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1. Using research to prepare for outbreaks of severe acute respiratory infection

Author

Mich, V. (Vann), Pho, Y. (Yaty), Bory, S. (Sotharith), Vann, M. (Mich), Teav, B. (Bunlor), Som, L. (Leakhann), Jarrvisalo, M. J. (Mikko J.), Pulkkinen, A. (Anni), Kuitunen, A. (Anne), Ala-kokko, T. (Tero), Melto, S. (Sari), Daix, T. (Thomas), Philippart, F. (Francois), Antoine, M. (Marchalot), Tiercelet, K. (Kelly), Bruel, C. (Cedric), Nicholas, S. (Sedillot), Siami, S. (Shidasp), Fabienne, T. (Taimon), Bruyere, R. (Raomi), Forceville, X. (Xavier), Erickson, S. (Simon), Campbell, L. (Lewis), Sonawane, R. (Ravikiran), Santamaria, J. (John), Kol, M. (Mark), Awasthi, S. (Shally), Powis, J. (Jeff), Hall, R. (Richard), McCarthy, A. E. (Anne E.), Jouvet, P. (Philippe), Opaysky, M. A. (Mary Anne), Gilfoyle, E. (Elaine), Farshait, N. (Nataly), Martin, D.-A. (Dori-Ann), Griesdale, D. (Donald), Katz, K. (Kevin), Ruberto, A. J. (Aaron J.), Carrier, F. M. (Francois Martin), Lamontagne, F. (Francois), Muscedere, J. (John), Rishu, A. (Asgar), Sin, W. C. (Wai Ching), Ngai, W. C. (Wallace Chun Wai), Young, P. (Paul), Forrest, A. (Annette), Kazemi, A. (Alex), Henderson, S. (Seton), Browne, T. (Troy), Ganeshalingham, A. (Anusha), McConnochie, R. (Rachael), Cho, J. H. (Jae Hwa), Park, T. S. (Tai Sun), Sim, Y. S. (Yun Su), Chang, Y. (Youjin), Lee, H. B. (Heung Bum), Park, S. Y. (Seung Yong), Chan, W. M. (Wai Ming), Lee, W.-Y. (Won-Yeon), Wallace, D. J. (David J.), Angus, D. C. (Derek C.), Charles, A. G. (Anthony G.), van Doom, H. R. (H. Rogier), Prin, M. (Meghan), Twagirumugabe, T. (Theogene), Umuhire, O. F. (Olivier Felix), Sylvain, H. (Habarurema), Al Qasim, E. (Eman), Heraud, J.-M. (Jean-Michel), Raberahona, M. (Mihaja), Rabarison, J. H. (Joelinotahiana Hasina), Patrigeon, S. P. (Santiago Perez), Ramirez-Venegas, A. (Alejandra), Melendez, J. A. (Javier Araujo), Guerrero, M. L. (M. Lourdes), Mambule, I. (Ivan), Ochieng, O. G. (Otieno George), Nadjm, B. (Behzad), Li, I. W. (Iris Wai Sum), Choi, W.-I. (Won-Il), Florence, K.-P. (Komurian-Pradel), Arabi, Y. M. (Yaseen M.), West, T. E. (T. Eoin), Riviello, E. D. (Elisabeth D.), Parke, R. (Rachael), Djillali, A. E. (Annane E.), Fowler, R. (Robert), Murthy, S. (Srinivas), Nichol, A. (Alistair), Cheng, A. C. (Allen C.), Semple, C. (Calum), George, M. (Maya), Valkonen, M. (Miia), McArthur, C. (Colin), Carson, G. (Gail), O'Neill, G. (Genevieve), Cobb, J. P. (J. Perren), Dunning, J. (Jake), Chiche, J.-D. (Jean-Daniel), Huh, J.-W. (Jin-Won), Marshall, J. (John), Rello, J. (Jordi), Guillebaud, J. (Julia), Razanazatovo, N. (Norosoa), Otieno, J. W. (Juilett Wambura), Green, K. (Karen), Rowan, K. (Kathy), Baillie, J. K. (John Kenneth), Merson, L. (Laura), Hsu, L. Y. (Li Yang), Christian, M. D. (Michael D.), Egi, M. (Moritoki), Shindo, N. (Nahoko), Horby, P. (Peter), Pardinaz-Solis, R. (Raul), Ubiergo, S. U. (Sebastian Ugarte), Webb, S. A. (Steve A. R.), Uyeki, T. M. (Timothy M.), Gordon, A. C. (Anthony C.), Paterson, D. L. (David L.), Everett, D. (Dean), Giamarellos-Bourboulis, E. J. (Evangelos J.), Longuere, K.-S. (Kajsa-Stina), Maslove, D. (David), Ohuma, E. (Eric), Growl, G. (Gloria), PedutemHumber, T. (Theresa), EllazarHumber, E. (Edward), Bahinskaya, I. (Ilona), Osbourne-Townsend, J. (Joan), Bentley, A. (Andrew), Goodson, J. (Jennifer), Welters, I. (Ingeborg), Malik, N. (Nadia), Browne, T. S. (T. S.), and Mahesh, V. (Vinaya)

Abstract

Severe acute respiratory infections (SARI) remain one of the leading causes of mortality around the world in all age groups. There is large global variation in epidemiology, clinical management and outcomes, including mortality. We performed a short period observational data collection in critical care units distributed globally during regional peak SARI seasons from 1 January 2016 until 31 August 2017, using standardised data collection tools. Data were collected for 1 week on all admitted patients who met the inclusion criteria for SARI, with follow-up to hospital discharge. Proportions of patients across regions were compared for microbiology, management strategies and outcomes. Regions were divided geographically and economically according to World Bank definitions. Data were collected for 682 patients from 95 hospitals and 23 countries. The overall mortality was 9.5%. Of the patients, 21.7% were children, with case fatality proportions of 1% for those less than 5 years. The highest mortality was in those above 60 years, at 18.6%. Case fatality varied by region: East Asia and Pacific 10.2% (21 of 206), Sub-Saharan Africa 4.3% (8 of 188), South Asia 0% (0 of 35), North America 13.6% (25 of 184), and Europe and Central Asia 14.3% (9 of 63). Mortality in low-income and low-middle-income countries combined was 4% as compared with 14% in high-income countries. Organ dysfunction scores calculated on presentation in 560 patients where full data were available revealed Sequential Organ Failure Assessment (SOFA) scores on presentation were significantly associated with mortality and hospital length of stay. Patients in East Asia and Pacific (48%) and North America (24%) had the highest SOFA scores of >12. Multivariable analysis demonstrated that initial SOFA score and age were independent predictors of hospital survival. There was variability across regions and income groupings for the critical care management and outcomes of SARI. Intensive care unit-specific factors, geography and management features were less reliable than baseline severity for predicting ultimate outcome. These findings may help in planning future outbreak severity assessments, but more globally representative data are required.

Published
2019

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

Author

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

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

Published
2019
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