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1. Long-stay Gabapentin Increases Explained: A National Nursing Home Clinician Survey on Prescribing intent.

Author

Winter, J., Kerns, J., Lafave, S., Winter, K., Brandt, N., Simoni-Wastila, L., Qato, D., Winter, C., Johnson, G., Krist, A., Gonzalez, M., Reves, S., and Etz, R.

Subjects
ANTICONVULSANTS, OFF-label use (Drugs), NURSE prescribing, PSYCHIATRIC drugs, DRUG prescribing
Abstract

OBJECTIVE: Much conjecture but little hard data exist to explain why gabapentin prescribing in nursing homes (NHs) has doubled in the last decade. Gabapentin, an anti-seizure medication, is approved to treat partial seizures as well as post-herpetic neuralgia. While details on prescribing intent are lacking, gabapentin is believed to be used primarily off-label. Since the long-stay use of anti-seizure medications like gabapentin are not reported to CMS by federal mandate, many aspects of such prescribing in NHs remains opaque relative to other monitored psychotropics.This NH clinician survey sought to clarify indications for gabapentin use and the factors spurring prescribing gains in NHs. METHODS: National online survey of US NH clinicians who prescribe psychotropic drugs, including physicians, NPs, and PAs. distributed via anonymous email using SurveyMonkey (09/15/2023-12/31/2023). Recruitment sought maximal participation by 1) directly contacting a 10% sample of 1493 NHs randomized by size, ownership, and region; 2) leveraging collaborations with NH clinician organizations; and 3) modified-Dillman methods to facilitate engagement. A multidisciplinary team developed the instrument with content informed by pilot data and existing literature. RESULTS: 131 surveys completed (~5% response rate). Participants: 71% White, 52% female, 72% physicians. Almost all gabapentin use in NHs was off-label. While most prescribing was for neuropathic - and increasingly all - pain, gabapentin also was used for psychiatric symptoms and behaviors. Prescribing was influenced by opiate and also antipsychotic, and anxiolytic reduction policies because gabapentin was perceived as an unmonitored and safer alternative to these medications. Only a fraction of long-stay gabapentin prescriptions were initiated in NHs; long-stay prevalence was influenced by increasing popularity in other care locations. CONCLUSiON: Off-label use for all forms of pain is a key driver of NH gabapentin increases, and closely tied to opioid reduction policies. Also highlighted is the less recognized significance of long-stay prescribing for psychiatric symptoms, and the similarly meaningful contribution of antipsychotic, anxiolytic, and other psychotropic reduction initiatives. Prescribers commonly perceive gabapentin as effective, safe, and safer than the medications it is replacing. Whether this is true remains unclear; the risks of gabapentin use in NHs are largely unknown. [ABSTRACT FROM AUTHOR]

Published
2024

7. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Vos, T, Barber, Rm, Bell, B, Bertozzi Villa, A, Biryukov, S, Bolliger, I, Charlson, F, Davis, A, Degenhardt, L, Dicker, D, Duan, L, Erskine, H, Feigin, Vl, Ferrari, Aj, Fitzmaurice, C, Fleming, T, Graetz, N, Guinovart, C, Haagsma, J, Hansen, Gm, Hanson, Sw, Heuton, Kr, Higashi, H, Kassebaum, N, Kyu, H, Laurie, E, Liang, X, Lofgren, K, Lozano, R, Macintyre, Mf, Moradi Lakeh, M, Naghavi, M, Nguyen, G, Odell, S, Ortblad, K, Roberts, Da, Roth, Ga, Sandar, L, Serina, Pt, Stanaway, Jd, Steiner, C, Thomas, B, Vollset, Se, Whiteford, H, Wolock, Tm, Ye, P, Zhou, M, Ãvila, Ma, Aasvang, Gm, Abbafati, C, Abbasoglu, Ozgoren, A, Abd Allah, F, Abdel, Aziz, Abera, Sf, Aboyans, V, Abraham, Jp, Abraham, B, Abubakar, I, Abu Raddad, Lj, Abu Rmeileh, Nm, Aburto, Tc, Achoki, T, Ackerman, In, Adelekan, A, Ademi, Z, Adou, Ak, Adsuar, Jc, Arnlov, J, Agardh, Ee, Khabouri, Al, Alam, Ss, Alasfoor, D, Albittar, Mi, Alegretti, Ma, Aleman, Av, Alemu, Za, Alfonso Cristancho, R, Alhabib, S, Ali, R, Alla, F, Allebeck, P, Allen, Pj, Almazroa, Ma, Alsharif, U, Alvarez, E, Alvis, Guzman, Ameli, N, O, Amini, H, Ammar, W, Anderson, Bo, Anderson, Hr, Antonio, Ca, Anwari, P, Apfel, H, Arsenijevic, Vs, Artaman, A, Asghar, Rj, Assadi, R, Atkins, Ls, Atkinson, C, Badawi, A, Bahit, Mc, Bakfalouni, T, Balakrishnan, K, Balalla, S, Banerjee, A, Barker Collo, Sl, Barquera, S, Barregard, L, Barrero, Lh, Basu, S, Basu, A, Baxter, A, Beardsley, J, Bedi, N, Beghi, E, Bekele, T, Bell, Ml, Benjet, C, Bennett, Da, Bensenor, Im, Benzian, H, Bernabe, E, Beyene, Tj, Bhala, N, Bhalla, A, Bhutta, Z, Bienhoff, K, Bikbov, B, Bin, Abdulhak, Blore, Jd, Blyth, Fm, Bohensky, Ma, Bora, Basara, B, Borges, G, Bornstein, Nm, Bose, D, Boufous, S, Bourne, Rr, Boyers, Ln, Brainin, M, Brauer, M, Brayne, Ce, Brazinova, A, Breitborde, Nj, Brenner, H, Briggs, Ad, Brooks, Pm, Brown, J, Brugha, Ts, Buchbinder, R, Buckle, Gc, Bukhman, G, Bulloch, Ag, Burch, M, Burnett, R, Cardenas, R, Cabral, Nl, Campos, Nonato, Campuzano, Ir, Carapetis, Jc, Carpenter, Do, Caso, V, Castaneda Orjuela, Ca, Catala Lopez, F, Chadha, Vk, Chang, Jc, Chen, H, Chen, W, Chiang, Pp, Chimed Ochir, O, Chowdhury, R, Christensen, H, Christophi, Ca, Chugh, Ss, Cirillo, Massimo, Coggeshall, M, Cohen, A, Colistro, V, Colquhoun, Sm, Contreras, Ag, Cooper, Lt, Cooper, C, Cooperrider, K, Coresh, J, Cortinovis, M, Criqui, Mh, Crump, Ja, Cuevas Nasu, L, Dandona, R, Dandona, L, Dansereau, E, Dantes, Hg, Dargan, Pi, Davey, G, Davitoiu, Dv, Dayama, A, La, De, Cruz, Gongora, De, V, Vega, La, De, Sf, Leo, D, Del, Pozo, Cruz, Dellavalle, Rp, Deribe, K, Derrett, S, Des, Jarlais, Dessalegn, M, Deveber, Ga, Dharmaratne, Sd, Diaz Torne, C, Ding, El, Dokova, K, Dorsey, Er, Driscoll, Tr, Duber, H, Durrani, Am, Edmond, Km, Ellenbogen, Rg, Endres, M, Ermakov, Sp, Eshrati, B, Esteghamati, A, Estep, K, Fahimi, S, Farzadfar, F, Fay, Df, Felson, Dt, Fereshtehnejad, Sm, Fernandes, Jg, Ferri, Cp, Flaxman, A, Foigt, N, Foreman, Kj, Fowkes, Fg, Franklin, Rc, Furst, T, Futran, Nd, Gabbe, Bj, Gankpe, Fg, Garcia, Guerra, Geleijnse, Fa, Gessner, Bd, Gibney, Kb, Gillum, Rf, Ginawi, Ia, Giroud, M, Giussani, G, Goenka, S, Goginashvili, K, Gona, P, Gonzalez, De, Cosio, T, Gosselin, Ra, Gotay, Cc, Goto, A, Gouda, Hn, Guerrant, Rl, Gugnani, Hc, Gunnell, D, Gupta, R, Gutierrez, Ra, Hafezi Nejad, N, Hagan, H, Halasa, Y, Hamadeh, Rr, Hamavid, H, Hammami, M, Hankey, Gj, Hao, Y, Harb, Hl, Haro, Jm, Havmoeller, R, Hay, Rj, Hay, S, Hedayati, Mt, Heredia, Pi, Heydarpour, P, Hijar, M, Hoek, Hw, Hoffman, Hj, Hornberger, Jc, Hosgood, Hd, Hossain, M, Hotez, Pj, Hoy, Dg, Hsairi, M, Hu, H, Hu, G, Huang, Jj, Huang, C, Huiart, L, Husseini, A, Iannarone, M, Iburg, Km, Innos, K, Inoue, M, Jacobsen, Kh, Jassal, Sk, Jeemon, P, Jensen, Pn, Jha, V, Jiang, G, Jiang, Y, Jonas, Jb, Joseph, J, Juel, K, Kan, H, Karch, A, Karimkhani, C, Karthikeyan, G, Katz, R, Kaul, A, Kawakami, N, Kazi, Ds, Kemp, Ah, Kengne, Ap, Khader, Ys, Khalifa, Se, Khan, Ea, Khan, G, Khang, Yh, Khonelidze, I, Kieling, C, Kim, D, Kim, S, Kimokoti, Rw, Kinfu, Y, Kinge, Jm, Kissela, Bm, Kivipelto, M, Knibbs, L, Knudsen, Ak, Kokubo, Y, Kosen, S, Kramer, A, Kravchenko, M, Krishnamurthi, Rv, Krishnaswami, S, Kuate, Defo, Kucuk, B, Bicer, B, Kuipers, Ej, Kulkarni, Vs, Kumar, K, Kumar, Ga, Kwan, Gf, Lai, T, Lalloo, R, Lam, H, Lan, Q, Lansingh, Vc, Larson, H, Larsson, A, Lawrynowicz, Ae, Leasher, Jl, Lee, Jt, Leigh, J, Leung, R, Levi, M, Li, B, Li, Y, Liang, J, Lim, S, Lin, Hh, Lind, M, Lindsay, Mp, Lipshultz, Se, Liu, S, Lloyd, Bk, Lockett, Ohno, S, Logroscino, G, Looker, Kj, Lopez, Ad, Lopez Olmedo, N, Lortet Tieulent, J, Lotufo, Pa, Low, N, Lucas, Rm, Lunevicius, R, Lyons, Ra, Ma, J, Ma, S, Mackay, Mt, Majdan, M, Malekzadeh, R, Mapoma, Cc, Marcenes, W, March, Lm, Margono, C, Marks, Gb, Marzan, Mb, Masci, Jr, Mason Jones, Aj, Matzopoulos, Rg, Mayosi, Bm, Mazorodze, Tt, Mcgill, Nw, Mcgrath, Jj, Mckee, M, Mclain, A, Mcmahon, Bj, Meaney, Pa, Mehndiratta, Mm, Mejia Rodriguez, F, Mekonnen, W, Melaku, Ya, Meltzer, M, Memish, Za, Mensah, G, Meretoja, A, Mhimbira, Fa, Micha, R, Miller, Tr, Mills, Ej, Mitchell, Pb, Mock, Cn, Moffitt, Te, Mohamed, Ibrahim, N, Mohammad, Ka, Mokdad, Ah, Mola, Gl, Monasta, L, Montico, M, Montine, Tj, Moore, Ar, Moran, Ae, Morawska, L, Mori, R, Moschandreas, J, Moturi, Wn, Moyer, M, Mozaffarian, D, Mueller, Uo, Mukaigawara, M, Murdoch, Me, Murray, J, Murthy, Ks, Naghavi, P, Nahas, Z, Naheed, A, Naidoo, Ks, Naldi, L, Nand, D, Nangia, V, Narayan, Km, Nash, D, Nejjari, C, Neupane, Sp, Newman, Lm, Newton, Cr, Ng, M, Ngalesoni, Fn, Nhung, Nt, Nisar, Mi, Nolte, S, Norheim, Of, Norman, Re, Norrving, B, Nyakarahuka, L, Ih, Oh, Ohkubo, T, Omer, Sb, Opio, Jn, Ortiz, A, Pandian, Jd, Panelo, Ci, Papachristou, C, Park, Ek, Parry, Cd, Caicedo, Aj, Patten, Sb, Paul, Vk, Pavlin, Bi, Pearce, N, Pedraza, Ls, Pellegrini, Ca, Pereira, Dm, Perez Ruiz, Fp, Perico, N, Pervaiz, A, Pesudovs, K, Peterson, Cb, Petzold, M, Phillips, Mr, Phillips, D, Phillips, B, Piel, Fb, Plass, D, Poenaru, D, Polanczyk, Gv, Polinder, S, Pope, Ca, Popova, S, Poulton, Rg, Pourmalek, F, Prabhakaran, D, Prasad, Nm, Qato, D, Quistberg, Da, Rafay, A, Rahimi, K, Rahimi Movaghar, V, Rahman, Su, Raju, M, Rakovac, I, Rana, Sm, Razavi, H, Refaat, A, Rehm, J, Remuzzi, G, Resnikoff, S, Ribeiro, Al, Riccio, Pm, Richardson, L, Richardus, Jh, Riederer, Am, Robinson, M, Roca, A, Rodriguez, A, Rojas Rueda, D, Ronfani, L, Rothenbacher, D, Roy, N, Ruhago, Gm, Sabin, N, Sacco, Rl, Ksoreide, K, Saha, S, Sahathevan, R, Sahraian, Ma, Sampson, U, Sanabria, Jr, Sanchez Riera, L, Santos, Is, Satpathy, M, Saunders, Je, Sawhney, M, Saylan, Mi, Scarborough, P, Schoettker, B, Schneider, Ij, Schwebel, Dc, Scott, Jg, Seedat, S, Sepanlou, Sg, Serdar, B, Servan Mori, Ee, Shackelford, K, Shaheen, A, Shahraz, S, Shamah, Levy, T, Shangguan, S, She, J, Sheikhbahaei, S, Shepard, Ds, Shi, P, Shibuya, K, Shinohara, Y, Shiri, R, Shishani, K, Shiue, I, Shrime, Mg, Sigfusdottir, Id, Silberberg, Dh, Simard, Ep, Sindi, S, Singh, Ja, Singh, L, Skirbekk, V, Sliwa, K, Soljak, M, Soneji, S, Soshnikov, Ss, Speyer, P, Sposato, La, Sreeramareddy, Ct, Stoeckl, H, Stathopoulou, Vk, Steckling, N, Stein, Mb, Stein, Dj, Steiner, Tj, Stewart, A, Stork, E, Stovner, Lj, Stroumpoulis, K, Sturua, L, Sunguya, Bf, Swaroop, M, Sykes, Bl, Tabb, Km, Takahashi, K, Tan, F, Tandon, N, Tanne, D, Tanner, M, Tavakkoli, M, Taylor, Hr, Ao, Te, Temesgen, Am, Ten, Have, M, Tenkorang, Ey, Terkawi, As, Theadom, Am, Thomas, E, Thorne Lyman, Al, Thrift, Ag, Tleyjeh, Im, Tonelli, M, Topouzis, F, Towbin, Ja, Toyoshima, H, Traebert, J, Tran, Bx, Trasande, L, Trillini, M, Truelsen, T, Trujillo, U, Tsilimbaris, M, Tuzcu, Em, Ukwaja, Kn, Undurraga, Ea, Uzun, Sb, Van, Brakel, Van, Wh, Vijver, De, Van, S, Dingenen, R, Van, Gool, Varakin, Yy, Vasankari, Tj, Vavilala, Ms, Veerman, Lj, Velasquez, Melendez, G, Venketasubramanian, N, Vijayakumar, L, Villalpando, S, Violante, Fs, Vlassov, Vv, Waller, S, Wallin, Mt, Wan, X, Wang, L, Wang, J, Wang, Y, Warouw, Ts, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Werdecker, A, Wessells, Kr, Westerman, R, Wilkinson, Jd, Williams, Hc, Williams, Tn, Woldeyohannes, Sm, Wolfe, Cd, Wong, Jq, Wong, H, Woolf, Ad, Wright, Jl, Wurtz, B, Xu, G, Yang, G, Yano, Y, Yenesew, Ma, Yentur, Gk, Yip, P, Yonemoto, N, Yoon, Sj, Younis, M, Yu, C, Kim, Ky, Zaki, Mel, Zhang, Y, Zhao, Z, Zhao, Y, Zhu, J, Zonies, D, Zunt, Jr, Salomon, Ja, Murray, C. J., Vos, T, Barber, Rm, Bell, B, Bertozzi-Villa, A, Biryukov, S, Bolliger, I, Charlson, F, Davis, A, Degenhardt, L, Dicker, D, Duan, L, Erskine, H, Feigin, Vl, Ferrari, Aj, Fitzmaurice, C, Fleming, T, Graetz, N, Guinovart, C, Haagsma, J, Hansen, Gm, Hanson, Sw, Heuton, Kr, Higashi, H, Kassebaum, N, Kyu, H, Laurie ELiang, X, Lofgren, K, Lozano, R, Macintyre, Mf, Moradi-Lakeh, M, Naghavi, M, Nguyen, G, Odell, S, Ortblad, K, Roberts, Da, Roth, Ga, Sandar, L, Serina, Pt, Stanaway, Jd, Steiner, C, Thomas, B, Vollset, Se, Whiteford, H, Wolock, Tm, Ye, P, Zhou, M, Ãvila, Ma, Aasvang, Gm, Abbafati, C, Abbasoglu Ozgoren, A, Abd-Allah, F, Abdel Aziz MI, Abera, Sf, Aboyans, V, Abraham, Jp, Abraham, B, Abubakar, I, Abu-Raddad, Lj, Abu-Rmeileh, Nm, Aburto, Tc, Achoki TAckerman IN, Adelekan, A, Ademi, Z, Adou, Ak, Adsuar, Jc, Arnlov, J, Agardh, Ee, Al Khabouri MJ, Alam, S, Alasfoor, D, Albittar, Mi, Alegretti MAAleman AV, Alemu, Za, Alfonso-Cristancho, R, Alhabib, S, Ali, R, Alla, F, Allebeck, P, Allen, Pj, Almazroa, Ma, Alsharif, U, Alvarez, E, Alvis-Guzman NAmeli, O, Amini, H, Ammar, W, Anderson, Bo, Anderson, Hr, Antonio, Ca, Anwari, P, Apfel, H, Arsenijevic, V, Artaman, A, Asghar, Rj, Assadi, R, Atkins, L, Atkinson, C, Badawi, A, Bahit, Mc, Bakfalouni, T, Balakrishnan, K, Balalla, S, Banerjee, A, Barker-Collo, Sl, Barquera, S, Barregard, L, Barrero LHBasu, S, Basu, A, Baxter, A, Beardsley, J, Bedi, N, Beghi, E, Bekele, T, Bell, Ml, Benjet, C, Bennett, Da, Bensenor, Im, Benzian, H, Bernabe, E, Beyene TJBhala, N, Bhalla, A, Bhutta, Z, Bienhoff, K, Bikbov, B, Bin Abdulhak, A, Blore, Jd, Blyth, Fm, Bohensky, Ma, Bora Basara, B, Borges, G, Bornstein, Nm, Bose, D, Boufous, S, Bourne, Rr, Boyers, Ln, Brainin, M, Brauer, M, Brayne, Ce, Brazinova, A, Breitborde, Nj, Brenner, H, Briggs, Ad, Brooks, Pm, Brown JBrugha TS, Buchbinder, R, Buckle, Gc, Bukhman, G, Bulloch, Ag, Burch, M, Burnett, R, Cardenas, R, Cabral, Nl, Campos Nonato IR, Campuzano JCCarapetis JR, Carpenter, Do, Caso, V, Castaneda-Orjuela, Ca, Catala-Lopez, F, Chadha, Vk, Chang, Jc, Chen, H, Chen, W, Chiang, Pp, Chimed-Ochir, O, Chowdhury, R, Christensen, H, Christophi, Ca, Chugh, S, Cirillo, M, Coggeshall, M, Cohen, A, Colistro, V, Colquhoun, Sm, Contreras, Ag, Cooper LTCooper, C, Cooperrider, K, Coresh, J, Cortinovis, M, Criqui, Mh, Crump, Ja, Cuevas-Nasu, L, Dandona, R, Dandona, L, Dansereau, E, Dantes, Hg, Dargan, Pi, Davey, G, Davitoiu, Dv, Dayama, A, De la Cruz-Gongora, V, de la Vega SF, De Leo, D, del Pozo-Cruz, B, Dellavalle, Rp, Deribe, K, Derrett, S, Des Jarlais DC, Dessalegn, M, Deveber, Ga, Dharmaratne, Sd, Diaz-Torne, C, Ding, El, Dokova, K, Dorsey, Er, Driscoll, Tr, Duber, H, Durrani, Am, Edmond, Km, Ellenbogen, Rg, Endres, M, Ermakov, Sp, Eshrati, B, Esteghamati, A, Estep, K, Fahimi, S, Farzadfar, F, Fay, Df, Felson, Dt, Fereshtehnejad SMFernandes JG, Ferri, Cp, Flaxman, A, Foigt, N, Foreman, Kj, Fowkes, Fg, Franklin, Rc, Furst, T, Futran, Nd, Gabbe, Bj, Gankpe, Fg, Garcia-Guerra FAGeleijnse JM, Gessner, Bd, Gibney, Kb, Gillum, Rf, Ginawi, Ia, Giroud, M, Giussani, G, Goenka, S, Goginashvili, K, Gona, P, Gonzalez de Cosio TGosselin RA, Gotay, Cc, Goto, A, Gouda, Hn, Guerrant, Rl, Gugnani, Hc, Gunnell, D, Gupta, R, Gutierrez, Ra, Hafezi-Nejad, N, Hagan HHalasa, Y, Hamadeh, Rr, Hamavid, H, Hammami, M, Hankey, Gj, Hao, Y, Harb, Hl, Haro, Jm, Havmoeller, R, Hay, Rj, Hay, S, Hedayati, Mt, Heredia Pi IB, Heydarpour, P, Hijar, M, Hoek, Hw, Hoffman, Hj, Hornberger, Jc, Hosgood, Hd, Hossain, M, Hotez, Pj, Hoy, Dg, Hsairi, M, Hu, H, Hu, G, Huang JJHuang, C, Huiart, L, Husseini, A, Iannarone, M, Iburg, Km, Innos, K, Inoue, M, Jacobsen, Kh, Jassal, Sk, Jeemon, P, Jensen, Pn, Jha, V, Jiang, G, Jiang YJonas JB, Joseph, J, Juel, K, Kan, H, Karch, A, Karimkhani, C, Karthikeyan, G, Katz, R, Kaul, A, Kawakami, N, Kazi, D, Kemp, Ah, Kengne, Ap, Khader, Y, Khalifa, Se, Khan, Ea, Khan, G, Khang, Yh, Khonelidze, I, Kieling, C, Kim, D, Kim, S, Kimokoti, Rw, Kinfu, Y, Kinge, Jm, Kissela, Bm, Kivipelto MKnibbs, L, Knudsen, Ak, Kokubo, Y, Kosen, S, Kramer, A, Kravchenko, M, Krishnamurthi, Rv, Krishnaswami, S, Kuate Defo, B, Kucuk Bicer, B, Kuipers EJKulkarni VS, Kumar, K, Kumar, Ga, Kwan, Gf, Lai, T, Lalloo, R, Lam, H, Lan, Q, Lansingh, Vc, Larson, H, Larsson, A, Lawrynowicz, Ae, Leasher, Jl, Lee, Jt, Leigh, J, Leung, R, Levi, M, Li, B, Li, Y, Liang, J, Lim, S, Lin, Hh, Lind, M, Lindsay, Mp, Lipshultz, Se, Liu, S, Lloyd, Bk, Lockett Ohno, S, Logroscino, G, Looker, Kj, Lopez, Ad, Lopez-Olmedo, N, Lortet-Tieulent, J, Lotufo, Pa, Low, N, Lucas, Rm, Lunevicius, R, Lyons, Ra, Ma, J, Ma, S, Mackay MTMajdan, M, Malekzadeh, R, Mapoma, Cc, Marcenes, W, March, Lm, Margono, C, Marks, Gb, Marzan, Mb, Masci, Jr, Mason-Jones, Aj, Matzopoulos RGMayosi BM, Mazorodze, Tt, Mcgill, Nw, Mcgrath, Jj, Mckee, M, Mclain, A, Mcmahon, Bj, Meaney, Pa, Mehndiratta, Mm, Mejia-Rodriguez, F, Mekonnen, W, Melaku, Ya, Meltzer, M, Memish, Za, Mensah, G, Meretoja, A, Mhimbira, Fa, Micha, R, Miller, Tr, Mills, Ej, Mitchell, Pb, Mock, Cn, Moffitt TEMohamed Ibrahim, N, Mohammad, Ka, Mokdad, Ah, Mola, Gl, Monasta, L, Montico, M, Montine, Tj, Moore, Ar, Moran, Ae, Morawska, L, Mori RMoschandreas, J, Moturi, Wn, Moyer, M, Mozaffarian, D, Mueller, Uo, Mukaigawara, M, Murdoch, Me, Murray, J, Murthy, K, Naghavi, P, Nahas ZNaheed, A, Naidoo, K, Naldi, L, Nand, D, Nangia, V, Narayan, Km, Nash, D, Nejjari, C, Neupane, Sp, Newman, Lm, Newton, Cr, Ng, M, Ngalesoni FNNhung NT, Nisar, Mi, Nolte, S, Norheim, Of, Norman, Re, Norrving, B, Nyakarahuka, L, Oh, Ih, Ohkubo, T, Omer, Sb, Opio, Jn, Ortiz, A, Pandian JDPanelo CI, Papachristou, C, Park, Ek, Parry, Cd, Caicedo, Aj, Patten, Sb, Paul, Vk, Pavlin, Bi, Pearce, N, Pedraza, L, Pellegrini, Ca, Pereira, Dm, Perez-Ruiz, Fp, Perico, N, Pervaiz, A, Pesudovs, K, Peterson, Cb, Petzold, M, Phillips, Mr, Phillips, D, Phillips, B, Piel, Fb, Plass, D, Poenaru, D, Polanczyk GVPolinder, S, Pope, Ca, Popova, S, Poulton, Rg, Pourmalek, F, Prabhakaran, D, Prasad, Nm, Qato, D, Quistberg, Da, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, Su, Raju, M, Rakovac, I, Rana, Sm, Razavi, H, Refaat, A, Rehm, J, Remuzzi, G, Resnikoff, S, Ribeiro, Al, Riccio, Pm, Richardson, L, Richardus, Jh, Riederer, Am, Robinson, M, Roca, A, Rodriguez, A, Rojas-Rueda, D, Ronfani, L, Rothenbacher, D, Roy, N, Ruhago, Gm, Sabin, N, Sacco, Rl, Ksoreide, K, Saha, S, Sahathevan, R, Sahraian, Ma, Sampson, U, Sanabria, Jr, Sanchez-Riera, L, Santos, I, Satpathy, M, Saunders, Je, Sawhney, M, Saylan MIScarborough, P, Schoettker, B, Schneider, Ij, Schwebel, Dc, Scott, Jg, Seedat, S, Sepanlou, Sg, Serdar, B, Servan-Mori, Ee, Shackelford, K, Shaheen AShahraz, S, Shamah Levy, T, Shangguan, S, She, J, Sheikhbahaei, S, Shepard, D, Shi, P, Shibuya, K, Shinohara, Y, Shiri, R, Shishani, K, Shiue, I, Shrime, Mg, Sigfusdottir, Id, Silberberg, Dh, Simard, Ep, Sindi, S, Singh, Ja, Singh, L, Skirbekk, V, Sliwa, K, Soljak, M, Soneji, S, Soshnikov, S, Speyer PSposato LA, 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Ryan, Westerman, Ronny, Wilkinson, James D., Williams, Hywel C., Williams, Thomas N., Woldeyohannes, Solomon M., Wolfe, Charles D.A., Wong, John Q., Wong, Haidong, Woolf, Anthony D., Wright, Jonathan L., Wurtz, Brittany, Xu, Gelin, Yang, Gonghuan, Yano, Yuichiro, Yenesew, Muluken A., Yentur, Gokalp K., Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa, Yu, Chuanhua, Kim, Kim Yun, Zaki, Maysaa El Sayed, Zhang, Yong, Zhao, Zheng, Zhao, Yong, Zhu, Jun, Zonies, David, Zunt, Joseph R., Salomon, Joshua A., Murray, Christopher J.L., Cell biology, Gastroenterology & Hepatology, Epidemiology, Health Technology Assessment (HTA), and Public Health

Subjects
Male, Gerontology, Nutrition and Disease, Epidemiology, years lived with disability, Global burden of disease, acute and chronic diseases, countries, Prevalence, Disease, Global Health, Medical and Health Sciences, Conduct disorder, Otitis-media, Cost of Illness, Residence Characteristics, Voeding en Ziekte, 80 and over, Global health, 2.2 Factors relating to the physical environment, 2.1 Biological and endogenous factors, countries, Aetiology, Child, Aged, 80 and over, Medicine(all), education.field_of_study, ATTENTION-DEFICIT/HYPERACTIVITY DISORDER, Incidence, Mortality rate, Incidence (epidemiology), Pain Research, Neglected Diseases, Alcohol dependence, General Medicine, Middle Aged, Global burden of disease, Global Burden of Disease Study 2013 Collaborators, Mental Health, Infectious Diseases, Attention deficit/Hyperactivity disorder, Burden of Illness, Child, Preschool, Acute Disease, Female, Life Sciences & Biomedicine, Adult, medicine.medical_specialty, Adolescent, GBD 2013, Population, acute and chronic diseases, Young Adult, Mental-disorders, Age Distribution, Medicine, General & Internal, Weights, General & Internal Medicine, medicine, Humans, Life Science, Disabled Persons, Sex Distribution, Preschool, education, Developing Countries, VLAG, Aged, Science & Technology, business.industry, Developed Countries, Cutaneous Leishmaniasis, Infant, Newborn, Infant, Health outcomes, Newborn, medicine.disease, Comorbidity, Brain Disorders, years lived with disability, Good Health and Well Being, Disease, injury, incidence, prevalence, YLDs, GBD 2010, Chronic Disease, Wounds and Injuries, business, 2.4 Surveillance and distribution, Iron-deficiency, Demography
Abstract

Summary Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. Interpretation Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries. Funding Bill & Melinda Gates Foundation. Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. Interpretation Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries. Funding Bill & Melinda Gates Foundation.

Published
2015
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8. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015

Author

Roth, GA, Johnson, C, Abajobir, A, Abd-Allah, F, Abera, SF, Abyu, G, Ahmed, M, Aksut, B, Alam, T, Alam, K, Alla, F, Alvis-Guzman, N, Amrock, S, Ansari, H, Arnlov, J, Asayesh, H, Atey, TM, Avila-Burgos, L, Awasthi, A, Banerjee, A, Barac, A, Barnighausen, T, Barregard, L, Bedi, N, Ketema, EB, Bennett, D, Berhe, G, Bhutta, Z, Bitew, S, Carapetis, J, Carrero, JJ, Malta, DC, Andres Castaneda-Orjuela, C, Castillo-Rivas, J, Catala-Lopez, F, Choi, J-Y, Christensen, H, Cirillo, M, Cooper, L, Criqui, M, Cundiff, D, Damasceno, A, Dandona, L, Dandona, R, Davletov, K, Dharmaratne, S, Dorairaj, P, Dubey, M, Ehrenkranz, R, Zaki, MES, Faraon, EJA, Esteghamati, A, Farid, T, Farvid, M, Feigin, V, Ding, EL, Fowkes, G, Gebrehiwot, T, Gillum, R, Gold, A, Gona, P, Gupta, R, Habtewold, TD, Hafezi-Nejad, N, Hailu, T, Hailu, GB, Hankey, G, Hassen, HY, Abate, KH, Havmoeller, R, Hay, SI, Horino, M, Hotez, PJ, Jacobsen, K, James, S, Javanbakht, M, Jeemon, P, John, D, Jonas, J, Kalkonde, Y, Karimkhani, C, Kasaeian, A, Khader, Y, Khan, A, Khang, Y-H, Khera, S, Khoja, AT, Khubchandani, J, Kim, D, Kolte, D, Kosen, S, Krohn, KJ, Kumar, GA, Kwan, GF, Lal, DK, Larsson, A, Linn, S, Lopez, A, Lotufo, PA, Abd El Razek, HM, Malekzadeh, R, Mazidi, M, Meier, T, Meles, KG, Mensah, G, Meretoja, A, Mezgebe, H, Miller, T, Mirrakhimov, E, Mohammed, S, Moran, AE, Musa, KI, Narula, J, Neal, B, Ngalesoni, F, Grant, N, Obermeyer, CM, Owolabi, M, Patton, G, Pedro, J, Qato, D, Qorbani, M, Rahimi, K, Rai, RK, Rawaf, S, Ribeiro, A, Safiri, S, Salomon, JA, Santos, I, Milicevic, MS, Sartorius, B, Schutte, A, Sepanlou, S, Shaikh, MA, Shin, M-J, Shishehbor, M, Shore, H, Santos Silva, DA, Sobngwi, E, Stranges, S, Swaminathan, S, Tabares-Seisdedos, R, Atnafu, NT, Tesfay, F, Thakur, JS, Thrift, A, Topor-Madry, R, Truelsen, T, Tyrovolas, S, Ukwaja, KN, Uthman, O, Vasankari, T, Vlassov, V, Vollset, SE, Wakayo, T, Watkins, D, Weintraub, R, Werdecker, A, Westerman, R, Wiysonge, CS, Wolfe, C, Workicho, A, Xu, G, Yano, Y, Yip, P, Yonemoto, N, Younis, M, Yu, C, Vos, T, Naghavi, M, Murray, C, Roth, GA, Johnson, C, Abajobir, A, Abd-Allah, F, Abera, SF, Abyu, G, Ahmed, M, Aksut, B, Alam, T, Alam, K, Alla, F, Alvis-Guzman, N, Amrock, S, Ansari, H, Arnlov, J, Asayesh, H, Atey, TM, Avila-Burgos, L, Awasthi, A, Banerjee, A, Barac, A, Barnighausen, T, Barregard, L, Bedi, N, Ketema, EB, Bennett, D, Berhe, G, Bhutta, Z, Bitew, S, Carapetis, J, Carrero, JJ, Malta, DC, Andres Castaneda-Orjuela, C, Castillo-Rivas, J, Catala-Lopez, F, Choi, J-Y, Christensen, H, Cirillo, M, Cooper, L, Criqui, M, Cundiff, D, Damasceno, A, Dandona, L, Dandona, R, Davletov, K, Dharmaratne, S, Dorairaj, P, Dubey, M, Ehrenkranz, R, Zaki, MES, Faraon, EJA, Esteghamati, A, Farid, T, Farvid, M, Feigin, V, Ding, EL, Fowkes, G, Gebrehiwot, T, Gillum, R, Gold, A, Gona, P, Gupta, R, Habtewold, TD, Hafezi-Nejad, N, Hailu, T, Hailu, GB, Hankey, G, Hassen, HY, Abate, KH, Havmoeller, R, Hay, SI, Horino, M, Hotez, PJ, Jacobsen, K, James, S, Javanbakht, M, Jeemon, P, John, D, Jonas, J, Kalkonde, Y, Karimkhani, C, Kasaeian, A, Khader, Y, Khan, A, Khang, Y-H, Khera, S, Khoja, AT, Khubchandani, J, Kim, D, Kolte, D, Kosen, S, Krohn, KJ, Kumar, GA, Kwan, GF, Lal, DK, Larsson, A, Linn, S, Lopez, A, Lotufo, PA, Abd El Razek, HM, Malekzadeh, R, Mazidi, M, Meier, T, Meles, KG, Mensah, G, Meretoja, A, Mezgebe, H, Miller, T, Mirrakhimov, E, Mohammed, S, Moran, AE, Musa, KI, Narula, J, Neal, B, Ngalesoni, F, Grant, N, Obermeyer, CM, Owolabi, M, Patton, G, Pedro, J, Qato, D, Qorbani, M, Rahimi, K, Rai, RK, Rawaf, S, Ribeiro, A, Safiri, S, Salomon, JA, Santos, I, Milicevic, MS, Sartorius, B, Schutte, A, Sepanlou, S, Shaikh, MA, Shin, M-J, Shishehbor, M, Shore, H, Santos Silva, DA, Sobngwi, E, Stranges, S, Swaminathan, S, Tabares-Seisdedos, R, Atnafu, NT, Tesfay, F, Thakur, JS, Thrift, A, Topor-Madry, R, Truelsen, T, Tyrovolas, S, Ukwaja, KN, Uthman, O, Vasankari, T, Vlassov, V, Vollset, SE, Wakayo, T, Watkins, D, Weintraub, R, Werdecker, A, Westerman, R, Wiysonge, CS, Wolfe, C, Workicho, A, Xu, G, Yano, Y, Yip, P, Yonemoto, N, Younis, M, Yu, C, Vos, T, Naghavi, M, and Murray, C

Abstract

BACKGROUND: The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. OBJECTIVES: The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden. METHODS: CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. RESULTS: In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75. CONCLUSIONS: CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD.

Published
2017

13. Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: The GBD 2013 study.

Author

Hamadeh R.R., Harewood H., Springer K., Da Costa Leite I., Lindsay M.P., Riccio P.M., Li B., Jiang G., Ma J., Zhou M., Zhu S., Liang X., Zhang Y., Alcala-Cerra G., Temesgen A., Sahle B.W., Prabhakaran D., Gupta R., Rajagopalan V., Warouw T.S., O'Donnell M.J., Ricci S., Asad M.M., Bwire V.K., Jee S.H., Khang Y.-H., Myint C.Y., Norheim O., Khalifa S.E., De Dieu Ngirabega J., Nyemazi J.P., Muhimpundu M.A., Saeedi M., Bedi N., Havmoeller R., Atwine L., O'Callaghan F., Critchley J.A., Ezzati M., Rothwell P.M., Whiteley W., Chen Z., Colomar M., Durrani A.M., Dayama A., Amlie-Lefond C., Huang C., Sumeet C., Cundiff D.K., Qato D., Kabagambe E.K., Ding E., Bukhman G., Kwan G., Thurston G., Coresh J., Lefondulq K., Corriere M.A., Mainoo N., Schwartz S.M., Fung T., Byers T.E., Rocca W.A., Lo W., Feigin V.L., Krishnamurthi R.V., Parmar P., Norrving B., Mensah G.A., Bennett D.A., Barker-Collo S., Moran A.E., Sacco R.L., Truelsen T., Davis S., Pandian J.D., Naghavi M., Forouzanfar M.H., Nguyen G., Johnson C.O., Vos T., Meretoja A., Murray C.J.L., Roth G.A., Abd-Allah F., Abera S.F., Akinyemi R.O., Salman R.A.-S., Anderson C.S., Bahit M.C., Banerjee A., Basu S., Beauchamp N.J., Bornstein N.M., Brainin M., Cabral N.L., Campos-Nonato I., Caso V., Catala-Lopez F., Chowdhury R., Christensen H.K., Connor M.D., DeVeber G., Dharmaratne S.D., Dokova K., Donnan G., Endres M., Fernandes J.G., Gankpe F., Geleijnse J.M., Gillium R.F., Giroud M., Hankey G.J., Jeemon P., Jonas J.B., Kazi D.S., Kengne A.P., Kim D., Kissela B.M., Kokubo Y., Kosen S., Kravchenko M., Lavados P.M., Liu M., Lotufo P.A., MacKay M.T., Malekzadeh R., Mehndiratta M.M., Melaku Y.A., Misganaw A., Nand D., Piradov M., Pourmalek F., Rojas-Rueda D., Roy N., Sahathevan R., Sampson U.K.A., Shamalov N., Sheth K.N., Shinohara Y., Shiue I., Soljak M., Sposato L.A., Stroumpoulis K., Tanne D., Thrift A.G., Tirschwell D.L., Varakin Y., Venketasubramanian N., Vlassov V.V., Wang W., Westerman R., Wolfe C., Yu C., Yunjin K., Stavreski B., Pearse E., Ademi Z., Guliyev T., Hamadeh R.R., Harewood H., Springer K., Da Costa Leite I., Lindsay M.P., Riccio P.M., Li B., Jiang G., Ma J., Zhou M., Zhu S., Liang X., Zhang Y., Alcala-Cerra G., Temesgen A., Sahle B.W., Prabhakaran D., Gupta R., Rajagopalan V., Warouw T.S., O'Donnell M.J., Ricci S., Asad M.M., Bwire V.K., Jee S.H., Khang Y.-H., Myint C.Y., Norheim O., Khalifa S.E., De Dieu Ngirabega J., Nyemazi J.P., Muhimpundu M.A., Saeedi M., Bedi N., Havmoeller R., Atwine L., O'Callaghan F., Critchley J.A., Ezzati M., Rothwell P.M., Whiteley W., Chen Z., Colomar M., Durrani A.M., Dayama A., Amlie-Lefond C., Huang C., Sumeet C., Cundiff D.K., Qato D., Kabagambe E.K., Ding E., Bukhman G., Kwan G., Thurston G., Coresh J., Lefondulq K., Corriere M.A., Mainoo N., Schwartz S.M., Fung T., Byers T.E., Rocca W.A., Lo W., Feigin V.L., Krishnamurthi R.V., Parmar P., Norrving B., Mensah G.A., Bennett D.A., Barker-Collo S., Moran A.E., Sacco R.L., Truelsen T., Davis S., Pandian J.D., Naghavi M., Forouzanfar M.H., Nguyen G., Johnson C.O., Vos T., Meretoja A., Murray C.J.L., Roth G.A., Abd-Allah F., Abera S.F., Akinyemi R.O., Salman R.A.-S., Anderson C.S., Bahit M.C., Banerjee A., Basu S., Beauchamp N.J., Bornstein N.M., Brainin M., Cabral N.L., Campos-Nonato I., Caso V., Catala-Lopez F., Chowdhury R., Christensen H.K., Connor M.D., DeVeber G., Dharmaratne S.D., Dokova K., Donnan G., Endres M., Fernandes J.G., Gankpe F., Geleijnse J.M., Gillium R.F., Giroud M., Hankey G.J., Jeemon P., Jonas J.B., Kazi D.S., Kengne A.P., Kim D., Kissela B.M., Kokubo Y., Kosen S., Kravchenko M., Lavados P.M., Liu M., Lotufo P.A., MacKay M.T., Malekzadeh R., Mehndiratta M.M., Melaku Y.A., Misganaw A., Nand D., Piradov M., Pourmalek F., Rojas-Rueda D., Roy N., Sahathevan R., Sampson U.K.A., Shamalov N., Sheth K.N., Shinohara Y., Shiue I., Soljak M., Sposato L.A., Stroumpoulis K., Tanne D., Thrift A.G., Tirschwell D.L., Varakin Y., Venketasubramanian N., Vlassov V.V., Wang W., Westerman R., Wolfe C., Yu C., Yunjin K., Stavreski B., Pearse E., Ademi Z., and Guliyev T.

Abstract

Background: Global stroke epidemiology is changing rapidly. Although age-standardized rates of stroke mortality have decreased worldwide in the past 2 decades, the absolute numbers of people who have a stroke every year, and live with the consequences of stroke or die from their stroke, are increasing. Regular updates on the current level of stroke burden are important for advancing our knowledge on stroke epidemiology and facilitate organization and planning of evidence-based stroke care. Objective(s): This study aims to estimate incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischemic stroke (IS) and hemorrhagic stroke (HS) for 188 countries from 1990 to 2013. Methodology: Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated using all available data on mortality and stroke incidence, prevalence and excess mortality. Statistical models and country-level covariate data were employed, and all rates were age-standardized to a global population. All estimates were produced with 95% uncertainty intervals (UIs). Result(s): In 2013, there were globally almost 25.7 million stroke survivors (71% with IS), 6.5 million deaths from stroke (51% died from IS), 113 million DALYs due to stroke (58% due to IS) and 10.3 million new strokes (67% IS). Over the 1990-2013 period, there was a significant increase in the absolute number of DALYs due to IS, and of deaths from IS and HS, survivors and incident events for both IS and HS. The preponderance of the burden of stroke continued to reside in developing countries, comprising 75.2% of deaths from stroke and 81.0% of stroke-related DALYs. Globally, the proportional contribution of stroke-related DALYs and deaths due to stroke compared to all diseases increased from 1990 (3.54% (95% UI 3.11-4.00) and 9.66% (95% UI 8.47-10.70), respectively) to 2013 (4.62% (95% UI 4.01-5.30) and 11.75% (95% UI 10.45-13.31), respectively), but there was

Published
2015

14. Sex differences in stroke incidence, prevalence,mortality and disability-adjusted life years: Results from the global burden of disease study 2013.

Author

Patrice Lindsay M., Thrift A.G., Stroumpoulis K., Prabhakaran D., Gupta R., Rajagopalan V., Kosen S., Warouw T.S., O'Donnell M.J., Shinohara Y., Asad M.M., Bwire V.K., Jee S.H., Khang Y.-H., Sahathevan R., Campos-Nonato I., Gankpe F., Myint C.Y., Norheim O., Khalifa S.E., Kravchenko M., Piradov M., Shalamov N., Varakin Y., De Dieu Ngirabega J., Nyemazi J.P., Muhimpundu M.A., Saeedi M., Bedi N., Havmoeller R., Atwine L., O'Callaghan F., Critchley J.A., Ezzati M., Soljak M., Connor M.D., Rothwell P.M., Salman R.A.-S., Whiteley W., Chen Z., Durrani A.M., Dayama A., Moran A.E., Misganaw A., Amlie-Lefond C., Huang C., Sumeet C., Cundiff D.K., Kazi D.S., Qato D., Kabagambe E.K., Ding E., Bukhman G., Kwan G., Coresh J., Lefondulq K., Corriere M.A., Mainoo N., Beauchamp N.J., Schwartz S.M., Chugh S., Fung T., Byers T.E., Sampson U.K.A., Rocca W.A., Lo W., Barker-Collo S., Bennett D.A., Krishnamurthi R.V., Parmar P., Feigin V.L., Naghavi M., Forouzanfar M.H., Johnson C.O., Nguyen G., Mensah G.A., Vos T., Murray C.J.L., Roth G.A., Abd-Allah F., Abera S.F., Akinyemi R.O., Bahit M.C., Banerjee A., Basu S., Brainin M., Bornstein N.M., Caso V., Catala-Lopez F., Chowdhury R., Christensen H.K., Colomar M., Davis S., Deveber G., Dharmaratne S.D., Donnan G., Dorairaj P., Dokova K., Endres M., Fernandes J.G., Geleijnse J.M., Gillum R.F., Giroud M., Hamadeh R.R., Hankey G.J., Jeemon P., Jiang G., Jonas J.B., Kalkonde Y., Kengne A.P., Kim D., Kissela B.M., Kokubo Y., Lavados P.M., Lotufo P.A., Mackay M.T., Malekzadeh R., Mehndiratta M.M., Nand D., Norrving B., Pandian J.D., Perkins H., Pourmalek F., Ricci S., Riccio P.M., Rojas-Rueda D., Roy N., Sacco R.L., Sheth K.N., Shiue I., Sposato L.A., Tanne D., Thurston G.D., Tirschwell D.L., Venketasubramanian N., Vlassov V.V., Westerman R., Wolfe C., Yunjin K., Meretoja A., Stavreski B., Anderson C.S., Pearse E., Ademi Z., Guliyev T., Harewood H., Springer K., Da Costa Leite I., Cabral N.L., Li B., Yu C., Ma J., Zhou M., Liu M., Zhu S., Wang W., Liang X., Zhang Y., Alcala-Cerra G., Truelsen T., Temesgen A., Sahle B.W., Melaku Y.A., Patrice Lindsay M., Thrift A.G., Stroumpoulis K., Prabhakaran D., Gupta R., Rajagopalan V., Kosen S., Warouw T.S., O'Donnell M.J., Shinohara Y., Asad M.M., Bwire V.K., Jee S.H., Khang Y.-H., Sahathevan R., Campos-Nonato I., Gankpe F., Myint C.Y., Norheim O., Khalifa S.E., Kravchenko M., Piradov M., Shalamov N., Varakin Y., De Dieu Ngirabega J., Nyemazi J.P., Muhimpundu M.A., Saeedi M., Bedi N., Havmoeller R., Atwine L., O'Callaghan F., Critchley J.A., Ezzati M., Soljak M., Connor M.D., Rothwell P.M., Salman R.A.-S., Whiteley W., Chen Z., Durrani A.M., Dayama A., Moran A.E., Misganaw A., Amlie-Lefond C., Huang C., Sumeet C., Cundiff D.K., Kazi D.S., Qato D., Kabagambe E.K., Ding E., Bukhman G., Kwan G., Coresh J., Lefondulq K., Corriere M.A., Mainoo N., Beauchamp N.J., Schwartz S.M., Chugh S., Fung T., Byers T.E., Sampson U.K.A., Rocca W.A., Lo W., Barker-Collo S., Bennett D.A., Krishnamurthi R.V., Parmar P., Feigin V.L., Naghavi M., Forouzanfar M.H., Johnson C.O., Nguyen G., Mensah G.A., Vos T., Murray C.J.L., Roth G.A., Abd-Allah F., Abera S.F., Akinyemi R.O., Bahit M.C., Banerjee A., Basu S., Brainin M., Bornstein N.M., Caso V., Catala-Lopez F., Chowdhury R., Christensen H.K., Colomar M., Davis S., Deveber G., Dharmaratne S.D., Donnan G., Dorairaj P., Dokova K., Endres M., Fernandes J.G., Geleijnse J.M., Gillum R.F., Giroud M., Hamadeh R.R., Hankey G.J., Jeemon P., Jiang G., Jonas J.B., Kalkonde Y., Kengne A.P., Kim D., Kissela B.M., Kokubo Y., Lavados P.M., Lotufo P.A., Mackay M.T., Malekzadeh R., Mehndiratta M.M., Nand D., Norrving B., Pandian J.D., Perkins H., Pourmalek F., Ricci S., Riccio P.M., Rojas-Rueda D., Roy N., Sacco R.L., Sheth K.N., Shiue I., Sposato L.A., Tanne D., Thurston G.D., Tirschwell D.L., Venketasubramanian N., Vlassov V.V., Westerman R., Wolfe C., Yunjin K., Meretoja A., Stavreski B., Anderson C.S., Pearse E., Ademi Z., Guliyev T., Harewood H., Springer K., Da Costa Leite I., Cabral N.L., Li B., Yu C., Ma J., Zhou M., Liu M., Zhu S., Wang W., Liang X., Zhang Y., Alcala-Cerra G., Truelsen T., Temesgen A., Sahle B.W., and Melaku Y.A.

Abstract

Background: Accurate information on stroke burden in men and women are important for evidence-based healthcare planning and resource allocation. Previously, limited research suggested that the absolute number of deaths from stroke in women was greater than in men, but the incidence and mortality rates were greater in men. However, sex differences in various metrics of stroke burden on a global scale have not been a subject of comprehensive and comparable assessment for most regions of the world, nor have sex differences in stroke burden been examined for trends over time. Method(s): Stroke incidence, prevalence, mortality, disability-adjusted life years (DALYs) and healthy years lost due to disability were estimated as part of the Global Burden of Disease (GBD) 2013 Study. Data inputs included all available information on stroke incidence, prevalence and death and case fatality rates. Analysis was performed separately by sex and 5-year age categories for 188 countries. Statistical models were employed to produce globally comprehensive results over time. All rates were age-standardized to a global population and 95% uncertainty intervals (UIs) were computed. Finding(s): In 2013, global ischemic stroke (IS) and hemorrhagic stroke (HS) incidence (per 100,000) in men (IS 132.77 (95% UI 125.34-142.77); HS 64.89 (95% UI 59.82-68.85)) exceeded those of women (IS 98.85 (95% UI 92.11-106.62); HS 45.48 (95% UI 42.43-48.53)). IS incidence rates were lower in 2013 compared with 1990 rates for both sexes (1990 male IS incidence 147.40 (95% UI 137.87-157.66); 1990 female IS incidence 113.31 (95% UI 103.52-123.40)), but the only significant change in IS incidence was among women.Copyright © 2015 S. Karger AG, Basel.

Published
2015

15. 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

Murray, C.J.L. (Christopher), Ortblad, K.F. (Katrina F), Guinovart, C. (Caterina), Lim, S.S. (Stephen), Wolock, T.M. (Timothy M), Roberts, D.A. (D Allen), Dansereau, E.A. (Emily A), Graetz, N. (Nicholas), Barber, R.M. (Ryan), Brown, J.C. (Jonathan C), Wang, H. (Haidong), Duber, H.C. (Herbert C), Naghavi, M. (Morteza), Dicker, D. (Daniel), Dandona, L. (Lalit), Salomon, J.A. (Joshua), Heuton, K.R. (Kyle R), Foreman, K. (Kyle), Phillips, D.E. (David E), Fleming, T.D. (Thomas D), Flaxman, A.D. (Abraham D), Phillips, B.K. (Bryan K), Johnson, E.M. (Elizabeth), Coggeshall, M.S. (Megan S), Abd-Allah, F. (Foad), Abera, S.F. (Semaw Ferede), Abraham, J.P. (Jerry), Abubakar, I. (Ibrahim), Abu-Raddad, L.J. (Laith J), Abu-Rmeileh, N.M. (Niveen Me), Achoki, T. (Tom), Adeyemo, A. (Adebowale), Adou, A.K. (Arsène Kouablan), Adsuar, J.C. (José C), Agardh, E.E. (Emilie Elisabet), Akena, D. (Dickens), Al Kahbouri, M.J. (Mazin J), Alasfoor, D. (Deena), Albittar, M.I. (Mohammed I), Alcalá-Cerra, G. (Gabriel), Alegretti, M.A. (Miguel Angel), Alemu, G. (Getnet), Alfonso-Cristancho, R. (Rafael), Alhabib, S. (Samia), Ali, R. (Raghib), Alla, F. (Francois), Allen, P.J. (Peter), Alsharif, U. (Ubai), Alvarez, E. (Elena), Alvis-Guzman, N. (Nelson), Amankwaa, A.A. (Adansi A), Amare, A.T. (Azmeraw T), Amini, H. (Hassan), Ammar, K.A., Anderson, B.O. (Benjamin), Antonio, C.A.T. (Carl Abelardo T), Anwari, P. (Palwasha), Ärnlöv, J. (Johan), Arsenijevic, V.S.A. (Valentina S Arsic), Artaman, A. (Ali), Asghar, R.J. (Rana J), Assadi, R. (Reza), Atkins, L.S. (Lydia S), Badawi, A.F. (Alaa), Banerjee, A. (Amitava), Basu, S. (Saonli), Beardsley, J. (Justin), Bekele, T. (Tolesa), Bell, M.L. (Michelle Lee), Bernabe, E. (Eduardo), Beyene, T.J. (Tariku Jibat), Bhala, N. (Neeraj), Bhalla, P.L. (Pankaj), Bhutta, Z.A. (Zulfiqar A), Abdulhak, A.B. (Aref Bin), Binagwaho, A. (Agnes), Blore, J.D. (Jed D), Bose, D. (Dipan), Brainin, M. (Michael), Breitborde, N. (Nicholas), Castañeda-Orjuela, C.A. (Carlos A), Catalá-López, F. (Ferrán), Chadha, D., Chang, J.-C. (Jung-Chen), Chiang, Y.T., Chuang, T.-W. (Ting-Wu), Colomar, M. (Mercedes), Cooper Jr., L.T. (Leslie Trumbull), Cooper, C. (Charles), Courville, K.J. (Karen J), Cowie, M.R. (Martin R.), Criqui, M. (Michael), Dandona, R. (Rakhi), Dayama, A. (Anand), Leo, D. (Diego) de, Degenhardt, F., Del Pozo-Cruz, B. (Borja), Deribe, K. (Kebede), Des Jarlais, D.C. (Don C), Dessalegn, M. (Muluken), Dharmaratne, S.D. (Samath D), Dilmen, U. (Uǧur), Ding, E.L. (Eric), Driscoll, J.M., Durrani, Z., Ellenbogen, R.G. (Richard G), Ermakov, S. (Sergey), Esteghamati, A. (Alireza), Faraon, E.J.A. (Emerito Jose A), Farzadfar, F. (Farshad), Fereshtehnejad, S.-M. (Seyed-Mohammad), Fijabi, D.O. (Daniel Obadare), Forouzanfar, M.H. (Mohammad H), Fra.Paleo, U. (Urbano), Gaffikin, L. (Lynne), Gamkrelidze, A. (Amiran), Gankpé, F.G. (Fortuné Gbètoho), Geleijnse, J.M. (Marianne), Gessner, B.D. (Bradford D), Gibney, K.B. (Katherine B), Ginawi, I.A.M. (Ibrahim Abdelmageem Mohamed), Glaser, E.L. (Elizabeth L), Gona, P. (Philimon), Goto, A. (Akimoto), Gouda, H.N. (Hebe N), Gugnani, H.C. (Harish Chander), Gupta, R. (Rajeev), Hafezi-Nejad, N. (Nima), Hamadeh, R.R. (Randah Ribhi), Hammami, M. (Mouhanad), Hankey, G.J. (Graeme), Harb, H.L. (Hilda L), Haro, J.M. (Josep Maria), Havmoeller, R. (Rasmus), Hay, S.I. (Simon I), Hedayati, M.T. (Mohammad T), Pi, I.B.H. (Ileana B Heredia), Hoek, H.W. (Hans), Hornberger, J.C. (John C), Hosgood, H.D. (H Dean), Hotez, P.J. (Peter), Hoy, D.G. (Damian G), Huang, J. (Jian), Iburg, K.M. (Kim M), Idrisov, B.T. (Bulat T), Innos, K. (Kaire), Jacobsen, K.H. (Kathryn H), Jeemon, P. (Panniyammakal), Jensen, P.N. (Paul N), Jha, V. (Vivekanand), Jiang, G. (Guohong), Jonas, J.B., Juel, K. (Knud), Kan, H. (Haidong), Kankindi, I. (Ida), Karam, V. (Vincent), Karch, F. (Francois), Karema, C.K. (Corine Kakizi), Kaul, A. (Anil), Kawakami, N. (Norito), Kazi, D.S. (Dhruv S), Kemp, A.H. (Andrew H), Kengne, A.P. (Andre Pascal), Keren, A. (Andre), Kereselidze, M. (Maia), Khader, Y.S. (Yousef Saleh), Khalifa, S.E.A.H. (Shams Eldin Ali Hassan), Khan, E.A. (Ejaz Ahmed), Khang, Y.-H. (Young-Ho), Khonelidze, I. (Irma), Kinfu, Y. (Yohannes), Kinge, J.M. (Jonas M), Knibbs, L. (Luke), Kokubo, Y. (Yoshihiro), Kosen, S. (Soewarta), Defo, B.K. (Barthelemy Kuate), Kulkarni, V.S. (Veena S), Kulkarni, C. (Chanda), Kumar, K. (Kuldeep), Kumar, R.B. (Ravi B), Kumar, G.A. (G Anil), Kwan, G.F. (Gene F), Lai, T. (Taavi), Balaji, A.L. (Arjun Lakshmana), Lam, H. (Hilton), Lan, Q. (Qing), Lansingh, V.C. (Van C), Larson, H.J. (Heidi J), Larsson, A. (Anders), Lee, J.-T. (Jong-Tae), Leigh, P.N. (Nigel), Leinsalu, M. (Mall), Leung, R. (Ricky), Li, Y. (Yichong), Li, Y. (Yongmei), Lima, G.M.F. (Graça Maria Ferreira) de, Lin, H.-H. (Hsien-Ho), Lipshultz, S.E. (Steven), Liu, S. (Simin), Liu, Y. (Yang), Lloyd, B.K. (Belinda K), Lotufo, P.A. (Paulo A), Machado, V.M.P. (Vasco Manuel Pedro), Maclachlan, J.H. (Jennifer H), Magis-Rodriguez, C. (Carlos), Majdan, M. (Marek), Mapoma, C.C. (Christopher Chabila), Marcenes, W. (Wagner), Marzan, M.B. (Melvin Barrientos), Masci, J.R. (Joseph R), Mashal, R., Mason-Jones, A.J. (Amanda J), Mayosi, B.M. (Bongani), Mazorodze, T.T. (Tasara T), Mckay, M.J. (Michael), Meaney, M.J., Mehndiratta, M.M. (Man Mohan), Mejia-Rodriguez, F. (Fabiola), Melaku, Y.A. (Yohannes Adama), Memish, Z.A. (Ziad), Mendoza, W. (Walter), Miller, T.R. (Ted R), Mills, E.J. (Edward J), Mohammad, K.A. (Karzan Abdulmuhsin), Mokdad, A.H. (Ali H), Mola, G.L. (Glen Liddell), Monasta, L. (Lorenzo), Montico, M. (Marcella), Moore, A.R. (Ami R), Mori, R. (Riccardo), Moturi, W.N. (Wilkister Nyaora), Mukaigawara, M. (Mitsuru), Murthy, A.C. (Adeline C.), Naheed, A. (Aliya), Naidoo, K.S. (Kovin S), Naldi, L. (Lucia), Nangia, M. (Monika), Narayan, K.M.V. (Venkat), Nash, J.H.E. (John), Nejjari, C. (Chakib), Nelson, R.D. (Robert), Neupane, S.P. (Sudan Prasad), Newton, C. (Cameron), Ng, M. (Marie), Nisar, M.I. (Muhammad Imran), Nolte, S. (Sandra), Norheim, O.F. (Ole F), Nowaseb, V. (Vincent), Nyakarahuka, L. (Luke), Oh, I.-H. (In-Hwan), Ohkubo, T. (Takayoshi), Olusanya, B.O. (Bolajoko O), Omer, S.B. (Saad B), Opio, J.N. (John Nelson), Orisakwe, O.E. (Orish Ebere), Pandian, N.G. (Natesa), Papachristou, C., Caicedo, M.S. (Marco), Patten, J., Paul, V.K. (Vinod K), Pavlin, B.I. (Boris Igor), Pearce, N. (Neil), Pereira, D.M. (David M), Pervaiz, Z. (Zahid), Pesudovs, K. (Konrad), Petzold, M. (Max), Pourmalek, F. (Farshad), Qato, D. (Dima), Quezada, A.D. (Amado D), Quistberg, D.A. (D Alex), Rafay, A. (Anwar), Rahimi, K. (Kazem), Rahimi-Movaghar, V. (Vafa), Rahman, S.U. (Sajjad Ur), Raju, M. (Murugesan), Rana, S.M. (Saleem M), Razavi, H. (Homie), Reilly, R.Q. (Robert Quentin), Remuzzi, G. (Giuseppe), Richardus, J.H. (Jan Hendrik), Ronfani, L. (Luca), Roy, N. (Nadine) van, Sabin, M.L. (Miriam Lewis), Saeedi, M.Y. (Mohammad Yahya), Sahraian, M.A. (Mohammad Ali), Samonte, G.M.J. (Genesis May J), Sawhney, M.S. (Monika), Schneider, I.J.C. (Ione J C), Schwebel, D.C. (David C), Seedat, S. (Soraya), Sepanlou, S.G. (Sadaf G), Servan-Mori, E.E. (Edson E), Sheikhbahaei, S. (Sara), Shibuya, K. (Kenji), Shin, H.H. (Hwashin Hyun), Shiue, I. (Ivy), Shivakoti, R. (Rupak), Sigfusdottir, I.D. (Inga Dora), Silberberg, D.H. (Donald H), Silva, A.P. (Andrea P), Simard, J. (Jacques), Singh, J.A. (Jasvinder), Skirbekk, V. (Vegard), Sliwa, K. (Karen), Soneji, S. (Samir), Soshnikov, S.S. (Sergey S), Sreeramareddy, C.T. (Chandrashekhar T), Stathopoulou, V.K. (Vasiliki Kalliopi), Stroumpoulis, K. (Konstantinos), Swaminathan, S., Sykes, B.C. (Bryan), Tabb, K.M. (Karen M), Talongwa, R.T. (Roberto Tchio), Tenkorang, E.Y. (Eric Yeboah), Terkawi, A.S. (Abdullah Sulieman), Thomson, A.J. (Alan J), Thorne-Lyman, A.L. (Andrew L), Towbin, J.A. (Jeffrey A), Traebert, J. (Jefferson), Tran, B.X. (Bach X), Dimbuene, Z.T. (Zacharie Tsala), Tsilimbaris, M. (Miltiadis), Uchendu, U.S. (Uche S), Ukwaja, K.N. (Kingsley N), Vallely, S.R. (Stephen), Vasankari, T.J. (Tommi J), Venketasubramanian, N. (Narayanaswamy), Violante, F.S. (Francesco S), Vlassov, V.V. (Vasiliy Victorovich), Waller, P. (Patrick), Wallin, M.T. (Mitchell T), Wang, L. (Linhong), Wang, S.X., Wang, Y. (Yanping), Weichenthal, S. (Scott), Weiderpass, E. (Elisabete), Weintraub, R.G. (Robert G), Westerman, R. (Ronny), White, R.G. (Richard), Wilkinson, J.D. (James D), Williams, T.N. (Thomas Neil), Woldeyohannes, S.M. (Solomon Meseret), Wong, J.B. (John), Xu, G. (Gelin), Yang, Y.C. (Yang C), Yano, K.-I., Yip, P. (Paul), Yonemoto, N. (Naohiro), Yoon, S.-J. (Seok-Jun), Younis, M. (Mustafa), Yu, C. (Chuanhua), Jin, K.Y. (Kim Yun), El Sayed Zaki, M. (Maysaa), Zhao, Y. (Yong), Zheng, Y. (Yuhui), Balakrishnan, K. (Kalpana), Zhou, M. (Ming), Zhu, J. (Jun), Zou, X.N. (Xiao Nong), Lopez, A.D. (Alan D), Vos, T. (Theo), Murray, C.J.L. (Christopher), Ortblad, K.F. (Katrina F), Guinovart, C. (Caterina), Lim, S.S. (Stephen), Wolock, T.M. (Timothy M), Roberts, D.A. (D Allen), Dansereau, E.A. (Emily A), Graetz, N. (Nicholas), Barber, R.M. (Ryan), Brown, J.C. (Jonathan C), Wang, H. (Haidong), Duber, H.C. (Herbert C), Naghavi, M. (Morteza), Dicker, D. (Daniel), Dandona, L. (Lalit), Salomon, J.A. (Joshua), Heuton, K.R. (Kyle R), Foreman, K. (Kyle), Phillips, D.E. (David E), Fleming, T.D. (Thomas D), Flaxman, A.D. (Abraham D), Phillips, B.K. (Bryan K), Johnson, E.M. (Elizabeth), Coggeshall, M.S. (Megan S), Abd-Allah, F. (Foad), Abera, S.F. (Semaw Ferede), Abraham, J.P. (Jerry), Abubakar, I. (Ibrahim), Abu-Raddad, L.J. (Laith J), Abu-Rmeileh, N.M. (Niveen Me), Achoki, T. (Tom), Adeyemo, A. (Adebowale), Adou, A.K. (Arsène Kouablan), Adsuar, J.C. (José C), Agardh, E.E. (Emilie Elisabet), Akena, D. (Dickens), Al Kahbouri, M.J. (Mazin J), Alasfoor, D. (Deena), Albittar, M.I. (Mohammed I), Alcalá-Cerra, G. (Gabriel), Alegretti, M.A. (Miguel Angel), Alemu, G. (Getnet), Alfonso-Cristancho, R. (Rafael), Alhabib, S. (Samia), Ali, R. (Raghib), Alla, F. (Francois), Allen, P.J. (Peter), Alsharif, U. (Ubai), Alvarez, E. (Elena), Alvis-Guzman, N. (Nelson), Amankwaa, A.A. (Adansi A), Amare, A.T. (Azmeraw T), Amini, H. (Hassan), Ammar, K.A., Anderson, B.O. (Benjamin), Antonio, C.A.T. (Carl Abelardo T), Anwari, P. (Palwasha), Ärnlöv, J. (Johan), Arsenijevic, V.S.A. (Valentina S Arsic), Artaman, A. (Ali), Asghar, R.J. (Rana J), Assadi, R. (Reza), Atkins, L.S. (Lydia S), Badawi, A.F. (Alaa), Banerjee, A. (Amitava), Basu, S. (Saonli), Beardsley, J. (Justin), Bekele, T. (Tolesa), Bell, M.L. (Michelle Lee), Bernabe, E. (Eduardo), Beyene, T.J. (Tariku Jibat), Bhala, N. (Neeraj), Bhalla, P.L. (Pankaj), Bhutta, Z.A. (Zulfiqar A), Abdulhak, A.B. (Aref Bin), Binagwaho, A. (Agnes), Blore, J.D. (Jed D), Bose, D. (Dipan), Brainin, M. (Michael), Breitborde, N. (Nicholas), Castañeda-Orjuela, C.A. (Carlos A), Catalá-López, F. (Ferrán), Chadha, D., Chang, J.-C. (Jung-Chen), Chiang, Y.T., Chuang, T.-W. (Ting-Wu), Colomar, M. (Mercedes), Cooper Jr., L.T. (Leslie Trumbull), Cooper, C. (Charles), Courville, K.J. (Karen J), Cowie, M.R. (Martin R.), Criqui, M. (Michael), Dandona, R. (Rakhi), Dayama, A. (Anand), Leo, D. (Diego) de, Degenhardt, F., Del Pozo-Cruz, B. (Borja), Deribe, K. (Kebede), Des Jarlais, D.C. (Don C), Dessalegn, M. (Muluken), Dharmaratne, S.D. (Samath D), Dilmen, U. (Uǧur), Ding, E.L. (Eric), Driscoll, J.M., Durrani, Z., Ellenbogen, R.G. (Richard G), Ermakov, S. (Sergey), Esteghamati, A. (Alireza), Faraon, E.J.A. (Emerito Jose A), Farzadfar, F. (Farshad), Fereshtehnejad, S.-M. (Seyed-Mohammad), Fijabi, D.O. (Daniel Obadare), Forouzanfar, M.H. (Mohammad H), Fra.Paleo, U. (Urbano), Gaffikin, L. (Lynne), Gamkrelidze, A. (Amiran), Gankpé, F.G. (Fortuné Gbètoho), Geleijnse, J.M. (Marianne), Gessner, B.D. (Bradford D), Gibney, K.B. (Katherine B), Ginawi, I.A.M. (Ibrahim Abdelmageem Mohamed), Glaser, E.L. (Elizabeth L), Gona, P. (Philimon), Goto, A. (Akimoto), Gouda, H.N. (Hebe N), Gugnani, H.C. (Harish Chander), Gupta, R. (Rajeev), Hafezi-Nejad, N. (Nima), Hamadeh, R.R. (Randah Ribhi), Hammami, M. (Mouhanad), Hankey, G.J. (Graeme), Harb, H.L. (Hilda L), Haro, J.M. (Josep Maria), Havmoeller, R. (Rasmus), Hay, S.I. (Simon I), Hedayati, M.T. (Mohammad T), Pi, I.B.H. (Ileana B Heredia), Hoek, H.W. (Hans), Hornberger, J.C. (John C), Hosgood, H.D. (H Dean), Hotez, P.J. (Peter), Hoy, D.G. (Damian G), Huang, J. (Jian), Iburg, K.M. (Kim M), Idrisov, B.T. (Bulat T), Innos, K. (Kaire), Jacobsen, K.H. (Kathryn H), Jeemon, P. (Panniyammakal), Jensen, P.N. (Paul N), Jha, V. (Vivekanand), Jiang, G. (Guohong), Jonas, J.B., Juel, K. (Knud), Kan, H. (Haidong), Kankindi, I. (Ida), Karam, V. (Vincent), Karch, F. (Francois), Karema, C.K. (Corine Kakizi), Kaul, A. (Anil), Kawakami, N. (Norito), Kazi, D.S. (Dhruv S), Kemp, A.H. (Andrew H), Kengne, A.P. (Andre Pascal), Keren, A. (Andre), Kereselidze, M. (Maia), Khader, Y.S. (Yousef Saleh), Khalifa, S.E.A.H. (Shams Eldin Ali Hassan), Khan, E.A. (Ejaz Ahmed), Khang, Y.-H. (Young-Ho), Khonelidze, I. (Irma), Kinfu, Y. (Yohannes), Kinge, J.M. (Jonas M), Knibbs, L. (Luke), Kokubo, Y. (Yoshihiro), Kosen, S. (Soewarta), Defo, B.K. (Barthelemy Kuate), Kulkarni, V.S. (Veena S), Kulkarni, C. (Chanda), Kumar, K. (Kuldeep), Kumar, R.B. (Ravi B), Kumar, G.A. (G Anil), Kwan, G.F. (Gene F), Lai, T. (Taavi), Balaji, A.L. (Arjun Lakshmana), Lam, H. (Hilton), Lan, Q. (Qing), Lansingh, V.C. (Van C), Larson, H.J. (Heidi J), Larsson, A. (Anders), Lee, J.-T. (Jong-Tae), Leigh, P.N. (Nigel), Leinsalu, M. (Mall), Leung, R. (Ricky), Li, Y. (Yichong), Li, Y. (Yongmei), Lima, G.M.F. (Graça Maria Ferreira) de, Lin, H.-H. (Hsien-Ho), Lipshultz, S.E. (Steven), Liu, S. (Simin), Liu, Y. (Yang), Lloyd, B.K. (Belinda K), Lotufo, P.A. (Paulo A), Machado, V.M.P. (Vasco Manuel Pedro), Maclachlan, J.H. (Jennifer H), Magis-Rodriguez, C. (Carlos), Majdan, M. (Marek), Mapoma, C.C. (Christopher Chabila), Marcenes, W. (Wagner), Marzan, M.B. (Melvin Barrientos), Masci, J.R. (Joseph R), Mashal, R., Mason-Jones, A.J. (Amanda J), Mayosi, B.M. (Bongani), Mazorodze, T.T. (Tasara T), Mckay, M.J. (Michael), Meaney, M.J., Mehndiratta, M.M. (Man Mohan), Mejia-Rodriguez, F. (Fabiola), Melaku, Y.A. (Yohannes Adama), Memish, Z.A. (Ziad), Mendoza, W. (Walter), Miller, T.R. (Ted R), Mills, E.J. (Edward J), Mohammad, K.A. (Karzan Abdulmuhsin), Mokdad, A.H. (Ali H), Mola, G.L. (Glen Liddell), Monasta, L. (Lorenzo), Montico, M. (Marcella), Moore, A.R. (Ami R), Mori, R. (Riccardo), Moturi, W.N. (Wilkister Nyaora), Mukaigawara, M. (Mitsuru), Murthy, A.C. (Adeline C.), Naheed, A. (Aliya), Naidoo, K.S. (Kovin S), Naldi, L. (Lucia), Nangia, M. (Monika), Narayan, K.M.V. (Venkat), Nash, J.H.E. (John), Nejjari, C. (Chakib), Nelson, R.D. (Robert), Neupane, S.P. (Sudan Prasad), Newton, C. (Cameron), Ng, M. (Marie), Nisar, M.I. (Muhammad Imran), Nolte, S. (Sandra), Norheim, O.F. (Ole F), Nowaseb, V. (Vincent), Nyakarahuka, L. (Luke), Oh, I.-H. (In-Hwan), Ohkubo, T. (Takayoshi), Olusanya, B.O. (Bolajoko O), Omer, S.B. (Saad B), Opio, J.N. (John Nelson), Orisakwe, O.E. (Orish Ebere), Pandian, N.G. (Natesa), Papachristou, C., Caicedo, M.S. (Marco), Patten, J., Paul, V.K. (Vinod K), Pavlin, B.I. (Boris Igor), Pearce, N. (Neil), Pereira, D.M. (David M), Pervaiz, Z. (Zahid), Pesudovs, K. (Konrad), Petzold, M. (Max), Pourmalek, F. (Farshad), Qato, D. (Dima), Quezada, A.D. (Amado D), Quistberg, D.A. (D Alex), Rafay, A. (Anwar), Rahimi, K. (Kazem), Rahimi-Movaghar, V. (Vafa), Rahman, S.U. (Sajjad Ur), Raju, M. (Murugesan), Rana, S.M. (Saleem M), Razavi, H. (Homie), Reilly, R.Q. (Robert Quentin), Remuzzi, G. (Giuseppe), Richardus, J.H. (Jan Hendrik), Ronfani, L. (Luca), Roy, N. (Nadine) van, Sabin, M.L. (Miriam Lewis), Saeedi, M.Y. (Mohammad Yahya), Sahraian, M.A. (Mohammad Ali), Samonte, G.M.J. (Genesis May J), Sawhney, M.S. (Monika), Schneider, I.J.C. (Ione J C), Schwebel, D.C. (David C), Seedat, S. (Soraya), Sepanlou, S.G. (Sadaf G), Servan-Mori, E.E. (Edson E), Sheikhbahaei, S. (Sara), Shibuya, K. (Kenji), Shin, H.H. (Hwashin Hyun), Shiue, I. (Ivy), Shivakoti, R. (Rupak), Sigfusdottir, I.D. (Inga Dora), Silberberg, D.H. (Donald H), Silva, A.P. (Andrea P), Simard, J. (Jacques), Singh, J.A. (Jasvinder), Skirbekk, V. (Vegard), Sliwa, K. (Karen), Soneji, S. (Samir), Soshnikov, S.S. (Sergey S), Sreeramareddy, C.T. (Chandrashekhar T), Stathopoulou, V.K. (Vasiliki Kalliopi), Stroumpoulis, K. (Konstantinos), Swaminathan, S., Sykes, B.C. (Bryan), Tabb, K.M. (Karen M), Talongwa, R.T. (Roberto Tchio), Tenkorang, E.Y. (Eric Yeboah), Terkawi, A.S. (Abdullah Sulieman), Thomson, A.J. (Alan J), Thorne-Lyman, A.L. (Andrew L), Towbin, J.A. (Jeffrey A), Traebert, J. (Jefferson), Tran, B.X. (Bach X), Dimbuene, Z.T. (Zacharie Tsala), Tsilimbaris, M. (Miltiadis), Uchendu, U.S. (Uche S), Ukwaja, K.N. (Kingsley N), Vallely, S.R. (Stephen), Vasankari, T.J. (Tommi J), Venketasubramanian, N. (Narayanaswamy), Violante, F.S. (Francesco S), Vlassov, V.V. (Vasiliy Victorovich), Waller, P. (Patrick), Wallin, M.T. (Mitchell T), Wang, L. (Linhong), Wang, S.X., Wang, Y. (Yanping), Weichenthal, S. (Scott), Weiderpass, E. (Elisabete), Weintraub, R.G. (Robert G), Westerman, R. (Ronny), White, R.G. (Richard), Wilkinson, J.D. (James D), Williams, T.N. (Thomas Neil), Woldeyohannes, S.M. (Solomon Meseret), Wong, J.B. (John), Xu, G. (Gelin), Yang, Y.C. (Yang C), Yano, K.-I., Yip, P. (Paul), Yonemoto, N. (Naohiro), Yoon, S.-J. (Seok-Jun), Younis, M. (Mustafa), Yu, C. (Chuanhua), Jin, K.Y. (Kim Yun), El Sayed Zaki, M. (Maysaa), Zhao, Y. (Yong), Zheng, Y. (Yuhui), Balakrishnan, K. (Kalpana), Zhou, M. (Ming), Zhu, J. (Jun), Zou, X.N. (Xiao Nong), Lopez, A.D. (Alan D), and Vos, T. (Theo)

Abstract

__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 mil

Published
2014
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23. A Realistic Talking Human Embodied Agent Mobile Phone Intervention to Promote HIV Medication Adherence and Retention in Care in Young HIV-Positive African American Men Who Have Sex With Men: Qualitative Study

Author

Dworkin, Mark, Chakraborty, Apurba, Lee, Sangyoon, Monahan, Colleen, Hightow-Weidman, Lisa, Garofalo, Robert, Qato, Dima, and Jimenez, Antonio

Subjects
Information technology, T58.5-58.64, Public aspects of medicine, RA1-1270
Abstract

BackgroundAvatars and embodied agents are a promising innovation for human health intervention because they may serve as a relational agent that might augment user engagement in a behavioral change intervention and motivate behavioral change such as antiretroviral adherence and retention in care. ObjectiveThis study aimed to develop a theory-driven talking avatar-like embodied agent mobile phone intervention guided by the information-motivation-behavioral skills model to promote HIV medication adherence and retention in care in young African American men who have sex with men (MSM). MethodsWe performed 5 iterative focus groups in Chicago with HIV-positive African American MSM aged 18-34 years to inform the ongoing development of a mobile phone app. Participants for the focus groups were recruited from 4 University of Illinois at Chicago Community Outreach Intervention Project sites located in different high HIV incidence areas of the city and the University of Illinois at Chicago HIV clinic using fliers and word of mouth. The focus group data analysis included developing an ongoing list of priorities for app changes and discussion between two of the investigators based on the project timeline, resources, and to what extent they served the app’s objectives. ResultsIn this study, 16 men participated, including 3 who participated in two groups. The acceptability for an embodied agent app was universal in all 5 focus groups. The app included the embodied agent response to questions and antiretroviral regimen information, adherence tracking, CD4 count and viral load tracking, motivational spoken messages, and customizability. Concerns that were identified and responded to in the development process included privacy, stigma, avoiding the harsh or commanding tone of voice, avoiding negative motivational statements, and making reminder functions for a variety of health care interactions. ConclusionsAn avatar-like embodied agent mHealth approach was acceptable to young HIV-positive African American MSM. Its relational nature may make it an effective method of informing, motivating, and promoting health behavioral skills. Furthermore, the app’s ease of access, stigma-free environment, and audiovisual format may help overcome some adherence barriers reported in this population.

Published
2018
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24. 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. Jacobsen, Kassebaum, Nicholas J., Bertozzi-Villa, Amelia, Coggeshall, Megan S., Shackelford, Katya A., Steiner, Caitlyn, Heuton, Kyle R., Gonzalez-Medina, Diego, Barber, Ryan, Huynh, Chantal, Dicker, Daniel, Templin, Tara, Wolock, Timothy M., Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw Ferede, Abubakar, Ibrahim, Achoki, Tom, Adelekan, Ademola, Ademi, Zanfina, Adou, Arsène Kouablan, Adsuar, José C., Agardh, Emilie E., Akena, Dicken, Alasfoor, Deena, Alemu, Zewdie Aderaw, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Al Kahbouri, Mazin J., Alla, Françoi, Allen, Peter J., Almazroa, Mohammad A., Alsharif, Ubai, Alvarez, Elena, Alvis-Guzmán, Nelson, Amankwaa, Adansi A., Amare, Azmeraw T., Amini, Hassan, Ammar, Walid, Antonio, Carl A.T., Anwari, Palwasha, Ärnlöv, Johan, Arsenijevic, Valentina S. Arsic, Artaman, Ali, Asad, Majed Masoud, Asghar, Rana J., Assadi, Reza, Atkins, Lydia S., Badawi, Alaa, Balakrishnan, Kalpana, Basu, Arindam, Basu, Sanjay, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L., Bernabe, Eduardo, Beyene, Tariku J., Bhutta, Zulfiqar, Abdulhak, Aref Bin, Blore, Jed D., Basara, Berrak Bora, Bose, Dipan, Breitborde, Nichola, Cárdenas, Rosario, Castañeda-Orjuela, Carlos A., Castro, Ruben Estanislao, Catalá-López, Ferrán, Cavlin, Alanur, Chang, Jung-Chen, Che, Xuan, Christophi, Costas A., Chugh, Sumeet S., Cirillo, Massimo, Colquhoun, Samantha M., Cooper, Leslie Trumbull, Cooper, Cyru, Da Costa Leite, Iuri, Dandona, Lalit, Dandona, Rakhi, Davis, Adrian, Dayama, Anand, Degenhardt, Louisa, De Leo, Diego, Del Pozo-Cruz, Borja, Deribe, Kebede, Dessalegn, Muluken, Deveber, Gabrielle A., Dharmaratne, Samath D., Dilmen, Uʇur, Ding, Eric L., Dorrington, Rob E., Driscoll, Tim R., Ermakov, Sergei Petrovich, Esteghamati, Alireza, Faraon, Emerito Jose A., Farzadfar, Farshad, Felicio, Manuela Mendonca, Fereshtehnejad, Seyed-Mohammad, De Lima, Graça Maria Ferreira, Forouzanfar, Mohammad H., França, Elisabeth B., Gaffikin, Lynne, Gambashidze, Ketevan, Gankpé, Fortuné Gbètoho, Garcia, Ana C., Geleijnse, Johanna M., Gibney, Katherine B., Giroud, Maurice, Glaser, Elizabeth L., Goginashvili, Ketevan, Gona, Philimon, González-Castell, Dinorah, Goto, Atsushi, Gouda, Hebe N., Gugnani, Harish Chander, Gupta, Rahul, Gupta, Rajeev, Hafezi-Nejad, Nima, Hamadeh, Randah Ribhi, Hammami, Mouhanad, Hankey, Graeme J., Harb, Hilda L., Havmoeller, Rasmu, Hay, Simon I., Pi, Ileana B. Heredia, Hoek, Hans W., Hosgood, H Dean, Hoy, Damian G., Husseini, Abdullatif, Idrisov, Bulat T., Innos, Kaire, Inoue, Manami, Jacobsen, Kathryn H., Jahangir, Eiman, Jee, Sun Ha, Jensen, Paul N., Jha, Vivekanand, Jiang, Guohong, Jonas, Jost B., Juel, Knud, Kabagambe, Edmond Kato, Kan, Haidong, Karam, Nadim E., Karch, André, Karema, Corine Kakizi, Kaul, Anil, Kawakami, Norito, Kazanjan, Konstantin, Kazi, Dhruv S., Kemp, Andrew H., Kengne, Andre Pascal, Kereselidze, Maia, Khader, Yousef Saleh, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz Ahmed, Khang, Young-Ho, Knibbs, Luke, Kokubo, Yoshihiro, Kosen, Soewarta, Defo, Barthelemy Kuate, Kulkarni, Chanda, Kulkarni, Veena S., Kumar, G. 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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25. Prescribing Trends and Associated Outcomes of Antiepileptic Drugs and Other Psychotropic Medications in US Nursing Homes: Proposal for a Mixed Methods Investigation.

Author

Winter JD, Kerns JW, Brandt N, Wastila L, Qato D, Sabo RT, Petterson S, Chung Y, Reves S, Winter C, Winter KM, Elonge E, Ewasiuk C, Fu YH, Funk A, Krist A, and Etz R

Subjects
Humans, United States epidemiology, Retrospective Studies, Male, Aged, Practice Patterns, Physicians', Female, Dementia drug therapy, Aged, 80 and over, Psychotropic Drugs therapeutic use, Anticonvulsants therapeutic use, Nursing Homes, COVID-19 epidemiology
Abstract

Background: Pilot data suggest that off-label, unmonitored antiepileptic drug prescribing for behavioral and psychological symptoms of dementia is increasing, replacing other psychotropic medications targeted by purposeful reduction efforts. This trend accelerated during the COVID-19 pandemic. Although adverse outcomes related to this trend remain unknown, preliminary results hint that harms may be increasing and concentrated in vulnerable populations., Objective: Using a mixed methods approach including both a retrospective secondary data analysis and a national clinician survey, this study aims to describe appropriate and potentially inappropriate antiepileptic and other psychoactive drug prescribing in US nursing homes (NHs), characteristics and patient-oriented outcomes associated with this prescribing, and how these phenomena may be changing under the combined stressors of the COVID-19 pandemic and the pressure of reduction initiatives., Methods: To accomplish the objective, resident-level, mixed-effects regression models and interrupted time-series analyses will draw on cohort elements linked at an individual level from the Centers for Medicare and Medicaid Services' (CMS) Minimum Data Set, Medicare Part D, Medicare Provider Analysis and Review, and Outpatient and Public Use Files. Quarterly cohorts of NH residents (2009-2021) will incorporate individual-level data, including demographics; health status; disease variables; psychotropic medication claims; comprehensive NH health outcomes; hospital and emergency department adverse events; and NH details, including staffing resources and COVID-19 statistics. To help explain and validate findings, we will conduct a national qualitative survey of NH prescribers regarding their knowledge and beliefs surrounding changing approaches to dementia care and associated outcomes., Results: Funding was obtained in September 2022. Institutional review board exemption approval was obtained in January 2023. The CMS Data Use Agreement was submitted in May 2023 and signed in March 2024. Data access was obtained in June 2024. Cohort creation is anticipated by January 2025, with crosswalks finalized by July 2025. The first survey was fielded in October 2023 and published in July 2024. The second survey was fielded in March 2024. The results are in review as of July 2024. Iterative survey cycles will continue biannually until December 2026. Multidisciplinary dissemination of survey analysis results began in July 2023, and dissemination of secondary data findings is anticipated to begin January 2025. These processes are ongoing, with investigation to wrap up by June 2027., Conclusions: This study will detail appropriate and inappropriate antiepileptic drug use and related outcomes in NHs and describe disparities in long-stay subpopulations treated or not treated with psychotropics. It will delineate the impact of the pandemic in combination with national policies on dementia management and outcomes. We believe this mixed methods approach, including processes that link multiple CMS data sets at an individual level and survey-relevant stakeholders, can be replicated and applied to evaluate a variety of patient-oriented questions in diverse clinical populations., International Registered Report Identifier (irrid): DERR1-10.2196/64446., (©Jonathan D Winter, J William Kerns, Nicole Brandt, Linda Wastila, Danya Qato, Roy T Sabo, Stephen Petterson, YoonKyung Chung, Sarah Reves, Christopher Winter, Katherine M Winter, Eposi Elonge, Craig Ewasiuk, Yu-Hua Fu, Adam Funk, Alex Krist, Rebecca Etz. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 19.09.2024.)

Published
2024
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26. Access to mifepristone, misoprostol, and contraceptive medicines in eight countries in the Eastern Mediterranean Region: descriptive analyses of country-level assessments.

Author

Afifi M, Hemachandra N, Sikandar Q, Hajjeh R, Loi UR, Läser L, Qato D, Abdul ZS, Chikvaidze P, Abbas RAR, Al-Kinani K, Hasan H, El-Kak F, Rady A, Brngali O, Hashem M, Bezad R, Amine C, Hafid H, Afzal S, Zaidi R, Thom E, Uzma Q, Al-Masri H, Qamar ZA, Ghanem B, Ward IA, Shaar AN, Farah U, Mohamed YO, Umar AU, and Eladawy M

Subjects
Humans, Female, Mediterranean Region, Contraceptive Agents supply & distribution, Middle East, Abortion, Induced statistics & numerical data, Abortion, Induced methods, Pregnancy, Family Planning Services standards, Misoprostol supply & distribution, Misoprostol therapeutic use, Health Services Accessibility, Mifepristone supply & distribution, Mifepristone administration & dosage
Abstract

Background: Despite their importance in reducing maternal mortality, information on access to Mifepristone, Misoprostol, and contraceptive medicines in the Eastern Mediterranean Region is limited., Methods: A standardized assessment tool measuring access to Mifepristone, Misoprostol, and contraceptive medicines included in the WHO essential medicines list (EML) was implemented in eight countries in the Eastern Mediterranean Region (Afghanistan, Iraq, Lebanon, Libya, Morocco, Palestine, Pakistan, and Somalia) between 2020-2021. The assessment focused on five access measures: 1) the inclusion of medicines in national family planning guidelines; 2) inclusion of medicines in comprehensive abortion care guidelines; 3) inclusion of medicines on national essential medicines lists; 4) medicines registration; and 5) procurement and forecasting of Mifepristone, Misoprostol, and contraceptive medicines. A descriptive analysis of findings from these eight national assessments was conducted., Results: Only Lebanon and Pakistan included all 12 contraceptives that are enlisted in the WHO-EML within their national family planning guidelines. Only Afghanistan and Lebanon included mifepristone and mifepristone-misoprostol combination in post-abortion care guidelines, but these medicines were not included in their national EMLs. Libya and Somalia lacked a national regulatory authority for medicines registration. Most contraceptives included on the national EMLs for Lebanon, Morocco and Pakistan were registered. Misoprostol was included on the EMLs-and registered-in six countries (Afghanistan, Iraq, Lebanon, Morocco, Palestine, and Pakistan). However, only three countries procured misoprostol (Iraq, Morocco, and Somalia)., Conclusion: These findings can guide efforts aimed at improving the availability of Mifepristone, Misoprostol, and contraceptive medicines in the Eastern Mediterranean Region. Opportunities include expanding national EMLs to include more options for Mifepristone, Misoprostol, and contraceptive medicines and strengthening the registration and procurement systems to ensure these medicines' availability were permitted under national law and where culturally acceptable., (© 2024. The Author(s).)

Published
2024
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27. Examining transitions of care among nursing home residents with and without antipsychotic medication use.

Author

Holmes SD, Kuzucan A, Brandt N, Briesacher B, Desai A, Feng Z, Fleming S, Johnson A, Olopoenia A, Qato D, Wallem A, Zarowitz B, and Wastila L

Abstract

Objectives: This study examines the association between antipsychotic (AP) medication use and care transitions in the nursing home (NH) population., Methods: This cross-sectional study used data from a 5% random sample of Medicare beneficiaries between 2011 and 2015. Propensity score adjusted negative binomial regression was performed and conditional probabilities of having a first transition from the NH to specific locations were calculated., Results: Among 150,284 eligible beneficiaries, the majority were female (67%), white (84%), and >75 years old (63%). Controlling for resident characteristics, the odds of having any transition was 5% lower among those with AP use [IRR (95% confidence interval (CI))=0.95(0.94-0.96)] relative to those with no AP use. Residents with AP use had higher proportions of transitions to hospital (22.7% vs. 19.5%, p  < 0.01), emergency department (19.6% vs. 10.7%, p  < 0.01), and different NH (1.5% vs. 0.4%, p  < 0.01), and lower proportions of transition to non-healthcare locations compared to those without AP use., Conclusions: Findings demonstrate that residents with AP use had higher probabilities of transitions to more costly care settings such as the emergency department and hospital compared to those without AP use. Future longitudinal studies will help to inform clinical interventions aimed at improving the quality of care for this population.

Published
2023
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28. Placement of selected new FDA-approved drugs in Medicare Part D formularies, 2009-2013.

Author

Stuart BC, Tom SE, Choi M, Johnson A, Sun K, Qato D, Obi EN, Zacker C, Park Y, and Arcona S

Subjects
Drug Approval, Humans, Retrospective Studies, United States, United States Food and Drug Administration, Formularies as Topic, Medicare Part D, Prescription Drugs
Abstract

Objectives: To assess formulary decisions by Part D plans for selected newly approved drugs., Study Design: Retrospective cohort study., Methods: Formulary placement and restrictions were identified for 33 drugs in 8 therapeutic classes (antihyperglycemics, anticoagulants, antiplatelets, disease-modifying agents for multiple sclerosis [MS] and rheumatoid arthritis [RA], chronic obstructive pulmonary disease [COPD] drugs, antiepileptics, and antipsychotics) in 863 Part D plans with continuous CMS contracts between 2009 and 2013. Multivariable models estimated the impact of drug characteristics and Part D plan characteristics on probability of drug adoption and, for adopters, evaluated factors associated with months to adoption and requirements for prior authorization (PA) or step therapy (ST)., Results: First Part D formulary placements varied from 2 to 14 months post FDA approval. On average, 56.7% of plans placed each drug within 6 months and 64.1% placed within 1 year of the National Drug Code assignment date. The most rapid adoption was for antipsychotics and antiepileptics. The slowest was for COPD drugs. More than 90% of disease-modifying agents for MS and RA were subject to PA. ST was uncommon except for antihyperglycemic agents. In adjusted analyses, enhanced benefit plans had a 4% higher probability of formulary placement (P <.01), and each additional star in the CMS star rating system increased the probability of adoption by 4% (P <.01). Overall, Medicare Advantage prescription drug plans had higher placement rates due to greater reliance on enhanced plan offerings and higher star ratings., Conclusions: We found significant heterogeneity in formulary placement and restrictions for 33 new drugs in the Part D marketplace between 2009 and 2013. Further research is necessary to determine whether this pattern applies to other drug classes.

Published
2018

29. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015.

Author

Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, Ahmed M, Aksut B, Alam T, Alam K, Alla F, Alvis-Guzman N, Amrock S, Ansari H, Ärnlöv J, Asayesh H, Atey TM, Avila-Burgos L, Awasthi A, Banerjee A, Barac A, Bärnighausen T, Barregard L, Bedi N, Belay Ketema E, Bennett D, Berhe G, Bhutta Z, Bitew S, Carapetis J, Carrero JJ, Malta DC, Castañeda-Orjuela CA, Castillo-Rivas J, Catalá-López F, Choi JY, Christensen H, Cirillo M, Cooper L Jr, Criqui M, Cundiff D, Damasceno A, Dandona L, Dandona R, Davletov K, Dharmaratne S, Dorairaj P, Dubey M, Ehrenkranz R, El Sayed Zaki M, Faraon EJA, Esteghamati A, Farid T, Farvid M, Feigin V, Ding EL, Fowkes G, Gebrehiwot T, Gillum R, Gold A, Gona P, Gupta R, Habtewold TD, Hafezi-Nejad N, Hailu T, Hailu GB, Hankey G, Hassen HY, Abate KH, Havmoeller R, Hay SI, Horino M, Hotez PJ, Jacobsen K, James S, Javanbakht M, Jeemon P, John D, Jonas J, Kalkonde Y, Karimkhani C, Kasaeian A, Khader Y, Khan A, Khang YH, Khera S, Khoja AT, Khubchandani J, Kim D, Kolte D, Kosen S, Krohn KJ, Kumar GA, Kwan GF, Lal DK, Larsson A, Linn S, Lopez A, Lotufo PA, El Razek HMA, Malekzadeh R, Mazidi M, Meier T, Meles KG, Mensah G, Meretoja A, Mezgebe H, Miller T, Mirrakhimov E, Mohammed S, Moran AE, Musa KI, Narula J, Neal B, Ngalesoni F, Nguyen G, Obermeyer CM, Owolabi M, Patton G, Pedro J, Qato D, Qorbani M, Rahimi K, Rai RK, Rawaf S, Ribeiro A, Safiri S, Salomon JA, Santos I, Santric Milicevic M, Sartorius B, Schutte A, Sepanlou S, Shaikh MA, Shin MJ, Shishehbor M, Shore H, Silva DAS, Sobngwi E, Stranges S, Swaminathan S, Tabarés-Seisdedos R, Tadele Atnafu N, Tesfay F, Thakur JS, Thrift A, Topor-Madry R, Truelsen T, Tyrovolas S, Ukwaja KN, Uthman O, Vasankari T, Vlassov V, Vollset SE, Wakayo T, Watkins D, Weintraub R, Werdecker A, Westerman R, Wiysonge CS, Wolfe C, Workicho A, Xu G, Yano Y, Yip P, Yonemoto N, Younis M, Yu C, Vos T, Naghavi M, and Murray C

Subjects
Adult, Aged, Cause of Death trends, Female, Global Health, Humans, Male, Middle Aged, Morbidity trends, Prevalence, Prospective Studies, Retrospective Studies, Risk Factors, Sex Distribution, Survival Rate trends, Young Adult, Cardiovascular Diseases epidemiology, Life Expectancy trends, Risk Assessment methods
Abstract

Background: The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world., Objectives: The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden., Methods: CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility., Results: In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75., Conclusions: CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD., (Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2017
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30. Trends in the utilization of antihypertensive medications among Palestine refugees in Jordan, 2008-2012.

Author

Saadeh R, Qato D, Khader A, Shahin Y, and Seita A

Abstract

Objectives: The purpose of this study is to describe trends in the utilization of antihypertensive medications, overall and by type of medication, specifically thiazide diuretics, as well as uncontrolled hypertension, in the Palestine refugee population in Jordan between 2008 and 2012., Methods: We analyzed aggregate procurement data on antihypertensive medications derived from the United Nations Relief and Works Agency (UNRWA) pharmacy records between 2008 and 2012. Antihypertensive medications were aggregated and utilization was calculated overall and for specific types of antihypertensive medications (e.g. β-blockers, diuretics). We used the WHO (World Health Organization) defined daily dose (DDD) methodology, often used to evaluate drug utilization patterns using aggregate data, to calculate utilization defined as DDDs per 100 persons with hypertension. In addition, UNRWA medical records were used to measure the prevalence of uncontrolled hypertension in the primary care setting. Uncontrolled hypertension was defined as a systolic/diastolic blood pressure ≥140/90 in at least 2 out of 3 readings, one of which is the most recent reading, during the year for a patient diagnosed with hypertension., Results: Overall, total utilization of antihypertensive medications has not changed between 2008 and 2012; hypertensive patients persistently used at least 2 antihypertensive medications daily (range 200-280 DDDs/100 patients with hypertension) during this five-year period. However, there is significant variation in utilization patterns by type of antihypertensive medication. While Angiotensin Converting Enzyme Inhibitors (ACE-I) were persistently the most commonly used antihypertensive medication, there utilization significantly (P < 0.05) declined by 26%. However, there was a statistically significant increase of 124% in the utilization of thiazide diuretics. Further, the prevalence of uncontrolled hypertension has also declined at a rate of 3% annually between 2008 and 2012., Conclusion: Our findings indicate that the STGs for hypertension management implemented in 2009 as part of UNRWA's essential drug program have increased the utilization of thiazide diuretics, and potentially contributed to improvements in hypertension control. This study also demonstrates that feasibility of drug utilization studies in monitoring and evaluating trends in the use of essential medications in low-resource settings.

Published
2015
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31. 'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.

Author

Qato DM, Daviglus ML, Wilder J, Lee T, Qato D, and Lambert B

Subjects
Chicago, Humans, Medically Underserved Area, Residence Characteristics, Urban Population, Health Services Accessibility, Health Services Needs and Demand, Minority Groups, Pharmacies supply & distribution
Abstract

Attempts to explain and address disparities in the use of prescription medications have focused almost exclusively on their affordability. However, the segregation of residential neighborhoods by race or ethnicity also may influence access to the pharmacies that, in turn, provide access to prescription medications within a community. We examined whether trends in the availability of pharmacies varied across communities in Chicago with different racial or ethnic compositions. We also examined the geographic accessibility of pharmacies to determine whether "pharmacy deserts," or low-access neighborhoods, were more common in segregated black and Hispanic communities than elsewhere. We found that throughout the period 2000-2012 the number of pharmacies was lower in segregated minority communities than in segregated white communities and integrated communities. In 2012 there were disproportionately more pharmacy deserts in segregated black communities, as well as in low-income communities and federally designated Medically Underserved Areas. Our findings suggest that public policies aimed at improving access to prescription medications may need to address factors beyond insurance coverage and medication affordability. Such policies could include financial incentives to locate pharmacies in pharmacy deserts or the incorporation of pharmacies into community health centers in Medically Underserved Areas., (Project HOPE—The People-to-People Health Foundation, Inc.)

Published
2014
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32. 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

Murray CJ, Ortblad KF, Guinovart C, Lim SS, Wolock TM, Roberts DA, Dansereau EA, Graetz N, Barber RM, Brown JC, Wang H, Duber HC, Naghavi M, Dicker D, Dandona L, Salomon JA, Heuton KR, Foreman K, Phillips DE, Fleming TD, Flaxman AD, Phillips BK, Johnson EK, Coggeshall MS, Abd-Allah F, Abera SF, Abraham JP, Abubakar I, Abu-Raddad LJ, Abu-Rmeileh NM, Achoki T, Adeyemo AO, Adou AK, Adsuar JC, Agardh EE, Akena D, Al Kahbouri MJ, Alasfoor D, Albittar MI, Alcalá-Cerra G, Alegretti MA, Alemu ZA, Alfonso-Cristancho R, Alhabib S, Ali R, Alla F, Allen PJ, Alsharif U, Alvarez E, Alvis-Guzman N, Amankwaa AA, Amare AT, Amini H, Ammar W, Anderson BO, Antonio CA, Anwari P, Arnlöv J, Arsenijevic VS, Artaman A, Asghar RJ, Assadi R, Atkins LS, Badawi A, Balakrishnan K, Banerjee A, Basu S, Beardsley J, Bekele T, Bell ML, Bernabe E, Beyene TJ, Bhala N, Bhalla A, Bhutta ZA, Abdulhak AB, Binagwaho A, Blore JD, Basara BB, Bose D, Brainin M, Breitborde N, Castañeda-Orjuela CA, Catalá-López F, Chadha VK, Chang JC, Chiang PP, Chuang TW, Colomar M, Cooper LT, Cooper C, Courville KJ, Cowie BC, Criqui MH, Dandona R, Dayama A, De Leo D, Degenhardt L, Del Pozo-Cruz B, Deribe K, Des Jarlais DC, Dessalegn M, Dharmaratne SD, Dilmen U, Ding EL, Driscoll TR, Durrani AM, Ellenbogen RG, Ermakov SP, Esteghamati A, Faraon EJ, Farzadfar F, Fereshtehnejad SM, Fijabi DO, Forouzanfar MH, Fra Paleo U, Gaffikin L, Gamkrelidze A, Gankpé FG, Geleijnse JM, Gessner BD, Gibney KB, Ginawi IA, Glaser EL, Gona P, Goto A, Gouda HN, Gugnani HC, Gupta R, Gupta R, Hafezi-Nejad N, Hamadeh RR, Hammami M, Hankey GJ, Harb HL, Haro JM, Havmoeller R, Hay SI, Hedayati MT, Pi IB, Hoek HW, Hornberger JC, Hosgood HD, Hotez PJ, Hoy DG, Huang JJ, Iburg KM, Idrisov BT, Innos K, Jacobsen KH, Jeemon P, Jensen PN, Jha V, Jiang G, Jonas JB, Juel K, Kan H, Kankindi I, Karam NE, Karch A, Karema CK, Kaul A, Kawakami N, Kazi DS, Kemp AH, Kengne AP, Keren A, Kereselidze M, Khader YS, Khalifa SE, Khan EA, Khang YH, Khonelidze I, Kinfu Y, Kinge JM, Knibbs L, Kokubo Y, Kosen S, Defo BK, Kulkarni VS, Kulkarni C, Kumar K, Kumar RB, Kumar GA, Kwan GF, Lai T, Balaji AL, Lam H, Lan Q, Lansingh VC, Larson HJ, Larsson A, Lee JT, Leigh J, Leinsalu M, Leung R, Li Y, Li Y, De Lima GM, Lin HH, Lipshultz SE, Liu S, Liu Y, Lloyd BK, Lotufo PA, Machado VM, Maclachlan JH, Magis-Rodriguez C, Majdan M, Mapoma CC, Marcenes W, Marzan MB, Masci JR, Mashal MT, Mason-Jones AJ, Mayosi BM, Mazorodze TT, Mckay AC, Meaney PA, Mehndiratta MM, Mejia-Rodriguez F, Melaku YA, Memish ZA, Mendoza W, Miller TR, Mills EJ, Mohammad KA, Mokdad AH, Mola GL, Monasta L, Montico M, Moore AR, Mori R, Moturi WN, Mukaigawara M, Murthy KS, Naheed A, Naidoo KS, Naldi L, Nangia V, Narayan KM, Nash D, Nejjari C, Nelson RG, Neupane SP, Newton CR, Ng M, Nisar MI, Nolte S, Norheim OF, Nowaseb V, Nyakarahuka L, Oh IH, Ohkubo T, Olusanya BO, Omer SB, Opio JN, Orisakwe OE, Pandian JD, Papachristou C, Caicedo AJ, Patten SB, Paul VK, Pavlin BI, Pearce N, Pereira DM, Pervaiz A, Pesudovs K, Petzold M, Pourmalek F, Qato D, Quezada AD, Quistberg DA, Rafay A, Rahimi K, Rahimi-Movaghar V, Ur Rahman S, Raju M, Rana SM, Razavi H, Reilly RQ, Remuzzi G, Richardus JH, Ronfani L, Roy N, Sabin N, Saeedi MY, Sahraian MA, Samonte GM, Sawhney M, Schneider IJ, Schwebel DC, Seedat S, Sepanlou SG, Servan-Mori EE, Sheikhbahaei S, Shibuya K, Shin HH, Shiue I, Shivakoti R, Sigfusdottir ID, Silberberg DH, Silva AP, Simard EP, Singh JA, Skirbekk V, Sliwa K, Soneji S, Soshnikov SS, Sreeramareddy CT, Stathopoulou VK, Stroumpoulis K, Swaminathan S, Sykes BL, Tabb KM, Talongwa RT, Tenkorang EY, Terkawi AS, Thomson AJ, Thorne-Lyman AL, Towbin JA, Traebert J, Tran BX, Dimbuene ZT, Tsilimbaris M, Uchendu US, Ukwaja KN, Uzun SB, Vallely AJ, Vasankari TJ, Venketasubramanian N, Violante FS, Vlassov VV, Vollset SE, Waller S, Wallin MT, Wang L, Wang X, Wang Y, Weichenthal S, Weiderpass E, Weintraub RG, Westerman R, White RA, Wilkinson JD, Williams TN, Woldeyohannes SM, Wong JQ, Xu G, Yang YC, Yano Y, Yentur GK, Yip P, Yonemoto N, Yoon SJ, Younis M, Yu C, Jin KY, El Sayed Zaki M, Zhao Y, Zheng Y, Zhou M, Zhu J, Zou XN, Lopez AD, and Vos T

Subjects
Age Distribution, Epidemics statistics & numerical data, Female, Humans, Incidence, Male, Mortality trends, Organizational Objectives, Sex Distribution, Global Health trends, HIV Infections epidemiology, Malaria epidemiology, Tuberculosis epidemiology
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., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Published
2014
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33. The politics of deteriorating health: the case of Palestine.

Author

Qato D

Subjects
Arabs, Cause of Death trends, Data Collection, Disease classification, Health Policy, Health Services Accessibility, Humans, Israel epidemiology, Health Status Indicators, Politics
Abstract

This article reviews the deteriorating health situation of the Palestinian population during the post-Oslo period of the Palestinian Authority and during the current Intifada. It seeks to record findings obtained through primary participants and documents and from personal observations in the field that situate Palestinian health conditions within their political framework. The ongoing crisis highlights longstanding problems in the Palestinian health infrastructure, which make it more vulnerable to Israeli policies, especially the movement restrictions and closures. Efforts by Palestinian professionals and the international health community to provide health services have been constantly thwarted. The Israeli authorities' disregard for Palestinian health care has escalated since 2000 and is directly responsible for a vast number of Palestinian deaths. Israel's indiscriminate obstructions to the coordinated functioning of a health care system in Palestine increase morbidity, degrade health, promote premature deaths, and damage the medical infrastructure. Moreover, the Israeli actions transgress international law and, ultimately, make peace in the region much less likely. This analysis provides further evidence of the social justice violations and the wide-ranging effects on health experienced daily by the Palestinian people as a direct result of the Israeli military occupation.

Published
2004
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34. Quinacrine induces cytochrome c-dependent apoptotic signaling in human cervical carcinoma cells.

Author

Fasanmade AA, Owuor ED, Ee RP, Qato D, Heller M, and Kong AN

Subjects
Blotting, Western, Caspase 8, Caspase 9, Caspases metabolism, Drug Interactions, Enzyme Activation drug effects, Female, HeLa Cells, Humans, Membrane Potentials drug effects, Mitochondria drug effects, Phospholipases A antagonists & inhibitors, Phospholipases A2, Quinacrine antagonists & inhibitors, Spectrometry, Fluorescence, Antimalarials pharmacology, Apoptosis drug effects, Cytochrome c Group physiology, Enzyme Inhibitors pharmacology, Quinacrine pharmacology, Signal Transduction drug effects, Uterine Cervical Neoplasms pathology
Abstract

Quinacrine (QU), a phospholipase-A2 (PLA-2) inhibitor has been used clinically as a chemotherapeutic adjuvant. To understand the mechanisms leading to its chemotherapeutic effect, we have investigated QU-induced apoptotic signaling pathways in human cervical squamous carcinoma HeLa cells. In this study, we found that QU induced cytochrome c-dependent apoptotic signaling. The release of pro-apoptotic cytochrome c was QU concentration- and time-dependent, and preceded activation of caspase-9 and -3. Flow cytometric FACScan analysis using fluorescence intensities of DiOC6 demonstrated that QU-induced cytochrome c release was independent of mitochondrial permeability transition (MPT), since the concentrations of QU that induced cytochrome c release did not alter mitochondrial membrane potential (delta pai(m)). Moreover, kinetic analysis of caspase activities showed that cytochrome c release led to the activation of caspase-9 and downstream death effector, caspase-3. Caspase-3 inhibitor (Ac-DEVD-CHO) partially blocked QU-induced apoptosis, suggesting the importance of caspase-3 in this apoptotic signaling mechanism. Supplementation with arachidonic acid (AA) sustained caspase-3 activation induced by QU. Using inhibitors against cellular arachidonate metabolism of lipooxygenase (Nordihydroxyguaiaretic Acid, NDGA) and cyclooxygenase (5,8,11,14-Eicosatetraynoic Acid, ETYA) demonstrated that QU-induced apoptotic signaling may be dependent on its role as a PLA-2 inhibitor. Interestingly, NDGA attenuated QU-induced cytochrome c release, caspase activity as well as apoptotic cell death. The blockade of cytochrome c release by NDGA was much more effective than that attained with cyclosporin A (CsA), a MPT inhibitor. ETYA was not effective in blocking cytochrome c release, except under very high concentrations. Caspase inhibitor z-VAD blocked the release of cytochrome c suggesting that this signaling event is caspase dependent, and caspase-8 activation may be upstream of the mitochondrial events. In summary, we report that QU induced cytochrome c-dependent apoptotic signaling cascade, which may be dependent on its role as a PLA-2 inhibitor. This apoptotic mechanism induced by QU may contribute to its known chemotherapeutic effects.

Published
2001
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