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11 results on '"Talongwa, Rt"'

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

Author

Wang, H, Liddell, CA, Coates, MM, Mooney, MD, Levitz, CE, Schumacher, AE, Apfel, H, Iannarone, M, Phillips, B, Lofgren, KT, Sandar, L, Dorrington, RE, Rakovac, I, Jacobs, TA, Liang, X, Zhou, M, Zhu, J, Yang, G, Wang, Y, Liu, S, Li, Y, Ozgoren, AA, Abera, SF, Abubakar, I, Achoki, T, Adelekan, A, Ademi, Z, Alemu, ZA, Allen, PJ, AlMazroa, MA, Alvarez, E, Amankwaa, AA, Amare, AT, Ammar, W, Anwari, P, Cunningham, SA, Asad, MM, Assadi, R, Banerjee, A, Basu, S, Bedi, N, Bekele, T, Bell, ML, Bhutta, Z, Blore, JD, Basara, BB, Boufous, S, Breitborde, N, Bruce, NG, Bui, LN, Carapetis, JR, Cárdenas, R, Carpenter, DO, Caso, V, Castro, RE, Catalá-Lopéz, F, Cavlin, A, Che, X, Chiang, PP, Chowdhury, R, Christophi, CA, Chuang, TW, Cirillo, M, da Costa Leite, I, Courville, KJ, Dandona, L, Dandona, R, Davis, A, Dayama, A, Deribe, K, Dharmaratne, SD, Dherani, MK, Dilmen, U, Ding, EL, Edmond, KM, Ermakov, SP, Farzadfar, F, Fereshtehnejad, SM, Fijabi, DO, Foigt, N, Forouzanfar, MH, Garcia, AC, Geleijnse, JM, Gessner, BD, Goginashvili, K, Gona, P, Goto, A, Gouda, HN, Green, MA, Greenwell, KF, Gugnani, HC, Gupta, R, Hamadeh, RR, Hammami, M, Harb, HL, Hay, Simon, Hedayati, MT, Hosgood, HD, Hoy, DG, Idrisov, BT, Islami, F, Ismayilova, S, Jha, Vivekanand, Jiang, G, Jonas, JB, Juel, K, Kabagambe, EK, Kazi, DS, Kengne, AP, Kereselidze, M, Khader, YS, Khalifa, SE, Khang, YH, Kim, D, Kinfu, Y, Kinge, JM, Kokubo, Y, Kosen, S, Defo, BK, Kumar, GA, Kumar, K, Kumar, RB, Lai, T, Lan, Q, Larsson, A, Lee, JT, Leinsalu, M, Lim, SS, Lipshultz, SE, Logroscino, G, Lotufo, PA, Lunevicius, R, Lyons, RA, Ma, S, Mahdi, AA, Marzan, MB, Mashal, MT, Mazorodze, TT, McGrath, JJ, Memish, ZA, Mendoza, W, Mensah, GA, Meretoja, A, Miller, TR, Mills, EJ, Mohammad, KA, Mokdad, AH, Monasta, L, Montico, M, Moore, AR, Moschandreas, Joanna, Msemburi, WT, Mueller, UO, Muszynska, MM, Naghavi, M, Naidoo, KS, Narayan, KM, Nejjari, C, Ng, M, de Dieu Ngirabega, J, Nieuwenhuijsen, MJ, Nyakarahuka, L, Ohkubo, T, Omer, SB, Caicedo, AJ, Pillay-van Wyk, V, Pope, D, Pourmalek, F, Prabhakaran, D, Rahman, SU, Rana, SM, Reilly, RQ, Rojas-Rueda, D, Ronfani, L, Rushton, L, Saeedi, MY, Salomon, JA, Sampson, U, Santos, IS, Sawhney, M, Schmidt, JC, Shakh-Nazarova, M, She, J, Sheikhbahaei, S, Shibuya, K, Shin, HH, Shishani, K, Shiue, I, Sigfusdottir, ID, Singh, JA, Skirbekk, V, Sliwa, K, Soshnikov, SS, Sposato, LA, Stathopoulou, VK, Stroumpoulis, K, Tabb, KM, Talongwa, RT, Teixeira, CM, Terkawi, AS, Thomson, AJ, Thorne-Lyman, AL, Toyoshima, H, Dimbuene, ZT, Uwaliraye, P, Uzun, SB, Vasankari, TJ, Vasconcelos, AM, Vlassov, VV, Vollset, SE, Waller, S, Wan, X, Weichenthal, S, Weiderpass, E, Weintraub, RG, Westerman, R, Wilkinson, JD, Williams, HC, Yang, YC, Yentur, GK, Yip, P, Yonemoto, N, Younis, M, Yu, C, Jin, KY, El Sayed Zaki, M, Zhu, S, Vos, T, Lopez, AD, and Murray, CJ

Abstract

Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success.We generated updated estimates of child mortality in early neonatal (age 0-6 days), late neonatal (7-28 days), postneonatal (29-364 days), childhood (1-4 years), and under-5 (0-4 years) age groups for 188 countries from 1970 to 2013, with more than 29,000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030.We estimated that 6·3 million (95% UI 6·0-6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1-18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6-177·4) in Guinea-Bissau to 2·3 (1·8-2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from -6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000-13 than during 1990-2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only -1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone.Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030.Bill & Melinda Gates Foundation, US Agency for International Development.

Published
2018

2. Evolution and patterns of global health financing 1995-2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries

Author

Dieleman, J, Campbell, M, Chapin, A, Eldrenkamp, E, Fan, VY, Haakenstad, A, Kates, J, Liu, YY, Matyasz, T, Micah, A, Reynolds, A, Sadat, N, Schneider, MT, Sorensen, R, Evans, T, Evans, D, Kurowski, C, Tandon, A, Abbas, KM, Abera, SF, Kiadaliri, AA, Ahmed, KY, Ahmed, MB, Alam, K, Alizadeh-Navaei, R, Alkerwi, A, Amini, E, Ammar, W, Amrock, SM, Antonio, CAT, Atey, TM, Avila-Burgos, L, Awasthi, A, Barac, A, Bernal, OA, Beyene, AS, Beyene, TJ, Birungi, C, Bizuayehu, HM, Breitborde, NJK, Cahuana-Hurtado, L, Castro, RE, Catala-Lopez, F, Dalal, K, Dandona, L, Dandona, R, Jager, P, Dharmaratne, SD, Dubey, M, Sofia e Sa Farinha, C, Faro, A, Feigl, AB, Fischer, F, Fitchett, JRA, Foigt, N, Giref, AZ, Gupta, R, Hamidi, S, Harb, HL, Hay, SI, Hendrie, D, Horino, M, Jurisson, M, Jakovljevic, MB, Javanbakht, M, John, D, Jonas, JB, Karimi, SM, Khang, YH, Khubchandani, J, Kim, YJ, Kinge, JM, Krohn, KJ, Kumar, GA, Abd El Razek, HM, Abd El Razek, MM, Majeed, A, Malekzadeh, R, Masiye, F, Meier, T, Meretoja, A, Miller, TR, Mirrakhimov, EM, Mohammed, S, Nangia, V, Olgiati, S, Osman, AS, Owolabi, MO, Patel, T, Caicedo, AJP, Pereira, DM, Perelman, J, Polinder, Suzanne, Rafay, A, Rahimi-Movaghar, V, Rai, RK, Ram, U, Ranabhat, CL, Roba, HS, Salama, J, Savic, M, Sepanlou, SG, Shrime, MG, Talongwa, RT, Te Ao, BJ, Tediosi, F, Tesema, AG, Thomson, AJ, Tobe-Gai, R, Topor-Madry, R, Undurraga, EA, Vasankari, T, Violante, FS, Werdecker, A, Wijeratne, T, Xu, G, Yonemoto, N, Younis, MZ, Yu, CH, Zaidi, Z, Zaki, ME, Murray, CJL, Global Burden D Hlth, F, and Public Health

Published
2017

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

Author

Barber, RM, Fullman, N, Sorensen, RJD, Bollyky, T, McKee, M, Nolte, E, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulle, AM, Abdurahman, AA, Abera, SF, Abraham, B, Abreha, GF, Adane, K, Adelekan, AL, Adetifa, IMO, Afshin, A, Agarwal, A, Agarwal, SK, Agarwal, S, Agrawal, A, Kiadaliri, AA, Ahmadi, A, Ahmed, KY, Ahmed, MB, Akinyemi, RO, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alam, SS, Alemu, ZA, Alene, KA, Alexander, L, Ali, R, Ali, SD, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Amo-Adjei, J, Amoako, YA, Anderson, BO, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Ärnlöv, J, Artaman, A, Asayesh, H, Assadi, R, Astatkie, A, Atey, TM, Atique, S, Atnafu, NT, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Quintanilla, BPA, Awasthi, A, Ayele, NN, Azzopardi, P, Saleem, HOB, Bärnighausen, T, Bacha, U, Badawi, A, Banerjee, A, Barac, A, Barboza, MA, Barker-Collo, SL, Barrero, LH, Basu, S, Baune, BT, Baye, K, Bayou, YT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Béjot, Y, Bello, AK, Bennett, DA, Bensenor, IM, Berhane, A, Bernabé, E, Bernal, OA, Beyene, AS, Beyene, TJ, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bose, D, Brainin, M, Brauer, M, Brazinova, A, Breitborde, NJK, Brenner, H, Butt, ZA, Cárdenas, R, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Carrero, JJ, Casey, D, Caso, V, Castañeda-Orjuela, CA, Rivas, JC, Catalá-López, F, Cecilio, P, Cercy, K, Charlson, FJ, Chen, AZ, Chew, A, Chibalabala, M, Chibueze, CE, Chisumpa, VH, Chitheer, AA, Chowdhury, R, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coggeshall, MS, Cooper, LT, Cortinovis, M, Crump, JA, Dalal, K, Danawi, H, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, De Leo, D, Del Gobbo, LC, del Pozo-Cruz, B, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dicker, D, Ding, EL, Dokova, K, Dorsey, ER, Doyle, KE, Dubey, M, Ehrenkranz, R, Ellingsen, CL, Elyazar, I, Enayati, A, Ermakov, SP, Eshrati, B, Esteghamati, A, Estep, K, Fürst, T, Faghmous, IDA, Fanuel, FBB, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Feigl, AB, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Fischer, F, Fitzmaurice, C, Fleming, TD, Foigt, N, Foreman, KJ, Forouzanfar, MH, Franklin, RC, Frostad, J, G/hiwot, TT, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gao, W, Garcia-Basteiro, AL, Gebre, T, Gebremedhin, AT, Gebremichael, MW, Gebru, AA, Gelaye, AA, Geleijnse, JM, Genova-Maleras, R, Gibney, KB, Giref, AZ, Gishu, MD, Giussani, G, Godwin, WW, Gold, A, Goldberg, EM, Gona, PN, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Greaves, F, Griswold, M, Guban, PI, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Habtewold, TD, Hafezi-Nejad, N, Haile, D, Hailu, AD, Hailu, GB, Hakuzimana, A, Hamadeh, RR, Hambisa, MT, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, Hendrie, D, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huntley, BM, Huynh, C, Iburg, KM, Ileanu, BV, Innos, K, Irenso, AA, Jahanmehr, N, Jakovljevic, MB, James, P, James, SL, Javanbakht, M, Jayaraman, SP, Jayatilleke, AU, Jeemon, P, Jha, V, John, D, Johnson, C, Johnson, SC, Jonas, JB, Juel, K, Kabir, Z, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Kasaeian, A, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kazanjan, K, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Kerbo, AA, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khan, G, Khang, Y-H, Khoja, ATA, Khonelidze, I, Khubchandani, J, Kibret, GD, Kim, D, Kim, P, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kissoon, N, Kivipelto, M, Kokubo, Y, Kolk, A, Kolte, D, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krishnaswami, S, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulkarni, VS, Kumar, GA, Kumsa, FA, Kutz, M, Kyu, HH, Lager, ACJ, Lal, A, Lal, DK, Lalloo, R, Lallukka, T, Lan, Q, Langan, SM, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Latif, AA, Lawrynowicz, AEB, Leasher, JL, Leigh, J, Leinsalu, M, Leshargie, CT, Leung, J, Leung, R, Levi, M, Liang, X, Lim, SS, Lind, M, Linn, S, Lipshultz, SE, Liu, P, Liu, Y, Lo, L-T, Logroscino, G, Lopez, AD, Lorch, SA, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Macarayan, ERK, Mackay, MT, El Razek, HMA, El Razek, MMA, Mahdavi, M, Majeed, A, Malekzadeh, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marcenes, W, Marks, GB, Marquez, N, Martinez-Raga, J, Marzan, MB, Massano, J, Mathur, MR, Maulik, PK, Mazidi, M, McAlinden, C, McGrath, JJ, McNellan, C, Meaney, PA, Mehari, A, Mehndiratta, MM, Meier, T, Mekonnen, AB, Meles, KG, Memish, ZA, Mengesha, MM, Mengiste, DT, Mengistie, MA, Menota, BG, Mensah, GA, Mereta, ST, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Millear, A, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Mock, CN, Mohammad, KA, Mohammed, S, Mohanty, SK, Mokdad, AH, Mola, GLD, Molokhia, M, Monasta, L, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Mori, R, Moses, M, Mueller, UO, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naheed, A, Naldi, L, Nangia, V, Nascimento, BR, Negoi, I, Neupane, SP, Newton, CR, Ng, M, Ngalesoni, FN, Ngunjiri, JW, Nguyen, G, Ningrum, DNA, Nolte, S, Nomura, M, Norheim, OF, Norrving, B, Noubiap, JJN, Obermeyer, CM, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olivares, PR, Olsen, HE, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ortiz, A, Osborne, RH, Osman, M, Owolabi, MO, PA, M, Pain, AW, Pakhale, S, Castillo, EP, Pana, A, Papachristou, C, Parsaeian, M, Patel, T, Patton, GC, Paudel, D, Paul, VK, Pearce, N, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pigott, DM, Pillay, JD, Pinho, C, Polinder, S, Pond, CD, Prakash, V, Purwar, M, Qorbani, M, Quistberg, DA, Radfar, A, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rai, RK, Ram, U, Rana, SM, Rankin, Z, Rao, PV, Rao, PC, Rawaf, S, Rego, MAS, Reitsma, M, Remuzzi, G, Renzaho, AMNN, Resnikoff, S, Rezaei, S, Rezai, MS, Ribeiro, AL, Roba, HS, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, NK, Sachdev, PS, Sackey, BB, Saeedi, MY, Safiri, S, Sagar, R, Sahraian, MA, Saleh, MM, Salomon, JA, Samy, AM, Sanabria, JR, Sanchez-Niño, MD, Sandar, L, Santos, IS, Santos, JV, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Savic, M, Sawhney, M, Saylan, MI, Schöttker, B, Schutte, AE, Schwebel, DC, Seedat, S, Seid, AM, Seifu, CN, Sepanlou, SG, Serdar, B, Servan-Mori, EE, Setegn, T, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shakh-Nazarova, M, Shamsipour, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shi, P, Shigematsu, M, Shin, M-J, Shiri, R, Shoman, H, Shrime, MG, Sibamo, ELS, Sigfusdottir, ID, Silva, DAS, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, OP, Singh, PK, Singh, V, Sinke, AH, Sinshaw, AE, Skirbekk, V, Sliwa, K, Smith, A, Sobngwi, E, Soneji, S, Soriano, JB, Sousa, TCM, Sposato, LA, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Steiner, C, Steinke, S, Stokes, MA, Stranges, S, Strong, M, Stroumpoulis, K, Sturua, L, Sufiyan, MB, Suliankatchi, RA, Sun, J, Sur, P, Swaminathan, S, Sykes, BL, Tabarés-Seisdedos, R, Tabb, KM, Taffere, GR, Talongwa, RT, Tarajia, M, Tavakkoli, M, Taveira, N, Teeple, S, Tegegne, TK, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Terkawi, AS, Tesema, AG, Thakur, JS, Thomson, AJ, Tillmann, T, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Tortajada, M, Troeger, C, Truelsen, T, Tura, AK, Uchendu, US, Ukwaja, KN, Undurraga, EA, Uneke, CJ, Uthman, OA, van Boven, JFM, Van Dingenen, R, Varughese, S, Vasankari, T, Venketasubramanian, N, Violante, FS, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Wagner, JA, Wakayo, T, Waller, SG, Walson, JL, Wang, H, Wang, Y-P, Watkins, DA, Weiderpass, E, Weintraub, RG, Wen, C-P, Werdecker, A, Wesana, J, Westerman, R, Whiteford, HA, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Won, S, Workicho, A, Workie, SB, Wubshet, M, Xavier, D, Xu, G, Yadav, AK, Yaghoubi, M, Yakob, B, Yan, LL, Yano, Y, Yaseri, M, Yimam, HH, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zambrana-Torrelio, C, Zapata, T, Zenebe, ZM, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Murray, CJL, Barber, RM, Fullman, N, Sorensen, RJD, Bollyky, T, McKee, M, Nolte, E, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulle, AM, Abdurahman, AA, Abera, SF, Abraham, B, Abreha, GF, Adane, K, Adelekan, AL, Adetifa, IMO, Afshin, A, Agarwal, A, Agarwal, SK, Agarwal, S, Agrawal, A, Kiadaliri, AA, Ahmadi, A, Ahmed, KY, Ahmed, MB, Akinyemi, RO, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alam, SS, Alemu, ZA, Alene, KA, Alexander, L, Ali, R, Ali, SD, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Amo-Adjei, J, Amoako, YA, Anderson, BO, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Ärnlöv, J, Artaman, A, Asayesh, H, Assadi, R, Astatkie, A, Atey, TM, Atique, S, Atnafu, NT, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Quintanilla, BPA, Awasthi, A, Ayele, NN, Azzopardi, P, Saleem, HOB, Bärnighausen, T, Bacha, U, Badawi, A, Banerjee, A, Barac, A, Barboza, MA, Barker-Collo, SL, Barrero, LH, Basu, S, Baune, BT, Baye, K, Bayou, YT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Béjot, Y, Bello, AK, Bennett, DA, Bensenor, IM, Berhane, A, Bernabé, E, Bernal, OA, Beyene, AS, Beyene, TJ, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bose, D, Brainin, M, Brauer, M, Brazinova, A, Breitborde, NJK, Brenner, H, Butt, ZA, Cárdenas, R, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Carrero, JJ, Casey, D, Caso, V, Castañeda-Orjuela, CA, Rivas, JC, Catalá-López, F, Cecilio, P, Cercy, K, Charlson, FJ, Chen, AZ, Chew, A, Chibalabala, M, Chibueze, CE, Chisumpa, VH, Chitheer, AA, Chowdhury, R, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coggeshall, MS, Cooper, LT, Cortinovis, M, Crump, JA, Dalal, K, Danawi, H, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, De Leo, D, Del Gobbo, LC, del Pozo-Cruz, B, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dicker, D, Ding, EL, Dokova, K, Dorsey, ER, Doyle, KE, Dubey, M, Ehrenkranz, R, Ellingsen, CL, Elyazar, I, Enayati, A, Ermakov, SP, Eshrati, B, Esteghamati, A, Estep, K, Fürst, T, Faghmous, IDA, Fanuel, FBB, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Feigl, AB, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Fischer, F, Fitzmaurice, C, Fleming, TD, Foigt, N, Foreman, KJ, Forouzanfar, MH, Franklin, RC, Frostad, J, G/hiwot, TT, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gao, W, Garcia-Basteiro, AL, Gebre, T, Gebremedhin, AT, Gebremichael, MW, Gebru, AA, Gelaye, AA, Geleijnse, JM, Genova-Maleras, R, Gibney, KB, Giref, AZ, Gishu, MD, Giussani, G, Godwin, WW, Gold, A, Goldberg, EM, Gona, PN, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Greaves, F, Griswold, M, Guban, PI, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Habtewold, TD, Hafezi-Nejad, N, Haile, D, Hailu, AD, Hailu, GB, Hakuzimana, A, Hamadeh, RR, Hambisa, MT, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, Hendrie, D, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huntley, BM, Huynh, C, Iburg, KM, Ileanu, BV, Innos, K, Irenso, AA, Jahanmehr, N, Jakovljevic, MB, James, P, James, SL, Javanbakht, M, Jayaraman, SP, Jayatilleke, AU, Jeemon, P, Jha, V, John, D, Johnson, C, Johnson, SC, Jonas, JB, Juel, K, Kabir, Z, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Kasaeian, A, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kazanjan, K, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Kerbo, AA, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khan, G, Khang, Y-H, Khoja, ATA, Khonelidze, I, Khubchandani, J, Kibret, GD, Kim, D, Kim, P, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kissoon, N, Kivipelto, M, Kokubo, Y, Kolk, A, Kolte, D, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krishnaswami, S, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulkarni, VS, Kumar, GA, Kumsa, FA, Kutz, M, Kyu, HH, Lager, ACJ, Lal, A, Lal, DK, Lalloo, R, Lallukka, T, Lan, Q, Langan, SM, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Latif, AA, Lawrynowicz, AEB, Leasher, JL, Leigh, J, Leinsalu, M, Leshargie, CT, Leung, J, Leung, R, Levi, M, Liang, X, Lim, SS, Lind, M, Linn, S, Lipshultz, SE, Liu, P, Liu, Y, Lo, L-T, Logroscino, G, Lopez, AD, Lorch, SA, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Macarayan, ERK, Mackay, MT, El Razek, HMA, El Razek, MMA, Mahdavi, M, Majeed, A, Malekzadeh, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marcenes, W, Marks, GB, Marquez, N, Martinez-Raga, J, Marzan, MB, Massano, J, Mathur, MR, Maulik, PK, Mazidi, M, McAlinden, C, McGrath, JJ, McNellan, C, Meaney, PA, Mehari, A, Mehndiratta, MM, Meier, T, Mekonnen, AB, Meles, KG, Memish, ZA, Mengesha, MM, Mengiste, DT, Mengistie, MA, Menota, BG, Mensah, GA, Mereta, ST, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Millear, A, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Mock, CN, Mohammad, KA, Mohammed, S, Mohanty, SK, Mokdad, AH, Mola, GLD, Molokhia, M, Monasta, L, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Mori, R, Moses, M, Mueller, UO, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naheed, A, Naldi, L, Nangia, V, Nascimento, BR, Negoi, I, Neupane, SP, Newton, CR, Ng, M, Ngalesoni, FN, Ngunjiri, JW, Nguyen, G, Ningrum, DNA, Nolte, S, Nomura, M, Norheim, OF, Norrving, B, Noubiap, JJN, Obermeyer, CM, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olivares, PR, Olsen, HE, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ortiz, A, Osborne, RH, Osman, M, Owolabi, MO, PA, M, Pain, AW, Pakhale, S, Castillo, EP, Pana, A, Papachristou, C, Parsaeian, M, Patel, T, Patton, GC, Paudel, D, Paul, VK, Pearce, N, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pigott, DM, Pillay, JD, Pinho, C, Polinder, S, Pond, CD, Prakash, V, Purwar, M, Qorbani, M, Quistberg, DA, Radfar, A, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rai, RK, Ram, U, Rana, SM, Rankin, Z, Rao, PV, Rao, PC, Rawaf, S, Rego, MAS, Reitsma, M, Remuzzi, G, Renzaho, AMNN, Resnikoff, S, Rezaei, S, Rezai, MS, Ribeiro, AL, Roba, HS, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, NK, Sachdev, PS, Sackey, BB, Saeedi, MY, Safiri, S, Sagar, R, Sahraian, MA, Saleh, MM, Salomon, JA, Samy, AM, Sanabria, JR, Sanchez-Niño, MD, Sandar, L, Santos, IS, Santos, JV, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Savic, M, Sawhney, M, Saylan, MI, Schöttker, B, Schutte, AE, Schwebel, DC, Seedat, S, Seid, AM, Seifu, CN, Sepanlou, SG, Serdar, B, Servan-Mori, EE, Setegn, T, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shakh-Nazarova, M, Shamsipour, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shi, P, Shigematsu, M, Shin, M-J, Shiri, R, Shoman, H, Shrime, MG, Sibamo, ELS, Sigfusdottir, ID, Silva, DAS, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, OP, Singh, PK, Singh, V, Sinke, AH, Sinshaw, AE, Skirbekk, V, Sliwa, K, Smith, A, Sobngwi, E, Soneji, S, Soriano, JB, Sousa, TCM, Sposato, LA, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Steiner, C, Steinke, S, Stokes, MA, Stranges, S, Strong, M, Stroumpoulis, K, Sturua, L, Sufiyan, MB, Suliankatchi, RA, Sun, J, Sur, P, Swaminathan, S, Sykes, BL, Tabarés-Seisdedos, R, Tabb, KM, Taffere, GR, Talongwa, RT, Tarajia, M, Tavakkoli, M, Taveira, N, Teeple, S, Tegegne, TK, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Terkawi, AS, Tesema, AG, Thakur, JS, Thomson, AJ, Tillmann, T, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Tortajada, M, Troeger, C, Truelsen, T, Tura, AK, Uchendu, US, Ukwaja, KN, Undurraga, EA, Uneke, CJ, Uthman, OA, van Boven, JFM, Van Dingenen, R, Varughese, S, Vasankari, T, Venketasubramanian, N, Violante, FS, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Wagner, JA, Wakayo, T, Waller, SG, Walson, JL, Wang, H, Wang, Y-P, Watkins, DA, Weiderpass, E, Weintraub, RG, Wen, C-P, Werdecker, A, Wesana, J, Westerman, R, Whiteford, HA, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Won, S, Workicho, A, Workie, SB, Wubshet, M, Xavier, D, Xu, G, Yadav, AK, Yaghoubi, M, Yakob, B, Yan, LL, Yano, Y, Yaseri, M, Yimam, HH, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zambrana-Torrelio, C, Zapata, T, Zenebe, ZM, Zodpey, S, Zoeckler, L, Zuhlke, LJ, and Murray, CJL

Published
2017

4. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015 : the Global Burden of Disease Study 2015

Author

GBD 2015 HIV Collaborators, Wang, H, Wolock, TM, Carter, A, Nguyen, G, Kyu, HH, Gakidou, E, Hay, SI, Mills, EJ, Trickey, A, Msemburi, W, Coates, MM, Mooney, MD, Fraser, MS, Sligar, A, Salomon, J, Larson, HJ, Friedman, J, Abajobir, AA, Abate, KH, Abbas, KM, Razek, MM, Abd-Allah, F, Abdulle, AM, Abera, SF, Abubakar, I, Abu-Raddad, LJ, Abu-Rmeileh, NM, Abyu, GY, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adofo, K, Adou, AK, Ajala, ON, Akinyemiju, TF, Akseer, N, Lami, FH, Al-Aly, Z, Alam, K, Alam, NK, Alasfoor, D, Aldhahri, SF, Aldridge, RW, Alegretti, MA, Aleman, AV, Alemu, ZA, Alfonso-Cristancho, R, Ali, R, Alkerwi, A, Alla, F, Mohammad, R, Al-Raddadi, S, Alsharif, U, Alvarez, E, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Antonio, CA, Anwari, P, Ärnlöv, J, Artaman, A, Asayesh, H, Asghar, RJ, Assadi, R, Atique, S, Atkins, LS, Avokpaho, EF, Awasthi, A, Quintanilla, BP, Bacha, U, Badawi, A, Barac, A, Bärnighausen, T, Basu, A, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, N, Bennett, DA, Bensenor, IM, Betsu, BD, Beyene, AS, Bhatia, E, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Bisanzio, D, Brainin, M, Brazinova, A, Breitborde, NJ, Brown, A, Burch, M, Butt, ZA, Campuzano, JC, Cárdenas, R, Carrero, JJ, Castañeda-Orjuela, CA, Rivas, JC, Catalá-López, F, Chang, HY, Chang, JC, Chavan, L, Chen, W, Chiang, PP, Chibalabala, M, Chisumpa, VH, Choi, JY, Christopher, DJ, Ciobanu, LG, Cooper, C, Dahiru, T, Damtew, SA, Dandona, L, Dandona, R, Das Neves, J, De Jager, P, De Leo, D, Degenhardt, L, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dharmaratne, SD, Ding, EL, Doshi, PP, Driscoll, TR, Dubey, M, Elshrek, YM, Elyazar, I, Endries, AY, Ermakov, SP, Eshrati, B, Esteghamati, A, Faghmous, ID, Farinha, CS, Faro, A, Farvid, MS, Farzadfar, F, Fereshtehnejad, SM, Fernandes, JC, Fischer, F, Fitchett, JR, Foigt, N, Fullman, N, Fürst, T, Gankpé, FG, Gebre, T, Gebremedhin, AT, Gebru, AA, Geleijnse, JM, Gessner, BD, Gething, PW, Ghiwot, TT, Giroud, M, Gishu, MD, Glaser, E, Goenka, S, Goodridge, A, Gopalani, SV, Goto, A, Gugnani, HC, Guimaraes, MD, Gupta, R, Gupta, V, Haagsma, J, Hafezi-Nejad, N, Hagan, H, Hailu, GB, Hamadeh, RR, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Harikrishnan, S, Haro, JM, Harun, KM, Havmoeller, R, Hedayati, MT, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Hoy, DG, Hsairi, M, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Idrisov, BT, Innos, K, Iyer, VJ, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jha, V, Jiang, G, Jiang, Y, Jibat, T, Jonas, JB, Kabir, Z, Kamal, R, Kan, H, Karch, A, Karema, CK, Karletsos, D, Kasaeian, A, Kaul, A, Kawakami, N, Kayibanda, JF, Keiyoro, PN, Kemp, AH, Kengne, AP, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khang, YH, Khubchandani, J, Kim, YJ, Kinfu, Y, Kivipelto, M, Kokubo, Y, Kosen, S, Koul, PA, Koyanagi, A, Defo, BK, Bicer, BK, Kulkarni, VS, Kumar, GA, Lal, DK, Lam, H, Lam, JO, Langan, SM, Lansingh, VC, Larsson, A, Leigh, J, Leung, R, Li, Y, Lim, SS, Lipshultz, SE, Liu, S, Lloyd, BK, Logroscino, G, Lotufo, PA, Lunevicius, R, Razek, HM, Mahdavi, M, Majdan, M, Majeed, A, Makhlouf, C, Malekzadeh, R, Mapoma, CC, Marcenes, W, Martinez-Raga, J, Marzan, MB, Masiye, F, Mason-Jones, AJ, Mayosi, BM, McKee, M, Meaney, PA, Mehndiratta, MM, Mekonnen, AB, Melaku, YA, Memiah, P, Memish, ZA, Mendoza, W, Meretoja, A, Meretoja, TJ, Mhimbira, FA, Miller, TR, Mikesell, J, Mirarefin, M, Mohammad, KA, Mohammed, S, Mokdad, AH, Monasta, L, Moradi-Lakeh, M, Mori, R, Mueller, UO, Murimira, B, Murthy, GV, Naheed, A, Naldi, L, Nangia, V, Nash, D, Nawaz, H, Nejjari, C, Ngalesoni, FN, De Dieu Ngirabega, J, Nguyen, QL, Nisar, MI, Norheim, OF, Norman, RE, Nyakarahuka, L, Ogbo, FA, Oh, IH, Ojelabi, FA, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ota, E, Padukudru, MA, Park, HY, Park, JH, Patil, ST, Patten, SB, Paul, VK, Pearson, K, Peprah, EK, Pereira, CC, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pillay, JD, Plass, D, Polinder, S, Pourmalek, F, Prokop, DM, Qorbani, M, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MH, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Rao, PV, Remuzzi, G, Rojas-Rueda, D, Ronfani, L, Roshandel, G, Roy, A, Ruhago, GM, Saeedi, MY, Sagar, R, Saleh, MM, Sanabria, JR, Santos, IS, Sarmiento-Suarez, R, Sartorius, B, Sawhney, M, Schutte, AE, Schwebel, DC, Seedat, S, Sepanlou, SG, Servan-Mori, EE, Shaikh, MA, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shibuya, K, Shin, HH, Sigfusdottir, ID, Silpakit, N, Silva, DA, Silveira, DG, Simard, EP, Sindi, S, Singh, JA, Singh, OP, Singh, PK, Skirbekk, V, Sliwa, K, Soneji, S, Sorensen, RJ, Soriano, JB, Soti, DO, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Sunguya, BF, Swaminathan, S, Sykes, BL, Tabarés-Seisdedos, R, Talongwa, RT, Tavakkoli, M, Taye, B, Tedla, BA, Tekle, T, Shifa, GT, Temesgen, AM, Terkawi, AS, Tesfay, FH, Tessema, GA, Thapa, K, Thomson, AJ, Thorne-Lyman, AL, Tobe-Gai, R, Topor-Madry, R, Towbin, JA, Tran, BX, Dimbuene, ZT, Tsilimparis, N, Tura, AK, Ukwaja, KN, Uneke, CJ, Uthman, OA, Venketasubramanian, N, Vladimirov, SK, Vlassov, VV, Vollset, SE, Wang, L, Weiderpass, E, Weintraub, RG, Werdecker, A, Westerman, R, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Wolfe, CD, Won, S, Wong, JQ, Xu, G, Yadav, AK, Yakob, B, Yalew, AZ, Yano, Y, Yaseri, M, Yebyo, HG, Yip, P, Yonemoto, N, Yoon, SJ, Younis, MZ, Yu, C, Yu, S, Zaidi, Z, Zaki, MELS, Zeeb, H, Zhang, H, Zhao, Y, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Lopez, AD, and Murray, CJ

Subjects
GBD 2015 HIV Collaborators
Abstract

BACKGROUND: Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. METHODS: For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. FINDINGS: Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1-3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5-2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6-40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7-1·9 million) in 2005, to 1·2 million deaths (1·1-1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. INTERPRETATION: Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030. Funding: We thank the countless individuals who have contributed to the Global Burden of Disease (GBD) Study 2015 in various capacities. We specifically thank Jeffrey Eaton and John Stover. HW and CJLM received funding for this study from the Bill & Melinda Gates Foundation; the National Institute of Mental Health, National Institutes of Health (NIH; R01MH110163); and the National Institute on Aging, NIH (P30AG047845). LJAR acknowledges the support of Qatar National Research Fund (NPRP 04-924-3-251) who provided the main funding for generating the data provided to the GBD-Institute for Health Metrics and Evaluation effort. BPAQ acknowledges institutional support from PRONABEC (National Program of Scholarship and Educational Loan), provided by the Peruvian government. DB is supported by the Bill & Melinda Gates Foundation (grant number OPP1068048). JDN was supported in his contribution to this work by a Fellowship from Fundacao para a Ciencia e a Tecnologia, Portugal (SFRH/BPD/92934/2013). KD is supported by a Wellcome Trust Fellowship in Public Health and Tropical Medicine (grant number 099876). TF received financial support from the Swiss National Science Foundation (SNSF; project number P300P3-154634). AG acknowledges funding from Sistema Nacional de Investigadores de Panama-SNI. PJ is supported by Wellcome Trust-DBT India Alliance Clinical and Public Health Intermediate Fellowship. MK receives research support from the Academy of Finland, the Swedish Research Council, Alzheimerfonden, Alzheimer's Research & Prevention Foundation, Center for Innovative Medicine (CIMED) at Karolinska Institutet South Campus, AXA Research Fund, Wallenberg Clinical Scholars Award from the Knut och Alice Wallenbergs Foundation, and the Sheika Salama Bint Hamdan Al Nahyan Foundation. AK's work was supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R&D&I and funded by the ISCIII (General Branch Evaluation and Promotion of Health Research), and the European Regional Development Fund (ERDF-FEDER). SML is funded by a National Institute for Health Research (NIHR) Clinician Scientist Fellowship (grant number NIHR/CS/010/014). HJL reports grants from the NIHR, EU Innovative Medicines Initiative, Centre for Strategic & International Studies, and WHO. WM is Program analyst, Population and Development, in the Peru Country Office of the United Nations Population Fund, which does not necessarily endorse this study. For UOM, funding from the German National Cohort Consortium (O1ER1511D) is gratefully acknowledged. KR reports grants from NIHR Oxford Biomedical Research Centre, NIHR Career Development Fellowship, and Oxford Martin School during the conduct of the study. GR acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group supported by the International Society of Nephrology (ISN). ISS reports grants from FAPESP (Brazilian public agency). RSS receives institutional support from Universidad de Ciencias Aplicadas y Ambientales, UDCA, Bogota Colombia. SS receives postdoctoral funding from the Fonds de la recherche en sante du Quebec (FRSQ), including its renewal. RTS was supported in part by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI14/00894 from ISCIII-FEDER. PY acknowledges support from Strategic Public Policy Research (HKU7003-SPPR-12).

Published
2016

5. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: the Global Burden of Disease Study 2015

Author

Wang, H, Wolock, TM, Carter, A, Nguyen, G, Kyu, HH, Gakidou, E, Hay, SI, Mills, EJ, Trickey, A, Msemburi, W, Coates, MM, Mooney, MD, Fraser, MS, Sligar, A, Salomon, J, Larson, HJ, Friedman, J, Abajobir, AA, Abate, KH, Abbas, KM, Abd El Razek, MM, Abd-Allah, F, Abdulle, AM, Abera, SF, Abubakar, I, Abu-Raddad, LJ, Abu-Rmeileh, NME, Abyu, GY, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adofo, K, Adou, AK, Ajala, ON, Akinyemiju, TF, Akseer, N, Al Lami, FH, Al-Aly, Z, Alam, K, Alam, NKM, Alasfoor, D, Aldhahri, SFS, Aldridge, RW, Alegretti, MA, Aleman, AV, Alemu, ZA, Alfonso-Cristancho, R, Ali, R, Alkerwi, A, Alla, F, Al-Raddadi, RMS, Alsharif, U, Alvarez, E, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Antonio, CAT, Anwari, P, Arnlov, J, Al, A, Asayesh, H, Asghar, RJ, Assadi, R, Atique, S, Atkins, LS, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Bacha, U, Badawi, A, Barac, A, Barnighausen, T, Basu, A, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, N, Bennett, DA, Bensenor, IM, Betsu, BD, Beyene, AS, Bhatia, E, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Bisanzio, D, Brainin, M, Brazinova, A, Breitborde, NJK, Brown, A, Burch, M, Butt, ZA, Campuzano, JC, Cardenas, R, Carrero, JJ, Castaneda-Orjuela, CA, Rivas, JC, Catala-Lopez, F, Chang, H-Y, Chang, J-C, Chavan, L, Chen, W, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Choi, J-YJ, Christopher, DJ, Ciobanu, LG, Cooper, C, Dahiru, T, Damtew, SA, Dandona, L, Dandona, R, das Neves, J, de Jager, P, De Leo, D, Degenhardt, L, Dellavalle, RP, Deribe, K, Deribew, A, Jarlais, DCD, Dharmaratne, SD, Ding, EL, Doshi, PP, Driscoll, TR, Dubey, M, Elshrek, YM, Elyazar, I, Endries, AY, Ermakov, SP, Eshrati, B, Esteghamati, A, Faghmous, IDA, Sofia e Sa Farinha, C, Faro, A, Farvid, MS, Farzadfar, F, Fereshtehnejad, S-M, Fernandes, JC, Fischer, F, Fitchett, JRA, Foigt, N, Fullman, N, Furst, T, Gankpe, FG, Gebre, T, Gebremedhin, AT, Gebru, AA, Geleijnse, JM, Gessner, BD, Gething, PW, Ghiwot, TT, Giroud, M, Gishu, MD, Glaser, E, Goenka, S, Goodridge, A, Gopalani, SV, Goto, A, Gugnani, HC, Guimaraes, MDC, Gupta, R, Gupta, V, Haagsma, J, Hafezi-Nejad, N, Hagan, H, Hailu, GB, Hamadeh, RR, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Harikrishnan, S, Haro, JM, Harun, KM, Havmoeller, R, Hedayati, MT, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Hoy, DG, Hsairi, M, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Idrisov, BT, Innos, K, Iyer, VJ, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jha, V, Jiang, G, Jiang, Y, Jibat, T, Jonas, JB, Kabir, Z, Kamal, R, Kan, H, Karch, A, Karema, CK, Karletsos, D, Kasaeian, A, Kaul, A, Kawakami, N, Kayibanda, JF, Keiyoro, PN, Kemp, AH, Kengne, AP, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khang, Y-H, Khubchandani, J, Kim, YJ, Kinfu, Y, Kivipelto, M, Kokubo, Y, Kosen, S, Koul, PA, Koyanagi, A, Defo, BK, Bicer, BK, Kulkarni, VS, Kumar, GA, Lal, DK, Lam, H, Lam, JO, Langan, SM, Lansingh, VC, Larsson, A, Leigh, J, Leung, R, Li, Y, Lim, SS, Lipshultz, SE, Liu, S, Lloyd, BK, Logroscino, G, Lotufo, PA, Lunevicius, R, Abd El Razek, HM, Mahdavi, M, Majdan, M, Majeed, A, Makhlouf, C, Malekzadeh, R, Mapoma, CC, Marcenes, W, Martinez-Raga, J, Marzan, MB, Masiye, F, Mason-Jones, AJ, Mayosi, BM, Mckee, M, Meaney, PA, Mehndiratta, MM, Mekonnen, AB, Melaku, YA, Memiah, P, Memish, ZA, Mendoza, W, Meretoja, A, Meretoja, TJ, Mhimbira, FA, Miller, TR, Mikesell, J, Mirarefin, M, Mohammad, KA, Mohammed, S, Mokdad, AH, Monasta, L, Moradi-Lakeh, M, Mori, R, Mueller, UO, Murimira, B, Murthy, GVS, Naheed, A, Naldi, L, Nangia, V, Nash, D, Nawaz, H, Nejjari, C, Ngalesoni, FN, Ngirabega, JDD, Quyen, LN, Nisar, MI, Norheim, OF, Norman, RE, Nyakarahuka, L, Ogbo, FA, Oh, I-H, Ojelabi, FA, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ota, E, Padukudru, MA, Park, H-Y, Park, J-H, Patil, ST, Patten, SB, Paul, VK, Pearson, K, Peprah, EK, Pereira, DM, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pillay, JD, Plass, D, Polinder, S, Pourmalek, F, Prokop, DM, Qorbani, M, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Rao, PV, Remuzzi, G, Rojas-Rueda, D, Ronfani, L, Roshandel, G, Roy, A, Ruhago, GM, Saeedi, MY, Sagar, R, Saleh, MM, Sanabria, JR, Santos, IS, Sarmiento-Suarez, R, Sartorius, B, Sawhney, M, Schutte, AE, Schwebel, DC, Seedat, S, Sepanlou, SG, Servan-Mori, EE, Shaikh, MA, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shibuya, K, Shin, HH, Sigfusdottir, ID, Silpakit, N, Santos Silva, DA, Alves Silveira, DG, Simard, EP, Sindi, S, Singh, JA, Singh, OP, Singh, PK, Skirbekk, V, Sliwa, K, Soneji, S, Sorensen, RJD, Soriano, JB, Soti, DO, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Sunguya, BF, Swaminathan, S, Sykes, BL, Tabares-Seisdedos, R, Talongwa, RT, Tavakkoli, M, Taye, B, Tedla, BA, Tekle, T, Shifa, GT, Temesgen, AM, Terkawi, AS, Tesfay, FH, Tessema, GA, Thapa, K, Thomson, AJ, Thorne-Lyman, AL, Tobe-Gai, R, Topor-Madry, R, Towbin, JA, Bach, XT, Dimbuene, ZT, Tsilimparis, N, Tura, AK, Ukwaja, KN, Uneke, CJ, Uthman, OA, Venketasubramanian, N, Vladimirov, SK, Vlassov, VV, Vollset, SE, Wang, L, Weiderpass, E, Weintraub, RG, Werdecker, A, Westerman, R, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Wolfe, CDA, Won, S, Wong, JQ, Xu, G, Yadav, AK, Yakob, B, Yalew, AZ, Yano, Y, Yaseri, M, Yebyo, HG, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Yu, S, Zaidi, Z, Zaki, MES, Zeeb, H, Zhang, H, Zhao, Y, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Lopez, AD, Murray, CJL, Wang, H, Wolock, TM, Carter, A, Nguyen, G, Kyu, HH, Gakidou, E, Hay, SI, Mills, EJ, Trickey, A, Msemburi, W, Coates, MM, Mooney, MD, Fraser, MS, Sligar, A, Salomon, J, Larson, HJ, Friedman, J, Abajobir, AA, Abate, KH, Abbas, KM, Abd El Razek, MM, Abd-Allah, F, Abdulle, AM, Abera, SF, Abubakar, I, Abu-Raddad, LJ, Abu-Rmeileh, NME, Abyu, GY, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adofo, K, Adou, AK, Ajala, ON, Akinyemiju, TF, Akseer, N, Al Lami, FH, Al-Aly, Z, Alam, K, Alam, NKM, Alasfoor, D, Aldhahri, SFS, Aldridge, RW, Alegretti, MA, Aleman, AV, Alemu, ZA, Alfonso-Cristancho, R, Ali, R, Alkerwi, A, Alla, F, Al-Raddadi, RMS, Alsharif, U, Alvarez, E, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Antonio, CAT, Anwari, P, Arnlov, J, Al, A, Asayesh, H, Asghar, RJ, Assadi, R, Atique, S, Atkins, LS, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Bacha, U, Badawi, A, Barac, A, Barnighausen, T, Basu, A, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, N, Bennett, DA, Bensenor, IM, Betsu, BD, Beyene, AS, Bhatia, E, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Bisanzio, D, Brainin, M, Brazinova, A, Breitborde, NJK, Brown, A, Burch, M, Butt, ZA, Campuzano, JC, Cardenas, R, Carrero, JJ, Castaneda-Orjuela, CA, Rivas, JC, Catala-Lopez, F, Chang, H-Y, Chang, J-C, Chavan, L, Chen, W, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Choi, J-YJ, Christopher, DJ, Ciobanu, LG, Cooper, C, Dahiru, T, Damtew, SA, Dandona, L, Dandona, R, das Neves, J, de Jager, P, De Leo, D, Degenhardt, L, Dellavalle, RP, Deribe, K, Deribew, A, Jarlais, DCD, Dharmaratne, SD, Ding, EL, Doshi, PP, Driscoll, TR, Dubey, M, Elshrek, YM, Elyazar, I, Endries, AY, Ermakov, SP, Eshrati, B, Esteghamati, A, Faghmous, IDA, Sofia e Sa Farinha, C, Faro, A, Farvid, MS, Farzadfar, F, Fereshtehnejad, S-M, Fernandes, JC, Fischer, F, Fitchett, JRA, Foigt, N, Fullman, N, Furst, T, Gankpe, FG, Gebre, T, Gebremedhin, AT, Gebru, AA, Geleijnse, JM, Gessner, BD, Gething, PW, Ghiwot, TT, Giroud, M, Gishu, MD, Glaser, E, Goenka, S, Goodridge, A, Gopalani, SV, Goto, A, Gugnani, HC, Guimaraes, MDC, Gupta, R, Gupta, V, Haagsma, J, Hafezi-Nejad, N, Hagan, H, Hailu, GB, Hamadeh, RR, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Harikrishnan, S, Haro, JM, Harun, KM, Havmoeller, R, Hedayati, MT, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Hoy, DG, Hsairi, M, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Idrisov, BT, Innos, K, Iyer, VJ, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jha, V, Jiang, G, Jiang, Y, Jibat, T, Jonas, JB, Kabir, Z, Kamal, R, Kan, H, Karch, A, Karema, CK, Karletsos, D, Kasaeian, A, Kaul, A, Kawakami, N, Kayibanda, JF, Keiyoro, PN, Kemp, AH, Kengne, AP, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khang, Y-H, Khubchandani, J, Kim, YJ, Kinfu, Y, Kivipelto, M, Kokubo, Y, Kosen, S, Koul, PA, Koyanagi, A, Defo, BK, Bicer, BK, Kulkarni, VS, Kumar, GA, Lal, DK, Lam, H, Lam, JO, Langan, SM, Lansingh, VC, Larsson, A, Leigh, J, Leung, R, Li, Y, Lim, SS, Lipshultz, SE, Liu, S, Lloyd, BK, Logroscino, G, Lotufo, PA, Lunevicius, R, Abd El Razek, HM, Mahdavi, M, Majdan, M, Majeed, A, Makhlouf, C, Malekzadeh, R, Mapoma, CC, Marcenes, W, Martinez-Raga, J, Marzan, MB, Masiye, F, Mason-Jones, AJ, Mayosi, BM, Mckee, M, Meaney, PA, Mehndiratta, MM, Mekonnen, AB, Melaku, YA, Memiah, P, Memish, ZA, Mendoza, W, Meretoja, A, Meretoja, TJ, Mhimbira, FA, Miller, TR, Mikesell, J, Mirarefin, M, Mohammad, KA, Mohammed, S, Mokdad, AH, Monasta, L, Moradi-Lakeh, M, Mori, R, Mueller, UO, Murimira, B, Murthy, GVS, Naheed, A, Naldi, L, Nangia, V, Nash, D, Nawaz, H, Nejjari, C, Ngalesoni, FN, Ngirabega, JDD, Quyen, LN, Nisar, MI, Norheim, OF, Norman, RE, Nyakarahuka, L, Ogbo, FA, Oh, I-H, Ojelabi, FA, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ota, E, Padukudru, MA, Park, H-Y, Park, J-H, Patil, ST, Patten, SB, Paul, VK, Pearson, K, Peprah, EK, Pereira, DM, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pillay, JD, Plass, D, Polinder, S, Pourmalek, F, Prokop, DM, Qorbani, M, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Rao, PV, Remuzzi, G, Rojas-Rueda, D, Ronfani, L, Roshandel, G, Roy, A, Ruhago, GM, Saeedi, MY, Sagar, R, Saleh, MM, Sanabria, JR, Santos, IS, Sarmiento-Suarez, R, Sartorius, B, Sawhney, M, Schutte, AE, Schwebel, DC, Seedat, S, Sepanlou, SG, Servan-Mori, EE, Shaikh, MA, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shibuya, K, Shin, HH, Sigfusdottir, ID, Silpakit, N, Santos Silva, DA, Alves Silveira, DG, Simard, EP, Sindi, S, Singh, JA, Singh, OP, Singh, PK, Skirbekk, V, Sliwa, K, Soneji, S, Sorensen, RJD, Soriano, JB, Soti, DO, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Sunguya, BF, Swaminathan, S, Sykes, BL, Tabares-Seisdedos, R, Talongwa, RT, Tavakkoli, M, Taye, B, Tedla, BA, Tekle, T, Shifa, GT, Temesgen, AM, Terkawi, AS, Tesfay, FH, Tessema, GA, Thapa, K, Thomson, AJ, Thorne-Lyman, AL, Tobe-Gai, R, Topor-Madry, R, Towbin, JA, Bach, XT, Dimbuene, ZT, Tsilimparis, N, Tura, AK, Ukwaja, KN, Uneke, CJ, Uthman, OA, Venketasubramanian, N, Vladimirov, SK, Vlassov, VV, Vollset, SE, Wang, L, Weiderpass, E, Weintraub, RG, Werdecker, A, Westerman, R, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Wolfe, CDA, Won, S, Wong, JQ, Xu, G, Yadav, AK, Yakob, B, Yalew, AZ, Yano, Y, Yaseri, M, Yebyo, HG, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Yu, S, Zaidi, Z, Zaki, MES, Zeeb, H, Zhang, H, Zhao, Y, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Lopez, AD, and Murray, CJL

Abstract

BACKGROUND: Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. METHODS: For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. FINDINGS: Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1-3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5-2·8 mi

Published
2016

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

Author

Carl Abelardo T. Antonio, Rob E. Dorrington, Belinda K Lloyd, Elisabete Weiderpass, Kovin Naidoo, Leslie T. Cooper, Sandra Nolte, Eduardo A. Undurraga, Mohammad A. AlMazroa, R. Kumar, Xiaofeng Liang, Amanda J. Mason-Jones, Kazem Rahimi, Sanjay Basu, Vasiliy Victorovich Vlassov, André Karch, Dipan Bose, Vivekanand Jha, Adansi A. Amankwaa, Kaire Innos, Ione Jayce Ceola Schneider, Itamar S. Santos, Anwar Rafay, Bolajoko O. Olusanya, Tommi Vasankari, Nana Kwaku Mainoo, Saleem M Rana, Wagner Marcenes, Fortuné Gbètoho Gankpé, Rana J. Asghar, Lela Sturua, Nicholas J K Breitborde, Corine Karema, Charles R. Newton, Uche S. Uchendu, Jongmin Lee, Inga Dora Sigfusdottir, Harish Chander Gugnani, Kaushalendra Kumar, Reza Assadi, Ibrahim Abubakar, Konstantinos Stroumpoulis, Megan Coggeshall, Timothy M. Wolock, Ronny Westerman, Samath D Dharmaratne, Katya Anne Shackelford, Anders Larsson, Jeffrey A. Towbin, Jixiang Ma, Lynne Gaffikin, Konstantin Kazanjan, Mohammad Ali Sahraian, Mohammad H. Forouzanfar, Yichong Li, Felix Sayinzoga, Daniel Dicker, Philimon Gona, Maurice Giroud, Maysaa El Sayed Zaki, Shiwei Liu, Lorenzo Monasta, Chantal Huynh, Abdullatif Husseini, Ted R. Miller, Solomon Meseret Woldeyohannes, D. Alex Quistberg, Justin Beardsley, Majed Asad, Uʇur Dilmen, Alaa Badawi, Hsien-Ho Lin, Haidong Kan, Vinod K. Paul, Mitsuru Mukaigawara, James Leigh, Xiao Nong Zou, Sajjad Ur Rahman, Valentina Arsić Arsenijević, Gokalp Kadri Yentur, Man Mohan Mehndiratta, Murugesan Raju, Stephanie J. London, Kingsley N. Ukwaja, Young-Ho Khang, Knud Juel, Mohsen Naghavi, Rasmus Havmoeller, Gelin Xu, Semaw Ferede Abera, Devina Nand, Norito Kawakami, Neil Pearce, Elisabeth Barboza França, Ferrán Catalá-López, Ketevan Goginashvili, Vegard Skirbekk, Neeraj Bedi, Barthelemy Kuate Defo, Andrew H. Kemp, H. Dean Hosgood, Vafa Rahimi-Movaghar, Konrad Pesudovs, Linhong Wang, Xiao Rong Wang, Alan D. Lopez, Ademola Lukman Adelekan, Joshua A. Salomon, Walter Mendoza, Aref A. Bin Abdulhak, Ivy Shiue, G Anil Kumar, Yuichiro Yano, Luke D. Knibbs, Jung-Chen Chang, Yousef Khader, Caitlyn Steiner, Selen Begüm Uzun, Luciano A. Sposato, Gabrielle deVeber, Raghib Ali, Andre Pascal Kengne, Chakib Nejjari, Rafael Alfonso-Cristancho, Tania Georgina Sánchez Pimienta, Roberto Tchio Talongwa, Hilda L Harb, Ali H. Mokdad, Edward J Mills, Angel J Paternina Caicedo, Xiaohong Li, Luke Nyakarahuka, Diego De Leo, Rashmi Gupta, Robert G. Weintraub, Tim Driscoll, Sun Ha Jee, Carolina Maria Teixeira, Ole Frithjof Norheim, Zulfiqar A Bhutta, Hwashin Hyun Shin, Palwasha Anwari, Daniel Pope, Hassan Amini, Jae-Hyun Park, Saad B. Omer, Eric L. Ding, Narayanaswamy Venketasubramanian, Juan Liang, Tara Templin, Arindam Basu, Farshad Farzadfar, Yang Yang, Xuan Che, Scott Weichenthal, Jeyaraj D Pandian, David L. Tirschwell, Adrian Davis, Hilton Lam, Feng Tan, Stephen S Lim, Soewarta Kosen, Atsushi Goto, Ratilal Lalloo, Yanping Wang, Glen Mola, Paulo A. Lotufo, Dhruv S. Kazi, Jose C. Adsuar, Amany H Refaat, Ruben Castro, Gene F. Kwan, Johanna M. Geleijnse, Emerito Jose A. Faraon, Costas A. Christophi, Theo Vos, Sara Sheikhbahaei, Guilherme V. Polanczyk, Jed D. Blore, Azmeraw T. Amare, Kyle R. Heuton, Walid Ammar, Louisa Degenhardt, Andrew Vallely, Guohong Jiang, Ricky Leung, Jasvinder A. Singh, Zewdie Aderaw Alemu, A Artaman, Steven E. Lipshultz, Carlos A Castañeda-Orjuela, Seyed-Mohammad Fereshtehnejad, Sadaf G. Sepanlou, Mark J. Nieuwenhuijsen, John Q. Wong, Manami Inoue, Coen H. Van Gool, James D. Wilkinson, Ejaz Ahmad Khan, Yoshihiro Kokubo, Manuela Mendonca Felicio, Farshad Pourmalek, Boris I. Pavlin, Karen Sliwa, Robert G. Nelson, Tom Achoki, Edmond K. Kabagambe, Orish Ebere Orisakwe, Christopher J L Murray, In-Hwan Oh, Uchechukwu K.A. Sampson, Ulrich O Mueller, Austin E Schumacher, Edson Serván-Mori, Berrak Bora Basara, Simon I. Hay, Anil Kaul, Foad Abd-Allah, Takayoshi Ohkubo, Kim Yun Jin, Abdullah Sulieman Terkawi, Mall Leinsalu, Sergei Petrovich Ermakov, Marek Majdan, Ileana B. Heredia Pi, Christina Papachristou, Scott B. Patten, Rajeev Gupta, Kalpana Balakrishnan, Mustafa Z. Younis, Kenji Shibuya, Graça Maria Ferreira De Lima, Andrea P. Silva, Maziar Moradi-Lakeh, Anand Dayama, Eiman Jahangir, Stefan Ma, Karen M. Tabb, Nicholas J Kassebaum, Shams Eldin Ali Hassan Khalifa, Mazin J. Al Kahbouri, Nadim E. Karam, Jun Zhu, Chandrashekhar T Sreeramareddy, Dinorah González-Castell, Diego Gonzalez-Medina, Aliya Naheed, Ryan M Barber, Salvador Villalpando, Yang Liu, Chanda Kulkarni, Vinay Nangia, Haidong Wang, Yongmei Li, Rosario Cárdenas, Randah R. Hamadeh, Suzanne Polinder, Van C. Lansingh, François Alla, Max Petzold, Bryan L. Sykes, Ubai Alsharif, Chuanhua Yu, Francesco Saverio Violante, Monika Sawhney, Ayse Abbasoglu Ozgoren, Graeme J. Hankey, Mouhanad Hammami, Iuri da Costa Leite, Dickens Akena, Rintaro Mori, Alanur Çavlin, Maia Kereselidze, Jonathan de la Cruz Monis, Deena Alasfoor, Taavi Lai, Eric Y. Tenkorang, Cyrus Cooper, Sudan Prasad Neupane, Dan Poenaru, Veena S. Kulkarni, Naohiro Yonemoto, Elizabeth Glaser, Sergey Soshnikov, Ziad A. Memish, Paul N. Jensen, Fabiola Mejía-Rodríguez, Ana C. Garcia, Rakhi Dandona, Emilie Agardh, Katherine B Gibney, Vasco Manuel Pedro Machado, Michelle L. Bell, David M. Pereira, Muluemebet Abera Wordofa, Samantha M. Colquhoun, Elena Alvarez, Stephen G. Waller, Ketevan Gambashidze, Eduardo Bernabé, Rafael Lozano, Damian G Hoy, Miltiadis K. Tsilimbaris, Hebe N. Gouda, Muhammad Imran Nisar, Zanfina Ademi, Andrew L. Thorne-Lyman, Denis Nash, Dima M. Qato, Luca Ronfani, Nobhojit Roy, Donald H. Silberberg, Monica S. Vavilala, Lydia S. Atkins, Hans W. Hoek, Muluken Dessalegn, David C. Schwebel, Christopher C. Mapoma, Jost B. Jonas, Tolesa Bekele, Lalit Dandona, Borja del Pozo-Cruz, Sumeet S. Chugh, Johan Ärnlöv, Tariku Jibat Beyene, Melvin Barrientos Marzan, Ami R. Moore, Marie Ng, Maigeng Zhou, Samia Alhabib, Massimo Cirillo, Soraya Seedat, Paul S. F. Yip, Nima Hafezi-Nejad, Amelia Bertozzi-Villa, Kebede Deribe, John Nelson Opio, Peter J. Allen, Marina Shakh-Nazarova, Bach Xuan Tran, Arsène Kouablan Adou, Yingfeng Zheng, Julio Cesar Montañez Hernandez, Yong Zhao, Nelson Alvis-Guzman, Bulat Idrisov, Alireza Esteghamati, Seok Jun Yoon, Kathryn H. 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Anil, Kumar, Kaushalendra, Kumar, Ravi B., Kwan, Gene, Lai, Taavi, Lalloo, Ratilal, Lam, Hilton, Lansingh, Van C., Larsson, Ander, Lee, Jong-Tae, Leigh, Jame, Leinsalu, Mall, Leung, Ricky, Li, Xiaohong, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S., Lin, Hsien-Ho, Lipshultz, Steven E., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., London, Stephanie J., Lotufo, Paulo A., Ma, Jixiang, Ma, Stefan, Machado, Vasco Manuel Pedro, Mainoo, Nana Kwaku, Majdan, Marek, Mapoma, Christopher Chabila, Marcenes, Wagner, Marzan, Melvin Barriento, Mason-Jones, Amanda J., Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Memish, Ziad A., Mendoza, Walter, Miller, Ted R., Mills, Edward J., Mokdad, Ali H., Mola, Glen Liddell, Monasta, Lorenzo, De La Cruz Monis, Jonathan, Hernandez, Julio Cesar Montañez, Moore, Ami R., Moradi-Lakeh, Maziar, Mori, Rintaro, Mueller, Ulrich O., Mukaigawara, Mitsuru, Naheed, Aliya, Naidoo, Kovin S., Nand, Devina, Nangia, Vinay, Nash, Deni, Nejjari, Chakib, Nelson, Robert G., Neupane, Sudan Prasad, Newton, Charles R., Ng, Marie, Nieuwenhuijsen, Mark J., Nisar, Muhammad Imran, Nolte, Sandra, Norheim, Ole F., Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O., Omer, Saad B., Opio, John Nelson, Orisakwe, Orish Ebere, Pandian, Jeyaraj D., Papachristou, Christina, Park, Jae-Hyun, Paternina Caicedo, Angel J., Patten, Scott B., Paul, Vinod K., Pavlin, Boris Igor, Pearce, Neil, Pereira, David M., Pesudovs, Konrad, Petzold, Max, Poenaru, Dan, Polanczyk, Guilherme V., Polinder, Suzanne, Pope, Dan, Pourmalek, Farshad, Qato, Dima, Quistberg, D. Alex, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Ur Rahman, Sajjad, Raju, Murugesan, Rana, Saleem M., Refaat, Amany, Ronfani, Luca, Roy, Nobhojit, Pimienta, Tania Georgina Sánchez, Sahraian, Mohammad Ali, Salomon, Joshua A., Sampson, Uchechukwu, Santos, Itamar S., Sawhney, Monika, Sayinzoga, Felix, Schneider, Ione J.C., Schumacher, Austin, Schwebel, David C., Seedat, Soraya, Sepanlou, Sadaf G., Servan-Mori, Edson E., Shakh-Nazarova, Marina, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin Hyun, Shiue, Ivy, Sigfusdottir, Inga Dora, Silberberg, Donald H., Silva, Andrea P., Singh, Jasvinder A., Skirbekk, Vegard, Sliwa, Karen, Soshnikov, Sergey S., Sposato, Luciano A., Sreeramareddy, Chandrashekhar T., Stroumpoulis, Konstantino, Sturua, Lela, Sykes, Bryan L., Tabb, Karen M., Talongwa, Roberto Tchio, Tan, Feng, Teixeira, Carolina Maria, Tenkorang, Eric Yeboah, Terkawi, Abdullah Sulieman, Thorne-Lyman, Andrew L., Tirschwell, David L., Towbin, Jeffrey A., Tran, Bach X., Tsilimbaris, Miltiadi, Uchendu, Uche S., Ukwaja, Kingsley N., Undurraga, Eduardo A., Uzun, Selen Begüm, Vallely, Andrew J., Van Gool, Coen H., Vasankari, Tommi J., Vavilala, Monica S., Venketasubramanian, N., Villalpando, Salvador, Violante, Francesco S., Vlassov, Vasiliy Victorovich, Vos, Theo, Waller, Stephen, Wang, Haidong, Wang, Linhong, Wang, Xiao Rong, Wang, Yanping, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G., Westerman, Ronny, Wilkinson, James D., Woldeyohannes, Solomon Meseret, Wong, John Q., Wordofa, Muluemebet Abera, Xu, Gelin, Yang, Yang C., Yano, Yuichiro, Yentur, Gokalp Kadri, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z., Yu, Chuanhua, Jin, Kim Yun, El Sayed Zaki, Maysaa, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zou, Xiao Nong, Lopez, Alan D., Naghavi, Mohsen, Murray, Christopher J.L., Lozano, Rafael, Kassebaum, Nj, Bertozzi-Villa, A, Coggeshall, M, Shackelford, Ka, Steiner, C, Heuton, Kr, Gonzalez-Medina, D, Barber, R, Huynh, C, 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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

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

Author

Karen Sliwa, Xiaofeng Liang, Vivekanand Jha, Dorairaj Prabhakaran, Rakhi Dandona, Gonghuan Yang, Xuan Che, Soewarta Kosen, Sergei Petrovich Ermakov, Ted R. Miller, Samath D Dharmaratne, Philimon Gona, Sergey Soshnikov, Atsushi Goto, Costas A. Christophi, Zacharie Tsala Dimbuene, Elena Alvarez, Yanping Wang, Peggy Pei-Chia Chiang, Mohammad H. Forouzanfar, Giancarlo Logroscino, Massimo Cirillo, Knud Juel, Johanna M. Geleijnse, Stefan Ma, Samaya Ismayilova, Karen Fern Greenwell, Michelle L. Bell, Saad B. Omer, Ademola Lukman Adelekan, Joshua A. Salomon, Dhruv S. Kazi, Jed D. Blore, Walid Ammar, Carly E Levitz, Kovin Naidoo, Solveig A. Cunningham, Stephen G. Waller, Anand Dayama, James D. Wilkinson, Vasiliki Stathopoulou, Meghan D. Mooney, Mall Leinsalu, Jonathan R. Carapetis, Paul S. F. Yip, Anders Larsson, Abbas Ali Mahdi, Hideaki Toyoshima, Guohong Jiang, Xia Wan, Chuanhua Yu, Soufiane Boufous, Ivy Shiue, Bulat Idrisov, Qing Lan, Chelsea A. Liddell, Austin E Schumacher, Valeria Caso, Nigel Bruce, Paulo A. Lotufo, Ibrahim Abubakar, Roberto Tchio Talongwa, Luke Nyakarahuka, Edward J Mills, Iuri da Costa Leite, Semaw Ferede Abera, Ana C. Garcia, Ayse Abbasoglu Ozgoren, Matthew M Coates, Konstantinos Stroumpoulis, Bradford D. Gessner, Kebede Deribe, Tommi Vasankari, Logan Sandar, Kenji Shibuya, Karen M. Tabb, Troy Jacobs, Christopher J L Murray, Chakib Nejjari, Katherine T. Lofgren, Melvin Barrientos Marzan, Haidong Wang, Joanna Moschandreas, Raimundas Lunevicius, Nataliya Foigt, Rashmi Gupta, Ziad A. Memish, Victoria Pillay-van Wyk, Randah R. Hamadeh, Azmeraw T. Amare, Lalit Dandona, Uchechukwu K.A. Sampson, Monika Sawhney, Vasiliy Victorovich Vlassov, Farhad Islami, Palwasha Anwari, Mustafa Z. Younis, Amitava Banerjee, Ruben Castro, David O. Carpenter, Karzan Abdulmuhsin Mohammad, Taavi Lai, Yousef Khader, Sara Sheikhbahaei, Atte Meretoja, Zanfina Ademi, Ivo Rakovac, Yang Yang, Hilda L Harb, Daniel Pope, Jun She, Yichong Li, Andrew L. Thorne-Lyman, Adrian Davis, Stein Emil Vollset, Andre Pascal Kengne, Henry Apfel, Mark J. Nieuwenhuijsen, John J. McGrath, Yoshihiro Kokubo, Jonas Minet Kinge, Elisabete Weiderpass, Rajiv Chowdhury, Damian G Hoy, Jürgen C Schmidt, Seyed-Mohammad Fereshtehnejad, Harish Chander Gugnani, Hywel C Williams, Karen Edmond, Peter J. Allen, Marina Shakh-Nazarova, Tom Achoki, Edmond K. Kabagambe, Naohiro Yonemoto, Jun Zhu, Simon I. Hay, Karen J. Courville, Ketevan Goginashvili, Theo Vos, Kim Yun Jin, Kawkab Shishani, Lorenzo Monasta, H. Dean Hosgood, Uʇur Dilmen, Marcella Montico, Shankuan Zhu, Ami R. Moore, Marie Ng, Maigeng Zhou, Hebe N. Gouda, Linh N Bui, Sanjay Basu, Mouhanad Hammami, Mohammad T Mashal, Bryan K. Phillips, Marissa Iannarone, Ronan A Lyons, Young-Ho Khang, Robert G. Weintraub, Luca Ronfani, Daniel Kim, Alanur Çavlin, Ferrán Catalá-López, Ronny Westerman, Maia Kereselidze, Itamar S. Santos, Reza Assadi, Hwashin Hyun Shin, Carolina Maria Teixeira, Berrak Bora Basara, David Rojas-Rueda, Abdullah Sulieman Terkawi, Adansi A. Amankwaa, Nicholas J K Breitborde, Gokalp Kadri Yentur, Kaushalendra Kumar, Daniel Obadare Fijabi, Neeraj Bedi, Robert Quentin Reilly, Ana Maria Nogales Vasconcelos, Scott Weichenthal, Mark A. Green, Selen Begüm Uzun, Mukesh Dherani, Shams Eldin Ali Hassan Khalifa, Majed Asad, Jasvinder A. Singh, Angel J Paternina Caicedo, Eric L. Ding, Jost B. Jonas, Tolesa Bekele, Alan J Thomson, Steven E. Lipshultz, Rosario Cárdenas, Sajjad Ur Rahman, George A. Mensah, Jongmin Lee, Inga Dora Sigfusdottir, Mohammad Yahya Saeedi, Magdalena M. Muszyńska, Ulrich O Mueller, Stephen S Lim, Barthelemy Kuate Defo, Alan D. Lopez, Luciano A. Sposato, G Anil Kumar, Farshad Pourmalek, Zulfiqar A Bhutta, Maysaa El Sayed Zaki, Shiwei Liu, K.M. Venkat Narayan, William Msemburi, Ting Wu Chuang, Zewdie Aderaw Alemu, Saleem M Rana, Mohammad Taghi Hedayati, Mohsen Naghavi, Vegard Skirbekk, Walter Mendoza, Ali H. Mokdad, Yohannes Kinfu, Jean de Dieu Ngirabega, Takayoshi Ohkubo, Parfait Uwaliraye, Tasara T. Mazorodze, Farshad Farzadfar, Rob E. Dorrington, Mohammad A. AlMazroa, R. Kumar, Lesley Rushton, Wang, H, Liddell, Ca, Coates, Mm, Mooney, Md, Levitz, Ce, Schumacher, Ae, Apfel, H, Iannarone, M, Phillips, B, Lofgren, Kt, Sandar, L, Dorrington, Re, Rakovac, I, Jacobs, Ta, Liang, X, Zhou, M, Zhu, J, Yang, G, Wang, Y, Liu, S, Li, Y, Ozgoren, Aa, Abera, Sf, Abubakar, I, Achoki, T, Adelekan, A, Ademi, Z, Alemu, Za, Allen, Pj, Almazroa, Ma, Alvarez, E, Amankwaa, Aa, Amare, At, Ammar, W, Anwari, P, Cunningham, Sa, Asad, Mm, Assadi, R, Banerjee, A, Basu, S, Bedi, N, Bekele, T, Bell, Ml, Bhutta, Z, Blore, J, Basara, Bb, Boufous, S, Breitborde, N, Bruce, Ng, Bui, Ln, Carapetis, Jr, Cárdenas, R, Carpenter, Do, Caso, V, Castro, Re, Catalá Lopéz, F, Cavlin, A, Che, X, Chiang, Pp, Chowdhury, R, Christophi, Ca, Chuang, Tw, Cirillo, Massimo, da Costa Leite, I, Courville, Kj, Dandona, L, Dandona, R, Davis, A, Dayama, A, Deribe, K, Dharmaratne, Sd, Dherani, Mk, Dilmen, U, Ding, El, Edmond, Km, Ermakov, Sp, Farzadfar, F, Fereshtehnejad, Sm, Fijabi, Do, Foigt, N, Forouzanfar, Mh, Garcia, Ac, Geleijnse, Jm, Gessner, Bd, Goginashvili, K, Gona, P, Goto, A, Gouda, Hn, Green, Ma, Greenwell, Kf, Gugnani, Hc, Gupta, R, Hamadeh, Rr, Hammami, M, Harb, Hl, Hay, S, Hedayati, Mt, Hosgood, Hd, Hoy, Dg, Idrisov, Bt, Islami, F, Ismayilova, S, Jha, V, Jiang, G, Jonas, Jb, Juel, K, Kabagambe, Ek, Kazi, D, Kengne, Ap, Kereselidze, M, Khader, Y, Khalifa, Se, Khang, Yh, Kim, D, Kinfu, Y, Kinge, Jm, Kokubo, Y, Kosen, S, Defo, Bk, Kumar, Ga, Kumar, K, Kumar, Rb, Lai, T, Lan, Q, Larsson, A, Lee, Jt, Leinsalu, M, Lim, S, Lipshultz, Se, Logroscino, G, Lotufo, Pa, Lunevicius, R, Lyons, Ra, Ma, S, Mahdi, Aa, Marzan, Mb, Mashal, Mt, Mazorodze, Tt, Mcgrath, Jj, Memish, Za, Mendoza, W, Mensah, Ga, Meretoja, A, Miller, Tr, Mills, Ej, Mohammad, Ka, Mokdad, Ah, Monasta, L, Montico, M, Moore, Ar, Moschandreas, J, Msemburi, Wt, Mueller, Uo, Muszynska, Mm, Naghavi, M, Naidoo, K, Narayan, Kv, Nejjari, C, Ng, M, de Dieu Ngirabega, J, Nieuwenhuijsen, Mj, Nyakarahuka, L, Ohkubo, T, Omer, Sb, Caicedo, Aj, Wyk, Vp, Pope, D, Prabhakaran, D, Rahman, Su, Rana, Sm, Reilly, Rq, Rojas Rueda, D, Ronfani, L, Rushton, L, Saeedi, My, Salomon, J, Sampson, U, Santos, I, Sawhney, M, Schmidt, Jc, Shakh Nazarova, M, She, J, Sheikhbahaei, S, Shibuya, K, Shin, Hh, Shishani, K, Shiue, I, Sigfusdottir, Id, Singh, Ja, Skirbekk, V, Sliwa, K, Soshnikov, S, Sposato, La, Stathopoulou, Vk, Stroumpoulis, K, Tabb, Km, Talongwa, Rt, Teixeira, Cm, Terkawi, A, Thomson, Aj, Thorne Lyman, Al, Toyoshima, H, Dimbuene, Zt, Uwaliraye, P, Uzun, Sb, Vasankari, Tj, Vasconcelos, Am, Vlassov, Vv, Vollset, Se, Vos, T, Waller, S, Wan, X, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Westerman, R, Wilkinson, Jd, Williams, Hc, Yang, Yc, Yentur, Gk, Yip, P, Yonemoto, N, Younis, M, Yu, C, Jin, Ky, El Sayed Zaki, M, Zhu, S, Lopez, Ad, and Murray, C. J.

Subjects
trends, Pediatrics, medicine.medical_specialty, Nutrition and Disease, democracy, Developing country, coverage, VDP::Medisinske fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803, millennium development goals, Global Health, survival, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, 030225 pediatrics, Voeding en Ziekte, Infant Mortality, Global health, Humans, Organizational Objectives, Medicine, 030212 general & internal medicine, 10. No inequality, VLAG, business.industry, Mortality rate, Infant, Newborn, 1. No poverty, Infant, health, General Medicine, Millennium Development Goals, Infant mortality, maternal education, 3. Good health, Secular variation, Child mortality, Socioeconomic Factors, income countries, Child, Preschool, Child Mortality, developing-countries, VDP::Midical sciences: 700::Health sciences: 800::Epidemiology, medical and dental statistics: 803, International development, business, Demography, child-mortality
Abstract

Summary Background Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success. Methods We generated updated estimates of child mortality in early neonatal (age 0–6 days), late neonatal (7–28 days), postneonatal (29–364 days), childhood (1–4 years), and under-5 (0–4 years) age groups for 188 countries from 1970 to 2013, with more than 29 000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030. Findings We estimated that 6·3 million (95% UI 6·0–6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1–18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6–177·4) in Guinea-Bissau to 2·3 (1·8–2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from −6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000–13 than during 1990–2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only −1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone. Interpretation Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030. Funding Bill & Melinda Gates Foundation, US Agency for International Development.

Published
2014

8. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Author

Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, Brauer M, Burnett R, Casey D, Coates MM, Cohen A, Delwiche K, Estep K, Frostad JJ, Astha KC, Kyu HH, Moradi-Lakeh M, Ng M, Slepak EL, Thomas BA, Wagner J, Aasvang GM, Abbafati C, Abbasoglu Ozgoren A, Abd-Allah F, Abera SF, Aboyans V, Abraham B, Abraham JP, Abubakar I, Abu-Rmeileh NM, Aburto TC, Achoki T, Adelekan A, Adofo K, Adou AK, Adsuar JC, Afshin A, Agardh EE, Al Khabouri MJ, Al Lami FH, Alam SS, Alasfoor D, Albittar MI, Alegretti MA, Aleman AV, Alemu ZA, Alfonso-Cristancho R, Alhabib S, Ali R, Ali MK, Alla F, Allebeck P, Allen PJ, Alsharif U, Alvarez E, Alvis-Guzman N, Amankwaa AA, Amare AT, Ameh EA, Ameli O, Amini H, Ammar W, Anderson BO, Antonio CA, Anwari P, Argeseanu Cunningham S, Arnlöv J, Arsenijevic VS, Artaman A, Asghar RJ, Assadi R, Atkins LS, Atkinson C, Avila MA, Awuah B, Badawi A, Bahit MC, Bakfalouni T, Balakrishnan K, Balalla S, Balu RK, Banerjee A, Barber RM, Barker-Collo SL, Barquera S, Barregard L, Barrero LH, Barrientos-Gutierrez T, Basto-Abreu AC, Basu A, Basu S, Basulaiman MO, Batis Ruvalcaba C, Beardsley J, Bedi N, Bekele T, Bell ML, Benjet C, Bennett DA, Benzian H, Bernabé E, Beyene TJ, Bhala N, Bhalla A, Bhutta ZA, Bikbov B, Bin Abdulhak AA, Blore JD, Blyth FM, Bohensky MA, Bora Başara B, Borges G, Bornstein NM, Bose D, Boufous S, Bourne RR, Brainin M, Brazinova A, Breitborde NJ, Brenner H, Briggs AD, Broday DM, Brooks PM, Bruce NG, Brugha TS, Brunekreef B, Buchbinder R, Bui LN, Bukhman G, Bulloch AG, Burch M, Burney PG, Campos-Nonato IR, Campuzano JC, Cantoral AJ, Caravanos J, Cárdenas R, Cardis E, Carpenter DO, Caso V, Castañeda-Orjuela CA, Castro RE, Catalá-López F, Cavalleri F, Çavlin A, Chadha VK, Chang JC, Charlson FJ, Chen H, Chen W, Chen Z, Chiang PP, Chimed-Ochir O, Chowdhury R, Christophi CA, Chuang TW, Chugh SS, Cirillo M, Claßen TK, Colistro V, Colomar M, Colquhoun SM, Contreras AG, Cooper C, Cooperrider K, Cooper LT, Coresh J, Courville KJ, Criqui MH, Cuevas-Nasu L, Damsere-Derry J, Danawi H, Dandona L, Dandona R, Dargan PI, Davis A, Davitoiu DV, Dayama A, de Castro EF, De la Cruz-Góngora V, De Leo D, de Lima G, Degenhardt L, del Pozo-Cruz B, Dellavalle RP, Deribe K, Derrett S, Des Jarlais DC, Dessalegn M, deVeber GA, Devries KM, Dharmaratne SD, Dherani MK, Dicker D, Ding EL, Dokova K, Dorsey ER, Driscoll TR, Duan L, Durrani AM, Ebel BE, Ellenbogen RG, Elshrek YM, Endres M, Ermakov SP, Erskine HE, Eshrati B, Esteghamati A, Fahimi S, Faraon EJ, Farzadfar F, Fay DF, Feigin VL, Feigl AB, Fereshtehnejad SM, Ferrari AJ, Ferri CP, Flaxman AD, Fleming TD, Foigt N, Foreman KJ, Paleo UF, Franklin RC, Gabbe B, Gaffikin L, Gakidou E, Gamkrelidze A, Gankpé FG, Gansevoort RT, García-Guerra FA, Gasana E, Geleijnse JM, Gessner BD, Gething P, Gibney KB, Gillum RF, Ginawi IA, Giroud M, Giussani G, Goenka S, Goginashvili K, Gomez Dantes H, Gona P, Gonzalez de Cosio T, González-Castell D, Gotay CC, Goto A, Gouda HN, Guerrant RL, Gugnani HC, Guillemin F, Gunnell D, Gupta R, Gupta R, Gutiérrez RA, Hafezi-Nejad N, Hagan H, Hagstromer M, Halasa YA, Hamadeh RR, Hammami M, Hankey GJ, Hao Y, Harb HL, Haregu TN, Haro JM, Havmoeller R, Hay SI, Hedayati MT, Heredia-Pi IB, Hernandez L, Heuton KR, Heydarpour P, Hijar M, Hoek HW, Hoffman HJ, Hornberger JC, Hosgood HD, Hoy DG, Hsairi M, Hu G, Hu H, Huang C, Huang JJ, Hubbell BJ, Huiart L, Husseini A, Iannarone ML, Iburg KM, Idrisov BT, Ikeda N, Innos K, Inoue M, Islami F, Ismayilova S, Jacobsen KH, Jansen HA, Jarvis DL, Jassal SK, Jauregui A, Jayaraman S, Jeemon P, Jensen PN, Jha V, Jiang F, Jiang G, Jiang Y, Jonas JB, Juel K, Kan H, Kany Roseline SS, Karam NE, Karch A, Karema CK, Karthikeyan G, Kaul A, Kawakami N, Kazi DS, Kemp AH, Kengne AP, Keren A, Khader YS, Khalifa SE, Khan EA, Khang YH, Khatibzadeh S, Khonelidze I, Kieling C, Kim D, Kim S, Kim Y, Kimokoti RW, Kinfu Y, Kinge JM, Kissela BM, Kivipelto M, Knibbs LD, Knudsen AK, Kokubo Y, Kose MR, Kosen S, Kraemer A, Kravchenko M, Krishnaswami S, Kromhout H, Ku T, Kuate Defo B, Kucuk Bicer B, Kuipers EJ, Kulkarni C, Kulkarni VS, Kumar GA, Kwan GF, Lai T, Lakshmana Balaji A, Lalloo R, Lallukka T, Lam H, Lan Q, Lansingh VC, Larson HJ, Larsson A, Laryea DO, Lavados PM, Lawrynowicz AE, Leasher JL, Lee JT, Leigh J, Leung R, Levi M, Li Y, Li Y, Liang J, Liang X, Lim SS, Lindsay MP, Lipshultz SE, Liu S, Liu Y, Lloyd BK, Logroscino G, London SJ, Lopez N, Lortet-Tieulent J, Lotufo PA, Lozano R, Lunevicius R, Ma J, Ma S, Machado VM, MacIntyre MF, Magis-Rodriguez C, Mahdi AA, Majdan M, Malekzadeh R, Mangalam S, Mapoma CC, Marape M, Marcenes W, Margolis DJ, Margono C, Marks GB, Martin RV, Marzan MB, Mashal MT, Masiye F, Mason-Jones AJ, Matsushita K, Matzopoulos R, Mayosi BM, Mazorodze TT, McKay AC, McKee M, McLain A, Meaney PA, Medina C, Mehndiratta MM, Mejia-Rodriguez F, Mekonnen W, Melaku YA, Meltzer M, Memish ZA, Mendoza W, Mensah GA, Meretoja A, Mhimbira FA, Micha R, Miller TR, Mills EJ, Misganaw A, Mishra S, Mohamed Ibrahim N, Mohammad KA, Mokdad AH, Mola GL, Monasta L, Montañez Hernandez JC, Montico M, Moore AR, Morawska L, Mori R, Moschandreas J, Moturi WN, Mozaffarian D, Mueller UO, Mukaigawara M, Mullany EC, Murthy KS, Naghavi M, Nahas Z, Naheed A, Naidoo KS, Naldi L, Nand D, Nangia V, Narayan KM, Nash D, Neal B, Nejjari C, Neupane SP, Newton CR, Ngalesoni FN, Ngirabega Jde D, Nguyen G, Nguyen NT, Nieuwenhuijsen MJ, Nisar MI, Nogueira JR, Nolla JM, Nolte S, Norheim OF, Norman RE, Norrving B, Nyakarahuka L, Oh IH, Ohkubo T, Olusanya BO, Omer SB, Opio JN, Orozco R, Pagcatipunan RS Jr, Pain AW, Pandian JD, Panelo CI, Papachristou C, Park EK, Parry CD, Paternina Caicedo AJ, Patten SB, Paul VK, Pavlin BI, Pearce N, Pedraza LS, Pedroza A, Pejin Stokic L, Pekericli A, Pereira DM, Perez-Padilla R, Perez-Ruiz F, Perico N, Perry SA, Pervaiz A, Pesudovs K, Peterson CB, Petzold M, Phillips MR, Phua HP, Plass D, Poenaru D, Polanczyk GV, Polinder S, Pond CD, Pope CA, Pope D, Popova S, Pourmalek F, Powles J, Prabhakaran D, Prasad NM, Qato DM, Quezada AD, Quistberg DA, Racapé L, Rafay A, Rahimi K, Rahimi-Movaghar V, Rahman SU, Raju M, Rakovac I, Rana SM, Rao M, Razavi H, Reddy KS, Refaat AH, Rehm J, Remuzzi G, Ribeiro AL, Riccio PM, Richardson L, Riederer A, Robinson M, Roca A, Rodriguez A, Rojas-Rueda D, Romieu I, Ronfani L, Room R, Roy N, Ruhago GM, Rushton L, Sabin N, Sacco RL, Saha S, Sahathevan R, Sahraian MA, Salomon JA, Salvo D, Sampson UK, Sanabria JR, Sanchez LM, Sánchez-Pimienta TG, Sanchez-Riera L, Sandar L, Santos IS, Sapkota A, Satpathy M, Saunders JE, Sawhney M, Saylan MI, Scarborough P, Schmidt JC, Schneider IJ, Schöttker B, Schwebel DC, Scott JG, Seedat S, Sepanlou SG, Serdar B, Servan-Mori EE, Shaddick G, Shahraz S, Levy TS, Shangguan S, She J, Sheikhbahaei S, Shibuya K, Shin HH, Shinohara Y, Shiri R, Shishani K, Shiue I, Sigfusdottir ID, Silberberg DH, Simard EP, Sindi S, Singh A, Singh GM, Singh JA, Skirbekk V, Sliwa K, Soljak M, Soneji S, Søreide K, Soshnikov S, Sposato LA, Sreeramareddy CT, Stapelberg NJ, Stathopoulou V, Steckling N, Stein DJ, Stein MB, Stephens N, Stöckl H, Straif K, Stroumpoulis K, Sturua L, Sunguya BF, Swaminathan S, Swaroop M, Sykes BL, Tabb KM, Takahashi K, Talongwa RT, Tandon N, Tanne D, Tanner M, Tavakkoli M, Te Ao BJ, Teixeira CM, Téllez Rojo MM, Terkawi AS, Texcalac-Sangrador JL, Thackway SV, Thomson B, Thorne-Lyman AL, Thrift AG, Thurston GD, Tillmann T, Tobollik M, Tonelli M, Topouzis F, Towbin JA, Toyoshima H, Traebert J, Tran BX, Trasande L, Trillini M, Trujillo U, Dimbuene ZT, Tsilimbaris M, Tuzcu EM, Uchendu US, Ukwaja KN, Uzun SB, van de Vijver S, Van Dingenen R, van Gool CH, van Os J, Varakin YY, Vasankari TJ, Vasconcelos AM, Vavilala MS, Veerman LJ, Velasquez-Melendez G, Venketasubramanian N, Vijayakumar L, Villalpando S, Violante FS, Vlassov VV, Vollset SE, Wagner GR, Waller SG, Wallin MT, Wan X, Wang H, Wang J, Wang L, Wang W, Wang Y, Warouw TS, Watts CH, Weichenthal S, Weiderpass E, Weintraub RG, Werdecker A, Wessells KR, Westerman R, Whiteford HA, Wilkinson JD, Williams HC, Williams TN, Woldeyohannes SM, Wolfe CD, Wong JQ, Woolf AD, Wright JL, Wurtz B, Xu G, Yan LL, Yang G, Yano Y, Ye P, Yenesew M, Yentür GK, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Younoussi Z, Yu C, Zaki ME, Zhao Y, Zheng Y, Zhou M, Zhu J, Zhu S, Zou X, Zunt JR, Lopez AD, Vos T, and Murray CJ

Subjects
Female, Global Health statistics & numerical data, Health Behavior, Humans, Male, Nutritional Status, Occupational Exposure adverse effects, Risk Assessment methods, Risk Factors, Sanitation trends, Environmental Exposure adverse effects, Global Health trends, Metabolic Diseases epidemiology, Occupational Diseases epidemiology
Abstract

Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution., Methods: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol., Findings: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa., Interpretation: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks., Funding: Bill & Melinda Gates Foundation., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Published
2015
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9. 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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10. 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

Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, 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, Abubakar I, 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 VS, Artaman A, Asad MM, Asghar RJ, Assadi R, Atkins LS, 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 JD, 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 SS, 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, Gupta R, Hafezi-Nejad N, Hamadeh RR, Hammami M, Hankey GJ, Harb HL, Havmoeller R, Hay SI, 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, Jonas JB, Juel K, Kabagambe EK, Kan H, Karam NE, Karch A, Karema CK, Kaul A, Kawakami N, Kazanjan K, Kazi DS, Kemp AH, Kengne AP, Kereselidze M, Khader YS, Khalifa SE, Khan EA, Khang YH, Knibbs L, Kokubo Y, Kosen S, Defo BK, Kulkarni C, Kulkarni VS, 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, Li Y, Liang J, Liang X, Lim SS, 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, Moradi-Lakeh M, Mori R, Mueller UO, Mukaigawara M, Naheed A, Naidoo KS, 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 JA, Sampson U, Santos IS, 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 SS, Sposato LA, Sreeramareddy CT, Stroumpoulis K, Sturua L, Sykes BL, Tabb KM, Talongwa RT, Tan F, Teixeira CM, Tenkorang EY, Terkawi AS, Thorne-Lyman AL, Tirschwell DL, Towbin JA, Tran BX, Tsilimbaris M, Uchendu US, Ukwaja KN, Undurraga EA, Uzun SB, Vallely AJ, van Gool CH, Vasankari TJ, Vavilala MS, Venketasubramanian N, Villalpando S, Violante FS, Vlassov VV, Vos T, Waller S, Wang H, Wang L, Wang X, 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, and Lozano R

Subjects
Age Distribution, Cause of Death trends, Female, Global Health statistics & numerical data, HIV Infections mortality, Humans, Models, Statistical, Organizational Objectives, Pregnancy, Pregnancy Complications, Infectious mortality, Risk Factors, Socioeconomic Factors, Time Factors, Global Health trends, Maternal Mortality trends
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., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Published
2014
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11. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Author

Wang H, Liddell CA, Coates MM, Mooney MD, Levitz CE, Schumacher AE, Apfel H, Iannarone M, Phillips B, Lofgren KT, Sandar L, Dorrington RE, Rakovac I, Jacobs TA, Liang X, Zhou M, Zhu J, Yang G, Wang Y, Liu S, Li Y, Ozgoren AA, Abera SF, Abubakar I, Achoki T, Adelekan A, Ademi Z, Alemu ZA, Allen PJ, AlMazroa MA, Alvarez E, Amankwaa AA, Amare AT, Ammar W, Anwari P, Cunningham SA, Asad MM, Assadi R, Banerjee A, Basu S, Bedi N, Bekele T, Bell ML, Bhutta Z, Blore JD, Basara BB, Boufous S, Breitborde N, Bruce NG, Bui LN, Carapetis JR, Cárdenas R, Carpenter DO, Caso V, Castro RE, Catalá-Lopéz F, Cavlin A, Che X, Chiang PP, Chowdhury R, Christophi CA, Chuang TW, Cirillo M, da Costa Leite I, Courville KJ, Dandona L, Dandona R, Davis A, Dayama A, Deribe K, Dharmaratne SD, Dherani MK, Dilmen U, Ding EL, Edmond KM, Ermakov SP, Farzadfar F, Fereshtehnejad SM, Fijabi DO, Foigt N, Forouzanfar MH, Garcia AC, Geleijnse JM, Gessner BD, Goginashvili K, Gona P, Goto A, Gouda HN, Green MA, Greenwell KF, Gugnani HC, Gupta R, Hamadeh RR, Hammami M, Harb HL, Hay S, Hedayati MT, Hosgood HD, Hoy DG, Idrisov BT, Islami F, Ismayilova S, Jha V, Jiang G, Jonas JB, Juel K, Kabagambe EK, Kazi DS, Kengne AP, Kereselidze M, Khader YS, Khalifa SE, Khang YH, Kim D, Kinfu Y, Kinge JM, Kokubo Y, Kosen S, Defo BK, Kumar GA, Kumar K, Kumar RB, Lai T, Lan Q, Larsson A, Lee JT, Leinsalu M, Lim SS, Lipshultz SE, Logroscino G, Lotufo PA, Lunevicius R, Lyons RA, Ma S, Mahdi AA, Marzan MB, Mashal MT, Mazorodze TT, McGrath JJ, Memish ZA, Mendoza W, Mensah GA, Meretoja A, Miller TR, Mills EJ, Mohammad KA, Mokdad AH, Monasta L, Montico M, Moore AR, Moschandreas J, Msemburi WT, Mueller UO, Muszynska MM, Naghavi M, Naidoo KS, Narayan KM, Nejjari C, Ng M, de Dieu Ngirabega J, Nieuwenhuijsen MJ, Nyakarahuka L, Ohkubo T, Omer SB, Caicedo AJ, Pillay-van Wyk V, Pope D, Pourmalek F, Prabhakaran D, Rahman SU, Rana SM, Reilly RQ, Rojas-Rueda D, Ronfani L, Rushton L, Saeedi MY, Salomon JA, Sampson U, Santos IS, Sawhney M, Schmidt JC, Shakh-Nazarova M, She J, Sheikhbahaei S, Shibuya K, Shin HH, Shishani K, Shiue I, Sigfusdottir ID, Singh JA, Skirbekk V, Sliwa K, Soshnikov SS, Sposato LA, Stathopoulou VK, Stroumpoulis K, Tabb KM, Talongwa RT, Teixeira CM, Terkawi AS, Thomson AJ, Thorne-Lyman AL, Toyoshima H, Dimbuene ZT, Uwaliraye P, Uzun SB, Vasankari TJ, Vasconcelos AM, Vlassov VV, Vollset SE, Waller S, Wan X, Weichenthal S, Weiderpass E, Weintraub RG, Westerman R, Wilkinson JD, Williams HC, Yang YC, Yentur GK, Yip P, Yonemoto N, Younis M, Yu C, Jin KY, El Sayed Zaki M, Zhu S, Vos T, Lopez AD, and Murray CJ

Subjects
Child, Preschool, Global Health statistics & numerical data, Humans, Infant, Infant, Newborn, Organizational Objectives, Risk Factors, Socioeconomic Factors, Child Mortality trends, Global Health trends, Infant Mortality trends
Abstract

Background: Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success., Methods: We generated updated estimates of child mortality in early neonatal (age 0-6 days), late neonatal (7-28 days), postneonatal (29-364 days), childhood (1-4 years), and under-5 (0-4 years) age groups for 188 countries from 1970 to 2013, with more than 29,000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030., Findings: We estimated that 6·3 million (95% UI 6·0-6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1-18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6-177·4) in Guinea-Bissau to 2·3 (1·8-2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from -6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000-13 than during 1990-2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only -1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone., Interpretation: Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030., Funding: Bill & Melinda Gates Foundation, US Agency for International Development., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Published
2014
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