala Rashad Elhabashy, Sr, Shaimaa I El-Jaafary, Hajer Elkout, Aisha Elsharkawy, Iqbal RF Elyazar, Aklilu Endalamaw, Daniel Adane Endalew, Sr, Sharareh Eskandarieh, Alireza Esteghamati, Sadaf Esteghamati, Sr, Arash Etemadi, Oluchi Ezekannagha, Mohammad Fareed, Roghiyeh Faridnia, Farshad Farzadfar, Mehdi Fazlzadeh, Valery L Feigin, Sr, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Sr, Masoud Foroutan, Richard Charles Franklin, Takeshi Fukumoto, Mohamed M Gad, Reta Tsegaye Gayesa, Teshome Gebre, Sr, Ketema Bizuwork Gebremedhin, Gebreamlak Gebremedhn Gebremeskel, Sr, Hailay Abrha Gesesew, Kebede Embaye Gezae, Keyghobad Ghadiri, Sr, Ahmad Ghashghaee, Pramesh Raj Ghimire, Sr, Paramjit Singh Gill, Sr, Tiffany K Gill, Themba G G Ginindza, Nelson G M Gomes, Sameer Vali Gopalani, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Sr, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Sr, Rajeev Gupta, Nima Hafezi-Nejad, Dessalegn H Haile, Sr, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Sr, Ninuk Hariyani, Ahmed I Hasaballah, Md Mehedi Hasan, Edris Hasanpoor, Amir Hasanzadeh, Hadi Hassankhani, Hamid Yimam Hassen, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Sr, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru I, Thomas R Hird, Chi Linh Hoang, Enayatollah Homaie Rad, Praveen Hoogar, Mohammad Hoseini, Naznin Hossain, Mostafa Hosseini, Mehdi Hosseinzadeh, Mowafa Househ, Mohamed Hsairi, Sr, Guoqing Hu, Mohammedaman Mama Hussen, Segun Emmanuel Ibitoye, Ehimario U Igumbor, Sr, Olayinka Stephen Ilesanmi, Milena D Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Chinwe Juliana Iwu, Neda Izadi, Sr, Anelisa Jaca, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Sr, Jost B Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Sr, Amaha Kahsay, Hamed Kalani, Tanuj Kanchan, Behzad Karami Matin, André Karch, Mohd Anisul Karim, Hamidreza Karimi-Sari, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Yawukal chane Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A Kayode, Ali Kazemi Karyani, Mihiretu M Kebede, Peter Njenga Keiyoro, Abraham Getachew Kelbore, Sr, Andre Pascal Kengne, Sr, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Sr, Junaid Khan, Md Nuruzzaman Khan I, Muhammad Shahzeb Khan, Khaled Khatab, Sr, Amir M Khater, Mona M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Salman Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Niranjan Kissoon, Sr, Shivakumar KM Marulasiddaiah M KMShivakumar, Sr, Sonali Kochhar, Tufa Kolola, Sr, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Moritz U G Kraemer, Kewal Krishan, Nuworza Kugbey, G Anil Kumar, Manasi Kumar, Sr, Pushpendra Kumar, Vivek Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Sheetal D Lad, Dharmesh Kumar Lal, Felix Lam, Faris Hasan Lami, Sr, Prabhat Lamichhane, Van Charles Lansingh, Savita Lasrado, Avula Laxmaiah, Paul H Lee, Sr, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Sr, Aubrey J Levine, Shanshan Li, Sr, Shai Linn, Shiwei Liu, Simin Liu, Rakesh Lodha, Joshua Longbottom, Jaifred Christian F Lopez, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, D R Mahadeshwara Prasad, Phetole Walter Mahasha, Sr, Narayan B Mahotra, Azeem Majeed, Reza Malekzadeh, Sr, Deborah Carvalho Malta, Abdullah A Mamun, Sr, Navid Manafi, Sr, Ana Laura Manda, Narendar Dawani Dawanu Manohar, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Joemer C Maravilla, Gabriel Martinez, Sr, Santi Martini, Francisco Rogerlândio Martins-Melo, Anthony Masaka, Benjamin Ballard Massenburg, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Sr, Kala M Mehta, Tefera C Chane Mekonnen, Gebrekiros Gebremichael Meles, Peter T N Memiah, Ziad A Memish, Sr, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Sr, Tomislav Mestrovic, Bartosz Miazgowski, Kebadnew Mulatu Mihretie, Sr, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Amjad Mohamadi-Bolbanabad, Dara K Mohammad, Karzan Abdulmuhsin Mohammad, Yousef Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Noushin Mohammadifard, Jemal Abdu Mohammed, Sr, Shafiu Mohammed, Farnam Mohebi, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Yoshan Moodley, Sr, Catrin E Moore, Sr, Ghobad Moradi, Masoud Moradi, Mohammad Moradi-Joo, Maziar Moradi-Lakeh, Paula Moraga, Linda Morales, Ilais Moreno Velásquez, Abbas Mosapour, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor I, Kindie Fentahun Muchie, Sr, Getahun Fentaw Mulaw, Sr, Sandra B Munro, Moses K Muriithi, Christopher J L Murray, GVS Murthy, Kamarul Imran Musa, Ghulam Mustafa, Sr, Saravanan Muthupandian, Sr, Ashraf F Nabhan, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Kovin S Naidoo, Gurudatta Naik, Farid Najafi, Vinay Nangia, Sr, Jobert Richie Nansseu, Bruno Ramos Nascimento, Sr, Javad Nazari, Duduzile Edith Ndwandwe, Sr, Ionut Negoi, Sr, Henok Biresaw Netsere Netsere, Sr, Josephine W Ngunjiri, Sr, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Dabere Nigatu, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Vuong Minh Nong, Ole F Norheim, Sr, Jean Jacques Noubiap, Soraya Nouraei Motlagh, Bogdan Oancea, Okechukwu Samuel Ogah, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Tinuke O Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Obinna E Onwujekwe, Sr, Eyal Oren, Doris V V Ortega-Altamirano, Sr, Osayomwanbo Osarenotor, Frank B Osei, Sr, Mayowa O Owolabi, Mahesh P A, Sr, Jagadish Rao Padubidri, Smita Pakhale, Sangram Kishor Patel, Angel J Paternina-Caicedo, Sr, Ashish Pathak, Sr, George C Patton, Deepak Paudel, Sr, Kebreab Paulos, Sr, Veincent Christian Filipino Pepito, Alexandre Pereira, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Bakhtiar Piroozi, Meghdad Pirsaheb, Maarten J Postma, Hadi Pourjafar, Farshad Pourmalek, Sr, Akram Pourshams, Hossein Poustchi, Sergio I Prada, Sr, Narayan Prasad, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, SHAFIUR Rahman, Fatemeh Rajati, Sr, Saleem Muhammad Rana, Sr, Chhabi Lal Ranabhat, Davide Rasella, David Laith Rawaf, Salman Rawaf, Sr, Lal Rawal, Wasiq Faraz Rawasia, Vishnu Renjith, Andre M N Renzaho, Sr, Serge Resnikoff, Sr, Melese Abate Reta, Negar Rezaei, Mohammad sadegh Rezai, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Sr, Maria Rios-Blancas, Leonardo Roever, Luca Ronfani, Elias Merdassa Roro, Sr, Jennifer M Ross, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Yogesh Damodar Sabde, Siamak Sabour, Ehsan Sadeghi, Sr, Yahya Safari, Roya Safari-Faramani, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, S Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Sr, Payman Salamati, Hosni Salem, Marwa R Rashad Salem I, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Sr, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Kaushik Sarkar, Sr, Abdur Razzaque Sarker, Nizal Sarrafzadegan I, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Monika Sawhney, Sonia Saxena, Sr, David C Schwebel, Sr, Anbissa Muleta Senbeta IV, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Sr, Hosein Shabaninejad, Azadeh Shafieesabet, Sr, Masood Ali Shaikh, Ali S Shalash, Sr, Seifadin Ahmed Shallo, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Hamid Sharifi, Hatem Samir Shehata, Sr, Aziz Sheikh, B Suresh Kumar Shetty, Sr, Kenji Shibuya, Sr, Wondimeneh Shibabaw Shiferaw, Sr, Desalegn Markos Shifti, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Sr, Reza Shirkoohi, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Ambrish Singh, Jasvinder A Singh, Narinder Pal Singh, Virendra Singh, Malede Mequanent Sisay, Eirini Skiadaresi, Mohammad Reza Sobhiyeh, Sr, Anton Sokhan, Shahin Soltani, Ranjani Somayaji, Moslem Soofi, Muluken Bekele Sorrie, Sr, Ireneous N Soyiri, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Sr, Hafiz Ansar Rasul Suleria, Marufa Sultana, Bruno Fokas Sunguya, Bryan L Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Jr, Ingan Ukur Tarigan, Aberash Abay Tasew, Yonatal Mesfin Tefera, Sr, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay I, Fisaha Haile Haile Tesfay, Belay Tessema, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Nihal Thomas, Alemayehu Toma Toma, Sr, Roman Topor-Madry, Marcos Roberto Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Sr, Benjamin S Chudi Uzochukwu, Sr, Pascual R Valdez, Santosh Varughese, Sr, Francesco S Violante, Sr, Sebastian Vollmer, Sr, Feleke Gebremeskel W/hawariat, Sr, Yasir Waheed, Mitchell Taylor Wallin, Yafeng Wang, Yuan-Pang Wang, Marcia Weaver, Bedilu Girma Weji, Girmay Teklay Weldesamuel, Catherine A Welgan, Andrea Werdecker, Ronny Westerman, Sr, Taweewat Wiangkham, Charles Shey Wiysonge, Sr, Haileab Fekadu Wolde, Sr, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Sr, Getasew Taddesse Worku, Sr, Ai-Min Wu, Gelin Xu, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Sr, Hiroshi Yatsuya, Alex Yeshaneh, Christopher Sabo Yilgwan, Mekdes Tigistu Yilma, Paul Yip, Sr, Engida Yisma, Naohiro Yonemoto, Sr, Seok-Jun Yoon, Mustafa Z Younis, Mahmoud Yousefifard, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Nejimu Biza Zepro, Taddese Alemu Zerfu, Yunquan Zhang, Xiu-Ju George Zhao, Arash Ziapour, Sanjay Zodpey, Sr, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr

Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.

Published
2020
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9. Ambulance use is not associated with patient acuity after road traffic collisions: a cross-sectional study from Addis Ababa, Ethiopia

Author

Yonas Abebe, Tolesa Dida, Engida Yisma, and David M. Silvestri

Subjects
Ethiopia, Africa, Trauma, Road traffic collisions, Road traffic accident, Road traffic injury, Special situations and conditions, RC952-1245, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Africa accounts for one sixth of global road traffic deaths—most in the pre-hospital setting. Ambulance transport is expensive relative to other modes of pre-hospital transport, but has advantages in time-sensitive, high-acuity scenarios. Many countries, including Ethiopia, are expanding ambulance fleets, but clinical characteristics of patients using ambulances remain ill-defined. Methods This is a cross-sectional study of 662 road traffic collisions (RTC) patients arriving to a single trauma referral center in Addis Ababa, Ethiopia, over 7 months. Emergency Department triage records were used to abstract clinical and arrival characteristics, including acuity. The outcome of interest was ambulance arrival. Secondary outcomes of interest were inter-facility referral and referral communication. Descriptive and multivariable statistics were computed to identify factors independently associated with outcomes. Results Over half of patients arrived with either high (13.1%) or moderate (42.2%) acuity. Over half (59.0%) arrived by ambulance, and nearly two thirds (65.9%) were referred. Among referred patients, inter-facility communication was poor (57.7%). Patients with high acuity were most likely to be referred (aOR 2.20, 95%CI 1.16–4.17), but were not more likely to receive ambulance transport (aOR 1.56, 95%CI 0.86–2.84) or inter-facility referral communication (aOR 0.98, 95%CI 0.49–1.94) than those with low acuity. Nearly half (40.2%) of all patients were referred by ambulance despite having low acuity. Conclusions Despite ambulance expansion in Addis Ababa, ambulance use among RTC patients remains heavily concentrated among those with low-acuity. Inter-facility referral appears a primary contributor to low-acuity ambulance use. In other contexts, similar routine ambulance monitoring may help identify low-value utilization. Regional guidelines may help direct ambulance use where most valuable, and warrant further evaluation.

Published
2018
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10. Initiation of breastfeeding within one hour of birth among mothers with infants younger than or equal to 6 months of age attending public health institutions in Addis Ababa, Ethiopia

Author

Meseret Ekubay, Aster Berhe, and Engida Yisma

Subjects
Initiation of breastfeeding, Public health institution, Addis Ababa, Ethiopia, Pediatrics, RJ1-570, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Breast milk is comprised of the essential nutrients that an infant needs in the first six months of life. Timely initiation of breastfeeding guarantees that infants receive the colostrum, ‘the first breastmilk’, which contains antibodies that protect the newborn against diseases. Breastfeeding within the first hour of life prevents newborn death due to sepsis, pneumonia, diarrhea and hypothermia. Although breastfeeding is a common practice in sub-Saharan Africa, evidence show that early initiation of breastfeeding is low. Methods We conducted a cross-sectional study of 583 mothers with infants younger than or equal to 6 months of age attending Maternal and Child Health (MCH) clinics of public health institutions in Addis Ababa, Ethiopia from April to May 2012. A simple random sampling design was used to select the institutions included in this study. Data from mothers of infants were collected using interviewer-administered questionnaire. We analyzed the data to examine factors associated with initiation of breastfeeding within one hour of birth using logistic regression models. Results Of 564 (96.7%, 564/583) mothers who breastfed their infants, 58.3% (329/564) initiated breastfeeding within one hour of birth. In the adjusted analysis, mothers who had three or more infants had about twice higher odds of timely initiation of breastfeeding within one hour of birth (Adjusted Odds Ratio [aOR] 2.10; 95% Confidence Interval [CI]1.04, 4.30) compared with mothers who had one infant. Furthermore, women who started antenatal care at their fourth month of pregnancy or later had a 49.0% higher odds of initiation of breastfeeding within one hour of birth (aOR 1.49; 95% CI 1.01, 2.19) compared to mothers who started antenatal care before their fourth month of pregnancy. Conclusions Initiation of breastfeeding within one hour of birth was low. Initiation of breastfeeding within one hour of birth was highest among multiparous women, mothers aged 30–34 years, and women who began antenatal care at their fourth month of pregnancy or later. Public health officials and health care providers should consider interventions to promote and support early initiation of breastfeeding.

Published
2018
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11. Prevalence and severity of menopause symptoms among perimenopausal and postmenopausal women aged 30-49 years in Gulele sub-city of Addis Ababa, Ethiopia

Author

Engida Yisma, Natnael Eshetu, Stephanie Ly, and Berhanu Dessalegn

Subjects
Menopause, Reproductive, Aging, Ethiopia, Gynecology and obstetrics, RG1-991, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Menopause is a natural phenomenon occurring as women approach middle-age. It is characterized by declining of ovarian function and onset of the last menstrual period and subsequent 12-month cessation of menstruation. Due to a growing aging population and longer life expectancies, sub-Saharan African women will spend a significant portion of their lives in postmenopause. Menopausal symptom research has been primarily conducted on Caucasian women from high-income countries. Understanding menopause symptom prevalence and perceptions among diverse women in Ethiopia will better inform reproductive health care. Methods We conducted a multi-stage, cross-sectional study on 226 perimenopausal and postmenopausal women aged 30-49 years in Gulele sub-city of Addis Ababa, Ethiopia. Data on socio-demographic characteristics, menopausal status and an 11-item Menopause Rating Scale (MRS) were collected using interviewer-administered questionnaire. Statistical analyses consisted of descriptive data and chi-squared analyses. Results Study participants were 40.4 ± 5.9 years, on average, with the majority married, educated at secondary school level, and comprised different ethnicities and wealth tertiles. The most prevalent types of menopausal symptoms reported from the MRS were from somatic subscale (65.9%) while psychological (46.0%) and urogenital subscale symptoms (30.5%) were also prevalent. The most commonly reported individual symptoms were: hot flushes (65.9% (95% CI: 59.4%–72.1%)), difficulty falling asleep (49.6% (95% CI: 42.9%-56.3%)), depressive mood (46.0% (95% CI: 39.4%-52.8%)), irritability (45.1% (95% CI: 38.5%-51.9%)), and anxiety (39.8% (95% CI: 33.4%-46.5%)). Each of the somatic, psychological, and urogenital MRS subscale scores were higher among postmenopausal women compared to perimenopausal women. Women self-reported differing severity levels of symptoms with high severity reported in 8.4% of total MRS, 1.3% of somatic, 10.6% of psychological, and 8.4% of urogenital scales. Conclusions Our study provides the first presentation of menopausal symptoms among perimenopausal and postmenopausal women in the Gulele sub-city of Addis Ababa, Ethiopia. We capture the prevalence of menopausal symptoms experienced as well as self-rated severity through the MRS. Our findings reflect menopausal symptoms in our specific study population and have been found to be consistent with previous international research.

Published
2017
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12. Impact of caesarean section on breastfeeding indicators: within-country and meta-analyses of nationally representative data from 33 countries in sub-Saharan Africa

Author

Ben W Mol, John W Lynch, Engida Yisma, and Lisa G Smithers

Subjects
Medicine
Abstract

Objective To examine the impact of caesarean section on breastfeeding indicators—early initiation of breastfeeding, exclusive breastfeeding under 6 months and children ever breastfed (at least once)—in sub-Saharan Africa.Design Secondary analysis of Demographic and Health Surveys (DHS).Setting Thirty-three low-income and middle-income countries with a survey conducted between 2010 and 2017/2018.Participants Women aged 15–49 years with a singleton live last birth during the 2 years preceding the survey.Main outcome measures We analysed the DHS data to examine the impact of caesarean section on breastfeeding indicators using the modified Poisson regression models for each country adjusted for potential confounders. For each breastfeeding indicator, the within-country adjusted prevalence ratios (aPR) were pooled in random-effects meta-analysis.Results The within-country analyses showed, compared with vaginal birth, caesarean section was associated with aPR for early initiation of breastfeeding that ranged from 0.24 (95% CI 0.17 to 0.33) in Tanzania to 0.89 (95% CI 0.78 to 1.00) in South Africa. The aPR for exclusive breastfeeding under 6 months ranged from 0.58 (95% CI 0.34 to 0.98) in Angola to 1.93 (95% CI 0.46 to 8.10) in Cote d'Ivoire, while the aPR for children ever breastfed ranged from 0.91 (95% CI 0.82 to 1.02) in Gabon to 1.02 (95% CI 0.99 to 1.04) in Gambia. The meta-analysis showed caesarean section was associated with a 46% lower prevalence of early initiation of breastfeeding (pooled aPR, 0.54 (95% CI 0.48 to 0.60)). However, meta-analysis indicated little association with exclusive breastfeeding under 6 months (pooled aPR, 0.94 (95% CI 0.88 to 1.01)) and children ever breastfed (pooled aPR, 0.98 (95% CI 0.98 to 0.99)) among caesarean versus vaginally born children.Conclusions Caesarean section had a negative influence on early initiation of breastfeeding but showed little difference in exclusive breastfeeding under 6 months and children ever breastfed in sub-Saharan Africa.

Published
2019
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13. Effect of behavioural activation for individuals with post-stroke depression: A systematic review and meta-analysis

Author

Sandra Walsh, Engida Yisma, Susan Hillier, Marianne Gillam, Richard Gray, and Martin Jones

Abstract

ObjectivesPost-stroke depression (PSD) affects one third of stroke survivors and substantially impacts recovery, so it is important to identify effective treatments for PSD. Behavioural activation (BA), a relatively simple intervention, has demonstrated efficacy in the treatment of adults with unipolar depression. However, its use and efficacy in the treatment of PSD has not been documented in a systematic review. This systematic review and meta-analysis considers: What effect does BA have on reducing depression symptoms in individuals diagnosed with PSD?MethodMEDLINE, Embase, Emcare, Cochrane Library, and PsycINFO, were searched for randomised controlled trials (RCTs) published in English, on 13 July 2021. To chart the data, we employed a customized extraction sheet. The Cochrane Collaboration risk-of-bias 2 tool was used to determine study quality.ResultsTwo papers, written by the same lead authors, met the inclusion criteria. The Communication and Low Mood trial and the Behavioural Activation Therapy for Post-Stroke Depression trial were conducted in the United Kingdom and published in 2012 and 2019, respectively. Meta-analysis showed BA was associated with a decrease in depression symptoms in patients with PSD relative to treatment as usual (standard mean difference (SMD) -0.54; 95% confidence interval (CI) -0.90 to -0.18).ConclusionBA may be more effective when compared to treatment as usual in reducing depression symptoms in individuals with PSD. Although our meta-analysis found positive effects of BA, the evidence is inconclusive due to the small number of studies. High-quality RCTs are needed to confirm the benefits of BA in PSD.Strengths and limitations of this studyThis review followed PRISMA guidelines with a protocol published in advance of the review being conducted.This is the first review to consider whether BA is effective in reducing PSD.We focused on depression as a single primary outcome; other outcome measures, such as quality of life, could have been considered.Based on the review questions inclusion was limited to experimental designs. Other designs provide additional insights into the application of BA to PSD that is beyond the scope of this study.Our review was restricted to studies published in English and did not examine grey literature; therefore, some studies may not have been included.

Published
2023
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14. Do undertaking rural placements and place of origin inform where allied health graduates work in South Australia?

Author

Lee San Puah, Marianne Gillam, Sandra Walsh, Martin Jones, Engida Yisma, Puah, Lee San, Gillam, Marianne, Walsh, Sandra, Jones, Martin, and Yisma, Engida

Subjects
recruitment and retention, Public Health, Environmental and Occupational Health, rural health, Family Practice, student placements, allied health
Abstract

Refereed/Peer-reviewed Objective: To examine the principal place of practice after graduation of students who participated in the Rural Health Multidisciplinary Training (RHMT) program and allied health students' place of origin Design: Cross-sectional study. Participants: Graduates who completed their degree in podiatry, occupational therapy and physiotherapy in 2019. Main Outcome Measures: Principal place of practice at first and third years after graduation. Results: In 2020, 40 allied health professionals (AHPs) who graduated from the University of South Australia in 2019 were practising in rural areas but only 26 of them remained in the rural practice in 2022. The retention rate for rural practice was 65% within 2 years. However, in 2022, 25 allied health professionals left their metropolitan employment location and transitioned to rural practice. Of the 25 allied health graduates who joined the rural practice in 2022, most of them (80%, 20/25) had either rural exposure through the RMHT program or were from rural origin. Conclusions: Rural exposure via the RHMT program and allied health students' rural place of origin have an important role for rural principal place of practice at first and third years after graduation.

Published
2023

15. Geographical distribution of 3 allied health professions in South Australia: A summary of access and disadvantage

Author

Sara Jones, Esther May, Vincent L. Versace, Sandra Walsh, Martin Jones, Engida Yisma, Marianne Gillam, Yisma, Engida, Gillam, Marianne, Versace, Vincent L, Jones, Sara, Walsh, Sandra, May, Esther, and Jones, Martin

Subjects
Index (economics), Population, Allied Health Personnel, Distribution (economics), Context (language use), South Australia, geographical distribution, Humans, education, Disadvantage, education.field_of_study, socio-economic disadvantage, Descriptive statistics, business.industry, Public Health, Environmental and Occupational Health, Allied health professions, Cross-Sectional Studies, Geography, Health Occupations, health workforce distribution, allied health professionals, Rural Health Services, Rural area, Family Practice, business, Modified Monash Model, Demography
Abstract

Refereed/Peer-reviewed Objective: To describe the distribution of 3 allied health professionals— occupational therapists, physiotherapists and podiatrists— in South Australia stratified by the Modified Monash Model and the Index of Relative Socio- Economic Disadvantage Design: A descriptive data linkage cross-sectional study. Setting: The state of South Australia, Australia Participants and main outcome measures: Distribution of the 3 registered allied health professional groups stratified by Modified Monash Model and Index of Relative Socio-Economic Disadvantage. Results: The largest proportion of the 3 allied health professional groups (occupational therapists, physiotherapists and podiatrists) were found in areas classified as Modified Monash 1 and Modified Monash 2 (86.5%). The lowest proportion of allied health professionals were found in Modified Monash 7. The largest number of allied health professionals per 10 000 population was found in areas classified as Modified Monash 1 and Modified Monash 2. The lowest number of allied health professionals per 10 000 population was found in Modified Monash 7 areas. The largest number of allied health professionals per 10 000 population was found in areas with Index of Relative Socio-Economic Disadvantage quintile 2, while the lowest number of allied health professionals per 10 000 population was found in areas with Index of Relative Socio-Economic Disadvantage quintile 1. Conclusions: The distribution of allied health professionals according to geographical remoteness, socio-economic disadvantage and per 10 000 population varies widely in South Australia. The number of allied health professionals per 10 000 population was lowest in rural and remote/very remote areas, explaining the typically poor access to allied health services for communities in these areas. The number of allied health professionals per 10 000 population according to Index of Relative Socio-Economic Disadvantage was variable within the context of both urban and rural areas.

Published
2021
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16. Elective labor induction vs expectant management of pregnant women at term and children's educational outcomes at 8 years of age

Author

B. W. J. Mol, Lisa G. Smithers, Engida Yisma, John Lynch, and Murthy N. Mittinty

Subjects
Adult, Male, medicine.medical_specialty, Term Birth, Average treatment effect, medicine.medical_treatment, Gestational Age, Child Development, Pregnancy, Numeracy, South Australia, Epidemiology, medicine, Humans, Radiology, Nuclear Medicine and imaging, Labor, Induced, Child, Propensity Score, Watchful Waiting, Contraindication, Labor, Obstetric, Radiological and Ultrasound Technology, Obstetrics, business.industry, Vaginal delivery, Obstetrics and Gynecology, General Medicine, Delivery, Obstetric, Reproductive Medicine, Labor induction, Educational Status, Gestation, Population study, Female, business
Abstract

Objective To estimate the effect of elective induction of labour at 39 weeks of gestation on children's educational outcomes as measured by the Australian National Assessment Program-Literacy and Numeracy (NAPLAN) tests at year 3 (~8 years of age), compared with expectant management. Methods We merged perinatal data, including information regarding all infants in South Australia from 1999 to 2008, with children's school assessment data (i.e., NAPLAN data). The study population included all singleton births born without malformations at 39-42 weeks of gestation in vertex presentation. Children had to have undertaken year-3 NAPLAN (~8 years of age). We excluded births from women who had a contraindication to vaginal delivery and with conditions possibly justifying elective delivery before 39 weeks of gestation. Our outcome of interest was children's educational outcomes as measured by NAPLAN. The NAPLAN included five learning domains (reading, writing, spelling, grammar and numeracy). Each domain was categorised according to performing at or below versus above the National Minimum Standards (NMS). Average Treatment Effects (ATEs) of elective induction of labour at 39 weeks for children performing at/below the NMS for each domain were estimated using Augmented Inverse Probability Weighted (AIPW) estimator accounting for potential confounders. Results Among 53,843 children born at 39-42 weeks with vertex presentation from 1999-2008 and those who were expected to participate in year 3 NAPLAN from 2008-2015, a total of 31,120 children had at least one year 3 NAPLAN domain. Of these (i.e., 31,120 children), 1,353 children were delivered after elective induction of labour at 39 weeks while 29,767 children were born following expectant management. The ATEs (mean differences) comparing elective induction of labour at 39 weeks with expectant management for children scoring at/below the NMS on each domain were: reading (0.01 (95% CI -0.02 to 0.03)), writing (0.02 (95% CI 0.00 to 0.04)), spelling (0.01 (95% CI -0.01 to 0.04)), grammar (0.02 (95% CI -0.01 to 0.04)) and numeracy (0.03 (95% CI -0.00 to 0.05)). Conclusion Elective induction of labour at 39 weeks of gestation did not affect children's standardised literacy and numeracy testing outcomes at eight years of age when compared with expectant management. This article is protected by copyright. All rights reserved.

Published
2021
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17. Sexual assault as a risk factor for gynaecological morbidity: An exploratory systematic review and meta-analysis

Author

Tayla Hassam, Prathima Chowdary, Alice Han, Engida Yisma, Emma Kelso, Ben W.J. Mol, Hassam, Tayla, Kelso, Emma, Chowdary, Prathima, Yisma, Engida, Mol, Ben W, and Han, Alice

Subjects
Child abuse, medicine.medical_specialty, child abuse, sex offenses, morbidity, genital diseases, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Prolapse, Vaginismus, Humans, Medicine, 030212 general & internal medicine, Risk factor, sexual, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics, Pelvic pain, gynecology, Sex Offenses, Australia, Obstetrics and Gynecology, medicine.disease, female, Reproductive Medicine, Sexual abuse, Meta-analysis, Vulvodynia, Female, Sex offense, Morbidity, medicine.symptom, business
Abstract

Among Australian females, sexual assault affects 1 in 5 Australian women [1], and 1 in 10 girls [2]. While it is well known that females who experience sexual assault have an increased risk of future pelvic pain, there is limited knowledge regarding the occurrence of other gynaecological morbidity. We performed systematic review and meta-analysis for the relationship between sexual assault and gynaecological morbidity. We searched online electronic databases for observational studies on the subject published between 1993 and 2018. Search terms included variants of ‘sexual abuse’, ‘sexual assault’ and a range of gynaecological morbidity. Two independent reviewers completed study selection, quality assessment and data extraction. For each gynaecological symptom we calculated common odds ratios and 95 % confidence intervals in relation to sexual abuse history. Our search identified 1846 studies, of which 38 studies were included. A history of sexual assault was significantly associated with overall gynaecological morbidity (RR 1.42; 95%CI, 1.27–1.59), pelvic pain (RR 1.60; 95%CI, 1.36–1.89), ‘dyspareunia’ (pooled RR 1.74, 95%CI, 1.50–2.02); ‘dysmenorrhea’ (pooled RR 1.20; 95%CI, 1.11–1.29); ‘abnormal menstrual bleeding’ (pooled RR 1.29; 95%CI, 1.12–1.49)) and ‘urinary incontinence’ (pooled RR 1.31; 95%CI, 1.12–1.53)), while association was not statistically significant for ‘vaginismus’(pooled RR 1.71; 95%CI, 0.87–3.36) and ‘vulvodynia’ (pooled RR 1.49; 95%CI, 0.76–2.91). There was no relation with ‘prolapse’ (pooled RR 1.10; 95%CI, 0.53–2.30). Females with a history of sexual assault have a significantly increased risk of different gynaecological disorders later in life.

Published
2020
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18. Estimating global injuries morbidity and mortality

Author

Zohreh Arefi, Rasmus Havmoeller, Pietro Ferrara, Vijay Kumar Chattu, Payman Salamati, Agegnehu Bante Getenet, Seyedeh Zahra Masoumi, Alexander C. Tsai, Andrew T Olagunju, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Tim Driscoll, Reza Rawassizadeh, Vishnu Renjith, Taras Kavetskyy, Ejaz Ahmad Khan, Gebreamlak Gebremedhn Gebremeskel, Richard C. Franklin, Naznin Hossain, Bhaskaran Unnikrishnan, Fariborz Mansour-Ghanaei, Arash Tehrani-Banihashemi, Morteza Naserbakht, Sangram Kishor Patel, Vera Marisa Costa, Suzanne Polinder, Ziad El-Khatib, Ashish Pathak, Mika Shigematsu, Bryan L. Sykes, David M. Pigott, Zeleke Aschalew Melketsedik, Hadi Hassankhani, Nuworza Kugbey, Lal B. Rawal, Masoud Foroutan, Dejana Braithwaite, Muluken Bekele Sorrie, Grant M. A. Wyper, Joht Singh Chandan, Akbar Barzegar, Hamid Safarpour, Kate E. LeGrand, Giulio Castelpietra, Dina Nur Anggraini Ningrum, Seth Christopher Yaw Appiah, Amin Soheili, Azeem Majeed, Akshaya Srikanth Bhagavathula, Nikolay Ivanovich Briko, Vahid Yazdi-Feyzabadi, Walter Mendoza, Ghulam Mustafa, Cuong Tat Nguyen, Pengpeng Ye, Mahesh P A, Carlos Miguel Rios González, Ahmad Daryani, Ibrahim Abdollahpour, Masoud Moradi, Haileab Fekadu Wolde, Mohammad Rabiee, Jaya Prasad Tripathy, Jack T Fox, Diep Ngoc Nguyen, Pallab K. Maulik, Ai-Min Wu, Félix Carvalho, Yun Jin Kim, Fatemeh Rajati, Nathaniel J Henry, David C. Schwebel, Ali H. Mokdad, Akine Eshete Abosetugn, Leonardo Roever, Ketema Bizuwork Gebremedhin, Khalid A Altirkawi, Hayimro Edemealem Merie, Farhad Ghamari, Ramesh Holla, Arash Sarveazad, Devasahayam J. Christopher, Kedir Hussein Abegaz, Suresh Jungari, Rohan Borschmann, Irfan Ullah, Nitin Joseph, Catalina Liliana Andrei, Abdallah M. Samy, Roman Topor-Madry, Michal Grivna, Ivo Rakovac, Mohammad Zamani, Antonio Maria Borzì, Atif Amin Baig, Mohsen Bayati, Mohammad Ali Mansournia, Fatemeh Heydarpour, Juanita A. Haagsma, Segun Emmanuel Ibitoye, Mehdi Sayyah, Teshome Abegaz Kamil, Fakher Rahim, Dillon O Sylte, Feng Sha, Palash Chandra Banik, Mohan Bairwa, Mariya Vladimirovna Titova, Yong Yu, Delia Hendrie, Spencer L. James, Anusha Ganapati Bhat, Seok Jun Yoon, Siavash Rahimi, Jost B. Jonas, Michael R. Phillips, Diana Silva, Amir Hossein Goudarzian, Samath D Dharmaratne, Roba Khundkar, Jemal Abdu Mohammed, Joemer C. Maravilla, Eleonora Dubljanin, Arun Balachandran, Arman Latifi, Randah R. Hamadeh, G. K. Mini, Alessandra C. Goulart, Andreea Mirica, Fatemeh Zarei, Habte Belete, Telma Zahirian Moghadam, Maseer Khan, Morenike Oluwatoyin Folayan, Atte Meretoja, Jasvinder A. Singh, Guilherme Borges, Yasir Waheed, Fahad Alanezi, Masoud Moghadaszadeh, Guoqing Hu, Archith Boloor, Luca Ronfani, Olayinka Stephen Ilesanmi, Vahid Rashedi, Mehran Shams-Beyranvand, Trang Huyen Nguyen, Yonatal Mesfin Tefera, Yousef Khader, Adnan Kisa, Simon I. Hay, Takeshi Fukumoto, Shahrzad Bazargan-Hejazi, Yuichiro Yano, Carlos A Castañeda-Orjuela, Suzanne Barker-Collo, Ghasem Azarian, Sezer Kisa, Basema Saddik, Leake Gebremeskel, Yetunde O. John-Akinola, Jennifer Rickard, Ilais Moreno Velásquez, Priya Rathi, Ali Bijani, Smita Pakhale, Francesco Saverio Violante, Neeraj Bedi, Efat Mohamadi, Deborah Carvalho Malta, Marek Majdan, Feleke Mekonnen Demeke, Chukwudi A Nnaji, Richard Ofori-Asenso, Prateek Rastogi, Xuefeng Liu, Monika Sawhney, Ayman Grada, Prasanna Mithra, Shanshan Li, Masood Ali Shaikh, Erin B Hamilton, Hung Chak Ho, Zichen Liu, Irini Chatziralli, Paulo A. Lotufo, Yuming Guo, Daniel N. Kiirithio, Hamidreza Komaki, Aristidis Tsatsakis, Brijesh Sathian, Daniel Kim, Yoosik Youm, Kebreab Paulos, Saqib Ali, Beriwan Abdulqadir Ali, M. Mofizul Islam, Ahad Bakhtiari, Karen M. Tabb, Davood Anvari, Tomislav Mestrovic, Yunquan Zhang, Muhammad Aziz Rahman, Naohiro Yonemoto, Rupak Desai, Peter Njenga Keiyoro, Rajan Nikbakhsh, Zahra Sadat Dibaji Forooshani, Carlo La Vecchia, Amrit Banstola, Niguse Meles Alema, Shivakumar K.M. Kondlahalli, Soraya Seedat, Filippo Ariani, Chi Linh Hoang, Maziar Moradi-Lakeh, Erika Ota, Dimas Ria Angga Pribadi, Van C. Lansingh, Mohammed Madadin, Mostafa Dianati Nasab, Biniyam Sahiledengle Geberemariyam, Amanda J. Mason-Jones, Marcela Agudelo-Botero, Dinh-Toi Chu, Bach Xuan Tran, Till Bärnighausen, Mehdi Mirzaei-Alavijeh, Mohammad Ali Jahani, Bereket Duko Adema, In-Hwan Oh, Paul S. F. Yip, Ionut Negoi, Eduarda Fernandes, Reza Ghanei Gheshlagh, Kelly Jones, Mahdi Safdarian, Josep Maria Haro, Zahiruddin Quazi Syed, Diego De Leo, Khanh Bao Tran, Syed Mohamed Aljunid, Yasser S. Amer, Tommi Vasankari, Vasily Vlassov, Jose C. Adsuar, Zoubida Zaidi, Asadollah Gholamian, Theo Vos, Nauman Khalid, Malke Asaad, André Faro, Rushdia Ahmed, Tuomo J. Meretoja, Ireneous N. Soyiri, Ana Isabel Ribeiro, Hoa Thi Do, Temesgen Gebeyehu Wondmeneh, Vladimir Andreevich Korshunov, Manasi Kumar, Josip Car, Shoaib Hassan, Mukhammad David Naimzada, Gurudatta Naik, Ali Rajabpour-Sanati, Mustafa Z. Younis, Farid Najafi, Ester Cerin, Lorenzo Monasta, Amit Arora, Rizwan Suliankatchi Abdulkader, Huong Lan Thi Nguyen, Javad Nazari, Joel M. Francis, Martin Amogre Ayanore, Farahnaz Joukar, Babak Moazen, Kebede Deribe, Nithin Kumar, Seyed-Mohammad Fereshtehnejad, Getinet Ayano, Serge Resnikoff, Mark A. Stokes, Alaa Badawi, Narinder Kumar, Habibolah Khazaie, Sojib Bin Zaman, Faris Lami, Jens R. Chapman, Onome Bright Oghenetega, Dhirendra N Sinha, Engida Yisma, Aso Mohammad Darwesh, Demelash Abewa Elemineh, Junaid Khan, Shane D. Morrison, Mansour Ghafourifard, Ata Rafiee, Hadush Gebremariam, Oghenowede Eyawo, Amir Hasanzadeh, Ana Laura Manda, Muhammed Magdy Abd El Razek, Morteza Arab-Zozani, Narayana Manjunatha, Navid Manafi, Ritesh G. Menezes, Ferrán Catalá-López, Hossein Poustchi, Ghobad Moradi, Suliman Alghnam, Tinuke O Olagunju, Mohiuddin Ahsanul Kabir Chowdhury, Man Mohan Mehndiratta, Sorin Hostiuc, Jalal Arabloo, Shaun Wen Huey Lee, Chris D Castle, Joan B. Soriano, Syed Amir Gilani, Mariam Molokhia, Gaurav Gupta, Inga Dora Sigfusdottir, Isabela M. Benseñor, Desalegn Getnet Demsie, Atalay Goshu Muluneh, Young Eun Kim, Olatunde Aremu, Leeberk Raja Inbaraj, Jae Il Shin, Berhe Etsay Tesfay, Neha Chaudhary, Juan Sanabria, Soosanna Kumary Chattu, Sanni Yaya, Rekha Thapar, Biruk Wogayehu Taddele, Maciej Banach, Salman Rawaf, Nicholas L S Roberts, Jagadish Rao Padubidri, Manoochehr Karami, Derrick A Bennett, Duduzile Ndwandwe, Soheil Hassanipour, Ashish Badiye, Krittika Bhattacharyya, Obinna Onwujekwe, Kewal Krishan, João Coelho, Ahmed Abdelalim, Kerrie E. Doyle, Tomasz Miazgowski, Rahman Shiri, Demelash Woldeyohannes Handiso, Navid Rabiee, Nikita Otstavnov, Brian J. Hall, Olalekan A. Uthman, Rohollah Kalhor, Swayam Prakash, Beatriz Paulina Ayala Quintanilla, Gebre Teklemariam Demoz, Ted R. Miller, Rebecca Ivers, Chuanhua Yu, Pascual R. Valdez, Martha Híjar, Taweewat Wiangkham, Maysaa El Sayed Zaki, Rafael Tabarés-Seisdedos, Melkamu Merid Mengesha, Seyedmojtaba Seyedmousavi, Ravi Prakash Jha, Songhomitra Panda-Jonas, Aidin Abedi, Savita Lasrado, Veincent Christian Filipino Pepito, Amir Almasi-Hashiani, Burcu Kucuk Bicer, Hagazi Gebremedhin Kassaye, Yousef Veisani, Ayenew Kassie Tesema, Amir Radfar, Pawan Faris, Oladimeji Adebayo, Fares Alahdab, Heather Orpana, Narayan Bahadur Mahotra, Tripti Khanna, Girikumar Kumaresh, Alireza Rafiei, João Mauricio Castaldelli-Maia, Subramanian Senthilkumaran, Cyrus Alinia, Era Upadhyay, Stanislav S. Otstavnov, Ahmed Omar Bali, Farshad Farzadfar, Vivek Kumar, Sanghamitra Pati, Gholamreza Roshandel, Daiane Borges Machado, Yuan-Pang Wang, Rafael Alves Guimarães, Aziz Sheikh, Jeevan Pereira, Ahamarshan Jayaraman Nagarajan, Soraya Siabani, Kamarul Imran Musa, Farshad Pourmalek, Janet L Leasher, Shafiu Mohammed, Shyam Sundar Budhathoki, Mehdi Naderi, Mehdi Hosseinzadeh, Eun-Kee Park, Marwa Rashad Salem, Alireza Ansari-Moghaddam, Achala Upendra Jayatilleke, Paolo Lauriola, Amir Kasaeian, Adam Belay Wondmieneh, Tilahun Belete Mossie, Rovshan Khalilov, Milena M Santric Milicevic, Ai Koyanagi, Shailesh Advani, Felix Akpojene Ogbo, Nihad A. Almasri, Abdur Razzaque Sarker, Salman Khazaei, Narayanaswamy Venketasubramanian, Josephine W. Ngunjiri, Mihajlo Jakovljevic, Matthew Cunningham, Shaimaa I. El-Jaafary, Hosni Salem, Sharareh Eskandarieh, Muktar Beshir Ahmed, Amy E. Peden, Rajaram Yadav, Srikanta Banerjee, Kenean Getaneh Tlaye, Ronan A Lyons, Farzad Jalilian, Jacek Jerzy Jozwiak, Soufiane Boufous, Leila R Kalankesh, Abdelrahman Ibrahim Abushouk, Mikk Jürisson, Hamid Reza Tohidinik, Flavia M. Cicuttini, Zachary V Dingels, Florian Fischer, Saad M.A. Dahlawi, Rahmatollah Moradzadeh, Getnet Gedefaw, Tauseef Ahmad, Faramarz Shaahmadi, Hamed Zandian, Bruno Ramos Nascimento, Gregory J. Bertolacci, Hamid Yimam Hassen, Christian Lycke Ellingsen, Zulfiqar A Bhutta, Pankaj Bhardwaj, Dawit Habte Woldeyes, Robert C. Reiner, Rakhi Dandona, Akram Pourshams, Lorainne Tudor Car, Inbal Salz, Reza Mohammadpourhodki, Farnam Mohebi, A. A. Fomenkov, Abraham Getachew Kelbore, Benjamin B. Massenburg, Yousef Mohammad, Arash Ziapour, Zabihollah Yousefi, Biresaw Wassihun Alemu, Neeti Kapoor, Seyed Sina Naghibi Irvani, Vinod C. Nayak, Yoshan Moodley, Venkatesh Maled, Zhi-Jiang Zhang, Arielle Wilder Eagan, Saif Ullah, Anwar Rafay, Ali Koolivand, Ibrahim A Khalil, Parul Puri, Lidia Sanchez Riera, Vinay Nangia, Tanuj Kanchan, Mu'awiyyah Babale Sufiyan, Lidia Morawska, Saeed Shahabi, Tiffany K. Gill, Traolach S. Brugha, Michael K. Hole, Vahid Alipour, Sowmya J. Rao, Pankaj Singh, Rosario Cárdenas, Abdollah Mohammadian-Hafshejani, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Moritz U. G. Kraemer, Claudio Alberto Dávila-Cervantes, Samer Hamidi, Gbenga A. Kayode, Miloud Taki Eddine Aichour, Peter Memiah, Erkin M. Mirrakhimov, Sheikh Mohammed Shariful Islam, Sadia Bibi, Bartosz Miazgowski, Daniel Y. Cho, Keyvan Pakshir, Aziz Rezapour, R V Polibin, Sudha Jayaraman, S. Mohammad Sajadi, Amir Manafi, Berhe Gebremichael, Ali Yadollahpour, Barthelemy Kuate Defo, Alan D. Lopez, Masoud Behzadifar, Mohammad A. Mohseni Bandpei, Ali Kabir, Jee-Young Jasmine Choi, Gebretsadkan Hintsa Tekulu, Kidanemaryam Berhe, Bill & Melinda Gates Foundation, Sanofi, HUS Comprehensive Cancer Center, Clinicum, University of Helsinki, Helsinki University Hospital Area, HUS Neurocenter, James, S. L., Castle, C. D., Dingels, Z. V., Fox, J. T., Hamilton, E. B., Liu, Z., Roberts, N. L. S., Sylte, D. O., Bertolacci, G. J., Cunningham, M., Henry, N. J., Legrand, K. E., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abedi, A., Abegaz, K. H., Abosetugn, A. E., Abushouk, A. I., Adebayo, O. M., Adsuar, J. C., Advani, S. M., Agudelo-Botero, M., Ahmad, T., Ahmed, M. B., Ahmed, R., Aichour, M. T. E., Alahdab, F., Alanezi, F. M., Alema, N. M., Alemu, B. W., Alghnam, S. A., Ali, B. A., Ali, S., Alinia, C., Alipour, V., Aljunid, S. M., Almasi-Hashiani, A., Almasri, N. A., Altirkawi, K., Amer, Y. S. A., Andrei, C. L., Ansari-Moghaddam, A., Antonio, C. A. T., Anvari, D., Appiah, S. C. Y., Arabloo, J., Arab-Zozani, M., Arefi, Z., Aremu, O., Ariani, F., Arora, A., Asaad, M., Quintanilla, B. P. A., Ayano, G., Ayanore, M. A., Azarian, G., Badawi, A., Badiye, A. D., Baig, A. A., Bairwa, M., Bakhtiari, A., Balachandran, A., Banach, M., Banerjee, S. K., Banik, P. C., Banstola, A., Barker-Collo, S. L., Barnighausen, T. W., Barzegar, A., Bayati, M., Bazargan-Hejazi, S., Bedi, N., Behzadifar, M., Belete, H., Bennett, D. A., Bensenor, I. M., Berhe, K., Bhagavathula, A. S., Bhardwaj, P., Bhat, A. G., Bhattacharyya, K., Bhutta, Z. A., Bibi, S., Bijani, A., Boloor, A., Borges, G., Borschmann, R., Borzi, A. M., Boufous, S., Braithwaite, D., Briko, N. I., Brugha, T., Budhathoki, S. S., Car, J., Cardenas, R., Carvalho, F., Castaldelli-Maia, J. M., Castaneda-Orjuela, C. A., Castelpietra, G., Catala-Lopez, F., Cerin, E., Chandan, J. S., Chapman, J. R., Chattu, V. K., Chattu, S. K., Chatziralli, I., Chaudhary, N., Cho, D. Y., Choi, J. -Y. J., Chowdhury, M. A. K., Christopher, D. J., Chu, D. -T., Cicuttini, F. M., Coelho, J. M., Costa, V. M., Dahlawi, S. M. A., Daryani, A., Davila-Cervantes, C. A., De Leo, D., Demeke, F. M., Demoz, G. T., Demsie, D. G., Deribe, K., Desai, R., Nasab, M. D., Da Silva, D. D., Forooshani, Z. S. D., Do, H. T., Doyle, K. E., Driscoll, T. R., Dubljanin, E., Adema, B. D., Eagan, A. W., Elemineh, D. A., El-Jaafary, S. I., El-Khatib, Z., Ellingsen, C. L., El Sayedzaki, M., Eskandarieh, S., Eyawo, O., Faris, P. S., Faro, A., Farzadfar, F., Fereshtehnejad, S. -M., Fernandes, E., Ferrara, P., Fischer, F., Folayan, M. O., Fomenkov, A. A., Foroutan, M., Francis, J. M., Franklin, R. C., Fukumoto, T., Geberemariyam, B. S., Gebremariam, H., Gebremedhin, K. B., Gebremeskel, L. G., Gebremeskel, G. G., Gebremichael, B., Gedefaw, G. A., Geta, B., Getenet, A. B., Ghafourifard, M., Ghamari, F., Gheshlagh, R. G., Gholamian, A., Gilani, S. A., Gill, T. K., Goudarzian, A. H., Goulart, A. C., Grada, A., Grivna, M., Guimaraes, R. A., Guo, Y., Gupta, G., Haagsma, J. A., Hall, B. J., Hamadeh, R. R., Hamidi, S., Handiso, D. W., Haro, J. M., Hasanzadeh, A., Hassan, S., Hassanipour, S., Hassankhani, H., Hassen, H. Y., Havmoeller, R., Hendrie, D., Heydarpour, F., Hijar, M., Ho, H. C., Hoang, C. L., Hole, M. K., Holla, R., Hossain, N., Hosseinzadeh, M., Hostiuc, S., Hu, G., Ibitoye, S. E., Ilesanmi, O. S., Inbaraj, L. R., Irvani, S. S. N., Islam, M. M., Islam, S. M. S., Ivers, R. Q., Jahani, M. A., Jakovljevic, M., Jalilian, F., Jayaraman, S., Jayatilleke, A. U., Jha, R. P., John-Akinola, Y. O., Jonas, J. B., Jones, K. M., Joseph, N., Joukar, F., Jozwiak, J. J., Jungari, S. B., Jurisson, M., Kabir, A., Kahsay, A., Kalankesh, L. R., Kalhor, R., Kamil, T. A., Kanchan, T., Kapoor, N., Karami, M., Kasaeian, A., Kassaye, H. G., Kavetskyy, T., Kayode, G. A., Keiyoro, P. N., Kelbore, A. G., Khader, Y. S., Khafaie, M. A., Khalid, N., Khalil, I. A., Khalilov, R., Khan, M., Khan, E. 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Subjects
Male, Populations/contexts, 1106 Human Movement and Sports Sciences, Global injuries, population, 030204 cardiovascular system & hematology, Global Health, contexts, context, Global Burden of Disease, 0302 clinical medicine, Quality-Adjusted Life Year, Global health, 030212 general & internal medicine, Original Research, Data, populations/contexts, Incidence (epidemiology), Incidence, methodology, 3142 Public health care science, environmental and occupational health, Female, Public Health, TERRITORIES, Quality-Adjusted Life Years, descriptive epidemiology, Human, Disabilities, 195 COUNTRIES, statistical issue, 1117 Public Health and Health Services, 03 medical and health sciences, AGE, Life Expectancy, Environmental health, Injury prevention, SYSTEMATIC ANALYSIS, statistical issues, Humans, Mortality, Estimation, SEX-SPECIFIC MORTALITY, DISABILITY, Public Health, Environmental and Occupational Health, populations, Morbidity, Wounds and Injuries, 1106 Human Movement and Sports Sciences, 1117 Public Health and Health Services, 1701 Psychology, Quality-adjusted life year, Years of potential life lost, 1701 Psychology, Life expectancy, Estimates, Human medicine, populations/context
Abstract

Background. While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods. In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results. GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions. GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future. Seyed Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. Alaa Badawi acknowledges support by the Public Health Agency of Canada. Till Bärnighausen acknowledges support by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. Traolach Brugha received support from NatCen Social Research (http://natcen.ac.uk/) via NHS Digital and Department of Health and Social Care London, for the Adult Psychiatric Morbidity Survey (APMS) programme. Felix Carvalho received support from UID/MULTI/04378/2019 with funding from FCT/MCTES through national funds. Vera M Costa acknowledges support from grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. Kebede Deribe is supported by a grant from the Wellcome Trust [grant number 201900] as part of his International Intermediate Fellowship. Tim Driscoll acknowledges that work on occupational risk factors was partially supported by funds from the World Health Organization. Eduarda Fernandes acknowledges support from UID/QUI/50006/2019 with funding from FCT/MCTES through national funds. Yuming Guo acknowledges support from Career Development Fellowships of the Australian National Health and Medical Research Council (numbers APP1107107 and APP1163693). Sheikh Mohammed Shariful Islam is funded by a Fellowship from National Heart Foundation of Australia and Institute for Physical Activity and Nutrition, Deakin University. Mihajlo Jakovljevic acknowledges support by the Ministry of Education Science and Technological Development of the Republic of Serbia through the Grant number OI175014; publication of results was not contingent upon Ministry's censorship or approval. Sudha Jayaraman acknowledges support from: NIH R21: 1R21TW010439-01A1 (PI); Rotary Foundation Global Grant #GG1749568 (PI); NIH P20: 1P20CA210284-01A1 (Co-PI) and DOD grant W81XWH-16-2-0040 (Co-I), during the period of this study. Yun Jin Kim acknowledges support from a grant from the Research Management Centre, Xiamen University Malaysia [grant number: XMUMRF/2018-C2/ITCM/0001]. Kewal Krishan is supported by UGC Centre of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India. Mansai Kumar acknowledges support from FIC/ NIH K43 1K43MH114320-01. Amanda Mason-Jones acknowledges support by the University of York. Mariam Molokhia is supported by the National Institute for Health Research Biomedical Research Center at Guy’s and St Thomas’s National Health Service Foundation Trust and King’s College London. Ilais Moreno Velasquez is supported by the Sistema Nacional de Investigación (SNI, Senacyt, Panama). Mukhammad David Naimzada acknowledges support from Government of the Russian Federation (Agreement No – 075-02-2019-967). Duduzile Ndwandwe acknowledges support from Cochrane South Africa, South African Medical Research Council. Stanislav S. Otstavnov acknowledges the support from the Government of the Russian Federation (Agreement No – 075-02-2019-967). Ashish Pathak acknowledges support from Indian Council of Medical Research (ICMR), New Delhi, India (Grant number 2013-1253). Michael R Phillips acknowledges support in part by a grant from the National Natural Science Foundation of China (No.81761128031). Abdallah M. Samy received a fellowship from the Egyptian Fulbright Mission Program. Milena Santric Milicevic acknowledges the support from the Ministry of Education, Science and Technological Development, Republic of Serbia (Contract No. 175087). Seyedmojtaba Seyedmousavi was supported by the Intramural Research Program of the National Institutes of Health, Clinical Center, Department of Laboratory Medicine, Bethesda, MD, USA. Rafael Tabarés-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII-FEDER. Sojib Bin Zaman acknowledges support from an "Australian Government Research Training Program (RTP) Scholarship.

Published
2020
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19. Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

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Giulio Castelpietra, Feng Sha, Khalid A Altirkawi, Seyedeh Zahra Masoumi, Gebreamlak Gebremedhn Gebremeskel, Ahmad Daryani, Ibrahim Abdollahpour, Simon I. Hay, Deborah Carvalho Malta, Erin B Hamilton, Kate E. LeGrand, Nikolay Ivanovich Briko, Ana-Laura Manda, Aziz Eftekhari, Irfan Ullah, Seth Christopher Yaw Appiah, Zichen Liu, Maida Umar, Shaimaa I. El-Jaafary, Marina Pinheiro, Farhad Ghamari, Milad Mohammadoo-Khorasani, Rajaram Yadav, Syed Mohamed Aljunid, Ramesh Holla, Farzad Jalilian, Jacek Jerzy Jozwiak, Omar Mukhtar Salman, Bayew Kelkay, Tanuj Kanchan, Irina Filip, Michael R. Phillips, Hamid Reza Tohidinik, Demelash Abewa Elemineh, Reza Malekzadeh, Tomasz Miazgowski, Diana Silva, Samath D Dharmaratne, Eleonora Dubljanin, Fatemeh Zare, Jasvinder A. Singh, Hagazi Gebremedhin Kassaye, Nathaniel J Henry, Venkatesh Maled, Girikumar Kumaresh, Alireza Rafiei, Zhi-Jiang Zhang, Arielle Wilder Eagan, Merhawi Gebremedhin Tekle, Gholamreza Roshandel, Jeevan Pereira, Tinuke O Olagunju, Olatunde Aremu, Mohammad Zamani, Mu'awiyyah Babale Sufiyan, Lidia Morawska, Bayisa Abdissa Baye, Eduarda Fernandes, Feleke Mekonnen Demeke, Beriwan Abdulqadir Ali, Ibrahim A Khalil, Hafte Kahsay Kebede, Songhomitra Panda-Jonas, Yuichiro Yano, Haileab Fekadu Wolde, Antonio Maria Borzì, Delia Hendrie, Azeem Majeed, Vahid Rashedi, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Derrick A Bennett, Roba Khundkar, Mohammed Madadin, Biniyam Sahiledengle Geberemariyam, Parul Puri, Lidia Sanchez Riera, Yetunde O. John-Akinola, Jennifer Rickard, Saeed Shahabi, Tiffany K. Gill, Jemal Abdu Mohammed, Alessandra C. Goulart, Mohiuddin Ahsanul Kabir Chowdhury, Roya Safari-Faramani, Pawan Faris, Farhad Moradpour, Guilherme Borges, Sadia Bibi, Bartosz Miazgowski, Wubalem Fekadu, Rakhi Dandona, Ali Reza Soltanian, Alaa Badawi, Amir Hasanzadeh, Hassan Haghparast Bidgoli, Carlos A Castañeda-Orjuela, Morteza Arab-Zozani, Vinay Nangia, Gaurav Gupta, Farkhonde Salehi, Isabela M. Benseñor, Rekha Thapar, Yasser S. Amer, Naohiro Yonemoto, Ahmad Ghashghaee, Amanda J. Mason-Jones, Marcela Agudelo-Botero, Ashraf Nabhan, Saeed Safari, Lorainne Tudor Car, Ayman Grada, Stanislav S. 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I., Mokdad, A. H., Reiner, R. C., Sartorius, B., Vos, T., James, Spencer L, Castle, Chris D, Dingels, Zachary V, Fox, Jack T, Adema, Bereket Duko, Yisma, Engida, and Vos, Theo

Subjects
Dánarmein, Fötlun, Dánartíðni, Lífslíkur, Life expectancy, 1106 Human Movement and Sports Sciences, burden of disease, Global Health, Global Burden of Disease, 0302 clinical medicine, Quality-Adjusted Life Year, Global health, Medicine, LIFE EXPECTANCY, 030212 general & internal medicine, POPULATION, Cause of death, Original Research, RISK, education.field_of_study, Global disease burdens, Injuries, Sjúkdómar, Incidence (epidemiology), Incidence, Population health, Burden of disease, Global, global, 3142 Public health care science, environmental and occupational health, 3. Good health, Descriptive epidemiology, Lýðheilsa, Quality-Adjusted Life Years, Public Health, TERRITORIES, descriptive epidemiology, Human, Population, 195 COUNTRIES, Humans, Life Expectancy, Morbidity, Wounds and Injuries, 1117 Public Health and Health Services, 03 medical and health sciences, AGE, SYSTEMATIC ANALYSIS, Mortality, education, Disability, SEX-SPECIFIC MORTALITY, business.industry, Faraldsfræði, DISABILITY, Public Health, Environmental and Occupational Health, Quality-adjusted life year, Years of potential life lost, Áverkar, 1701 Psychology, Human medicine, business, 030217 neurology & neurosurgery, Demography
Abstract

Publisher's version (útgefin grein), Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care., Bill and Melinda Gates Foundation OPP1152504, "Peer Reviewed"

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

Author

Nataliya Foigt, Dina Nur Anggraini Ningrum, Ayenew Negesse Abejie, Samath Dhamminda Dharmaratne, Paramjit Gill, Marcela Agudelo-Botero, Alyssa N. Sbarra, Mario Poljak, Siavash Rahimi, Olalekan A. Uthman, Animut Alebel, Mohsen Naghavi, Olatunji O. Adetokunboh, Maarten J. Postma, Zemichael Gizaw, Chhabi Lal Ranabhat, Leonardo Roever, Mojtaba Bagherzadeh, Smita Pakhale, Seyyed Meysam Mousavi, Morenike Oluwatoyin Folayan, Robert C. Reiner, Phetole Walter Mahasha, Walter Mendoza, Azeem Majeed, Agus Sudaryanto, Dessalegn Ajema Berbada, Kate E. LeGrand, Takeshi Fukumoto, Mehdi Sayyah, Konrad Pesudovs, Mahesh P A, Nihal Thomas, Man Mohan Mehndiratta, Malede Mequanent Sisay, Azadeh Shafieesabet, Muhammad Usman, Balbir Singh, Ahsan Saleem, Ahmed Abualhasan, Maheswar Satpathy, Vijay Kumar Chattu, Mehdi Fazlzadeh, Ali H. Mokdad, Irfan Ullah, Sahar Saeedi Moghaddam, Luca Ronfani, James Albright, Si Si, Bartosz Miazgowski, Moses K. Muriithi, Catalina Liliana Andrei, Isaac Oluwafemi Dipeolu, Brijesh Sathian, Shishay Wahdey Tekelemedhin, Tufa Kolola, Mona M. Khater, Reta Tsegaye Gayesa, Andrew T Olagunju, Achala Upendra Jayatilleke, David L. Smith, Raaj Kishore Biswas, Rosario Cardenas, Andre M. N. Renzaho, Benjamin K. Mayala, Soraya Siabani, Ebrahim Babaee, Tsegaye Lolaso Lenjebo, Miliva Mozaffor, Bolajoko O. Olusanya, Joseph Frostad, Emma Elizabeth Spurlock, Hesham M. Al-Mekhlafi, Aso Mohammad Darwesh, Quynh Anh P. Nguyen, Kebede Embaye Gezae, Junaid Khan, Dessalegn Haile, Marcel Ausloos, David C. Schwebel, Bruno Piassi Sao Jose, Milena Ilic, Ionut Negoi, Ninuk Hariyani, Jost B. Jonas, Dian Kusuma, Sachin R Atre, Goura Kishor Rath, Muhammad Aziz Rahman, Dereje Bayissa Demissie, Eirini Skiadaresi, Simon I. Hay, Preeti Dhillon, Ejaz Ahmad Khan, Mohammad Hasan Imani-Nasab, Gebrehiwot G. Kassa, Nicole Davis Weaver, Mowafa Househ, Soumyadeep Bhaumik, Bahram Armoon, Martin Amogre Ayanore, Shaimaa I. 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Santos, Temesgen Yihunie Akalu, Amir Kasaeian, Yahya Safari, Abel Fekadu Fekadu Dadi, Mohammad Fareed, Peter Memiah, Ali Kabir, Ensiyeh Jenabi, Ali Yadollahpour, Josephine W. Ngunjiri, Barthelemy Kuate Defo, Carlos A Castañeda-Orjuela, Reza Malekzadeh, Shymaa Enany, Hamidreza Haririan, Ayman Grada, Amador Goodridge, Salvatore Rubino, Jacob Olusegun Olusanya, Jalal Arabloo, Mohammad Reza Salahshoor, Masoud Behzadifar, Fernando de la Hoz, Mohammed Shannawaz, Hosni Salem, Syed Mohamed Aljunid, G Anil Kumar, Veincent Christian Filipino Pepito, Andre Rodrigues Duraes, Duduzile Ndwandwe, Jasvinder A. Singh, Yuan-Pang Wang, Tissa Wijeratne, Ingan Ukur Tarigan, Giuseppe Remuzzi, Sebastian Vollmer, Rakhi Dandona, Ahmed Abdelalim, Akram Pourshams, Felix Akpojene Ogbo, Alan J Thomson, Yves Miel H Zuniga, Alex Yeshaneh, Birhanu Geta Meharie, Mihajlo Jakovljevic, Obinna Onwujekwe, Ali S. Shalash, Bahram Mohajer, Nefsu Awoke, Hoa Thi Do, Jaifred Christian F. Lopez, Ernoiz Antriyandarti, Yilma Chisha Dea Geramo, Lucas Guimarães Abreu, Mohammad Ali Sahraian, Giang Hai Ha, Nizal Sarrafzadegan, Vinay Nangia, David M. Pigott, Arash Ziapour, Seyed Sina Naghibi Irvani, Andrew S. Azman, Amira Hamed Darwish, MohammadBagher Shamsi, Soewarta Kosen, Degena Bahrey Tadesse, Soufiane Boufous, Mehedi Hasan, Franz Castro, Adauto Martins Soares Filho, Oliver J. Brady, Elizabeth A. Cromwell, Olatunde Aremu, Samad Azari, Hala Rashad Elhabashy, Hamid Yimam Hassen, Julia Moreira Pescarini, Saeed Amini, Mehdi Ahmadi, Andualem Henok, Yafeng Wang, Nevine El Nahas, Paul S. F. Yip, Miguel A Barboza, Ibrahim Abdollahpour, Augustine Mwangi Gatotoh, Gurudatta Naik, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, hawariat, Enrico Rubagotti, Andre Faro, Kebede Deribe, Bhaskaran Unnikrishnan, Robert L. Thompson, Muhammad Shahdaat Bin Sayeed, Lalit Dandona, Seyyed Shamsadin Athari, Ashish Pathak, Masoud Moradi, Muluken Bekele Sorrie, Vivekanand Jha, Cuong Tat Nguyen, Naser Mohammad Gholi Mezerji, Chabila C Mapoma, Aubrey J. Levine, Solomon Gedlu Nigatu, Keivan Ahmadi, Hailay Abrha Gesesew, Getasew Taddesse Worku, Kewal Krishan, Hany Aref, Alebachew Fasil Fasil, Aziz Eftekhari, Claudiu Herteliu, Wasiq Faraz Rawasia, Zoubida Zaidi, Simin Mouodi, Dawit Zewdu Wondafrash, Hafiz Ansar Rasul Suleria, Oluchi Ezekannagha, Getinet Ayano, Gebremicheal Gebreslassie Kasahun, Usman Iqbal, Andrey Nikolaevich Briko, Workua Mekonnen Metekiya, Chuanhua Yu, Pascual R. Valdez, Mohsen Mazidi, Hamidreza Komaki, Turki Alanzi, Amir Jalali, Mina Anjomshoa, Chukwudi A Nnaji, Mostafa Leili, Hagos Degefa Hidru, Morteza Shamsizadeh, Tomislav Mestrovic, Beatriz Paulina Ayala Quintanilla, Chi Linh Hoang, Jemal Abdu Mohammed, Christopher J L Murray, Reza Shirkoohi, Aditya Prasad Dash, Thomas Pilgrim, Alessandra C. Goulart, Rajeev Gupta, Mustafa Z. Younis, Maha El Tantawi, Maysaa El Sayed Zaki, Aleksandra Barac, Christiane Dolecek, Mohammad Mahdi Zamani, Jean Jacques Noubiap, Faris Lami, Mehdi Naderi, Yunquan Zhang, Babak Eshrati, Jagadish Rao Padubidri, Navid Rabiee, Mayowa O. Owolabi, Netsanet Fentahun, Nuruzzaman Khan, Roghayeh Mohammadibakhsh, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Dharmesh Kumar Lal, Habtamu Kebebe Kasaye, Ketema Bizuwork Gebremedhin, Surendra Karki, Edgar Denova-Gutiérrez, Félix Carvalho, Yun Jin Kim, Sonia Lewycka, Rashmi Gupta, Olayinka Stephen Ilesanmi, Neeraj Bedi, Binaya Chalise, Masood Ali Shaikh, Lauren E. Schaeffer, Kerrie E. Doyle, Gianna Gayle Herrera Amul, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Jorge Cano, Jai K Das, Ana Isabel Ribeiro, Boris Bikbov, Sameer Vali Gopalani, Mohsen Afarideh, Behnam Heidari, Fares Alahdab, Takahiro Tabuchi, J. Car, Hilton Y. Lam, Diego Augusto Santos Silva, Linda Morales, Brian J. Hall, Mamusha Aman Hussen, Carsten Flohr, Ravi Prakash Jha, Shafiu Mohammed, Tara Ballav Adhikari, Abbas Mosapour, Muktar Beshir Ahmed, Wondimeneh Shibabaw Shiferaw, Mohamed M. Gad, Assefa Desalew, Eugenio Traini, Aisha Elsharkawy, Benjamin Uzochukwu, Anas M. Saad, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Ansariadi Ansariadi, Abdallah M. Samy, Roman Topor-Madry, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Maryam Khayamzadeh, Farah Daoud, Arash Tehrani-Banihashemi, Public Health, Johnson, KB, Local Burden of Disease 2019 Neglected Tropical Diseases Collaborator, Violante FS, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, and Instituto de Saúde Pública da Universidade do Porto

Subjects
medicine.medical_specialty, Geospatial analysis, 030231 tropical medicine, Elephantiasis, ELIMINATION, computer.software_genre, Article, Local Burden of Disease 2019 Neglected Tropical Diseases Collaborators, 1117 Public Health and Health Services, 03 medical and health sciences, 0302 clinical medicine, RA0421, Environmental health, Global health, medicine, 030212 general & internal medicine, Mass drug administration, Lymphatic filariasis, Public health, lcsh:Public aspects of medicine, Tropical disease, lcsh:RA1-1270, General Medicine, medicine.disease, 3. Good health, QR, Geography, Lymphatic system, ITC-ISI-JOURNAL-ARTICLE, A990 Medicine and Dentistry not elsewhere classified, ITC-GOLD, computer, 0605 Microbiology
Abstract

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

Published
2020
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21. Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17

Author

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

Subjects
Drinking water access, Sanitation, Universal design, Geographic Mapping, Socioeconomic Factor, DISEASE, 0302 clinical medicine, RA0421, Hygiene, 11. Sustainability, Global health, 030212 general & internal medicine, media_common, 2. Zero hunger, Public health, lcsh:Public aspects of medicine, 1. No poverty, General Medicine, 3142 Public health care science, environmental and occupational health, 6. Clean water, Low-income countries, 3. Good health, A990 Medicine and Dentistry not elsewhere classified, CHILD GROWTH, TERRITORIES, HYGIENE, Human, 0605 Microbiology, Diarrhea, AFRICA, medicine.medical_specialty, media_common.quotation_subject, 030231 tropical medicine, Local Burden of Disease WaSH Collaborators, Developing country, Article, Geographical inequalities, 1117 Public Health and Health Services, 12. Responsible consumption, Developing Countrie, 03 medical and health sciences, NUTRITIONAL INTERVENTIONS, Environmental health, medicine, SYSTEMATIC ANALYSIS, Humans, QUALITY, Sanitation/statistics & numerical data, Open defecation, Improved sanitation, hand washing, Developing Countries, Models, Statistical, Middle-income countries, Drinking Water, lcsh:RA1-1270, Bayes Theorem, GLOBAL BURDEN, diarrheal disease, DIARRHEA, Diarrhea/epidemiology, Local Burden of Disease WaSH Collaborator, Socioeconomic Factors, 0605 Microbiology, 1117 Public Health and Health Services, ITC-ISI-JOURNAL-ARTICLE, Business, Human medicine, Sanitation facilities, ITC-GOLD
Abstract

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce highresolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. This work was primarily supported by a grant from the Gates Foundation (OPP1132415). LGA has received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance Code 001), Conselho Nacional de Desenvolvimento Científico e Tecnológico and Fundação de Amparo à Pesquisa do Estado de Minas Gerais. OOA acknowledges the Department of Science and Innovation, National Research Foundation, and DSI/NRF Centre of Excellence for Epidemiological Modelling and Analysis, Stellenbosch, South Africa. SMAl acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. HTA acknowledges Aksum University. MAu and CH are partly supported by a grant from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. AAz acknowledges funding from the Gates Foundation (OPP1171700). ABad is supported by the Public Health Agency of Canada. TWB was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research; the EU; the Wellcome Trust; and from National Institute of Child Health and Human Development of National Institutes of Health (NIH; R01-HD084233), National Institute on Aging of NIH (P01AG041710), National Institute of Allergy and Infectious Diseases of NIH (R01-AI124389 and R01-AI112339), as well as Fogarty International Center of NIH (D43-TW009775). DABen was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the UK Department of Health and Social Care. GBB is supported by Sistema Nacional de Investigación (SNI) de la Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) of Panamá. FCar acknowledges UID/ MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/Ministério da Ciência, Tecnologia e Ensino Superior through national funds. VMC acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. JDN acknowledges support from the Alexander von Humboldt Foundation. DBD acknowledges support from the Gates Foundation. KD is supported by a Wellcome Trust grant (number 201900/Z/16/Z) as part of his International Intermediate Fellowship. AGo acknowledges Sistema Nacional de Investigadores de Panamá (SNI), Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). CH is partly supported by a grant co-funded by European Fund for Regional Development through the Operational Program for Competitiveness (project ID P_40_382). SMSI is funded by a Fellowship from National Heart Foundation of Australia and Deakin University. MJ and the Serbian part of this GBD contribution was co-funded through grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. JK is a recipient of the 2020 Benjamin V Cohen Peace Fellowship from Ball State University Center for Peace and Conflict Studies. YJK’s work was supported by the Research Management Centre, Xiamen University Malaysia, grants number XMUMRF/2018-C2/ ITCM/0001. KKr is supported by a DST PURSE grant and UGC Center of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. BL acknowledges support from the NIHR Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence, Oxford. PTNM acknowledges the Council for the Development of Social Science Research in Africa. ANA acknowledges Debre Markos University for its support in-terms of office and internet access while reviewing this paper. AMSam received a fellowship from the Egyptian Fulbright Mission programme. MMS-M acknowledges the support of the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). AShi acknowledges the support of Health Data Research UK. MRS acknowledges the Clinical Research Development Center of Imam Reza Hospital, Kermanshah university of Medical sciences for their wise advice. JBS is part of Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. RT-S was supported in part by grant PI17/00719 from Instituto de Salud Carlos III–FEDER. BU acknowledges Manipal Academy of Higher Education, Manipal. TWij acknowledges the Migraine Foundation Australia and the Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Anuradhapuraya, Sri Lanka. CSW was supported by the South African Medical Research Council. SBZ received a scholarship from the Australian Government research training program in support of his academic career.

Published
2020
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22. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017

Author

Manisha Dubey, Fatemeh Rajati, Mehran Shams-Beyranvand, Amir Khater, Reza Shirkoohi, Segun Emmanuel Ibitoye, David C. Schwebel, Milena Ilic, Kebede Embaye Gezae, Ali Akbar Fazaeli, Ronny Westerman, Taye Abuhay Zewale, Ravi Mehrotra, Sezer Kisa, Junaid Khan, Jost B. Jonas, Dian Kusuma, Marcel Ausloos, Getnet Gedefaw, Hamed Zandian, Edward J Mills, Aparna Lal, Atalay Goshu Muluneh, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Jacqueline Elizabeth Alcalde Rabanal, Yousef Veisani, Sharath Burugina Nagaraja, Christopher Troeger, Ismael R. Campos-Nonato, Kidane Tadesse Gebremariam, Maysaa El Sayed Zaki, Oliver J. Brady, David Laith Rawaf, Tamer H. Farag, Simin Mouodi, Hafiz Ansar Rasul Suleria, Saleh Salehi Zahabi, Soumyadeep Bhaumik, Samad Azari, Getinet Ayano, Faris Lami, Raaj Kishore Biswas, Maryam Adabi, Alaa Badawi, Saravanan Muthupandian, Amir Hasanzadeh, Martin Amogre Ayanore, Maziar Moradi-Lakeh, Mohamad-Hani Temsah, Kavumpurathu Raman Thankappan, Bineyam Taye, Nader Jafari Balalami, Hamid Yimam Hassen, Karzan Abdulmuhsin Mohammad, Paul H. Lee, Emerito Jose A. Faraon, Kewal Krishan, Muhammad Ali, Ehsan Sadeghi, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Lal B. Rawal, Alyssa N. Sbarra, Behnam Heidari, Dietrich Rothenbacher, Hagos Tasew Atalay, Eric L. Ding, Noushin Mohammadifard, Nihal Thomas, Man Mohan Mehndiratta, Sanghamitra Pati, Addisu Melese, Niranjan Kissoon, Farzad Manafi, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Mohammad Reza Sobhiyeh, Frank B. Osei, Koku Sisay Tamirat, Yahya Salimi, Pranab Chatterjee, Gebreamlak Gebremedhn Gebremeskel, Olatunji O. Adetokunboh, Benjamin K. Mayala, Bhaskaran Unnikrishnan, Zahid A Butt, Olufemi Ajumobi, Fiseha Wadilo Wada, Shafiu Mohammed, Charles Shey Shey Wiysonge, Félix Carvalho, Masresha Tessema Anegago, Yun Jin Kim, Ai-Min Wu, Ketema Bizuwork Gebremedhin, Paulina A. Lindstedt, Ana-Laura Manda, Aziz Eftekhari, Rakhi Dandona, Mehdi Fazlzadeh, Nicole Davis Weaver, Muluken Bekele Sorrie, Marwa Rashad Salem, Kassawmar Angaw Bogale, Dongyu Zhang, Saeed Safari, Vivekanand Jha, Keivan Ahmadi, Turki Alanzi, Amir Jalali, Hamidreza Haririan, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Lucas Guimarães Abreu, Gessessew Bugssa Hailu, Surendra Karki, Kirsten E. Wiens, Boikhutso Tlou, Soraya Siabani, Muluken Azage Yenesew, Asnakew Achaw Ayele, Ayalew Jejaw Zeleke, Osayomwanbo Osarenotor, Susanna Dunachie, Marcos Roberto Tovani-Palone, Daniel Bekele Ketema, Tissa Wijeratne, Dessalegn Ajema Berbada, André Karch, Ebrahim Babaee, Akram Pourshams, Seyyed Meysam Mousavi, Bal Govind Chauhan, Giuseppe Remuzzi, Vera Marisa Costa, Mehdi Yaseri, Tahereh Pashaei, Benn Sartorius, Helen Derara Diro, Anelisa Jaca, Mostafa Hosseini, Nikolay Ivanovich Briko, Franz Castro, Cuong Tat Nguyen, Chalachew Genet Akal, Natalie Maria Cormier, Ghulam Mustafa, Sonia Lewycka, Achala Upendra Jayatilleke, David L. Smith, Ibrahim A Khalil, Genet Melak Alamene, George C Patton, Andem Effiong, Gebrekiros Gebremichael Meles, Collins Chansa, Tsegaye Lolaso Lenjebo, Van C. Lansingh, Chabila C Mapoma, Olayinka Stephen Ilesanmi, Aso Mohammad Darwesh, Aubrey J. Levine, Miliva Mozaffor, Till Bärnighausen, Ali Rostami, André Faro, Rushdia Ahmed, Colm McAlinden, Duduzile Ndwandwe, Neeraj Bedi, Irfan Ullah, Winfried März, Rajeev Gupta, Masood Ali Shaikh, Catalina Liliana Andrei, Ali Kazemi Karyani, Shaimaa I. El-Jaafary, Abbas Mosapour, Javad Nazari, Obinna Onwujekwe, Narinder Pal Singh, Dabere Nigatu, Tanuj Kanchan, Jagdish Khubchandani, Aklilu Endalamfaw, Hajer Elkout, Michelle L. Bell, Beyene Meressa Adhena, Evanson Z. Sambala, Nelson Alvis-Guzman, Nefsu Awoke, Mohammad Ali Sahraian, Muki Shey, Christiane Dolecek, Kedir Hussein Abegaz, Syed Ather Hussain, Birhan Tamene Alemnew, Arash Etemadi, Anwar E. Ahmed, Vinay Nangia, Sachin R Atre, Roghiyeh Faridnia, Robert C. Reiner, Rajat Das Gupta, Aniruddha Deshpande, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Muktar Beshir Ahmed, Kiana Ramezanzadeh, Jacek Jerzy Jozwiak, Chi Linh Hoang, Bahram Armoon, Manfred Accrombessi, Christopher J L Murray, Ebrahim M Yimer, Rashmi Gupta, Ahmed Omar Bali, Dadi Marami, Arash Tehrani-Banihashemi, Getnet Mengistu, Govinda Prasad Dhungana, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Ali S. Akanda, Satar Rezaei, Wondimeneh Shibabaw Shiferaw, Irina Filip, Mohammad Fareed, Hagos Degefa Hidru, Morteza Shamsizadeh, Mojtaba Hoseini-Ghahfarokhi, Yared A Asmare Aynalem, Gelin Xu, Zubair Kabir, Khalid A Altirkawi, Beatriz Paulina Ayala Quintanilla, Kenean Getaneh Tlaye, Devasahayam J. Christopher, Malede Mequanent Sisay, Yibeltal Alemu Bekele, Mika Shigematsu, Bryan L. Sykes, Quique Bassat, Jemal Abdu Mohammed, Seyed Mostafa Mir, Moslem Soofi, Nuruzzaman Khan, Ensiyeh Jenabi, Seyed-Mohammad Fereshtehnejad, Alireza Esteghamati, Paramjit Gill, Nathaniel J Henry, Meghnath Dhimal, Hosein Shabaninejad, Trang Huyen Nguyen, Amjad Mohamadi-Bolbanabad, Eugenio Traini, Mohammad Zamani, Arianna Maever L. Amit, Mehran Alijanzadeh, Florian Fischer, Rafael Moreira Claro, Pushpendra Kumar, Shai Linn, Lucas Earl, Haileab Fekadu Wolde, Getenet Dessie, Doris D. V. Ortega-Altamirano, John S. Ji, Moritz U. G. Kraemer, Saeed Amini, Ziad A. Memish, Aisha Elsharkawy, Ken Lee Chin, Mustafa Z. Younis, Daniel Diaz, Hebat Allah Salah A. Yousof, Seifadin Ahmed Shallo, Tomohide Yamada, Adrian Pana, Salman Rawaf, Amir Almasi-Hashiani, Platon D. Lopukhov, Alireza Rafiei, Dragos Virgil Davitoiu, Hossein Poustchi, Ayele Geleto Bali, Francesco Saverio Violante, Leonardo Roever, Giovanni Damiani, Maha El Tantawi, Nuworza Kugbey, Hadi Pourjafar, Michael R.M. Abrigo, Dinh-Toi Chu, Farkhonde Salehi, Phetole Walter Mahasha, Farnam Mohebi, Sathish Thirunavukkarasu, Dharmesh Kumar Lal, Senbagam Duraisamy, Demelash Woldeyohannes Handiso, Eleonora Dubljanin, Takeshi Fukumoto, Biruck Desalegn Yirsaw, Fakher Rahim, Jasvinder A. Singh, Jai K Das, Savita Lasrado, Ana Isabel Ribeiro, Santosh Varughese, Adnan Kisa, Laurie B. Marczak, Amira Shaheen, Peter Njenga Keiyoro, Nader Jahanmehr, Yuming Guo, Arash Ziapour, Alex Yeshaneh, Ninuk Hariyani, Seyed Sina Naghibi Irvani, Sameer Vali Gopalani, Joel M. Francis, Asmamaw Demis, Ahamarshan Jayaraman Nagarajan, Praveen Hoogar, Nicola Luigi Bragazzi, Yunquan Zhang, Yousef Mohammad, Iman El Sayed, Vafa Rahimi-Movaghar, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Marzieh Nojomi, Tewodros Eshete Wonde, Sameh Magdeldin, Anton Sokhan, Nauman Khalid, Nima Hafezi-Nejad, Ben Lacey, Luca Ronfani, James Albright, Senthilkumar Balakrishnan, Ejaz Ahmad Khan, Khanh Bao Tran, Guoqing Hu, Yousef Khader, Parvaneh Mirabi, Boris Bikbov, Feleke Mekonnen Demeke, Assefa Desalew, Yasir Waheed, Berhe Etsay Tesfay, Julio Cesar Campuzano Rincon, Ernoiz Antriyandarti, Brian J. Hall, James A Platts-Mills, Gbenga A. Kayode, Jan-Walter De Neve, Maria Jesus Rios-Blancas, Navid Manafi, Ravi Prakash Jha, Yilma Chisha Dea Geramo, Hamideh Salimzadeh, Fisaha Haile Tesfay, Abdullah Al Mamun, Ali Bijani, Hedley Quintana, Shanshan Li, Kebreab Paulos, Joan B. Soriano, Victor Adekanmbi, Oladimeji Adebayo, David Teye Doku, Brijesh Sathian, Bakhtiar Piroozi, MohammadBagher Shamsi, Netsanet Fentahun, Shymaa Enany, Ayman Grada, Salvatore Rubino, Kenji Shibuya, Norberto Perico, Sergio I. Prada, Andrea Farioli, Gebremicheal Gebreslassie Kasahun, Mohsen Afarideh, Maciej Banach, Andrey Nikolaevich Briko, Mohsen Asadi-Lari, Rakesh Lodha, David M. Pigott, Bárbara Niegia Garcia de Goulart, Hadi Hassankhani, Daniel Adane Endalew, Siamak Sabour, Yoshan Moodley, Preeti Dhillon, Dilaram Acharya, Anas M. Saad, Ibrahim Abdelmageed Ginawi, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Hasan Yusefzadeh, Mohammad Rabiee, Ajay Patle, Rahman Shiri, Girmay Teklay Weldesamuel, Sivan Yegnanarayana Iyer Saraswathy, Mekdes Tigistu Yilma, Davide Guido, Chuanhua Yu, Abdallah M. Samy, Ali Talha Khalil, Ashish Awasthi, Pascual R. Valdez, Nelson G.M. Gomes, Nejimu Biza Zepro, Taweewat Wiangkham, Anthony Masaka, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Huyen Phuc Do, Krittika Bhattacharyya, Maryam Khayamzadeh, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Farah Daoud, QuynhAnh P Nguyen, Suleman Atique, Sheikh Mohammed Shariful Islam, Indang Trihandini, Mario Poljak, Bartosz Miazgowski, Huda Basaleem, Rafael Alves Guimares, Mina Anjomshoa, Peng Jia, Yafeng Wang, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Itamar S. Santos, Alireza Khatony, Desalegn Tadese Mengistu, Samath D Dharmaratne, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Konrad Pesudovs, Tina Beyranvand, Liliana Preotescu, Leticia Avila-Burgos, Enrico Rubagotti, Amira Hamed Darwish, Mahdi Safdarian, Ali Yadollahpour, Vijay Kumar Chattu, Moses K. Muriithi, Azmeraw T. Amare, Si Si, Joshua Longbottom, Somayeh Bohlouli, Khaled Khatab, Masoud Behzadifar, Anusha Ganapati Bhat, G Anil Kumar, Margaret Kosek, Mona M. Khater, Reta Tsegaye Gayesa, Ghobad Moradi, Srinivas Goli, Ruth W Kimokoti, Jalal Arabloo, Kimberly B. Johnson, Andrew T Olagunju, Mowafa Househ, In-Hwan Oh, Arya Haj-Mirzaian, Desta Haftu Hayelom, Jae Il Shin, Ahmed Abdelalim, Catherine A. Welgan, Veincent Christian Filipino Pepito, Andre Rodrigues Duraes, Yuan-Pang Wang, Rosario Cárdenas, Mohammad Khazaei, Sebastian Vollmer, Xiu-Ju Zhao, Mihajlo Jakovljevic, Degu Abate, Ali S. Shalash, Davide Rasella, Melese Abate Reta, Hedayat Abbastabar, Manu Raj Mathur, Aliasghar Ahmad Kiadaliri, Ritesh G. Menezes, Molly K. Miller-Petrie, Beriwan Abdulqadir Ali, Ahmed I. Hasaballah, Joseph Frostad, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Deborah Carvalho Malta, Brigette F. Blacker, Carlo La Vecchia, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Zewdie Aderaw Alemu, Foad Abd-Allah, Elias Merdassa Roro, Agus Sudaryanto, Fariba Ghassemi, Behzad Karami Matin, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Maheswar Satpathy, Mahesh P A, Carlos Miguel Rios González, Pallab K. Maulik, Amir Kasaeian, Ali H. Mokdad, Alemayehu Toma Mena, Tamirat Tesfaye Dasa, Abdur Razzaque Sarker, Andre M. N. Renzaho, Muhammad Aziz Rahman, Ali Kabir, Josephine W. Ngunjiri, Aberash Abay Tassew, Kala M. Mehta, Ionut Negoi, Hosni Salem, Hesham M. Al-Mekhlafi, Sharareh Eskandarieh, Rufus A. Adedoyin, Saleem M Rana, Engida Yisma, Sahel Valadan Tahbaz, Hossein Farzam, Krishna K. Aryal, Lalit Dandona, Masoud Moradi, Juan Sanabria, Gebre Teklemariam Demoz, Naser Mohammad Gholi Mezerji, Shirin Djalalinia, Suraj Bhattarai, Ammas Siraj Mohammed, Claudiu Herteliu, Dawit Zewdu Wondafrash, Mohsen Bayati, Arvin Haj-Mirzaian, Gulfaraz Khan, Mostafa Leili, Nasir Salam, Ehsan Khodamoradi, Jean Jacques Noubiap, Vahid Alipour, Mohammad Ali Mansournia, Rajesh Sagar, Jagadish Rao Padubidri, Manasi Kumar, Mehdi Sharif, Fatemeh Heydarpour, Navid Rabiee, Gvs Murthy, Hamed Kalani, Mayowa O. Owolabi, Claudio Alberto Davila, Oluchi Okpala, Shivakumar K.M. Kondlahalli, Mathew M. Baumann, Bereket Duko Adema, Lorenzo Monasta, Paul S. F. Yip, Mohammad Hossein Khosravi, Rizwan Suliankatchi Abdulkader, Ibrahim Abdollahpour, Dhirendra N Sinha, Farid Najafi, Kebede Deribe, Paula Moraga, Mehedi Hasan, Mohammad Moradi-Joo, Melkamu Merid Mengesha, Temesgen Yihunie Akalu, Vishnu Renjith, Syed Mohamed Aljunid, Zemenu Tadesse Tessema, Amir Radfar, Nuno Taveira, Masoud Foroutan, Demelash Abewa Elemineh, Chinwe Juliana Iwu, Kamarul Imran Musa, Getaneh Alemu Abebe, Farshad Pourmalek, Olatunde Aremu, Mohammad Reza Salahshoor, Derrick A Bennett, Ahmad Daryani, Alebachew Fasil Ashagre, Apurba Shil, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Mehdi Hosseinzadeh, Rovshan Khalilov, Ai Koyanagi, Salman Khazaei, Jennifer Rickard, Ali Almasi, Sandra B. Munro, Carlos Zambrana-Torrelio, Naohiro Yonemoto, Ahmad Ghashghaee, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Instituto de Saúde Pública da Universidade do Porto, Local Burden Dis Diarrhoea, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, Reiner, Robert C, Wiens, Kirsten E, Deshpande, Aniruddha, Baumann, Mathew M, Adema, Bereket Duko, Yirsaw, Biruck Desalegn, Yisma, Engida, Hay, Simon I, Local Burden of Disease Diarrhoea Collaborators, Tampere University, Health Sciences, University of Helsinki, Institute for Molecular Medicine Finland, Clinicum, HUS Comprehensive Cancer Center, Local Burden of Disease Diarrhoea Collaborator, and Violante FS

Subjects
Low income countries, medicine.medical_treatment, 030204 cardiovascular system & hematology, Global Health, THERAPY, Global Burden of Disease, 0302 clinical medicine, Prevalence, Global health, Medicine, WATER, 030212 general & internal medicine, Children, 11 Medical and Health Sciences, Incidence, Mortality rate, Incidence (epidemiology), 1. No poverty, General Medicine, 3142 Public health care science, environmental and occupational health, Diarrhoea, 3. Good health, Child, Preschool, Middle income countries, A990 Medicine and Dentistry not elsewhere classified, TERRITORIES, Life Sciences & Biomedicine, Infants, Diarrhea, AFRICA, medicine.medical_specialty, Childhood deaths, RJ, sanitation, Developing country, Childhood diarrhoeal morbidity, ITC-HYBRID, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, Environmental health, SYSTEMATIC ANALYSIS, Life Science, Humans, Healthcare Disparities, Oral rehydration therapy, Risk factor, hand washing, Developing Countries, Disease burden, Global Nutrition, Wereldvoeding, Science & Technology, SEX-SPECIFIC MORTALITY, business.industry, CHOLERA, Public health, Bayes Theorem, diarrheal disease, Local Burden of Disease Diarrhoea Collaborators, ITC-ISI-JOURNAL-ARTICLE, NA, Human medicine, Diarrea, business
Abstract

Background: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation: By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). S Aljunid reports additional funding from the International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia and Department of Health Policy and Management, Faculty of Public Health, Kuwait University for the approval and support to participate in this research project outside of the study. A Awasthi is supported by the Department of Science and Technology, Government of India, New Delhi, through the INSPIRE Faculty Program outside of the study. A Badawi reports additional funding from the Public Health Agency of Canada outside of the study. A Barac reports additional funding from the Project of Ministry of Education, Science and Technology of the Republic of Serbia (no III45005) outside of the study. T Bärnighausen reports additional funding by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research outside of the study. F Carvalho and E Fernandez report additional funding from the Portuguese national funds (UID/MULTI/04378/2019 and UID/QUI/50006/2019) outside of the study. V M Costa reports additional funding from Fundação da Ciência e Tecnologia (FCT) for her grant (SFRH/BPD/110001/2015), which was funded by national funds through FCT – Fundação para a Ciência e a Tecnologia, IP, under the Norma Transitória – DL57/2016/CP1334/CT0006 outside of the study. J De Neve reports additional funding from the Alexander von Humboldt Foundation outside of the study. K Deribe reports additional funding from the Wellcome Trust (grant number 201900) as part of his International Intermediate Fellowship outside of the study. D Endalew and M Moradi report additional funding from Wolkite University. M Ausloos, C Herteliu, and A Pana report additional funding from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI (project number PN-III-P4-ID-PCCF-2016-0084) outside of the study. C Herteliu reports additional funding from the European Fund for Regional Development through Operational Program for Competitiveness (Project ID P_40_382) and the European Fund for Regional Development, through InterReg Romania-Hungary (project code EMS ROHU 217) outside of the study. P Hoogar reports additional funding from the Centre for Holistic Development and Research (CHDR), Kalaghatagi and The Department of Studies in Anthropology, Karnatak University, D S Islam reports additional funding from the National Heart Foundation of Australia and the Institute for Physical Activity and Nutrition, Deakin University outside of the study. A Khatony reports additional funding from the Clinical Research Development Center of Imam Reza Hospital in Kermanshah outside of the study. J Khubchandani reports additional funding from Merck Research Laboratories outside of the study. K Krishan reports additional funding from the UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India outside of the study. M Kumar reports additional funding from the Fogarty Foundation/NIH through a K43 award (TW010716-01A1) outside of the study. B Lacey reports additional funding from the National Institute for Health Research Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence (Oxford, UK) outside of the study. A M Samy reports additional funding from the Egyptian Fulbright Mission Program (EFMP) outside of the study. S Seyedmousavi reports additional funding from the Intramural Program of National Institute of Health Clinical Center, Bethesda, MD, USA outside of the study. M Shey reports additional funding from the Wellcome Trust Kenji Shibuya reports additional funding from Japan's Ministry of Health, Labour and Welfare and Japan's Ministry of Education, Culture, Sport, Science and Technology outside of the study. M Sobhiyeh reports additional funding from the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences outside of the study. J Soriano reports additional funding from Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain outside of the study. N Taveira reports additional funding from the LIFE study (RIA2016MC-1615) of the European and Developing Countries Clinical Trials Partnership (EDCTP) program supported by the European Union outside of the study. B Unnikrishnan reports additional funding from the Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India outside of the study. T Wijeratne reports additional funding from the Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Sri Lanka outside of the study. C S Wiysonge reports additional funding from the South African Medical Research Council and the National Research Foundation of South Africa outside of the study.

Published
2020

23. Mapping disparities in education across low- and middle-income countries

Author

Lauren E. Schaeffer, Belay Tessema, Reza Malekzadeh, Olatunde Aremu, Mehdi Hosseinzadeh, Milena M Santric Milicevic, Seyyed Meysam Mousavi, Azeem Majeed, Badr Hasan Sobaih, Jalal Arabloo, Philimon Gona, Aliasghar Ahmad Kiadaliri, Mostafa Qorbani, Fatemeh Rajati, Ipsita Sutradhar, Giuseppe Remuzzi, Babak Eshrati, Olufemi Ajumobi, Lauren Woyczynski, Parul Puri, Vinay Nangia, Guoqing Hu, Yousef Khader, Suzanne Barker-Collo, Hamideh Salimzadeh, Félix Carvalho, Yun Jin Kim, Moslem Soofi, Ali Bijani, Shanshan Li, Catalina Liliana Andrei, Ali Kazemi Karyani, Mehran Asadi-Aliabadi, Andrea Sylvia Winkler, Arya Haj-Mirzaian, Maziar Moradi-Lakeh, Farnam Mohebi, Mohamad-Hani Temsah, Kala M. Mehta, Simon I. Hay, Benjamin B. Massenburg, Sanjay Zodpey, Tuomo J. Meretoja, Ireneous N. Soyiri, Bach Xuan Tran, George C Patton, Kavumpurathu Raman Thankappan, Engida Yisma, Vasily Vlassov, Samer Hamidi, Ghulam Mustafa, André Faro, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Rajat Gupta, Shirin Djalalinia, Dina Nur Anggraini Ningrum, Sheikh Mohammed Shariful Islam, Juan Sanabria, Leonardo Roever, Dayane Gabriele Alves Silveira, Samad Azari, Vahid Alipour, Gabrielle B. Britton, Luca Ronfani, Rosario Cárdenas, Maarten J. Postma, Hamid Yimam Hassen, Pn Sylaja, Brijesh Sathian, Paul S. F. Yip, Vegard Skirbekk, Chhabi Lal Ranabhat, Paramjit Gill, Walter Mendoza, Lorenzo Monasta, Dara K. Mohammad, Naznin Hossain, Dhirendra N Sinha, Ali H. Mokdad, Aziz Rezapour, Megan F. Schipp, Ziyad Al-Aly, Takeshi Fukumoto, Kebede Deribe, Paula Moraga, Mohammad Ebrahimi Kalan, Ai Koyanagi, Andre M. N. 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Mayala, Mahmood Moosazadeh, Soraya Siabani, Derrick A Bennett, Collaborators, Local Burden of Disease Educational Attainment, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Clinicum, Helsinki University Hospital Area, University of Helsinki, Local Burden Dis Educ Attainment C, Graetz N., Woyczynski L., Wilson K.F., Hall J.B., Abate K.H., Abd-Allah F., Adebayo O.M., Adekanmbi V., Afshari M., Ajumobi O., Akinyemiju T., Alahdab F., Al-Aly Z., Rabanal J.E.A., Alijanzadeh M., Alipour V., Altirkawi K., Amiresmaili M., Anber N.H., Andrei C.L., Anjomshoa M., Antonio C.A.T., Arabloo J., Aremu O., Aryal K.K., Asadi-Aliabadi M., Atique S., Ausloos M., Awasthi A., Quintanilla B.P.A., Azari S., Badawi A., Banoub J.A.M., Barker-Collo S.L., Barnett A., Bedi N., Bennett D.A., Bhattacharjee N.V., Bhattacharyya K., Bhattarai S., Bhutta Z.A., Bijani A., Bikbov B., Britton G., Burstein R., Butt Z.A., Cardenas R., Carvalho F., Castaneda-Orjuela C.A., Castro F., Cerin E., Chang J.-C., Collison M.L., Cooper C., Cork M.A., Daoud F., Das Gupta R., Weaver N.D., De Neve J.-W., Deribe K., Desalegn B.B., Deshpande A., Desta M., Dhimal M., Diaz D., Dinberu M.T., Djalalinia S., Dubey M., Dubljanin E., Duraes A.R., Dwyer-Lindgren L., Earl L., Kalan M.E., El-Khatib Z., Eshrati B., Faramarzi M., Fareed M., Faro A., Fereshtehnejad S.-M., Fernandes E., Filip I., Fischer F., Fukumoto T., Garcia J.A., Gill P.S., Gill T.K., Gona P.N., Gopalani S.V., Grada A., Guo Y., Gupta R., Gupta V., Haj-Mirzaian A., Hamadeh R.R., Hamidi S., Hasan M., Hassen H.Y., Hendrie D., Henok A., Henry N.J., Prado B.H., Herteliu C., Hole M.K., Hossain N., Hosseinzadeh M., Hu G., Ilesanmi O.S., Irvani S.S.N., Islam S.M.S., Izadi N., Jakovljevic M., Jha R.P., Ji J.S., Jonas J.B., Shushtari Z.J., Jozwiak J.J., Kanchan T., Kasaeian A., Karyani A.K., Keiyoro P.N., Kesavachandran C.N., Khader Y.S., Khafaie M.A., Khan E.A., Khater M.M., Kiadaliri A.A., Kiirithio D.N., Kim Y.J., Kimokoti R.W., Kinyoki D.K., Kisa A., Kosen S., Koyanagi A., Krishan K., Defo B.K., Kumar M., Kumar P., Lami F.H., Lee P.H., Levine A.J., Li S., Liao Y., Lim L.-L., Listl S., Lopez J.C.F., Majdan M., Majdzadeh R., Majeed A., Malekzadeh R., Mansournia M.A., Martins-Melo F.R., Masaka A., Massenburg B.B., Mayala B.K., Mehta K.M., Mendoza W., Mensah G.A., Meretoja T.J., Mestrovic T., Miller T.R., Mini G.K., Mirrakhimov E.M., Moazen B., Mohammad D.K., Darwesh A.M., Mohammed S., Mohebi F., Mokdad A.H., Monasta L., Moodley Y., Moosazadeh M., Moradi G., Moradi-Lakeh M., Moraga P., Morawska L., Morrison S.D., Mosser J.F., Mousavi S.M., Murray C.J.L., Mustafa G., Nahvijou A., Najafi F., Nangia V., Ndwandwe D.E., Negoi I., Negoi R.I., Ngunjiri J.W., Nguyen C.T., Nguyen L.H., Ningrum D.N.A., Noubiap J.J., Shiadeh M.N., Nyasulu P.S., Ogbo F.A., Olagunju A.T., Olusanya B.O., Olusanya J.O., Onwujekwe O.E., Ortega-Altamirano D.D.V., Ortiz-Panozo E., Overland S., Mahesh P.A., Pana A., Panda-Jonas S., Pati S., Patton G.C., Perico N., Pigott D.M., Pirsaheb M., Postma M.J., Pourshams A., Prakash S., Puri P., Qorbani M., Radfar A., Rahim F., Rahimi-Movaghar V., Rahman M.H.U., Rajati F., Ranabhat C.L., Rawaf D.L., Rawaf S., Reiner R.C., Remuzzi G., Renzaho A.M.N., Rezaei S., Rezapour A., Rios-Gonzalez C., Roever L., Ronfani L., Roshandel G., Rostami A., Rubagotti E., Sadat N., Sadeghi E., Safari Y., Sagar R., Salam N., Salamati P., Salimi Y., Salimzadeh H., Samy A.M., Sanabria J., Santric Milicevic M.M., Sartorius B., Sathian B., Sawant A.R., Schaeffer L.E., Schipp M.F., Schwebel D.C., Senbeta A.M., Sepanlou S.G., Shaikh M.A., Shams-Beyranvand M., Shamsizadeh M., Sharafi K., Sharma R., She J., Sheikh A., Shigematsu M., Siabani S., Silveira D.G.A., Singh J.A., Sinha D.N., Skirbekk V., Sligar A., Sobaih B.H., Soofi M., Soriano J.B., Soyiri I.N., Sreeramareddy C.T., Sudaryanto A., Babale Sufiyan M., Sutradhar I., Sylaja P., Tabares-Seisdedos R., Tadesse B.T., Temsah M.-H., Terkawi A.S., Tessema B., Tessema Z.T., Thankappan K.R., Topor-Madry R., Tovani-Palone M.R., Tran B.X., Car L.T., Ullah I., Uthman O.A., Valdez P.R., Veisani Y., Violante F.S., Vlassov V., Vollmer S., Thu Vu G., Waheed Y., Wang Y.-P., Wilkinson J.C., Winkler A.S., Wolfe C.D.A., Yamada T., Yeshaneh A., Yip P., Yisma E., Yonemoto N., Younis M.Z., Yousefifard M., Yu C., Bin Zaman S., Zhang J., Zhang Y., Zodpey S., Gakidou E., Hay S.I., Graetz, Nicholas, Woyczynski, Lauren, Wilson, Katherine F, Hall, Jason B, Yisma, Engida, Hay, Simon I, Local Burden of Disease Educational Attainment Collaborators, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Value, Affordability and Sustainability (VALUE)

Subjects
Male, ATTAINMENT, Health Status, Disease, education, low- and middle-income countries, 0302 clinical medicine, WORLD, gender, Global health, risk factors, 030212 general & internal medicine, Aetiology, 10. No inequality, media_common, Developing world, Pediatric, Multidisciplinary, 1. No poverty, Multidisciplinary Sciences, Geography, Science & Technology - Other Topics, Female, HEALTH, developing world, social and economic factors, Engineering sciences. Technology, disparitie, AFRICA, medicine.medical_specialty, Inequality, General Science & Technology, media_common.quotation_subject, MODELS, Developing country, Local Burden of Disease Educational Attainment Collaborators, Article, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Education, 03 medical and health sciences, 2.3 Psychological, medicine, Humans, Society, Social determinants of health, Developing Countries, Science & Technology, Equity (economics), MORTALITY, Public health, Bayes Theorem, Educational attainment, 3141 Health care science, society, Good Health and Well Being, Risk factors, Socioeconomic Factors, Demographic economics, 030217 neurology & neurosurgery
Abstract

Educational attainment is an important social determinant of maternal, newborn, and child health1–3. As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting4–6. The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness7,8; however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health9–11. Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but—to our knowledge—no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries12–14. By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations., Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations.

Published
2020
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24. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17

Author

Ninuk Hariyani, Benjamin Uzochukwu, Anas M. Saad, Sivan Yegnanarayana Iyer Saraswathy, Amirhossein Sahebkar, Behzad Karami Matin, Abdallah M. Samy, Roman Topor-Madry, Nelson G.M. Gomes, Afsaneh Arzani, Simin Liu, Maryam Khayamzadeh, Ejaz Ahmad Khan, Asmamaw Bizuneh Demis, Anelisa Jaca, Amir Kasaeian, Fereshteh Ansari, Abdur Razzaque Sarker, Ali Kabir, Jorge Cano, Marcos Roberto Tovani-Palone, Tufa Kolola, Josephine W. Ngunjiri, Roghiyeh Faridnia, Kedir Hussein Abegaz, Hosni Salem, Sharareh Eskandarieh, Norberto Perico, Sergio I. Prada, Fisaha Haile Tesfay, Jai K Das, Ana Isabel Ribeiro, Sameer Vali Gopalani, Dessalegn Haile, Shivakumar Km Marulasiddaiah M. KMShivakumar, Narayan Prasad, Pranab Chatterjee, Shafiu Mohammed, Ravi Prakash Jha, Xiu Ju George Zhao, Farshad Farzadfar, Ahmad Daryani, Pramesh Raj Ghimire, Abbas Mosapour, Ebrahim Babaee, Rajat Das Gupta, Jean Jacques Noubiap, Daniel Bekele Ketema, Teshome Bekele Elema I, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Muktar Beshir Ahmed, Wondimeneh Shibabaw Shiferaw, Mehran Asadi-Aliabadi, Mohamed M. Gad, Eugenio Traini, Milena Santric-Milicevic, Bakhtiar Piroozi, Mohsen Afarideh, Duduzile Ndwandwe, Ibrahim Abdollahpour, Aisha Elsharkawy, Bárbara Niegia Garcia de Goulart, Soufiane Boufous, Obinna Onwujekwe, Seyyed Meysam Mousavi, Azeem Majeed, Meghnath Dhimal, Bruno F. Sunguya, Daniel Adane Endalew, Hosein Shabaninejad, Siddhesh Zadey, Takahiro Tabuchi, Gebrekiros Gebremichael Meles, Davide Guido, Trang Huyen Nguyen, Yonatal Mesfin Tefera, Hala Elhabashy, Devasahayam J. Christopher, Malede Mequanent Sisay, Davide Rasella, Hedayat Abbastabar, Maziar Moradi-Lakeh, Anthony Masaka, Wagaye Fentahun Chanie, B. Suresh Kumar Shetty, Matiwos Soboka Daba, Tesfaye Yitna Yitna Chichiabellu, Arianna Maever L. 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Shalash, Thirunavukkarasu Sathish, Sachin R Atre, Mohamed I Hegazy, Mehedi Hasan, Hamidreza Haririan, Lucas Guimarães Abreu, Nejimu Biza Zepro, Surendra Karki, Krittika Bhattacharyya, Hiroshi Yatsuya, Gbenga A. Kayode, Osayomwanbo Osarenotor, Paul H. Lee, Deepak Paudel, Hagos Tasew Atalay, Hatem S Shehata, Mohammad Fareed, Adnan Kisa, Hisham Atan Edinur, Mehran Alijanzadeh, Shafiur Rahman, Mohammad Hossein Khosravi, Anusha Ganapati Bhat, Bahram Mohajer, Narinder Pal Singh, Shai Linn, Savita Lasrado, Joseph Adel Mattar Banoub, Amir Almasi-Hashiani, Mohd Anisul Karim, Praveen Hoogar, Kerrie E. Doyle, Bedilu Girma Weji, Juan Sanabria, Olatunji O. Adetokunboh, Mohamed Hsairi, Alireza Esteghamati, Seok Jun Yoon, Paramjit Gill, Dabere Nigatu, Tariq Jamal Siddiqi, Muhammad Usman, Rafael Alves Guimarães, Zemenu Tadesse Tessema, Aziz Sheikh, Florian Fischer, Peter Memiah, Rakesh Lodha, Nihal Thomas, Karzan Abdulmuhsin Mohammad, Mohammad Sadegh Rezai, Tanuj Kanchan, Vinay Nangia, Ashraf Nabhan, Gebre Teklemariam Demoz, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Sadaf G. Sepanlou, Michellr L. Bell, Nicola Luigi Bragazzi, Aklilu Endalamaw, Vishnu Renjith, Chinwe Juliana Iwu, Gabrielle B. Britton, Colm McAlinden, Ayenew Negesse Abejie, Smita Pakhale, Doris V.V. Ortega-Altamirano, Noushin Mohammadifard, Deborah Carvalho Malta, Vo Dinh Bay, Kirsten E. Wiens, Hamidreza Karimi-Sari, Mustafa Z. Younis, Shaimaa I. El-Jaafary, Morenike Oluwatoyin Folayan, Phetole Walter Mahasha, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Mohammad Hifz Ur Rahman, Sheikh Mohammed Shariful Islam, Maarten J. Postma, Usman Iqbal, Abdu A. Adamu, Marwa R.Rashad Salem I, Fares Alahdab, Vafa Rahimi-Movaghar, Zulfiqar A. Bhutta, Masoud Foroutan, Muhammad Shahzeb Khan, In-Hwan Oh, Yahya Salimi, Takeshi Fukumoto, Chhabi Lal Ranabhat, Tiffany K. Gill, Angel Paternina-Caicedo, Walter Mendoza, Sojib Bin Zaman, Olayinka Stephen Ilesanmi, Brigette F. Blacker, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Ambrish Singh, Mehdi Fazlzadeh, Mahesh P A, Carlo La Vecchia, Alex Yeshaneh, Benjamin K. Mayala, Aniruddha Deshpande, Agus Sudaryanto, Neeraj Bedi, Morteza Shamsizadeh, Jemal Abdu Mohammed, Vahid Alipour, Haileab Fekadu Wolde, Boris Bikbov, Ahmed Abualhasan, Ali H. Mokdad, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Jacek Jerzy Jozwiak, Alessandra C. Goulart, Mahmoud Yousefifard, Masood Ali Shaikh, Roya Safari-Faramani, MohammadBagher Shamsi, Aso Mohammad Darwesh, Amir Anoushiravani, Kebede Embaye Gezae, Degena Bahrey Tadesse, Paula Moraga, Maha El Tantawi, Rosario Cárdenas, Assefa Desalew, Vivek Kumar, Mina Anjomshoa, Junaid Khan, Jagdish Khubchandani, Marcel Ausloos, Soraya Siabani, Anwar E. Ahmed, Mohammed Ibrahim Mohialdeen Gubari, Andre M. N. Renzaho, Vuong Minh Nong, Kaushik Sarkar, Bruno Piassi Sao Jose, Yafeng Wang, Mitchell T. Wallin, Edgar Denova-Gutiérrez, Mohammad Hasan Imani-Nasab, Melese Abate Reta, Kala M. Mehta, Yahya Safari, Marufa Sultana, David C. Schwebel, Roghayeh Mohammadibakhsh, Samath D Dharmaratne, Maysaa El Sayed Zaki, Shiwei Liu, Gail Davey, Milena Ilic, Yunquan Zhang, Bahram Armoon, Seyed-Mohammad Fereshtehnejad, Jost B. Jonas, Dian Kusuma, Yawukal chane Kasahun, Beatriz Paulina Ayala Quintanilla, Mohammad Moradi-Joo, Gebrehiwot G. Kassa, Maria Jesus Rios-Blancas, Serge Resnikoff, Seifadin Ahmed Shallo, Bartosz Miazgowski, Huda Basaleem, Jobert Richie Nansseu, Enrico Rubagotti, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Maryam Adabi, Saravanan Muthupandian, Soumyadeep Bhaumik, hawariat, Carlos A Castañeda-Orjuela, Bhaskaran Unnikrishnan, Martin Amogre Ayanore, Dragos Virgil Davitoiu, Hossein Poustchi, Moses K. Muriithi, Dharmesh Kumar Lal, Ayman Grada, Rafael Tabarés-Seisdedos, Seyyed Shamsadin Athari, Ashish Pathak, Salvatore Rubino, Kenji Shibuya, Ana Laura Manda, Muluken Bekele Sorrie, Vivekanand Jha, Habtamu Kebebe Kasaye, Mohammad Hoseini, Sonali Kochhar, Van C. Lansingh, Ali Almasi, Amir Radfar, Till Bärnighausen, Marcia R. Weaver, Mowafa Househ, Arya Haj-Mirzaian, Gebremicheal Gebreslassie Kasahun, Arash Etemadi, Getahun Fentaw Mulaw, Zubair Kabir, Cuong Tat Nguyen, Chabila C Mapoma, Aubrey J. Levine, Solomon Gedlu Nigatu, Aslam Pervaiz, Muhammed Magdy Abd El Razek, Nataliya A. Foigt, Andrey Nikolaevich Briko, Sadaf Esteghamati, Chuanhua Yu, Pascual R. Valdez, Jennifer Rickard, Jennifer M. Ross, Ionut Negoi, Hailay Abrha Gesesew, Kamarul Imran Musa, Farshad Pourmalek, Kiomars Sharafi, Sangram Kishor Patel, Vera Marisa Costa, Mostafa Hosseini, Hajer Elkout, Mika Shigematsu, Bryan L. Sykes, Afarin Rahimi-Movaghar, Nuworza Kugbey, Vijay Kumar Chattu, Payman Salamati, Mona M. Khater, Reta Tsegaye Gayesa, Ehsan Sadeghi, Andrew T Olagunju, Govinda Prasad Dhungana, Dina Nur Anggraini Ningrum, Yaschilal Muche Belayneh, Leonardo Roever, Luca Ronfani, Nathaniel J. Henry, Brijesh Sathian, Hamid Sharifi, Liliana Preotescu, Joshua Longbottom, Somayeh Bohlouli, Huong Lan Thi Nguyen, Khaled Khatab, Ziyad Al-Aly, Ghobad Moradi, Ruth W Kimokoti, Jalal Arabloo, Mariam Molokhia, Maciej Banach, Hasan Yusefzadeh, Rahman Shiri, Girmay Teklay Weldesamuel, Mekdes Tigistu Yilma, Taweewat Wiangkham, Soewarta Kosen, Kovin Naidoo, Fernando de la Hoz, Mohammed Shannawaz, Berhe Etsay Tesfay I, Yogesh Sabde, Syed Mohamed Aljunid, Belay Tessema, Reza Malekzadeh, Tinuke O Olagunju, Olatunde Aremu, Mohammad Reza Salahshoor, Derrick A Bennett, Oladimeji M. Adebayo, Teshome Gebre, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Mehdi Hosseinzadeh, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Rovshan Khalilov, Ai Koyanagi, Salman Khazaei, Ismael R. Campos-Nonato, Alaa Badawi, Amir Hasanzadeh, Gebreamlak Gebremedhn Gebremeskel, Gessessew Bugssa Hailu, Dessalegn Ajema Berbada, Kate E. LeGrand, Azadeh Shafieesabet, Nikolay Ivanovich Briko, Robert S. Bernstein, Irfan Ullah, Isaac Oluwafemi Dipeolu, Hadi Hassankhani, Keyghobad Ghadiri, Local Burden of Disease Diarrhoea Collaborator, Violante FS, Wiens, KE, Lindstedt, PA, Blacker, BF, Johnson, KB, Yisma, E, Ahmed, Muktar Beshir, Reiner, Robert C, Duko, Bereket, Local Burden of Disease Diarrhoea Collaborators, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Local Burden Dis Diarrhoea, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, HUS Comprehensive Cancer Center, Clinicum, Institute for Molecular Medicine Finland, Department of Oncology, University of Helsinki, and Instituto de Saúde Pública da Universidade do Porto

Subjects
RJ101, medicine.medical_treatment, CHILDREN, ZINC, 0302 clinical medicine, 030212 general & internal medicine, media_common, Geography, lcsh:Public aspects of medicine, 1. No poverty, Low income and middle income countries, General Medicine, 3142 Public health care science, environmental and occupational health, 3. Good health, Child, Preschool, A990 Medicine and Dentistry not elsewhere classified, Geographical inequalities, 0605 Microbiology, Diarrhea, AFRICA, Inequality, DEATHS, media_common.quotation_subject, 030231 tropical medicine, Developing country, Article, RS, 1117 Public Health and Health Services, 03 medical and health sciences, MORBIDITY, Environmental health, DIARRHEAL DISEASE, medicine, Humans, Oral rehydration therapy, Healthcare Disparities, Developing Countries, Models, Statistical, CHOLERA, MORTALITY, Infant, Newborn, Infant, lcsh:RA1-1270, Bayes Theorem, Middle income, GLOBAL BURDEN, Child mortality, 0605 Microbiology, 1117 Public Health and Health Services, Health Care Surveys, ITC-ISI-JOURNAL-ARTICLE, Fluid Therapy, NA, Human medicine, ITC-GOLD
Abstract

Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000-17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000-7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910-68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). L G Abreu has received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance Code 001), Conselho Nacional de Desenvolvimento Científico e Tecnológico and Fundação de Amparo à Pesquisa do Estado de Minas Gerais. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. H T Atalay acknowledges Aksum University. M Ausloos and C Herteliu are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. P S Azzopardi was supported by an Australian National Health and Medical Research Council (NHMRC) early career fellowship. A Badawi is supported by the Public Health Agency of Canada. T W Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research; the EU; the Wellcome Trust; and from National Institute of Child Health and Human Development of National Institutes of Health (NIH; R01-HD084233), National Institute on Aging of NIH (P01-AG041710), National Institute of Allergy and Infectious Diseases of NIH (R01-AI124389 and R01-AI112339), as well as Fogarty International Center of NIH (D43-TW009775). G B Britton is supported by Sistema Nacional de Investigación (SNI) de la Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) of Panamá. A Barac is funded by the Project of Ministry of Education, Science and Technology of the Republic of Serbia (number III45005). D A Bennett was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the UK Department of Health and Social Care. V M Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/Ministério da Ciência, Tecnologia e Ensino Superior through national funds. K Deribe is supported by a Wellcome Trust grant (number 201900/Z/16/Z) as part of his International Intermediate Fellowship. C Herteliu is partially supported by a grant co-funded by European Fund for Regional Development through the Operational Program for Competitiveness (project ID P_40_382). P Hoogar thanks Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education, Manipal and Centre for Holistic Development and Research, Kalaghatgi-Karnataka. S M S Islam is funded by a Fellowship from National Heart Foundation of Australia and Deakin University. M Jakovljevic and the Serbian part of this GBD contribution was co-funded through grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. A P Kengne is supported by the South African Medical Research Council. Y J Kim's work was supported by the Research Management Centre, Xiamen University Malaysia, grants number XMUMRF/2018-C2/ITCM/0001. K Krishan is supported by a DST PURSE grant and UGC Center of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar acknowledges K43 TW010716-03. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence, Oxford. P T N Memiah acknowledges the Council for the Development of Social Science Research in Africa. M Molokhia is supported by the NIHR Biomedical Research Center at Guy's and St Thomas' National Health Service Foundation Trust and King's College London. I Moreno Velásquez is supported by the Sistema Nacional de Investigación (SENACYT, Panamá). G C Patton is funded by an NHMRC Fellowship. A M Samy received a fellowship from the Egyptian Fulbright Mission programme. M M Santric-Milicevic acknowledges the support of the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). A Sheikh acknowledges the support of Health Data Research UK. M R Sobhiyeh acknowledges the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences for their wise advice. R Tabarés-Seisdedos was supported in part by grant PI17/00719 from Instituto de Salud Carlos III–FEDER. B Unnikrishnan acknowledges Manipal Academy of Higher Education, Manipal. M R Weaver was supported by the Bill & Melinda Gates Foundation grant OPP1127433. C S Wiysonge was supported by the South African Medical Research Council.

Published
2020
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25. Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017

Author

Hassan Haghparast Bidgoli, Young Eun Kim, Duduzile Ndwandwe, Marilita M Moschos, Diego De Leo, Mark A. Stokes, Faris Lami, Lorenzo Monasta, Amit Arora, Hamid Asayesh, Dhirendra N Sinha, Ferrán Catalá-López, Ana Maria Nogales Vasconcelos, Swayam Prakash, Rafael Tabarés-Seisdedos, Melkamu Merid Mengesha, Yuichiro Yano, Olalekan A. Uthman, Amir Radfar, Manasi Kumar, Kamarul Imran Musa, Babak Moazen, Spencer L. James, Ahmad Daryani, Achala Upendra Jayatilleke, Siavash Rahimi, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Dan J. Stein, Kathryn H. Jacobsen, Jiabin Shen, Rajesh Kumar Rai, Ehimario U. Igumbor, Amir Kasaeian, Ali Kabir, Morteza Shamsizadeh, Ziad El-Khatib, Sharareh Eskandarieh, Sorin Hostiuc, Jarnail Singh Thakur, Takeshi Fukumoto, Shai Linn, João Pedro Silva, Olayinka Stephen Ilesanmi, Gizachew Assefa Tessema, Naohiro Yonemoto, Jacek Jerzy Jozwiak, Masood Ali Shaikh, Seyyed Meysam Mousavi, Syed Mohamed Aljunid, Azeem Majeed, Alexandra Brazinova, Nader Jahanmehr, Yuming Guo, Sonia Saxena, Juanita A. Haagsma, Devasahayam J. Christopher, Lorainne Tudor Car, Shamsa Zafar, Roghayeh Mohammadibakhsh, Khanh Bao Tran, Reza Malekzadeh, Martha Híjar, Addisu Melese, Tinuke O Olagunju, Guoqing Hu, Yousef Khader, Olatunde Aremu, Yahya Salimi, Corina Benjet, Seyed-Mohammad Fereshtehnejad, Julio Cesar Campuzano Rincon, Rizwan Kalani, Bach Xuan Tran, Serge Resnikoff, Félix Carvalho, Suzanne Barker-Collo, Basema Saddik, Abraham Getachew Kelbore, Chris D Castle, Andre Pascal Kengne, Joan B. Soriano, Aliasghar Ahmad Kiadaliri, Derrick A Bennett, Pedro R. Olivares, Ali Bijani, Shanshan Li, Srinivas Murthy, Dragos Virgil Davitoiu, Farid Najafi, Seyed Sina Naghibi Irvani, Maziar Moradi-Lakeh, Adauto Martins Soares Filho, Vasily Vlassov, Alessandra C. Goulart, Alireza Ahmadi, Theo Vos, Heather Orpana, Narayan Bahadur Mahotra, Dillon O Sylte, Tuomo J. Meretoja, Ireneous N. Soyiri, Susan M Sawyer, Nauman Khalid, Louisa Degenhardt, Kebede Embaye Gezae, Ubai Alsharif, Richard C. Franklin, Shane D. Morrison, Randah R. Hamadeh, G. K. Mini, Naznin Hossain, Zachary V Dingels, Kate Dolan, Florian Fischer, Atte Meretoja, Yasir Waheed, Milena M Santric Milicevic, Ai Koyanagi, Sadaf G. Sepanlou, Manisha Dubey, Michael Phillips, Koustuv Dalal, Maysaa El Sayed Zaki, Elena Varavikova, Rahul Gupta, Rajaa Al-Raddadi, Sergey Soshnikov, David Laith Rawaf, Zoubida Zaidi, David C. Schwebel, Hassan Magdy Abd El Razek, Jost B. Jonas, Flávia Ribeiro Machado, Yoshan Moodley, Stefania Mondello, Nicholas L S Roberts, N. Bedi, Amrit Banstola, Yong Zhao, Vladimir I. Starodubov, Beatriz Paulina Ayala Quintanilla, Juan Jesus Carrero, Manzoor Ahmad Malik, George C Patton, André Faro, In-Hwan Oh, Anwar Rafay, Simon I. Hay, Deborah Carvalho Malta, Erin B Hamilton, Man Mohan Mehndiratta, Suliman Alghnam, Olanrewaju Oladimeji, Sojib Bin Zaman, Ratilal Lalloo, Zichen Liu, Mahmood Moosazadeh, Isabela M. Benseñor, Muluken Azage Yenesew, Ivy Shiue, Hilton Lam, Soraya Seedat, Mete Saylan, Eduarda Fernandes, Khalid A Altirkawi, Chuanhua Yu, Jasvinder A. Singh, Pascual R. Valdez, Jan-Walter De Neve, Guilherme Borges, Seth Christopher Yaw Appiah, Linh Phuong Doan, Christopher S. Crowe, Andualem Henok, Carlos A Castañeda-Orjuela, Mina Anjomshoa, Bruno Ramos Nascimento, Paul S. F. Yip, Samath D Dharmaratne, Ayman Grada, Christian Lycke Ellingsen, Zulfiqar A Bhutta, Gurudatta Naik, Shahrzad Bazargan-Hejazi, Tomislav Mestrovic, Long Hoang Nguyen, Karen M. Tabb, Kebede Deribe, Mustafa Z. Younis, Yuan-Pang Wang, Van C. Lansingh, Felix Akpojene Ogbo, Mihajlo Jakovljevic, Till Bärnighausen, Naser Mohammad Gholi Mezerji, Kiana Ramezanzadeh, Muhammed Magdy Abd El Razek, Rasmus Havmoeller, Konrad Pesudovs, Salman Rawaf, Walter Mendoza, Smita Pakhale, Mahesh P A, Ted R. Miller, Rebecca Ivers, Gabrielle deVeber, Pallab K. Maulik, Ali H. Mokdad, Burcu Kucuk Bicer, Andre M. N. Renzaho, Muhammad Aziz Rahman, Fares Alahdab, Vafa Rahimi-Movaghar, Dipan Bose, Alireza Rafiei, Payman Salamati, Engida Yisma, Huong Lan Thi Nguyen, Juan Sanabria, Priyanka Yadav, Andrew T Olagunju, Ejaz Ahmad Khan, Irina Filip, Shahab Rezaeian, Ghobad Moradi, Mohammad Zamani, Rosario Cárdenas, Delia Hendrie, Yogesh Sabde, Marek Majdan, Mariam Molokhia, Adnan Kisa, Jacob E. Sunshine, Narayanaswamy Venketasubramanian, Mahdi Sharif-Alhoseini, Sanjay Zodpey, Ashish Awasthi, Rahman Shiri, Zahra Jorjoran Shushtari, Shivanthi Balalla, Samer Hamidi, Hailemariam Abiy Alemu Meheretu, Raimundas Lunevicius, Suzanne Polinder, Tomasz Miazgowski, Sheikh Mohammed Shariful Islam, Tim Driscoll, Son Hoang Nguyen, Mika Shigematsu, Bryan L. Sykes, Arash Tehrani-Banihashemi, Dina Nur Anggraini Ningrum, Josep Maria Haro, Leonardo Roever, Gholamreza Roshandel, Andrea Sylvia Winkler, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Luca Ronfani, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Jee-Young Jasmine Choi, Mohammad Ali Mansournia, Daniel Kim, Maheswar Satpathy, Ionut Negoi, Michael K. Hole, Miloud Taki Eddine Aichour, Erkin M. Mirrakhimov, Barthelemy Kuate Defo, Alan D. Lopez, Masoud Behzadifar, Rohan Borschmann, Ana-Laura Manda, Ione Jayce Ceola Schneider, Lydia R. Lucchesi, Trang Huyen Nguyen, Mu'awiyyah Babale Sufiyan, Janet L Leasher, Shafiu Mohammed, Lidia Morawska, Getenet Dessie, Reza Assadi, Tiffany K. Gill, Francesco Saverio Violante, Monika Sawhney, Enayatollah Homaie Rad, Yirga Legesse Nirayo, Muktar Beshir Ahmed, Oladimeji Adebayo, Mikk Jürisson, Soumyadeep Bhaumik, Hadi Hassankhani, Stanislav S. Otstavnov, Aziz Sheikh, Benjamin Uzochukwu, Aman Yesuf Endries, Eun-Kee Park, Jack T Fox, Abdallah M. Samy, Richard Ofori-Asenso, Ravi Prakash Jha, Inbal Salz, Benjamin B. Massenburg, Soufiane Boufous, Hamid Yimam Hassen, Pablo Montero-Zamora, Tissa Wijeratne, Abdullah T Khoja, Lidia Sanchez Riera, Vinay Nangia, Bill & Melinda Gates Foundation, Haagsma, Juanita A, James, Spencer L, Castle, Chris D, Dingels, Zachary V, Yisma, Engida, Vos, Theo, Haagsma J.A., James S.L., Castle C.D., Dingels Z.V., Fox J.T., Hamilton E.B., Liu Z., Lucchesi L.R., Roberts N.L.S., Sylte D.O., Adebayo O.M., Ahmadi A., Ahmed M.B., Aichour M.T.E., Alahdab F., Alghnam S.A., Aljunid S.M., Al-Raddadi R.M., Alsharif U., Altirkawi K., Anjomshoa M., Antonio C.A.T., Appiah S.C.Y., Aremu O., Arora A., Asayesh H., Assadi R., Awasthi A., Ayala Quintanilla B.P., Balalla S., Banstola A., Barker-Collo S.L., Barnighausen T.W., Bazargan-Hejazi S., Bedi N., Behzadifar M., Benjet C., Bennett D.A., Bensenor I.M., Bhaumik S., Bhutta Z.A., Bijani A., Borges G., Borschmann R., Bose D., Boufous S., Brazinova A., Campuzano Rincon J.C., Cardenas R., Carrero J.J., Carvalho F., Castaneda-Orjuela C.A., Catala-Lopez F., Choi J.-Y.J., Christopher D.J., Crowe C.S., Dalal K., Daryani A., Davitoiu D.V., Degenhardt L., De Leo D., De Neve J.-W., Deribe K., Dessie G.A., Deveber G.A., Dharmaratne S.D., Doan L.P., Dolan K.A., Driscoll T.R., Dubey M., El-Khatib Z., Ellingsen C.L., El Sayed Zaki M., Endries A.Y., Eskandarieh S., Faro A., Fereshtehnejad S.-M., Fernandes E., Filip I., Fischer F., Franklin R.C., Fukumoto T., Gezae K.E., Gill T.K., Goulart A.C., Grada A., Guo Y., Gupta R., Haghparast Bidgoli H., Haj-Mirzaian A., Hamadeh R.R., Hamidi S., Haro J.M., Hassankhani H., Hassen H.Y., Havmoeller R., Hendrie D., Henok A., Hijar M., Hole M.K., Homaie Rad E., Hossain N., Hostiuc S., Hu G., Igumbor E.U., Ilesanmi O.S., Irvani S.S.N., Islam S.M.S., Ivers R.Q., Jacobsen K.H., Jahanmehr N., Jakovljevic M., Jayatilleke A.U., Jha R.P., Jonas J.B., Jorjoran Shushtari Z., Jozwiak J.J., Jurisson M., Kabir A., Kalani R., Kasaeian A., Kelbore A.G., Kengne A.P., Khader Y.S., Khafaie M.A., Khalid N., Khan E.A., Khoja A.T., Kiadaliri A.A., Kim Y.-E., Kim D., Kisa A., Koyanagi A., Kuate Defo B., Kucuk Bicer B., Kumar M., Lalloo R., Lam H., Lami F.H., Lansingh V.C., Leasher J.L., Li S., Linn S., Lunevicius R., MacHado F.R., Magdy Abd El Razek H., Magdy Abd El Razek M., Mahotra N.B., Majdan M., Majeed A., Malekzadeh R., Malik M.A., Malta D.C., Manda A.-L., Mansournia M.A., Massenburg B.B., Maulik P.K., Meheretu H.A.A., Mehndiratta M.M., Melese A., Mendoza W., Mengesha M.M., Meretoja T.J., Meretoja A., Mestrovic T., Miazgowski T., Miller T.R., Mini G.K., Mirrakhimov E.M., Moazen B., Mohammad Gholi Mezerji N., Mohammadibakhsh R., Mohammed S., Molokhia M., Monasta L., Mondello S., Montero-Zamora P.A., Moodley Y., Moosazadeh M., Moradi G., Moradi-Lakeh M., Morawska L., Velasquez I.M., Morrison S.D., Moschos M.M., Mousavi S.M., Murthy S., Musa K.I., Naik G., Najafi F., Nangia V., Nascimento B.R., Ndwandwe D.E., Negoi I., Nguyen T.H., Nguyen S.H., Nguyen L.H., Nguyen H.L.T., Ningrum D.N.A., Nirayo Y.L., Ofori-Asenso R., Ogbo F.A., Oh I.-H., Oladimeji O., Olagunju A.T., Olagunju T.O., Olivares P.R., Orpana H.M., Otstavnov S.S., Mahesh P.A., Pakhale S., Park E.-K., Patton G.C., Pesudovs K., Phillips M.R., Polinder S., Prakash S., Radfar A., Rafay A., Rafiei A., Rahimi S., Rahimi-Movaghar V., Rahman M.A., Rai R.K., Ramezanzadeh K., Rawaf S., Rawaf D.L., Renzaho A.M.N., Resnikoff S., Rezaeian S., Roever L., Ronfani L., Roshandel G., Sabde Y.D., Saddik B., Salamati P., Salimi Y., Salz I., Samy A.M., Sanabria J., Sanchez Riera L., Santric Milicevic M.M., Satpathy M., Sawhney M., Sawyer S.M., Saxena S., Saylan M., Schneider I.J.C., Schwebel D.C., Seedat S., Sepanlou S.G., Shaikh M.A., Shams-Beyranvand M., Shamsizadeh M., Sharif-Alhoseini M., Sheikh A., Shen J., Shigematsu M., Shiri R., Shiue I., Silva J.P., Singh J.A., Sinha D.N., Soares Filho A.M., Soriano J.B., Soshnikov S., Soyiri I.N., Starodubov V.I., Stein D.J., Stokes M.A., Sufiyan M.B., Sunshine J.E., Sykes B.L., Tabares-Seisdedos R., Tabb K.M., Tehrani-Banihashemi A., Tessema G.A., Thakur J.S., Tran K.B., Tran B.X., Tudor Car L., Uthman O.A., Uzochukwu B.S.C., Valdez P.R., Varavikova E., Vasconcelos A.M.N., Venketasubramanian N., Violante F.S., Vlassov V., Waheed Y., Wang Y.-P., Wijeratne T., Winkler A.S., Yadav P., Yano Y., Yenesew M.A., Yip P., Yisma E., Yonemoto N., Younis M.Z., Yu C., Zafar S., Zaidi Z., Zaman S.B., Zamani M., Zhao Y., Zodpey S., Hay S.I., Lopez A.D., Mokdad A.H., Vos T., Public Health, HUS Comprehensive Cancer Center, Clinicum, Department of Surgery, University of Helsinki, Helsinki University Hospital Area, and HUS Neurocenter

Subjects
Epidemiology, burden of disease, descriptive epidemiology, epidemiology, ECONOMIC-DEVELOPMENT, 1106 Human Movement and Sports Sciences, Poison control, Global Health, Global Burden of Disease, 0302 clinical medicine, Quality-Adjusted Life Year, Global health, 030212 general & internal medicine, 10. No inequality, 1. No poverty, Burden of disease, DALYS, 3142 Public health care science, environmental and occupational health, ddc, 3. Good health, Descriptive epidemiology, Epidemiological transition, REGISTRATION, Disabled Person, Public Health, Human, medicine.medical_specialty, DEATHS, Adolescent, 1117 Public Health and Health Services, 03 medical and health sciences, Life Expectancy, Injury prevention, SYSTEMATIC ANALYSIS, medicine, Disability-adjusted life year, Disease burden, Estimation, burden of disease, descriptive epidemiology, epidemiology, MORTALITY, Public health, EPIDEMIOLOGIC TRANSITION, Public Health, Environmental and Occupational Health, 030208 emergency & critical care medicine, TRENDS, EXPECTANCY HALE, 1701 Psychology, Wounds and Injuries, Human medicine, Demography
Abstract

Incluye: Correction: Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017. Inj Prev. 2020 Oct;26(Supp 1):i164. doi: 10.1136/injuryprev-2019-043296corr1. Epub 2020 Sep 28. PMID: 32989004 Background: The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. Methods: Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. Results: For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. Conclusions: The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum. Funding for GBD 2017 was provided by the Bill and Melinda Gates Foundation. Sí

Published
2020
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26. Ambulance use is not associated with patient acuity after road traffic collisions: a cross-sectional study from Addis Ababa, Ethiopia

Author

Tolesa Dida, Engida Yisma, Yonas Abebe, David M. Silvestri, Abebe, Yonas, Dida, Tolesa, Yisma, Engida, and Silvestri, David M

Subjects
Male, Cross-sectional study, Ambulances, Triage acuity, 0302 clinical medicine, Pre-hospital, Medicine, 030212 general & internal medicine, Child, Referral and Consultation, Road traffic, lcsh:RC952-1245, Accidents, Traffic, Road traffic accident, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Middle Aged, Road traffic injury, trauma, Emergency Medicine, road traffic collisions, road traffic injury, Female, referral, Medical emergency, Referral, Emergency Service, Hospital, Research Article, Adult, Adolescent, Road traffic collisions, lcsh:Special situations and conditions, Trauma, Ambulance, triage acuity, Young Adult, 03 medical and health sciences, Humans, ambulance, Retrospective Studies, Emergency department triage, business.industry, road traffic accident, Patient Acuity, pre-hospital, 030208 emergency & critical care medicine, Retrospective cohort study, lcsh:RC86-88.9, medicine.disease, Triage, Cross-Sectional Studies, Africa, Referral center, Ethiopia, business
Abstract

Background Africa accounts for one sixth of global road traffic deaths—most in the pre-hospital setting. Ambulance transport is expensive relative to other modes of pre-hospital transport, but has advantages in time-sensitive, high-acuity scenarios. Many countries, including Ethiopia, are expanding ambulance fleets, but clinical characteristics of patients using ambulances remain ill-defined. Methods This is a cross-sectional study of 662 road traffic collisions (RTC) patients arriving to a single trauma referral center in Addis Ababa, Ethiopia, over 7 months. Emergency Department triage records were used to abstract clinical and arrival characteristics, including acuity. The outcome of interest was ambulance arrival. Secondary outcomes of interest were inter-facility referral and referral communication. Descriptive and multivariable statistics were computed to identify factors independently associated with outcomes. Results Over half of patients arrived with either high (13.1%) or moderate (42.2%) acuity. Over half (59.0%) arrived by ambulance, and nearly two thirds (65.9%) were referred. Among referred patients, inter-facility communication was poor (57.7%). Patients with high acuity were most likely to be referred (aOR 2.20, 95%CI 1.16–4.17), but were not more likely to receive ambulance transport (aOR 1.56, 95%CI 0.86–2.84) or inter-facility referral communication (aOR 0.98, 95%CI 0.49–1.94) than those with low acuity. Nearly half (40.2%) of all patients were referred by ambulance despite having low acuity. Conclusions Despite ambulance expansion in Addis Ababa, ambulance use among RTC patients remains heavily concentrated among those with low-acuity. Inter-facility referral appears a primary contributor to low-acuity ambulance use. In other contexts, similar routine ambulance monitoring may help identify low-value utilization. Regional guidelines may help direct ambulance use where most valuable, and warrant further evaluation. Electronic supplementary material The online version of this article (10.1186/s12873-018-0158-5) contains supplementary material, which is available to authorized users.

Published
2018
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27. Cesarean section in Ethiopia: prevalence and sociodemographic characteristics

Author

John Lynch, Lisa G. Smithers, Engida Yisma, Ben W.J. Mol, Yisma, Engida, Smithers, Lisa G, Lynch, John W, and Mol, Ben W

Subjects
Adult, Rural Population, Urban Population, genetic structures, prevalence, Health Services Accessibility, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, parasitic diseases, Humans, Medicine, Poisson Distribution, 030212 general & internal medicine, 030219 obstetrics & reproductive medicine, cesarean section, Cesarean Section, business.industry, Obstetrics and Gynecology, Middle Aged, Health Surveys, rate, Parity, Socioeconomic Factors, Section (archaeology), sociodemographic, Pediatrics, Perinatology and Child Health, Educational Status, population characteristics, Female, Ethiopia, Health Facilities, business, geographic locations, Demography
Abstract

Objective: The objective of this study was to assess the prevalence and sociodemographic characteristics of cesarean section in Ethiopia. Methods: We used data collected for Ethiopia Demographic and Health Surveys (DHS) conducted in 2000, 2005, 2011, and 2016. A two-stage, stratified, clustered random sampling design was used to gather information from women who gave birth within the 5-year period before each of the surveys. We analyzed the data to identify sociodemographic characteristics associated with cesarean section using log-Poisson regression models. Results: The national cesarean section rate increased from 0.7% in 2000 to 1.9% in 2016, with increases across seven of the eleven administrative regions of Ethiopia. Addis Ababa had the highest cesarean section rate (21.4%) in 2016 and the greatest increase since 2000. In the adjusted analysis, women who gave birth in private health facility had a 78.0% higher risk of cesarean section (adjusted prevalence ratio (aPR) (95% CI) 1.78 (1.22, 2.58)) compared with women who gave birth in public health facility. Having four or more births was associated with a lower risk of cesarean section compared with first births (aPR (95% CI) 0.36 (0.16, 0.79)). Conclusions: The Ethiopian national cesarean section rate is about 2%, but the rate varies widely among administrative regions, suggesting unequal access. Cesarean sections were highest among urban mothers, first births, births to women with higher education, and births to women from the richest quintile of household wealth. Refereed/Peer-reviewed

Published
2017
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28. OP101 The impact of caesarean section on breastfeeding indicators in sub-saharan africa: a meta-analysis of demographic and health surveys

Author

Lisa G. Smithers, Ben W.J. Mol, John Lynch, and Engida Yisma

Subjects
Sub saharan, biology, business.industry, medicine.medical_treatment, Confounding, Breastfeeding, biology.organism_classification, Random effects model, Early initiation, Tanzania, Meta-analysis, medicine, Caesarean section, business, Demography
Abstract

Background The association between caesarean section and breastfeeding is poorly understood in sub-Saharan Africa. We aimed to examine the impact of caesarean section on breastfeeding indicators—early initiation of breastfeeding, exclusive breastfeeding, and ever breastfeeding—in sub-Saharan Africa. Methods We used the most recent data from 32 Demographic and Health Surveys (DHS) completed in sub-Saharan Africa. We analysed the data to examine the impact of caesarean section on breastfeeding indicators using log-Poisson regression models for each country adjusted for potential confounders. For each breastfeeding indicator, the within-country adjusted prevalence ratios were pooled in random effects meta-analysis. Results The within-country adjusted analyses showed, compared with vaginal birth, caesarean section was associated with adjusted prevalence ratios (aPR) for early initiation of breastfeeding that ranged from 0·23 (95%CI, 0·16, 0·31) in Tanzania to 0·81 (95%CI, 0·64, 1·02) in Cameroon. Similarly, the aPR for exclusive breastfeeding ranged from 0·57 (95%CI; 0·33, 0·99) in Senegal to 1·60 (95%CI; 1·07, 2·39) in Mali, while the aPR for ever breastfeeding ranged from 0·90 (95%CI, 0·82, 0·99) in Liberia to 1·02 (95%CI, 0·98, 1·06) in Guinea. Meta-analysis combining the adjusted effects from 32 countries showed that caesarean section was associated with a 47% lower prevalence of early initiation of breastfeeding (pooled PR, 0·53 (95%CI, 0·48, 0·58)), but not with exclusive breastfeeding (pooled PR, 0·93 (95%CI; 0·86, 0·99)) nor ever breastfeeding (pooled PR, 0·98 (95%CI; 0·98, 0·99)). Conclusion Caesarean section had a negative influence on early initiation of breastfeeding, but showed little difference in exclusive- and ever-breastfeeding between infants born by caesarean versus vaginal birth in sub-Saharan Africa.

Published
2019
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29. Epidemiology of injuries from fire, heat and hot substances: global, regional and national morbidity and mortality estimates from the Global Burden of Disease 2017 study

Author

Molly R Nixon, Ejaz Ahmad Khan, David Laith Rawaf, Zoubida Zaidi, Koustuv Dalal, Irina Filip, Navid Manafi, Mohammad Zamani, Chris D Castle, Syed Amir Gilani, Erin B. Hamilton, Amir Radfar, Nicholas L S Roberts, Mostafa Dianati Nasab, Jagadish Rao Padubidri, Ahmad Daryani, Jennifer Rickard, Navid Rabiee, Amrit Banstola, Amin Soheili, Félix Carvalho, Juanita A. Haagsma, Mark A. Stokes, Catherine Bisignano, Gene Bukhman, Abdollah Mohammadian-Hafshejani, Zachary V Dingels, Florian Fischer, Muktar Beshir Ahmed, Salman Rawaf, Roya Safari-Faramani, Hamid Reza Tohidinik, Hoa Thi Do, Simon I. Hay, Pascual R. Valdez, Achala Upendra Jayatilleke, Shane D. Morrison, Payman Salamati, Christopher S. Crowe, Ted R. Miller, Andrew T Olagunju, Fares Alahdab, Ehimario U. Igumbor, Benjamin B. Massenburg, Alan D. Lopez, Zewudu Andualem, Eduarda Fernandes, Vafa Rahimi-Movaghar, Subramanian Senthilkumaran, Bach Xuan Tran, Ashish Badiye, Suzanne Polinder, Reza Malekzadeh, Tinuke O Olagunju, Carl Abelardo T. Antonio, Mika Shigematsu, Neeti Kapoor, Venkatesh Maled, Vahid Alipour, Sorin Hostiuc, Zhi-Jiang Zhang, Ritesh G. Menezes, Tissa Wijeratne, Ibrahim A Khalil, Cuong Tat Nguyen, Amir Kasaeian, Mohammad Rabiee, Jack T Fox, Srikanth Mangalam, Spencer L. James, Abdallah M. Samy, Dillon O Sylte, Till Bärnighausen, Ketema Bizuwork Gebremedhin, Huyen Phuc Do, Amaha Kahsay, Jalal Arabloo, Samer Hamidi, Takeshi Fukumoto, Olayinka Stephen Ilesanmi, Akbar Barzegar, Bartosz Miazgowski, Gebreamlak Gebremedhn Gebremeskel, Mowafa Househ, Maheswar Satpathy, Sadaf G. Sepanlou, Mohammed Madadin, Darrah McCracken, Ali Manafi, Aman Yesuf Endries, Ionut Negoi, Mohsen Bayati, Mojtaba Bagherzadeh, Reza Mohammadpourhodki, Seyed Sina Naghibi Irvani, Lydia R. Lucchesi, Trang Huyen Nguyen, Monika Sawhney, Soumyadeep Bhaumik, David C. Schwebel, Engida Yisma, Aziz Rezapour, Maryam Khazaee-Pool, Elias Merdassa Roro, Marek Majdan, Nathaniel J. Henry, Nobhojit Roy, Yoshihiro Kokubo, Ali H. Mokdad, Yousef Khader, Ali Bijani, Hagazi Gebre Meles, Alireza Ahmadi, Tuomo J. Meretoja, Son Hoang Nguyen, Public Health, James, Spencer L, Lucchesi, Lydia R, Bisignano, Catherine, Castle, Chris D, Yisma, Engida, Mokdad, Ali H, HUS Comprehensive Cancer Center, Clinicum, and University of Helsinki

Subjects
Hot Temperature, BURNS, Population, 1106 Human Movement and Sports Sciences, Poison control, burden of disease, Global Health, Occupational safety and health, 1117 Public Health and Health Services, Global Burden of Disease, 03 medical and health sciences, AGE, 0302 clinical medicine, MIDDLE-INCOME COUNTRIES, Environmental health, Injury prevention, SYSTEMATIC ANALYSIS, Global health, Prevalence, Medicine, burn, Humans, LIFE EXPECTANCY, 030212 general & internal medicine, education, POPULATION, Original Research, education.field_of_study, SEX-SPECIFIC MORTALITY, business.industry, DISABILITY, Incidence (epidemiology), Incidence, Public Health, Environmental and Occupational Health, 030208 emergency & critical care medicine, 3142 Public health care science, environmental and occupational health, 3. Good health, PART I, Years of potential life lost, 1701 Psychology, Life expectancy, Wounds and Injuries, TERRITORIES, Public Health, Quality-Adjusted Life Years, Morbidity, business, descriptive epidemiology
Abstract

BackgroundPast research has shown how fires, heat and hot substances are important causes of health loss globally. Detailed estimates of the morbidity and mortality from these injuries could help drive preventative measures and improved access to care.MethodsWe used the Global Burden of Disease 2017 framework to produce three main results. First, we produced results on incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years from 1990 to 2017 for 195 countries and territories. Second, we analysed these results to measure mortality-to-incidence ratios by location. Third, we reported the measures above in terms of the cause of fire, heat and hot substances and the types of bodily injuries that result.ResultsGlobally, there were 8 991 468 (7 481 218 to 10 740 897) new fire, heat and hot substance injuries in 2017 with 120 632 (101 630 to 129 383) deaths. At the global level, the age-standardised mortality caused by fire, heat and hot substances significantly declined from 1990 to 2017, but regionally there was variability in age-standardised incidence with some regions experiencing an increase (eg, Southern Latin America) and others experiencing a significant decrease (eg, High-income North America).ConclusionsThe incidence and mortality of injuries that result from fire, heat and hot substances affect every region of the world but are most concentrated in middle and lower income areas. More resources should be invested in measuring these injuries as well as in improving infrastructure, advancing safety measures and ensuring access to care.

Published
2019
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30. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Gregory A Roth, Degu Abate, Kalkidan Hassen Abate, Solomon M Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Haftom Temesgen Abebe, Molla Abebe, Zegeye Abebe, Ayenew Negesse Abejie, Semaw F Abera, Olifan Zewdie Abil, Haftom Niguse Abraha, Aklilu Roba Abrham, Laith Jamal Abu-Raddad, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Beyene Meressa Adhena, Mina G Adib, Amha Admasie, Ashkan Afshin, Gina Agarwal, Kareha M Agesa, Anurag Agrawal, Sutapa Agrawal, Alireza Ahmadi, Mehdi Ahmadi, Muktar Beshir Ahmed, Sayem Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Mohammad Esmaeil Akbari, Rufus Olusola Akinyemi, Nadia Akseer, Ziyad Al-Aly, Ayman Al-Eyadhy, Rajaa M Al-Raddadi, Fares Alahdab, Khurshid Alam, Tahiya Alam, Animut Alebel, Kefyalew Addis Alene, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'a Alkerwi, François Alla, Peter Allebeck, Jordi Alonso, Khalid Altirkawi, Nelson Alvis-Guzman, Azmeraw T Amare, Leopold N Aminde, Erfan Amini, Walid Ammar, Yaw Ampem Amoako, Nahla Hamed Anber, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Hossein Ansari, Mustafa Geleto Ansha, Carl Abelardo T Antonio, Palwasha Anwari, Olatunde Aremu, Johan Ärnlöv, Amit Arora, Monika Arora, Al Artaman, Krishna K Aryal, Hamid Asayesh, Ephrem Tsegay Asfaw, Zerihun Ataro, Suleman Atique, Sachin R Atre, Marcel Ausloos, Euripide F G A Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Yohanes Ayele, Rakesh Ayer, Peter S Azzopardi, Arefeh Babazadeh, Umar Bacha, Hamid Badali, Alaa Badawi, Ayele Geleto Bali, Katherine E Ballesteros, Maciej Banach, Kajori Banerjee, Marlena S Bannick, Joseph Adel Mattar Banoub, Miguel A Barboza, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Simon Barquera, Lope H Barrero, Quique Bassat, Sanjay Basu, Bernhard T Baune, Habtamu Wondifraw Baynes, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Yannick Béjot, Bayu Begashaw Bekele, Abate Bekele Belachew, Ezra Belay, Yihalem Abebe Belay, Michelle L Bell, Aminu K Bello, Derrick A Bennett, Isabela M Bensenor, Adam E Berman, Eduardo Bernabe, Robert S Bernstein, Gregory J Bertolacci, Mircea Beuran, Tina Beyranvand, Ashish Bhalla, Suraj Bhattarai, Soumyadeeep Bhaumik, Zulfiqar A Bhutta, Belete Biadgo, Molly H Biehl, Ali Bijani, Boris Bikbov, Ver Bilano, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Donal Bisanzio, Tuhin Biswas, Brigette F Blacker, Berrak Bora Basara, Rohan Borschmann, Cristina Bosetti, Kayvan Bozorgmehr, Oliver J Brady, Luisa C Brant, Carol Brayne, Alexandra Brazinova, Nicholas J K Breitborde, Hermann Brenner, Paul Svitil Briant, Gabrielle Britton, Traolach Brugha, Reinhard Busse, Zahid A Butt, Charlton S K H Callender, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Mate Car, Rosario Cárdenas, Giulia Carreras, Juan J Carrero, Austin Carter, Félix Carvalho, Carlos A Castañeda-Orjuela, Jacqueline Castillo Rivas, Chris D Castle, Clara Castro, Franz Castro, Ferrán Catalá-López, Ester Cerin, Yazan Chaiah, Jung-Chen Chang, Fiona J Charlson, Pankaj Chaturvedi, Peggy Pei-Chia Chiang, Odgerel Chimed-Ochir, Vesper Hichilombwe Chisumpa, Abdulaal Chitheer, Rajiv Chowdhury, Hanne Christensen, Devasahayam J Christopher, Sheng-Chia Chung, Flavia M Cicuttini, Liliana G Ciobanu, Massimo Cirillo, Aaron J Cohen, Leslie Trumbull Cooper, Paolo Angelo Cortesi, Monica Cortinovis, Ewerton Cousin, Benjamin C Cowie, Michael H Criqui, Elizabeth A Cromwell, Christopher Stephen Crowe, John A Crump, Matthew Cunningham, Alemneh Kabeta Daba, Abel Fekadu Dadi, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Paul I Dargan, Ahmad Daryani, Siddharth K Das, Rajat Das Gupta, José Das Neves, Tamirat Tesfaye Dasa, Aditya Prasad Dash, Adrian C Davis, Nicole Davis Weaver, Dragos Virgil Davitoiu, Kairat Davletov, Fernando Pio De La Hoz, Jan-Walter De Neve, Meaza Girma Degefa, Louisa Degenhardt, Tizta T Degfie, Selina Deiparine, Gebre Teklemariam Demoz, Balem Betsu Demtsu, Edgar Denova-Gutiérrez, Kebede Deribe, Nikolaos Dervenis, Don C Des Jarlais, Getenet Ayalew Dessie, Subhojit Dey, Samath D Dharmaratne, Daniel Dicker, Mesfin Tadese Dinberu, Eric L Ding, M Ashworth Dirac, Shirin Djalalinia, Klara Dokova, David Teye Doku, Christl A Donnelly, E Ray Dorsey, Pratik P Doshi, Dirk Douwes-Schultz, Kerrie E Doyle, Tim R Driscoll, Manisha Dubey, Eleonora Dubljanin, Eyasu Ejeta Duken, Bruce B Duncan, Andre R Duraes, Hedyeh Ebrahimi, Soheil Ebrahimpour, Dumessa Edessa, David Edvardsson, Anne Elise Eggen, Charbel El Bcheraoui, Maysaa El Sayed Zaki, Ziad El-Khatib, Hajer Elkout, Christian Lycke Ellingsen, Matthias Endres, Aman Yesuf Endries, Benjamin Er, Holly E Erskine, Babak Eshrati, Sharareh Eskandarieh, Reza Esmaeili, Alireza Esteghamati, Mahdi Fakhar, Hamed Fakhim, Mahbobeh Faramarzi, Mohammad Fareed, Farzaneh Farhadi, Carla Sofia E sá Farinha, Andre Faro, Maryam S Farvid, Farshad Farzadfar, Mohammad Hosein Farzaei, Valery L Feigin, Andrea B Feigl, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Joao C Fernandes, Alize J Ferrari, Garumma Tolu Feyissa, Irina Filip, Samuel Finegold, Florian Fischer, Christina Fitzmaurice, Nataliya A Foigt, Kyle J Foreman, Carla Fornari, Tahvi D Frank, Takeshi Fukumoto, John E Fuller, Nancy Fullman, Thomas Fürst, João M Furtado, Neal D Futran, Silvano Gallus, Alberto L Garcia-Basteiro, Miguel A Garcia-Gordillo, William M Gardner, Abadi Kahsu Gebre, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Bereket Gebremichael, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Johanna M Geleijnse, Ricard Genova-Maleras, Yilma Chisha Dea Geramo, Peter W Gething, Kebede Embaye Gezae, Mohammad Rasoul Ghadami, Reza Ghadimi, Khalil Ghasemi Falavarjani, Maryam Ghasemi-Kasman, Mamata Ghimire, Katherine B Gibney, Paramjit Singh Gill, Tiffany K Gill, Richard F Gillum, Ibrahim Abdelmageed Ginawi, Maurice Giroud, Giorgia Giussani, Shifalika Goenka, Ellen M Goldberg, Srinivas Goli, Hector Gómez-Dantés, Philimon N Gona, Sameer Vali Gopalani, Taren M Gorman, Atsushi Goto, Alessandra C Goulart, Elena V Gnedovskaya, Ayman Grada, Giuseppe Grosso, Harish Chander Gugnani, Andre Luiz Sena Guimaraes, Yuming Guo, Prakash C Gupta, Rahul Gupta, Rajeev Gupta, Tanush Gupta, Reyna Alma Gutiérrez, Bishal Gyawali, Juanita A Haagsma, Nima Hafezi-Nejad, Tekleberhan B Hagos, Tewodros Tesfa Hailegiyorgis, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Alexis J Handal, Graeme J Hankey, Hilda L Harb, Sivadasanpillai Harikrishnan, Josep Maria Haro, Mehedi Hasan, Hadi Hassankhani, Hamid Yimam Hassen, Rasmus Havmoeller, Roderick J Hay, Simon I Hay, Yihua He, Akbar Hedayatizadeh-Omran, Mohamed I Hegazy, Behzad Heibati, Mohsen Heidari, Delia Hendrie, Andualem Henok, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Pouria Heydarpour, Sousan Heydarpour, Desalegn Tsegaw Hibstu, Hans W Hoek, Michael K Hole, Enayatollah Homaie Rad, Praveen Hoogar, H Dean Hosgood, Seyed Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Peter J Hotez, Damian G Hoy, Thomas Hsiao, Guoqing Hu, John J Huang, Abdullatif Husseini, Mohammedaman Mama Hussen, Susan Hutfless, Bulat Idrisov, Olayinka Stephen Ilesanmi, Usman Iqbal, Seyed Sina Naghibi Irvani, Caleb Mackay Salpeter Irvine, Nazrul Islam, Sheikh Mohammed Shariful Islam, Farhad Islami, Kathryn H Jacobsen, Leila Jahangiry, Nader Jahanmehr, Sudhir Kumar Jain, Mihajlo Jakovljevic, Moti Tolera Jalu, Spencer L James, Mehdi Javanbakht, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Kathy J Jenkins, Ravi Prakash Jha, Vivekanand Jha, Catherine O Johnson, Sarah C Johnson, Jost B Jonas, Ankur Joshi, Jacek Jerzy Jozwiak, Suresh Banayya Jungari, Mikk Jürisson, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Rizwan Kalani, Manoochehr Karami, Behzad Karami Matin, André Karch, Corine Karema, Hamidreza Karimi-Sari, Amir Kasaeian, Dessalegn H Kassa, Getachew Mullu Kassa, Tesfaye Dessale Kassa, Nicholas J Kassebaum, Srinivasa Vittal Katikireddi, Anil Kaul, Zhila Kazemi, Ali Kazemi Karyani, Dhruv Satish Kazi, Adane Teshome Kefale, Peter Njenga Keiyoro, Grant Rodgers Kemp, Andre Pascal Kengne, Andre Keren, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Behzad Khafaei, Morteza Abdullatif Khafaie, Alireza Khajavi, Nauman Khalid, Ibrahim A Khalil, Ejaz Ahmad Khan, Muhammad Shahzeb Khan, Muhammad Ali Khan, Young-Ho Khang, Mona M Khater, Abdullah T Khoja, Ardeshir Khosravi, Mohammad Hossein Khosravi, Jagdish Khubchandani, Aliasghar A Kiadaliri, Getiye D Kibret, Zelalem Teklemariam Kidanemariam, Daniel N Kiirithio, Daniel Kim, Young-Eun Kim, Yun Jin Kim, Ruth W Kimokoti, Yohannes Kinfu, Adnan Kisa, Katarzyna Kissimova-Skarbek, Mika Kivimäki, Ann Kristin Skrindo Knudsen, Jonathan M Kocarnik, Sonali Kochhar, Yoshihiro Kokubo, Tufa Kolola, Jacek A Kopec, Parvaiz A Koul, Ai Koyanagi, Michael A Kravchenko, Kewal Krishan, Barthelemy Kuate Defo, Burcu Kucuk Bicer, G Anil Kumar, Manasi Kumar, Pushpendra Kumar, Michael J Kutz, Igor Kuzin, Hmwe Hmwe Kyu, Deepesh P Lad, Sheetal D Lad, Alessandra Lafranconi, Dharmesh Kumar Lal, Ratilal Lalloo, Tea Lallukka, Jennifer O Lam, Faris Hasan Lami, Van C Lansingh, Sonia Lansky, Heidi J Larson, Arman Latifi, Kathryn Mei-Ming Lau, Jeffrey V Lazarus, Georgy Lebedev, Paul H Lee, James Leigh, Mostafa Leili, Cheru Tesema Leshargie, Shanshan Li, Yichong Li, Juan Liang, Lee-Ling Lim, Stephen S Lim, Miteku Andualem Limenih, Shai Linn, Shiwei Liu, Yang Liu, Rakesh Lodha, Chris Lonsdale, Alan D Lopez, Stefan Lorkowski, Paulo A Lotufo, Rafael Lozano, Raimundas Lunevicius, Stefan Ma, Erlyn Rachelle King Macarayan, Mark T Mackay, Jennifer H MacLachlan, Emilie R Maddison, Fabiana Madotto, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Dhaval P Maghavani, Marek Majdan, Reza Majdzadeh, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Ana-Laura Manda, Luiz Garcia Mandarano-Filho, Helena Manguerra, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Dadi Marami, Joemer C Maravilla, Wagner Marcenes, Laurie Marczak, Ashley Marks, Guy B Marks, Gabriel Martinez, Francisco Rogerlândio Martins-Melo, Ira Martopullo, Winfried März, Melvin B Marzan, Joseph R Masci, Benjamin Ballard Massenburg, Manu Raj Mathur, Prashant Mathur, Richard Matzopoulos, Pallab K Maulik, Mohsen Mazidi, Colm McAlinden, John J McGrath, Martin McKee, Brian J McMahon, Suresh Mehata, Man Mohan Mehndiratta, Ravi Mehrotra, Kala M Mehta, Varshil Mehta, Tefera C Mekonnen, Addisu Melese, Mulugeta Melku, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Desalegn Tadese Mengistu, Getnet Mengistu, George A Mensah, Seid Tiku Mereta, Atte Meretoja, Tuomo J Meretoja, Tomislav Mestrovic, Haftay Berhane Mezgebe, Bartosz Miazgowski, Tomasz Miazgowski, Anoushka I Millear, Ted R Miller, Molly Katherine Miller-Petrie, G K Mini, Parvaneh Mirabi, Mojde Mirarefin, Andreea Mirica, Erkin M Mirrakhimov, Awoke Temesgen Misganaw, Habtamu Mitiku, Babak Moazen, Karzan Abdulmuhsin Mohammad, Moslem Mohammadi, Noushin Mohammadifard, Mohammed A Mohammed, Shafiu Mohammed, Viswanathan Mohan, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Ghobad Moradi, Maziar Moradi-Lakeh, Mehdi Moradinazar, Paula Moraga, Lidia Morawska, Ilais Moreno Velásquez, Joana Morgado-Da-Costa, Shane Douglas Morrison, Marilita M Moschos, Simin Mouodi, Seyyed Meysam Mousavi, Kindie Fentahun Muchie, Ulrich Otto Mueller, Satinath Mukhopadhyay, Kate Muller, John Everett Mumford, Jonah Musa, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Jean B Nachega, Gabriele Nagel, Aliya Naheed, Azin Nahvijou, Gurudatta Naik, Sanjeev Nair, Farid Najafi, Luigi Naldi, Hae Sung Nam, Vinay Nangia, Jobert Richie Nansseu, Bruno Ramos Nascimento, Gopalakrishnan Natarajan, Nahid Neamati, Ionut Negoi, Ruxandra Irina Negoi, Subas Neupane, Charles R J Newton, Frida N Ngalesoni, Josephine W Ngunjiri, Anh Quynh Nguyen, Grant Nguyen, Ha Thu Nguyen, Huong Thanh Nguyen, Long Hoang Nguyen, Minh Nguyen, Trang Huyen Nguyen, Emma Nichols, Dina Nur Anggraini Ningrum, Yirga Legesse Nirayo, Molly R Nixon, Nomonde Nolutshungu, Shuhei Nomura, Ole F Norheim, Mehdi Noroozi, Bo Norrving, Jean Jacques Noubiap, Hamid Reza Nouri, Malihe Nourollahpour Shiadeh, Mohammad Reza Nowroozi, Peter S Nyasulu, Christopher M Odell, Richard Ofori-Asenso, Felix Akpojene Ogbo, In-Hwan Oh, Olanrewaju Oladimeji, Andrew T Olagunju, Pedro R Olivares, Helen Elizabeth Olsen, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Kanyin L Ong, Sok King Sk Ong, Eyal Oren, Heather M Orpana, Alberto Ortiz, Justin R Ortiz, Stanislav S Otstavnov, Simon Øverland, Mayowa Ojo Owolabi, Raziye Özdemir, Mahesh P A, Rosana Pacella, Smita Pakhale, Abhijit P Pakhare, Amir H Pakpour, Adrian Pana, Songhomitra Panda-Jonas, Jeyaraj Durai Pandian, Andrea Parisi, Eun-Kee Park, Charles D H Parry, Hadi Parsian, Shanti Patel, Sanghamitra Pati, George C Patton, Vishnupriya Rao Paturi, Katherine R Paulson, Alexandre Pereira, David M Pereira, Norberto Perico, Konrad Pesudovs, Max Petzold, Michael R Phillips, Frédéric B Piel, David M Pigott, Julian David Pillay, Meghdad Pirsaheb, Farhad Pishgar, Suzanne Polinder, Maarten J Postma, Akram Pourshams, Hossein Poustchi, Ashwini Pujar, Swayam Prakash, Narayan Prasad, Caroline A Purcell, Mostafa Qorbani, Hedley Quintana, D Alex Quistberg, Kirankumar Waman Rade, Amir Radfar, Anwar Rafay, Alireza Rafiei, Fakher Rahim, Kazem Rahimi, Afarin Rahimi-Movaghar, Mahfuzar Rahman, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Rajesh Kumar Rai, Sasa Rajsic, Usha Ram, Chhabi Lal Ranabhat, Prabhat Ranjan, Puja C Rao, David Laith Rawaf, Salman Rawaf, Christian Razo-García, K Srinath Reddy, Robert C Reiner, Marissa B Reitsma, Giuseppe Remuzzi, Andre M N Renzaho, Serge Resnikoff, Satar Rezaei, Shahab Rezaeian, Mohammad Sadegh Rezai, Seyed Mohammad Riahi, Antonio Luiz P Ribeiro, Maria Jesus Rios-Blancas, Kedir Teji Roba, Nicholas L S Roberts, Stephen R Robinson, Leonardo Roever, Luca Ronfani, Gholamreza Roshandel, Ali Rostami, Dietrich Rothenbacher, Ambuj Roy, Enrico Rubagotti, Perminder S Sachdev, Basema Saddik, Ehsan Sadeghi, Hosein Safari, Mahdi Safdarian, Sare Safi, Saeid Safiri, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, Nasir Salam, Joseph S Salama, Payman Salamati, Raphael De Freitas Saldanha, Zikria Saleem, Yahya Salimi, Sundeep Santosh Salvi, Inbal Salz, Evanson Zondani Sambala, Abdallah M Samy, Juan Sanabria, Maria Dolores Sanchez-Niño, Damian Francesco Santomauro, Itamar S Santos, João Vasco Santos, Milena M Santric Milicevic, Bruno Piassi Sao Jose, Abdur Razzaque Sarker, Rodrigo Sarmiento-Suárez, Nizal Sarrafzadegan, Benn Sartorius, Shahabeddin Sarvi, Brijesh Sathian, Maheswar Satpathy, Arundhati R Sawant, Monika Sawhney, Sonia Saxena, Mehdi Sayyah, Elke Schaeffner, Maria Inês Schmidt, Ione J C Schneider, Ben Schöttker, Aletta Elisabeth Schutte, David C Schwebel, Falk Schwendicke, James G Scott, Mario Sekerija, Sadaf G Sepanlou, Edson Serván-Mori, Seyedmojtaba Seyedmousavi, Hosein Shabaninejad, Katya Anne Shackelford, Azadeh Shafieesabet, Mehdi Shahbazi, Amira A Shaheen, Masood Ali Shaikh, Mehran Shams-Beyranvand, Mohammadbagher Shamsi, Morteza Shamsizadeh, Kiomars Sharafi, Mehdi Sharif, Mahdi Sharif-Alhoseini, Rajesh Sharma, Jun She, Aziz Sheikh, Peilin Shi, Mekonnen Sisay Shiferaw, Mika Shigematsu, Rahman Shiri, Reza Shirkoohi, Ivy Shiue, Farhad Shokraneh, Mark G Shrime, Si Si, Soraya Siabani, Tariq J Siddiqi, Inga Dora Sigfusdottir, Rannveig Sigurvinsdottir, Donald H Silberberg, Diego Augusto Santos Silva, João Pedro Silva, Natacha Torres Da Silva, Dayane Gabriele Alves Silveira, Jasvinder A Singh, Narinder Pal Singh, Prashant Kumar Singh, Virendra Singh, Dhirendra Narain Sinha, Karen Sliwa, Mari Smith, Badr Hasan Sobaih, Soheila Sobhani, Eugène Sobngwi, Samir S Soneji, Moslem Soofi, Reed J D Sorensen, Joan B Soriano, Ireneous N Soyiri, Luciano A Sposato, Chandrashekhar T Sreeramareddy, Vinay Srinivasan, Jeffrey D Stanaway, Vladimir I Starodubov, Vasiliki Stathopoulou, Dan J Stein, Caitlyn Steiner, Leo G Stewart, Mark A Stokes, Michelle L Subart, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Patrick John Sur, Ipsita Sutradhar, Bryan L Sykes, P N Sylaja, Dillon O Sylte, Cassandra E I Szoeke, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Santosh Kumar Tadakamadla, Ken Takahashi, Nikhil Tandon, Segen Gebremeskel Tassew, Nuno Taveira, Arash Tehrani-Banihashemi, Tigist Gashaw Tekalign, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Omar Temsah, Abdullah Sulieman Terkawi, Manaye Yihune Teshale, Belay Tessema, Gizachew Assefa Tessema, Kavumpurathu Raman Thankappan, Sathish Thirunavukkarasu, Nihal Thomas, Amanda G Thrift, George D Thurston, Binyam Tilahun, Quyen G To, Ruoyan Tobe-Gai, Marcello Tonelli, Roman Topor-Madry, Anna E Torre, Miguel Tortajada-Girbés, Mathilde Touvier, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Khanh Bao Tran, Suryakant Tripathi, Christopher E Troeger, Thomas Clement Truelsen, Nu Thi Truong, Afewerki Gebremeskel Tsadik, Derrick Tsoi, Lorainne Tudor Car, E Murat Tuzcu, Stefanos Tyrovolas, Kingsley N Ukwaja, Irfan Ullah, Eduardo A Undurraga, Rachel L Updike, Muhammad Shariq Usman, Olalekan A Uthman, Selen Begüm Uzun, Muthiah Vaduganathan, Afsane Vaezi, Gaurang Vaidya, Pascual R Valdez, Elena Varavikova, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Santos Villafaina, Francesco S Violante, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Stein Emil Vollset, Theo Vos, Gregory R Wagner, Fasil Shiferaw Wagnew, Yasir Waheed, Mitchell Taylor Wallin, Judd L Walson, Yanping Wang, Yuan-Pang Wang, Molla Mesele Wassie, Elisabete Weiderpass, Robert G Weintraub, Fitsum Weldegebreal, Kidu Gidey Weldegwergs, Andrea Werdecker, Adhena Ayaliew Werkneh, T Eoin West, Ronny Westerman, Harvey A Whiteford, Justyna Widecka, Lauren B Wilner, Shadrach Wilson, Andrea Sylvia Winkler, Charles Shey Wiysonge, Charles D A Wolfe, Shouling Wu, Yun-Chun Wu, Grant M A Wyper, Denis Xavier, Gelin Xu, Simon Yadgir, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Bereket Yakob, Lijing L Yan, Yuichiro Yano, Mehdi Yaseri, Yasin Jemal Yasin, Gökalp Kadri Yentür, Alex Yeshaneh, Ebrahim M Yimer, Paul Yip, Biruck Desalegn Yirsaw, Engida Yisma, Naohiro Yonemoto, Gerald Yonga, Seok-Jun Yoon, Marcel Yotebieng, Mustafa Z Younis, Mahmoud Yousefifard, Chuanhua Yu, Vesna Zadnik, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Zohreh Zare, Ayalew Jejaw Zeleke, Zerihun Menlkalew Zenebe, Anthony Lin Zhang, Kai Zhang, Maigeng Zhou, Sanjay Zodpey, Liesl Joanna Zuhlke, Mohsen Naghavi, and Christopher J L Murray., Rubagotti, Enrico, Abay, Solomon M., Roth, Gregory, Abd Allah, Foad, Abdela, Jemal, Abbastabar, Hedayat, and Abbasi, Nooshin

Subjects
Overview, Disease, Territory, Causes of death, humanities
Abstract

Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. The Lancet Publishing Group

Published
2019

31. Factors associated with acceptance of provider-initiated HIV testing and counseling among pregnant women in Ethiopia

Author

Engida Yisma, Xiaoxia Zhang, Chulei Tang, Bingjie Tian, Honghong Wang, Ketema Bizuwork Gebremedhin, Gebremedhin, Ketema Bizuwork, Tian, Bingjie, Tang, Chulei, Zhang, Xiaoxia, Yisma, Engida, and Wang, Honghong

Subjects
medicine.medical_specialty, 030231 tropical medicine, Human immunodeficiency virus (HIV), Medicine (miscellaneous), Hiv testing, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, medicine, Effective treatment, provider initiated HIV testing and counseling (PITC), 030212 general & internal medicine, Pharmacology, Toxicology and Pharmaceutics (miscellaneous), Original Research, Intervention program, Transmission (medicine), business.industry, Health Policy, HIV, Odds ratio, pregnant woman, Patient Preference and Adherence, Family medicine, Structured interview, Ethiopia, business, Social Sciences (miscellaneous)
Abstract

Ketema Bizuwork Gebremedhin,1 Bingjie Tian,2 Chulei Tang,3 Xiaoxia Zhang,3 Engida Yisma,1,4 Honghong Wang3 1Department of Nursing and Midwifery, School of Allied Health Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of General Surgery, Affiliated Huashan Hospital of Fudan University, Shanghai, China; 3Department of Fundamental Nursing, Xiangya School of Nursing, Central South University, Changsha, China; 4School of Medicine, Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia Introduction: The global human immunodeficiency virus (HIV) epidemic disproportionately affects sub-Saharan African countries, including Ethiopia. Provider-initiated HIV testing and counseling (PITC) is a tool to identify HIV-positive pregnant women and an effective treatment and prevention strategy. However, its success depends upon the willingness of pregnant women to accept HIV testing.Objectives: To describe the level of acceptance of PITC and associated factors among pregnant women attending 8 antenatal care clinics in Adama, Ethiopia.Methods: Trained nursing students and employees from an HIV clinic conducted face-to-face structured interviews in private offices at the clinics from August to September, 2016.Results: Among the 441 respondents, 309 (70.1%) accepted PITC. Women with more antenatal care visits (odds ratio [OR] =2.59, 95% CI: 1.01–6.63), reported better quality of the PITC service (OR =1.91, 95% CI: 1.19–3.08), and higher level of knowledge on mother-to-child transmission (OR =1.82, 95% CI: 1.03–3.20), were more likely to accept PITC, while women who were older in age (OR =0.37, 95% CI: 0.19–0.74) and perceived negative attitudes from their partners toward HIV-positive results (OR =0.31, 95% CI: 0.10–0.94) were less likely to accept the PITC service.Conclusion: About one-third of pregnant women are not willing to accept PITC. When designing intervention program to improve the acceptance of PITC, we should take into consideration the personal factors, HIV-related knowledge, and attitude of women as well as institutional factors. Keywords: pregnant woman, HIV, provider initiated HIV testing and counseling (PITC), Ethiopia

Published
2018

32. Initiation of breastfeeding within one hour of birth among mothers with infants younger than or equal to 6 months of age attending public health institutions in Addis Ababa, Ethiopia

Author

Aster Berhe, Engida Yisma, Meseret Ekubay, Ekubay, Meseret, Berhe, Aster, and Yisma, Engida

Subjects
0301 basic medicine, medicine.medical_specialty, Psychological intervention, Breastfeeding, Breast milk, Public health institution, 03 medical and health sciences, 0302 clinical medicine, Health care, medicine, 030212 general & internal medicine, Initiation of breastfeeding, initiation of breastfeeding, Pregnancy, 030109 nutrition & dietetics, Obstetrics, business.industry, Research, lcsh:Public aspects of medicine, Public health, lcsh:RJ1-570, Obstetrics and Gynecology, lcsh:Pediatrics, lcsh:RA1-1270, Odds ratio, medicine.disease, public health institution, Pediatrics, Perinatology and Child Health, Addis Ababa, Ethiopia, business, Breast feeding
Abstract

Background: Breast milk is comprised of the essential nutrients that an infant needs in the first six months of life. Timely initiation of breastfeeding guarantees that infants receive the colostrum, 'the first breastmilk', which contains antibodies that protect the newborn against diseases. Breastfeeding within the first hour of life prevents newborn death due to sepsis, pneumonia, diarrhea and hypothermia. Although breastfeeding is a common practice in sub-Saharan Africa, evidence show that early initiation of breastfeeding is low. Methods: We conducted a cross-sectional study of 583 mothers with infants younger than or equal to 6 months of age attending Maternal and Child Health (MCH) clinics of public health institutions in Addis Ababa, Ethiopia from April to May 2012. A simple random sampling design was used to select the institutions included in this study. Data from mothers of infants were collected using interviewer-administered questionnaire. We analyzed the data to examine factors associated with initiation of breastfeeding within one hour of birth using logistic regression models. Results: Of 564 (96.7%, 564/583) mothers who breastfed their infants, 58.3% (329/564) initiated breastfeeding within one hour of birth. In the adjusted analysis, mothers who had three or more infants had about twice higher odds of timely initiation of breastfeeding within one hour of birth (Adjusted Odds Ratio [aOR] 2.10; 95% Confidence Interval [CI]1.04, 4.30) compared with mothers who had one infant. Furthermore, women who started antenatal care at their fourth month of pregnancy or later had a 49.0% higher odds of initiation of breastfeeding within one hour of birth (aOR 1.49; 95% CI 1.01, 2.19) compared to mothers who started antenatal care before their fourth month of pregnancy. Conclusions: Initiation of breastfeeding within one hour of birth was low. Initiation of breastfeeding within one hour of birth was highest among multiparous women, mothers aged 30-34 years, and women who began antenatal care at their fourth month of pregnancy or later. Public health officials and health care providers should consider interventions to promote and support early initiation of breastfeeding. Refereed/Peer-reviewed

Published
2018
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34. Knowledge, Attitude, Practice and Associated Factors towards Voluntary Blood Donation among Regular Health Science Students of Samara University, Ethiopia

Author

Mesfin Wudu, Misgan Legesse Liben, Engida Yisma, Yohannes Ayalew, and Woldemichael Tadesse

Subjects
business.industry, Developing country, Bivariate analysis, Odds ratio, Simple random sample, Logistic regression, Stratified sampling, Odds, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Medicine, 030212 general & internal medicine, business, Curriculum, General Nursing, Demography
Abstract

Background: In spite of, extensive efforts and a number of blood donation programs being organized worldwide, availability of adequate and safe blood still remains short to meet the increased demand in developing countries including Ethiopian. The major challenge was recruitment of voluntary, non-remunerated blood donors. Literatures identified that many factors are responsible such as, lack of knowledge, negative attitudes, and inconvenience for facilities. Increase level of knowledge and positive attitude towards voluntary blood donation in young people is highest priority. Methods: Institutional based cross-sectional quantitative study was used to assess KAP and associated factors towards voluntary blood donation (VBD) among health science students of Samara University, Afar Northeast Ethiopia, using pre-tested structured self-administered questionnaire. Stratified sampling method was used and individual was selected by simple random sampling method. Data was analyzed by SPSS version 20.0. Logistic regression analysis was used to identify associated factors. Predictor variables with p-values up to 0.25 in bivariate regression were entered to multivariate regression and p-value

Published
2018
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37. Menopause: a contextualized experience across social structures

Author

Engida Yisma, Stephanie Ly, Yisma, Engida, and Ly, Stephanie

Subjects
Biopsychosocial model, media_common.quotation_subject, menopause, medicine.disease, Femininity, Middle age, Developmental psychology, Menopause, Menstruation, life course perspective, Transgender hormone therapy, biopsychosocial model, sociocultural, medicine, Life course approach, Sociology, history, Psychosocial, media_common, biomedical model
Abstract

Menopause is a phenomenon experienced by women as they approach middle age, marking the end of menstruation and reproduction. Throughout history, menopause has been classified in negative terms as a malady and decay of femininity necessitating a cure, which led to the controversial development of hormone replacement therapy. Feminists and activists challenged existing stereotypes and emphasized menopause as a natural transition. There is still little consensus on universal menopause symptoms since wide variations are reported across geographic regions and cultures. These differences can be better examined via individual menopausal experiences, which are unique and shaped by attitudes and expectations. Macro-level structures often place psychosocial constraints on individual women imposing roles after menopause or creating expectations of common symptoms. This chapter applies three theoretical frameworks to the menopausal experience. The biomedical model portrays menopause as a result of biological pathways with clear diagnoses of menopausal stages and is widely used by physicians. The life course perspective views menopause as a lifelong process that is shaped by the current time period with early life advantages or disadvantages that affect women as they enter their menopausal years. The biopsychosocial model integrates women's experiences of menopause into a hierarchy of structures. Each woman is shaped by microlevel factors like genetics and body functions while also influenced by macro-level structures within her family or society. As the number of women experiencing menopause rises with emerging demographic shifts, special consideration to individual and global experiences of menopause should be integrated to advance well-being.

Published
2017

38. Additional file 1: of Prevalence and severity of menopause symptoms among perimenopausal and postmenopausal women aged 30-49Â years in Gulele sub-city of Addis Ababa, Ethiopia

Author

Engida Yisma, Natnael Eshetu, Ly, Stephanie, and Berhanu Dessalegn

Abstract

The study questionnaire in both English and Amharic languages. It consists of comprehensive information regarding the participantsâ socio-demographic characteristics, menopausal status, menopause knowledge and attitude, and an 11-item Menopause Rating Scale. (PDF 365Â kb)

Published
2017
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39. Subchronic oral administration of crude khat extract (Catha edulis forsk) induces schizophernic [sic]-like symptoms in mice

Author

Epherm Engidawork, Engida Yisma, Tegegne Bogale, Bogale, Tegegne, Engidawork, Epherm, and Yisma, Engida

Subjects
0301 basic medicine, mice, Catha edulis forsk, Administration, Oral, Physiology, Negative control, Catha, Pharmacology, Locomotor activity, Mice, 03 medical and health sciences, subchronic administration, Cognition, 0302 clinical medicine, Memory task, Oral administration, Khat, Crude khat extract, medicine, Schizophernia, Animals, Ketamine, schizophernia, Social Behavior, Adverse effect, Dose-Response Relationship, Drug, biology, Plant Extracts, business.industry, General Medicine, biology.organism_classification, crude khat extract, 030104 developmental biology, Complementary and alternative medicine, Schizophrenia, Subchronic administration, business, Time score, Locomotion, 030217 neurology & neurosurgery, Research Article, medicine.drug
Abstract

Background: Chewing fresh leaves of the khat plant (Catha edulis forsk) is a deep rooted and widespread habit in East Africa and the Middle East. Although a body of knowledge exists about the adverse effects of khat on health, data are sparse with regard to the consequences of long-term khat chewing in resulting schizophrenic like symptoms. Methods: A crude extract of khat at different doses (100 mg/kg (K (khat)100), 200 mg/kg (K200) and 400 mg/kg (K400)) were administered for experimental group of mice whereas standard (ketamine (KT) 10 mg/kg- positive controls (KT10)) and vehicle (2 % v/v Tween-80 in distilled water - negative control groups (CON)) were administered for control groups of mice daily for two months to evaluate subchronic oral administration of crude khat extract to induce schizophrenic-like symptoms in mice. Mice were subjected to a battery of behavioural tests and parameters like locomotor activity, total time spent in social interaction and level of cognition among different groups of mice were measured and analyzed. Results: Khat at all doses significantly increased (p < 0.001) the mean locomotor activity score of mice compared to CON. However, the mean locomotor activity score of mice treated with khat was significantly lower (p < 0.001) compared to the mean locomotor activity score of KT10 mice (p < 0.001). The mean total time score (in seconds) spent in social interaction, mean total time score (in seconds) spent in sniffing and following the partner was significantly higher (p < 0.001) in CON groups of mice compared to khat and ketamine treated groups. Moreover, in spatial memory task, the mean latency score (in seconds) to find the platform of khat and ketamine treated mice was significantly higher (p < 0.05) when compared to CON. Conclusions: Subchronic oral administration of khat showed an enhanced locomotor activity, reduced social interaction and impaired cognitive function, which demonstrated that long-term use of khat is associated with schizophernic-like symptoms. Refereed/Peer-reviewed

Published
2016

40. Department of Error

Author

Maziar Moradi-Lakeh, Krishna K. Aryal, Mohamad-Hani Temsah, Ahmad Daryani, Claudio Alberto Davila, Achala Upendra Jayatilleke, David L. Smith, Chinwe Juliana Iwu, Kavumpurathu Raman Thankappan, Ibrahim Abdollahpour, Mehdi Fazlzadeh, Robert C. Reiner, Bineyam Taye, Dadi Marami, Ghulam Mustafa, Manasi Kumar, Mostafa Leili, Mehdi Sharif, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Oluchi Okpala, Shivakumar K.M. Kondlahalli, Nihal Thomas, Man Mohan Mehndiratta, Ebrahim Babaee, Tsegaye Lolaso Lenjebo, Miliva Mozaffor, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Carlos Miguel Rios González, Pallab K. Maulik, Ali H. Mokdad, Mehran Alijanzadeh, Florian Fischer, Lalit Dandona, Aso Mohammad Darwesh, Alemayehu Toma Mena, Jennifer Rickard, Benjamin K. Mayala, Seyed Mostafa Mir, Moslem Soofi, Bhaskaran Unnikrishnan, Boris Bikbov, Bereket Duko Adema, Jagdish Khubchandani, Sachin R Atre, Rafael Moreira Claro, Sandra B. Munro, Carlos Zambrana-Torrelio, Kassawmar Angaw Bogale, Soraya Siabani, Muluken Azage Yenesew, Birhan Tamene Alemnew, Anwar E. Ahmed, Morteza Shamsizadeh, Masresha Tessema Anegago, Muluken Bekele Sorrie, Vivekanand Jha, Gebrekiros Gebremichael Meles, Andre M. N. Renzaho, Muhammad Aziz Rahman, Hebat Allah Salah A. Yousof, Naohiro Yonemoto, Ahmad Ghashghaee, Kebede Embaye Gezae, Hadi Pourjafar, Junaid Khan, Farnam Mohebi, Marcel Ausloos, Manisha Dubey, Quynh Anh P. Nguyen, Assefa Desalew, Vera Marisa Costa, Mohammad Fareed, Ronny Westerman, Maciej Banach, Paul S. F. Yip, Kala M. Mehta, Mehdi Yaseri, Quique Bassat, Amir Almasi-Hashiani, Fatemeh Rajati, Irina Filip, Gelin Xu, Derrick A Bennett, Atalay Goshu Muluneh, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Fariba Ghassemi, Behzad Karami Matin, David C. Schwebel, Syed Ather Hussain, Milena Ilic, Xiu Ju Zhao, Jost B. Jonas, Dian Kusuma, Martin Amogre Ayanore, Mostafa Hosseini, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Santosh Varughese, Cuong Tat Nguyen, Chalachew Genet Akal, Chabila C Mapoma, Aubrey J. Levine, Jacqueline Elizabeth Alcalde Rabanal, Hesham M. Al-Mekhlafi, Rufus A. Adedoyin, Gudlavalleti Vs Murthy, Amir Khater, Olufemi Ajumobi, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Lorenzo Monasta, Mohammad Hossein Khosravi, Rizwan Suliankatchi Abdulkader, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Dhirendra N Sinha, Shai Linn, Fisaha Haile Tesfay, Abdullah Al Mamun, Yoshan Moodley, Amjad Mohamadi-Bolbanabad, Hajer Elkout, Mohammad Zamani, Yousef Mohammad, Yousef Veisani, Iman El Sayed, Asmamaw Bizuneh Demis, Alex Yeshaneh, Sharath Burugina Nagaraja, Segun Emmanuel Ibitoye, Charles Shey Wiysonge, Pushpendra Kumar, Engida Yisma, Maysaa El Sayed Zaki, Kebede Deribe, Ali Akbar Fazaeli, Moritz U. G. Kraemer, Ayele Geleto Bali, Platon D. Lopukhov, Paula Moraga, Giovanni Damiani, Alebachew Fasil Ashagre, Hossein Farzam, Amir Kasaeian, Taye Abuhay Zewale, Ben Lacey, Mika Shigematsu, Bryan L. Sykes, Abdur Razzaque Sarker, Ali Kabir, Lal B. Rawal, Juan Sanabria, Ehsan Khodamoradi, Saeed Amini, Hasan Yusefzadeh, Josephine W. Ngunjiri, Aberash Abay Tassew, Sezer Kisa, Biruck Desalegn Yirsaw, Hosni Salem, Ayman Grada, Jean Jacques Noubiap, Mina Anjomshoa, Gebre Teklemariam Demoz, Sharareh Eskandarieh, Maryam Adabi, Nuworza Kugbey, Rahman Shiri, Melkamu Merid Mengesha, Zemenu Tadesse Tessema, Amir Radfar, Girmay Teklay Weldesamuel, Sahel Valadan Tahbaz, Nader Jahanmehr, Yuming Guo, Roghiyeh Faridnia, Mehdi Naderi, Ziad A. Memish, Adnan Kisa, Gbenga A. Kayode, Yafeng Wang, Ehsan Sadeghi, Behnam Heidari, Apurba Shil, Kamarul Imran Musa, Jagadish Rao Padubidri, Farshad Pourmalek, Saravanan Muthupandian, Navid Rabiee, Mario Poljak, Nima Hafezi-Nejad, Hagos Degefa Hidru, Jemal Abdu Mohammed, MohammadBagher Shamsi, Mohsen Asadi-Lari, Sameh Magdeldin, Berhe Etsay Tesfay, Khanh Bao Tran, James A Platts-Mills, Jan-Walter De Neve, Maria Jesus Rios-Blancas, Hedley Quintana, Félix Carvalho, Yun Jin Kim, Eric L. Ding, Noushin Mohammadifard, Saeed Safari, Addisu Melese, Rakesh Lodha, Reza Shirkoohi, Itamar S. Santos, Alireza Khatony, Mohammad Khazaei, Mekdes Tigistu Yilma, Taweewat Wiangkham, Hamed Kalani, Mayowa O. Owolabi, Mohammad Reza Sobhiyeh, Frank B. Osei, Narayan Bahadur Mahotra, Zewdie Aderaw Alemu, Konrad Pesudovs, Kewal Krishan, Samath D Dharmaratne, Ayalew Jejaw Zeleke, Osayomwanbo Osarenotor, Tina Beyranvand, Yahya Salimi, Winfried März, Sheikh Mohammed Shariful Islam, Azmeraw T. Amare, Julio Cesar Campuzano Rincon, Maha El Tantawi, Anusha Ganapati Bhat, Susanna Dunachie, Shymaa Enany, Anelisa Jaca, Desalegn Tadese Mengistu, Salvatore Rubino, Nelson J. Alvis-Zakzuk, Indang Trihandini, Bartosz Miazgowski, Huda Basaleem, Zahid A Butt, Vijay Kumar Chattu, Navid Manafi, Si Si, Joan B. Soriano, Victor Adekanmbi, Andrea Farioli, Masoud Moradi, Joseph Frostad, Collins Chansa, Enrico Rubagotti, Edward J Mills, Senbagam Duraisamy, Foad Abd-Allah, Moses K. Muriithi, Elias Merdassa Roro, Netsanet Fentahun, Kenji Shibuya, Amira Hamed Darwish, Ai-Min Wu, Tomohide Yamada, Lauren E. Schaeffer, Sonia Lewycka, Catalina Liliana Andrei, Ali Kazemi Karyani, Beyene Meressa Adhena, Shaimaa I. El-Jaafary, Francisco Rogerlandio Martins-Melo, Faris Lami, Aziz Eftekhari, Naser Mohammad Gholi Mezerji, André Karch, Suraj Bhattarai, Mona M. Khater, Paulina A. Lindstedt, Marcos Roberto Tovani-Palone, Kedir Hussein Abegaz, Padukudru Anand Mahesh, Alexandre C. Pereira, Ammas Siraj Mohammed, Mehdi Hosseinzadeh, Reta Tsegaye Gayesa, In-Hwan Oh, Dietrich Rothenbacher, Margaret Kosek, Yunquan Zhang, Ketema Bizuwork Gebremedhin, Rahul Gupta, Claudiu Herteliu, Nicole Davis Weaver, Dawit Zewdu Wondafrash, Oliver J. Brady, Samad Azari, Ebrahim M Yimer, Andrew T Olagunju, Ana Laura Manda, Ali Rostami, Aniruddha Deshpande, Ninuk Hariyani, Gulfaraz Khan, Narinder Pal Singh, Dabere Nigatu, Jae Il Shin, Preeti Dhillon, Duduzile Ndwandwe, Michelle L. Bell, Rakhi Dandona, Mojtaba Hoseini-Ghahfarokhi, Obinna Onwujekwe, Olatunji O. Adetokunboh, Tanuj Kanchan, Suleman Atique, Rovshan Khalilov, Ai Koyanagi, Ejaz Ahmad Khan, Jalal Arabloo, Ahmed Abdelalim, Van C. Lansingh, Ali Almasi, Catherine A. Welgan, Surendra Karki, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Hamid Yimam Hassen, Mohammad Ali Sahraian, Akram Pourshams, Mowafa Househ, Dilaram Acharya, Getnet Mengistu, Arya Haj-Mirzaian, Salman Khazaei, Bahram Armoon, Emerito Jose Aquino Faraon, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, David Laith Rawaf, Ali S. Akanda, Till Bärnighausen, Veincent Christian Filipino Pepito, Ahmed Omar Bali, Norberto Perico, Sergio I. Prada, Mohammad Moradi-Joo, Helen Derara Diro, Gebremicheal Gebreslassie Kasahun, Andre Rodrigues Duraes, Ajay Patle, Simin Mouodi, Yuan-Pang Wang, Alireza Esteghamati, Paramjit Gill, Ahamarshan Jayaraman Nagarajan, Meghnath Dhimal, Hafiz Ansar Rasul Suleria, Saleh Salehi Zahabi, Nader Jafari Balalami, Lucas Earl, Haileab Fekadu Wolde, Doris D. V. Ortega-Altamirano, Beatriz Paulina Ayala Quintanilla, Franz Castro, Deborah Carvalho Malta, Desta Haftu Hayelom, Sebastian Vollmer, Getinet Ayano, Arianna Maever L. Amit, Bárbara Niegia Garcia de Goulart, John S. Ji, Raaj Kishore Biswas, Michael R.M. Abrigo, Arash Etemadi, Andrey Nikolaevich Briko, Nefsu Awoke, Anton Sokhan, Daniel Adane Endalew, Ibrahim Abdelmageed Ginawi, Jacek Jóźwiak, Mihajlo Jakovljevic, Degu Abate, Ali S. Shalash, Hamidreza Haririan, Lucas Guimarães Abreu, Davide Guido, Masoud Foroutan, Karzan Abdulmuhsin Mohammad, Niranjan Kissoon, Farkhonde Salehi, Ashish Awasthi, Hosein Shabaninejad, Trang Huyen Nguyen, Anthony Masaka, Getenet Dessie, Fakher Rahim, Aklilu Endalamaw, Kiana Ramezanzadeh, Farzad Manafi, Olayinka Stephen Ilesanmi, Vahid Alipour, Neeraj Bedi, Kimberly B. Johnson, Laurie B. Marczak, Mehran Shams-Beyranvand, Amira Shaheen, Zubair Kabir, Saleem Muhammad Rana, Marzieh Nojomi, Peter Njenga Keiyoro, Yared Asmare Aynalem, Tissa Wijeratne, Fiseha Wadilo Wada, Giuseppe Remuzzi, Carlo La Vecchia, Chuanhua Yu, Pascual R. Valdez, Senthilkumar Balakrishnan, Phetole Walter Mahasha, Liliana Preotescu, Tewodros Eshete Wonde, Keivan Ahmadi, Masood Ali Shaikh, Leticia Avila-Burgos, Ken Lee Chin, Dinh-Toi Chu, Francesco Saverio Violante, Yasir Waheed, Daniel Diaz, Rosario Cárdenas, Ibrahim A Khalil, Ernoiz Antriyandarti, Adrian Pana, Salman Rawaf, Nauman Khalid, Nejimu Biza Zepro, Turki Alanzi, Amir Jalali, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Demelash Woldeyohannes Handiso, Nuruzzaman Khan, Takeshi Fukumoto, Christiane Dolecek, Melese Abate Reta, Vinay Nangia, Soumyadeep Bhaumik, Ravi Mehrotra, Seyed-Mohammad Fereshtehnejad, Brigette F. Blacker, Savita Lasrado, Seifadin Ahmed Shallo, Arash Ziapour, Krittika Bhattacharyya, Praveen Hoogar, Nicola Luigi Bragazzi, Mahdi Safdarian, Seyed Sina Naghibi Irvani, Chi Linh Hoang, Boikhutso Tlou, Manfred Accrombessi, Christopher J L Murray, Dragos Virgil Davitoiu, Hossein Poustchi, Farid Najafi, Sathish Thirunavukkarasu, Daniel Bekele Ketema, Dharmesh Kumar Lal, Vafa Rahimi-Movaghar, Christopher Troeger, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Paul H. Lee, Genet Melak Alamene, George C Patton, Andem Effiong, André Faro, Rushdia Ahmed, Colm McAlinden, Parvaneh Mirabi, Joshua Longbottom, Hagos Tasew Atalay, Alireza Rafiei, Somayeh Bohlouli, Temesgen Yihunie Akalu, Syed Mohamed Aljunid, Javad Nazari, Ismael R. Campos-Nonato, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Arvin Haj-Mirzaian, Sanghamitra Pati, Bakhtiar Piroozi, Rafael Alves Guimarães, Khaled Khatab, Evanson Z. Sambala, Mohsen Afarideh, Nelson Alvis-Guzman, Koku Sisay Tamirat, Mustafa Z. Younis, Hamed Zandian, Aparna Lal, Tamer H. Farag, Tahereh Pashaei, Benn Sartorius, Kidane Tadesse Gebremariam, Demelash Abewa Elemineh, Marwa Rashad Salem, Davide Rasella, Hedayat Abbastabar, Manu Raj Mathur, Peng Jia, Natalie Maria Cormier, Olatunde Aremu, Mohammad Reza Salahshoor, Kirsten E. Wiens, Ghobad Moradi, Srinivas Goli, Ruth W Kimokoti, Aliasghar Ahmad Kiadaliri, Khalid A Altirkawi, Ritesh G. Menezes, Molly K. Miller-Petrie, Alaa Badawi, Beriwan Abdulqadir Ali, Ensiyeh Jenabi, Getnet Azeze Gedefaw, Ahmed I. Hasaballah, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Eleonora Dubljanin, Amir Hasanzadeh, Jasvinder A. Singh, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Feleke Mekonnen Demeke, Agus Sudaryanto, Muhammad Ali, Yilma Chisha Dea Geramo, Leonardo Roever, Gebreamlak Gebremedhn Gebremeskel, Maheswar Satpathy, Asnakew Achaw Ayele, Seyyed Meysam Mousavi, Devasahayam J. Christopher, Malede Mequanent Sisay, Yibeltal Alemu Bekele, Tamirat Tesfaye Dasa, Gessessew Bugssa Hailu, Luca Ronfani, James Albright, Nathaniel J. Henry, Ionut Negoi, Dessalegn Ajema Berbada, Brijesh Sathian, Yousef Khader, Bal Govind Chauhan, Nikolay Ivanovich Briko, Hamideh Salimzadeh, Ali Bijani, Irfan Ullah, Shirin Djalalinia, Shanshan Li, Kebreab Paulos, Mohsen Bayati, Nasir Salam, Mohammad Ali Mansournia, Rajesh Sagar, Fatemeh Heydarpour, Siamak Sabour, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Mathew M. Baumann, Mehedi Hasan, Vishnu Renjith, Nuno Taveira, Getaneh Alemu Abebe, Pranab Chatterjee, Shafiu Mohammed, Dongyu Zhang, Abbas Mosapour, Muki Shey, Rajat Das Gupta, Muktar Beshir Ahmed, Satar Rezaei, Wondimeneh Shibabaw Shiferaw, Kenean Getaneh Tlaye, Eugenio Traini, Oladimeji Adebayo, Aisha Elsharkawy, David M. Pigott, Hadi Hassankhani, Anas M. Saad, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Abdallah M. Samy, Ali Talha Khalil, Nelson G.M. Gomes, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Huyen Phuc Do, Maryam Khayamzadeh, Rajeev Gupta, Davoud Adham, Farah Daoud, Jai K Das, Ana Isabel Ribeiro, Sameer Vali Gopalani, Joel M. Francis, Alyssa N. Sbarra, Brian J. Hall, Ravi Prakash Jha, David Teye Doku, Guoqing Hu, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, S. Mohammad Sajadi, Shankar M Bakkannavar, Ali Yadollahpour, Masoud Behzadifar, and G Anil Kumar

Subjects
Burden of disease, 030219 obstetrics & reproductive medicine, business.industry, Low income and middle income countries, General Medicine, Specific mortality, 030204 cardiovascular system & hematology, Article, 3. Good health, 03 medical and health sciences, Geography, 0302 clinical medicine, Environmental health, Medicine, 030212 general & internal medicine, Geographical inequalities, business, Demography
Abstract

Reiner RC Jr, Hay SI. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395: 1779–801—In this Article, the author byline has been amended to Local Burden of Disease Diarrhoea Collaborators. This correction has been made to the online version as of June 4, 2020, and the printed version is correct. © 2020 Elsevier Ltd

Published
2018
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41. Injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia: a prospective hospital based study

Author

Engida Yisma, Aklilu Azazh, Mohammed Seid, Fikre Enquselassie, Seid, Mohammed, Azazh, Aklilu, Enquselassie, Fikre, and Yisma, Engida

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Poison control, Occupational safety and health, Young Adult, Injury Severity Score, Injury characteristics, Tikur Anbessa specialized hospital, Injury prevention, Humans, Medicine, Prospective Studies, Aged, Outcome, Aged, 80 and over, business.industry, road traffic accident, Mortality rate, Accidents, Traffic, Road traffic accident, Glasgow Coma Scale, Emergency department, Length of Stay, Middle Aged, Emergency medicine, Emergency Medicine, outcome, Wounds and Injuries, Female, Body region, injury characteristics, Addis Ababa, Ethiopia, Emergency Service, Hospital, business, Research Article
Abstract

Background Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people. More than a million people die each year on the world’s roads, and the risk of dying as a result of a road traffic injury is highest in Africa. Methods A prospective hospital based study was undertaken to assess injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. A structured pre-tested questionnaire was used to gather the required data. The collected data were analyzed using SPSS version 20.0. Hierarchical multiple regression analysis was used to identify predictors of fatalities among the road traffic crash victims. Results A total of 230 road traffic accident victims were studied. The majority of the study subjects were men 165 (71.7 %) and the male/female ratio was 2.6:1. The victims’ ages ranged from 14 to 80 years with the mean and standard deviations of 32.15 and ± 14.38 years respectively. Daily laborers (95 (41.3 %)) and students (28 (12.2 %)) were the majority of road traffic accident victims. Head (50.4 %) and musculoskeletal (extremities) (47.0 %) were the most common body region injured. Fractures (78.0 %) and open wounds (56.5 %) were the most common type of injuries sustained. The overall length of hospital stay (LOS) ranged from 1 day to 61 days with mean (± standard deviation) of 7.12 ± 10.5 days and the mortality rate was 7.4 %. Hierarchical multiple regression analysis showed that age of the victims (ß = 0.16, p

Published
2015

43. Completion of the modified World Health Organization (WHO) partograph during labour in public health institutions of Addis Ababa, Ethiopia

Author

Engida Yisma, Nebreed Fesseha, Berhanu Dessalegn, Ayalew Astatkie, Yisma, Engida, Dessalegn, Berhanu, Astatkie, Ayalew, and Fesseha, Nebreed

Subjects
Program evaluation, Adult, medicine.medical_specialty, Modified WHO partograph, Reproductive medicine, Developing country, World Health Organization, Completion, Health facility, Nursing, Pregnancy, Obstetrics and Gynaecology, Health care, medicine, modified WHO partograph, public health institutions, Childbirth, Humans, completion, Perinatal Mortality, Retrospective Studies, Labor, Obstetric, business.industry, Public health, Data Collection, Research, Obstetrics and Gynecology, Checklist, Public health institutions, Obstetrics, Pregnancy Complications, Maternal Mortality, Reproductive Medicine, Family medicine, Female, Addis Ababa, Ethiopia, business
Abstract

Background: The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. The partograph consists of a graphic representation of labour and is an excellent visual resource to analyze cervix, uterine contraction and foetal presentation in relation to time. However, poor utilization of the partograph was found in the public health institutions which reflect poor monitoring of mothers in labour and/or poor pregnancy outcome. Methods. A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study. Results: All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed. Conclusions: This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour or simply inappropriate completion of the instrument and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths. Refereed/Peer-reviewed

Published
2013

44. Knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia

Author

Ayalew Astatkie, Engida Yisma, Nebreed Fesseha, Berhanu Dessalegn, Yisma, Engida, Dessalegn, Berhanu, Astatkie, Ayalew, and Fesseha, Nebreed

Subjects
Adult, medicine.medical_specialty, knowledge, Psychological intervention, Reproductive medicine, utilization, Prolonged labour, Birthing Centers, lcsh:Gynecology and obstetrics, Nursing, Health facility, Pregnancy, Surveys and Questionnaires, partograph, Obstetrics and Gynaecology, medicine, Childbirth, Humans, obstetric care givers, public health institutions, Partograph, Obstetric care givers, Diagnostic Techniques, Obstetrical and Gynecological, lcsh:RG1-991, Obstructed labour, Labor, Obstetric, business.industry, Hospitals, Public, Public health, Obstetrics and Gynecology, medicine.disease, Delivery, Obstetric, Public health institutions, Obstetric labor complication, Obstetric Labor Complications, Obstetrics, Personnel, Hospital, Utilization, Cross-Sectional Studies, Logistic Models, Knowledge, Caregivers, Family medicine, Female, Addis Ababa, Clinical Competence, Ethiopia, business, Research Article
Abstract

Background Globally, there was an estimated number of 287,000 maternal deaths in 2010. Eighty five percent (245,000) of these deaths occurred in Sub-Saharan Africa and Southern Asia. Among the causes of these deaths were obstructed and prolonged labour which could be prevented by cost effective and affordable health interventions like the use of the partograph. The Use of the partograph is a well-known best practice for quality monitoring of labour and subsequent prevention of obstructed and prolonged labour. However, a number of cases of obstructed labour do happen in health facilities due to poor quality of intrapartum care. Methods A cross-sectional quantitative study assessed knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia using a structured interviewer administered questionnaire. The collected data was analyzed using SPSS version 16.0. Logistic regression analysis was used to identify factors associated with knowledge and use of partograph among obstetric care givers. Results Knowledge about the partograph was fair: 189 (96.6%) of all the respondents correctly mentioned at least one component of the partograph, 104 (53.3%) correctly explained the function of alert line and 161 (82.6%) correctly explained the function of action line. The study showed that 112 (57.3%) of the obstetric care givers at public health institutions reportedly utilized partograph to monitor mothers in labour. The utilization of the partograph was significantly higher among obstetric care givers working in health centres (67.9%) compared to those working in hospitals (34.4%) [Adjusted OR = 3.63(95%CI: 1.81, 7.28)]. Conclusions A significant percentage of obstetric care givers had fair knowledge of the partograph and why it is necessary to use it in the management of labour and over half of obstetric care givers reported use of the partograph to monitor mothers in labour. Pre-service and on-job training of obstetric care givers on the use of the partograph should be given emphasis. Mandatory health facility policy is also recommended to ensure safety of women in labour in public health facilities in Addis Ababa, Ethiopia.

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