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1. Study of Epidemiological Characteristics of Fatal Injuries Using Death Registry Data in Georgia

Author: Nino Chkhaberidze, Ketevan Axobadze, Maia Kereselidze, Nato Pitskhelauri, Maka Jorbenadze, and Nino Chikhladze
Subjects: georgia, fatal injury, epidemiology, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Objective: This study aimed to evaluate epidemiological aspects of fatal injuries in Georgia.Methods: This was a retrospective, descriptive study that included all traumatic injury deaths in Georgiafrom January 1 to December 31, 2018. The National Center for Disease Control and Public Health of Georgia’sThe Electronic Death Register database was utilized in this research.Results: Of the study fatal injuries, 74% (n=1489) were males. 74% (n=1480) of all fatal injuries were causedby unintentional injuries. Road traffic accidents (25%, n=511) and falls (16%, n=322) were the primary causesof mortality. During the research year, the number of Years of life lost (YLL) was associated with injuries andwas increased to 58172 for both sexes (rate per 1000 population: 15.6). Most of the years were lost in the agegroup of 25-29 years (7515.37). Road traffic deaths accounted for 30% (17613.50) of YLL.Conclusion: Injuries are still a major public health problem in Georgia. In 2018, 2012 individuals died frominjuries across the country. However, mortality and YLL rates of injury varied by age and cause of injury. Toprevent injury-related mortality, it is crucial to conduct ongoing research on high-risk populations.
Published: 2023
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2. Premature mortality attributable to COVID-19: potential years of life lost in 17 countries around the world, January–August 2020

Author: Maider Pagola Ugarte, Souzana Achilleos, Annalisa Quattrocchi, John Gabel, Ourania Kolokotroni, Constantina Constantinou, Nicoletta Nicolaou, Jose Manuel Rodriguez-Llanes, Qian Huang, Olesia Verstiuk, Nataliia Pidmurniak, Jennifer Wenjing Tao, Bo Burström, Petra Klepac, Ivan Erzen, Mario Chong, Manuel Barron, Terje P. Hagen, Zhanna Kalmatayeva, Kairat Davletov, Inbar Zucker, Zalman Kaufman, Maia Kereselidze, Levan Kandelaki, Nolwenn Le Meur, Lucy Goldsmith, Julia A. Critchley, Maria Angelica Pinilla, Gloria Isabel Jaramillo, Domingos Teixeira, Lara Ferrero Goméz, Jackeline Lobato, Carolina Araújo, Joseph Cuthbertson, Catherine M. Bennett, Antonis Polemitis, Andreas Charalambous, Christiana A. Demetriou, and On behalf of the C-MOR consortium
Subjects: COVID-19, SARS-CoV-2, Disease burden, Potential years of life lost, PYLL, Pandemic, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Understanding the impact of the burden of COVID-19 is key to successfully navigating the COVID-19 pandemic. As part of a larger investigation on COVID-19 mortality impact, this study aims to estimate the Potential Years of Life Lost (PYLL) in 17 countries and territories across the world (Australia, Brazil, Cape Verde, Colombia, Cyprus, France, Georgia, Israel, Kazakhstan, Peru, Norway, England & Wales, Scotland, Slovenia, Sweden, Ukraine, and the United States [USA]). Methods Age- and sex-specific COVID-19 death numbers from primary national sources were collected by an international research consortium. The study period was established based on the availability of data from the inception of the pandemic to the end of August 2020. The PYLL for each country were computed using 80 years as the maximum life expectancy. Results As of August 2020, 442,677 (range: 18–185,083) deaths attributed to COVID-19 were recorded in 17 countries which translated to 4,210,654 (range: 112–1,554,225) PYLL. The average PYLL per death was 8.7 years, with substantial variation ranging from 2.7 years in Australia to 19.3 PYLL in Ukraine. North and South American countries as well as England & Wales, Scotland and Sweden experienced the highest PYLL per 100,000 population; whereas Australia, Slovenia and Georgia experienced the lowest. Overall, males experienced higher PYLL rate and higher PYLL per death than females. In most countries, most of the PYLL were observed for people aged over 60 or 65 years, irrespective of sex. Yet, Brazil, Cape Verde, Colombia, Israel, Peru, Scotland, Ukraine, and the USA concentrated most PYLL in younger age groups. Conclusions Our results highlight the role of PYLL as a tool to understand the impact of COVID-19 on demographic groups within and across countries, guiding preventive measures to protect these groups under the ongoing pandemic. Continuous monitoring of PYLL is therefore needed to better understand the burden of COVID-19 in terms of premature mortality.
Published: 2022
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3. The Burden of Disease due to COVID-19 (BoCO-19): A study protocol for a secondary analysis of surveillance data in Southern and Eastern Europe, and Central Asia.

Author: Caoimhe Cawley, Jonila Gabrani, Aleksandar Stevanović, Rakhat Aidaraliev, Mehtap Çakmak Barsbay, Seila Cilovic Lagarija, Kairat Davletov, Tolkun Djamangulova, Natalya Glushkova, Matthias An der Heiden, Pranvera Kaçaniku-Gunga, Maia Kereselidze, Besfort Kryeziu, Khorolsuren Lkhagvasuren, Samir Mehdiyev, Dariia Oharova, Diloram Sadikkhodjayeva, Milena Santric Milicevic, Milica Stanisic, Stela Stojisavljevic, Gulcan Tecirli, Natasa Terzic, Annelene Wengler, Alexander Rommel, and BoCO-19 Study Group
Subjects: Medicine, Science
Abstract: IntroductionThe COVID-19 pandemic has had an extensive impact on public health worldwide. However, in many countries burden of disease indicators for COVID-19 have not yet been calculated or used for monitoring. The present study protocol describes an approach developed in the project "The Burden of Disease due to COVID-19. Towards a harmonization of population health metrics for the surveillance of dynamic outbreaks" (BoCO-19). The process of data collection and aggregation across 14 different countries and sub-national regions in Southern and Eastern Europe and Central Asia is described, as well as the methodological approaches used.Materials and methodsThe study implemented in BoCO-19 is a secondary data analysis, using information from national surveillance systems as part of mandatory reporting on notifiable diseases. A customized data collection template is used to gather aggregated data on population size as well as COVID-19 cases and deaths. Years of life lost (YLL), as one component of the number of Disability Adjusted Life Years (DALY), are calculated as described in a recently proposed COVID-19 disease model (the 'Burden-EU' model) for the calculation of DALY. All-cause mortality data are collected for excess mortality sensitivity analyses. For the calculation of Years lived with disability (YLD), the Burden-EU model is adapted based on recent evidence. Because Covid-19 cases vary in terms of disease severity, the possibility and suitability of applying a uniform severity distribution of cases across all countries and sub-national regions will be explored. An approach recently developed for the Global Burden of Disease Study, that considers post-acute consequences of COVID-19, is likely to be adopted. Findings will be compared to explore the quality and usability of the existing data, to identify trends across age-groups and sexes and to formulate recommendations concerning potential improvements in data availability and quality.DiscussionBoCO-19 serves as a collaborative platform in order to build international capacity for the calculation of burden of disease indicators, and to support national experts in the analysis and interpretation of country-specific data, including their strengths and weaknesses. Challenges include inherent differences in data collection and reporting systems between countries, as well as assumptions that have to be made during the calculation process.
Published: 2023
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4. The incidence of colorectal cancer (CRC) in Georgia continues to increase: A population-based registry study

Author: Miranda Nonikashvili, Maia Kereselidze, Otar Toidze, and Tina Beruchashvili
Subjects: Colorectal cancer, Cancer screening, Cancer registry, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Introduction: CRC is one of the most common and serious public health problem. In Georgia, it ranks among the top five most fatal cancers for both men and women. This study aimed to utilize cancer registry data to evaluate the incidence and stage distribution of CRC in Georgia. Methods: The study included all new cases of CRC registered in Georgia during the period 2018–2021 (classified under ICD-10 codes C18-C21). The annual gender- and age-group-specific population figures were obtained from the National Statistics Office of Georgia (GEOSTAT). Results: Among the cases analyzed, the majority of patients were men (53.23%). Only about one third of the cases were diagnosed at the localized stage. The study found that the number of patients diagnosed with CRC in Georgia gradually increased from 2018 to 2021. The age-standardized incidence rates of CRC in men and women in 2021 were 17.09 and 12.04 per 100,000 individuals, respectively, with men having a slightly higher rate. The crude and direct age-standardized incidence rates increased over the 4-year period, but slightly changed in 2020. The directly adjusted incidence rate over the 4-year period was 55.44 per 100,000 population. The share of distant stage has reduced in both men and women from 2018 to 2021, but detection at localized stage remains low. Conclusions: The incidence of colorectal cancer in Georgia increased with advancing stage, emphasizing the need to enhance the country's cancer control program to improve screening uptake.
Published: 2023
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5. Incidence and Patterns of Digestive Organ Cancer in Georgia: Insights from a Population-Based Registry Study in 2021

Author: Beruchashvili, Miranda Nonikashvili, Maia Kereselidze, Otar Toidze, and Tina
Subjects: digestive organ cancer, cancer registry, public health
Abstract: Digestive organ cancer, also known as gastrointestinal (GI) cancer, refers to cancer that occurs in the digestive tract. In this population-based registry study, we aimed to investigate the incidence of GI in Georgia and to identify any patterns in the occurrence of different types of this disease. The study included all cases of GI cancer that were diagnosed in Georgia in 2021. We analyzed 1635 patients’ data to determine the overall and age-standardized incidence of GI cancer in the country. The analyses were performed for esophagus, stomach, colon, rectum, anus, liver and intrahepatic bile ducts, gallbladder, and pancreas separately. The descriptive statistics used in the study—specifically counts, means, proportions, and rates—were calculated using the statistical software STATA version 17.0. (StataCorp, College Station, TX, USA). The results of the study showed that the incidence of digestive organ cancer in Georgia was similar to the global average. However, there were some notable differences in the specific types of GI cancer that were most common in the country. Overall, this study provides important insights into the incidence of digestive organ cancer in Georgia and highlights the need for further research to better understand the factors that contribute to this disease.
Published: 2023
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6. Epidemiological characteristics of injury in Georgia: A one-year retrospective study

Author: Nino Chkhaberidze, Eka Burkadze, Ketevan Axobadze, Nato Pitskhelauri, Maia Kereselidze, Nino Chikhladze, Madalina Adina Coman, and Corinne Peek-Asa
Subjects: Adult, Aged, 80 and over, Male, Georgia, Adolescent, Length of Stay, Middle Aged, Article, Hospitalization, Young Adult, Quality of Life, Humans, General Earth and Planetary Sciences, Female, Aged, Retrospective Studies, General Environmental Science
Abstract: INTRODUCTION: Injury is a major health problem worldwide and a leading cause of death and disability. Disability caused by traumatic injury is often severe and long-lasting. Injuries place a large burden on societies and individuals in the community, both in cost and lost quality of life. Progress in developing effective injury prevention programs in developing countries is hindered by the lack of basic epidemiological injury data regarding the prevalence of traumatic injuries. The aim of this research was to describe the epidemiological characteristics of injury in all hospitals in Georgia. METHODS: The database of the National Center for Disease Control and Public Health of Georgia for 2018, which includes all hospital admissions, was used to identify injury cases treated in hospitals. Cases were included based on the S and T diagnosis coded of ICD-10. RESULTS: A total of 25103 adult patients were admitted for an injury, of whom 14798 (59%) were males and 10305 (41%) were females, between the ages of 18 and 108 years old. The highest prevalence was among the age group 25–44 years old (n=8654; 34%), followed by 45–64 years old (n=6852; 27%). The main mechanism of injury was falls (n=13932; 55%) and exposure to mechanical forces (n=2701; 11%). Over 1,50% (n=379) of injuries resulted in death after hospitalization. The median hospital length of stay (LOS) was 2 days. There was a significant association between age, mechanism of injury, type of injury, performed surgical interventions, and longer LOS. CONCLUSION: Injuries are prevalent throughout the life course and cause substantial hospitalization time. This research can help focus prevention efforts can focus on the demographic and injury causes that are most prevalent.
Published: 2022
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7. Impact of Hepatitis C Virus (HCV) Infection and Treatment on Mortality in the Country of Georgia, 2015–2020

Author: Lia Gvinjilia, Davit Baliashvili, Shaun Shadaker, Francisco Averhoff, Levan Kandelaki, Maia Kereselidze, Tengiz Tsertsvadze, Nikoloz Chkhartishvili, Maia Butsashvili, David Metreveli, Amiran Gamkrelidze, and Paige A Armstrong
Subjects: Microbiology (medical), Infectious Diseases
Abstract: Background Mortality related to hepatitis C virus (HCV) infection is a key indicator for elimination. We assessed the impact of HCV infection and treatment on mortality in the country of Georgia during 2015–2020. Methods We conducted a population-based cohort study using data from Georgia's national HCV Elimination Program and death registry. We calculated all-cause mortality rates in 6 cohorts: (1) Negative for anti-HCV; (2) anti-HCV positive, unknown viremia status; (3) current HCV infection and untreated; (4) discontinued treatment; (5) completed treatment, no sustained virologic response (SVR) assessment; (6) completed treatment and achieved SVR. Cox proportional hazards models were used to calculate adjusted hazards ratios and confidence intervals. We calculated the cause-specific mortality rates attributable to liver-related causes. Results After a median follow-up of 743 days, 100 371 (5.7%) of 1 764 324 study participants died. The highest mortality rate was observed among HCV infected patients who discontinued treatment (10.62 deaths per 100 PY, 95% confidence interval [CI]: 9.65, 11.68), and untreated group (10.33 deaths per 100 PY, 95% CI: 9.96, 10.71). In adjusted Cox proportional hazards model, the untreated group had almost 6-times higher hazard of death compared to treated groups with or without documented SVR (adjusted hazard ratio [aHR] = 5.56, 95% CI: 4.89, 6.31). Those who achieved SVR had consistently lower liver-related mortality compared to cohorts with current or past exposure to HCV. Conclusions This large population-based cohort study demonstrated the marked beneficial association between hepatitis C treatment and mortality. The high mortality rates observed among HCV infected and untreated persons highlights the need to prioritize linkage to care and treatment to achieve elimination goals.
Published: 2023
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8. European Cancer Summit 2022 Submission for Prevention, Early Detection and Screening NetworkEarly detection and screening of Colorectal Cancer (CRC) in Georgia

Author: Miranda Nonikashvili, Maia Kereselidze, and Tina Beruchashvili
Subjects: Oncology, Health Policy
Published: 2023
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9. DETECTION OF GASTRIC CANCER AT A LATE STAGE AS AN IMPORTANT FACTOR AFFECTING THE SURVIVAL OF PATIENTS

Author: SABA ZHIZHILASHVILI, IRAKLI MCHEDLISHVILI, NANA MEBONIA, ANNA ZHIZHILASHVILI, and MAIA KERESELIDZE
Published: 2022
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10. Impact of the COVID-19 pandemic on total, sex- and age-specific all-cause mortality in 20 countries worldwide during 2020: results from the C-MOR project

Author: Christiana A Demetriou, Souzana Achilleos, Annalisa Quattrocchi, John Gabel, Elena Critselis, Constantina Constantinou, Nicoletta Nicolaou, Giuseppe Ambrosio, Catherine M Bennett, Nolwenn Le Meur, Julia A Critchley, Laust Hvas Mortensen, Jose Manuel Rodriguez-Llanes, Mario Chong, Gleb Denissov, Petra Klepac, Lucy P Goldsmith, Antonio José Leal Costa, Terje P Hagen, Marie Chan Sun, Qian Huang, Nataliia Pidmurniak, Inbar Zucker, Joseph Cuthbertson, Bo Burström, Manuel Barron, Ivan Eržen, Fabrizio Stracci, Wilson Calmon, Cyndy Martial, Olesia Verstiuk, Zalman Kaufman, Wenjing Tao, Maia Kereselidze, Nino Chikhladze, Antonis Polemitis, Andreas Charalambous, University of Nicosia, École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), This work was supported by the University of Nicosia Medical School (internal funding). The funding source did not have any involvement in study design, the collection, analysis and interpretation of data, in the writing of the report, and or in the decision to submit the paper for publication.
Subjects: Pandemic, Epidemiology, SARS-CoV-2, COVID-19, Global impact, Infection control, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, Excess mortality, All-cause mortality
Abstract: Background To understand the impact of the COVID-19 pandemic on mortality, this study investigates overall, sex- and age-specific excess all-cause mortality in 20 countries, during 2020. Methods Total, sex- and age-specific weekly all-cause mortality for 2015–2020 was collected from national vital statistics databases. Excess mortality for 2020 was calculated by comparing weekly 2020 observed mortality against expected mortality, estimated from historical data (2015–2019) accounting for seasonality, long- and short-term trends. Crude and age-standardized rates were analysed for total and sex-specific mortality. Results Austria, Brazil, Cyprus, England and Wales, France, Georgia, Israel, Italy, Northern Ireland, Peru, Scotland, Slovenia, Sweden, and the USA displayed substantial excess age-standardized mortality of varying duration during 2020, while Australia, Denmark, Estonia, Mauritius, Norway, and Ukraine did not. In sex-specific analyses, excess mortality was higher in males than females, except for Slovenia (higher in females) and Cyprus (similar in both sexes). Lastly, for most countries substantial excess mortality was only detectable (Austria, Cyprus, Israel, and Slovenia) or was higher (Brazil, England and Wales, France, Georgia, Italy, Northern Ireland, Sweden, Peru and the USA) in the oldest age group investigated. Peru demonstrated substantial excess mortality even in the Conclusions This study highlights that excess all-cause mortality during 2020 is context dependent, with specific countries, sex- and age-groups being most affected. As the pandemic continues, tracking excess mortality is important to accurately estimate the true toll of COVID-19, while at the same time investigating the effects of changing contexts, different variants, testing, quarantine, and vaccination strategies.
Published: 2022
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11. STATE OF PLAY OF PSYCHOSOCIAL REHABILITATION SERVICES AND ASSESSMENT OF THE NEEDS OF POST-BREAST CANCER TREATMENT IN GEORGIA

Author: Marina Shakh-Nazarova, Irina Kandelaki, Vasil Tkeshelashvili, Tina Beruchashvili, Nana Ubilava, Sophie Tsikoridze, Mari Kutateladze, Mariam Lobzhanidze, Maia Kereselidze, and Dea Baghaturia
Subjects: medicine.medical_specialty, 030219 obstetrics & reproductive medicine, Rehabilitation, business.industry, medicine.medical_treatment, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, 030220 oncology & carcinogenesis, Family medicine, Medicine, business, Psychosocial
Abstract: Studies assessing cancer patients' needs have revealed that 32% of patients diagnosed with cancer clearly state the need for psychosocial rehabilitation services.The present study aims to assess the psychosocial state of women after breast cancer surgery in Georgia, identify the challenges in the accessibility of full-value services, and facilitate the formation of an evidence-based best practice policy. 360 women, after breast cancer surgery, have participated in the study, among them, 180 women have received psychosocial rehabilitation training (main group), and 180 women (control group) have not used such service. The need for post-treatment psychological rehabilitation was reported by 93% of the main group respondents that is 30% more than the result for the same question in the control group.The same is confirmed by the survey of medical staff - 97%. It is noteworthy that 80% of interviewed medical staff believe that psychosocial rehabilitation is as important as other treatment.The majority of interviewed respondents in both groups (main group – 57.2%,control group – 64%) speak about a financial burden.The study has also revealed a low awareness both in cancer patients and medical staff. Among the interviewed medical staff, 60 % have no information about the rehabilitation services available in Georgia.
Published: 2021
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12. A global systematic analysis of the occurrence, severity, and recovery pattern of long COVID in 2020 and 2021

Author: Sarah Wulf Hanson, Cristiana Abbafati, Joachim G Aerts, Ziyad Al-Aly, Charlie Ashbaugh, Tala Ballouz, Oleg Blyuss, Polina Bobkova, Gouke Bonsel, Svetlana Borzakova, Danilo Buonsenso, Denis Butnaru, Austin Carter, Helen Chu, Cristina De Rose, Mohamed Mustafa Diab, Emil Ekbom, Maha El Tantawi, Victor Fomin, Robert Frithiof, Aysylu Gamirova, Petr V Glybochko, Juanita A. Haagsma, Shaghayegh Haghjooy Javanmard, Erin B Hamilton, Gabrielle Harris, Majanka H Heijenbrok-Kal, Raimund Helbok, Merel E Hellemons, David Hillus, Susanne M Huijts, Michael Hultström, Waasila Jassat, Florian Kurth, Ing-Marie Larsson, Miklós Lipcsey, Chelsea Liu, Callan D Loflin, Andrei Malinovschi, Wenhui Mao, Lyudmila Mazankova, Denise McCulloch, Dominik Menges, Noushin Mohammadifard, Daniel Munblit, Nikita A Nekliudov, Osondu Ogbuoji, Ismail M Osmanov, José L. Peñalvo, Maria Skaalum Petersen, Milo A Puhan, Mujibur Rahman, Verena Rass, Nickolas Reinig, Gerard M Ribbers, Antonia Ricchiuto, Sten Rubertsson, Elmira Samitova, Nizal Sarrafzadegan, Anastasia Shikhaleva, Kyle E Simpson, Dario Sinatti, Joan B Soriano, Ekaterina Spiridonova, Fridolin Steinbeis, Andrey A Svistunov, Piero Valentini, Brittney J van de Water, Rita van den Berg-Emons, Ewa Wallin, Martin Witzenrath, Yifan Wu, Hanzhang Xu, Thomas Zoller, Christopher Adolph, James Albright, Joanne O Amlag, Aleksandr Y Aravkin, Bree L Bang-Jensen, Catherine Bisignano, Rachel Castellano, Emma Castro, Suman Chakrabarti, James K Collins, Xiaochen Dai, Farah Daoud, Carolyn Dapper, Amanda Deen, Bruce B Duncan, Megan Erickson, Samuel B Ewald, Alize J Ferrari, Abraham D. Flaxman, Nancy Fullman, Amiran Gamkrelidze, John R Giles, Gaorui Guo, Simon I Hay, Jiawei He, Monika Helak, Erin N Hulland, Maia Kereselidze, Kris J Krohn, Alice Lazzar-Atwood, Akiaja Lindstrom, Rafael Lozano, Beatrice Magistro, Deborah Carvalho Malta, Johan Månsson, Ana M Mantilla Herrera, Ali H Mokdad, Lorenzo Monasta, Shuhei Nomura, Maja Pasovic, David M Pigott, Robert C Reiner, Grace Reinke, Antonio Luiz P Ribeiro, Damian Francesco Santomauro, Aleksei Sholokhov, Emma Elizabeth Spurlock, Rebecca Walcott, Ally Walker, Charles Shey Wiysonge, Peng Zheng, Janet Prvu Bettger, Christopher JL Murray, and Theo Vos
Abstract: ImportanceWhile much of the attention on the COVID-19 pandemic was directed at the daily counts of cases and those with serious disease overwhelming health services, increasingly, reports have appeared of people who experience debilitating symptoms after the initial infection. This is popularly known as long COVID.ObjectiveTo estimate by country and territory of the number of patients affected by long COVID in 2020 and 2021, the severity of their symptoms and expected pattern of recoveryDesignWe jointly analyzed ten ongoing cohort studies in ten countries for the occurrence of three major symptom clusters of long COVID among representative COVID cases. The defining symptoms of the three clusters (fatigue, cognitive problems, and shortness of breath) are explicitly mentioned in the WHO clinical case definition. For incidence of long COVID, we adopted the minimum duration after infection of three months from the WHO case definition. We pooled data from the contributing studies, two large medical record databases in the United States, and findings from 44 published studies using a Bayesian meta-regression tool. We separately estimated occurrence and pattern of recovery in patients with milder acute infections and those hospitalized. We estimated the incidence and prevalence of long COVID globally and by country in 2020 and 2021 as well as the severity-weighted prevalence using disability weights from the Global Burden of Disease study.ResultsAnalyses are based on detailed information for 1906 community infections and 10526 hospitalized patients from the ten collaborating cohorts, three of which included children. We added published data on 37262 community infections and 9540 hospitalized patients as well as ICD-coded medical record data concerning 1.3 million infections. Globally, in 2020 and 2021, 144.7 million (95% uncertainty interval [UI] 54.8–312.9) people suffered from any of the three symptom clusters of long COVID. This corresponds to 3.69% (1.38–7.96) of all infections. The fatigue, respiratory, and cognitive clusters occurred in 51.0% (16.9–92.4), 60.4% (18.9–89.1), and 35.4% (9.4–75.1) of long COVID cases, respectively. Those with milder acute COVID-19 cases had a quicker estimated recovery (median duration 3.99 months [IQR 3.84–4.20]) than those admitted for the acute infection (median duration 8.84 months [IQR 8.10–9.78]). At twelve months, 15.1% (10.3–21.1) continued to experience long COVID symptoms.Conclusions and relevanceThe occurrence of debilitating ongoing symptoms of COVID-19 is common. Knowing how many people are affected, and for how long, is important to plan for rehabilitative services and support to return to social activities, places of learning, and the workplace when symptoms start to wane.Key PointsQuestionWhat are the extent and nature of the most common long COVID symptoms by country in 2020 and 2021?FindingsGlobally, 144.7 million people experienced one or more of three symptom clusters (fatigue; cognitive problems; and ongoing respiratory problems) of long COVID three months after infection, in 2020 and 2021. Most cases arose from milder infections. At 12 months after infection, 15.1% of these cases had not yet recovered.MeaningThe substantial number of people with long COVID are in need of rehabilitative care and support to transition back into the workplace or education when symptoms start to wane.
Published: 2022
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13. Early and late detection of cancer in Georgia: Evidence from a population-based cancer registry, 2018-2019

Author: Tornike Batavani, Maia Kereselidze, Nino Chikhladze, and Nato Pitskhelauri
Subjects: Male, Cancer Research, Georgia, Epidemiology, Incidence, Georgia (Republic), Oncology, Stomach Neoplasms, Neoplasms, Humans, Female, Registries, Thyroid Neoplasms, Colorectal Neoplasms, Early Detection of Cancer
Abstract: Georgia is an upper middle-income country, which has lower cancer survival rates than most of the countries in the World Health Organization European region, as well as compared to many other post-Soviet states and upper middle-income countries. The purpose of our study was to analyse the cancer stage distribution data of Georgia as a first step towards identifying the areas of early cancer detection in the country that might need improvement or require further research.Descriptive analysis of the population-based cancer registry of Georgia was performed using the data for the period of 01.01.2018-31.12.2019.Around 57 % of cancers in males and 56 % of cancers in females were amenable to early detection. At least 35.7 % of these cancers in males and 44.2 % in females were detected early. 15.2 % (n = 964) of male and 35.3 % (n = 3179) of female cancer patients met the age criteria for the respective cancer screening programmes. Breast, colorectal, cervical and stomach cancers contributed to 58.7 % of all late-stage cancers in females. Lung, prostate, colorectal, laryngeal and stomach cancers made up 72.4 % of all late-stage cancer cases among males. At least 83.8 % (n = 1438) of thyroid cancers in females and 84.2 % (n = 246) of thyroid cancers in males were diagnosed at stage I. Moreover, stage I thyroid cancer cases made up 50.7 % of all stage I cancer cases detected in women and 25.6 % of all stage I cancers in men. At least 42.4 % of stage I thyroid cancers in females and 37.4 % of stage I thyroid cancers in males were papillary microcarcinomas.The potential of early cancer detection is underutilised in Georgia and there is a need to strengthen screening and especially early diagnosis in the country. The possibility of thyroid cancer overdiagnosis requires further investigation.
Published: 2022

14. GENERAL EPIDEMIOLOGICAL CHARACTERISTICS OF BURN RELATED INJURIES

Author: MARIAM ANDRIADZE, NINO CHIKHLADZE, and MAIA KERESELIDZE
Abstract: Burn related injuries represent a significant global health problem. These injuries can be cause of high mortality and morbidity throughout the world, as well as different kinds of disabilities. More than 180,000 people die from burn injuries every year. Injuries related to burns can seriously affect patients’ quality of life. These injuries can also lead to serious psychological disorders. Despite the fact that injuries associated with burns are more common in developing countries, especially among the population with low socioeconomic status, burn injuries are widespread in the developed and high-income countries as well. The types and causes of burn injuries are correlated with age, gender, established safety standards, education levels as well as traditional customs. The habits and typical traditions established among different populations, reflect on the causation and types of burns which are widespread in that country or region. The studies conducted in different countries indicate that children are mostly exposed to the risk of getting burn injuries throughout the world. Unintentional burn injuries are one of the leading causes for childhood deaths. Due to these injuries, more than 100,000 children are hospitalized every year in the world. Hot liquid scalds are most frequent causes of pediatric burn injuries. Burn injuries can be preventable, therefore more epidemiological researches need to be conducted about this issue in order to plan preventive measures.
Published: 2022
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15. 125 Road traffic injuries in children: evidence from national database

Author: Nino Chikhladze, Ketevan Akhobadze, Nino Chkhaberidze, Nato Pitskhelauri, Maia Kereselidze, and Corinne Peek-Asa
Published: 2022
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16. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020???21

Author: Haidong Wang, Katherine R Paulson, Spencer A Pease, Stefanie Watson, Haley Comfort, Peng Zheng, Aleksandr Y Aravkin, Catherine Bisignano, Ryan M Barber, Tahiya Alam, John E Fuller, Erin A May, Darwin Phan Jones, Meghan E Frisch, Cristiana Abbafati, Christopher Adolph, Adrien Allorant, Joanne O Amlag, Bree Bang-Jensen, Gregory J Bertolacci, Sabina S Bloom, Austin Carter, Emma Castro, Suman Chakrabarti, Jhilik Chattopadhyay, Rebecca M Cogen, James K Collins, Kimberly Cooperrider, Xiaochen Dai, William James Dangel, Farah Daoud, Carolyn Dapper, Amanda Deen, Bruce B Duncan, Megan Erickson, Samuel B Ewald, Tatiana Fedosseeva, Alize J Ferrari, Joseph Jon Frostad, Nancy Fullman, John Gallagher, Amiran Gamkrelidze, Gaorui Guo, Jiawei He, Monika Helak, Nathaniel J Henry, Erin N Hulland, Bethany M Huntley, Maia Kereselidze, Alice Lazzar-Atwood, Kate E LeGrand, Akiaja Lindstrom, Emily Linebarger, Paulo A Lotufo, Rafael Lozano, Beatrice Magistro, Deborah Carvalho Malta, Johan Månsson, Ana M Mantilla Herrera, Fatima Marinho, Alemnesh H Mirkuzie, Awoke Temesgen Misganaw, Lorenzo Monasta, Paulami Naik, Shuhei Nomura, Edward G O'Brien, James Kevin O'Halloran, Latera Tesfaye Olana, Samuel M Ostroff, Louise Penberthy, Robert C Reiner Jr, Grace Reinke, Antonio Luiz P Ribeiro, Damian Francesco Santomauro, Maria Inês Schmidt, David H Shaw, Brittney S Sheena, Aleksei Sholokhov, Natia Skhvitaridze, Reed J D Sorensen, Emma Elizabeth Spurlock, Ruri Syailendrawati, Roman Topor-Madry, Christopher E Troeger, Rebecca Walcott, Ally Walker, Charles Shey Wiysonge, Nahom Alemseged Worku, Bethany Zigler, David M Pigott, Mohsen Naghavi, Ali H Mokdad, Stephen S Lim, Simon I Hay, Emmanuela Gakidou, and Christopher J L Murray
Subjects: mortality, Covid 19, excess mortality, SARS-CoV-2, Seroepidemiologic Studies, COVID-19, Humans, General Medicine, Global Health, Pandemics
Abstract: Mortality statistics are fundamental to public health decision making. Mortality varies by time and location, and its measurement is affected by well known biases that have been exacerbated during the COVID-19 pandemic. This paper aims to estimate excess mortality from the COVID-19 pandemic in 191 countries and territories, and 252 subnational units for selected countries, from Jan 1, 2020, to Dec 31, 2021.All-cause mortality reports were collected for 74 countries and territories and 266 subnational locations (including 31 locations in low-income and middle-income countries) that had reported either weekly or monthly deaths from all causes during the pandemic in 2020 and 2021, and for up to 11 year previously. In addition, we obtained excess mortality data for 12 states in India. Excess mortality over time was calculated as observed mortality, after excluding data from periods affected by late registration and anomalies such as heat waves, minus expected mortality. Six models were used to estimate expected mortality; final estimates of expected mortality were based on an ensemble of these models. Ensemble weights were based on root mean squared errors derived from an out-of-sample predictive validity test. As mortality records are incomplete worldwide, we built a statistical model that predicted the excess mortality rate for locations and periods where all-cause mortality data were not available. We used least absolute shrinkage and selection operator (LASSO) regression as a variable selection mechanism and selected 15 covariates, including both covariates pertaining to the COVID-19 pandemic, such as seroprevalence, and to background population health metrics, such as the Healthcare Access and Quality Index, with direction of effects on excess mortality concordant with a meta-analysis by the US Centers for Disease Control and Prevention. With the selected best model, we ran a prediction process using 100 draws for each covariate and 100 draws of estimated coefficients and residuals, estimated from the regressions run at the draw level using draw-level input data on both excess mortality and covariates. Mean values and 95% uncertainty intervals were then generated at national, regional, and global levels. Out-of-sample predictive validity testing was done on the basis of our final model specification.Although reported COVID-19 deaths between Jan 1, 2020, and Dec 31, 2021, totalled 5·94 million worldwide, we estimate that 18·2 million (95% uncertainty interval 17·1-19·6) people died worldwide because of the COVID-19 pandemic (as measured by excess mortality) over that period. The global all-age rate of excess mortality due to the COVID-19 pandemic was 120·3 deaths (113·1-129·3) per 100 000 of the population, and excess mortality rate exceeded 300 deaths per 100 000 of the population in 21 countries. The number of excess deaths due to COVID-19 was largest in the regions of south Asia, north Africa and the Middle East, and eastern Europe. At the country level, the highest numbers of cumulative excess deaths due to COVID-19 were estimated in India (4·07 million [3·71-4·36]), the USA (1·13 million [1·08-1·18]), Russia (1·07 million [1·06-1·08]), Mexico (798 000 [741 000-867 000]), Brazil (792 000 [730 000-847 000]), Indonesia (736 000 [594 000-955 000]), and Pakistan (664 000 [498 000-847 000]). Among these countries, the excess mortality rate was highest in Russia (374·6 deaths [369·7-378·4] per 100 000) and Mexico (325·1 [301·6-353·3] per 100 000), and was similar in Brazil (186·9 [172·2-199·8] per 100 000) and the USA (179·3 [170·7-187·5] per 100 000).The full impact of the pandemic has been much greater than what is indicated by reported deaths due to COVID-19 alone. Strengthening death registration systems around the world, long understood to be crucial to global public health strategy, is necessary for improved monitoring of this pandemic and future pandemics. In addition, further research is warranted to help distinguish the proportion of excess mortality that was directly caused by SARS-CoV-2 infection and the changes in causes of death as an indirect consequence of the pandemic.BillMelinda Gates Foundation, J Stanton, T Gillespie, and J and E Nordstrom.
Published: 2022

17. Distribution of Colorectal Cancer in the Georgian Population: Analysis of the Population-Based Cancer Registry Database of Georgia

Author: Miranda Nonikashvili, Maia Kereselidze, and Tina Beruchashvili
Published: 2022
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18. May Measurement Month 2018: an analysis of blood pressure screening results in Georgia

Author: Bezhan Tsinamdzgvrishvili, Amiran Gamkrelidze, Dali Trapaidze, Lela Sturua, Nino Grdzelidze, Tamar Abesadze, Nana Mebonia, Lela Shengelia, Maia Kereselidze, Lika Tkeshelashvili, Tamar Vakhtangadze, Nino Asatiani, Thomas Beaney, Anca Chis Ster, and Neil R Poulter
Subjects: 03 medical and health sciences, 0302 clinical medicine, Cardiovascular System & Hematology, Hypertension, Control, AcademicSubjects/MED00200, 030212 general & internal medicine, Articles, 030204 cardiovascular system & hematology, Cardiology and Cardiovascular Medicine, 1102 Cardiorespiratory Medicine and Haematology, May Measurement Month
Abstract: May Measurement Month (MMM) is aimed at raising public awareness about arterial hypertension—the main risk factor for cardiovascular diseases in the population. Screening was carried out at 200 sites on a national scale. More than 500 volunteers, including doctors (80%) and medical students (20%) participated in the screening. To familiarize them with the research tools and standard blood pressure (BP) measurement method, their training was conducted by the Georgian Society of Hypertension in Tbilisi and other large cities. Social and mass media, medical societies, and other stakeholders were actively involved in the recruitment process. A total of 10 756 people were screened. The mean age of participants was 53.1 years (SD 16.1). Males—67.9%, females—32.1%. One hundred percent were White. After multiple imputation, the number of hypertensive patients was 6.037 (56.1%) and out of them 4950 were aware and 4701 (77.9%) were on medication, 1336 (22.1%) were not taking a medication. Of those taking antihypertensive medication, 38.2% had controlled BP. In spite of non-randomized selection and certain restrictions with respect to extrapolation of the results, MMM comprehensively reflects an urgent problem and major gaps in the health system. Based on the above, its importance is extremely valuable for identifying public health policy priorities.
Published: 2020

19. Characteristics of discharged patients from hospitals - Georgian descriptive study

Author: T. Manjavidze, L. Kandelaki, Nino Grdzelidze, K. Gambashidze, N Skhvitaridze, Maia Kereselidze, and Amiran Gamkrelidze
Subjects: medicine.medical_specialty, business.industry, Public Health, Environmental and Occupational Health, Cancer, Disease, medicine.disease, Comorbidity, Asymptomatic, 8.A. Oral session: Preparedness and surveillance of Covid-20, Diabetes mellitus, Internal medicine, Epidemiology, Severity of illness, medicine, AcademicSubjects/MED00860, AcademicSubjects/SOC01210, medicine.symptom, business, AcademicSubjects/SOC02610, Parallel Programme, Kidney disease
Abstract: COVID-19, the disease caused by the novel coronavirus, started spreading rapidly across the world. Although, many aspects of disease is still under the observation. Therefore, in this study retrospectively was investigated the data on patients discharged from Georgian hospitals between February and June. According to Georgian regulation, all patients with confirmed COVID-19 should be hospitalized. The data sources were hospitalization registry and the standardized case report forms. In this descriptive study, epidemiological characteristics of 500 COVID-19 cases confirmed with PCR tests were analyzed. Among variables were: gender, age and geographic distribution, disease characteristics, underlying health conditions, test-related features, etc. Majority of patients (72.0%) were admitted to hospitals by the ambulance. The mean age of the patients was 43 years. The sex distribution was merely the same for both genders (49.4% male and 50.6% female). The most common symptoms were fever (82.4%, 95% CI 78.4-85.9), fatigue (49.6%, 95% CI 44.7-54.5), and cough (38.3%, 95% CI 33.6-43.1). The proportion of asymptomatic cases during the PCR testing were 16.6%. More than one symptom was observed in 57.6% of patients. Most common underlying health conditions were cardiovascular diseases (21.8%), diabetes (7.6%), kidney disease (3.6%), chronic lung disease (2.4%), cancer (2.2%), and chronic hepatitis (1.8%). Disease severity significantly differ among cases. Of those without comorbidity conditions, 94% had mild severity. However, among those with comorbidity conditions 35% were sever or critical. 50% of patients were reported as obese. The proportion of severe or critical patients was higher with BMI-18.5-24.9 and BMI ≥30. The case-fatality rate was 2.6%, with majority of deaths among aged ≥70. The severity of illness was strongly associated with comorbidity conditions and BMI. These findings are important to contribute and improve evidence-based knowledge for the novel coronavirus. Key messages Hospitalization of all COVID-19 cases, despite their severity, improving positive outcome of patients. Follow-up for discharged patients is necessary to control medium and long-term impact of COVID-19.
Published: 2020
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20. Case management of preterm deliveries: Birth-registry based study

Author: T Lobjanidze, Maia Kereselidze, N Skhvitaridze, and D Baghaturia
Subjects: medicine.medical_specialty, business.industry, Obstetrics, Public Health, Environmental and Occupational Health, Medicine, business, Case management
Abstract: Modern studies are possible to determine the degree of newborn's prematurity. Evidence based data from 65 countries show the increasing trend of preterm births over the past 20 years. Numbers from the National Center for Disease Control and Public Health of Georgia indicate that of 51 183 infants born in 2018, 7 071 (14%) were delivered between 34 to 37 gestational weeks. The aim of this study was to determine the similarities and differences between preterm newborns delivered at 34-37 gestational weeks according the selected variables. This is the quantitative, retrospective study. Data source was the Georgian birth registry for the year 2018. Variables, as gestational age, mode of delivery, newborn weight, Apgar score, newborn diagnoses according the ICD-10, length of stay in maternity home, and others were used for descriptive statistics. In 2018, for preterm deliveries at 34-37 gestational weeks, 53.7% of newborns were delivered by cesarean section and 46.3% physiologically. Despite the similar characteristics, majority of cases had different length of stay at maternity homes, with variation from four to 66 days. The big concern was the quality of target variables - in 30% of cases occurred missing information. Inconsistent occurred in cross-checking of variables - newborns stay at hospital over the recommended data was not justified by provided diagnosis. The results show the big variance between the preterm newborns with the similar characteristics, delivered at 34-37 gestational weeks in Georgia, mainly for the length of stay. Study reveal necessity to provide awareness rising activities among medical personnel to provide reliable, timely and validated data. The major recommendation is to advice Georgian health sector representatives to develop a mechanism for monitoring and ensuring the measures to evaluate the quality of data, uploaded in the birth registry. Key messages Reliable, consistent and validated data are contributing to the rationalization of the healthcare associated resources and controlling costs. Ongoing monitoring of quality in Georgian birth registry should be top priority of responsible authorities.
Published: 2020
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21. Study of induced abortion based on the Georgian Birth Registry

Author: Maia Kereselidze, N Skhvitaridze, D Kandelaki, and T Lobjanidze
Subjects: Georgian, medicine.medical_specialty, business.industry, Obstetrics, Public Health, Environmental and Occupational Health, language, Medicine, Abortion, business, language.human_language
Abstract: Among the countries of the WHO European region, Georgia has the highest numbers of abortion and comprise 420 per 1 000 live births. According the national law and regulation it is necessary to have a mandatory waiting period for five days before the induced abortion. In this study, we aim to assess the usability of different methods and evaluate the effectiveness of mandatory waiting period of induced abortions. We provided retrospective study of secondary data based on cases, extracted from the Georgian Birth Registry. The main variables used for the descriptive statistics were: demographic information of selected cases, parity, gestational age, mode of abortion, real length of mandatory waiting period from registration till the induced abortion. In 2018, was registered 13 612 cases of induced abortion before gestation week 12. Of these, most cases were observed in two age groups: 27.6% was performed among women aged 25-29 and 27.5% among women aged 30-34. From total reported induced abortion cases, 5.4% were provided by dilatation and curettage (from these, 12.6% occurred before 6 weeks gestation), 41.4% was performed by aspiration (from these, 6% occurred at 10-11 weeks of gestation), and 53.2% provided using medical drug-induction (from these, 1.2% occurred at 10-11 weeks of gestation). Of all cases, 14.5% were primiparous women. In 29.3% of cases there were not observed obligatory waiting period before the abortion. 68% of total cases changed the geographical location for the performing induced abortion. According our results, the application of methods of induced abortion is not fully in line with the international recommendations. Additionally, there is violation of national law for keeping mandatory waiting period before induced abortion. The mandatory waiting period before the induced abortion is less effective in Georgia. Moreover, the share of induced abortions performed during the first pregnancy is high. Key messages Health promotion educational activities should be concerned on providing proper information about negative aspects of induced abortion and promote other ways of contraception. Medical personnel should have continues education to be well aware about application of different methodologies of induced abortion.
Published: 2020
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22. Socio-Demographic Determinants of Road Traffic Fatalities in Women of Reproductive Age in the Republic of Georgia: Evidence from the National Reproductive Age Mortality Study (2014)

Author: N. Sharashidze, Maia Kereselidze, Marina Topuridze, Babill Stray-Pedersen, Ekaterine Pestvenidze, Nino Berdzuli, Lela Sturua, Nino Lomia, and Arne Stray-Pedersen
Subjects: medicine.medical_specialty, Population, Ethnic group, International Journal of Women's Health, socioeconomic factors, Logistic regression, Odds, women’s health, Maternity and Midwifery, Medicine, Social determinants of health, education, Original Research, education.field_of_study, business.industry, Public health, Obstetrics and Gynecology, mortality, wealth status, Verbal autopsy, Confidence interval, road traffic injuries, Oncology, employment, business, human activities, Demography
Abstract: Nino Lomia,1 Nino Berdzuli,1 Nino Sharashidze,2 Lela Sturua,3 Ekaterine Pestvenidze,1 Maia Kereselidze,4 Marina Topuridze,5 Babill Stray-Pedersen6,†, Arne Stray-Pedersen7 1Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; 2Department of Clinical and Research Skills, Faculty of Medicine, Iv. Javakhishvili Tbilisi State University, Tbilisi, Georgia; 3Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia; 4Department of Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia; 5Health Promotion Division, Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia; 6Department of Obstetrics and Gynecology, Rikshospitalet, Oslo University Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; 7Department of Forensic Sciences, Oslo University Hospital, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway†Dr Babill Stray Pedersen passed away on 24 April, 2019Correspondence: Nino Lomia Email ninolomia@yahoo.comPurpose: Globally and in the European region, the road traffic injuries (RTI) have emerged as a major public health and development problem, killing the most productive adult members of a population, including women. This study aimed to identify the key socio-demographic determinants of premature and avoidable RTI mortality in reproductive-aged women (15– 49 years) in Georgia.Materials and Methods: The study employed verbal autopsy data from the second national reproductive age mortality survey (RAMOS 2014). Univariate and multivariate logistic regression models were fitted using the Firth method to assess the crude and adjusted effects of each individual level socio-demographic factor on the odds of RTI-attributed death, with corresponding 95% confidence intervals (COR and AOR, 95% CI).Results: Of 843 women aged 15– 49 years, 78 (9.3%) were the victims of fatal traffic crashes. After multivariate adjustment, the odds of dying from RTI were significantly higher in women aged 15– 29 years (AOR=7.73, 95% CI= 4.20 to 14.20), those being employed (AOR=2.11, 95% CI= 1.22 to 3.64) and the wealthiest (AOR=2.88, 95% CI= 1.44 to 5.77) compared, respectively, to their oldest (40– 49 years), unemployed and poorest counterparts. Conversely, there were no statistically significant ethnic, marital, rural/urban, and educational disparities in women’s RTI fatalities. Overall, motorized four-wheeler occupants (78.2%), particularly passengers (71.8%), appeared to be the most common victims of fatal road injuries than pedestrians (20.5%). Alarmingly, the vast majority (85.9%) of any type of road users died instantly at the scene of collision, as compared to deaths en route to hospital (1.3%) or in hospital (11.5%).Conclusion: Age, employment, and wealth status appeared to be the strong independent predictors of young women’s RTI mortality in Georgia. Future comprehensive research would be advantageous for further deciphering the differential impact of social determinants on traffic-induced fatalities, as a vital platform for evidence-based remedial actions on this predictable and preventable safety hazard.Keywords: women’s health, road traffic injuries, mortality, socioeconomic factors, employment, wealth status
Published: 2020

23. Socio-Demographic Determinants of Mortality from Chronic Noncommunicable Diseases in Women of Reproductive Age in the Republic of Georgia: Evidence from the National Reproductive Age Mortality Study (2014)

Author: Lela Sturua, Nino Lomia, Babill Stray-Pedersen, Nino Berdzuli, Marina Topuridze, N. Sharashidze, Ekaterine Pestvenidze, Tamar Antelava, Arne Stray-Pedersen, and Maia Kereselidze
Subjects: unemployment, noncommunicable diseases, Ethnic group, International Journal of Women's Health, socioeconomic factors, Logistic regression, Odds, 03 medical and health sciences, 0302 clinical medicine, women’s health, Maternity and Midwifery, Medicine, 030212 general & internal medicine, Risk factor, Socioeconomic status, Original Research, education, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics and Gynecology, Odds ratio, Verbal autopsy, mortality, Oncology, Life course approach, business, Demography
Abstract: Nino Lomia,1 Nino Berdzuli,1 Ekaterine Pestvenidze,1 Lela Sturua,2 Nino Sharashidze,3 Maia Kereselidze,4 Marina Topuridze,5 Tamar Antelava,6 Babill Stray-Pedersen1,7,†, Arne Stray-Pedersen1,8 1Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; 2Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia; 3Department of Clinical and Research Skills, Faculty of Medicine, Iv. Javakhishvili Tbilisi State University, Tbilisi, Georgia; 4Department of Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia; 5Health Promotion Division, Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia; 6EVEX Medical Corporation, Tbilisi, Georgia; 7Department of Obstetrics and Gynecology, Rikshospitalet, Oslo University Hospital, Oslo, Norway; 8Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway†Dr Babill Stray-Pedersen passed away on 24 April, 2019Correspondence: Nino Lomia Tel +995 595 197055Email ninolomia@yahoo.comPurpose: Worldwide, noncommunicable diseases (NCDs) are the leading cause of premature death of women, taking the highest toll in developing countries. This study aimed to identify key socio-demographic determinants of NCD mortality in reproductive-aged women (15– 49 years) in Georgia.Materials and Methods: The study employed the verbal autopsy data from the second National Reproductive Age Mortality Survey 2014. Univariate and multivariate logistic regression models were fitted to explore the association between each risk factor and NCD mortality, measured by crude and adjusted odds ratio (AOR) with respective 95% confidence intervals (95% CI).Results: In the final sample of 843 women, 586 (69.5%) deaths were attributed to NCDs, the majority of which occurred outside a hospital (72.7%) and among women aged 45– 49 years (46.8%), ethnic Georgians (85.2%), urban residents (60.1%), those being married (60.6%), unemployed (75.1%) or having secondary and higher education (69.5%), but with nearly equal distribution across the wealth quintiles. After multivariate adjustment, the odds of dying from NCDs were significantly higher in women aged 45– 49 years (AOR=17.69, 95% CI= 9.35 to 33.50), those being least educated (AOR=1.55, 95% CI= 1.01 to 2.37) and unemployed (AOR=1.47, 95% CI= 1.01 to 2.14) compared, respectively, to their youngest (15– 24 years), more educated and employed counterparts. Strikingly, the adjusted odds were significantly lower in “other” ethnic minorities (AOR=0.29, 95% CI= 0.14 to 0.61) relative to ethnic Georgians. Contrariwise, there were no significant associations between NCD mortality and women’s marital or wealth status, place of residence (rural/urban) or place of death.Conclusion: Age, ethnicity, education, and employment were found to be strong independent predictors of young women’s NCD mortality in Georgia. Further research on root causes of inequalities in mortality across the socioeconomic spectrum is warranted to inform equity- and life course-based multisectoral, integrated policy responses that would be conducive to enhancing women’s survival during and beyond reproduction.Keywords: women’s health, mortality, noncommunicable diseases, socioeconomic factors, education, unemployment
Published: 2020

24. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Sorin Hostiuc, Shaun Wen Huey Lee, Jorge R. Ledesma, Carsten Flohr, Masoumeh Sadeghi, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Mehdi Bohluli, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Seyyed Meysam Mousavi, Bernhard T. Baune, Ehsan Ahmadpour, Dinh-Toi Chu, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Mohammad Taghi Khodayari, Gianna Gayle Herrera Amul, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Fereshteh Ansari, Michael K. Hole, Azeem Majeed, Iman Halvaei, Saqib Ali, Arianna Maever L. Amit, Tomas Y. Yeheyis, John S. Ji, Martin McKee, Jamileh Shadid, Leonardo Roever, Peng Jia, Ettore Beghi, Pablo M. Lavados, Young Eun Kim, Vahid Alipour, Sowmya J. Rao, Ahmad Daryani, Cathleen Keller, Ibrahim Abdollahpour, Nicole K. DeCleene, Ebrahim Babaee, Saman Esmaeilnejad, Boris Bikbov, William M. Gardner, Lydia M. Haile, Luca Ronfani, Azalea M. Thomson, Irena Ilic, Ruth W. Kimokoti, Yingxi Zhao, Guoqing Hu, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Nathaniel J. Henry, Brijesh Sathian, Daniel Kim, Peter Memiah, Mohammad Hadi Abbasi, Andrea Farioli, Zahra Kamiab, Bolajoko O. Olusanya, Matthew C. Doxey, Tommi Vasankari, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Shanshan Li, Tanvir M. Huda, Dillon O Sylte, Rosario Cárdenas, Agegnehu Bante, Helen Ippolito, Alyssa Acebedo, Jeffrey D. Stanaway, Anwar Faraj, João Pedro Silva, Amin Mousavi Khaneghah, Pushpendra Kumar, Sangram Kishor Patel, Josephine W. Ngunjiri, Holly E. Erskine, Eugene Sobngwi, Filippo Ariani, Shane D. Morrison, Mohammad Aghaali, Meghan D. Mooney, Vera Marisa Costa, Palash Chandra Banik, Rupak Desai, Ken Takahashi, Maigeng Zhou, Morteza Oladnabi, Bogdan Oancea, Daniela Ribeiro, Mohammad Farahmand, Irmina Maria Michalek, Yetunde O. John-Akinola, Khem Narayan Pokhrel, Emilie R Maddison, Syed Mohamed Aljunid, Damian G. Hoy, Hosni Salem, V. Prakash, Shuhei Nomura, Inga Dora Sigfusdottir, Anders Larsson, Sharareh Eskandarieh, Abdollah Mohammadian-Hafshejani, Somayeh Bohlouli, Joana Morgado-da-Costa, Siamak Sabour, Theo Vos, Han Yong Wunrow, Khaled Khatab, Alireza Zangeneh, Ann Kristin Knudsen, Marissa B Reitsma, Hannah J. Henrikson, Randah R. Hamadeh, Tuomo J. Meretoja, Ireneous N. Soyiri, Giuseppe Grosso, Ziyad Al-Aly, Taraneh Yousefinezhadi, Joseph L Ward, Roba Khundkar, Ricardo Santiago Gomez, Reza Malekzadeh, John J. McGrath, Sandra B. Munro, Shahin Soltani, Amy E. Peden, Rufus Akinyemi, Marcel Ausloos, Naohiro Yonemoto, Bogdan Wojtyniak, Ahmad Ghashghaee, Guilherme Borges, Sadia Bibi, Farhad Islami, Hamed Mirzaei, Mohammad Ali Sahraian, M. Ashworth Dirac, Hosna Janjani, Kairat Davletov, Hermann Brenner, Yuichiro Yano, Elissa M. Abrams, Ana Vukovic, Bartosz Miazgowski, Jobert Richie Nansseu, Jennifer O Lam, Mona Pathak, Leeberk Raja Inbaraj, Thirunavukkarasu Sathish, Asadollah Gholamian, Carlos A Castañeda-Orjuela, Babak Eshrati, Edgar Denova-Gutiérrez, Atte Meretoja, Lorenzo Monasta, Ronan A. Lyons, Neda Kianipour, Desalegn Getnet Demsie, Yasir Waheed, Desta Debalkie Atnafu, Davide Sattin, Kevin S Ikuta, Ghobad Moradi, Srinivas Goli, Krittika Bhattacharyya, Mika Kivimäki, Christopher Troeger, Jordi Alonso, Alireza Ahmadi, Navid Manafi, Caroline Stein, Songhomitra Panda-Jonas, Jason Nguyen, Moses K. Muriithi, Aziz Rezapour, Ismael R. Campos-Nonato, Adrian Pana, H. Dean Hosgood, Noore Alam, James L. Fisher, Mariam Molokhia, Susan F. Rumisha, Ernoiz Antriyandarti, Ayman Grada, Emma Nichols, Babak Asghari, André Luiz Sena Guimarães, Ferrán Catalá-López, Aletta E. Schutte, Fiona B. Bennitt, Maciej Banach, Antonio Biondi, Donal Bisanzio, Josip Car, Ronny Westerman, Shafiu Mohammed, Biniyam Sahiledengle Geberemariyam, Kenji Shibuya, Meghdad Pirsaheb, Milena Santric-Milicevic, Karen M. Tabb, Paula Moraga, Soheil Hassanipour, Hasan Yusefzadeh, Avina Vongpradith, Dara K. Mohammad, Ralph Maddison, Babak Moazen, Getachew Mullu Kassa, Rahman Shiri, Fernando Neves Hugo, Hmwe H Kyu, Zachary V Dingels, Florian Fischer, Valentin Yurievich Skryabin, Rafael Tabarés-Seisdedos, Massimo Cirillo, Nikita Otstavnov, Robert C. Reiner, Van C. Lansingh, Rodrigo Sarmiento-Suarez, Ashkan Afshin, Benjamin A Stark, Mohsen Abbasi-Kangevari, Natalie C. Galles, Behnam Heidari, Eun-Kee Park, Mohammad Ali Jahani, Suzanne Polinder, Mahalaqua Nazli Khatib, Farhad Jadidi-Niaragh, Amir Radfar, Mowafa Househ, Derrick A Bennett, Gaorui Guo, Hesam Ghiasvand, Taweewat Wiangkham, Tamás Joó, Cristiana Abbafati, Kathryn Mei Ming Lau, Anita K. Nandi, Miklós Szócska, Manasi Kumar, Eduardo A. Undurraga, Oladimeji M. Adebayo, Simon Yadgir, Victor Aboyans, Justin J. Lang, Catherine O. Johnson, Soewarta Kosen, Carla Sofia e.Sá Farinha, Marcos Roberto Tovani-Palone, Kamarul Imran Musa, Farshad Pourmalek, Kiomars Sharafi, Heather Orpana, Samuel B. Albertson, Mahdi Afshari, Nicholas J K Breitborde, Nelson J. Alvis-Zakzuk, Adrian Oţoiu, Iván Landires, Robert G. Weintraub, Kidanemaryam Berhe, André Faro, Sophia Emmons-Bell, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Yordanos Gizachew Yeshitila, Mehdi Hosseinzadeh, Arash Etemadi, Oleguer Plana-Ripoll, Theodore Patrick Younker, Joemer C. Maravilla, Alireza Ansari-Moghaddam, Borhan Mansouri, Narayanaswamy Venketasubramanian, Seyed Mohammad Kazem Aghamir, Linda Morales, Amanda Deen, Noushin Mohammadifard, Obinna Onwujekwe, Ai Koyanagi, Michele Nguyen, Chieh Han, Kiana Ramezanzadeh, Mika Shigematsu, Mohammed Shannawaz, Khurshid Alam, Javad Nazari, Bryan L. 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L., Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Public Health, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Sálfræðideild (HR), Department of Psychology (RU), Samfélagssvið (HR), School of Social Sciences (RU), Háskólinn í Reykjavík, Reykjavik University, GBD 2019 Diseases and Injuries Collaborator, Violante FS, Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation, and UT-I-ITC-ACQUAL
Subjects: Male, Life expectancy, Disability-Adjusted Life Year, Diseases, Disease, communicable disease, systematic analysis, Global Burden of Disease, 0302 clinical medicine, 80 and over, Medicine, 10. No inequality, Child, 11 Medical and Health Sciences, injuries, Aged, 80 and over, education.field_of_study, Sjúkdómar, DEMENTIA, FALLS, General Medicine, Forvarnir, 3. Good health, Child, Preschool, Human, GBD, Population health, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Humans, Global Burden of Disease Study, education, Aged, Spatial Analysis, Global burden, Disability, Prevention, DISABILITY, Infant, Spatial Analysi, Mortality rate, Global Burden of Disease, Diseases, Injuries, Systematic analysis, PREVENTION, Years of potential life lost, Risk factors, Disease study, ITC-ISI-JOURNAL-ARTICLE, RISK-FACTORS, Clinical Medicine, RA, Demography, Fötlun, Dánartíðni, Áhættuþættir, 030204 cardiovascular system & hematology, Risk Factors, Cause of Death, Global health, 030212 general & internal medicine, 1. No poverty, Disability-Adjusted Life Years, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, 3142 Public health care science, environmental and occupational health, Adolescent, Adult, Age Distribution, Female, Infant, Newborn, Young Adult, Lýðheilsa, CLINICAL-TRIALS, Population, Settore MED/01 - Statistica Medica, diseases, ITC-HYBRID, Heilbrigðisvísindi, General & Internal Medicine, Mortality, Preschool, Disease burden, business.industry, Risk Factor, Klinisk medicin, Newborn, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Áverkar, Systematic analysis, NA, business
Abstract: Publisher's version (útgefin grein), Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd., Research reported in this publication was supported by the Bill & Melinda Gates Foundation; the University of Melbourne; Queensland Department of Health, Australia; the National Health and Medical Research Council, Australia; Public Health England; the Norwegian Institute of Public Health; St Jude Children's Research Hospital; the Cardiovascular Medical Research and Education Fund; the National Institute on Ageing of the National Institutes of Health (award P30AG047845); and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The authors alone are responsible for the views expressed in this Article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated, the National Health Service (NHS), the National Institute for Health Research (NIHR), the UK Department of Health and Social Care, or Public Health England; the United States Agency for International Development (USAID), the US Government, or MEASURE Evaluation; or the European Centre for Disease Prevention and Control (ECDC). This research used data from the Chile National Health Survey 2003, 2009-10, and 2016-17. The authors are grateful to the Ministry of Health, the survey copyright owner, for allowing them to have the database. All results of the study are those of the authors and in no way committed to the Ministry. The Costa Rican Longevity and Healthy Aging Study project is a longitudinal study by the University of Costa Rica's Centro Centroamericano de Poblacion and Instituto de Investigaciones en Salud, in collaboration with the University of California at Berkeley. The original pre-1945 cohort was funded by the Wellcome Trust (grant 072406), and the 1945-55 Retirement Cohort was funded by the US National Institute on Aging (grant R01AG031716). The principal investigators are Luis Rosero-Bixby and William H Dow and co-principal investigators are Xinia Fernandez and Gilbert Brenes. The accuracy of the authors' statistical analysis and the findings they report are not the responsibility of ECDC. ECDC is not responsible for conclusions or opinions drawn from the data provided. ECDC is not responsible for the correctness of the data and for data management, data merging and data collation after provision of the data. ECDC shall not be held liable for improper or incorrect use of the data. The Health Behaviour in School-Aged Children (HBSC) study is an international study carried out in collaboration with WHO/EURO. The international coordinator of the 1997-98, 2001-02, 2005-06, and 2009-10 surveys was Candace Currie and the databank manager for the 1997-98 survey was Bente Wold, whereas for the following surveys Oddrun Samdal was the databank manager. A list of principal investigators in each country can be found on the HBSC website. Data used in this paper come from the 2009-10 Ghana Socioeconomic Panel Study Survey, which is a nationally representative survey of more than 5000 households in Ghana. The survey is a joint effort undertaken by the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana and the Economic Growth Centre (EGC) at Yale University. It was funded by EGC. ISSER and the EGC are not responsible for the estimations reported by the analysts. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law, 2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. Data for this research was provided by MEASURE Evaluation, funded by USAID. The authors thank the Russia Longitudinal Monitoring Survey, conducted by the National Research University Higher School of Economics and ZAO Demoscope together with Carolina Population Center, University of North Carolina at Chapel Hill and the Institute of Sociology, Russia Academy of Sciences for making data available. This paper uses data from the Bhutan 2014 STEPS survey, implemented by the Ministry of Health with the support of WHO; the Kuwait 2006 and 2014 STEPS surveys, implemented by the Ministry of Health with the support of WHO; the Libya 2009 STEPS survey, implemented by the Secretariat of Health and Environment with the support of WHO; the Malawi 2009 STEPS survey, implemented by Ministry of Health with the support of WHO; and the Moldova 2013 STEPS survey, implemented by the Ministry of Health, the National Bureau of Statistics, and the National Center of Public Health with the support of WHO. This paper uses data from Survey of Health, Ageing and Retirement in Europe (SHARE) Waves 1 (DOI:10.6103/SHARE. w1.700), 2 (10.6103/SHARE.w2.700), 3 (10.6103/SHARE.w3.700), 4 (10.6103/SHARE.w4.700), 5 (10.6103/SHARE.w5.700), 6 (10.6103/SHARE.w6.700), and 7 (10.6103/SHARE.w7.700); see Borsch-Supan and colleagues (2013) for methodological details. The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N degrees 211909, SHARE-LEAP: GA N degrees 227822, SHARE M4: GA N degrees 261982) and Horizon 2020 (SHARE-DEV3: GA N degrees 676536, SERISS: GA N degrees 654221) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged. This study has been realised using the data collected by the Swiss Household Panel, which is based at the Swiss Centre of Expertise in the Social Sciences. The project is financed by the Swiss National Science Foundation. The United States Aging, Demographics, and Memory Study is a supplement to the Health and Retirement Study (HRS), which is sponsored by the National Institute of Aging (grant number NIA U01AG009740). It was conducted jointly by Duke University and the University of Michigan. The HRS is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. This paper uses data from Add Health, a program project designed by J Richard Udry, Peter S Bearman, and Kathleen Mullan Harris, and funded by a grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due to Ronald R Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website. No direct support was received from grant P01-HD31921 for this analysis. The data reported here have been supplied by the United States Renal Data System. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US Government. Collection of data for the Mozambique National Survey on the Causes of Death 2007-08 was made possible by USAID under the terms of cooperative agreement GPO-A-00-08-000_D3-00. This manuscript is based on data collected and shared by the International Vaccine Institute (IVI) from an original study IVI conducted. L G Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Brazil; finance code 001) and Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, a Brazilian funding agency). I N Ackerman was supported by a Victorian Health and Medical Research Fellowship awarded by the Victorian Government. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. A Agrawal acknowledges the Wellcome Trust DBT India Alliance Senior Fellowship. 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. M Ausloos, C Herteliu, and A Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. A Badawi is supported by the Public Health Agency of Canada. D A Bennett was supported by the NIHR Oxford Biomedical Research Centre. R Bourne acknowledges the Brien Holden Vision Institute, University of Heidelberg, Sightsavers, Fred Hollows Foundation, and Thea Foundation. G B Britton and I Moreno Velasquez were supported by the Sistema Nacional de Investigacion, SNI-SENACYT, Panama. R Buchbinder was supported by an Australian National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship. J J Carrero was supported by the Swedish Research Council (2019-01059). F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. A R Chang was supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases grant K23 DK106515. V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundacao para a Ciencia e Tecnologia, IP, under the Norma Transitaria DL57/2016/CP1334/CT0006. A Douiri acknowledges support and funding from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust and the Royal College of Physicians, and support from the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. B B Duncan acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. H E Erskine is the recipient of an Australian NHMRC Early Career Fellowship grant (APP1137969). A J Ferrari was supported by a NHMRC Early Career Fellowship grant (APP1121516). H E Erskine and A J Ferrari are employed by and A M Mantilla-Herrera and D F Santomauro affiliated with the Queensland Centre for Mental Health Research, which receives core funding from the Queensland Department of Health. M L Ferreira holds an NHMRC Research Fellowship. C Flohr was supported by the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust. M Freitas acknowledges financial support from the EU (European Regional Development Fund [FEDER] funds through COMPETE POCI-01-0145-FEDER-029248) and National Funds (Fundacao para a Ciencia e Tecnologia) through project PTDC/NAN-MAT/29248/2017. A L S Guimaraes acknowledges support from CNPq. C Herteliu was partially supported by a grant co-funded by FEDER through Operational Competitiveness Program (project ID P_40_382). P Hoogar acknowledges Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education and Centre for Holistic Development and Research, Kalaghatagi. F N Hugo acknowledges the Visiting Professorship, PRINT Program, CAPES Foundation, Brazil. B-F Hwang was supported by China Medical University (CMU107-Z-04), Taichung, Taiwan. S M S Islam was funded by a National Heart Foundation Senior Research Fellowship and supported by Deakin University. R Q Ivers was supported by a research fellowship from the National Health and Medical Research Council of Australia. M Jakovljevic acknowledges the Serbian part of this GBD-related contribution was co-funded through Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. P Jeemon was supported by a Clinical and Public Health intermediate fellowship (grant number IA/CPHI/14/1/501497) from the Wellcome Trust-Department of Biotechnology, India Alliance (2015-20). O John is a recipient of UIPA scholarship from University of New South Wales, Sydney. S V Katikireddi acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13, MC_UU_12017/15), and the Scottish Government Chief Scientist Office (SPHSU13, SPHSU15). C Kieling is a CNPq researcher and a UK Academy of Medical Sciences Newton Advanced Fellow. Y J Kim was supported by Research Management Office, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/00010). K Krishan is supported by UGC Centre of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar was supported by K43 TW 010716 FIC/NIMH. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. J V Lazarus was supported by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III [ISCIII]/ESF, the EU [CP18/00074]). K J Looker thanks the NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England, for research support. S Lorkowski was funded by the German Federal Ministry of Education and Research (nutriCARD, grant agreement number 01EA1808A). R A Lyons is supported by Health Data Research UK (HDR-9006), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, NIHR (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust. J J McGrath is supported by the Danish National Research Foundation (Niels Bohr Professorship), and the Queensland Health Department (via West Moreton HHS). P T N Memiah acknowledges support from CODESRIA. U O Mueller gratefully acknowledges funding by the German National Cohort Study BMBF grant number 01ER1801D. S Nomura acknowledges the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). A Ortiz was supported by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. S B Patten was supported by the Cuthbertson & Fischer Chair in Pediatric Mental Health at the University of Calgary. G C Patton was supported by an aNHMRC Senior Principal Research Fellowship. M R Phillips was supported in part by the National Natural Science Foundation of China (NSFC, number 81371502 and 81761128031). A Raggi, D Sattin, and S Schiavolin were supported by grants from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4-Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). P Rathi and B Unnikrishnan acknowledge Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. A L P Ribeiro was supported by Brazilian National Research Council, CNPq, and the Minas Gerais State Research Agency, FAPEMIG. D C Ribeiro was supported by The Sir Charles Hercus Health Research Fellowship (#18/111) Health Research Council of New Zealand. D Ribeiro acknowledges financial support from the EU (FEDER funds through the Operational Competitiveness Program; POCI-01-0145-FEDER-029253). P S Sachdev acknowledges funding from the NHMRC of Australia Program Grant. A M Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. M M Santric-Milicevic acknowledges the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). R Sarmiento-Suarez received institutional support from Applied and Environmental Sciences University (Bogota, Colombia) and ISCIII (Madrid, Spain). A E Schutte received support from the South African National Research Foundation SARChI Initiative (GUN 86895) and Medical Research Council. S T S Skou is currently funded by a grant from Region Zealand (Exercise First) and a grant from the European Research Council under the EU's Horizon 2020 research and innovation program (grant agreement number 801790). J B Soriano is funded by Centro de Investigacion en Red de Enfermedades Respiratorias, ISCIII. R Tabares-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII-FEDER. N Taveira was partially supported by the European & Developing Countries Clinical Trials Partnership, the EU (LIFE project, reference RIA2016MC-1615). S Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral programme (reference number CD15/00019 from ISCIII-FEDER). S B Zaman received a scholarship from the Australian Government research training programme in support of his academic career., "Peer Reviewed"
Published: 2020
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25. May Measurement Month 2017: an analysis of blood pressure screening results in Georgia-Europe

Author: Neil R Poulter, D. Trapaidze, B. Tsinamdzgvrishvili, Tamar Abesadze, Nino Grdzelidze, Maia Kereselidze, Ramaz Urushadze, Lela Sturua, Amiran Gamkrelidze, Thomas Beaney, Nana Mebonia, Ekaterine Ruadze, and Xin Xia
Subjects: medicine.medical_specialty, education.field_of_study, Measurement method, business.industry, Population, Mean age, Articles, Blood pressure, Cardiovascular System & Hematology, Family medicine, Scale (social sciences), medicine, Risk factor, Cardiology and Cardiovascular Medicine, business, education, 1102 Cardiorespiratory Medicine and Haematology, Public health policy, Public awareness
Abstract: Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. According to STEPS-Georgia, between 2010 and 2016, arterial hypertension prevalence (BP ≥140/90 mmHg or being treated) increased from 33.4% to 37.7%. According to the Health for All (HFA) (WHO data set) Database in Georgia in 2015 cardiovascular disease (CVD) mortality contributed to 42.6% of overall deaths; among them 23.3% is due to coronary heart disease (CHD), and 30% due to cerebrovascular diseases. An opportunistic screening of volunteers aged ≥18 was carried out in May 2017 (MMM17). BP measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. Screening was carried out in 50 sites at a national scale (clinics, public places). Five hundred volunteers, mostly medical personnel took part in the project. A total of 6144 individuals were screened during MMM17. After multiple imputations, 3744 (60.9%) had hypertension. Of those not on anti-hypertensive medication, 958 (28.5%) respondents were found to have hypertension, while 1862 (66.8%) individuals receiving anti-hypertensive medication, had uncontrolled BP. MMM17 was the largest BP screening campaign undertaken in Georgia. Approximately 60% of those screened had hypertension and among those who receive medication, up to 70% are treated inadequately. These results suggest that opportunistic screening can identify a significant number of people with raised BP.
Published: 2019

26. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

Author: Nancy, Fullman, Jamal, Yearwood, Solomon, M, Abay, Cristiana, Abbafati, Foad, Abd-Allah, Jemal, Abdela, Ahmed, Abdelalim, Zegeye, Abebe, Teshome, Abuka, Abebo, Victor, Aboyans, Haftom, Niguse, Abraha, Daisy, M, X, Abreu, Laith, Abu-Raddad, J, Akilew, Awoke, Adane, Rufus, Adesoji, Adedoyin, Olatunji, Adetokunboh, Tara, Ballav, Adhikari, Mohsen, Afarideh, Ashkan, Afshin, Gina, Agarwal, Dominic, Agius, Anurag, Agrawal, Sutapa, Agrawal, Aliasghar, Ahmad, Kiadaliri, Miloud, Taki, Eddine, Aichour, Mohammed, Akibu, Rufus, Olusola, Akinyemi, Tomi, Akinyemiju, F, Nadia, Akseer, Faris, Hasan, Lami, Al, Fares, Alahdab, Ziyad, Al-Aly, Khurshid, Alam, Tahiya, Alam, Deena, Alasfoor, Mohammed, I, Albittar, Kefyalew, Addis, Alene, Ayman, Al-Eyadhy, Syed, Danish, Ali, Mehran, Alijanzadeh, Syed, M, Aljunid, Ala’A, Alkerwi, François, Alla, Peter, Allebeck, Christine, Allen, Mahmoud, A, Alomari, Rajaa, Al-Raddadi, Ubai, Alsharif, Khalid, A, Altirkawi, Nelson, Alvis-Guzman, Azmeraw, T, Amare, Kebede, Amenu, Walid, Ammar, Yaw, Ampem, Amoako, Nahla, Anber, Catalina, Liliana, Andrei, Sofia, Androudi, Carl, Abelardo, Antonio, T, Valdelaine, E, Araújo, M, Olatunde, Aremu, Johan, Ärnlöv, Artaman, Al, Krishna, Kumar, Aryal, Hamid, Asayesh, Ephrem, Tsegay, Asfaw, Solomon, Weldegebreal, Asgedom, Rana, Jawad, Asghar, Mengistu, Mitiku, Ashebir, Netsanet, Abera, Asseffa, Tesfay, Mehari, Atey, Sachin, R, Atre, Madhu, Atteraya, S, Leticia, Avila-Burgos, Euripide, Frinel, Arthur, G, Avokpaho, Ashish, Awasthi, Beatriz, Paulina, Ayala, Quintanilla, Animut, Alebel, Ayalew, Henok, Tadesse, Ayele, Rakesh, Ayer, Tambe, Betrand, Ayuk, Peter, Azzopardi, Natasha, Azzopardi-Muscat, Tesleem, Kayode, Babalola, Hamid, Badali, Alaa, Badawi, Maciej, Banach, Amitava, Banerjee, Amrit, Banstola, Ryan, M, Barber, Miguel, Barboza, A, Suzanne, L, Barker-Collo, Till, Bärnighausen, Simon, Barquera, Lope, H, Barrero, Quique, Bassat, Sanjay, Basu, Bernhard, T, Baune, Shahrzad, Bazargan-Hejazi, Neeraj, Bedi, Ettore, Beghi, Masoud, Behzadifar, Meysam, Behzadifar, Bayu, Begashaw, Bekele, Abate, Bekele, Belachew, Saba, Abraham, Belay, Yihalem, Abebe, Belay, Michelle, L, Bell, Aminu, Bello, K, Derrick, A, Bennett, James, Bennett, R, Isabela, M, Bensenor, Derbew, Fikadu, Berhe, Eduardo, Bernabé, Robert, Steven, Bernstein, Mircea, Beuran, Ashish, Bhalla, Paurvi, Bhatt, Soumyadeep, Bhaumik, Zulfiqar, A, Bhutta, Belete, Biadgo, Ali, Bijani, Boris, Bikbov, Charles, Birungi, Stan, Biryukov, Hailemichael, Bizuneh, Ian, W, Bolliger, Kaylin, Bolt, Ibrahim, R, Bou-Orm, Kayvan, Bozorgmehr, Oliver, Jerome, Brady, Alexandra, Brazinova, Nicholas, J, Breitborde, K, Hermann, Brenner, Gabrielle, Britton, Traolach, S, Brugha, Zahid, Butt, A, Lucero, Cahuana-Hurtado, Ismael, Ricardo, Campos-Nonato, Julio, Cesar, Campuzano, Josip, Car, Mate, Car, Rosario, Cárdenas, Juan, Jesus, Carrero, Felix, Carvalho, Carlos, A, Castañeda-Orjuela, Jacqueline, Castillo, Rivas, Ferrán, Catalá-López, Kelly, Cercy, Julian, Chalek, Hsing-Yi, Chang, Jung-Chen, Chang, Aparajita, Chattopadhyay, Pankaj, Chaturvedi, Peggy, Pei-Chia, Chiang, Vesper, Hichilombwe, Chisumpa, Jee-Young, J, Choi, Hanne, Christensen, Devasahayam, Jesudas, Christopher, Sheng-Chia, Chung, Liliana, G, Ciobanu, Cirillo, Massimo, Danny, Colombara, Sara, Conti, Cyrus, Cooper, Leslie, Cornaby, Paolo, Angelo, Cortesi, Monica, Cortinovis, Alexandre, Costa, Pereira, Ewerton, Cousin, Michael, H, Criqui, Elizabeth, Cromwell, A, Christopher, Stephen, Crowe, John, Crump, A, Alemneh, Kabeta, Daba, Berihun, Assefa, Dachew, Abel, Fekadu, Dadi, Lalit, Dandona, Rakhi, Dandona, Paul, I, Dargan, Ahmad, Daryani, Maryam, Daryani, Jai, Das, Siddharth, Kumar, Das, José, Das, Neves, Nicole, Davis, Weaver, Kairat, Davletov, Barbora, De, Courten, Diego, Leo, De, Jan-Walter, De, Neve, Robert, Dellavalle, P, Gebre, Demoz, Kebede, Deribe, Don, C, Des, Jarlais, Subhojit, Dey, Samath, D, Dharmaratne, Meghnath, Dhimal, Shirin, Djalalinia, David, Teye, Doku, Kate, Dolan, Ray, 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Amanuel, Tesfay, Gebremedhin, Yalemzewod, Assefa, Gelaw, Johanna, M, Geleijnse, Demeke, Geremew, Peter, W, Gething, Reza, Ghadimi, Khalil, Ghasemi, Falavarjani, Maryam, Ghasemi-Kasman, Paramjit, Singh, Gill, Ababi, Zergaw, Giref, Maurice, Giroud, Melkamu, Dedefo, Gishu, Giorgia, Giussani, William, W, Godwin, Srinivas, Goli, Hector, Gomez-Dantes, Philimon, N, Gona, Amador, Goodridge, Sameer, Vali, Gopalani, Yevgeniy, Goryakin, Alessandra, Carvalho, Goulart, Ayman, Grada, Max, Griswold, Giuseppe, Grosso, Harish, Chander, Gugnani, Yuming, Guo, Rahul, Gupta, Rajeev, Gupta, Tanush, Gupta, Tarun, Gupta, Vipin, Gupta, Juanita, A, Haagsma, Vladimir, Hachinski, Nima, Hafezi-Nejad, Gessessew, Bugssa, Hailu, Randah, Ribhi, Hamadeh, Samer, Hamidi, Graeme, J, Hankey, Hilda, Harb, L, Heather, C, Harewood, Sivadasanpillai, Harikrishnan, Josep, Maria, Haro, Hamid, Yimam, Hassen, Rasmus, Havmoeller, Caitlin, Hawley, Simon, I, Hay, Jiawei, He, Stephen, J, Hearps, C, Mohamed, I, Hegazy, Behzad, Heibati, Mohsen, Heidari, Delia, Hendrie, Nathaniel, J, Henry, Victor, Hugo, Herrera, Ballesteros, Claudiu, Herteliu, Desalegn, Tsegaw, Hibstu, Molla, Kahssay, Hiluf, Hans, W, Hoek, Enayatollah, Homaie, Rad, Nobuyuki, Horita, Dean, H, Hosgood, Mostafa, Hosseini, Seyed, Reza, Hosseini, Mihaela, Hostiuc, Sorin, Hostiuc, Damian, G, Hoy, Mohamed, Hsairi, Aung, Soe, Htet, Guoqing, Hu, John, J, Huang, Kim, Moesgaard, Iburg, Fachmi, Idris, Ehimario, Uche, Igumbor, Chad, Ikeda, Bogdan, Vasile, Ileanu, Olayinka, Ilesanmi, S, Kaire, Innos, Seyed, Sina, Naghibi, Irvani, Caleb, M, Irvine, S, Farhad, Islami, Troy, A, Jacobs, Kathryn, Jacobsen, H, Nader, Jahanmehr, Rajesh, Jain, Sudhir, Kumar, Jain, Mihajlo, Jakovljevic, M, Moti, Tolera, Jalu, Amr, Jamal, A, Mehdi, Javanbakht, Achala, Upendra, Jayatilleke, Panniyammakal, Jeemon, Ravi, Prakash, Jha, Vivekanand, Jha, Jacek, Józwiak, Oommen, John, Sarah, Charlotte, Johnson, Jost, Jonas, B, Vasna, Joshua, Mikk, Jürisson, Zubair, Kabir, Rajendra, Kadel, Amaha, 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Maria Jesu, Rivera, Juan A., Roever, Leonardo, Ronfani, Luca, Roshandel, Gholamreza, Rostami, Ali, Roth, Gregory A., Rothenbacher, Dietrich, Roy, Ambuj, Roy, Nobhojit, Ruhago, George Mugambage, Sabde, Yogesh Damodar, Sachdev, Perminder S., Sadat, Nafi, Safdarian, Mahdi, Safiri, Saeid, Sagar, Rajesh, Sahebkar, Amirhossein, Sahraian, Mohammad Ali, Sajadi, Haniye Sadat, Salama, Joseph, Salamati, Payman, De Freitas Saldanha, Raphael, Salimzadeh, Hamideh, Salomon, Joshua A., Samy, Abdallah M., Sanabria, Juan Ramon, Sancheti, Parag K., Sanchez-Niño, Maria Dolore, Santomauro, Damian, Santos, Itamar S., Santric Milicevic, Milena M., Sarker, Abdur Razzaque, Sarrafzadegan, Nizal, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Saxena, Sonia, Saylan, Mete I., Schaeffner, Elke, Schmidhuber, Josef, Schmidt, Maria Inê, Schneider, Ione J.C., Schumacher, Austin E., Schutte, Aletta E., Schwebel, David C., Schwendicke, Falk, Sekerija, Mario, Sepanlou, Sadaf G., Servan-Mori, Edson 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Stathopoulou, Vasiliki, Steel, Nichola, Stein, Dan J., Stokes, Mark Andrew, Sturua, Lela, Sufiyan, Muawiyyah Babale, Suliankatchi, Rizwan Abdulkader, Sunguya, Bruno F., Sur, Patrick J., Sykes, Bryan L., Sylaja, P.N., Szoeke, Cassandra E.I., Tabarés-Seisdedos, Rafael, Tadakamadla, Santosh Kumar, Tadesse, Andualem Henok, Taffere, Getachew Redae, Tandon, Nikhil, Tariku, Amare Tariku, Taveira, Nuno, Tehrani-Banihashemi, Arash, Temam Shifa, Girma, Temsah, Mohamad-Hani, Terkawi, Abdullah Sulieman, Tesema, Azeb Gebresilassie, Tesfaye, Dawit Jember, Tessema, Belay, Thakur, J.S., Thomas, Nihal, Thompson, Matthew J., Tillmann, Taavi, To, Quyen G., Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Torre, Anna, Tortajada, Miguel, Tran, Bach Xuan, Tran, Khanh Bao, Tripathi, Avnish, Tripathy, Srikanth Prasad, Troeger, Christopher, Truelsen, Thoma, Tsoi, Derrick, Tudor Car, Lorainne, Tuem, Kald Beshir, Tyrovolas, Stefano, Uchendu, Uche S., Ukwaja, Kingsley Nnanna, Ullah, Irfan, Updike, Rachel, Uthman, Olalekan A., Uzochukwu, Benjamin S. Chudi, Valdez, Pascual Rubén, Van Boven, Job F.M., Varughese, Santosh, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Violante, Francesco S., Vladimirov, Sergey K., Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wagnew, Fasil, Waheed, Yasir, Wallin, Mitchell T., Walson, Judd L., Wang, Yafeng, Wang, Yuan-Pang, Wassie, Molla Mesele, Weaver, Marcia R., Weiderpass, Elisabete, Weintraub, Robert G., Weiss, Jordan, Weldegwergs, Kidu Gidey, Werdecker, Andrea, West, T. 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Sd, Aljunid, Sm, Alomari, Ma, Altirkawi, Ka, Amare, At, Amoako, Ya, Andrei, Cl, Antonio, Cat, Araújo, Vem, Aryal, Kk, Asfaw, Et, Asgedom, Sw, Asghar, Rj, Ashebir, Mm, Asseffa, Na, Atey, Tm, Atre, Sr, Avokpaho, Efga, Ayala Quintanilla, Bp, Ayalew, Aa, Ayele, Ht, Ayuk, Tb, Babalola, Tk, Barber, Rm, Barboza, Ma, Barker-Collo, Sl, Barrero, Lh, Baune, Bt, Bekele, Bb, Belachew, Ab, Belay, Sa, Belay, Ya, Bell, Ml, Bello, Ak, Bennett, Da, Bennett, Jr, Bensenor, Im, Berhe, Df, Bhutta, Za, Bolliger, Iw, Bou-Orm, Ir, Brady, Oj, Breitborde, Njk, Butt, Za, Campos-Nonato, Ir, Campuzano, Jc, Carrero, Jj, Castañeda-Orjuela, Ca, Chang, Hy, Chang, Jc, Chiang, Pp, Chisumpa, Vh, Choi, Jj, Christopher, Dj, Chung, Sc, Ciobanu, Lg, Cortesi, Pa, Criqui, Mh, Cromwell, Ea, Crump, Ja, Daba, Ak, Dachew, Ba, Dadi, Af, Dargan, Pi, Das, Sk, De Neve, Jw, Dellavalle, Rp, Des Jarlais, Dc, Dharmaratne, Sd, Doku, Dt, Dorsey, Er, Dos Santos, Kpb, Doyle, Ke, Driscoll, Tr, Duncan, Bb, Ehrlich, Jr, El-Khatib, Zz, Endries, Ay, Faraon, Eja, Feigin, Vl, Feigl, Ab, Fereshtehnejad, Sm, Fernandes, Jc, Fijabi, Do, Flaxman, Ad, Foreman, Kj, Frostad, Jj, Futran, Nd, Gebre, Ak, Gebrehiwot, Tt, Gebremedhin, At, Gelaw, Ya, Geleijnse, Jm, Gething, Pw, Giref, Az, Gishu, Md, Godwin, Ww, Gona, Pn, Gopalani, Sv, Goulart, Ac, Gugnani, Hc, Haagsma, Ja, Hailu, Gb, Hamadeh, Rr, Hankey, Gj, Harb, Hl, Harewood, Hc, Haro, Jm, Hassen, Hy, Hay, Si, Hearps, Sjc, Hegazy, Mi, Henry, Nj, Herrera Ballesteros, Vh, Hibstu, Dt, Hiluf, Mk, Hoek, Hw, Hosgood, Hd, Hosseini, Sr, Hoy, Dg, Huang, Jj, Iburg, Km, Igumbor, Eu, Ileanu, Bv, Irvani, Ssn, Irvine, Cm, Jacobs, Ta, Jacobsen, Kh, Jain, Sk, Jakovljevic, Mb, Jalu, Mt, Jamal, Aa, Jayatilleke, Au, Jha, Rp, Johnson, Sc, Jonas, Jb, Karema, Ck, Karimi, Sm, Kassa, Dh, Kassa, Gm, Kassa, Td, Kassebaum, Nj, Katikireddi, Sv, Keiyoro, Pn, Kemp, Gr, Kengne, Ap, Ketema, Eb, Khafaie, Ma, Khalil, Ia, Khan, Ea, Khan, Mn, Khan, Ma, Khanal, Mn, Khang, Yh, Khater, Mm, Khoja, Ata, Kibret, Gd, Kiirithio, Dn, Kim, Yj, Kimokoti, Rw, Kopec, Ja, Koul, Pa, Krohn, Kj, Kumar, Ga, Kyu, Hh, Lad, Dp, Lal, Dk, Lang, Jj, Lansingh, Vc, Lazarus, Jv, Leasher, Jl, Lee, Ph, Leshargie, Ct, Liben, Ml, Lim, Ll, Lopez, Ad, Lorch, Sa, Lotufo, Pa, Lucas, Tcd, Lyons, Ra, Macarayan, Erk, Mackay, Mt, Maddison, Er, Malta, Dc, Mamun, Aa, Mansournia, Ma, Mantovani, Lg, Mapoma, Cc, Martins, Sco, Martins-Melo, Fr, Massenburg, Bb, Mathur, Mr, Maulik, Pk, Mcgrath, Jj, Mehta, Km, Meles, Kg, Memish, Za, Mengiste, Da, Mengistu, Dt, Menota, Bg, Mensah, Ga, Meretoja, Tj, Mezgebe, Hb, Miller, Tr, Mini, Gk, Mirrakhimov, Em, Mitchell, Pb, Mlashu, Fw, Mohammad, Ka, Mohammed, Ma, Mokdad, Ah, Mola, Gl, Montañez Hernandez, Jc, Morrison, Sd, Mousavi, Sm, Mueller, Uo, Murthy, Gv, Musa, Ki, Naik, Ga, Nansseu, Jrn, Narayan, Kv, Nascimento, Br, Negoi, Ri, Newton, Cr, Ngunjiri, Jw, Nguyen, Th, Ningrum, Dna, Nong, Vm, Norheim, Of, Noubiap, Jjn, Obermeyer, Cm, Ogbo, Fa, Oh, Ih, Olagunju, At, Olagunju, To, Olivares, Pr, Oliveira, Ppv, Olsen, He, Olusanya, Bo, Olusanya, Jo, Opio, Jn, Ortega-Altamirano, Dv, Pain, Aw, Palone, Mrt, Pandian, Jd, Park, Ek, Patil, St, Patton, Gc, Paturi, Vr, Pedroso, Mm, Pedroza, Sp, Pereira, Dm, Phillips, Mr, Piel, Fb, Pigott, Dm, Pillay, Jd, Piradov, Ma, Pond, Cd, Postma, Mj, Prasad, Nm, Quintana, Hk, Rahman, Ma, Rahman, Su, Rai, Rk, Raju, Sb, Rana, Sm, Rawaf, Dl, Ray, Se, Razo-García, Ca, Reiner, Rc, Reitsma, Mb, Renzaho, Amn, Ribeiro, Al, Rios Blancas, Mj, Rivera, Ja, Roth, Ga, Ruhago, Gm, Sabde, Yd, Sahraian, Ma, Saldanha, Rf, Salomon, Ja, Samy, Am, Sanabria, Jr, Sancheti, Pk, Sanchez-Niño, Md, Santric Milicevic, Mm, Sarker, Ar, Saylan, Mi, Schmidt, Mi, Schneider, Ijc, Schumacher, Ae, Schutte, Ae, Schwebel, Dc, Sepanlou, Sg, Servan-Mori, Ee, Shaikh, Ma, Shariful Islam, Sm, Shfare, Mt, Shrime, Mg, Shukla, Sr, Sigfusdottir, Id, Silberberg, Dh, Silva, Da, Silva, Jp, Silveira, Dga, Singh, Ja, Singh, Np, Sinha, Dn, Sinke, Ah, Soares Filho, Am, Sobaih, Bha, Sorensen, Rjd, Soriano, Jb, Soyiri, In, 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Subjects: Peformance, Coverage, Dánartíðni, Lífslíkur, Life expectancy, GBD, Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0–100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best), universal health coverage, Article, access quality health care, health care access and quality index, Nations, Healthcare Acce, Cause-specific mortality, Psychology, Healthcare Access and Quality Index, Mælitæki, States, Medicine (all), Health care, Þjóðir, Public Health, Global Health, Social Medicine and Epidemiology, Quality, Heilbrigðisþjónusta, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Sálfræði, Indicator, Amenable mortality, Transition, we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0–100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8–98·1) in Iceland, followed by 96·6 (94·9–97·9) in Norway and 96·1 (94·5–97·3) in the Netherlands, to values as low as 18·6 (13·1–24·4) in the Central African Republic, 19·0 (14·3–23·7) in Somalia, and 23·4 (20·2–26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1–93·6) in Beijing to 48·0 (43·4–53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6–68·8) in Goa to 34·0 (30·3–38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view—and subsequent provision—of quality health care for all populations, Trends, Inequalities
Abstract: Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97.1 (95% UI 95.8-98.1) in Iceland, followed by 96.6 (94.9-97.9) in Norway and 96.1 (94.5-97.3) in the Netherlands, to values as low as 18.6 (13.1-24.4) in the Central African Republic, 19.0 (14.3-23.7) in Somalia, and 23.4 (20.2-26.8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91.5 (89.1-936) in Beijing to 48.0 (43.4-53.2) in Tibet (a 43.5-point difference), while India saw a 30.8-point disparity, from 64.8 (59.6-68.8) in Goa to 34.0 (30.3-38.1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4.8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20.9-point to 17.0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17.2-point to 20.4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view and subsequent provision of quality health care for all populations., Bill & Melinda Gates Foundation. Barbora de Courten is supported by a National Heart Foundation Future Leader Fellowship (100864). Ai Koyanagi’s work is supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R + D + I and funded by the ISCIII —General Branch Evaluation and Promotion of Health Research—and the European Regional Development Fund (ERDF-FEDER). Alberto Ortiz was supported by Spanish Government (Instituto de Salud Carlos III RETIC REDINREN RD16/0019 FEDER funds). Ashish Awasthi acknowledges funding support from Department of Science and Technology, Government of India through INSPIRE Faculty scheme Boris Bikbov has received funding from the European Union’s Horizon 2020 research and innovation programme under Marie Sklodowska-Curie grant agreement No. 703226. Boris Bikbov acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group. Panniyammakal Jeemon acknowledges support from the clinical and public health intermediate fellowship from the Wellcome Trust and Department of Biotechnology, India Alliance (2015–20). Job F M van Boven was supported by the Department of Clinical Pharmacy & Pharmacology of the University Medical Center Groningen, University of Groningen, Netherlands. Olanrewaju Oladimeji is an African Research Fellow hosted by Human Sciences Research Council (HSRC), South Africa and he also has honorary affiliations with Walter Sisulu University (WSU), Eastern Cape, South Africa and School of Public Health, University of Namibia (UNAM), Namibia. He is indeed grateful for support from HSRC, WSU and UNAM. EUI is supported in part by the South African National Research Foundation (NRF UID: 86003). Ulrich Mueller acknowledges funding by the German National Cohort Study grant No 01ER1511/D, Gabrielle B Britton is supported by Secretaría Nacional de Ciencia, Tecnología e Innovación and Sistema Nacional de Investigación de Panamá. Giuseppe Remuzzi acknowledges that the work related to this paper has been done on behalf of the GBD Genitourinary Disease Expert Group. Behzad Heibati would like to acknowledge Air pollution Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran. Syed Aljunid acknowledges the National University of Malaysia for providing the approval to participate in this GBD Project. Azeem Majeed and Imperial College London are grateful for support from the Northwest London National Insititute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research & Care. Tambe Ayuk acknowledges the Institute of Medical Research and Medicinal Plant Studies for office space provided. José das Neves was supported in his contribution to this work by a Fellowship from Fundação para a Ciência e a Tecnologia, Portugal (SFRH/BPD/92934/2013). João Fernandes gratefully acknowledges funding from FCT–Fundação para a Ciência e a Tecnologia (grant number UID/Multi/50016/2013). Jan-Walter De Neve was supported by the Alexander von Humboldt Foundation. Kebede Deribe is funded by a Wellcome Trust Intermediate Fellowship in Public Health and Tropical Medicine (201900). Kazem Rahimi was supported by grants from the Oxford Martin School, the NIHR Oxford BRC and the RCUK Global Challenges Research Fund. Laith J Abu-Raddad acknowledges the support of Qatar National Research Fund (NPRP 9-040-3-008) who provided the main funding for generating the data provided to the GBD-IHME effort. Liesl Zuhlke is funded by the national research foundation of South Africa and the Medical Research Council of South Africa. Monica Cortinovis acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group. Chuanhua Yu acknowleges support from the National Natural Science Foundation of China (grant number 81773552 and grant number 81273179) Norberto Perico acknowledges that work related to this paper has been done on behalf of the GBD Genitourinary Disease Expert Group. Charles Shey Wiysonge’s work is supported by the South African Medical Research Council and the National Research Foundation of South Africa (grant numbers 106035 and 108571). John J McGrath is supported by grant APP1056929 from the John Cade Fellowship from the National Health and Medical Research Council and the Danish National Research Foundation (Niels Bohr Professorship). Quique Bassat is an ICREA (Catalan Institution for Research and Advanced Studies) research professor at ISGlobal. Richard G White is funded by the UK MRC and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement that is also part of the EDCTP2 programme supported by the European Union (MR/P002404/1), the Bill & Melinda Gates Foundation (TB Modelling and Analysis Consortium: OPP1084276/OPP1135288, CORTIS: OPP1137034/OPP1151915, Vaccines: OPP1160830), and UNITAID (4214-LSHTM-Sept15; PO 8477-0-600). Rafael Tabarés-Seisdedos was supported in part by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI17/00719 from ISCIII-FEDER. Mihajlo Jakovljevic acknowleges contribution from the Serbian Ministry of Education Science and Technological Development of the Republic of Serbia (grant OI 175 014). Shariful Islam is funded by a Senior Fellowship from Institute for Physical Activity and Nutrition, Deakin University and received career transition grants from High Blood Pressure Research Council of Australia. Sonia Saxena is funded by various grants from the NIHR. Stefanos Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral program (reference number CD15/00019 from the Instituto de Salud Carlos III (ISCIII–Spain) and the Fondos Europeo de Desarrollo Regional. Stefanos was awarded with a 6 months visiting fellowship funding at IHME from M-AES (reference no. MV16/00035 from the Instituto de Salud Carlos III). S Vittal Katikreddi was funded by a NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the MRC (MC_UU_12017/13 & MC_ UU_12017/15) and the Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15). Traolach S Brugha has received funding from NHS Digital UK to collect data used in this study. The work of Hamid Badali was financially supported by Mazandaran University of Medical Sciences, Sari, Iran. The work of Stefan Lorkowski is funded by the German Federal Ministry of Education and Research (nutriCARD, Grant agreement number 01EA1411A). Mariam Molokhia’s research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We also thank the countless individuals who have contributed to GBD 2016 in various capacities.
Published: 2018

27. Leading causes of death of women of reproductive age in the Republic of Georgia: findings from the National Reproductive Age Mortality Survey (2014)

Author: Babill Stray-Pedersen, Marina Topuridze, Ekaterine Pestvenidze, Maia Kereselidze, Nino Berdzuli, Lela Sturua, and Nino Lomia
Subjects: verbal autopsy, noncommunicable diseases, Population, International Journal of Women's Health, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Uterine cancer, women’s health, Maternity and Midwifery, medicine, cancer, 030212 general & internal medicine, education, Reproductive health, Original Research, injuries, Cervical cancer, education.field_of_study, business.industry, Mortality rate, Obstetrics and Gynecology, Cancer, medicine.disease, Verbal autopsy, mortality, Oncology, business, Demography
Abstract: Nino Lomia,1 Nino Berdzuli,1 Lela Sturua,2 Maia Kereselidze,3 Marina Topuridze,4 Ekaterine Pestvenidze,1 Babill Stray-Pedersen1,5 1Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; 2Department of Non-Communicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia; 3Department of Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia; 4Health Promotion Division, Department of Non-Communicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia; 5Department of Obstetrics and Gynecology, Rikshospitalet, Oslo University Hospital, Oslo, Norway Purpose: An understanding of women’s health problems during the reproductive years, based on reliable cause-of-death data, is of critical importance to avoid premature female mortality. This study aimed to investigate mortality levels, cause-specific patterns, and trends in women of reproductive age in Georgia. Materials and methods: The National Reproductive Age Mortality Survey (2014) was conducted to identify all causes of death for women aged 15–49 years in 2012. The leading causes were compared with those in 2006, using directly age-standardized death rates (ASDRs). The accuracy of official cause-of-death data was assessed against verbal autopsy (VA) diagnoses, using kappa statistics, sensitivity, positive predictive value, and misclassification analyses. Results: Of 913 eligible deaths, VAs were completed for 878 deaths. Noncommunicable diseases (NCDs) were the dominant causes of death (69.6% or 53.1/100,000), with cancer taking a major toll (45.2% or 34.5/100,000), followed by injuries (18.6% or 14.2/100,000). Breast cancer (12.5%), road injuries (9.1%), cervical cancer (6.5%), cerebrovascular diseases (5.2%), uterine cancer (4.1%), brain cancer (3.4%), suicide (3.1%), stomach cancer (3.0%), maternal disorders (2.6%), and liver cirrhosis (2.2%) contributed to the 10 leading specific causes of death, with the majority being substantially underreported in official statistics. This was primarily due to a significantly higher proportion (84%, p
Published: 2018

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

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Christopher, Troeger, Amelia, VanderZanden, Stein Emil, Vollset, Valentine, Wanga, Harvey A, Whiteford, Timothy, Wolock, Leo, Zoeckler, Kalkidan Hassen, Abate, Cristiana, Abbafati, Kaja M, Abbas, Foad, Abd-Allah, Semaw Ferede, Abera Daisy, M X, Abreu Laith, J Abu-Raddad, Gebre Yitayih, Abyu, Tom, Achoki, Ademola Lukman, Adelekan Zanfi, na Ademi, Arsène Kouablan, Adou José, C Adsuar, Kossivi Agbelenko, Afanvi, Ashkan, Afshin, Emilie Elisabet, Agardh, Arnav, Agarwal, Anurag, Agrawal, Aliasghar Ahmad, Kiadaliri Oluremi, N Ajala, Ali Shafqat, Akanda Rufus, Olusola Akinyemi, Tomi F, Akinyemiju, Nadia, Akseer, Faris Hasan, Al Lami, Samer, Alabed, Ziyad, Al-Aly, Khurshid, Alam, Noore K, M Alam, Deena, Alasfoor, Saleh Fahed, Aldhahri Robert, William Aldridge, Miguel Angel, Alegretti Alicia, V Aleman, Zewdie Aderaw, Alemu Lily, T Alexander, Samia, Alhabib, Raghib, Ali, Ala’a, Alkerwi, François, Alla, Peter, Allebeck, Rajaa, Al-Raddadi, Ubai, Alsharif, Khalid A, Altirkawi Elena, Alvarez Martin, Nelson, Alvis-Guzman, Azmeraw T, Amare Adeladza, Kofi Amegah, Emmanuel A, Ameh, Heresh, Amini, Walid, Ammar, Stephen Marc, Amrock Hjalte, H Andersen, Benjamin O, Anderson Gregory, M Anderson, Carl Abelardo, T Antonio, Atsede Fantahun, Aregay, Johan, Ärnlöv, Valentina S, Arsic Arsenijevic, Al, Artaman, Hamid, Asayesh, Rana Jawad, Asghar, Suleman, Atique, Euripide Frinel, G Arthur, Avokpaho, Ashish, Awasthi, Peter, Azzopardi, Umar, Bacha, Alaa, Badawi, Maria C, Bahit, Kalpana, Balakrishnan, Amitava, Banerjee, Aleksandra, Barac, Suzanne L, Barker-Collo, Till, Bärnighausen, Lars, Barregard, Lope H, Barrero, Arindam, Basu, Sanjay, Basu, Yibeltal Tebekaw, Bayou, Shahrzad, Bazargan-Hejazi, Justin, Beardsley, Neeraj, Bedi, Ettore, Beghi, Haileeyesus Adamu, Belay, Brent, Bell, Michelle L, Bell Aminu, K Bello, Derrick A, Bennett Isabela, M Bensenor, Adugnaw, Berhane, Eduardo, Bernabé, Balem Demtsu, Betsu Addisu, Shunu Beyene, Neeraj, Bhala, Ashish, Bhalla, Sibhatu, Biadgilign, Boris, Bikbov, 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Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khalil, Ibrahim A, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khera, Sahil, Khoja, Tawfik Ahmed Muthafer, Kieling, Christian, Kim, Daniel, Kim, Yun Jin, Kissela, Brett M, Kissoon, Niranjan, Knibbs, Luke D, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek A, Kosen, Soewarta, Koul, Parvaiz A, Koyanagi, Ai, Krog, Norun Hjertager, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A, Kuipers, Ernst J, Kulkarni, Veena S, Kumar, G Anil, Kwan, Gene F, Lal, Aparna, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lam, Jennifer O, Langan, Sinead M, Lansingh, Van C, Larsson, Ander, Laryea, Dennis Odai, Latif, Asma Abdul, Lawrynowicz, Alicia Elena Beatriz, Leigh, Jame, Levi, Miriam, Li, Yongmei, Lindsay, M Patrice, Lipshultz, Steven E, Liu, Patrick Y, Liu, Shiwei, Liu, Yang, Lo, Loon-Tzian, Logroscino, Giancarlo, Lotufo, Paulo A, Lucas, Robyn M, Lunevicius, Raimunda, Lyons, Ronan A, Ma, Stefan, 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Subjects: VITAL-STATISTICS, INTEGRATED APPROACH, ECONOMIC-DEVELOPMENT, DEVELOPMENT ASSISTANCE, UNITED-STATES, Global Health, Communicable Disease, Communicable Diseases, cause of death, Medicine, General & Internal, Life Expectancy, General & Internal Medicine, Humans, Mortality, Medicine(all), Science & Technology, Mortality, Premature, Medicine (all), EPIDEMIOLOGIC TRANSITION, GBD 2015 Mortality and Causes of Death Collaborators, CIVIL REGISTRATION, Public Health, Global Health, Social Medicine and Epidemiology, Articles, 11 Medical And Health Sciences, ROAD TRAFFIC INJURIES, ALZHEIMERS-DISEASE, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, VERBAL AUTOPSY, Life Sciences & Biomedicine, Human
Abstract: Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.
Published: 2016

29. Global, regional, and national levels and causes of maternal mortality during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013

Author: Carl Abelardo T. Antonio, Rob E. Dorrington, Belinda K Lloyd, Elisabete Weiderpass, Kovin Naidoo, Leslie T. Cooper, Sandra Nolte, Eduardo A. Undurraga, Mohammad A. AlMazroa, R. Kumar, Xiaofeng Liang, Amanda J. Mason-Jones, Kazem Rahimi, Sanjay Basu, Vasiliy Victorovich Vlassov, André Karch, Dipan Bose, Vivekanand Jha, Adansi A. Amankwaa, Kaire Innos, Ione Jayce Ceola Schneider, Itamar S. Santos, Anwar Rafay, Bolajoko O. Olusanya, Tommi Vasankari, Nana Kwaku Mainoo, Saleem M Rana, Wagner Marcenes, Fortuné Gbètoho Gankpé, Rana J. Asghar, Lela Sturua, Nicholas J K Breitborde, Corine Karema, Charles R. Newton, Uche S. Uchendu, Jongmin Lee, Inga Dora Sigfusdottir, Harish Chander Gugnani, Kaushalendra Kumar, Reza Assadi, Ibrahim Abubakar, Konstantinos Stroumpoulis, Megan Coggeshall, Timothy M. Wolock, Ronny Westerman, Samath D Dharmaratne, Katya Anne Shackelford, Anders Larsson, Jeffrey A. Towbin, Jixiang Ma, Lynne Gaffikin, Konstantin Kazanjan, Mohammad Ali Sahraian, Mohammad H. Forouzanfar, Yichong Li, Felix Sayinzoga, Daniel Dicker, Philimon Gona, Maurice Giroud, Maysaa El Sayed Zaki, Shiwei Liu, Lorenzo Monasta, Chantal Huynh, Abdullatif Husseini, Ted R. Miller, Solomon Meseret Woldeyohannes, D. Alex Quistberg, Justin Beardsley, Majed Asad, Uʇur Dilmen, Alaa Badawi, Hsien-Ho Lin, Haidong Kan, Vinod K. Paul, Mitsuru Mukaigawara, James Leigh, Xiao Nong Zou, Sajjad Ur Rahman, Valentina Arsić Arsenijević, Gokalp Kadri Yentur, Man Mohan Mehndiratta, Murugesan Raju, Stephanie J. London, Kingsley N. Ukwaja, Young-Ho Khang, Knud Juel, Mohsen Naghavi, Rasmus Havmoeller, Gelin Xu, Semaw Ferede Abera, Devina Nand, Norito Kawakami, Neil Pearce, Elisabeth Barboza França, Ferrán Catalá-López, Ketevan Goginashvili, Vegard Skirbekk, Neeraj Bedi, Barthelemy Kuate Defo, Andrew H. Kemp, H. Dean Hosgood, Vafa Rahimi-Movaghar, Konrad Pesudovs, Linhong Wang, Xiao Rong Wang, Alan D. Lopez, Ademola Lukman Adelekan, Joshua A. Salomon, Walter Mendoza, Aref A. Bin Abdulhak, Ivy Shiue, G Anil Kumar, Yuichiro Yano, Luke D. Knibbs, Jung-Chen Chang, Yousef Khader, Caitlyn Steiner, Selen Begüm Uzun, Luciano A. Sposato, Gabrielle deVeber, Raghib Ali, Andre Pascal Kengne, Chakib Nejjari, Rafael Alfonso-Cristancho, Tania Georgina Sánchez Pimienta, Roberto Tchio Talongwa, Hilda L Harb, Ali H. Mokdad, Edward J Mills, Angel J Paternina Caicedo, Xiaohong Li, Luke Nyakarahuka, Diego De Leo, Rashmi Gupta, Robert G. Weintraub, Tim Driscoll, Sun Ha Jee, Carolina Maria Teixeira, Ole Frithjof Norheim, Zulfiqar A Bhutta, Hwashin Hyun Shin, Palwasha Anwari, Daniel Pope, Hassan Amini, Jae-Hyun Park, Saad B. Omer, Eric L. Ding, Narayanaswamy Venketasubramanian, Juan Liang, Tara Templin, Arindam Basu, Farshad Farzadfar, Yang Yang, Xuan Che, Scott Weichenthal, Jeyaraj D Pandian, David L. Tirschwell, Adrian Davis, Hilton Lam, Feng Tan, Stephen S Lim, Soewarta Kosen, Atsushi Goto, Ratilal Lalloo, Yanping Wang, Glen Mola, Paulo A. Lotufo, Dhruv S. Kazi, Jose C. Adsuar, Amany H Refaat, Ruben Castro, Gene F. Kwan, Johanna M. Geleijnse, Emerito Jose A. Faraon, Costas A. Christophi, Theo Vos, Sara Sheikhbahaei, Guilherme V. Polanczyk, Jed D. Blore, Azmeraw T. Amare, Kyle R. Heuton, Walid Ammar, Louisa Degenhardt, Andrew Vallely, Guohong Jiang, Ricky Leung, Jasvinder A. Singh, Zewdie Aderaw Alemu, A Artaman, Steven E. Lipshultz, Carlos A Castañeda-Orjuela, Seyed-Mohammad Fereshtehnejad, Sadaf G. Sepanlou, Mark J. Nieuwenhuijsen, John Q. Wong, Manami Inoue, Coen H. Van Gool, James D. Wilkinson, Ejaz Ahmad Khan, Yoshihiro Kokubo, Manuela Mendonca Felicio, Farshad Pourmalek, Boris I. Pavlin, Karen Sliwa, Robert G. Nelson, Tom Achoki, Edmond K. Kabagambe, Orish Ebere Orisakwe, Christopher J L Murray, In-Hwan Oh, Uchechukwu K.A. Sampson, Ulrich O Mueller, Austin E Schumacher, Edson Serván-Mori, Berrak Bora Basara, Simon I. Hay, Anil Kaul, Foad Abd-Allah, Takayoshi Ohkubo, Kim Yun Jin, Abdullah Sulieman Terkawi, Mall Leinsalu, Sergei Petrovich Ermakov, Marek Majdan, Ileana B. Heredia Pi, Christina Papachristou, Scott B. Patten, Rajeev Gupta, Kalpana Balakrishnan, Mustafa Z. Younis, Kenji Shibuya, Graça Maria Ferreira De Lima, Andrea P. Silva, Maziar Moradi-Lakeh, Anand Dayama, Eiman Jahangir, Stefan Ma, Karen M. Tabb, Nicholas J Kassebaum, Shams Eldin Ali Hassan Khalifa, Mazin J. Al Kahbouri, Nadim E. Karam, Jun Zhu, Chandrashekhar T Sreeramareddy, Dinorah González-Castell, Diego Gonzalez-Medina, Aliya Naheed, Ryan M Barber, Salvador Villalpando, Yang Liu, Chanda Kulkarni, Vinay Nangia, Haidong Wang, Yongmei Li, Rosario Cárdenas, Randah R. Hamadeh, Suzanne Polinder, Van C. Lansingh, François Alla, Max Petzold, Bryan L. Sykes, Ubai Alsharif, Chuanhua Yu, Francesco Saverio Violante, Monika Sawhney, Ayse Abbasoglu Ozgoren, Graeme J. Hankey, Mouhanad Hammami, Iuri da Costa Leite, Dickens Akena, Rintaro Mori, Alanur Çavlin, Maia Kereselidze, Jonathan de la Cruz Monis, Deena Alasfoor, Taavi Lai, Eric Y. Tenkorang, Cyrus Cooper, Sudan Prasad Neupane, Dan Poenaru, Veena S. Kulkarni, Naohiro Yonemoto, Elizabeth Glaser, Sergey Soshnikov, Ziad A. Memish, Paul N. Jensen, Fabiola Mejía-Rodríguez, Ana C. Garcia, Rakhi Dandona, Emilie Agardh, Katherine B Gibney, Vasco Manuel Pedro Machado, Michelle L. Bell, David M. Pereira, Muluemebet Abera Wordofa, Samantha M. Colquhoun, Elena Alvarez, Stephen G. Waller, Ketevan Gambashidze, Eduardo Bernabé, Rafael Lozano, Damian G Hoy, Miltiadis K. Tsilimbaris, Hebe N. Gouda, Muhammad Imran Nisar, Zanfina Ademi, Andrew L. Thorne-Lyman, Denis Nash, Dima M. Qato, Luca Ronfani, Nobhojit Roy, Donald H. Silberberg, Monica S. Vavilala, Lydia S. Atkins, Hans W. Hoek, Muluken Dessalegn, David C. Schwebel, Christopher C. Mapoma, Jost B. Jonas, Tolesa Bekele, Lalit Dandona, Borja del Pozo-Cruz, Sumeet S. Chugh, Johan Ärnlöv, Tariku Jibat Beyene, Melvin Barrientos Marzan, Ami R. Moore, Marie Ng, Maigeng Zhou, Samia Alhabib, Massimo Cirillo, Soraya Seedat, Paul S. F. Yip, Nima Hafezi-Nejad, Amelia Bertozzi-Villa, Kebede Deribe, John Nelson Opio, Peter J. Allen, Marina Shakh-Nazarova, Bach Xuan Tran, Arsène Kouablan Adou, Yingfeng Zheng, Julio Cesar Montañez Hernandez, Yong Zhao, Nelson Alvis-Guzman, Bulat Idrisov, Alireza Esteghamati, Seok Jun Yoon, Kathryn H. 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Anil, Kumar, Kaushalendra, Kumar, Ravi B., Kwan, Gene, Lai, Taavi, Lalloo, Ratilal, Lam, Hilton, Lansingh, Van C., Larsson, Ander, Lee, Jong-Tae, Leigh, Jame, Leinsalu, Mall, Leung, Ricky, Li, Xiaohong, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S., Lin, Hsien-Ho, Lipshultz, Steven E., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., London, Stephanie J., Lotufo, Paulo A., Ma, Jixiang, Ma, Stefan, Machado, Vasco Manuel Pedro, Mainoo, Nana Kwaku, Majdan, Marek, Mapoma, Christopher Chabila, Marcenes, Wagner, Marzan, Melvin Barriento, Mason-Jones, Amanda J., Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Memish, Ziad A., Mendoza, Walter, Miller, Ted R., Mills, Edward J., Mokdad, Ali H., Mola, Glen Liddell, Monasta, Lorenzo, De La Cruz Monis, Jonathan, Hernandez, Julio Cesar Montañez, Moore, Ami R., Moradi-Lakeh, Maziar, Mori, Rintaro, Mueller, Ulrich O., Mukaigawara, Mitsuru, Naheed, Aliya, Naidoo, Kovin S., Nand, Devina, Nangia, Vinay, Nash, Deni, Nejjari, Chakib, Nelson, Robert G., Neupane, Sudan Prasad, Newton, Charles R., Ng, Marie, Nieuwenhuijsen, Mark J., Nisar, Muhammad Imran, Nolte, Sandra, Norheim, Ole F., Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O., Omer, Saad B., Opio, John Nelson, Orisakwe, Orish Ebere, Pandian, Jeyaraj D., Papachristou, Christina, Park, Jae-Hyun, Paternina Caicedo, Angel J., Patten, Scott B., Paul, Vinod K., Pavlin, Boris Igor, Pearce, Neil, Pereira, David M., Pesudovs, Konrad, Petzold, Max, Poenaru, Dan, Polanczyk, Guilherme V., Polinder, Suzanne, Pope, Dan, Pourmalek, Farshad, Qato, Dima, Quistberg, D. Alex, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Ur Rahman, Sajjad, Raju, Murugesan, Rana, Saleem M., Refaat, Amany, Ronfani, Luca, Roy, Nobhojit, Pimienta, Tania Georgina Sánchez, Sahraian, Mohammad Ali, Salomon, Joshua A., Sampson, Uchechukwu, Santos, Itamar S., Sawhney, Monika, Sayinzoga, Felix, Schneider, Ione J.C., Schumacher, Austin, Schwebel, David C., Seedat, Soraya, Sepanlou, Sadaf G., Servan-Mori, Edson E., Shakh-Nazarova, Marina, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin Hyun, Shiue, Ivy, Sigfusdottir, Inga Dora, Silberberg, Donald H., Silva, Andrea P., Singh, Jasvinder A., Skirbekk, Vegard, Sliwa, Karen, Soshnikov, Sergey S., Sposato, Luciano A., Sreeramareddy, Chandrashekhar T., Stroumpoulis, Konstantino, Sturua, Lela, Sykes, Bryan L., Tabb, Karen M., Talongwa, Roberto Tchio, Tan, Feng, Teixeira, Carolina Maria, Tenkorang, Eric Yeboah, Terkawi, Abdullah Sulieman, Thorne-Lyman, Andrew L., Tirschwell, David L., Towbin, Jeffrey A., Tran, Bach X., Tsilimbaris, Miltiadi, Uchendu, Uche S., Ukwaja, Kingsley N., Undurraga, Eduardo A., Uzun, Selen Begüm, Vallely, Andrew J., Van Gool, Coen H., Vasankari, Tommi J., Vavilala, Monica S., Venketasubramanian, N., Villalpando, Salvador, Violante, Francesco S., Vlassov, Vasiliy Victorovich, Vos, Theo, Waller, Stephen, Wang, Haidong, Wang, Linhong, Wang, Xiao Rong, Wang, Yanping, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G., Westerman, Ronny, Wilkinson, James D., Woldeyohannes, Solomon Meseret, Wong, John Q., Wordofa, Muluemebet Abera, Xu, Gelin, Yang, Yang C., Yano, Yuichiro, Yentur, Gokalp Kadri, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z., Yu, Chuanhua, Jin, Kim Yun, El Sayed Zaki, Maysaa, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zou, Xiao Nong, Lopez, Alan D., Naghavi, Mohsen, Murray, Christopher J.L., Lozano, Rafael, Kassebaum, Nj, Bertozzi-Villa, A, Coggeshall, M, Shackelford, Ka, Steiner, C, Heuton, Kr, Gonzalez-Medina, D, Barber, R, Huynh, C, Dicker, D, Templin, T, Wolock, Tm, Ozgoren, Aa, Abd-Allah, F, Abera, Sf, Achoki, T, Adelekan, A, Ademi, Z, Adou, Ak, Adsuar, Jc, Agardh, Ee, Akena, D, Alasfoor, D, Alemu, Za, Alfonso-Cristancho, R, Alhabib, S, Ali, R, Al Kahbouri, Mj, Alla, F, Allen, Pj, Almazroa, Ma, Alsharif, U, Alvarez, E, Alvis-Guzmán, N, Amankwaa, Aa, Amare, At, Amini, H, Ammar, W, Antonio, Ca, Anwari, P, Arnlöv, J, Arsenijevic, V, Artaman, A, Asad, Mm, Asghar, Rj, Assadi, R, Atkins, L, Badawi, A, Balakrishnan, K, Basu, A, Basu, S, Beardsley, J, Bedi, N, Bekele, T, Bell, Ml, Bernabe, E, Beyene, Tj, Bhutta, Z, Bin Abdulhak, A, Blore, J, Basara, Bb, Bose, D, Breitborde, N, Cárdenas, R, Castañeda-Orjuela, Ca, Castro, Re, Catalá-López, F, Cavlin, A, Chang, Jc, Che, X, Christophi, Ca, Chugh, S, Cirillo, M, Colquhoun, Sm, Cooper, Lt, Cooper, C, da Costa Leite, I, Dandona, L, Dandona, R, Davis, A, Dayama, A, Degenhardt, L, De Leo, D, Del Pozo-Cruz, B, Deribe, K, Dessalegn, M, Deveber, Ga, Dharmaratne, Sd, Dilmen, U, Ding, El, Dorrington, Re, Driscoll, Tr, Ermakov, Sp, Esteghamati, A, Faraon, Ej, Farzadfar, F, Felicio, Mm, Fereshtehnejad, Sm, de Lima, Gm, Forouzanfar, Mh, França, Eb, Gaffikin, L, Gambashidze, K, Gankpé, Fg, Garcia, Ac, Geleijnse, Jm, Gibney, Kb, Giroud, M, Glaser, El, Goginashvili, K, Gona, P, González-Castell, D, Goto, A, Gouda, Hn, Gugnani, Hc, Gupta, R, Hafezi-Nejad, N, Hamadeh, Rr, Hammami, M, Hankey, Gj, Harb, Hl, Havmoeller, R, Hay, S, Pi, Ib, Hoek, Hw, Hosgood, Hd, Hoy, Dg, Husseini, A, Idrisov, Bt, Innos, K, Inoue, M, Jacobsen, Kh, Jahangir, E, Jee, Sh, Jensen, Pn, Jha, V, Jiang, G, Juel, K, Kabagambe, Ek, Kan, H, Karam, Ne, Karch, A, Karema, Ck, Kaul, A, Kawakami, N, Kazanjan, K, Kazi, D, Kemp, Ag, Kengne, Ap, Kereselidze, M, Khader, Y, Khalifa, Se, Khan, Ea, Khang, Yh, Knibbs, L, Kokubo, Y, Kosen, S, Defo, Bk, Kulkarni, C, Kulkarni, V, Kumar, Ga, Kumar, K, Kumar, Rb, Kwan, G, Lai, T, Lalloo, R, Lam, H, Lansingh, Vc, Larsson, A, Lee, Jt, Leigh, J, Leinsalu, M, Leung, R, Li, X, Li, Y, Liang, J, Liang, X, Lim, S, Lin, Hh, Lipshultz, Se, Liu, S, Liu, Y, Lloyd, Bk, London, Sj, Lotufo, Pa, Ma, J, Ma, S, Machado, Vm, Mainoo, Nk, Majdan, M, Mapoma, Cc, Marcenes, W, Marzan, Mb, Mason-Jones, Aj, Mehndiratta, Mm, Mejia-Rodriguez, F, Memish, Za, Mendoza, W, Miller, Tr, Mills, Ej, Mokdad, Ah, Mola, Gl, Monasta, L, de la Cruz Monis, J, Hernandez, Jc, Moore, Ar, Mori, R, Mueller, Uo, Mukaigawara, M, Naheed, A, Naidoo, K, Nand, D, Nangia, V, Nash, D, Nejjari, C, Nelson, Rg, Neupane, Sp, Newton, Cr, Ng, M, Nieuwenhuijsen, Mj, Nisar, Mi, Nolte, S, Norheim, Of, Nyakarahuka, L, Oh, Ih, Ohkubo, T, Olusanya, Bo, Omer, Sb, Opio, Jn, Orisakwe, Oe, Pandian, Jd, Papachristou, C, Park, Jh, Caicedo, Aj, Patten, Sb, Paul, Vk, Pavlin, Bi, Pearce, N, Pereira, Dm, Pesudovs, K, Petzold, M, Poenaru, D, Polanczyk, Gv, Polinder, S, Pope, D, Pourmalek, F, Qato, D, Quistberg, Da, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Ur Rahman, S, Raju, M, Rana, Sm, Refaat, A, Ronfani, L, Roy, N, Pimienta, Tg, Sahraian, Ma, Salomon, J, Sampson, U, Santos, I, Sawhney, M, Sayinzoga, F, Schneider, Ij, Schumacher, A, Schwebel, Dc, Seedat, S, Sepanlou, Sg, Servan-Mori, Ee, Shakh-Nazarova, M, Sheikhbahaei, S, Shibuya, K, Shin, Hh, Shiue, I, Sigfusdottir, Id, Silberberg, Dh, Silva, Ap, Singh, Ja, Skirbekk, V, Sliwa, K, Soshnikov, S, Sposato, La, Sreeramareddy, Ct, Stroumpoulis, K, Sturua, L, Sykes, Bl, Tabb, Km, Talongwa, Rt, Tan, F, Teixeira, Cm, Tenkorang, Ey, Terkawi, A, Thorne-Lyman, Al, Tirschwell, Dl, Towbin, Ja, Tran, Bx, Tsilimbaris, M, Uchendu, U, Ukwaja, Kn, Undurraga, Ea, Uzun, Sb, Vallely, Aj, van Gool, Ch, Vasankari, Tj, Vavilala, M, Venketasubramanian, N, Villalpando, S, Violante, F, Vlassov, Vv, Vos, T, Waller, S, Wang, H, Wang, L, Wang, Sx, Wang, Y, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Westerman, R, Wilkinson, Jd, Woldeyohannes, Sm, Wong, Jq, Wordofa, Ma, Xu, G, Yang, Yc, Yano, Y, Yentur, Gk, Yip, P, Yonemoto, N, Yoon, Sj, Younis, Mz, Yu, C, Jin, Ky, El Sayed Zaki, M, Zhao, Y, Zheng, Y, Zhou, M, Zhu, J, Zou, Xn, Lopez, Ad, Naghavi, M, Murray, Cj, Lozano, R, Cell biology, Epidemiology, Public Health, Erasmus MC other, Cardiothoracic Surgery, and Pathology
Subjects: Pediatrics, Time Factors, Nutrition and Disease, hiv-infection, immunodeficiency virus-1 infection, peripartum cardiomyopathy, Poison control, HIV Infections, IMMUNODEFICIENCY VIRUS-1 INFECTION, Socioeconomic Factor, Global Health, 0302 clinical medicine, PERIPARTUM CARDIOMYOPATHY, pregnancy-related mortality, Risk Factors, Pregnancy, Voeding en Ziekte, Cause of Death, Global health, HIV Infection, 030212 general & internal medicine, Pregnancy Complications, Infectious, 10. No inequality, Cause of death, 030219 obstetrics & reproductive medicine, south-africa, Medicine (all), 1. No poverty, WOMEN, PREGNANCY-RELATED MORTALITY, health initiatives, General Medicine, SOUTH-AFRICA, 3. Good health, Maternal Mortality, World Health, CHILD SURVIVAL, Female, Maternal death, women, Human, medicine.medical_specialty, Time Factor, DEATHS, child survival, Article, adult mortality, 03 medical and health sciences, Age Distribution, HEALTH INITIATIVES, SDG 3 - Good Health and Well-being, HIV-INFECTION, ADULT MORTALITY, Injury prevention, medicine, Organizational Objectives, Organizational Objective, Humans, VLAG, Models, Statistical, business.industry, Risk Factor, medicine.disease, deaths, Standardized mortality ratio, Socioeconomic Factors, Relative risk, Pregnancy Complications, Infectiou, business, Demography
Abstract: BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.METHODS: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values.FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland.INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.FUNDING: Bill & Melinda Gates Foundation.
Published: 2016
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30. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Author: Vasiliki Stathopoulou, Kiran Thapa, Vesper Hichilombwe Chisumpa, Azeem Majeed, Hjalte Holm Andersen, Devasahayam J. Christopher, Alireza Mohammadi, John J. McGrath, Konstantin Kazanjan, Naohiro Yonemoto, Guoqing Hu, Yousef Khader, Suzanne Barker-Collo, Frida Namnyak Ngalesoni, Jennifer O Lam, Laetitia Huiart, Xiaofeng Liang, Amanuel Tesfay Gebremedhin, Lalit Dandona, Felix Masiye, Joseph R Fitchett, Derrick A Bennett, Rosana E. Norman, Theo Vos, Tuomo J. Meretoja, Rahman Shiri, Melvin Barrientos Marzan, Charles R. Newton, Kelly Cercy, Masoud Vaezghasemi, Elena Alvarez Martin, Christopher Troeger, Ismael R. Campos-Nonato, Amany H Refaat, Ruben Castro, Amiran Gamkrelidze, Michael R. Phillips, Samath D Dharmaratne, Reed J D Sorensen, Roderick J. Hay, Johan Ärnlöv, Ivo Rakovac, Alexandra Brazinova, Nancy Fullman, Sara Sheikhbahaei, Liliana G Ciobanu, Nader Jahanmehr, Yuming Guo, Luigi Naldi, Rana Jawad Asghar, Tsegaye Tewelde Gebrehiwot, Corine Karema, Biju Abraham, Rynaz H S Rabiee, Emerito Jose A. Faraon, Philimon Gona, Jonathan I. Silverberg, Alexandria Brown, Kovin Naidoo, Suleman Atique, Yun Jin Kim, Benn Sartorius, Hwashin Hyun Shin, George Mugambage Ruhago, Adugnaw Berhane, Tesfaye Tekle, Abdur Rahman Khan, Vipin Gupta, Nima Hafezi-Nejad, Héctor Gómez-Dantés, Jun She, Ted R. Miller, Tolesa Bekele, Yohannes Kinfu, Srinivas Murthy, Alaa Badawi, Mahfuzar Rahman, Raghib Ali, Robert G. Weintraub, Nicholas Steel, Khalid A Altirkawi, Muhammad Imran Nisar, Man Mohan Mehndiratta, Thomas N. Williams, Adrian Davis, Usha Ram, Nobuyuki Horita, Qingyang Xiao, Bishal Gyawali, Burcu Kucuk Bicer, Eun-Kee Park, Subas Neupane, Mohammad Tavakkoli, Lorenzo Monasta, Roman Topor-Madry, Marc-Alain Widdowson, James Leigh, Padukudru Anand Mahesh, Stephen M. Amrock, Stefan Ma, Virendra Singh, Amir Kasaeian, Mahdi Mahdavi, Shahrzad Bazargan-Hejazi, Kim Moesgaard Iburg, Vafa Rahimi-Movaghar, Julio Cesar Campuzano, Maria Dolores Sanchez-Niño, Jean B. Nachega, Hamid Asayesh, Pratik Pinal Doshi, Charles Shey Wiysonge, Peter J. Hotez, Ying Jiang, Girma Temam Shifa, Warren D. Lo, Francis Apolinary Mhimbira, Joan B. Soriano, Ritul Kamal, Young-Ho Khang, Isaac Akinkunmi Adedeji, Daniel C Casey, Adeladza Kofi Amegah, Demewoz Haile, Tomi Akinyemiju, Andrew L. Thorne-Lyman, Achala Upendra Jayatilleke, Rajeev Gupta, Rosario Cárdenas, Peter W. Gething, Ami R. 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Subjects: Pediatrics, Nutrition and Disease, Global Health, Communicable Disease, 0302 clinical medicine, Voeding en Ziekte, Infant Mortality, Compensation law of mortality, Global health, Medicine, LIFE EXPECTANCY, 030212 general & internal medicine, DEVELOPING-COUNTRIES, 10. No inequality, Medicine(all), NEWBORN BABIES, Medicine (all), Mortality rate, 1. No poverty, DEATH, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, 11 Medical And Health Sciences, Stillbirth, 3. Good health, Child Mortality, SURVIVAL, CHILD-MORTALITY, HEALTH, Life Sciences & Biomedicine, DEVELOPMENT GOAL 4, Human, INTERVENTIONS, medicine.medical_specialty, RJ, INTEGRATED APPROACH, Developing country, Communicable Diseases, neonatal, 03 medical and health sciences, Medicine, General & Internal, 030225 pediatrics, General & Internal Medicine, Life Science, Humans, Global Burden of Disease Study, VLAG, Estimation, Science & Technology, business.industry, Klinisk medicin, Infant, GBD 2015 Child Mortality Collaborators, Infant mortality, Malaria, Child mortality, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Life expectancy, Clinical Medicine, RG, business, Demography
Abstract: BACKGROUND: Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. METHODS: Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1-4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980-2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age-sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). FINDINGS: Globally, 5·8 million (95% uncertainty interval [UI] 5·7-6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7-53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3-43·6) to 2·6 million (2·6-2·7) neonatal deaths and 47·0% (35·1-57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6-3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional deficiencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as differences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone. INTERPRETATION: Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention packages to innovative financing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030. FUNDING: Bill & Melinda Gates Foundation. Erratum: Department of Error, The Lancet,Volume 389, Issue 10064, 2017, Page e1. DOI: 10.1016/S0140-6736(16)32608-3
Published: 2016
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31. Electrophysiological Evidence for Ventral Stream Deficits in Schizophrenia Patients

Author: George Kapanadze, Andreas Brand, Maya Roinishvili, Gijs Plomp, Eka Chkonia, Michael H. Herzog, and Maia Kereselidze
Subjects: Adult, Male, Visual perception, Posterior parietal cortex, Sensory system, Electroencephalography, Stimulus (physiology), Visual processing, Discrimination, Psychological, Parietal Lobe, Reaction Time, medicine, Humans, electroencephalography (EEG), Brain Mapping, medicine.diagnostic_test, Parietal lobe, Brain, N1, Regular Article, Middle Aged, Psychiatry and Mental health, dorsal stream, Case-Control Studies, Schizophrenia, Visual Perception, Evoked Potentials, Visual, Female, Occipital Lobe, backward masking, Psychology, Occipital lobe, Perceptual Masking, Neuroscience, Photic Stimulation, Psychomotor Performance, discrimination
Abstract: Schizophrenic patients suffer from many deficits including visual, attentional, and cognitive ones. Visual deficits are of particular interest because they are at the fore-end of information processing and can provide clear examples of interactions between sensory, perceptual, and higher cognitive functions. Visual deficits in schizophrenic patients are often attributed to impairments in the dorsal (where) rather than the ventral (what) stream of visual processing. We used a visual-masking paradigm in which patients and matched controls discriminated small vernier offsets. We analyzed the evoked electroencephalography (EEG) responses and applied distributed electrical source imaging techniques to estimate activity differences between conditions and groups throughout the brain. Compared with controls, patients showed strongly reduced discrimination accuracy, confirming previous work. The behavioral deficits corresponded to pronounced decreases in the evoked EEG response at around 200 ms after stimulus onset. At this latency, patients showed decreased activity for targets in left parietal cortex (dorsal stream), but the decrease was most pronounced in lateral occipital cortex (in the ventral stream). These deficiencies occurred at latencies that reflect object processing and fine shape discriminations. We relate the reduced ventral stream activity to deficient top-down processing of target stimuli and provide a framework for relating the commonly observed dorsal stream deficiencies with the currently observed ventral stream deficiencies.
Published: 2012
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32. The Global Burden of Cancer 2013

Author: Juan R. Sanabria, Janet L Leasher, Eun-Kee Park, Al Artaman, James Leigh, Braden Te Ao, Graham S Cooke, Alan D. Lopez, G Anil Kumar, Rakhi Dandona, Randah R. Hamadeh, Scott B. Patten, Chante Karimkhani, Vasiliy Victorovich Vlassov, Marcella Montico, Sara Sheikhbahaei, Taavi Tillmann, Jasvinder A. Singh, Gillian M. Hansen, Chandrashekhar T Sreeramareddy, Paul S. F. Yip, Yuichiro Yano, Coen H. Van Gool, Nima Hafezi-Nejad, Luke D. Knibbs, Max Petzold, Mark Green, Charles D.A. Wolfe, Ulrich O Mueller, Johanna M. Geleijnse, David C. Schwebel, Chuanhua Yu, Jost B. Jonas, Christine Allen, Paulo A. Lotufo, Robyn M. Lucas, Lalit Dandona, Matias Trillini, Christopher J L Murray, Subhojit Dey, Naohiro Yonemoto, Hannah Hamavid, W. S. Marcenes, Mohsen Naghavi, Mustafa Z. Younis, Babak Eshrati, Ronny Westerman, Roderick J Hay, Kedede Deribe, Lorenzo Monasta, Brian J. McMahon, Tommi J. Vasankari, Luigi Naldi, Denis Nash, Maziar Moradi-Lakeh, Kjetil Søreide, Gabrielle deVeber, Robert P. Dellavalle, Ferrán Catalá-López, Hans Krueger, Scott Weichenthal, Christina Fitzmaurice, Kinnari S. Murthy, Wubegzier Mekonnen, Yongmei Li, Joshua A. Salomon, Gulfaraz Khan, Kingsley N. Ukwaja, Edward J Mills, Theo Vos, Ismael Campos, Luca Ronfani, H. Dean Hosgood, Ami R. Moore, Reza Malekzadeh, Farshad Pourmalek, Rosario Cardenas, Nobhojit Roy, Daniel Kim, Diego De Leo, Francesco Saverio Violante, Semaw Ferede Abera, Alireza Esteghamati, Vafa Rahimi-Movaghar, Haidong Wang, Rafael Lozano, Ken Takahashi, Raimundas Lunevicius, Kathryn H. Jacobsen, David O. Carpenter, Edgar P. Simard, Benjamin C Cowie, Mark G. Shrime, Graeme J. Hankey, Raghib Ali, Michael F. MacIntyre, Robert G. Weintraub, Ali Mokdad, Maia Kereselidze, A. Werdecker, David M. Pereira, Itamar S. Santos, Dietrich Plass, David Rojas-Rueda, Carlos A Castañeda-Orjuela, Kenji Shibuya, Daniel Dicker, Carolyn C. Gotay, Mohammad H. Forouzanfar, Stein Emil Vollset, Tim Driscoll, George D. Thurston, Hywel C Williams, Seyed-Mohammad Fereshtehnejad, Bradford D. Gessner, Kim Yun Jin, Carl Abelardo T. Antonio, Nicholas J K Breitborde, Ivy Shiue, Rachel Woodbrook, Ubai Alsharif, Richard C. Franklin, Dhruv S. Kazi, Sandra Nolte, Azmeraw T. Amare, Marcello Tonelli, Sadaf G. Sepanlou, In-Hwan Oh, Yohannes Adama Melaku, Justin Beardsley, Jennifer H MacLachlan, Amanda W Pain, Fitzmaurice, Christina, Dicker, Daniel, Pain, Amanda, Hamavid, Hannah, Moradi-Lakeh, Maziar, Macintyre, Michael F, Allen, Christine, Hansen, Gillian, Woodbrook, Rachel, Wolfe, Charle, Hamadeh, Randah R, Moore, Ami, Werdecker, Andrea, Gessner, Bradford D, Te Ao, Braden, Mcmahon, Brian, Karimkhani, Chante, Yu, Chuanhua, Cooke, Graham S, Schwebel, David C, Carpenter, David O, Pereira, David M, Nash, Deni, Kazi, Dhruv S, De Leo, Diego, Plass, Dietrich, Ukwaja, Kingsley N, Thurston, George D, Yun Jin, Kim, Simard, Edgar P, Mills, Edward, Park, Eun-Kee, Catalá-López, Ferrán, Deveber, Gabrielle, Gotay, Carolyn, Khan, Gulfaraz, Hosgood, H Dean, Santos, Itamar S, Leasher, Janet L, Singh, Jasvinder, Leigh, Jame, Jonas, Jost B, Jonas, Jost, Sanabria, Juan, Beardsley, Justin, Jacobsen, Kathryn H, Takahashi, Ken, Franklin, Richard C, Ronfani, Luca, Montico, Marcella, Naldi, Luigi, Tonelli, Marcello, Geleijnse, Johanna, Petzold, Max, Shrime, Mark G, Younis, Mustafa, Yonemoto, Naohiro, Breitborde, Nichola, Yip, Paul, Pourmalek, Farshad, Lotufo, Paulo A, Esteghamati, Alireza, Hankey, Graeme J, Ali, Raghib, Lunevicius, Raimunda, Malekzadeh, Reza, Dellavalle, Robert, Weintraub, Robert, Lucas, Robyn, Hay, Roderick, Rojas-Rueda, David, Westerman, Ronny, Sepanlou, Sadaf G, Nolte, Sandra, Patten, Scott, Weichenthal, Scott, Abera, Semaw Ferede, Fereshtehnejad, Seyed-Mohammad, Shiue, Ivy, Driscoll, Tim, Vasankari, Tommi, Alsharif, Ubai, Rahimi-Movaghar, Vafa, Vlassov, Vasiliy V, Marcenes, W S, Mekonnen, Wubegzier, Melaku, Yohannes Adama, Yano, Yuichiro, Artaman, Al, Campos, Ismael, Maclachlan, Jennifer, Mueller, Ulrich, Kim, Daniel, Trillini, Matia, Eshrati, Babak, Williams, Hywel C, Shibuya, Kenji, Dandona, Rakhi, Murthy, Kinnari, Cowie, Benjamin, Amare, Azmeraw T, Antonio, Carl Abelardo, Castañeda-Orjuela, Carlo, van Gool, Coen H, Violante, Francesco, Oh, In-Hwan, Deribe, Kedede, Soreide, Kjetil, Knibbs, Luke, Kereselidze, Maia, Green, Mark, Cardenas, Rosario, Roy, Nobhojit, Tillmann, Taavi, Tillman, Taavi, Li, Yongmei, Krueger, Han, Monasta, Lorenzo, Dey, Subhojit, Sheikhbahaei, Sara, Hafezi-Nejad, Nima, Kumar, G Anil, Sreeramareddy, Chandrashekhar T, Dandona, Lalit, Wang, Haidong, Vollset, Stein Emil, Mokdad, Ali, Salomon, Joshua A, Lozano, Rafael, Vos, Theo, Forouzanfar, Mohammad, Lopez, Alan, Murray, Christopher, and Naghavi, Mohsen
Subjects: Gerontology, Male, Cancer Research, Time Factors, Nutrition and Disease, Sex Factor, Global Health, Disability Evaluation, Risk Factors, Voeding en Ziekte, Neoplasms, Epidemiology of cancer, Prevalence, Age Factor, Child, Aged, 80 and over, Mortality rate, Incidence, Age Factors, Middle Aged, Prognosis, Oncology, Child, Preschool, Female, Human, Adult, Adolescent, Time Factor, Prognosi, Young Adult, Sex Factors, Breast cancer, Age Distribution, Life Expectancy, medicine, Life Science, Humans, Disability-adjusted life year, Sex Distribution, VLAG, Aged, Cancer Death Rate, Cancer prevention, business.industry, Risk Factor, Cancer, medicine.disease, Years of potential life lost, Neoplasm, business, Demography
Abstract: Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. OBJECTIVE To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013. EVIDENCE REVIEW The general methodology of the Global Burden of Disease (GBD) 2013 study was used. Cancer registries were the source for cancer incidence data as well as mortality incidence (MI) ratios. Sources for cause of death data include vital registration system data, verbal autopsy studies, and other sources. TheMI ratios were used to transform incidence data to mortality estimates and cause of death estimates to incidence estimates. Cancer prevalence was estimated usingMI ratios as surrogates for survival data; YLDs were calculated by multiplying prevalence estimates with disability weights, which were derived from population-based surveys; YLLs were computed by multiplying the number of estimated cancer deaths at each age with a reference life expectancy; and DALYs were calculated as the sum of YLDs and YLLs. FINDINGS In 2013 there were 14.9 million incident cancer cases, 8.2 million deaths, and 196.3 million DALYs. Prostate cancer was the leading cause for cancer incidence (1.4 million) for men and breast cancer for women (1.8 million). Tracheal, bronchus, and lung (TBL) cancer was the leading cause for cancer death in men and women, with 1.6 million deaths. For men, TBL cancer was the leading cause of DALYs (24.9 million). For women, breast cancer was the leading cause of DALYs (13.1 million). Age-standardized incidence rates (ASIRs) per 100 000 and age-standardized death rates (ASDRs) per 100 000 for both sexes in 2013 were higher in developing vs developed countries for stomach cancer (ASIR, 17 vs 14; ASDR, 15 vs 11), liver cancer (ASIR, 15 vs 7; ASDR, 16 vs 7), esophageal cancer (ASIR, 9 vs 4; ASDR, 9 vs 4), cervical cancer (ASIR, 8 vs 5; ASDR, 4 vs 2), lip and oral cavity cancer (ASIR, 7 vs 6; ASDR, 2 vs 2), and nasopharyngeal cancer (ASIR, 1.5 vs 0.4; ASDR, 1.2 vs 0.3). Between 1990 and 2013, ASIRs for all cancers combined (except nonmelanoma skin cancer and Kaposi sarcoma) increased by more than 10% in 113 countries and decreased by more than 10% in 12 of 188 countries. CONCLUSIONS AND RELEVANCE Cancer poses a major threat to public health worldwide, and incidence rates have increased in most countries since 1990. The trend is a particular threat to developing nations with health systems that are ill-equipped to deal with complex and expensive cancer treatments. The annual update on the Global Burden of Cancer will provide all stakeholders with timely estimates to guide policy efforts in cancer prevention, screening, treatment, and palliation.
Published: 2015

33. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Author: Soumya Swaminathan, Berrak Bora Basara, Niveen M E Abu-Rmeileh, Shams Eldin Ali Hassan Khalifa, Nadim E. Karam, Jongmin Lee, Roberto Tchio Talongwa, Inga Dora Sigfusdottir, Yang Yang, Stein Emil Vollset, Joseph R. Masci, Daniel Dicker, Maysaa El Sayed Zaki, Shiwei Liu, Valentina Arsić Arsenijević, Ting Wu Chuang, Linhong Wang, Xiao Rong Wang, Bryan K. Phillips, Don C. Des Jarlais, Vasco Manuel Pedro Machado, Vasiliki Stathopoulou, David Phillips, Luke Nyakarahuka, Leslie T. Cooper, Sandra Nolte, Charles R. Newton, Christina Papachristou, Stephen G. Waller, Carlos Magis-Rodriguez, D. Allen Roberts, Elisabete Weiderpass, Aliya Naheed, Andre Keren, Amanda J. Mason-Jones, Karen J. Courville, Ted R. Miller, Kinnari S. Murthy, Bolajoko O. Olusanya, Tommi Vasankari, Kyle J Foreman, Gabriel Alcalá-Cerra, Yousef Khader, Lorenzo Monasta, Austine Olufemi Adeyemo, Rakhi Dandona, Sanjay Basu, Samir Soneji, Rana J. Asghar, Yohannes Adama Melaku, Rafael Alfonso-Cristancho, John Q. Wong, Yoshihiro Kokubo, Young-Ho Khang, Dhruv S. Kazi, Tom Achoki, Homie Razavi, Uche S. Uchendu, Ashish Bhalla, Ferrán Catalá-López, Peggy Pei-Chia Chiang, Kim Moesgaard Iburg, Kaire Innos, Nicholas J K Breitborde, Zacharie Tsala Dimbuene, Elena Alvarez, Vafa Rahimi-Movaghar, Qing Lan, Simon I. Hay, Kaushalendra Kumar, Ubai Alsharif, Scott B. Patten, Gelin Xu, Theo Vos, Kalpana Balakrishnan, Raghib Ali, Marcella Montico, Andrea P. Silva, Robert G. Weintraub, Timothy M. Wolock, Mohammad Ali Sahraian, Heidi J. Larson, Kingsley N. Ukwaja, Saad B. Omer, Scott Weichenthal, D. Alex Quistberg, Justin Beardsley, Chandrashekhar T Sreeramareddy, Jennifer H MacLachlan, Hsien-Ho Lin, H. Dean Hosgood, Karzan Abdulmuhsin Mohammad, Ryan M Barber, Ibrahim Abubakar, Irma Khonelidze, Ileana B. Heredia Pi, Cyrus Cooper, Hilton Lam, Urbano Fra Paleo, Joshua A. Salomon, Ricky Leung, Farshad Pourmalek, Robert G. Nelson, Konstantinos Stroumpoulis, Megan Coggeshall, Mazin J. Al Kahbouri, Richard G. Ellenbogen, Hwashin Hyun Shin, Ida Kankindi, Guohong Jiang, Yanping Wang, Daniel Obadare Fijabi, Carlos A Castañeda-Orjuela, Chakib Nejjari, Diego De Leo, Rashmi Gupta, Gene F. Kwan, Johanna M. Geleijnse, Kenji Shibuya, Hassan Amini, Nsanzimana Sabin, Benjamin C Cowie, Karen M. Tabb, Chanda Kulkarni, Jed D. Blore, Amado D Quezada, Norito Kawakami, Walid Ammar, Van C. Lansingh, François Alla, Seyed-Mohammad Fereshtehnejad, Yichong Li, Vineet K. Chadha, Jasvinder A. Singh, Agnes Binagwaho, Andrew L. Thorne-Lyman, Denis Nash, Palwasha Anwari, Mohammad T Mashal, Kim Yun Jin, Steven E. Lipshultz, Veena S. Kulkarni, Amitava Banerjee, Naohiro Yonemoto, James D. Wilkinson, Aslam Pervaiz, Emilie Agardh, Barthelemy Kuate Defo, Alan D. Lopez, Carl Abelardo T. Antonio, Abraham D. Flaxman, Boris I. Pavlin, Karen Sliwa, Dima M. Qato, G Anil Kumar, Lynne Gaffikin, K.M. Venkat Narayan, Luca Ronfani, Kazem Rahimi, Vivekanand Jha, Gokalp Kadri Yentur, Wagner Marcenes, Giuseppe Remuzzi, Anwar Rafay, Anand Dayama, Robert Quentin Reilly, Alaa Badawi, Selen Begüm Uzun, James Leigh, Vinay Nangia, Ivy Shiue, J Brown, Nobhojit Roy, Genesis May J. Samonte, Edward J Mills, Soewarta Kosen, Atsushi Goto, Sajjad Ur Rahman, Jose C. Adsuar, Semaw Ferede Abera, Jefferson Traebert, Amiran Gamkrelidze, Andrew H. Kemp, Vasiliy Victorovich Vlassov, André Karch, Edgar P. Simard, Aref A. Bin Abdulhak, Samath D Dharmaratne, Ione Jayce Ceola Schneider, Andre Pascal Kengne, Corine Karema, Harish Chander Gugnani, Reza Assadi, Glen Mola, Paulo A. Lotufo, Christopher J L Murray, Rajeev Gupta, Philimon Gona, Mustafa Z. Younis, Herbert C. Duber, Mitchell T. Wallin, Arjun Lakshmana Balaji, Max Petzold, Francesco Saverio Violante, Monika Sawhney, Kovin Naidoo, Mercedes Colomar, Chuanhua Yu, Mitsuru Mukaigawara, Emerito Jose A. Faraon, Jung-Chen Chang, A Artaman, Muhammad Imran Nisar, Dickens Akena, Xiao Nong Zou, Knud Juel, Mohammed I. Albittar, Mohammad Yahya Saeedi, Sergey Petrovich Ermakov, Ole Frithjof Norheim, Graeme J. Hankey, Jerry Puthenpurakal Abraham, Mouhanad Hammami, Zulfiqar A Bhutta, Rintaro Mori, Maia Kereselidze, Josep Maria Haro, Emily Dansereau, Michael Brainin, Elizabeth Glaser, Ziad A. Memish, Anders Larsson, Solomon Meseret Woldeyohannes, Azmeraw T. Amare, Louisa Degenhardt, Yuichiro Yano, Luke D. Knibbs, Sadaf G. Sepanlou, Hilda L Harb, In-Hwan Oh, Katherine B Gibney, Abdullah Sulieman Terkawi, Adansi A. Amankwaa, Nicholas Graetz, Fortuné Gbètoho Gankpé, Vincent Nowaseb, David M. Pereira, Alan J Thomson, Miguel Angel Alegretti, Rupak Shivakoti, Adnan M. Durrani, Dipan Bose, Saleem M Rana, Mohammad Taghi Hedayati, Mohsen Naghavi, Vegard Skirbekk, Walter Mendoza, Ali H. Mokdad, Soraya Seedat, Zewdie Aderaw Alemu, Edson Serván-Mori, Anil Kaul, Foad Abd-Allah, Paul S. F. Yip, Marek Majdan, Peter A. Meaney, Kebede Deribe, Paul N. Jensen, Fabiola Mejía-Rodríguez, Bradford D. Gessner, Ami R. Moore, Marie Ng, Maigeng Zhou, Mohammad H. Forouzanfar, John J Huang, Tim Driscoll, Samia Alhabib, Jun Zhu, Michael H. Criqui, Eduardo Bernabé, Lalit Dandona, Miltiadis K. Tsilimbaris, Borja del Pozo-Cruz, Johan Ärnlöv, Luigi Naldi, Tariku Jibat Beyene, Rasmus Havmoeller, Bongani M. Mayosi, Konrad Pesudovs, Richard A. White, Ejaz Ahmad Khan, Orish Ebere Orisakwe, Graça Maria Ferreira De Lima, Yang Liu, Haidong Wang, Yongmei Li, Bryan L. Sykes, Ronny Westerman, Vinod K. Paul, Angel J Paternina Caicedo, Abigail C. McKay, Eric L. Ding, Narayanaswamy Venketasubramanian, Uur Dilmen, Stephen S Lim, Andrew Vallely, Alireza Esteghamati, Seok Jun Yoon, John Hornberger, Kathryn H. Jacobsen, Yong Zhao, Thomas D. Fleming, Nelson Alvis-Guzman, Damian G Hoy, Hebe N. Gouda, Mall Leinsalu, Elizabeth Johnson, Wilkister N. Moturi, Bach Xuan Tran, Donald H. Silberberg, Yingfeng Zheng, Lydia S. Atkins, Hans W. Hoek, Muluken Dessalegn, David C. Schwebel, Christopher C. Mapoma, Jost B. Jonas, Tolesa Bekele, Ibrahim Abdelmageem Mohamed Ginawi, Bulat Idrisov, Man Mohan Mehndiratta, Thomas N. Williams, Jeffrey A. Towbin, Caterina Guinovart, Jeyaraj D Pandian, Panniyammakal Jeemon, Taavi Lai, Haidong Kan, Tasara T. Mazorodze, Murugesan Raju, Randah R. Hamadeh, Neil Pearce, Melvin Barrientos Marzan, Nima Hafezi-Nejad, John Nelson Opio, Deena Alasfoor, Peter J. Hotez, Jonas Minet Kinge, Peter J. Allen, Eric Y. Tenkorang, Sudan Prasad Neupane, Laith J. Abu-Raddad, Katrina F Ortblad, Arsène Kouablan Adou, Farshad Farzadfar, Sergey Soshnikov, Neeraj Bhala, Sara Sheikhbahaei, Kyle R. Heuton, Michelle L. Bell, Yohannes Kinfu, Takayoshi Ohkubo, Belinda K Lloyd, R. Kumar, Jan Hendrik Richardus, Benjamin O. Anderson, Cell biology, Epidemiology, Public Health, Erasmus MC other, Pathology, Cardiothoracic Surgery, Murray, Christopher J.L, Ortblad, Katrina F., Guinovart, Caterina, Lim, Stephen S., Wolock, Timothy M., Roberts, D. Allen, Dansereau, Emily A., Graetz, Nichola, Barber, Ryan M., Brown, Jonathan C., Wang, Haidong, Duber, Herbert C., Naghavi, Mohsen, Dicker, Daniel, Dandona, Lalit, Salomon, Joshua A., Heuton, Kyle R., Foreman, Kyle, Phillips, David E., Fleming, Thomas D., Flaxman, Abraham D., Phillips, Bryan K., Johnson, Elizabeth K., Coggeshall, Megan S., Abd-Allah, Foad, Abera, Semaw Ferede, Abraham, Jerry P., Abubakar, Ibrahim, Abu-Raddad, Laith J., Abu-Rmeileh, Niveen Me, Achoki, Tom, Adeyemo, Austine Olufemi, Adou, Arsène Kouablan, Adsuar, José C., Agardh, Emilie Elisabet, Akena, Dicken, Al Kahbouri, Mazin J., Alasfoor, Deena, Albittar, Mohammed I., Alcalá-Cerra, Gabriel, Alegretti, Miguel Angel, Alemu, Zewdie Aderaw, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Alla, Francoi, Allen, Peter J., Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amankwaa, Adansi A., Amare, Azmeraw T., Amini, Hassan, Ammar, Walid, Anderson, Benjamin O., Antonio, Carl Abelardo T., Anwari, Palwasha, Ärnlöv, Johan, Arsic Arsenijevic, Valentina S., Artaman, Ali, Asghar, Rana J., Assadi, Reza, Atkins, Lydia S., Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Basu, Sanjay, Beardsley, Justin, Bekele, Tolesa, Bell, Michelle L., Bernabe, Eduardo, Beyene, Tariku Jibat, Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A., Bin Abdulhak, Aref, Binagwaho, Agne, Blore, Jed D., Bora Basara, Berrak, Bose, Dipan, Brainin, Michael, Breitborde, Nichola, Castañeda-Orjuela, Carlos A., Catalá-López, Ferrán, Chadha, Vineet K., Chang, Jung-Chen, Chiang, Peggy Pei-Chia, Chuang, Ting-Wu, Colomar, Mercede, Cooper, Leslie Trumbull, Cooper, Cyru, Courville, Karen J., Cowie, Benjamin C., Criqui, Michael H., Dandona, Rakhi, Dayama, Anand, De Leo, Diego, Degenhardt, Louisa, Del Pozo-Cruz, Borja, Deribe, Kebede, Des Jarlais, Don C., Dessalegn, Muluken, Dharmaratne, Samath D., Dilmen, Uur, Ding, Eric L., Driscoll, Tim R., Durrani, Adnan M., Ellenbogen, Richard G., Ermakov, Sergey Petrovich, Esteghamati, Alireza, Faraon, Emerito Jose A., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fijabi, Daniel Obadare, Forouzanfar, Mohammad H., Paleo, Urbano Fra., Gaffikin, Lynne, Gamkrelidze, Amiran, Gankpé, Fortuné Gbètoho, Geleijnse, Johanna M., Gessner, Bradford D., Gibney, Katherine B., Ginawi, Ibrahim Abdelmageem Mohamed, Glaser, Elizabeth L., Gona, Philimon, Goto, Atsushi, Gouda, Hebe N., Gugnani, Harish Chander, Gupta, Rajeev, Gupta, Rahul, Hafezi-Nejad, Nima, Hamadeh, Randah Ribhi, Hammami, Mouhanad, Hankey, Graeme J., Harb, Hilda L., Haro, Josep Maria, Havmoeller, Rasmu, Hay, Simon I., Hedayati, Mohammad T., Heredia Pi, Ileana B., Hoek, Hans W., Hornberger, John C., Hosgood, H. Dean, Hotez, Peter J., Hoy, Damian G., Huang, John J., Iburg, Kim M., Idrisov, Bulat T., Innos, Kaire, Jacobsen, Kathryn H., Jeemon, Panniyammakal, Jensen, Paul N., Jha, Vivekanand, Jiang, Guohong, Jonas, Jost B., Juel, Knud, Kan, Haidong, Kankindi, Ida, Karam, Nadim E., Karch, André, Karema, Corine Kakizi, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S., Kemp, Andrew H., Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Khader, Yousef Saleh, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz Ahmed, Khang, Young-Ho, Khonelidze, Irma, Kinfu, Yohanne, Kinge, Jonas M., Knibbs, Luke, Kokubo, Yoshihiro, Kosen, S., Kuate Defo, Barthelemy, Kulkarni, Veena S., Kulkarni, Chanda, Kumar, Kaushalendra, Kumar, Ravi B., Kumar, G. Anil, Kwan, Gene F., Lai, Taavi, Lakshmana Balaji, Arjun, Lam, Hilton, Lan, Qing, Lansingh, Van C., Larson, Heidi J., Larsson, Ander, Lee, Jong-Tae, Leigh, Jame, Leinsalu, Mall, Leung, Ricky, Li, Yichong, Li, Yongmei, De Lima, Graça Maria Ferreira, Lin, Hsien-Ho, Lipshultz, Steven E., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Machado, Vasco Manuel Pedro, Maclachlan, Jennifer H., Magis-Rodriguez, Carlo, Majdan, Marek, Mapoma, Christopher Chabila, Marcenes, Wagner, Marzan, Melvin Barriento, Masci, Joseph R., Mashal, Mohammad Taufiq, Mason-Jones, Amanda J., Mayosi, Bongani M., Mazorodze, Tasara T., Mckay, Abigail Cecilia, Meaney, Peter A., Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Miller, Ted R., Mills, Edward J., Mohammad, Karzan Abdulmuhsin, Mokdad, Ali H., Mola, Glen Liddell, Monasta, Lorenzo, Montico, Marcella, Moore, Ami R., Mori, Rintaro, Moturi, Wilkister Nyaora, Mukaigawara, Mitsuru, Murthy, Kinnari S., Naheed, Aliya, Naidoo, Kovin S., Naldi, Luigi, Nangia, Vinay, Narayan, K.M. Venkat, Nash, Deni, Nejjari, Chakib, Nelson, Robert G., Neupane, Sudan Prasad, Newton, Charles R., Ng, Marie, Nisar, Muhammad Imran, Nolte, Sandra, Norheim, Ole F., Nowaseb, Vincent, Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O., Omer, Saad B., Opio, John Nelson, Orisakwe, Orish Ebere, Pandian, Jeyaraj D., Papachristou, Christina, Paternina Caicedo, Angel J., Patten, Scott B., Paul, Vinod K., Pavlin, Boris Igor, Pearce, Neil, Pereira, David M., Pervaiz, Aslam, Pesudovs, Konrad, Petzold, Max, Pourmalek, Farshad, Qato, Dima, Quezada, Amado D., Quistberg, D. Alex, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Sajjad Ur, Raju, Murugesan, Rana, Saleem M., Razavi, Homie, Reilly, Robert Quentin, Remuzzi, Giuseppe, Richardus, Jan Hendrik, Ronfani, Luca, Roy, Nobhojit, Sabin, Nsanzimana, Saeedi, Mohammad Yahya, Sahraian, Mohammad Ali, Samonte, Genesis May J., Sawhney, Monika, Schneider, Ione J.C., Schwebel, David C., Seedat, Soraya, Sepanlou, Sadaf G., Servan-Mori, Edson E., Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin Hyun, Shiue, Ivy, Shivakoti, Rupak, Sigfusdottir, Inga Dora, Silberberg, Donald H., Silva, Andrea P., Simard, Edgar P., Singh, Jasvinder A., Skirbekk, Vegard, Sliwa, Karen, Soneji, Samir, Soshnikov, Sergey S., Sreeramareddy, Chandrashekhar T., Stathopoulou, Vasiliki Kalliopi, Stroumpoulis, Konstantino, Swaminathan, Soumya, Sykes, Bryan L., Tabb, Karen M., Talongwa, Roberto Tchio, Tenkorang, Eric Yeboah, Terkawi, Abdullah Sulieman, Thomson, Alan J., Thorne-Lyman, Andrew L., Towbin, Jeffrey A., Traebert, Jefferson, Tran, Bach X., Tsala Dimbuene, Zacharie, Tsilimbaris, Miltiadi, Uchendu, Uche S., Ukwaja, Kingsley N., Uzun, Selen Begüm, Vallely, Andrew J., Vasankari, Tommi J., Venketasubramanian, N., Violante, Francesco S., Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Waller, Stephen, Wallin, Mitchell T., Wang, Linhong, Wang, Xiao Rong, Wang, Yanping, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G., Westerman, Ronny, White, Richard A., Wilkinson, James D., Williams, Thomas Neil, Woldeyohannes, Solomon Meseret, Wong, John Q., Xu, Gelin, Yang, Yang C., Yano, Yuichiro, Yentur, Gokalp Kadri, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa, Yu, Chuanhua, Jin, Kim Yun, El Sayed Zaki, Maysaa, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zou, Xiao Nong, Lopez, Alan D., and Vos, Theo
Subjects: Gerontology, SEVERE FEBRILE ILLNESS, Male, verbal autopsy, Nutrition and Disease, Cost effectiveness, MILLENNIUM DEVELOPMENT GOALS, HIV Infections, active antiretroviral therapy, Global Health, COST-EFFECTIVENESS, 0302 clinical medicine, Voeding en Ziekte, Global health, HIV Infection, 030212 general & internal medicine, 0303 health sciences, ACTIVE ANTIRETROVIRAL THERAPY, Incidence (epidemiology), Medicine (all), Incidence, General Medicine, Millennium Development Goals, 3. Good health, middle-income countries, projection package, World Health, VERBAL AUTOPSY, Female, Human, Tuberculosis, Tuberculosi, PROJECTION PACKAGE, prospective cohort, Epidemic, millennium development goals, 03 medical and health sciences, Age Distribution, Acquired immunodeficiency syndrome (AIDS), SDG 3 - Good Health and Well-being, MIDDLE-INCOME COUNTRIES, medicine, Organizational Objective, Humans, Organizational Objectives, FEMALE SEX WORKERS, Mortality, Sex Distribution, Epidemics, cost-effectiveness, female sex workers, 030304 developmental biology, VLAG, business.industry, plasmodium-falciparum malaria, PLASMODIUM-FALCIPARUM MALARIA, medicine.disease, Verbal autopsy, Malaria, PROSPECTIVE COHORT, severe febrile illness, business, Demography
Abstract: BACKGROUND: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration.METHODS: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets.FINDINGS: Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990.INTERPRETATION: Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action.FUNDING: Bill & Melinda Gates Foundation.
Published: 2014
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34. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Author: Karen Sliwa, Xiaofeng Liang, Vivekanand Jha, Dorairaj Prabhakaran, Rakhi Dandona, Gonghuan Yang, Xuan Che, Soewarta Kosen, Sergei Petrovich Ermakov, Ted R. Miller, Samath D Dharmaratne, Philimon Gona, Sergey Soshnikov, Atsushi Goto, Costas A. Christophi, Zacharie Tsala Dimbuene, Elena Alvarez, Yanping Wang, Peggy Pei-Chia Chiang, Mohammad H. Forouzanfar, Giancarlo Logroscino, Massimo Cirillo, Knud Juel, Johanna M. Geleijnse, Stefan Ma, Samaya Ismayilova, Karen Fern Greenwell, Michelle L. Bell, Saad B. Omer, Ademola Lukman Adelekan, Joshua A. Salomon, Dhruv S. Kazi, Jed D. Blore, Walid Ammar, Carly E Levitz, Kovin Naidoo, Solveig A. Cunningham, Stephen G. Waller, Anand Dayama, James D. Wilkinson, Vasiliki Stathopoulou, Meghan D. Mooney, Mall Leinsalu, Jonathan R. Carapetis, Paul S. F. Yip, Anders Larsson, Abbas Ali Mahdi, Hideaki Toyoshima, Guohong Jiang, Xia Wan, Chuanhua Yu, Soufiane Boufous, Ivy Shiue, Bulat Idrisov, Qing Lan, Chelsea A. Liddell, Austin E Schumacher, Valeria Caso, Nigel Bruce, Paulo A. Lotufo, Ibrahim Abubakar, Roberto Tchio Talongwa, Luke Nyakarahuka, Edward J Mills, Iuri da Costa Leite, Semaw Ferede Abera, Ana C. Garcia, Ayse Abbasoglu Ozgoren, Matthew M Coates, Konstantinos Stroumpoulis, Bradford D. Gessner, Kebede Deribe, Tommi Vasankari, Logan Sandar, Kenji Shibuya, Karen M. Tabb, Troy Jacobs, Christopher J L Murray, Chakib Nejjari, Katherine T. Lofgren, Melvin Barrientos Marzan, Haidong Wang, Joanna Moschandreas, Raimundas Lunevicius, Nataliya Foigt, Rashmi Gupta, Ziad A. Memish, Victoria Pillay-van Wyk, Randah R. Hamadeh, Azmeraw T. Amare, Lalit Dandona, Uchechukwu K.A. Sampson, Monika Sawhney, Vasiliy Victorovich Vlassov, Farhad Islami, Palwasha Anwari, Mustafa Z. Younis, Amitava Banerjee, Ruben Castro, David O. Carpenter, Karzan Abdulmuhsin Mohammad, Taavi Lai, Yousef Khader, Sara Sheikhbahaei, Atte Meretoja, Zanfina Ademi, Ivo Rakovac, Yang Yang, Hilda L Harb, Daniel Pope, Jun She, Yichong Li, Andrew L. Thorne-Lyman, Adrian Davis, Stein Emil Vollset, Andre Pascal Kengne, Henry Apfel, Mark J. Nieuwenhuijsen, John J. McGrath, Yoshihiro Kokubo, Jonas Minet Kinge, Elisabete Weiderpass, Rajiv Chowdhury, Damian G Hoy, Jürgen C Schmidt, Seyed-Mohammad Fereshtehnejad, Harish Chander Gugnani, Hywel C Williams, Karen Edmond, Peter J. Allen, Marina Shakh-Nazarova, Tom Achoki, Edmond K. Kabagambe, Naohiro Yonemoto, Jun Zhu, Simon I. Hay, Karen J. Courville, Ketevan Goginashvili, Theo Vos, Kim Yun Jin, Kawkab Shishani, Lorenzo Monasta, H. Dean Hosgood, Uʇur Dilmen, Marcella Montico, Shankuan Zhu, Ami R. Moore, Marie Ng, Maigeng Zhou, Hebe N. Gouda, Linh N Bui, Sanjay Basu, Mouhanad Hammami, Mohammad T Mashal, Bryan K. Phillips, Marissa Iannarone, Ronan A Lyons, Young-Ho Khang, Robert G. Weintraub, Luca Ronfani, Daniel Kim, Alanur Çavlin, Ferrán Catalá-López, Ronny Westerman, Maia Kereselidze, Itamar S. Santos, Reza Assadi, Hwashin Hyun Shin, Carolina Maria Teixeira, Berrak Bora Basara, David Rojas-Rueda, Abdullah Sulieman Terkawi, Adansi A. Amankwaa, Nicholas J K Breitborde, Gokalp Kadri Yentur, Kaushalendra Kumar, Daniel Obadare Fijabi, Neeraj Bedi, Robert Quentin Reilly, Ana Maria Nogales Vasconcelos, Scott Weichenthal, Mark A. Green, Selen Begüm Uzun, Mukesh Dherani, Shams Eldin Ali Hassan Khalifa, Majed Asad, Jasvinder A. Singh, Angel J Paternina Caicedo, Eric L. Ding, Jost B. Jonas, Tolesa Bekele, Alan J Thomson, Steven E. Lipshultz, Rosario Cárdenas, Sajjad Ur Rahman, George A. Mensah, Jongmin Lee, Inga Dora Sigfusdottir, Mohammad Yahya Saeedi, Magdalena M. Muszyńska, Ulrich O Mueller, Stephen S Lim, Barthelemy Kuate Defo, Alan D. Lopez, Luciano A. Sposato, G Anil Kumar, Farshad Pourmalek, Zulfiqar A Bhutta, Maysaa El Sayed Zaki, Shiwei Liu, K.M. Venkat Narayan, William Msemburi, Ting Wu Chuang, Zewdie Aderaw Alemu, Saleem M Rana, Mohammad Taghi Hedayati, Mohsen Naghavi, Vegard Skirbekk, Walter Mendoza, Ali H. Mokdad, Yohannes Kinfu, Jean de Dieu Ngirabega, Takayoshi Ohkubo, Parfait Uwaliraye, Tasara T. Mazorodze, Farshad Farzadfar, Rob E. Dorrington, Mohammad A. AlMazroa, R. Kumar, Lesley Rushton, Wang, H, Liddell, Ca, Coates, Mm, Mooney, Md, Levitz, Ce, Schumacher, Ae, Apfel, H, Iannarone, M, Phillips, B, Lofgren, Kt, Sandar, L, Dorrington, Re, Rakovac, I, Jacobs, Ta, Liang, X, Zhou, M, Zhu, J, Yang, G, Wang, Y, Liu, S, Li, Y, Ozgoren, Aa, Abera, Sf, Abubakar, I, Achoki, T, Adelekan, A, Ademi, Z, Alemu, Za, Allen, Pj, Almazroa, Ma, Alvarez, E, Amankwaa, Aa, Amare, At, Ammar, W, Anwari, P, Cunningham, Sa, Asad, Mm, Assadi, R, Banerjee, A, Basu, S, Bedi, N, Bekele, T, Bell, Ml, Bhutta, Z, Blore, J, Basara, Bb, Boufous, S, Breitborde, N, Bruce, Ng, Bui, Ln, Carapetis, Jr, Cárdenas, R, Carpenter, Do, Caso, V, Castro, Re, Catalá Lopéz, F, Cavlin, A, Che, X, Chiang, Pp, Chowdhury, R, Christophi, Ca, Chuang, Tw, Cirillo, Massimo, da Costa Leite, I, Courville, Kj, Dandona, L, Dandona, R, Davis, A, Dayama, A, Deribe, K, Dharmaratne, Sd, Dherani, Mk, Dilmen, U, Ding, El, Edmond, Km, Ermakov, Sp, Farzadfar, F, Fereshtehnejad, Sm, Fijabi, Do, Foigt, N, Forouzanfar, Mh, Garcia, Ac, Geleijnse, Jm, Gessner, Bd, Goginashvili, K, Gona, P, Goto, A, Gouda, Hn, Green, Ma, Greenwell, Kf, Gugnani, Hc, Gupta, R, Hamadeh, Rr, Hammami, M, Harb, Hl, Hay, S, Hedayati, Mt, Hosgood, Hd, Hoy, Dg, Idrisov, Bt, Islami, F, Ismayilova, S, Jha, V, Jiang, G, Jonas, Jb, Juel, K, Kabagambe, Ek, Kazi, D, Kengne, Ap, Kereselidze, M, Khader, Y, Khalifa, Se, Khang, Yh, Kim, D, Kinfu, Y, Kinge, Jm, Kokubo, Y, Kosen, S, Defo, Bk, Kumar, Ga, Kumar, K, Kumar, Rb, Lai, T, Lan, Q, Larsson, A, Lee, Jt, Leinsalu, M, Lim, S, Lipshultz, Se, Logroscino, G, Lotufo, Pa, Lunevicius, R, Lyons, Ra, Ma, S, Mahdi, Aa, Marzan, Mb, Mashal, Mt, Mazorodze, Tt, Mcgrath, Jj, Memish, Za, Mendoza, W, Mensah, Ga, Meretoja, A, Miller, Tr, Mills, Ej, Mohammad, Ka, Mokdad, Ah, Monasta, L, Montico, M, Moore, Ar, Moschandreas, J, Msemburi, Wt, Mueller, Uo, Muszynska, Mm, Naghavi, M, Naidoo, K, Narayan, Kv, Nejjari, C, Ng, M, de Dieu Ngirabega, J, Nieuwenhuijsen, Mj, Nyakarahuka, L, Ohkubo, T, Omer, Sb, Caicedo, Aj, Wyk, Vp, Pope, D, Prabhakaran, D, Rahman, Su, Rana, Sm, Reilly, Rq, Rojas Rueda, D, Ronfani, L, Rushton, L, Saeedi, My, Salomon, J, Sampson, U, Santos, I, Sawhney, M, Schmidt, Jc, Shakh Nazarova, M, She, J, Sheikhbahaei, S, Shibuya, K, Shin, Hh, Shishani, K, Shiue, I, Sigfusdottir, Id, Singh, Ja, Skirbekk, V, Sliwa, K, Soshnikov, S, Sposato, La, Stathopoulou, Vk, Stroumpoulis, K, Tabb, Km, Talongwa, Rt, Teixeira, Cm, Terkawi, A, Thomson, Aj, Thorne Lyman, Al, Toyoshima, H, Dimbuene, Zt, Uwaliraye, P, Uzun, Sb, Vasankari, Tj, Vasconcelos, Am, Vlassov, Vv, Vollset, Se, Vos, T, Waller, S, Wan, X, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Westerman, R, Wilkinson, Jd, Williams, Hc, Yang, Yc, Yentur, Gk, Yip, P, Yonemoto, N, Younis, M, Yu, C, Jin, Ky, El Sayed Zaki, M, Zhu, S, Lopez, Ad, and Murray, C. J.
Subjects: trends, Pediatrics, medicine.medical_specialty, Nutrition and Disease, democracy, Developing country, coverage, VDP::Medisinske fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803, millennium development goals, Global Health, survival, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, 030225 pediatrics, Voeding en Ziekte, Infant Mortality, Global health, Humans, Organizational Objectives, Medicine, 030212 general & internal medicine, 10. No inequality, VLAG, business.industry, Mortality rate, Infant, Newborn, 1. No poverty, Infant, health, General Medicine, Millennium Development Goals, Infant mortality, maternal education, 3. Good health, Secular variation, Child mortality, Socioeconomic Factors, income countries, Child, Preschool, Child Mortality, developing-countries, VDP::Midical sciences: 700::Health sciences: 800::Epidemiology, medical and dental statistics: 803, International development, business, Demography, child-mortality
Abstract: Summary Background Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success. Methods We generated updated estimates of child mortality in early neonatal (age 0–6 days), late neonatal (7–28 days), postneonatal (29–364 days), childhood (1–4 years), and under-5 (0–4 years) age groups for 188 countries from 1970 to 2013, with more than 29 000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030. Findings We estimated that 6·3 million (95% UI 6·0–6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1–18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6–177·4) in Guinea-Bissau to 2·3 (1·8–2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from −6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000–13 than during 1990–2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only −1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone. Interpretation Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030. Funding Bill & Melinda Gates Foundation, US Agency for International Development.
Published: 2014
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35. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015

Author: Barber R. M. a, Fullman N. a, Sorensen R. J. D. a, Bollyky T. f, McKee M. i, Nolte E. g, Abajobir A. A. j, Abate K. H. n, Abbafati C. o, Abbas K. M. p, Abd-Allah F. q, Abdulle A. M. r, Abdurahman, A. A. ac, Abera, S. F. ad, ah Abraham, B. ai, Abreha, G. F. ad, Adane, K. af, Adelekan, A. L. aj, ak Adetifa, I. M. O. i al, Afshin A. a, Agarwal, A. ao, ap Agarwal, S. K. aq, S. ar, Agrawal, A. as, Ahmad Kiadaliri, A. au, Ahmadi, A. ax, Ahmed, K. Y. ay, Ahmed M. B. m, Akinyemi, R. O. ak, az Akinyemiju, T. F. ba, Akseer, N. am, bc Al-Aly, Z. bd, Alam, K. be, bf dn, dq Alam, N. bg, S. S. bh, Alemu, Z. A. ay, Alene, K. A. bi, Alexander L. a, Ali, R. bm, S. D. bn, bo bp, Alizadeh-Navaei, R. bq, Alkerwi, A. bs, Alla, F. bt, Allebeck, P. bu, Allen C. a, Al-Raddadi, R. cb, Alsharif, U. cd, Altirkawi, K. A. ce, Alvarez Martin, E. cf, Alvis-Guzman, N. cg, Amare, A. T. ch, cj gr, Amini E. s, t wy, Ammar, W. cl, Amo-Adjei, J. cm, cn Amoako, Y. A. co, Anderson B. O. e, Androudi, S. cq, Ansari, H. cr, Ansha, M. G. cs, Antonio, C. A. T. ct, Ärnlöv, J. bv, cv Artaman, A. cw, Asayesh, H. cx, Assadi, R. cy, Astatkie, A. cz, Atey, T. M. ag, Atique, S. da, Atnafu, N. T. dc, dd Atre, S. R. de, Avila-Burgos, L. df, Avokpaho, E. F. G. A. dg, Ayala Quintanilla, B. P. di, dj Awasthi, A. dk, Ayele, N. N. dl, Azzopardi, P. dm, dn dr, Ba Saleem, H. O. dt, Bärnighausen, T. du, dz ea, Bacha, U. eb, Badawi, A. an, ec Banerjee, A. ed, Barac, A. eg, Barboza, M. A. ej, ek Barker-Collo, S. L. el, Barrero, L. H. en, Basu, S. eo, Baune, B. T. ch, gr Baye, K. eq, Bayou, Y. T. er, Bazargan-Hejazi, S. es, et Bedi, N. eu, Beghi, E. ev, Béjot, Y. ew, Bello, A. K. ex, Bennett, D. A. bm, Bensenor, I. M. ez, Berhane, A. fa, Bernabé, E. fd, Bernal, O. A. fe, Beyene, A. S. ff, ki Beyene, T. J. eq, fi Bhutta, Z. A. bc, fj Biadgilign, S. fk, Bikbov, B. fl, Birlik, S. M. fm, Birungi, C. ef, Biryukov S. a, Bisanzio, D. bk, Bizuayehu, H. M. fn, Bose, D. fo, Brainin, M. fp, Brauer M. a, fq Brazinova, A. fr, fs Breitborde, N. J. K. fu, Brenner, H. fw, Butt, Z. A. fx, Cárdenas, R. fy, Cahuana-Hurtado, Campos-Nonato, I. R. df, dx Car, J. fz, Carrero, J. J. bw, Casey D. a, Caso, V. ga, Castañeda-Orjuela, C. A. gb, Castillo Rivas, J. gd, ge Catalá-López, F. gf, gg Cecilio, P. gh, Cercy K. a, Charlson F. J. a, j gi, Chen A. Z. a, Chew A. a, Chibalabala, M. gj, Chibueze, C. E. gk, Chisumpa, V. H. gl, gm Chitheer, A. A. gn, Chowdhury, R. go, Christensen, H. gp, Christopher, D. J. gq, Ciobanu, L. G. ci, Cirillo, M. gs, Coggeshall M. S. a, Cooper, L. T. gt, Cortinovis, M. fl, Crump, J. A. gu, Dalal, K. gv, Danawi, H. gw, Dandona L. a, gy Dandona, R. a gy, Dargan, P. I. gz, Das Neves, J. ha, hb Davey, G. hd, Davitoiu, D. V. he, Davletov, K. hf, De Leo, D. hh, Del Gobbo, L. C. eo, Del Pozo-Cruz, B. em, Dellavalle, R. P. hi, Deribe, K. ep, hj Deribew, A. al, Des Jarlais, D. C. hk, hl Dey, S. hm, Dharmaratne, S. D. hn, Dicker D. a, Ding, E. L. dx, Dokova, K. ho, Dorsey, E. R. hp, Doyle, K. E. hq, hr Dubey, M. hs, Ehrenkranz R. a, Ellingsen, C. L. hu, Elyazar, I. hv, Enayati, A. hw, Ermakov, S. P. hx, hy Eshrati, B. hz, ia Esteghamati, A. t wz, Estep K. a, Fürst T. h, ic ie, Faghmous I. D. A. i, Fanuel, F. B. B. cz, if Faraon, E. J. A. cu, ig Farid, T. A. ih, Farinha, C. S. E. S. ii, ij Faro, A. ik, Farvid, M. S. dw, il Farzadfar, F. u xa, Feigin, V. L. im, Feigl, A. B. du, Fereshtehnejad, S. -M. bx, Fernandes, J. G. in, J. C. io, Feyissa, T. R. ip, Fischer, F. iq, Fitzmaurice C. a, b ir, Fleming T. D. a, Foigt, N. is, Foreman K. J. a, ib Forouzanfar, M. H. it, Franklin, R. C. iu, Frostad J. a, Ghiwot T. T. n, Gakidou E. a, Gambashidze, K. iv, Gamkrelidze, A. iv, Gao, W. ix, Garcia-Basteiro, A. L. iy, iz Gebre, T. ja, Gebremedhin A. T. n, jb Gebremichael, M. W. ag, Gebru, A. A. ag, jc Gelaye, A. A. jd, Geleijnse, J. M. fh, Genova-Maleras, R. je, jf Gibney, K. B. jg, Giref, A. Z. eq, Gishu, M. D. fg, jh Giussani, G. ev, Godwin W. W. a, Gold A. a, Goldberg E. M. a, Gona, P. N. ji, Goodridge, A. jj, Gopalani, S. V. jk, Goto, A. jl, Graetz N. a, Greaves, F. ib, jm Griswold, M. a Guban, P. I. jn, Gugnani, H. C. jo, Gupta, P. C. jp, R. jq, R. jr, T. js, V. jt, Habtewold, T. D. fb, jv Hafezi-Nejad, N. t xb, Haile, D. eq, Hailu, A. D. ep, jx Hailu, G. B. ag, jc Hakuzimana, A. jz, ka Hamadeh, R. R. kb, Hambisa, M. T. ff, Hamidi, S. kc, Hammami, M. kd, Hankey, G. J. ke, kf kg, Hao, Y. kh, Harb, H. L. cl, Hareri, H. A. eq, Haro, J. M. mw, Hassanvand M. S. w, xc Havmoeller, R. ca, Hay, R. J. fd, kk Hay, S. I. a bl, Hendrie, D. kl, Heredia-Pi, I. B. df, Hoek, H. W. ju, km Horino, M. ko, Horita, N. kp, Hosgood, H. D. kq, Htet, A. S. kr, ks Hu, G. kt, Huang, H. ku, J. J. kv, Huntley B. M. a, Huynh C. a, Iburg, K. M. kw, Ileanu, B. V. kx, Innos, K. ky, Irenso, A. A. fg, kj Jahanmehr, N. kz, Jakovljevic, M. B. lb, James, P. dv, S. L. lc, Javanbakht, M. ld, Jayaraman, S. P. le, Jayatilleke, A. U. lf, lg Jeemon, P. gx, lh li, nh Jha, V. bm, lk John, D. ll, Johnson C. a, Johnson S. C. a, Jonas, J. B. lm, Juel, K. ln, Kabir, Z. lo, Kalkonde, Y. lp, Kamal, R. lq, Kan, H. ls, Karch, A. lt, lu Karema, C. K. id, lv Karimi, S. M. lw, Kasaeian A. t, y xd, Kassebaum N. J. a, lx Kastor, A. hs, Katikireddi, S. V. ly, Kazanjan, Keiyoro, P. N. lz, ma Kemmer, L. a Kemp, A. H. mc, me Kengne, A. P. jz, mf Kerbo, A. A. if, Kereselidze, M. iv, Kesavachandran, C. N. lq, Khader, Y. S. mg, Khalil I. a, Khan, A. R. ih, E. A. mh, G. mi, Khang, Y. -H. mj, Khoja, A. T. A. ml, Khonelidze, I. iv, Khubchandani, J. mm, Kibret, G. D. ay, Kim, D. mn, Kim P. a, Y. J. mo, Kimokoti, R. W. mp, Kinfu, Y. mq, Kissoon, N. fq, Kivipelto, M. by, Kokubo, Y. mr, Kolk, A. ms, Kolte, D. mt, Kopec, J. A. fq, Kosen, S. mu, Koul, P. A. mv, Koyanagi, A. mw, Kravchenko, M. mx, Krishnaswami, S. my, Krohn K. J. a, Kuate Defo, B. mz, Kucuk Bicer, B. nb, Kuipers, E. J. nd, Kulkarni, V. S. ne, Kumar, G. A. lj, Kumsa, F. A. fg, kj Kutz, M. a Kyu, H. H. a Lager, A. C. J. nf, Lal, A. ng, D. K. ni, Lalloo R. k, Lallukka, T. nj, Lan, Q. nl, Langan S. M. i, Lansingh, V. C. nm, nn Larson, H. J. a h, Larsson, A. no, Laryea, D. O. cp, Latif, A. A. np, Lawrynowicz, A. E. B. nq, Leasher, J. L. nr, Leigh, J. bf, Leinsalu, M. ky, nt Leshargie, C. T. ay, Leung J. e, j Leung, R. nu, Levi, M. nv, Liang, X. nw, Lim S. S. a, Lind M. a, Linn, S. nx, Lipshultz, S. E. ny, nz Liu, P. a Liu, Y. oa, L. -T. ob, oc Logroscino, G. od, Lopez, A. D. do, Lorch, S. A. oe, Lotufo, P. A. ez, Lozano, R. df, Lunevicius, R. of, og Lyons, R. A. mb, Macarayan, E. R. K. kv, Mackay, M. T. oh, Magdy Abd El Razek, H. oi, M. oj, Mahdavi, M. ok, ol Majeed, A. ib, Malekzadeh R. z, xe Malta, D. C. on, Mantovani LG, Manyazewal, T. op, Mapoma, C. C. gl, Marcenes, W. oq, Marks, G. B. md, ns Marquez, N. a Martinez-Raga, J. or, os Marzan, M. B. ot, Massano, J. hc, ou Mathur, M. R. ni, Maulik, P. K. ov, Mazidi, M. ow, McAlinden, C. ox, oy McGrath, J. J. l McNellan, C. a Meaney, P. A. oz, pa Mehari, A. pb, Mehndiratta, M. M. pc, Meier, T. pd, Mekonnen, A. B. bf, bj Meles, K. G. ad, Memish, Z. A. pe, pf Mengesha, M. M. ff, Mengiste, D. T. ae, Mengistie M. A. n, Menota, B. G. eq, Mensah, G. A. pg, Mereta S. T. n, Meretoja, A. dp, ph Meretoja, T. J. nk, pi Mezgebe, H. B. ag, Micha, R. pj, Millear A. a, Mills, E. J. pl, Minnig S. a, Mirarefin M. a, pm Mirrakhimov, E. M. pn, po Mock, C. N. c Mohammad, K. A. pp, Mohammed, S. ea, pq Mohanty, S. K. hs, Mokdad A. H. a, Mola, G. L. D. pr, Molokhia, M. fd, Monasta, L. ps, Montico, M. ps, Moradi-Lakeh M. a, pt Moraga, P. pz, Morawska, L. pv, pw Mori, R. qa, Moses M. a, Mueller, U. O. qc, Murthy, S. fq, Musa, K. I. qd, Nachega, J. B. qe, qf qg, Nagata, C. qh, Nagel, G. qj, Naghavi M. a, Naheed, A. bh, Naldi, L. qk, Nangia, V. ql, Nascimento, B. R. qm, qn Negoi, I. qo, Neupane, S. P. ks, Newton, C. R. qp, Ng M. a, Ngalesoni, F. N. qq, Ngunjiri, J. W. qr, Nguyen G. a, Ningrum, D. N. A. db, qs Nolte, S. cc, qt rj, Nomura, M. qv, Norheim, O. F. jx, Norrving, B. av, Noubiap, J. J. N. jz, qw Obermeyer, C. M. qx, Ogbo, F. A. qy, I. -H. ra, Okoro, A. rb, Oladimeji, O. rc, rd Olagunju, A. T. ci, Olivares, P. R. re, Olsen H. E. a, Olusanya, B. O. rf, J. O. rf, Opio, J. N. rg, Oren, E. rh, Ortiz, A. ri, Osborne, R. H. rk, Osman, M. dy, rl Owolabi, M. O. rm, rn Mahesh, P. A. ro, Pain A. W. a, Pakhale, S. rp, Palomares Castillo, E. rq, rr Pana, A. kx, Papachristou, C. cd, Parsaeian M. u, v xa, Patel, T. rs, Patton, G. C. dn, Paudel, D. rt, Paul, V. K. aq, Pearce N. i, Pereira, D. M. ru, Perez-Padilla, R. rv, Perez-Ruiz, F. rw, rx Perico, N. Pesudovs, K. ry, Petzold, M. rz, sa Phillips, M. R. oa, sb Pigott, D. M. a Pillay, J. D. sc, Pinho C. a, Polinder, S. nc, Pond, C. D. sd, Prakash, V. se, Purwar, M. sf, Qorbani, M. sg, Quistberg D. A. c, d Radfar, A. sh, Rafay, A. si, sj Rahimi, K. bm, Rahimi-Movaghar, V. aa, xf Rahman, M. sk, Rahman, M. H. U. hs, Rai, R. K. sl, Ram, U. hs, Rana, S. M. si, sj Rankin, Z. a Rao, P. V. sm, sn Rao, P. C. a Rawaf, S. ib, Rego, M. A. S. om, Reitsma M. a, Remuzzi, G. fl, so sp, Renzaho, A. M. N. N. qz, Resnikoff, S. sq, sr Rezaei, S. aw, Rezai, M. S. br, Ribeiro, A. L. qm, Roba, H. S. ff, Rokni, M. B. ac, Ronfani, Roshandel G. z, st xe, Roth G. A. a, Rothenbacher, D. qi, Roy, N. K. su, sv Sachdev, P. S. ss, sw Sackey, B. B. sx, Saeedi, M. Y. sy, Safiri, S. sz, Sagar, R. aq, Sahraian, M. A. ab, xg Saleh, M. M. ta, Salomon, J. A. du, Samy, A. M. tb, Sanabria, J. R. tc, td Sanchez-Niño, M. D. te, Sandar L. a, Santos, I. S. ey, J. V. hc, Santric Milicevic, M. M. eh, ei Sarmiento-Suarez, R. tf, Sartorius, B. tg, ti Satpathy, M. aq, Savic, M. hu, Sawhney, M. tj, Saylan, M. I. tk, Schöttker, B. fv, tl Schutte, A. E. tm, tn Schwebel, D. C. bb, Seedat, S. qf, Seid, A. M. ff, Seifu, C. N. if, Sepanlou S. G. z, xe Serdar, B. to, Servan-Mori, E. E. df, Setegn, T. ck, Shackelford K. A. a, Shaheen, A. tp, Shahraz, S. tq, Shaikh, M. A. tr, Shakh-Nazarova, Shamsipour M. x, Shariful Islam, S. M. bh, Sharma, J. ts, R. tt, She, J. lr, Sheikhbahaei S. t, wz Shen, J. ft, tu Shi, P. pk, Shigematsu, M. tv, tw Shin, M. -J. tx, Shiri, R. nj, Shoman, H. tz, Shrime, M. G. dy, Sibamo, E. L. S. if, Sigfusdottir, I. D. ua, Silva, D. A. S. ub, Silveira, D. G. A. uc, Sindi, S. ca, Singh, J. A. ud, O. P. ue, P. K. uf, V. ug, Sinke, A. H. uh, Sinshaw, A. E. ui, Skirbekk, V. hu, kn Sliwa, K. jy, Smith A. a, Sobngwi, E. uj, uk Soneji, S. ul, Soriano, J. B. um, Sousa, T. C. M. un, Sposato, L. A. uo, Sreeramareddy, C. T. up, Stathopoulou, V. uq, Steel, N. jm, ur Steiner, C. a Steinke, S. us, Stokes, M. A. qu, Stranges, S. bs, Strong, M. ut, Stroumpoulis, K. uu, uv Sturua, L. iv, Sufiyan, M. B. uw, Suliankatchi, R. A. ux, Sun, J. px, py uy, Sur P. a, Swaminathan, S. uz, Sykes, B. L. va, Tabarés-Seisdedos, R. gf, Tabb, K. M. vb, Taffere, G. R. ad, Talongwa, R. T. vc, Tarajia, M. vd, Tavakkoli, M. ve, Taveira, N. vf, vg Teeple, S. a Tegegne, T. K. ay, Tehrani-Banihashemi, A. pu, Tekelab, T. ip, vh Tekle, D. Y. ag, Temam Shifa, G. eq, vi Terkawi, A. S. vj, vk vl, Tesema, A. G. ag, Thakur, J. S. vm, Thomson, A. J. vn, Tillmann, T. ee, Tiruye, T. Y. ay, Tobe-Gai, R. vo, Tonelli, M. vp, Topor-Madry, R. vq, vr Tortajada, M. vs, Troeger C. a, Truelsen, T. vt, Tura, A. K. fg, jv Uchendu, U. S. vu, Ukwaja, K. N. vv, Undurraga, E. A. vw, Uneke, C. J. vx, Uthman, O. A. vy, Van Boven, J. F. M. jv, Van Dingenen, R. vz, Varughese, S. gq, Vasankari, T. wa, Venketasubramanian, N. wb, Violante, F. S. wc, Vladimirov, S. K. wd, Vlassov, V. V. we, Vollset S. E. a, ht jw, Vos T. a, Wagner J. A. a, Wakayo T. n, Waller, S. G. wf, Walson J. L. e, wg Wang, H. a Wang, Y. -P. wh, Watkins D. A. e, jz Weiderpass, E. bz, wi wj, wk Weintraub, R. G. dn, oh Wen, C. -P. iw, Werdecker, A. qb, Wesana, J. wl, wm Westerman, R. qc, wn Whiteford, H. A. a j, gi Wilkinson, J. D. ny, nz Wiysonge, C. S. qf, wo Woldeyes, Wolfe, C. D. A. fc, wp Won, S. mk, Workicho A. n, wq Workie, S. B. if, Wubshet, M. wr, ws Xavier, D. wt, G. wu, Yadav, A. K. hs, Yaghoubi, M. wv, Yakob, B. th, Yan, L. L. ww, Yano, Y. wx, Yaseri, M. la, xi Yimam, H. H. dc, Yip, P. xj, xk Yonemoto, N. xl, Yoon, S. -J. ty, Younis, M. Z. xm, C. xn, xo Zaidi, Z. xp, El Sayed Zaki, M. xq, Zambrana-Torrelio, C. xr, xs Zapata, T. xt, Zenebe, Z. M. ag, Zodpey, Zoeckler L. a, Zuhlke, L. J. xu, Murray C. J. L., Barber, Ryan, Fullman, Nancy, Sorensen, Reed, Thomas, Bollyky, Martin, Mckee, Ellen, Nolte, Amanuel, Alemu, Abajobir, Kalkidan, Hassen, Abate, Cristiana, Abbafati, Kaja, Abba, Foad, Abd Allah, Abdishakur, Abdulle, Ahmed, Abdulahi, Abdurahman, Semaw, Ferede, Abera, Biju, Abraham, Girmatsion, Fisseha, Abreha, Kelemework, Adane, Ademola, Lukman, Adelekan, Ifedayo, Morayo, Adetifa, Ashkan, Afshin, Arnav, Agarwal, Sanjay, Kumar, Agarwal, Sunilkumar, Agarwal, Anurag, Agrawal, Aliasghar, Ahmad, Kiadaliri, Alireza, Ahmadi, Kedir, Yimam, Ahmed, Muktar, Beshir, Ahmed, Rufus, Olusola, Akinyemi, Tomi, F, Akinyemiju, Nadia, Akseer, Ziyad, Al Aly, Khurshid, Alam, Noore, Alam, Sayed, Saidul, Alam, Zewdie, Aderaw, Alemu, Kefyalew, Addi, Alene, Lily, Alexander, Raghib, Ali, Syed, Danish, Ali, Reza, Alizadeh Navaei, Ala’A, Alkerwi, François, Alla, Peter, Allebeck, Christine, Allen, Rajaa, Al Raddadi, Ubai, Alsharif, Khalid, Altirkawi, Elena, Alvarez, Martin, Nelson, Alvis Guzman, Azmeraw, Amare, 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Mente, Birlik, Charles, Birungi, Stan, Biryukov, Donal, Bisanzio, Habtamu, Mellie, Bizuayehu, Dipan, Bose, Michael, Brainin, Michael, Brauer, Alexandra, Brazinova, Nicholas, Breitborde, Hermann, Brenner, Zahid, Butt, Rosario, Cárdena, Lucero, Cahuana Hurtado, Ismael, Ricardo, Campos, Nonato, Josip, Car, Juan, Jesu, Carrero, Daniel, Casey, Valeria, Caso, Carlos, Castañeda Orjuela, Jacqueline, Castillo, Rivas, Ferrán, Catalá López, Pedro, Cecilio, Kelly, Cercy, Fiona, Charlson, Alan, Chen, Adrienne, Chew, Mirriam, Chibalabala, Chioma, Ezinne, Chibueze, Vesper, Hichilombwe, Chisumpa, Abdulaal, Chitheer, Rajiv, Chowdhury, Hanne, Christensen, Devasahayam, Jesuda, Christopher, Liliana, Ciobanu, Cirillo, Massimo, Megan, Coggeshall, Leslie, Trumbull, Cooper, Monica, Cortinovi, John, Crump, Koustuv, Dalal, Hadi, Danawi, Lalit, Dandona, Rakhi, Dandona, Paul, Dargan, Jose, Da, Neves, Gail, Davey, Dragos, V, Davitoiu, Kairat, Davletov, Diego, De, Leo, Liana, Del, Gobbo, Borja, Del, Pozo, Cruz, Robert, Dellavalle, Kebede, Deribe, Amare, Deribew, Don, De, Jarlais, Subhojit, Dey, Samath, Dharmaratne, Daniel, Dicker, Eric, Ding, Klara, Dokova, Ray, Dorsey, Kerrie, Doyle, Manisha, Dubey, Rebecca, Ehrenkranz, Christian, Lycke, Ellingsen, Iqbal, Elyazar, Ahmadali, Enayati, Sergey, Petrovich, Ermakov, Babak, Eshrati, Alireza, Esteghamati, Kara, Estep, Thomas, Fürst, Imad, Faghmou, Fanuel, Belayneh, Bekele, Fanuel, Emerito, Jose, Aquino, Faraon, Talha, Farid, Carla, Sofia, Sa, Farinha, Andre, Faro, Maryam, Farvid, Farshad, Farzadfar, Valery, Feigin, Andrea, Feigl, Seyed Mohammad, Fereshtehnejad, Jefferson, Fernande, João, Fernande, Tesfaye, Regassa, Feyissa, Florian, Fischer, Christina, Fitzmaurice, Thomas, Fleming, Nataliya, Foigt, Kyle, Foreman, Mohammad, Forouzanfar, Richard, Franklin, Joseph, Frostad, Tsegaye, Tewelde, G/hiwot, Emmanuela, Gakidou, Ketevan, Gambashidze, Amiran, Gamkrelidze, Wayne, Gao, Alberto, Garcia Basteiro, Teshome, Gebre, Amanuel, Tesfay, Gebremedhin, 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Albertina Santiago, Reitsma, Marissa, Remuzzi, Giuseppe, Renzaho, Andre M N N, Resnikoff, Serge, Rezaei, Satar, Rezai, Mohammad Sadegh, Ribeiro, Antonio L, Roba, Hirbo Shore, Rokni, Mohammad Bagher, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Nawal K, Sachdev, Perminder S, Sackey, Ben Benasco, Saeedi, Mohammad Yahya, Safiri, Saeid, Sagar, Rajesh, Sahraian, Mohammad Ali, Saleh, Muhammad Muhammad, Salomon, Joshua A, Samy, Abdallah M, Sanabria, Juan Ramon, Sanchez-Niño, Maria Dolore, Sandar, Logan, Santos, Itamar S, Santos, João Vasco, Milicevic, Milena M Santric, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Saylan, Mete I, Schöttker, Ben, Schutte, Aletta E, Schwebel, David C, Seedat, Soraya, Seid, Abdulbasit Musa, Seifu, Canaan Negash, Sepanlou, Sadaf G, Serdar, Berrin, Servan-Mori, Edson E, Setegn, Tesfaye, Shackelford, Katya Anne, Shaheen, Amira, Shahraz, Saeid, Shaikh, Masood Ali, Shakh-Nazarova, Marina, Shamsipour, Mansour, Islam, Sheikh Mohammed Shariful, Sharma, Jayendra, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Shi, Peilin, Shigematsu, Mika, Shin, Min-Jeong, Shiri, Rahman, Shoman, Haitham, Shrime, Mark G, Sibamo, Ephrem Lejore Sibamo, Sigfusdottir, Inga Dora, Silva, Diego Augusto Santo, Silveira, Dayane Gabriele Alve, Sindi, Shireen, Singh, Abhishek, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Singh, Virendra, Sinke, Abiy Hiruye, Sinshaw, Aklilu Endalamaw, Skirbekk, Vegard, Sliwa, Karen, Smith, Alison, Sobngwi, Eugene, Soneji, Samir, Soriano, Joan B, Sousa, Tatiane Cristina Morae, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stathopoulou, Vasiliki, Steel, Nichola, Steiner, Caitlyn, Steinke, Sabine, Stokes, Mark Andrew, Stranges, Saverio, Strong, Mark, Stroumpoulis, Konstantino, Sturua, Lela, Sufiyan, Muawiyyah Babale, Suliankatchi, Rizwan Abdulkader, Sun, Jiandong, Sur, Patrick, Swaminathan, Soumya, Sykes, Bryan L, Tabarés-Seisdedos, Rafael, Tabb, Karen M, Taffere, Getachew Redae, Talongwa, Roberto Tchio, Tarajia, Musharaf, Tavakkoli, Mohammad, Taveira, Nuno, Teeple, Stephanie, Tegegne, Teketo Kassaw, Tehrani-Banihashemi, Arash, Tekelab, Tesfalidet, Tekle, Dejen Yemane, Shifa, Girma Temam, Terkawi, Abdullah Sulieman, Tesema, Azeb Gebresilassie, Thakur, J.S., Thomson, Alan J, Tillmann, Taavi, Tiruye, Tenaw Yimer, Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Tortajada, Miguel, Troeger, Christopher, Truelsen, Thoma, Tura, Abera Kenay, Uchendu, Uche S, Ukwaja, Kingsley N, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Uthman, Olalekan A, van Boven, Job F M, Van Dingenen, Rita, Varughese, Santosh, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Violante, Francesco S, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wagner, Joseph A, Wakayo, Tolassa, Waller, Stephen G, Walson, Judd L, Wang, Haidong, Wang, Yuan-Pang, Watkins, David A, Weiderpass, Elisabete, Weintraub, Robert G, Wen, Chi-Pang, Werdecker, Andrea, Wesana, Joshua, Westerman, Ronny, Whiteford, Harvey A, Wilkinson, James D, Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles D A, Won, Sungho, Workicho, Abdulhalik, Workie, Shimelash Bitew, Wubshet, Mamo, Xavier, Deni, Xu, Gelin, Yadav, Ajit Kumar, Yaghoubi, Mohsen, Yakob, Bereket, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Yimam, Hassen Hamid, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, El Sayed Zaki, Maysaa, Zambrana-Torrelio, Carlo, Zapata, Toma, Zenebe, Zerihun Menlkalew, Zodpey, Sanjay, Zoeckler, Leo, Zuhlke, Liesl Joanna, and Murray, Christopher J L
Subjects: Dánartíðni, Lífslíkur, Life expectancy, Diseases, Health insurance, Globan Burden of Disease, Healthcare Access, DEVELOPMENT GOALS, Methods, Psychology, LIFE EXPECTANCY, Risk assessment, Public health, Globan Burden of Disease, Injuries, Tölfræði, Sjúkdómar, Statistics, DEATH, Þjóðir, Staðtölur, 11 Medical And Health Sciences, Healthcare access, Health status indicators, Health policy, Global burden of disease, Gæðastjórnun, Sálfræði, COMPARATIVE RISK-ASSESSMENT, Lýðheilsa, Life Sciences & Biomedicine, Standards, UNITED-STATES, Sjúkratryggingar, Medicine, General & Internal, General & Internal Medicine, Heilbrigðisstefna, SYSTEMATIC ANALYSIS, Mortality, Public health systems, medicine (all), Áhættugreining, Science & Technology, Health services accessibility, Staðlar, TRENDS, Heilbrigðisþjónusta, MEDICAL-CARE, AVOIDABLE MORTALITY, Áverkar, Aðferðafræði, Quality of health care, EUROPEAN COUNTRIES, Heilbrigðiskerfi
Abstract: Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r= 0.88), an index of 11 universal health coverage interventions (r= 0.83), and human resources for health per 1000 (r= 0.77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28.6 to 94.6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40.7 (95% uncertainty interval, 39.0-42.8) in 1990 to 53.7 (52.2-55.4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21.2 in 1990 to 20.1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73.8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-systemcharacteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world., Bill & Melinda Gates Foundation.
Published: 2017

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35 results on '"Maia Kereselidze"'

1. Study of Epidemiological Characteristics of Fatal Injuries Using Death Registry Data in Georgia

2. Premature mortality attributable to COVID-19: potential years of life lost in 17 countries around the world, January–August 2020

3. The Burden of Disease due to COVID-19 (BoCO-19): A study protocol for a secondary analysis of surveillance data in Southern and Eastern Europe, and Central Asia.

4. The incidence of colorectal cancer (CRC) in Georgia continues to increase: A population-based registry study

5. Incidence and Patterns of Digestive Organ Cancer in Georgia: Insights from a Population-Based Registry Study in 2021

6. Epidemiological characteristics of injury in Georgia: A one-year retrospective study

7. Impact of Hepatitis C Virus (HCV) Infection and Treatment on Mortality in the Country of Georgia, 2015–2020

8. European Cancer Summit 2022 Submission for Prevention, Early Detection and Screening NetworkEarly detection and screening of Colorectal Cancer (CRC) in Georgia

9. DETECTION OF GASTRIC CANCER AT A LATE STAGE AS AN IMPORTANT FACTOR AFFECTING THE SURVIVAL OF PATIENTS

10. Impact of the COVID-19 pandemic on total, sex- and age-specific all-cause mortality in 20 countries worldwide during 2020: results from the C-MOR project

11. STATE OF PLAY OF PSYCHOSOCIAL REHABILITATION SERVICES AND ASSESSMENT OF THE NEEDS OF POST-BREAST CANCER TREATMENT IN GEORGIA

12. A global systematic analysis of the occurrence, severity, and recovery pattern of long COVID in 2020 and 2021

13. Early and late detection of cancer in Georgia: Evidence from a population-based cancer registry, 2018-2019

14. GENERAL EPIDEMIOLOGICAL CHARACTERISTICS OF BURN RELATED INJURIES

15. 125 Road traffic injuries in children: evidence from national database

16. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020???21

17. Distribution of Colorectal Cancer in the Georgian Population: Analysis of the Population-Based Cancer Registry Database of Georgia

18. May Measurement Month 2018: an analysis of blood pressure screening results in Georgia

19. Characteristics of discharged patients from hospitals - Georgian descriptive study

20. Case management of preterm deliveries: Birth-registry based study

21. Study of induced abortion based on the Georgian Birth Registry

22. Socio-Demographic Determinants of Road Traffic Fatalities in Women of Reproductive Age in the Republic of Georgia: Evidence from the National Reproductive Age Mortality Study (2014)

23. Socio-Demographic Determinants of Mortality from Chronic Noncommunicable Diseases in Women of Reproductive Age in the Republic of Georgia: Evidence from the National Reproductive Age Mortality Study (2014)

24. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

25. May Measurement Month 2017: an analysis of blood pressure screening results in Georgia-Europe

26. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

27. Leading causes of death of women of reproductive age in the Republic of Georgia: findings from the National Reproductive Age Mortality Survey (2014)

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

29. Global, regional, and national levels and causes of maternal mortality during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013

30. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

31. Electrophysiological Evidence for Ventral Stream Deficits in Schizophrenia Patients

32. The Global Burden of Cancer 2013

33. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

34. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

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

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35 results on '"Maia Kereselidze"'

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