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1. Provider adherence to clinical care recommendations for infants and children who died in seven low- and middle-income countries in the Child Health and Mortality Prevention Surveillance (CHAMPS) networkResearch in context

Author: Chris A. Rees, Kitiezo Aggrey Igunza, Zachary J. Madewell, Victor Akelo, Dickens Onyango, Shams El Arifeen, Emily S. Gurley, Mohammad Zahid Hossain, Afruna Rahman, Muntasir Alam, J. Anthony G. Scott, Nega Assefa, Lola Madrid, Anteneh Belachew, Haleluya Leulseged, Karen L. Kotloff, Samba O. Sow, Milagritos D. Tapia, Adama Mamby Keita, Diakaridia Sidibe, Antonio Sitoe, Rosauro Varo, Sara Ajanovic, Quique Bassat, Inácio Mandomando, Beth A. Tippett Barr, Ikechukwu Ogbuanu, Carrie Jo Cain, Ima-Abasi Bassey, Ronita Luke, Khadija Gassama, Shabir Madhi, Ziyaad Dangor, Sana Mahtab, Sithembiso Velaphi, Jeanie du Toit, Portia C. Mutevedzi, Dianna M. Blau, Robert F. Breiman, Cynthia G. Whitney, Fatima Solomon, Gillian Sorour, Hennie Lombaard, Jeannette Wadula, Karen Petersen, Martin Hale, Nelesh P. Govender, Peter J. Swart, Sanjay G. Lala, Richard Chawana, Yasmin Adam, Amy Wise, Ashleigh Fritz, Nellie Myburgh, Pedzisai Ndagurwa, Cleopas Hwinya, Sanwarul Bari, Shahana Parveen, Mohammed Kamal, A.S.M. Nawshad Uddin Ahmed, Mahbubul Hoque, Saria Tasnim, Ferdousi Islam, Farida Ariuman, Mohammad Mosiur Rahman, Ferdousi Begum, K. Zaman, Mustafizur Rahman, Dilruba Ahmed, Meerjady Sabrina Flora, Tahmina Shirin, Mahbubur Rahman, Joseph Oundo, Alexander M. Ibrahim, Fikremelekot Temesgen, Tadesse Gure, Addisu Alemu, Melisachew Mulatu Yeshi, Mahlet Abayneh Gizaw, Stian Orlien, Solomon Ali, Peter Otieno, Peter Nyamthimba Onyango, Janet Agaya, Richard Oliech, Joyce Akinyi Were, Dickson Gethi, Sammy Khagayi, George Aol, Thomas Misore, Harun Owuor, Christopher Mugah, Bernard Oluoch, Christine Ochola, Sharon M. Tennant, Carol L. Greene, Ashka Mehta, J. Kristie Johnson, Brigitte Gaume, Rima Koka, Karen D. Fairchild, Diakaridia Kone, Doh Sanogo, Uma U. Onwuchekwa, Nana Kourouma, Seydou Sissoko, Cheick Bougadari Traore, Jane Juma, Kounandji Diarra, Awa Traore, Tiéman Diarra, Kiranpreet Chawla, Tacilta Nhampossa, Zara Manhique, Sibone Mocumbi, Clara Menéndez, Khátia Munguambe, Ariel Nhacolo, Maria Maixenchs, Andrew Moseray, Fatmata Bintu Tarawally, Martin Seppeh, Ronald Mash, Julius Ojulong, Babatunde Duduyemi, James Bunn, Alim Swaray-Deen, Joseph Bangura, Amara Jambai, Margaret Mannah, Okokon Ita, Cornell Chukwuegbo, Sulaiman Sannoh, Princewill Nwajiobi, Dickens Kowuor, Erick Kaluma, Oluseyi Balogun, Solomon Samura, Samuel Pratt, Francis Moses, Tom Sesay, James Squire, Joseph Kamanda Sesay, Osman Kaykay, Binyam Halu, Hailemariam Legesse, Francis Smart, Sartie Kenneh, Soter Ameh, Jana Ritter, Tais Wilson, Jonas Winchell, Jakob Witherbee, Navit T. Salzberg, Jeffrey P. Koplan, Margaret Basket, Ashutosh Wadhwa, Kyu Han Lee, Valentine Wanga, Roosecelis Martines, Shamta Warang, Maureen Diaz, Jessica Waller, Shailesh Nair, Lucy Liu, Courtney Bursuc, Kristin LaHatte, Sarah Raymer, John Blevins, Solveig Argeseanu, Kurt Vyas, and Manu Bhandari
Subjects: Childhood, Mortality, Clinical care, Guideline adherence, Medicine (General), R5-920
Abstract: Summary: Background: Most childhood deaths globally are considered preventable through high-quality clinical care, which includes adherence to clinical care recommendations. Our objective was to describe adherence to World Health Organization recommendations for the management of leading causes of death among children. Methods: We conducted a retrospective, descriptive study examining clinical data for children aged 1–59 months who were hospitalized and died in a Child Health and Mortality Prevention Surveillance (CHAMPS) catchment, December 2016–June 2021. Catchment areas included: Baliakandi and Faridpur, Bangladesh; Kersa, Haramaya, and Harar, Ethiopia; Kisumu and Siaya, Kenya; Bamako, Mali; Manhiça and Quelimane, Mozambique; Makeni, Sierra Leone; Soweto, South Africa. We reviewed medical records of those who died from lower respiratory tract infections, sepsis, malnutrition, malaria, and diarrheal diseases to determine the proportion who received recommended treatments and compared adherence by hospitalization duration. Findings: CHAMPS enrolled 460 hospitalized children who died from the leading causes (median age 12 months, 53.0% male). Median hospital admission was 31 h. There were 51.0% (n = 127/249) of children who died from lower respiratory tract infections received supplemental oxygen. Administration of intravenous fluids for sepsis (15.9%, n = 36/226) and supplemental feeds for malnutrition (14.0%, n = 18/129) were uncommon. There were 51.4% (n = 55/107) of those who died from malaria received antimalarials. Of the 80 children who died from diarrheal diseases, 76.2% received intravenous fluids. Those admitted for ≥24 h more commonly received antibiotics for lower respiratory tract infections and sepsis, supplemental feeds for malnutrition, and intravenous fluids for sepsis than those admitted
Published: 2023
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2. Clinical outcomes of intrauterine device insertions by newly trained providers: The ECHO trial experience

Author: Irina Yacobson, Valentine Wanga, Khatija Ahmed, Tsungai Chipato, Peter Gichangi, James Kiarie, Cheryl Louw, Susan Morrison, Margaret Moss, Nelly R. Mugo, Thesla Palanee-Phillips, Melanie Pleaner, Caitlin W. Scoville, Katherine K. Thomas, and Kavita Nanda
Subjects: Copper intrauterine device, Expulsion, Insertion, IUD, Provider training, Uterine perforation, Gynecology and obstetrics, RG1-991, Public aspects of medicine, RA1-1270
Abstract: Objectives: To assess the rates of failed insertion, expulsion, and perforation when intrauterine device (IUD) insertions were done by newly trained clinicians, and to examine factors that may affect these outcomes. Study design: We evaluated skill-based outcomes following IUD insertion at 12 African sites in a secondary analysis of the Evidence for Contraceptive Options and HIV Outcomes (ECHO) randomized trial. Before trial initiation, we provided competency-based IUD training to clinicians and offered ongoing clinical support. We used Cox proportional hazards regression to examine factors associated with expulsion. Results: Among 2582 IUD acceptors who underwent first attempted IUD insertion, 141 experienced insertion failure (5.46%) and seven had uterine perforation (0.27%). Perforation was more common among breastfeeding women within three months postpartum (0.65%) compared with non-breastfeeding women (0.22%). We recorded 493 expulsions (15.5 per 100 person-years, 95% confidence interval [CI] 14.1─16.9): 383 partial and 110 complete. The risk of IUD expulsion was lower among women older than 24 years (aHR 0.63, 95% CI 0.50─0.78) and may be higher among nulliparous women. (aHR 1.65, 95% CI 0.97─2.82). Breastfeeding (aHR 0.94, 95% CI 0.72─1.22) had no significant effect on expulsion. IUD expulsion rate was highest during the first three months of the trial. Conclusions: IUD insertion failure and uterine perforation rates in our study were comparable to those reported in the literature. These results suggest that training, ongoing support, and opportunities to apply new skills were effective in ensuring good clinical outcomes for women receiving IUD insertion by newly trained providers. Implications: Data from this study support recommendations to program managers, policymakers, and clinicians that IUDs can be inserted safely in resource-constrained settings when providers receive appropriate training and support.
Published: 2023
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3. Cost of pre-exposure prophylaxis delivery in family planning clinics to prevent HIV acquisition among adolescent girls and young women in Kisumu, Kenya.

Author: Valentine Wanga, Kathryn Peebles, Alfred Obiero, Felix Mogaka, Victor Omollo, Josephine B Odoyo, Jennifer F Morton, Elizabeth A Bukusi, Connie Celum, Jared M Baeten, and Ruanne V Barnabas
Subjects: Medicine, Science
Abstract: IntroductionOral pre-exposure prophylaxis (PrEP) is increasingly being implemented in sub-Saharan Africa. Adolescent girls and young women (AGYW) in Kenya contribute more than half of all new infections among young people aged 15-24 years, highlighting the need for evidence on the cost of PrEP in real-world implementation to inform the budget impact, cost-effectiveness, and financial sustainability of PrEP programs.MethodsWe estimated the cost of delivering PrEP to AGYW enrolled in a PrEP implementation study in two family planning clinics in Kisumu county, located in western Kenya. We derived total annual costs and the average cost per client-month of PrEP by input type (variable or fixed) and visit type (initiation or follow-up). We estimated all costs as implemented in the study, and under implementation by the Kenyan Ministry of Health (MoH), both at the program volume observed and if the facilities were delivering PrEP at full capacity (scaled-MoH).ResultsFor the costing period between March 2018 and March 2019, 615 HIV-negative women contributed 1,128 (502 initiation and 626 follow-up) visits. The average cost per client-month of PrEP dispensed per study protocol and per the MoH scenario was $28.92 and $14.52, respectively. If the MoH scaled the program so that facilities could see PrEP clients at capacity, the average cost per client-month of PrEP was $10.88. Medication costs accounted for the largest proportion of the total annual costs (48% in MoH scenario and 65% in the scaled-MoH scenario).ConclusionsUsing data from a PrEP implementation program, we found that the cost per client-month of PrEP dispensed is reduced by 62% if PrEP delivery at the two clinics is scaled up by the MoH. Our findings are valuable for informing local resource allocation and budgetary cost projections for scale-up of PrEP delivery to AGYW. Additionally, previous cost-effectiveness studies have been limited by the use of fixed assumptions of the cost of PrEP per person-month. Our study provides cost estimates from practical data which will better inform cost-effectiveness and budget impact analyses.
Published: 2021
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4. Demographic, psychosocial and clinical factors associated with postpartum depression in Kenyan women

Author: Linnet Ongeri, Valentine Wanga, Phelgona Otieno, Jane Mbui, Elizabeth Juma, Ann Vander Stoep, and Muthoni Mathai
Subjects: Postpartum depression, Antenatal depression, Psychosocial risk factors, Edinburgh postpartum depression scale, Psychiatry, RC435-571
Abstract: Abstract Background Few longitudinal studies have examined associations between risk factors during pregnancy and mental health outcomes during the postpartum period. We used a cohort study design to estimate the prevalence, incidence and correlates of significant postpartum depressive symptoms in Kenyan women. Methods We recruited adult women residing in an urban, resource-poor setting and attending maternal and child health clinics in two public hospitals in Nairobi, Kenya. A translated Kiswahili Edinburgh Postpartum Depression Scale was used to screen for depressive symptoms at baseline assessment in the 3rd trimester and follow up assessment at 6–10 weeks postpartum. Information was collected on potential demographic, psychosocial and clinical risk variables. Potential risk factors for postpartum depression were evaluated using multivariate logistic regression analysis. Results Out of the 171 women who were followed up at 6–10 weeks postpartum, 18.7% (95% CI: 13.3–25.5) were found to have postpartum depression using an EPDS cut off of 10. In multivariate analyses, the odds of having postpartum depression was increased more than seven-fold in the presence of conflict with partner (OR = 7.52, 95% CI: 2.65–23.13). The association between antepartum and postpartum depression was quite strong but did not reach statistical significance (OR = 3.37, 95% CI: 0.98–11.64). Conclusions The high prevalence of significant postnatal depressive symptoms among Kenyan women underscores the need for addressing this public health burden. Depression screening and psychosocial support interventions that address partner conflict resolution should be offered as part of maternal health care.
Published: 2018
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5. The global burden of disease study 2013: What does it mean for the NTDs?

Author: Jennifer R Herricks, Peter J Hotez, Valentine Wanga, Luc E Coffeng, Juanita A Haagsma, María-Gloria Basáñez, Geoffrey Buckle, Christine M Budke, Hélène Carabin, Eric M Fèvre, Thomas Fürst, Yara A Halasa, Charles H King, Michele E Murdoch, Kapa D Ramaiah, Donald S Shepard, Wilma A Stolk, Eduardo A Undurraga, Jeffrey D Stanaway, Mohsen Naghavi, and Christopher J L Murray
Subjects: Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Published: 2017
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6. Surveillance of ADHD Among Children in the United States: Validity and Reliability of Parent Report of Provider Diagnosis

Author: Robyn A. Cree, Rebecca H. Bitsko, Melissa L. Danielson, Valentine Wanga, Joseph Holbrook, Kate Flory, Lorraine F. Kubicek, Steven W. Evans, Julie Sarno Owens, and Steven P. Cuffe
Subjects: Diagnostic and Statistical Manual of Mental Disorders, Clinical Psychology, Attention Deficit Disorder with Hyperactivity, Predictive Value of Tests, Prevalence, Developmental and Educational Psychology, Humans, Reproducibility of Results, Child, United States
Abstract: Objective: To evaluate the appropriateness of parent-reported diagnosis of ADHD as a surveillance tool. Method: We assessed agreement over time and concordance of parent-reported diagnosis against Diagnostic and Statistical Manual (DSM)-based criteria. We compared concordance of diagnosis and DSM-based criteria by child characteristics, including treatment. Results: Among parents who reported their child had ADHD, 95.7% reported it again 2 years later. Comparing diagnosis with DSM-based criteria, specificity and negative predictive value were high, sensitivity was moderate, and positive predictive value was low. Most children with an ADHD diagnosis who did not meet DSM-based criteria met sub-threshold criteria or took medication for ADHD. Concordance differed by child characteristics and treatment. Conclusion: Parent-reported diagnosed ADHD is reliable over time. Although differences in parent-reported diagnosis and DSM-based criteria were noted, these may reflect children with milder symptoms or treated ADHD. Parent-report of child ADHD ever diagnosis may be a good single-item indicator for prevalence.
Published: 2022
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7. Stability of mental disorder prevalence estimates among school-aged children and adolescents: findings from the community-based project to learn about youth-mental health (PLAY-MH) and replication-PLAY-MH (Re-PLAY-MH), 2014–2017

Author: Valentine Wanga, Melissa L. Danielson, Rebecca H. Bitsko, Joseph R. Holbrook, Corey Lipton, Angelika H. Claussen, E. Rebekah Siceloff, and Kate Flory
Subjects: Parents, Mental Health, Schools, Adolescent, Epidemiology, Mental Disorders, Prevalence, Humans, Child
Abstract: This study evaluated the stability over time of prevalence estimates of mental disorders among school-aged children from the same community.We compared screening status and weighted prevalence of selected mental disorders from the two-stage school-based South Carolina Project to Learn About Youth-Mental Health (Time 1) and its replication study (Time 2) conducted between 2014 and 2017. During stage 1, two teacher screeners were used to group students into high or low risk for a mental disorder. During stage 2, parents of selected students completed a structured diagnostic interview to assess whether their child met criteria for specific disorders.For stage 1, 19.9% of students screened as high risk for a mental disorder at Time 2 compared to 17.8% at Time 1. Among students included at both timepoints, 9.1% screened as high risk at both timepoints while screening status changed for 20.7%. The overall prevalence of included mental disorders was approximately 18% at both time points There were no differences (P-values.05) in prevalence of individual mental disorders between Time 1 (range:0.3%-6.7%) and Time 2 (range:1.2%-7.7%).Study findings demonstrate that similar methodology yielded similar prevalence estimates of mental disorders and can inform community-level planning for improving mental health in children.
Published: 2022
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8. Notes From the Field: Prevalence of Previous Dengue Virus Infection Among Children and Adolescents — U.S. Virgin Islands, 2022

Author: Valerie V. Mac, Joshua M. Wong, Hannah R. Volkman, Janice Perez-Padilla, Brian Wakeman, Mark Delorey, Brad J. Biggerstaff, Anna Fagre, Annellie Gumbs, Aubrey Drummond, Brenae Zimmerman, Briana Lettsome, Freddy A. Medina, Gabriela Paz-Bailey, Marlon Lawrence, Brett Ellis, Hannah G. Rosenblum, Jamaal Carroll, Joseph Roth, Janelle Rossington, Jessica R. Meeker, Joy Joseph, Julia Janssen, Lisa Laplace Ekpo, Monifa Carrillo, Niurka Hernandez, Patricia Charles, Rafael Tosado, Raymond Soto, Shanice Battle, Stephen M. Bart, Valentine Wanga, Wilfredo Valentin, Winifred Powell, Zula Battiste, Esther M. Ellis, and Laura E. Adams
Subjects: Health (social science), Health Information Management, Epidemiology, Health, Toxicology and Mutagenesis, General Medicine
Published: 2023
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9. Long-Term Symptoms Among Adults Tested for SARS-CoV-2 — United States, January 2020–April 2021

Author: Caitlyn Lutfy, Megan E Gerdes, Alyson B. Goodman, Miriam A M Nji, Tim McLeod, Sallyann M Coleman King, Julie Rushmore, Robert A Bonacci, Valentine Wanga, Geoffrey P. Whitfield, Lina V Dimitrov, Emilia H. Koumans, Jennifer R. Cope, Sharon Saydah, Brendan R Jackson, Alfonso C Hernandez-Romieu, Jessica S. Rogers-Brown, Jennifer R Chevinsky, and Dena Bushman
Subjects: Adult, Male, medicine.medical_specialty, Pediatrics, Health (social science), Adolescent, Epidemiology, Health, Toxicology and Mutagenesis, Population, Negative Test Result, Young Adult, COVID-19 Testing, Post-Acute COVID-19 Syndrome, Health Information Management, Health care, medicine, Humans, Full Report, Young adult, education, Aged, education.field_of_study, SARS-CoV-2, business.industry, Public health, COVID-19, General Medicine, Middle Aged, United States, Confidence interval, Test (assessment), Vaccination, Female, business
Abstract: Long-term symptoms often associated with COVID-19 (post-COVID conditions or long COVID) are an emerging public health concern that is not well understood. Prevalence of post-COVID conditions has been reported among persons who have had COVID-19 (range = 5%-80%), with differences possibly related to different study populations, case definitions, and data sources (1). Few studies of post-COVID conditions have comparisons with the general population of adults with negative test results for SARS-CoV-2, the virus that causes COVID-19, limiting ability to assess background symptom prevalence (1). CDC used a nonprobability-based Internet panel established by Porter Novelli Public Services* to administer a survey to a nationwide sample of U.S. adults aged ≥18 years to compare the prevalence of long-term symptoms (those lasting >4 weeks since onset) among persons who self-reported ever receiving a positive SARS-CoV-2 test result with the prevalence of similar symptoms among persons who reported always receiving a negative test result. The weighted prevalence of ever testing positive for SARS-CoV-2 was 22.2% (95% confidence interval [CI] = 20.6%-23.8%). Approximately two thirds of respondents who had received a positive test result experienced long-term symptoms often associated with SARS-CoV-2 infection. Compared with respondents who received a negative test result, those who received a positive test result reported a significantly higher prevalence of any long-term symptom (65.9% versus 42.9%), fatigue (22.5% versus 12.0%), change in sense of smell or taste (17.3% versus 1.7%), shortness of breath (15.5% versus 5.2%), cough (14.5% versus 4.9%), headache (13.8% versus 9.9%), and persistence (>4 weeks) of at least one initially occurring symptom (76.2% versus 69.6%). Compared with respondents who received a negative test result, a larger proportion of those who received a positive test result reported believing that receiving a COVID-19 vaccine made their long-term symptoms better (28.7% versus 15.7%). Efforts to address post-COVID conditions should include helping health care professionals recognize the most common post-COVID conditions and optimize care for patients with persisting symptoms, including messaging on potential benefits of COVID-19 vaccination.
Published: 2021
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10. Factors Associated With Severe Illness in Patients Aged21 Years Hospitalized for COVID-19

Author: Rewa Choudhary, Bryant J. Webber, Lindsay S. Womack, Hannah K. Dupont, Sophia K. Chiu, Valentine Wanga, Megan E. Gerdes, Sophia Hsu, Dallas S. Shi, Theresa M. Dulski, Osatohamwen I. Idubor, Arthur M. Wendel, Nickolas T. Agathis, Kristi Anderson, Tricia Boyles, Eleanor S. Click, Juliana Da Silva, Mary E. Evans, Jeremy A.W. Gold, Julia C. Haston, Pamela Logan, Susan A. Maloney, Marisol Martinez, Pavithra Natarajan, Kevin B. Spicer, Mark Swancutt, Valerie A. Stevens, Jessica Rogers-Brown, Gyan Chandra, Megan Light, Frederick E. Barr, Jessica Snowden, Larry K. Kociolek, Matthew McHugh, David L. Wessel, Joelle N. Simpson, Kathleen C. Gorman, Kristen A. Breslin, Roberta L. DeBiasi, Aaron Thompson, Mark W. Kline, Julie A. Boom, Ila R. Singh, Michael Dowlin, Mark Wietecha, Beth Schweitzer, Sapna Bamrah Morris, Emilia H. Koumans, Jean Y. Ko, David A. Siegel, and Anne A. Kimball
Subjects: Coinfection, SARS-CoV-2, COVID-19, Infant, General Medicine, Respiratory Syncytial Virus Infections, Pediatrics, United States, Hospitalization, Cross-Sectional Studies, Pediatrics, Perinatology and Child Health, Humans, Obesity, Child
Abstract: OBJECTIVES To describe coronavirus disease 2019 (COVID-19)–related pediatric hospitalizations during a period of B.1.617.2 (Δ) variant predominance and to determine age-specific factors associated with severe illness. METHODS We abstracted data from medical charts to conduct a cross-sectional study of patients aged RESULTS Of 947 hospitalized patients, 759 (80.1%) had COVID-19, of whom 287 (37.8%) had severe illness. Factors associated with severe illness included coinfection with respiratory syncytial virus (RSV) (PR 3.64) and bacteria (PR 1.88) in infants; RSV coinfection in patients aged 1 to 4 years (PR 1.96); and obesity in patients aged 5 to 11 (PR 2.20) and 12 to 17 years (PR 2.48). Having ≥2 underlying medical conditions was associated with severe illness in patients aged CONCLUSIONS Among patients hospitalized for COVID-19, factors associated with severe illness included RSV coinfection in those aged
Published: 2022

11. Post-COVID conditions and healthcare utilization among adults with and without disabilities—2021 Porter Novelli FallStyles survey

Author: Maureen J. Miller, Leora R. Feldstein, Joseph Holbrook, Ian D. Plumb, Emma K. Accorsi, Qing C. Zhang, Qi Cheng, Jean Y. Ko, Valentine Wanga, Stacey Konkle, Lina V. Dimitrov, Jeanne Bertolli, and Sharon Saydah
Subjects: Public Health, Environmental and Occupational Health, General Medicine
Published: 2023
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12. Children, adolescents, and young adults hospitalized with COVID-19 and diabetes in summer 2021

Author: Nickolas T, Agathis, Lindsay S, Womack, Bryant J, Webber, Rewa, Choudhary, Valentine, Wanga, Jean Y, Ko, Hannah, Dupont, Giuseppina, Imperatore, Emilia H, Koumans, Sharon, Saydah, Anne A, Kimball, and David A, Siegel
Subjects: COVID-19 Vaccines, Adolescent, SARS-CoV-2, Endocrinology, Diabetes and Metabolism, COVID-19, Diabetic Ketoacidosis, Young Adult, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Pediatrics, Perinatology and Child Health, Internal Medicine, Humans, Child, Retrospective Studies
Abstract: More information is needed to understand the clinical epidemiology of children and young adults hospitalized with diabetes and COVID-19. We describe the demographic and clinical characteristics of patients21 years old hospitalized with COVID-19 and either Type 1 or Type 2 Diabetes Mellitus (T1DM or T2DM) during peak incidence of SARS-CoV-2 infection with the B.1.617.2 (Delta) variant.This is a descriptive sub-analysis of a retrospective chart review of patients aged21 years hospitalized with COVID-19 in six US children's hospitals during July-August 2021. Patients with COVID-19 and either newly diagnosed or known T1DM or T2DM were described using originally collected data and diabetes-related data specifically collected on these patients.Of the 58 patients hospitalized with COVID-19 and diabetes, 34 had T1DM and 24 had T2DM. Of those with T1DM and T2DM, 26% (9/34) and 33% (8/24), respectively, were newly diagnosed. Among those12 years old and eligible for COVID-19 vaccination, 93% were unvaccinated (42/45). Among patients with T1DM, 88% had diabetic ketoacidosis (DKA) and 6% had COVID-19 pneumonia; of those with T2DM, 46% had DKA and 58% had COVID-19 pneumonia. Of those with T1DM or T2DM, 59% and 46%, respectively, required ICU admission.Our findings highlight the importance of considering diabetes in the evaluation of children and young adults presenting with COVID-19; the challenges of managing young patients who present with both COVID-19 and diabetes, particularly T2DM; and the importance of preventive actions like COVID-19 vaccination to prevent severe illness among those eligible with both COVID-19 and diabetes.
Published: 2022

13. Brief Report: Bacterial Vaginosis and Risk of HIV Infection in the Context of CD101 Gene Variation

Author: Nelly Mugo, Elizabeth A. Bukusi, Romel D. Mackelprang, Valentine Wanga, Craig R. Cohen, Katherine K. Thomas, Connie Celum, Hiv Transmission Study, Partners in Prevention Hsv, Jairam R. Lingappa, Guy de Bruyn, Elizabeth Irungu, Jared M. Baeten, and Deborah Donnell
Subjects: Adult, Male, HIV Infections, Context (language use), Young Adult, Antigens, CD, Risk Factors, medicine, Humans, Genetic Predisposition to Disease, Pharmacology (medical), Sex organ, Longitudinal Studies, Africa South of the Sahara, Membrane Glycoproteins, Coinfection, business.industry, Hazard ratio, Genetic Variation, Vaginosis, Bacterial, medicine.disease, Confidence interval, Infectious Diseases, Immunology, Serodiscordant, Cohort, Female, Nugent score, Bacterial vaginosis, business
Abstract: Author(s): Wanga, Valentine; Mackelprang, Romel D; Thomas, Katherine K; Donnell, Deborah; Cohen, Craig R; Mugo, Nelly R; Bukusi, Elizabeth A; de Bruyn, Guy; Irungu, Elizabeth; Celum, Connie; Baeten, Jared M; Lingappa, Jairam R; Partners in Prevention HSV/HIV Transmission Study and the Partners PrEP Study | Abstract: BackgroundWhether bacterial vaginosis (BV) and CD101 immunoglobulin-like (Ig-like) variants independently increase HIV risk through mucosal inflammation is not well understood. We evaluated whether the impact of BV on HIV acquisition in women differs by the presence or absence of candidate CD101 Ig-like variants.MethodsWe used data from 2 studies of HIV serodiscordant couples in east (Kenya, Tanzania, and Uganda) and southern (Botswana, South Africa, and Zambia) Africa, which longitudinally assessed HIV acquisition (by ELISA) and BV (by Nugent score ≥7). We used previously generated CD101 sequence data for each case and control participant to create a binary variable indicating the presence/absence of any of 5 CD101 Ig-like variants.ResultsConfirming previously shown results in this cohort, Ig-like variants increased HIV-infection risk (adjusted hazard ratio [aHR], = 2.63; 95% confidence interval [CI], 1.41 to 4.89). BV was associated with 2.5-fold higher HIV-infection risk only in the absence of Ig-like variants (aHR = 2.47; 95% CI, 0.99 to 6.15; P = 0.052), whereas in the presence of Ig-like variants, BV was not associated with higher HIV-infection risk (aHR = 0.87; 95% CI, 0.35 to 2.15; P = 0.765); however, a test for interaction was nonsignificant (P = 0.116).ConclusionsWe hypothesized that both BV and CD101 Ig-like variants facilitate HIV acquisition by augmenting similar genital inflammation pathways. Our findings indicate that inflammatory mucosal effects of Ig-like variants may influence the impact of BV on HIV risk. Host-defined inflammatory pathways may be useful targets for HIV prevention.
Published: 2020
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14. Prevalence of Select New Symptoms and Conditions Among Persons Aged Younger Than 20 Years and 20 Years or Older at 31 to 150 Days After Testing Positive or Negative for SARS-CoV-2

Author: Alfonso C. Hernandez-Romieu, Thomas W. Carton, Sharon Saydah, Eduardo Azziz-Baumgartner, Tegan K. Boehmer, Nedra Y. Garret, L. Charles Bailey, Lindsay G. Cowell, Christine Draper, Kenneth H. Mayer, Kshema Nagavedu, Jon E. Puro, Sonja A. Rasmussen, William E. Trick, Valentine Wanga, Jennifer R. Chevinsky, Brendan R. Jackson, Alyson B. Goodman, Jennifer R. Cope, Adi V. Gundlapalli, and Jason P. Block
Subjects: Adult, Aged, 80 and over, Male, Time Factors, Adolescent, SARS-CoV-2, Age Factors, Infant, Newborn, COVID-19, Infant, General Medicine, Middle Aged, Cohort Studies, Young Adult, Socioeconomic Factors, Child, Preschool, Prevalence, Humans, Female, Symptom Assessment, Child, Aged
Abstract: New symptoms and conditions can develop following SARS-CoV-2 infection. Whether they occur more frequently among persons with SARS-CoV-2 infection compared with those without is unclear.To compare the prevalence of new diagnoses of select symptoms and conditions between 31 and 150 days after testing among persons who tested positive vs negative for SARS-CoV-2.This cohort study analyzed aggregated electronic health record data from 40 health care systems, including 338 024 persons younger than 20 years and 1 790 886 persons aged 20 years or older who were tested for SARS-CoV-2 during March to December 2020 and who had medical encounters between 31 and 150 days after testing.International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes were used to capture new symptoms and conditions that were recorded 31 to 150 days after a SARS-CoV-2 test but absent in the 18 months to 7 days prior to testing. The prevalence of new symptoms and conditions was compared between persons with positive and negative SARS-CoV-2 tests stratified by age (20 years or older and young than 20 years) and care setting (nonhospitalized, hospitalized, or hospitalized and ventilated).A total of 168 701 persons aged 20 years or older and 26 665 younger than 20 years tested positive for SARS-CoV-2, and 1 622 185 persons aged 20 years or older and 311 359 younger than 20 years tested negative. Shortness of breath was more common among persons with a positive vs negative test result among hospitalized patients (≥20 years: prevalence ratio [PR], 1.89 [99% CI, 1.79-2.01];20 years: PR, 1.72 [99% CI, 1.17-2.51]). Shortness of breath was also more common among nonhospitalized patients aged 20 years or older with a positive vs negative test result (PR, 1.09 [99% CI, 1.05-1.13]). Among hospitalized persons aged 20 years or older, the prevalence of new fatigue (PR, 1.35 [99% CI, 1.27-1.44]) and type 2 diabetes (PR, 2.03 [99% CI, 1.87-2.19]) was higher among those with a positive vs a negative test result. Among hospitalized persons younger than 20 years, the prevalence of type 2 diabetes (PR, 2.14 [99% CI, 1.13-4.06]) was higher among those with a positive vs a negative test result; however, the prevalence difference was less than 1%.In this cohort study, among persons hospitalized after a positive SARS-CoV-2 test result, diagnoses of certain symptoms and conditions were higher than among those with a negative test result. Health care professionals should be aware of symptoms and conditions that may develop after SARS-CoV-2 infection, particularly among those hospitalized after diagnosis.
Published: 2022

15. Perceived Racial/Ethnic Discrimination, Physical and Mental Health Conditions in Childhood, and the Relative Role of Other Adverse Experiences

Author: Helena J. Hutchins, Caroline M. Barry, Valentine Wanga, Sarah Bacon, Rashid Njai, Angelika H. Claussen, Reem M. Ghandour, Lydie A. Lebrun-Harris, Kiana Perkins, and Lara R. Robinson
Subjects: General Medicine, Article
Abstract: Adverse childhood experiences (ACEs) are associated with poor health. Childhood experiences of racial/ethnic discrimination and other forms of racism may underlie or exacerbate other ACEs. We explored health-related associations with perceived racial/ethnic discrimination relative to other ACEs, using data from 2016–2019 National Survey of Children’s Health, an annual cross-sectional, nationally representative survey. Parent responses for 88,183 children ages 6–17 years with complete data for ACEs (including racial/ethnic discrimination) were analyzed for associations between racial/ethnic discrimination, other ACEs, demographics, and physical and mental health conditions with weighted prevalence estimates and Wald chi-square tests. To assess associations between racial/ethnic discrimination and health conditions relative to other ACEs, we used weighted Poisson regressions, adjusted for exposure to other ACEs, age, and sex. We assessed effect modification by race/ethnicity. Prevalence of other ACEs was highest among children with racial/ethnic discrimination, and both racial/ethnic discrimination and other ACEs were associated with having one or more health conditions. Adjusted associations between racial/ethnic discrimination and health conditions differed by race/ethnicity (interaction P-values < 0.001) and were strongest for mental health conditions among Hispanic/Latino (adjusted prevalence ratio (aPR)=1.62, 95% confidence interval (CI): 1.24–2.10) and non-Hispanic/Latino Asian American (aPR=2.25, 95% CI: 1.37–3.71) children. Results suggest racial/ethnic discrimination and other ACEs are associated with child health conditions, with differences in relative associations by race/ethnicity. Public health efforts to prevent childhood adversity, including racial/ethnic discrimination and other forms of racism could be associated with improvements in child health.
Published: 2022

16. Kidney injury biomarkers during exposure to tenofovir-based preexposure prophylaxis

Author: Connie Celum, Jonathan Barasch, Valentine Wanga, Jared M. Baeten, Deborah Donnell, Allan R. Ronald, Partners PrEP Study Team, Kenneth K. Mugwanya, Andrea D. Branch, Nelly Mugo, Thomas L Nickolas, Christina M. Wyatt, and Renee Heffron
Subjects: Adult, 0301 basic medicine, medicine.medical_specialty, Anti-HIV Agents, Immunology, Urology, Renal function, HIV Infections, Kidney, Emtricitabine, Placebo, Article, 03 medical and health sciences, Pre-exposure prophylaxis, 0302 clinical medicine, medicine, Kidney injury, Humans, Immunology and Allergy, 030212 general & internal medicine, Tenofovir, Proteinuria, business.industry, Incidence (epidemiology), 030104 developmental biology, Infectious Diseases, medicine.anatomical_structure, Pre-Exposure Prophylaxis, medicine.symptom, business, Biomarkers, medicine.drug
Abstract: We previously reported a higher incidence of non-albumin proteinuria and a small but significant decline in estimated glomerular filtration rate (eGFR) among HIV-negative adults randomized to emtricitabine/tenofovir disoproxil fumarate preexposure prophylaxis (FTC/TDF PrEP) versus placebo. In a nested case--control study among participants randomized to FTC/TDF PrEP, established kidney injury biomarkers measured at 12 months were not significantly different between participants who subsequently experienced one of these kidney endpoints and randomly selected controls who did not.
Published: 2021
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17. Outcomes Among Patients Referred to Outpatient Rehabilitation Clinics After COVID-19 diagnosis — United States, January 2020–March 2021

Author: Catherine A. Okoro, Alfonso C Hernandez-Romieu, Robert A Bonacci, Jennifer R. Cope, Jennifer R Chevinsky, Dena Bushman, Alan Evans, Sapna Bamrah Morris, Brendan R Jackson, Valentine Wanga, Jessica S. Rogers-Brown, Julie Rushmore, Tim McLeod, Meredith G Dixon, Emily Koumans, William B. Thompson, Diane Brozowsky, David Hopwood, Caitlyn Lutfy, and Alyson B. Goodman
Subjects: Adult, Male, medicine.medical_specialty, Health (social science), Adolescent, Epidemiology, Health, Toxicology and Mutagenesis, medicine.medical_treatment, MEDLINE, Ambulatory Care Facilities, Asymptomatic, Young Adult, Health Information Management, Health care, Humans, Medicine, Young adult, Referral and Consultation, Aged, Aged, 80 and over, Rehabilitation, business.industry, Case-control study, COVID-19, General Medicine, Odds ratio, Middle Aged, Mental health, United States, Treatment Outcome, Case-Control Studies, Physical therapy, Female, Erratum, medicine.symptom, business
Abstract: As of June 30, 2021, 33.5 million persons in the United States had received a diagnosis of COVID-19 (1). Although most patients infected with SARS-CoV-2, the virus that causes COVID-19, recover within a few weeks, some experience post-COVID-19 conditions. These range from new or returning to ongoing health problems that can continue beyond 4 weeks. Persons who were asymptomatic at the time of infection can also experience post-COVID-19 conditions. Data on post-COVID-19 conditions are emerging and information on rehabilitation needs among persons recovering from COVID-19 is limited. Using data acquired during January 2020-March 2021 from Select Medical* outpatient rehabilitation clinics, CDC compared patient-reported measures of health, physical endurance, and health care use between patients who had recovered from COVID-19 (post-COVID-19 patients) and patients needing rehabilitation because of a current or previous diagnosis of a neoplasm (cancer) who had not experienced COVID-19 (control patients). All patients had been referred to outpatient rehabilitation. Compared with control patients, post-COVID-19 patients had higher age- and sex-adjusted odds of reporting worse physical health (adjusted odds ratio [aOR] = 1.8), pain (aOR = 2.3), and difficulty with physical activities (aOR = 1.6). Post-COVID-19 patients also had worse physical endurance, measured by the 6-minute walk test† (6MWT) (p
Published: 2021
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18. Obesity, chronic job discrimination and social support

Author: Colin Cannonier, Janella Melius, Valentine Wanga, and Kenneth Kungu
Subjects: Supervisor, Family support, 05 social sciences, Stressor, Sensitivity training, medicine.disease, General Business, Management and Accounting, Obesity, 03 medical and health sciences, Social support, 0302 clinical medicine, Human resource management, 0502 economics and business, medicine, 030212 general & internal medicine, Psychology, Body mass index, 050203 business & management, Clinical psychology
Abstract: PurposeThe purpose of this paper is to investigate the relationship between body mass index (BMI) and chronic job discrimination. Additionally, the authors explore the contribution of various forms of social support to that relationship.Design/methodology/approachThe data for this study were obtained from the National Survey of Midlife Development in the USA (MIDUS). Only those who reported being employed participated in the study (n= 1,150). The variables of interest included BMI, supervisor support, coworker support, family support, friend support, religious support and chronic job discrimination. Analysis included correlations, ANOVA’s and hierarchical linear regression.FindingsBMI was positively associated with chronic job discrimination. Respondents in the obese and morbidly obese categories reported higher job discrimination compared to normal weight respondents. Family support, supervisor support and coworker support were associated with less reported chronic job discrimination.Practical implicationsOrganizational leaders should acknowledge that obesity is associated with discrimination. Organizations should thus create anti-discrimination policies covering weight-based discrimination, conduct sensitivity training for all employees and train and coach supervisors on effective ways of offering support to employees.Originality/valueThis study contributes to the understanding of the role various forms of social support can play in reducing perceptions of chronic job discrimination. The paper is unique in that it considers several sources from which people draw support in managing for stressors.
Published: 2019
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19. Cost of pre-exposure prophylaxis delivery in family planning clinics to prevent HIV acquisition among adolescent girls and young women in Kisumu, Kenya

Author: Connie Celum, Ruanne V. Barnabas, Elizabeth A. Bukusi, Valentine Wanga, Josephine Odoyo, Victor Omollo, Felix Mogaka, Kathryn Peebles, Alfred Obiero, Jennifer F Morton, and Jared M. Baeten
Subjects: RNA viruses, Cost estimate, Economics, Cost-Benefit Analysis, Administration, Oral, Social Sciences, HIV Infections, Pathology and Laboratory Medicine, Biochemistry, Geographical Locations, Pre-exposure prophylaxis, 0302 clinical medicine, Immunodeficiency Viruses, Medicine and Health Sciences, Salaries, Medicine, Public and Occupational Health, 030212 general & internal medicine, Activity-based costing, Average cost, Virus Testing, Multidisciplinary, Family planning, Medical Microbiology, Family Planning Services, Viral Pathogens, Creatinine, Financial sustainability, Viruses, Female, Pathogens, 0305 other medical science, Research Article, Kenya, Adolescent, Anti-HIV Agents, Science, HIV prevention, Microbiology, 03 medical and health sciences, Young Adult, Diagnostic Medicine, Environmental health, Retroviruses, Humans, Hiv acquisition, Microbial Pathogens, 030505 public health, business.industry, Prophylaxis, Lentivirus, Organisms, Biology and Life Sciences, HIV, Health Care, Health Care Facilities, Labor Economics, People and Places, Africa, Pre-Exposure Prophylaxis, Preventive Medicine, business, Biomarkers, Program Evaluation
Abstract: Introduction Oral pre-exposure prophylaxis (PrEP) is increasingly being implemented in sub-Saharan Africa. Adolescent girls and young women (AGYW) in Kenya contribute more than half of all new infections among young people aged 15–24 years, highlighting the need for evidence on the cost of PrEP in real-world implementation to inform the budget impact, cost-effectiveness, and financial sustainability of PrEP programs. Methods We estimated the cost of delivering PrEP to AGYW enrolled in a PrEP implementation study in two family planning clinics in Kisumu county, located in western Kenya. We derived total annual costs and the average cost per client-month of PrEP by input type (variable or fixed) and visit type (initiation or follow-up). We estimated all costs as implemented in the study, and under implementation by the Kenyan Ministry of Health (MoH), both at the program volume observed and if the facilities were delivering PrEP at full capacity (scaled-MoH). Results For the costing period between March 2018 and March 2019, 615 HIV-negative women contributed 1,128 (502 initiation and 626 follow-up) visits. The average cost per client-month of PrEP dispensed per study protocol and per the MoH scenario was $28.92 and $14.52, respectively. If the MoH scaled the program so that facilities could see PrEP clients at capacity, the average cost per client-month of PrEP was $10.88. Medication costs accounted for the largest proportion of the total annual costs (48% in MoH scenario and 65% in the scaled-MoH scenario). Conclusions Using data from a PrEP implementation program, we found that the cost per client-month of PrEP dispensed is reduced by 62% if PrEP delivery at the two clinics is scaled up by the MoH. Our findings are valuable for informing local resource allocation and budgetary cost projections for scale-up of PrEP delivery to AGYW. Additionally, previous cost-effectiveness studies have been limited by the use of fixed assumptions of the cost of PrEP per person-month. Our study provides cost estimates from practical data which will better inform cost-effectiveness and budget impact analyses.
Published: 2021

20. Sexual behavior and perceived HIV risk among HIV-negative members of serodiscordant couples in East Africa

Author: Nelly Mugo, Valentine Wanga, Renee Heffron, Jessica E. Haberer, Andrew Mujugira, Stephen Asiimwe, Connie Celum, Kenneth Ngure, Elizabeth A. Bukusi, Timothy R Muwonge, Jared M. Baeten, and Josephine Odoyo
Subjects: Adult, Male, medicine.medical_specialty, Social Psychology, Anti-HIV Agents, Sexual Behavior, Human immunodeficiency virus (HIV), Psychological intervention, HIV Infections, medicine.disease_cause, Article, law.invention, Odds, Condoms, 03 medical and health sciences, 0302 clinical medicine, Risk-Taking, Condom, law, Risk Factors, Antiretroviral Therapy, Highly Active, HIV Seronegativity, HIV Seropositivity, medicine, Humans, Uganda, 030212 general & internal medicine, 030505 public health, Unsafe Sex, business.industry, Public health, Public Health, Environmental and Occupational Health, Middle Aged, Kenya, Risk perception, Health psychology, Infectious Diseases, Sexual Partners, Serodiscordant, Female, Pre-Exposure Prophylaxis, 0305 other medical science, business, Demography
Abstract: HIV risk perception may influence the use of HIV prevention interventions. Using data from HIV-negative adults enrolled in a study of pre-exposure prophylaxis (PrEP) and antiretroviral therapy for HIV-serodiscordant couples in Kenya and Uganda, we examined associations between: (1) condom use and risk perception and (2) risk perception and PrEP adherence. Two-thirds of HIV-negative partners reported condomless sex with their HIV-positive partner or another partner in the month prior to study enrollment. Compared to those who reported no condomless sex, participants who reported condomless sex during the month prior to study visit had fivefold higher odds of reporting “high risk” vs “no risk” perception (36.3 versus 10.9%: aOR 4.9, 95% CI 3.4–6.9). Reporting condomless sex in the most recent sex act was associated with increased odds of perceiving some HIV risk (aOR for high risk = 7.3, 95% CI 4.9–10.8; aOR for moderate risk = 4.8, 95% CI 3.5–6.7; aOR for low risk = 3.5, 95% CI 2.7–4.6). We found no significant association between risk perception and PrEP adherence. Sexual behavior aligned with perceived HIV risk, which can facilitate an HIV-negative individual’s decisions about PrEP use.
Published: 2020

21. Uptake and impact of facility-based HIV self-testing on PrEP delivery: a pilot study among young women in Kisumu, Kenya

Author: Valentine Wanga, Connie Celum, Josephine Odoyo, Rachel Johnson, Victor Omollo, James P. Hughes, Lara Kidoguchi, Jared M. Baeten, Jennifer F Morton, and Elizabeth A. Bukusi
Subjects: Adult, medicine.medical_specialty, Multiple Partners, Repeat testing, Adolescent, Anti-HIV Agents, Human immunodeficiency virus (HIV), Clinical settings, HIV Infections, Pilot Projects, Hiv testing, medicine.disease_cause, Ambulatory Care Facilities, 03 medical and health sciences, Young Adult, 0302 clinical medicine, self‐testing, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Research Articles, 030505 public health, business.industry, Public Health, Environmental and Occupational Health, satisfaction, Kenya, Confidence interval, PrEP, HIV testing, counselling, Infectious Diseases, Self-Testing, Family planning, standard of care, Family medicine, Relative risk, Family Planning Services, Female, Pre-Exposure Prophylaxis, 0305 other medical science, business, Research Article
Abstract: Introduction HIV testing is a required part of delivery of pre‐exposure prophylaxis (PrEP) for HIV prevention. However, repeat testing can be challenging in busy, under‐staffed clinical settings, which could negatively impact PrEP uptake and continuation. We prospectively evaluated optional facility‐based HIV self‐testing (HIVST) among young women using PrEP in an implementation programme. Methods Between February and November 2019, we collected data from young women receiving PrEP at two family planning facilities in Kisumu, Kenya. At each PrEP follow‐up visit, women were given the option to choose between provider‐initiated testing and HIVST. We assessed factors associated with HIVST uptake and compared satisfaction with HIV testing and clinic experience between acceptors and decliners of HIVST. Results A total of 172 women were offered HIVST at 202 PrEP follow‐up visits. The median age was 21 years, 27% had multiple partners and 15% reported previously using HIVST. HIVST was accepted at 34.7% (70/202) of visits. Age (adjusted relative risk (aRR) 1.09 per year, 95% CI (confidence interval) 1.01 to 1.18), never being married (aRR 1.81, 95% CI 1.11 to 2.95) and having more PrEP follow‐up visits (aRR 1.13 per visit, 95% CI 1.04 to 1.23) were associated with HIVST uptake. Compared to HIVST decliners, HIVST acceptors were more likely to be very happy with their overall testing experience (73% vs. 47% of visits, p = 0.003) and were more likely to say they would use HIVST in the future (96% vs. 76%, p
Published: 2020

22. Covariate-adjusted Spearman's rank correlation with probability-scale residuals

Author: Valentine Wanga, Bryan E. Shepherd, Qi Liu, and Chun Li
Subjects: Statistics and Probability, education.field_of_study, General Immunology and Microbiology, Applied Mathematics, Fisher transformation, Population, Estimator, General Medicine, 01 natural sciences, Spearman's rank correlation coefficient, General Biochemistry, Genetics and Molecular Biology, 010104 statistics & probability, 03 medical and health sciences, 0302 clinical medicine, Statistics, Covariate, Econometrics, 030212 general & internal medicine, 0101 mathematics, General Agricultural and Biological Sciences, education, Correction for attenuation, Partial correlation, Rank correlation, Mathematics
Abstract: It is desirable to adjust Spearman's rank correlation for covariates, yet existing approaches have limitations. For example, the traditionally defined partial Spearman's correlation does not have a sensible population parameter, and the conditional Spearman's correlation defined with copulas cannot be easily generalized to discrete variables. We define population parameters for both partial and conditional Spearman's correlation through concordance-discordance probabilities. The definitions are natural extensions of Spearman's rank correlation in the presence of covariates and are general for any orderable random variables. We show that they can be neatly expressed using probability-scale residuals (PSRs). This connection allows us to derive simple estimators. Our partial estimator for Spearman's correlation between X and Y adjusted for Z is the correlation of PSRs from models of X on Z and of Y on Z, which is analogous to the partial Pearson's correlation derived as the correlation of observed-minus-expected residuals. Our conditional estimator is the conditional correlation of PSRs. We describe estimation and inference, and highlight the use of semiparametric cumulative probability models, which allow preservation of the rank-based nature of Spearman's correlation. We conduct simulations to evaluate the performance of our estimators and compare them with other popular measures of association, demonstrating their robustness and efficiency. We illustrate our method in two applications, a biomarker study and a large survey.
Published: 2017
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23. Impact of Tenofovir-Based Pre-exposure Prophylaxis on Biomarkers of Bone Formation, Bone Resorption, and Bone Mineral Metabolism in HIV-Negative Adults

Author: Kenneth H. Fife, Patrick Ndase, Nelly Mugo, Lisa M. Frenkel, James Kiarie, M. Juliana McElrath, Renee Heffron, Connie Celum, Kenneth K. Mugwanya, James D. Campbell, Valentine Wanga, Allan R. Ronald, Craig W. Hendrix, Carey Farquhar, Jairam R. Lingappa, Craig R. Cohen, Elly Katabira, Elioda Tumwesigye, Christina M. Wyatt, Ting Hong, Jonathan Wangisi, Elizabeth A. Bukusi, Grace John-Stewart, Elzbieta Dworakowski, Thomas L. Nickolas, Janaina Ramalho, Jordan W. Tappero, Andrea D. Branch, Michael T. Yin, Jared M. Baeten, Deborah Donnell, Renu Nandakumar, Robert W. Coombs, and Edwin Were
Subjects: 0301 basic medicine, kidney, bone turnover, 030106 microbiology, antiretroviral therapy, HIV prevention, Physiology, Parathyroid hormone, Renal function, Emtricitabine, Bone resorption, Bone remodeling, 03 medical and health sciences, Pre-exposure prophylaxis, chemistry.chemical_compound, 0302 clinical medicine, Major Article, Medicine, 030212 general & internal medicine, Bone mineral, business.industry, tubular dysfunction, 16. Peace & justice, 3. Good health, Infectious Diseases, Oncology, chemistry, Sclerostin, business, medicine.drug
Abstract: Background Pre-exposure prophylaxis (PrEP) with emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF) reduces the risk of HIV seroconversion but may promote bone mineral density (BMD) decline. The mechanisms of BMD decline with FTC/TDF remain unclear, and studies in HIV-positive individuals have been confounded by the effects of HIV and concomitant antiretroviral medications. We evaluated the impact of FTC/TDF on biomarkers of bone remodeling and bone mineral metabolism in HIV-negative men and women enrolled in the Partners PrEP Study. Methods In a random sample of HIV-negative participants randomized to FTC/TDF PrEP (n = 50) or placebo (n = 50), serum parathyroid hormone (PTH), bone biomarkers (C-telopeptide, procollagen 1 intact N-terminal propeptide, and sclerostin), and plasma fibroblast growth factor 23 were measured at baseline and month 24, and the percentage change was compared between groups. In a complementary analysis, we compared the change in biomarkers between participants with and without a 25% decline in glomerular filtration rate (GFR) on FTC/TDF. Results Baseline characteristics were similar between the groups (median age, 38 years; 40% women). Vitamin D insufficiency was common, but baseline GFR and PTH were in the normal range. We observed a significantly greater percent increase in serum C-telopeptide in participants randomized to FTC/TDF vs placebo (P = .03), suggesting an increase in bone remodeling. We observed no differences in the other biomarkers, or in a separate analysis comparing participants with and without a decline in GFR. Conclusions Increased bone remodeling may mediate the BMD decline observed with tenofovir-containing PrEP and antiretroviral therapy, independent of a TDF-mediated decrease in kidney function.
Published: 2019

24. Demographic, psychosocial and clinical factors associated with postpartum depression in Kenyan women

Author: Jane Mbui, Valentine Wanga, Muthoni Mathai, Phelgona Otieno, Ann Vander Stoep, Elizabeth Juma, and Linnet Ongeri
Subjects: Adult, Postpartum depression, medicine.medical_specialty, Urban Population, lcsh:RC435-571, Pregnancy Trimester, Third, Psychological intervention, Cohort Studies, Depression, Postpartum, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Risk Factors, Psychosocial risk factors, lcsh:Psychiatry, Prevalence, medicine, Humans, Mass Screening, Longitudinal Studies, 030212 general & internal medicine, Psychiatric Status Rating Scales, Antenatal depression, Depression, business.industry, Public health, Postpartum Period, medicine.disease, Kenya, Mental health, 030227 psychiatry, Psychiatry and Mental health, Edinburgh postpartum depression scale, Female, business, Psychosocial, Postpartum period, Follow-Up Studies, Research Article, Cohort study, Demography
Abstract: Background Few longitudinal studies have examined associations between risk factors during pregnancy and mental health outcomes during the postpartum period. We used a cohort study design to estimate the prevalence, incidence and correlates of significant postpartum depressive symptoms in Kenyan women. Methods We recruited adult women residing in an urban, resource-poor setting and attending maternal and child health clinics in two public hospitals in Nairobi, Kenya. A translated Kiswahili Edinburgh Postpartum Depression Scale was used to screen for depressive symptoms at baseline assessment in the 3rd trimester and follow up assessment at 6–10 weeks postpartum. Information was collected on potential demographic, psychosocial and clinical risk variables. Potential risk factors for postpartum depression were evaluated using multivariate logistic regression analysis. Results Out of the 171 women who were followed up at 6–10 weeks postpartum, 18.7% (95% CI: 13.3–25.5) were found to have postpartum depression using an EPDS cut off of 10. In multivariate analyses, the odds of having postpartum depression was increased more than seven-fold in the presence of conflict with partner (OR = 7.52, 95% CI: 2.65–23.13). The association between antepartum and postpartum depression was quite strong but did not reach statistical significance (OR = 3.37, 95% CI: 0.98–11.64). Conclusions The high prevalence of significant postnatal depressive symptoms among Kenyan women underscores the need for addressing this public health burden. Depression screening and psychosocial support interventions that address partner conflict resolution should be offered as part of maternal health care.
Published: 2018
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25. Genomewide association study of tenofovir pharmacokinetics and creatinine clearance in AIDS Clinical Trials Group protocol A5202

Author: Edward P. Acosta, Bryan E. Shepherd, Charles S. Venuto, Chun Li, Gene D. Morse, Eric S. Daar, David W. Haas, and Valentine Wanga
Subjects: Adult, Cyclopropanes, Male, medicine.medical_specialty, Efavirenz, Anti-HIV Agents, Renal function, Pharmacology, Emtricitabine, Polymorphism, Single Nucleotide, Gastroenterology, Article, chemistry.chemical_compound, immune system diseases, Interquartile range, Abacavir, Internal medicine, Genetics, Humans, Medicine, General Pharmacology, Toxicology and Pharmaceutics, Tenofovir, Molecular Biology, Genetics (clinical), Acquired Immunodeficiency Syndrome, Ritonavir, business.industry, virus diseases, Dideoxynucleosides, Benzoxazines, Atazanavir, Clinical trial, chemistry, Alkynes, Creatinine, Molecular Medicine, Female, business, Genome-Wide Association Study, medicine.drug
Abstract: BACKGROUND Tenofovir disoproxil fumarate (TDF) causes kidney toxicity in some patients. We carried out genomewide analyses to identify associations with plasma tenofovir clearance and change in creatinine clearance (CrCl) during the first 6 months after initiating therapy among patients randomized to TDF/emtricitabine-containing regimens in AIDS Clinical Trials Group protocol A5202. METHODS Pharmacokinetic analyses involved 501 patients randomized to the tenofovir arm. CrCl analyses involved 1096 patients, including 548 controls randomized to abacavir-containing regimens. All had been randomized to also receive atazanavir/ritonavir or efavirenz. Multivariable linear regression and generalized least squares models were used to test for associations between polymorphisms and tenofovir clearance and CrCl change, with Bonferroni correction. Planned subanalyses considered candidate genes and polymorphisms. RESULTS Median CrCl at baseline was 116 ml/min (interquartile range 99.8-135.5). The median change in CrCl after 6 months was -0.5 ml/min (-10.7 to +10.8) and 2.2 (interquartile range -9.9 to +13.2) in tenofovir and abacavir arms, respectively. In genomewide analyses SLC17A1 rs12662869 was found to be associated with an increase in tenofovir clearance (P=7.1×10). In candidate gene analysis for tenofovir clearance, most polymorphisms evaluated were in ABCC4. In the ABCC4 region, the lowest P-value was for CLDN10 rs12866697 (P=1.4×10). Among African Americans, SLC22A2 rs3127573 was associated with a greater 6-month CrCl increase in the tenofovir arm after correcting for multiple comparisons (P=3.3×10). CONCLUSION Among patients randomized to receive TDF/emtricitabine in A5202, there were no significant genomewide associations with change in CrCl. This study did not replicate polymorphisms previously implicated in tenofovir-associated renal injury.
Published: 2015
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26. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015

Author: Haidong, Wang, Mohsen, Naghavi, Christine, Allen, Ryan M, Barber Zulfi, qar A, Bhutta, Austin, Carter, Daniel C, Casey Fiona, J Charlson, Alan Zian, Chen Matthew, M Coates, Megan, Coggeshall, Lalit, Dandona, Daniel J, Dicker Holly, E Erskine, Alize J, Ferrari, Christina, Fitzmaurice, Kyle, Foreman, Mohammad H, Forouzanfar Maya, S Fraser, Nancy, Fullman, Peter W, Gething Ellen, M Goldberg, Nicholas, Graetz, Juanita A, Haagsma Simon, I Hay, Chantal, Huynh, Catherine O, Johnson Nicholas, J Kassebaum, Yohannes, Kinfu, Xie Rachel, Kulikoff, Michael, Kutz, Hmwe H, Kyu Heidi, J Larson, Janni, Leung, Xiaofeng, Liang, Stephen S, Lim, Margaret, Lind, Rafael, Lozano, Neal, Marquez, George A, Mensah, Joe, Mikesell, Ali H, Mokdad Meghan, D Mooney, Grant, Nguyen, Elaine, Nsoesie, David M, Pigott, Christine, Pinho, Gregory A, Roth Joshua, A Salomon, Logan, Sandar, Naris, Silpakit, Amber, Sligar, Reed J, D Sorensen, Jeff rey, Stanaway, Caitlyn, Steiner, Stephanie, Teeple, Bernadette A, Thomas, Christopher, Troeger, Amelia, VanderZanden, Stein Emil, Vollset, Valentine, Wanga, Harvey A, Whiteford, Timothy, Wolock, Leo, Zoeckler, Kalkidan Hassen, Abate, Cristiana, Abbafati, Kaja M, Abbas, Foad, Abd-Allah, Semaw Ferede, Abera Daisy, M X, Abreu Laith, J Abu-Raddad, Gebre Yitayih, Abyu, Tom, Achoki, Ademola Lukman, Adelekan Zanfi, na Ademi, Arsène Kouablan, Adou José, C Adsuar, Kossivi Agbelenko, Afanvi, Ashkan, Afshin, Emilie Elisabet, Agardh, Arnav, Agarwal, Anurag, Agrawal, Aliasghar Ahmad, Kiadaliri Oluremi, N Ajala, Ali Shafqat, Akanda Rufus, Olusola Akinyemi, Tomi F, Akinyemiju, Nadia, Akseer, Faris Hasan, Al Lami, Samer, Alabed, Ziyad, Al-Aly, Khurshid, Alam, Noore K, M Alam, Deena, Alasfoor, Saleh Fahed, Aldhahri Robert, William Aldridge, Miguel Angel, Alegretti Alicia, V Aleman, Zewdie Aderaw, Alemu Lily, T Alexander, Samia, Alhabib, Raghib, Ali, Ala’a, Alkerwi, François, Alla, Peter, Allebeck, Rajaa, Al-Raddadi, Ubai, Alsharif, Khalid A, Altirkawi Elena, Alvarez Martin, Nelson, Alvis-Guzman, Azmeraw T, Amare Adeladza, Kofi Amegah, Emmanuel A, Ameh, Heresh, Amini, Walid, Ammar, Stephen Marc, Amrock Hjalte, H Andersen, Benjamin O, Anderson Gregory, M Anderson, Carl Abelardo, T Antonio, Atsede Fantahun, Aregay, Johan, Ärnlöv, Valentina S, Arsic Arsenijevic, Al, Artaman, Hamid, Asayesh, Rana Jawad, Asghar, Suleman, Atique, Euripide Frinel, G Arthur, Avokpaho, Ashish, Awasthi, Peter, Azzopardi, Umar, Bacha, Alaa, Badawi, Maria C, Bahit, Kalpana, Balakrishnan, Amitava, Banerjee, Aleksandra, Barac, Suzanne L, Barker-Collo, Till, Bärnighausen, Lars, Barregard, Lope H, Barrero, Arindam, Basu, Sanjay, Basu, Yibeltal Tebekaw, Bayou, Shahrzad, Bazargan-Hejazi, Justin, Beardsley, Neeraj, Bedi, Ettore, Beghi, Haileeyesus Adamu, Belay, Brent, Bell, Michelle L, Bell Aminu, K Bello, Derrick A, Bennett Isabela, M Bensenor, Adugnaw, Berhane, Eduardo, Bernabé, Balem Demtsu, Betsu Addisu, Shunu Beyene, Neeraj, Bhala, Ashish, Bhalla, Sibhatu, Biadgilign, Boris, Bikbov, Aref A, Bin Abdulhak, Brian J, Biroscak, Stan, Biryukov, Espen, Bjertness, Jed D, Blore Christopher, D Blosser, Megan A, Bohensky, Rohan, Borschmann, Dipan, Bose, Rupert R, A Bourne, Michael, Brainin, Carol E, G Brayne, Alexandra, Brazinova, Nicholas J, K Breitborde, Hermann, Brenner, Jerry D, Brewer, Alexandria, Brown, Jonathan, Brown, Traolach S, Brugha Geoff, rey Colin, Buckle Zahid, A Butt, Bianca, Calabria, Ismael Ricardo, Campos-Nonato Julio, Cesar Campuzano, Jonathan R, Carapetis, Rosario, Cárdenas, David O, Carpenter Juan, Jesus Carrero, Carlos A, Castañeda-Orjuela Jacqueline, Castillo Rivas, Ferrán, Catalá-López, Fiorella, Cavalleri, Kelly, Cercy, Jorge, Cerda, Wanqing, Chen, Adrienne, Chew, Peggy Pei-Chia, Chiang, Mirriam, Chibalabala, Chioma Ezinne, Chibueze, Odgerel, Chimed-Ochir, Vesper Hichilombwe, Chisumpa Jee-Young, Jasmine Choi, Rajiv, Chowdhury, Hanne, Christensen, Devasahayam Jesudas, Christopher Liliana, G Ciobanu, Cirillo Massimo, Aaron J, Cohen, Valentina, 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Machado, Vasco Manuel Pedro, Mackay, Mark T, Maclachlan, Jennifer H, Razek, Hassan Magdy Abd El, Magdy, Mohammed, Razek, Abd El, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Manamo, Wondimu Ayele Ayele, Mandisarisa, John, Mangalam, Srikanth, Mapoma, Chabila C, Marcenes, Wagner, Margolis, David Joel, Martin, Gerard Robert, Martinez-Raga, Jose, Marzan, Melvin Barriento, Masiye, Felix, Mason-Jones, Amanda J, Massano, João, Matzopoulos, Richard, Mayosi, Bongani M, Mcgarvey, Stephen Theodore, Mcgrath, John J, Mckee, Martin, Mcmahon, Brian J, Meaney, Peter A, Mehari, Alem, Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R, Mirarefin, Mojde, Misganaw, Awoke, Mock, Charles N, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mohan, Viswanathan, Mola, Glen Liddell D, Monasta, Lorenzo, Hernandez, Julio Cesar Montañez, Montero, Pablo, Montico, Marcella, Montine, Thomas J, Moradi-Lakeh, Maziar, Morawska, Lidia, Morgan, Katherine, Mori, Rintaro, Mozaffarian, Dariush, Mueller, Ulrich O, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Sriniva, Musa, Kamarul Imran, Nachega, Jean B, Nagel, Gabriele, Naidoo, Kovin S, Naik, Nitish, Naldi, Luigi, Nangia, Vinay, Nash, Deni, Nejjari, Chakib, Neupane, Suba, Newton, Charles R, Newton, John N, Ng, Marie, Ngalesoni, Frida Namnyak, de Dieu Ngirabega, Jean, Nguyen, Quyen Le, Nisar, Muhammad Imran, Pete, Patrick Martial Nkamedjie, Nomura, Marika, Norheim, Ole F, Norman, Paul E, Norrving, Bo, Nyakarahuka, Luke, Ogbo, Felix Akpojene, Ohkubo, Takayoshi, Ojelabi, Foluke Adetola, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osman, Majdi, Ota, Erika, Ozdemir, Raziye, Pa, Mahesh, Pandian, Jeyaraj D, Pant, Puspa Raj, Papachristou, Christina, Park, Eun-Kee, Park, Jae-Hyun, Parry, Charles D, Parsaeian, Mahboubeh, Caicedo, Angel J Paternina, Patten, Scott B, Patton, George C, Paul, Vinod K, Pearce, Neil, Pedro, João Mário, Stokic, Ljiljana Pejin, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Piel, Frédéric B, Pillay, Julian David, Plass, Dietrich, Platts-Mills, James A, Polinder, Suzanne, Pope, C Arden, Popova, Svetlana, Poulton, Richie G, Pourmalek, Farshad, Prabhakaran, Dorairaj, Qorbani, Mostafa, Quame-Amaglo, Justice, Quistberg, D Alex, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajavi, Zhale, Rajsic, Sasa, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M, Ranabhat, Chhabi L, Rangaswamy, Thara, Rao, Puja, Rao, Sowmya R, Refaat, Amany H, Rehm, Jürgen, Reitsma, Marissa B, Remuzzi, Giuseppe, Resnikoff, Serge, Ribeiro, Antonio L, Ricci, Stefano, Blancas, Maria Jesus Rio, Roberts, Bayard, Roca, Anna, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Rothenbacher, Dietrich, Roy, Ambuj, Roy, Nawal K, Ruhago, George Mugambage, Sagar, Rajesh, Saha, Sukanta, Sahathevan, Ramesh, Saleh, Muhammad Muhammad, Sanabria, Juan R, Sanchez-Niño, Maria Dolore, Sanchez-Riera, Lidia, Santos, Itamar S, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Schaub, Michael P, Schmidt, Maria Inê, Schneider, Ione J C, Schöttker, Ben, Schutte, Aletta E, Schwebel, David C, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya A, Shaddick, Gavin, Shaheen, Amira, Shahraz, Saeid, Shaikh, Masood Ali, Shakh-Nazarova, Marina, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Shen, Ziyan, Shepard, Donald S, Sheth, Kevin N, Shetty, Balakrishna P, Shi, Peilin, Shibuya, Kenji, Shin, Min-Jeong, Shiri, Rahman, Shiue, Ivy, Shrime, Mark G, Sigfusdottir, Inga Dora, Silberberg, Donald H, Silva, Diego Augusto Santo, Silveira, Dayane Gabriele Alve, Silverberg, Jonathan I, Simard, Edgar P, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Singh, Virendra, Soneji, Samir, Søreide, Kjetil, Soriano, Joan B, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stathopoulou, Vasiliki, Stein, Dan J, Stein, Murray B, Stranges, Saverio, Stroumpoulis, Konstantino, Sunguya, Bruno F, Sur, Patrick, Swaminathan, Soumya, Sykes, Bryan L, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tabb, Karen M, Takahashi, Ken, Takala, Jukka S, Talongwa, Roberto Tchio, Tandon, Nikhil, Tavakkoli, Mohammad, Taye, Bineyam, Taylor, Hugh R, Ao, Braden J Te, Tedla, Bemnet Amare, Tefera, Worku Mekonnen, Have, Margreet Ten, Terkawi, Abdullah Sulieman, Tesfay, Fisaha Haile, Tessema, Gizachew Assefa, Thomson, Alan J, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tirschwell, David L, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Towbin, Jeffrey Allen, Traebert, Jefferson, Tran, Bach Xuan, Truelsen, Thoma, Trujillo, Ulise, Tura, Abera Kenay, Tuzcu, Emin Murat, Uchendu, Uche S, Ukwaja, Kingsley N, Undurraga, Eduardo A, Uthman, Olalekan A, Dingenen, Rita Van, van Donkelaar, Aaron, Vasankari, Tommi, Vasconcelos, Ana Maria Nogale, Venketasubramanian, Narayanaswamy, Vidavalur, Ramesh, Vijayakumar, Lakshmi, Villalpando, Salvador, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Wagner, Joseph A, Wagner, Gregory R, Wallin, Mitchell T, Wang, Linhong, Watkins, David A, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Westerman, Ronny, White, Richard A, Wijeratne, Tissa, Wilkinson, James D, Williams, Hywel C, Wiysonge, Charles Shey, Woldeyohannes, Solomon Meseret, Wolfe, Charles D A, Won, Sungho, Wong, John Q, Woolf, Anthony D, Xavier, Deni, Xiao, Qingyang, Xu, Gelin, Yakob, Bereket, Yalew, Ayalnesh Zemene, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Ye, Pengpeng, Yebyo, Henock Gebremedhin, Yip, Paul, Yirsaw, Biruck Desalegn, Yonemoto, Naohiro, Yonga, Gerald, Younis, Mustafa Z, Yu, Shicheng, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zannad, Faiez, Zavala, Diego E, Zeeb, Hajo, Zeleke, Berihun M, Zhang, Hao, Zodpey, Sanjay, Zonies, David, Zuhlke, Liesl Joanna, Vos, Theo, Lopez, Alan D, and Murray, Christopher J L
Subjects: VITAL-STATISTICS, INTEGRATED APPROACH, ECONOMIC-DEVELOPMENT, DEVELOPMENT ASSISTANCE, UNITED-STATES, Global Health, Communicable Disease, Communicable Diseases, cause of death, Medicine, General & Internal, Life Expectancy, General & Internal Medicine, Humans, Mortality, Medicine(all), Science & Technology, Mortality, Premature, Medicine (all), EPIDEMIOLOGIC TRANSITION, GBD 2015 Mortality and Causes of Death Collaborators, CIVIL REGISTRATION, Public Health, Global Health, Social Medicine and Epidemiology, Articles, 11 Medical And Health Sciences, ROAD TRAFFIC INJURIES, ALZHEIMERS-DISEASE, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, VERBAL AUTOPSY, Life Sciences & Biomedicine, Human
Abstract: Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.
Published: 2016

27. Probability-Scale Residuals in HIV/AIDS Research: Diagnostics and Inference

Author: Bryan E. Shepherd, Qi Liu, Valentine Wanga, and Chun Li
Published: 2017
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28. The global burden of disease study 2013: What does it mean for the NTDs?

Author: Thomas Fürst, Christine M. Budke, Valentine Wanga, Christopher J L Murray, Juanita A. Haagsma, Donald S. Shepard, María-Gloria Basáñez, Kapa D. Ramaiah, Charles H. King, Wilma A. Stolk, Mohsen Naghavi, Michele E. Murdoch, Eduardo A. Undurraga, Hélène Carabin, Jeffrey D. Stanaway, Peter J. Hotez, Eric M. Fèvre, Yara A. Halasa, Luc E. Coffeng, Jennifer R. Herricks, Geoffrey Buckle, and Public Health
Subjects: Viral Diseases, RC955-962, AZITHROMYCIN, Prevalence, Fevers, Global Health, Pathology and Laboratory Medicine, Geographical Locations, 0302 clinical medicine, Cost of Illness, FOOD-BORNE TREMATODIASIS, Risk Factors, Zoonoses, Arctic medicine. Tropical medicine, INFECTION, Epidemiology, Medicine and Health Sciences, Global health, Scabies, Schistosomiasis, Medicine, Public and Occupational Health, 030212 general & internal medicine, Incidence, Incidence (epidemiology), Neglected Diseases, Bacterial Infections, 11 Medical And Health Sciences, humanities, PREVALENCE, 3. Good health, Viewpoints, Infectious Diseases, Trachoma, Virus Diseases, Helminth Infections, Neglected tropical diseases, Quality-Adjusted Life Years, HEALTH, Public aspects of medicine, RA1-1270, Life Sciences & Biomedicine, Neglected Tropical Diseases, COUNTRIES, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Asia, Rabies, 030231 tropical medicine, TRACHOMA, 03 medical and health sciences, Signs and Symptoms, Diagnostic Medicine, Tropical Medicine, Environmental health, parasitic diseases, Parasitic Diseases, SYSTEMATIC ANALYSIS, Humans, ELIMINATION, Science & Technology, Cysticercosis, business.industry, Public Health, Environmental and Occupational Health, AFRICAN PROGRAM, 06 Biological Sciences, Tropical Diseases, medicine.disease, Quality-adjusted life year, Communicable Disease Control, People and Places, Parasitology, business
Abstract: The Global Burden of Disease Study (GBD) is a landmark initiative that systematically quantifies the prevalence, morbidity, and mortality for hundreds of diseases, injuries, and risk factors of global health importance. For the neglected tropical diseases (NTDs), the GBD 2010 confirmed a high disease burden for the 17 major NTDs prioritized by the World Health Organization (WHO) as well as for selected conditions also recognized as NTDs by PLOS Neglected Tropical Diseases, including amoebiasis, cholera, cryptosporidiosis, typhoid and paratyphoid fevers, trichomoniasis, venomous animal contact, and scabies (referred to here as “additional NTDs”) [1]. The GBD 2013 is intended to be the first in a series of annual updates for the GBD studies, with its initial results published in 2015 in The Lancet [2–4]. Here, we review information on the NTDs published in the GBD 2013 capstone papers [2–4] and present new NTD data and updated burden estimates from the GBD 2013 study and new country-specific estimates. We show key outputs of GBD 2013 including country-specific estimates of prevalence or incidence and health-gap metrics for the aforementioned NTDs.
Published: 2017

29. Covariate-adjusted Spearman's rank correlation with probability-scale residuals

Author: Qi, Liu, Chun, Li, Valentine, Wanga, and Bryan E, Shepherd
Subjects: Surveys and Questionnaires, Quality of Life, Humans, Computer Simulation, Female, HIV Infections, Biomarkers, Mozambique, Statistics, Nonparametric, Article, Probability
Abstract: It is desirable to adjust Spearman’s rank correlation for covariates, yet existing approaches have limitations. For example, the traditionally defined partial Spearman’s correlation does not have a sensible population parameter, and the conditional Spearman’s correlation defined with copulas cannot be easily generalized to discrete variables. We define population parameters for both partial and conditional Spearman’s correlation through concordance-discordance probabilities. The definitions are natural extensions of Spearman’s rank correlation in the presence of covariates and are general for any orderable random variables. We show that they can be neatly expressed using probability-scale residuals (PSRs). This connection allows us to derive simple estimators. Our partial estimator for Spearman’s correlation between X and Y adjusted for Z is the correlation of PSRs from models of X on Z and of Y on Z, which is analogous to the partial Pearson’s correlation derived as the correlation of observed-minus-expected residuals. Our conditional estimator is the conditional correlation of PSRs. We describe estimation and inference, and highlight the use of semiparametric cumulative probability models, which allow preservation of the rank-based nature of Spearman’s correlation. We conduct simulations to evaluate the performance of our estimators and compare them with other popular measures of association, demonstrating their robustness and efficiency. We illustrate our method in two applications, a biomarker study and a large survey.
Published: 2017

30. Global burden of cutaneous leishmaniasis

Author: Chante Karimkhani, Mohsen Naghavi, Valentine Wanga, Paria Naghavi, and Robert P. Dellavalle
Subjects: 0301 basic medicine, medicine.medical_specialty, biology, Transmission (medicine), Public health, Outbreak, Leishmaniasis, Cutaneous, medicine.disease, biology.organism_classification, Global Health, Zika virus, 03 medical and health sciences, 030104 developmental biology, Infectious Diseases, Geography, Cutaneous leishmaniasis, Environmental health, medicine, Humans, Disease prevention
Abstract: 1004 www.thelancet.com/infection Vol 16 September 2016 3 Burattini MN, Coutinho FAB, Lopez LF, et al. Potential exposure to Zika virus for foreign tourists during the 2016 Carnival and Olympic Games in Rio de Janeiro, Brazil. Epidemiol Infect 2016; 144: 1904–06. 4 Massad E, Coutinho FAB, Wilder-Smith A. Is Zika a substantial risk for visitors to the Rio de Janeiro Olympic Games? Lancet 2016; 388: 25. 5 Grills A, Morrison S, Nelson B, Miniota J, Watts A, Cetron MS. Projected Zika virus importation and subsequent ongoing transmission after travel to the 2016 Olympic and Paralympic games—country-specifi c assessment, July 2016. MMWR Morb Mortal Wkly Rep; published online July 13, 2016. http://dx.doi.org/10.15585/ mmwr.mm6528e1 (accessed July 14, 2016). 4 European Centre for Disease Prevention and Control. Potential risks to public health related to communicable diseases at the Olympics and Paralympics Games in Rio de Janeiro, Brazil 2016. Stockholm, 2016. http://ecdc.europa.eu/en/publications/ Publications/Risk-assessment-mass%20 gathering-Rio-2016-10May2016.pdf (accessed June 20, 2016). 5 Uyeki TM, Zane SB, Bodnar UR, et al. Large summertime infl uenza A outbreak among tourists in Alaska and the Yukon Territory. Clin Infect Dis 2003; 36: 1095–102.
Published: 2016

31. Global burden of cutaneous leishmaniasis: a cross-sectional analysis from the Global Burden of Disease Study 2013

Author: Chante Karimkhani, Mohsen Naghavi, Robert P. Dellavalle, Luc E. Coffeng, Paria Naghavi, Valentine Wanga, and Public Health
Subjects: 0301 basic medicine, Veterinary medicine, medicine.medical_specialty, business.industry, Incidence (epidemiology), 030231 tropical medicine, Prevalence, Developing country, Leishmaniasis, medicine.disease, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Infectious Diseases, Years of potential life lost, Cutaneous leishmaniasis, parasitic diseases, Epidemiology, medicine, Global health, business, Demography
Abstract: Summary Background High-quality epidemiological studies evaluating the burden of cutaneous leishmaniasis worldwide are lacking. We compared the burden of cutaneous leishmaniasis in each country to the overall global burden and assessed the equality of cutaneous leishmaniasis burden across different countries and regions. Methods Data were extracted from scientific literature, hospital sources, country reports, and WHO sources on the prevalence of sequalae of both acute and chronic cutaneous leishmaniasis. Prevalence data were combined with a disability weight to yield years lived with disability. Disability-adjusted life-years (DALYs) are a sum of the years lived with disability and years of life lost (or mortality, assumed to be zero). We compared DALYs due to cutaneous leishmaniasis for 152 countries using standard Z score analysis with Bonferroni correction (p Findings In 2013, the global mean age-standardised DALYs for cutaneous leishmaniasis was 0·58 per 100 000 people. Nine countries had significantly greater DALYs from cutaneous leishmaniasis than the mean: Afghanistan (87·0), Sudan (20·2), Syria (9·2), Yemen (6·2), Iraq (6·0), Burkina Faso (4·8), Bolivia (4·6), Haiti (4·1), and Peru (4·0). The Gini coefficient was 0·89. Andean Latin America, North Africa and Middle East, western sub-Saharan Africa, and south Asia had the highest DALYs from cutaneous leishmaniasis. Among males, Palestine had the highest incidence rates (616·2 cases per 100 000 people) followed by Afghanistan (566·4), Syria (357·1), and Nicaragua (354·8). Among females, Afghanistan had the highest incidence rates (623·9) followed by Syria (406·3), Palestine (222·1), and Nicaragua (180·8). Similar proportions of males and females had cutaneous leishmaniasis in most countries with a high incidence. Interpretation The burden from cutaneous leishmaniasis mainly falls on countries in Africa and the Middle East. Global and national data on the burden of cutaneous leishmaniasis disease are pivotal to promote field studies and initiate behavioural change. Funding Bill & Melinda Gates Foundation.
Published: 2016

32. 200 Global burden of cutaneous leishmaniasis

Author: Chante Karimkhani, Valentine Wanga, Mohsen Naghavi, Paria Naghavi, Luc E. Coffeng, and Robert P. Dellavalle
Subjects: medicine.medical_specialty, Cutaneous leishmaniasis, business.industry, medicine, Cell Biology, Dermatology, business, medicine.disease, Molecular Biology, Biochemistry
Published: 2016
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33. Improving the large scale purification of the HIV microbicide, griffithsin

Author: Kenneth E. Palmer, Joshua L Fuqua, and Valentine Wanga
Subjects: Anti-HIV Agents, Magnesium Chloride, Human immunodeficiency virus (HIV), Microbicide, medicine.disease_cause, 03 medical and health sciences, Tobacco, Protein purification, medicine, Purification methods, 030304 developmental biology, Active ingredient, Griffithsin, 0303 health sciences, Manufacturing technology, Chromatography, biology, 030306 microbiology, business.industry, N. benthamiana, Industrial scale, HIV, Recombinant Proteins, Biotechnology, Bentonite, biology.protein, Tobacco mosaic virus, Plant Lectins, business, Research Article
Abstract: Background Griffithsin is a broad spectrum antiviral lectin that inhibits viral entry and maturation processes through binding clusters of oligomannose glycans on viral envelope glycoproteins. An efficient, scaleable manufacturing process for griffithsin active pharmaceutical ingredient (API) is essential for particularly cost-sensitive products such as griffithsin -based topical microbicides for HIV-1 prevention in resource poor settings. Our previously published purification method used ceramic filtration followed by two chromatography steps, resulting in a protein recovery of 30%. Our objective was to develop a scalable purification method for griffithsin expressed in Nicotiana benthamiana plants that would increase yield, reduce production costs, and simplify manufacturing techniques. Considering the future need to transfer griffithsin manufacturing technology to resource poor areas, we chose to focus modifying the purification process, paying particular attention to introducing simple, low-cost, and scalable procedures such as use of temperature, pH, ion concentration, and filtration to enhance product recovery. Results We achieved >99% pure griffithsin API by generating the initial green juice extract in pH 4 buffer, heating the extract to 55°C, incubating overnight with a bentonite MgCl2 mixture, and final purification with Capto™ multimodal chromatography. Griffithsin extracted with this protocol maintains activity comparable to griffithsin purified by the previously published method and we are able to recover a substantially higher yield: 88 ± 5% of griffithsin from the initial extract. The method was scaled to produce gram quantities of griffithsin with high yields, low endotoxin levels, and low purification costs maintained. Conclusions The methodology developed to purify griffithsin introduces and develops multiple tools for purification of recombinant proteins from plants at an industrial scale. These tools allow for robust cost-effective production and purification of griffithsin. The methodology can be readily scaled to the bench top or industry and process components can be used for purification of additional proteins based on biophysical characteristics.
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34. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015

Author: Lim, Stephen S, Allen, Kate, Bhutta, Zulfiqar A, Dandona, Lalit, Forouzanfar, Mohammad H, Fullman, Nancy, Gething, Peter W, Goldberg, Ellen M, Hay, Simon I, Holmberg, Mollie, Kinfu, Yohannes, Kutz, Michael J, Larson, Heidi J, Liang, Xiaofeng, Lopez, Alan D, Lozano, Rafael, McNellan, Claire R, Mokdad, Ali H, Mooney, Meghan D, Naghavi, Mohsen, Olsen, Helen E, Pigott, David M, Salomon, Joshua A, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulle, Abdishakur M, Abraham, Biju, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen ME, Abyu, Gebre Yitayih, Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Afanvi, Kossivi Agbelenko, Afshin, Ashkan, Agarwal, Arnav, Agrawal, Anurag, Kiadaliri, Aliasghar Ahmad, Ahmadieh, Hamid, Ahmed, Kedir Yimam, Akanda, Ali Shafqat, Akinyemi, Rufus Olusola, Akinyemiju, Tomi F, Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Uzma, Alasfoor, Deena, AlBuhairan, Fadia S, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alemu, Zewdie Aderaw, Ali, Raghib, Alkerwi, Ala'a, Alkhateeb, Mohammad AB, Alla, Francois, Allebeck, Peter, Allen, Christine, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amberbir, Alemayehu, Amegah, Adeladza Kofi, Amini, Heresh, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H, Anderson, Benjamin O, Anderson, Gregory M, Antonio, Carl Abelardo T, Anwari, Palwasha, Arnlov, Johan, Artaman, Al, Asayesh, Hamid, Asghar, Rana Jawad, Atique, Suleman, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barber, Ryan, Barker-Collo, Suzanne L, Barnighausen, Till, Barrero, Lope H, Barrientos-Gutierrez, Tonatiuh, Basu, Sanjay, Bayou, Tigist Assefa, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Beghi, Ettore, Bejot, Yannick, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Benzian, Habib, Berhane, Adugnaw, Bernabe, Eduardo, Bernal, Oscar Alberto, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Bhala, Neeraj, Bhatt, Samir, Biadgilign, Sibhatu, Bienhoff, Kelly A, Bikbov, Boris, Binagwaho, Agnes, Bisanzio, Donal, Bjertness, Espen, Blore, Jed, Bourne, Rupert RA, Brainin, Michael, Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas JK, Broday, David M, Brugha, Traolach S, Buchbinder, Rachelle, Butt, Zahid A, Cahill, Leah E, Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Carabin, Helene, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel, Caso, Valeria, Castaneda-Orjuela, Carlos A, Castillo Rivas, Jacqueline, Catala-Lopez, Ferran, Cavalleri, Fiorella, Cecilio, Pedro, Chang, Hsing-Yi, Chang, Jung-Chen, Charlson, Fiona J, Che, Xuan, Chen, Alan Zian, Chiang, Peggy Pei-Chia, Chibalabala, Mirriam, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christensen, Hanne, Ciobanu, Liliana G, Cirillo, Massimo, Coates, Matthew M, Coggeshall, Megan, Cohen, Aaron J, Cooke, Graham S, Cooper, Cyrus, Cooper, Leslie Trumbull, Cowie, Benjamin C, Crump, John A, Damtew, Solomon Abrha, Dandona, Rakhi, Dargan, Paul I, das Neves, Jose, Davis, Adrian C, Davletov, Kairat, de Castro, E Filipa, De Leo, Diego, Degenhardt, Louisa, Del Gobbo, Liana C, Deribe, Kebede, Derrett, Sarah, Jarlais, Don C Des, Deshpande, Aniruddha, Deveber, Gabrielle A, Dey, Subhojit, Dharmaratne, Samath D, Dhillon, Preet K, Ding, Eric L, Dorsey, E Ray, Doyle, Kerrie E, Driscoll, Tim R, Duan, Leilei, Dubey, Manisha, Duncan, Bruce Bartholow, Ebrahimi, Hedyeh, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Erskine, Holly E, Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Farid, Talha A, Sofia e Sa Farinha, Carla, Faro, Andre, Farvid, Maryam S, Farzadfar, Farshad, Feigin, Valery L, Mendonca Felicio, Manuela, Fereshtehnejad, Seyed-Mohammad, Fernandes, Jefferson G, Fernandes, Joao C, Ferrari, Alize J, Fischer, Florian, Fitchett, Joseph RA, Fitzmaurice, Christina, Foigt, Nataliya, Foreman, Kyle, Fowkes, F Gerry R, Franca, Elisabeth Barboza, Franklin, Richard C, Fraser, Maya, Friedman, Joseph, Frostad, Joseph, Furst, Thomas, Gabbe, Belinda, Garcia-Basteiro, Alberto L, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebru, Alemseged Aregay, Gessner, Bradford D, Gillum, Richard F, Ginawi, Ibrahim Abdelmageem Mohamed, Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Giussani, Giorgia, Godwin, William, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Graetz, Nicholas, Greenwell, Karen Fern, Griswold, Max, Gugnani, Harish, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Gutierrez, Reyna A, Gyawali, Bishal, Haagsma, Juanita A, Haakenstad, Annie, Hafezi-Nejad, Nima, Haile, Demewoz, Hailu, Gessessew Bugssa, Halasa, Yara A, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Hankey, Graeme J, Harb, Hilda L, Haro, Josep Maria, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmus, Heredia-Pi, Ileana Beatriz, Hoek, Hans W, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hoy, Damian G, Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Iburg, Kim Moesgaard, Idrisov, Bulat T, Inoue, Manami, Islami, Farhad, Jacobs, Troy A, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, James, Peter, Jansen, Henrica AFM, Javanbakht, Mehdi, Jayaraman, Sudha P, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Ying, Jibat, Tariku, Jin, Ye, Jonas, Jost B, Kabir, Zubair, Kalkonde, Yogeshwar, Kamal, Ritul, Kan, Haidong, Kandel, Amit, Karch, Andre, Karema, Corine Kakizi, Karimkhani, Chante, Karunapema, Palitha, Kasaeian, Amir, Kassebaum, Nicholas J, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khan, Gulfaraz, Khang, Young-Ho, Khoja, Tawfi K Ahmed Muthafer, Khosravi, Ardeshir, Khubchandani, Jagdish, Kieling, Christian, Kim, Cho-Il, Kim, Daniel, Kim, Sungroul, Kim, Yun Jin, Kimokoti, Ruth W, Kissoon, Niranjan, Kivipelto, Miia, Knibbs, Luke D, Kokubo, Yoshihiro, Kolte, Dhaval, Kosen, Soewarta, Kotsakis, Georgios A, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael, Krueger, Hans, Defo, Barthelemy Kuate, Kuchenbecker, Ricardo S, Kuipers, Ernst J, Kulikoff, Xie Rachel, Kulkarni, Veena S, Kumar, G Anil, Kwan, Gene F, Kyu, Hmwe H, Lal, Aparna, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lan, Qing, Langan, Sinead M, Larsson, Anders, Laryea, Dennis Odai, Latif, Asma Abdul, Leasher, Janet L, Leigh, James, Leinsalu, Mall, Leung, Janni, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Lind, Margaret, Linn, Shai, Lipshultz, Steven E, Liu, Patrick Y, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Lo, Loon-Tzian, Logroscino, Giancarlo, Lotufo, Paulo A, Lucas, Robyn M, Lunevicius, Raimundas, Abd El Razek, Mohammed Magdy, Magis-Rodriguez, Carlos, Mahdavi, Mahdi, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Mapoma, Chabila C, Margolis, David Joel, Martin, Randall V, Martinez-Raga, Jose, Masiye, Felix, Mason-Jones, Amanda J, Massano, Joao, Matzopoulos, Richard, Mayosi, Bongani M, McGrath, John J, Mckee, Martin, Meaney, Peter A, Mehari, Alem, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Mensink, Gert BM, Meretoja, Atte, Meretoja, Tuomo J, Mesfin, Yonatan Moges, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R, Mills, Edward J, Mirarefi, Mojde, Misganaw, Awoke, Mitchell, Philip B, Mock, Charles N, Mohammadi, Alireza, Mohammed, Shafi U, Monasta, Lorenzo, De la Cruz Monis, Jonathan, Montanez Hernandez, Julio Cesar, Montico, Marcella, Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich O, Murdoch, Michele E, Murimira, Brighton, Murray, Joseph, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Musa, Kamarul Imran, Nachega, Jean B, Nagel, Gabriele, Naidoo, Kovin S, Naldi, Luigi, Nangia, Vinay, Neal, Bruce, Nejjari, Chakib, Newton, Charles R, Newton, John N, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Nguyen, Quyen Le, Nisar, Muhammad Imran, Pete, Patrick Martial Nkamedjie, Nolte, Sandra, Nomura, Marika, Norheim, Ole F, Norrving, Bo, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Oladimeji, Olanrewaju, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osborne, Richard H, Ota, Erika, Owolabi, Mayowa O, Mahesh, PA, Park, Eun-Kee, Park, Hye-Youn, Parry, Charles D, Parsaeian, Mahboubeh, Patel, Tejas, Patel, Vikram, Caicedo, Angel J Paternina, Patil, Snehal T, Patten, Scott B, Patton, George C, Paudel, Deepak, Pedro, Joao Mario, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Piel, Frederic B, Pillay, Julian David, Pinho, Christine, Pishgar, Farhad, Polinder, Suzanne, Poulton, Richie G, Pourmalek, Farshad, Qorbani, Mostafa, Rabiee, Rynaz HS, Radfar, Amir, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajsic, Sasa, Raju, Murugesan, Ram, Usha, Rana, Saleem M, Ranabhat, Chhabi Lal, Ranganathan, Kavitha, Rao, Puja C, Refaat, Amany H, Reitsma, Marissa B, Remuzzi, Giuseppe, Resnikoff, Serge, Ribeiro, Antonio L, Rios Blancas, Maria Jesus, Roba, Hirbo Shore, Roberts, Bayard, Rodriguez, Alina, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Roy, Nobhojit, Sackey, Ben Benasco, Sagar, Rajesh, Saleh, Muhammad Muhammad, Sanabria, Juan R, Santos, Joao Vasco, Santomauro, Damian F, Santos, Itamar S, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Sawyer, Susan M, Schmidhuber, Josef, Schmidt, Maria Ines, Schneider, Ione JC, Schutte, Aletta E, Schwebel, David C, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya, Shaheen, Amira, Shaikh, Masood Ali, Levy, Teresa Shamah, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Sheth, Kevin N, Shey, Muki, Shi, Peilin, Shibuya, Kenji, Shigematsu, Mika, Shin, Min-Jeong, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga Dora, Silpakit, Naris, Santos Silva, Diego Augusto, Silverberg, Jonathan I, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Skirbekk, Vegard, Sligar, Amber, Soneji, Samir, Soreide, Kjetil, Sorensen, Reed JD, Soriano, Joan B, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stahl, Hans-Christian, Stanaway, Jeff rey D, Stathopoulou, Vasiliki, Steckling, Nadine, Steel, Nicholas, Stein, Dan J, Steiner, Caitlyn, Stockl, Heidi, Stranges, Saverio, Strong, Mark, Sun, Jiandong, Sunguya, Bruno F, Sur, Patrick, Swaminathan, Soumya, Sykes, Bryan L, Szoeke, Cassandra EI, Tabares-Seisdedos, Rafael, Tabb, Karen M, Talongwa, Roberto Tchio, Tarawneh, Mohammed Rasoul, Tavakkoli, Mohammad, Taye, Bineyam, Taylor, Hugh R, Tedla, Bemnet Amare, Tefera, Worku, Tegegne, Teketo Kassaw, Tekle, Dejen Yemane, Shifa, Girma Temam, Terkawi, Abdullah Sulieman, Tessema, Gizachew Assefa, Thakur, JS, Thomson, Alan J, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Fotis, Tran, Bach Xuan, Truelsen, Thomas, Dimbuene, Zacharie Tsala, Tura, Abera Kenay, Tuzcu, Emin Murat, Tyrovolas, Stefanos, Ukwaja, Kingsley Nnanna, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Uthman, Olalekan A, van Donkelaar, Aaron, Varakin, Yuri Y, Vasankari, Tommi, Nogales Vasconcelos, Ana Maria, Veerman, J Lennert, Venketasubramanian, Narayanaswamy, Verma, Raj Kumar, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Volkow, Patricia, Vollset, Stein Emil, Wagner, Gregory R, Wallin, Mitchell T, Wang, Linhong, Wanga, Valentine, Watkins, David A, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Whiteford, Harvey A, Wilkinson, James D, Wiysonge, Charles Shey, Wolfe, Charles DA, Wolfe, Ingrid, Won, Sungho, Woolf, Anthony D, Workie, Shimelash Bitew, Wubshet, Mamo, Xu, Gelin, Yadav, Ajit Kumar, Yakob, Bereket, Yalew, Ayalnesh Zemene, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Ye, Pengpeng, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zambrana-Torrelio, Carlos, Zapata, Tomas, Zegeye, Elias Asfaw, Zhao, Yi, Zhou, Maigeng, Zodpey, Sanjay, Zonies, David, Murray, Christopher JL, Collaborators, GBD 2015 SDG, Stephen S., Lim, Kate, Allen, Zulfi qar A., Bhutta, Lalit, Dandona, Mohammad H., Forouzanfar, Nancy, Fullman, Peter W., Gething, Ellen M., Goldberg, Simon I., Hay, Mollie, Holmberg, Yohannes, Kinfu, Michael J., Kutz, Heidi J., Larson, Xiaofeng, Liang, Alan D., Lopez, Rafael, Lozano, Claire R., Mcnellan, Ali H., Mokdad, Meghan D., Mooney, Mohsen, Naghavi, Helen E., Olsen, David M., Pigott, Joshua A., Salomon, Theo, Vo, Haidong, Wang, Amanuel Alemu, Abajobir, Kalkidan Hassen, Abate, Cristiana, Abbafati, Kaja M., Abba, Foad Abd, Allah, Abdishakur M., Abdulle, Biju, Abraham, Ibrahim, Abubakar, Laith J., Abu Raddad, Niveen M. E., Abu Rmeileh, Gebre Yitayih, Abyu, Tom, Achoki, Akindele Olupelumi, Adebiyi, Isaac Akinkunmi, Adedeji, Kossivi Agbelenko, Afanvi, Ashkan, Afshin, Arnav, Agarwal, Anurag, Agrawal, Aliasghar Ahmad, Kiadaliri, Hamid, Ahmadieh, Kedir Yimam, Ahmed, Ali Shafqat, Akanda, Rufus Olusola, Akinyemi, Tomi F., Akinyemiju, Nadia, Akseer, Ziyad Al, Aly, Khurshid, Alam, Uzma, Alam, Deena, Alasfoor, Fadia S., Albuhairan, Saleh Fahed, Aldhahri, Robert William, Aldridge, Zewdie Aderaw, Alemu, Raghib, Ali, Ala’A, Alkerwi, Mohammad AB, Alkhateeb, François, Alla, Peter, Allebeck, Christine, Allen, Rajaa Al, Raddadi, Khalid A., Altirkawi, Elena Alvarez, Martin, Nelson Alvis, Guzman, Azmeraw T., Amare, Alemayehu, Amberbir, Adeladza Kofi, Amegah, Heresh, Amini, Walid, Ammar, Stephen Marc, Amrock, Hjalte H., Andersen, Benjamin O., Anderson, Gregory M., Anderson, Carl Abelardo T., Antonio, Palwasha, Anwari, Johan, Ärnlöv, Al, Artaman, Hamid, Asayesh, Rana Jawad, Asghar, Suleman, Atique, Euripide Frinel G., Arthur Avokpaho, Ashish, Awasthi, Beatriz Paulina Ayala, Quintanilla, Peter, Azzopardi, Umar, Bacha, Alaa, Badawi, Kalpana, Balakrishnan, Amitava, Banerjee, Aleksandra, Barac, Ryan, Barber, Suzanne L., Barker Collo, Till, Bärnighausen, Lope H., Barrero, Tonatiuh Barrientos, Gutierrez, Sanjay, Basu, Tigist Assefa, Bayou, Shahrzad Bazargan, Hejazi, Justin, Beardsley, Neeraj, Bedi, Ettore, Beghi, Yannick, Béjot, Michelle L., Bell, Aminu K., Bello, Derrick A., Bennett, Isabela M., Bensenor, Habib, Benzian, Adugnaw, Berhane, Eduardo, Bernabé, Oscar Alberto, Bernal, Balem Demtsu, Betsu, Addisu Shunu, Beyene, Neeraj, Bhala, Samir, Bhatt, Sibhatu, Biadgilign, Kelly A., Bienhoff, Boris, Bikbov, Agnes, Binagwaho, Donal, Bisanzio, Espen, Bjertne, Jed, Blore, Rupert R. A., Bourne, Michael, Brainin, Michael, Brauer, Alexandra, Brazinova, Nicholas J. K., Breitborde, David M., Broday, Traolach S., Brugha, Rachelle, Buchbinder, Zahid A., Butt, Leah E., Cahill, Ismael Ricardo Campos, Nonato, Julio Cesar, Campuzano, Hélène, Carabin, Rosario, Cárdena, Juan Jesus, Carrero, Austin, Carter, Daniel, Casey, Valeria, Caso, Carlos A., Castañeda Orjuela, Jacqueline Castillo, Riva, Ferrán Catalá, López, Fiorella, Cavalleri, Pedro, Cecílio, Hsing Yi, Chang, Jung Chen, Chang, Fiona J., Charlson, Xuan, Che, Alan Zian, Chen, Peggy Pei Chia, Chiang, Mirriam, Chibalabala, Vesper Hichilombwe, Chisumpa, Jee Young Jasmine, Choi, Rajiv, Chowdhury, Hanne, Christensen, Liliana G., Ciobanu, Cirillo, Massimo, Matthew M., Coate, Megan, Coggeshall, Aaron J., Cohen, Graham S., Cooke, Cyrus, Cooper, Leslie Trumbull, Cooper, Benjamin C., Cowie, John A., Crump, Solomon Abrha, Damtew, Rakhi, Dandona, Paul I., Dargan, José das, Neve, Adrian C., Davi, Kairat, Davletov, E., Filipa de Castro, Diego De, Leo, Louisa, Degenhardt, Liana C., Del Gobbo, Kebede, Deribe, Sarah, Derrett, Don C., Des Jarlai, Aniruddha, Deshpande, Gabrielle A., Deveber, Subhojit, Dey, Samath D., Dharmaratne, Preet K., Dhillon, Eric L., Ding, E., Ray Dorsey, Kerrie E., Doyle, Tim R., Driscoll, Leilei, Duan, Manisha, Dubey, Bruce Bartholow, Duncan, Hedyeh, Ebrahimi, Aman Yesuf, Endrie, Sergey Petrovich, Ermakov, Holly E., Erskine, Babak, Eshrati, Alireza, Esteghamati, Saman, Fahimi, Talha A., Farid, Carla Sofi a. e., Sa Farinha, André, Faro, Maryam S., Farvid, Farshad, Farzadfar, Valery L., Feigin, Manuela Mendonca, Felicio, Seyed Mohammad, Fereshtehnejad, Jefferson G., Fernande, Joao C., Fernande, Alize J., Ferrari, Florian, Fischer, Joseph R. A., Fitchett, Christina, Fitzmaurice, Nataliya, Foigt, Kyle, Foreman, F. Gerry R., Fowke, Elisabeth Barboza, Franca, Richard C., Franklin, Maya, Fraser, Joseph, Friedman, Joseph, Frostad, Thomas, Fürst, Belinda, Gabbe, Alberto L., Garcia Basteiro, Teshome, Gebre, Tsegaye Tewelde, Gebrehiwot, Amanuel Tesfay, Gebremedhin, Alemseged Aregay, Gebru, Bradford D., Gessner, Richard F., Gillum, Ibrahim Abdelmageem Mohamed, Ginawi, Ababi Zergaw, Giref, Maurice, Giroud, Melkamu Dedefo, Gishu, William, Godwin, Philimon, Gona, Amador, Goodridge, Sameer Vali, Gopalani, Carolyn C., Gotay, Atsushi, Goto, Hebe N., Gouda, Nicholas, Graetz, Karen Fern, Greenwell, Max, Griswold, Yuming, Guo, Rahul, Gupta, Rajeev, Gupta, Vipin, Gupta, Reyna A., Gutiérrez, Bishal, Gyawali, Juanita A., Haagsma, Annie, Haakenstad, Nima Hafezi, Nejad, Demewoz, Haile, Gessessew Bugssa, Hailu, Yara A., Halasa, Randah Ribhi, Hamadeh, Samer, Hamidi, Mouhanad, Hammami, Graeme J., Hankey, Hilda L., Harb, Josep Maria, Haro, Mohammad Sadegh, Hassanvand, Rasmus, Havmoeller, Ileana Beatriz Heredia, Pi, Hans W., Hoek, Masako, Horino, Nobuyuki, Horita, H., Dean Hosgood, Damian G., Hoy, Aung Soe, Htet, Guoqing, Hu, Hsiang, Huang, Kim Moesgaard, Iburg, Bulat T., Idrisov, Manami, Inoue, Farhad, Islami, Troy A., Jacob, Kathryn H., Jacobsen, Nader, Jahanmehr, Mihajlo B., Jakovljevic, Peter, Jame, Henrica A. F. M., Jansen, Mehdi, Javanbakht, Achala Upendra, Jayatilleke, Sun Ha, Jee, Panniyammakal, Jeemon, Vivekanand, Jha, Ying, Jiang, Tariku, Jibat, Ye, Jin, Jost B., Jona, Zubair, Kabir, Yogeshwar, Kalkonde, Ritul, Kamal, Haidong, Kan, Amit, Kandel, André, Karch, Corine Kakizi, Karema, Chante, Karimkhani, Palitha, Karunapema, Amir, Kasaeian, Nicholas J., Kassebaum, Anil, Kaul, Norito, Kawakami, Jeanne Françoise, Kayibanda, Peter Njenga, Keiyoro, Laura, Kemmer, Andrew Haddon, Kemp, Andre Pascal, Kengne, Andre, Keren, Chandrasekharan Nair, Kesavachandran, Yousef Saleh, Khader, Abdur Rahman, Khan, Ejaz Ahmad, Khan, Gulfaraz, Khan, Young Ho, Khang, Tawfi k., Ahmed Muthafer Khoja, Ardeshir, Khosravi, Jagdish, Khubchandani, Christian, Kieling, Cho il, Kim, Daniel, Kim, Sungroul, Kim, Yun Jin, Kim, Ruth W., Kimokoti, Niranjan, Kissoon, Miia, Kivipelto, Luke D., Knibb, Yoshihiro, Kokubo, Dhaval, Kolte, Soewarta, Kosen, Georgios A., Kotsaki, Parvaiz A., Koul, Ai, Koyanagi, Michael, Kravchenko, Hans, Krueger, Barthelemy Kuate, Defo, Ricardo S., Kuchenbecker, Ernst J., Kuiper, Xie Rachel, Kulikoff, Veena S., Kulkarni, G., Anil Kumar, Gene F., Kwan, Hmwe H., Kyu, Aparna, Lal, Dharmesh Kumar, Lal, Ratilal, Lalloo, Hilton, Lam, Qing, Lan, Sinead M., Langan, Anders, Larsson, Dennis Odai, Laryea, Asma Abdul, Latif, Janet L., Leasher, James, Leigh, Mall, Leinsalu, Janni, Leung, Ricky, Leung, Miriam, Levi, Yichong, Li, Yongmei, Li, Margaret, Lind, Shai, Linn, Steven E., Lipshultz, Patrick Y., Liu, Shiwei, Liu, Yang, Liu, Belinda K., Lloyd, Loon Tzian, Lo, Giancarlo, Logroscino, Paulo A., Lotufo, Robyn M., Luca, Raimundas, Luneviciu, Mohammed Magdy Abd El, Razek, Carlos Magis, Rodriguez, Mahdi, Mahdavi, Marek, Majdan, Azeem, Majeed, Reza, Malekzadeh, Deborah Carvalho, Malta, Chabila C., Mapoma, David Joel, Margoli, Randall V., Martin, Jose Martinez, Raga, Felix, Masiye, Amanda J., Mason Jone, João, Massano, Richard, Matzopoulo, Bongani M., Mayosi, John J., Mcgrath, Martin, Mckee, Peter A., Meaney, Alem, Mehari, Alemayehu B., Mekonnen, Yohannes Adama, Melaku, Peter, Memiah, Ziad A., Memish, Walter, Mendoza, Gert B. M., Mensink, Atte, Meretoja, Tuomo J., Meretoja, Yonatan Moges Mesfi, N, Francis Apolinary, Mhimbira, Renata, Micha, Ted R., Miller, Edward J., Mill, Mojde Mirarefi, N, Awoke, Misganaw, Philip B., Mitchell, Charles N., Mock, Alireza, Mohammadi, Shafi u., Mohammed, Lorenzo, Monasta, Jonathan de la Cruz, Moni, Julio Cesar Montañez, Hernandez, Marcella, Montico, Maziar Moradi, Lakeh, Lidia, Morawska, Rintaro, Mori, Ulrich O., Mueller, Michele E., Murdoch, Brighton, Murimira, Joseph, Murray, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Murthy, Kamarul Imran, Musa, Jean B., Nachega, Gabriele, Nagel, Kovin S., Naidoo, Luigi, Naldi, Vinay, Nangia, Bruce, Neal, Chakib, Nejjari, Charles R., Newton, John N., Newton, Frida Namnyak, Ngalesoni, Peter, Nguhiu, Grant, Nguyen, Quyen Le, Nguyen, Muhammad Imran, Nisar, Patrick Martial Nkamedjie, Pete, Sandra, Nolte, Marika, Nomura, Ole F., Norheim, Bo, Norrving, Carla Makhlouf, Obermeyer, Felix Akpojene, Ogbo, In Hwan, Oh, Olanrewaju, Oladimeji, Pedro R., Olivare, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Olusanya, John Nelson, Opio, Eyal, Oren, Alberto, Ortiz, Richard H., Osborne, Erika, Ota, Mayowa O., Owolabi, Mahesh, Pa, Eun Kee, Park, Hye Youn, Park, Charles D., Parry, Mahboubeh, Parsaeian, Tejas, Patel, Vikram, Patel, Angel J., Paternina Caicedo, Snehal T., Patil, Scott B., Patten, George C., Patton, Deepak, Paudel, João Mário, Pedro, David M., Pereira, Norberto, Perico, Konrad, Pesudov, Max, Petzold, Michael Robert, Phillip, Frédéric B., Piel, Julian David, Pillay, Christine, Pinho, Farhad, Pishgar, Suzanne, Polinder, Richie G., Poulton, Farshad, Pourmalek, Mostafa, Qorbani, Rynaz H. S., Rabiee, Amir, Radfar, Vafa Rahimi, Movaghar, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rahman, Rajesh Kumar, Rai, Sasa, Rajsic, Murugesan, Raju, Usha, Ram, Saleem M., Rana, Chhabi Lal, Ranabhat, Kavitha, Ranganathan, Puja C., Rao, Amany H., Refaat, Marissa B., Reitsma, Giuseppe, Remuzzi, Serge, Resnikoff, Antonio L., Ribeiro, Maria Jesus Rios, Blanca, Hirbo Shore, Roba, Bayard, Robert, Alina, Rodriguez, David Rojas, Rueda, Luca, Ronfani, Gholamreza, Roshandel, Gregory A., Roth, Dietrich, Rothenbacher, Ambuj, Roy, Nobhojit, Roy, Ben Benasco, Sackey, Rajesh, Sagar, Muhammad Muhammad, Saleh, Juan R., Sanabria, Damian F., Santomauro, Itamar S., Santo, Rodrigo Sarmiento, Suarez, Benn, Sartoriu, Maheswar, Satpathy, Miloje, Savic, Monika, Sawhney, Susan M., Sawyer, Josef, Schmidhuber, Maria Inês, Schmidt, Ione J. C., Schneider, Aletta E., Schutte, David C., Schwebel, Soraya, Seedat, Sadaf G., Sepanlou, Edson E., Servan Mori, Katya, Shackelford, Amira, Shaheen, Masood Ali, Shaikh, Teresa Shamah, Levy, Rajesh, Sharma, Jun, She, Sara, Sheikhbahaei, Jiabin, Shen, Kevin N., Sheth, Muki, Shey, Peilin, Shi, Kenji, Shibuya, Mika, Shigematsu, Min Jeong, Shin, Rahman, Shiri, Kawkab, Shishani, Ivy, Shiue, Inga Dora, Sigfusdottir, Naris, Silpakit, Diego Augusto Santos, Silva, Jonathan I., Silverberg, Edgar P., Simard, Shireen, Sindi, Abhishek, Singh, Gitanjali M., Singh, Jasvinder A., Singh, Om Prakash, Singh, Prashant Kumar, Singh, Vegard, Skirbekk, Amber, Sligar, Samir, Soneji, Kjetil, Søreide, Reed J. D., Sorensen, Joan B., Soriano, Sergey, Soshnikov, Luciano A., Sposato, Chandrashekhar T., Sreeramareddy, Hans Christian, Stahl, Jeff rey D., Stanaway, Vasiliki, Stathopoulou, Nadine, Steckling, Nicholas, Steel, Dan J., Stein, Caitlyn, Steiner, Heidi, Stöckl, Saverio, Strange, Mark, Strong, Jiandong, Sun, Bruno F., Sunguya, Patrick, Sur, Soumya, Swaminathan, Bryan L., Syke, Cassandra E. I., Szoeke, Rafael Tabarés, Seisdedo, Karen M., Tabb, Roberto Tchio, Talongwa, Mohammed Rasoul, Tarawneh, Mohammad, Tavakkoli, Bineyam, Taye, Hugh R., Taylor, Bemnet Amare, Tedla, Worku, Tefera, Teketo Kassaw, Tegegne, Dejen Yemane, Tekle, Girma Temam, Shifa, Abdullah Sulieman, Terkawi, Gizachew Assefa, Tessema, J. S., Thakur, Alan J., Thomson, Andrew L., Thorne Lyman, Amanda G., Thrift, George D., Thurston, Taavi, Tillmann, Ruoyan Tobe, Gai, Marcello, Tonelli, Roman Topor, Madry, Fotis, Topouzi, Bach Xuan, Tran, Zacharie Tsala, Dimbuene, Abera Kenay, Tura, Emin Murat, Tuzcu, Stefanos, Tyrovola, Kingsley Nnanna, Ukwaja, Eduardo A., Undurraga, Chigozie Jesse, Uneke, Olalekan A., Uthman, Aaron van, Donkelaar, Yuri Y., Varakin, Tommi, Vasankari, Ana Maria Nogales, Vasconcelo, J., Lennert Veerman, Narayanaswamy, Venketasubramanian, Raj Kumar, Verma, Francesco S., Violante, Vasiliy Victorovich, Vlassov, Patricia, Volkow, Stein Emil, Vollset, Gregory R., Wagner, Mitchell T., Wallin, Linhong, Wang, Valentine, Wanga, David A., Watkin, Scott, Weichenthal, Elisabete, Weiderpa, Robert G., Weintraub, Daniel J., Wei, Andrea, Werdecker, Ronny, Westerman, Harvey A., Whiteford, James D., Wilkinson, Charles Shey, Wiysonge, Charles D. A., Wolfe, Ingrid, Wolfe, Sungho, Won, Anthony D., Woolf, Shimelash Bitew, Workie, Mamo, Wubshet, Gelin, Xu, Ajit Kumar, Yadav, Bereket, Yakob, Ayalnesh Zemene, Yalew, Lijing L., Yan, Yuichiro, Yano, Mehdi, Yaseri, Pengpeng, Ye, Paul, Yip, Naohiro, Yonemoto, Seok Jun, Yoon, Mustafa Z., Youni, Chuanhua, Yu, Zoubida, Zaidi, Maysaa El Sayed, Zaki, Carlos Zambrana, Torrelio, Tomas, Zapata, Elias Asfaw, Zegeye, Yi, Zhao, Maigeng, Zhou, Sanjay, Zodpey, David, Zonie, Christopher J. L., Murray, Lim, Stephen S, Allen, Kate, Bhutta, Zulfiqar A, Dandona, Lalit, Forouzanfar, Mohammad H, Fullman, Nancy, Gething, Peter W, Goldberg, Ellen M, Hay, Simon I, Holmberg, Mollie, Kinfu, Yohanne, Kutz, Michael J, Larson, Heidi J, Liang, Xiaofeng, Lopez, Alan D, Lozano, Rafael, Mcnellan, Claire R, Mokdad, Ali H, Mooney, Meghan D, Naghavi, Mohsen, Olsen, Helen E, Pigott, David M, Salomon, Joshua A, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulle, Abdishakur M, Abraham, Biju, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen M E, Abyu, Gebre Yitayih, Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Afanvi, Kossivi Agbelenko, Afshin, Ashkan, Agarwal, Arnav, Agrawal, Anurag, Kiadaliri, Aliasghar Ahmad, Ahmadieh, Hamid, Ahmed, Kedir Yimam, Akanda, Ali Shafqat, Akinyemi, Rufus Olusola, Akinyemiju, Tomi F, Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Uzma, Alasfoor, Deena, Albuhairan, Fadia S, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alemu, Zewdie Aderaw, Ali, Raghib, Alkerwi, Ala'A, Alkhateeb, Mohammad AB, Alla, Françoi, Allebeck, Peter, Allen, Christine, Al-Raddadi, Rajaa, Altirkawi, Khalid A, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amberbir, Alemayehu, Amegah, Adeladza Kofi, Amini, Heresh, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H, Anderson, Benjamin O, Anderson, Gregory M, Antonio, Carl Abelardo T, Anwari, Palwasha, Ärnlöv, Johan, Artaman, Al, Asayesh, Hamid, Asghar, Rana Jawad, Atique, Suleman, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barber, Ryan, Barker-Collo, Suzanne L, Bärnighausen, Till, Barrero, Lope H, Barrientos-Gutierrez, Tonatiuh, Basu, Sanjay, Bayou, Tigist Assefa, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Beghi, Ettore, Béjot, Yannick, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Benzian, Habib, Berhane, Adugnaw, Bernabé, Eduardo, Bernal, Oscar Alberto, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Bhala, Neeraj, Bhatt, Samir, Biadgilign, Sibhatu, Bienhoff, Kelly A, Bikbov, Bori, Binagwaho, Agne, Bisanzio, Donal, Bjertness, Espen, Blore, Jed, Bourne, Rupert R A, Brainin, Michael, Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Broday, David M, Brugha, Traolach S, Buchbinder, Rachelle, Butt, Zahid A, Cahill, Leah E, Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Carabin, Hélène, Cárdenas, Rosario, Carrero, Juan Jesu, Carter, Austin, Casey, Daniel, Caso, Valeria, Castañeda-Orjuela, Carlos A, Rivas, Jacqueline Castillo, Catalá-López, Ferrán, Cavalleri, Fiorella, Cecílio, Pedro, Chang, Hsing-Yi, Chang, Jung-Chen, Charlson, Fiona J, Che, Xuan, Chen, Alan Zian, Chiang, Peggy Pei-Chia, Chibalabala, Mirriam, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christensen, Hanne, Ciobanu, Liliana G, Coates, Matthew M, Coggeshall, Megan, Cohen, Aaron J, Cooke, Graham S, Cooper, Cyru, Cooper, Leslie Trumbull, Cowie, Benjamin C, Crump, John A, Damtew, Solomon Abrha, Dandona, Rakhi, Dargan, Paul I, Neves, José da, Davis, Adrian C, Davletov, Kairat, de Castro, E Filipa, De Leo, Diego, Degenhardt, Louisa, Del Gobbo, Liana C, Deribe, Kebede, Derrett, Sarah, Des Jarlais, Don C, Deshpande, Aniruddha, Deveber, Gabrielle A, Dey, Subhojit, Dharmaratne, Samath D, Dhillon, Preet K, Ding, Eric L, Dorsey, E Ray, Doyle, Kerrie E, Driscoll, Tim R, Duan, Leilei, Dubey, Manisha, Duncan, Bruce Bartholow, Ebrahimi, Hedyeh, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Erskine, Holly E, Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Farid, Talha A, Farinha, Carla Sofia e Sa, Faro, André, Farvid, Maryam S, Farzadfar, Farshad, Feigin, Valery L, Felicio, Manuela Mendonca, Fereshtehnejad, Seyed-Mohammad, Fernandes, Jefferson G, Fernandes, Joao C, Ferrari, Alize J, Fischer, Florian, Fitchett, Joseph R A, Fitzmaurice, Christina, Foigt, Nataliya, Foreman, Kyle, Fowkes, F Gerry R, Franca, Elisabeth Barboza, Franklin, Richard C, Fraser, Maya, Friedman, Joseph, Frostad, Joseph, Fürst, Thoma, Gabbe, Belinda, Garcia-Basteiro, Alberto L, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebru, Alemseged Aregay, Gessner, Bradford D, Gillum, Richard F, Ginawi, Ibrahim Abdelmageem Mohamed, Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Godwin, William, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Graetz, Nichola, Greenwell, Karen Fern, Griswold, Max, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Gutiérrez, Reyna A, Gyawali, Bishal, Haagsma, Juanita A, Haakenstad, Annie, Hafezi-Nejad, Nima, Haile, Demewoz, Hailu, Gessessew Bugssa, Halasa, Yara A, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Hankey, Graeme J, Harb, Hilda L, Haro, Josep Maria, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmu, Heredia-Pi, Ileana Beatriz, Hoek, Hans W, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hoy, Damian G, Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Iburg, Kim Moesgaard, Idrisov, Bulat T, Inoue, Manami, Islami, Farhad, Jacobs, Troy A, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, James, Peter, Jansen, Henrica A F M, Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Ying, Jibat, Tariku, Jin, Ye, Jonas, Jost B, Kabir, Zubair, Kalkonde, Yogeshwar, Kamal, Ritul, Kan, Haidong, Kandel, Amit, Karch, André, Karema, Corine Kakizi, Karimkhani, Chante, Karunapema, Palitha, Kasaeian, Amir, Kassebaum, Nicholas J, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Françoise, Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khan, Gulfaraz, Khang, Young-Ho, Khoja, Tawfik Ahmed Muthafer, Khosravi, Ardeshir, Khubchandani, Jagdish, Kieling, Christian, Kim, Cho-il, Kim, Daniel, Kim, Sungroul, Kim, Yun Jin, Kimokoti, Ruth W, Kissoon, Niranjan, Kivipelto, Miia, Knibbs, Luke D, Kokubo, Yoshihiro, Kolte, Dhaval, Kosen, Soewarta, Kotsakis, Georgios A, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael, Krueger, Han, Defo, Barthelemy Kuate, Kuchenbecker, Ricardo S, Kuipers, Ernst J, Kulikoff, Xie Rachel, Kulkarni, Veena S, Kumar, G Anil, Kwan, Gene F, Kyu, Hmwe H, Lal, Aparna, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lan, Qing, Langan, Sinead M, Larsson, Ander, Laryea, Dennis Odai, Latif, Asma Abdul, Leasher, Janet L, Leigh, Jame, Leinsalu, Mall, Leung, Janni, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Lind, Margaret, Linn, Shai, Lipshultz, Steven E, Liu, Patrick Y, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Lo, Loon-Tzian, Logroscino, Giancarlo, Lotufo, Paulo A, Lucas, Robyn M, Lunevicius, Raimunda, El Razek, Mohammed Magdy Abd, Magis-Rodriguez, Carlo, Mahdavi, Mahdi, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Mapoma, Chabila C, Margolis, David Joel, Martin, Randall V, Martinez-Raga, Jose, Masiye, Felix, Mason-Jones, Amanda J, Massano, João, Matzopoulos, Richard, Mayosi, Bongani M, Mcgrath, John J, Mckee, Martin, Meaney, Peter A, Mehari, Alem, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Mensink, Gert B M, Meretoja, Atte, Meretoja, Tuomo J, Mesfin, Yonatan Moge, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R, Mills, Edward J, Mirarefin, Mojde, Misganaw, Awoke, Mitchell, Philip B, Mock, Charles N, Mohammadi, Alireza, Mohammed, Shafiu, Monasta, Lorenzo, de la Cruz Monis, Jonathan, Hernandez, Julio Cesar Montañez, Montico, Marcella, Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich O, Murdoch, Michele E, Murimira, Brighton, Murray, Joseph, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Sriniva, Musa, Kamarul Imran, Nachega, Jean B, Nagel, Gabriele, Naidoo, Kovin S, Naldi, Luigi, Nangia, Vinay, Neal, Bruce, Nejjari, Chakib, Newton, Charles R, Newton, John N, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Pete, Patrick Martial Nkamedjie, Nolte, Sandra, Nomura, Marika, Norheim, Ole F, Norrving, Bo, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Oladimeji, Olanrewaju, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osborne, Richard H, Ota, Erika, Owolabi, Mayowa O, Pa, Mahesh, Park, Eun-Kee, Park, Hye-Youn, Parry, Charles D, Parsaeian, Mahboubeh, Patel, Teja, Patel, Vikram, Caicedo, Angel J Paternina, Patil, Snehal T, Patten, Scott B, Patton, George C, Paudel, Deepak, Pedro, João Mário, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Piel, Frédéric B, Pillay, Julian David, Pinho, Christine, Pishgar, Farhad, Polinder, Suzanne, Poulton, Richie G, Pourmalek, Farshad, Qorbani, Mostafa, Rabiee, Rynaz H S, Radfar, Amir, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajsic, Sasa, Raju, Murugesan, Ram, Usha, Rana, Saleem M, Ranabhat, Chhabi Lal, Ranganathan, Kavitha, Rao, Puja C, Refaat, Amany H, Reitsma, Marissa B, Remuzzi, Giuseppe, Resnikoff, Serge, Ribeiro, Antonio L, Blancas, Maria Jesus Rio, Roba, Hirbo Shore, Roberts, Bayard, Rodriguez, Alina, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Roy, Nobhojit, Sackey, Ben Benasco, Sagar, Rajesh, Saleh, Muhammad Muhammad, Sanabria, Juan R, Santomauro, Damian F, Santos, Itamar S, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Sawyer, Susan M, Schmidhuber, Josef, Schmidt, Maria Inê, Schneider, Ione J C, Schutte, Aletta E, Schwebel, David C, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya, Shaheen, Amira, Shaikh, Masood Ali, Levy, Teresa Shamah, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Sheth, Kevin N, Shey, Muki, Shi, Peilin, Shibuya, Kenji, Shigematsu, Mika, Shin, Min-Jeong, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga Dora, Silpakit, Nari, Silva, Diego Augusto Santo, Silverberg, Jonathan I, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Skirbekk, Vegard, Sligar, Amber, Soneji, Samir, Søreide, Kjetil, Sorensen, Reed J D, Soriano, Joan B, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stahl, Hans-Christian, Stanaway, Jeffrey D, Stathopoulou, Vasiliki, Steckling, Nadine, Steel, Nichola, Stein, Dan J, Steiner, Caitlyn, Stöckl, Heidi, Stranges, Saverio, Strong, Mark, Sun, Jiandong, Sunguya, Bruno F, Sur, Patrick, Swaminathan, Soumya, Sykes, Bryan L, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tabb, Karen M, Talongwa, Roberto Tchio, Tarawneh, Mohammed Rasoul, Tavakkoli, Mohammad, Taye, Bineyam, Taylor, Hugh R, Tedla, Bemnet Amare, Tefera, Worku, Tegegne, Teketo Kassaw, Tekle, Dejen Yemane, Shifa, Girma Temam, Terkawi, Abdullah Sulieman, Tessema, Gizachew Assefa, Thakur, J.S., Thomson, Alan J, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Tran, Bach Xuan, Dimbuene, Zacharie Tsala, Tura, Abera Kenay, Tuzcu, Emin Murat, Tyrovolas, Stefano, Ukwaja, Kingsley Nnanna, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Uthman, Olalekan A, van Donkelaar, Aaron, Varakin, Yuri Y, Vasankari, Tommi, Vasconcelos, Ana Maria Nogale, Veerman, J Lennert, Venketasubramanian, Narayanaswamy, Verma, Raj Kumar, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Volkow, Patricia, Vollset, Stein Emil, Wagner, Gregory R, Wallin, Mitchell T, Wang, Linhong, Wanga, Valentine, Watkins, David A, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Whiteford, Harvey A, Wilkinson, James D, Wiysonge, Charles Shey, Wolfe, Charles D A, Wolfe, Ingrid, Won, Sungho, Woolf, Anthony D, Workie, Shimelash Bitew, Wubshet, Mamo, Xu, Gelin, Yadav, Ajit Kumar, Yakob, Bereket, Yalew, Ayalnesh Zemene, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Ye, Pengpeng, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, El Sayed Zaki, Maysaa, Zambrana-Torrelio, Carlo, Zapata, Toma, Zegeye, Elias Asfaw, Zhao, Yi, Zhou, Maigeng, Zodpey, Sanjay, Zonies, David, and Murray, Christopher J L
Subjects: Conservation of Natural Resources, spline regressions, Health Status, Global Health, Goal, Health Statu, Cost of Illness, Risk Factors, Universal Health Insurance, Quality-Adjusted Life Year, health-related SDG performance indicators, socio-demographic index, Health Status Indicators, Humans, Conservation of Natural Resource, Disabled Persons, Health Status Indicator, Medicine(all), Insurance, Health, Risk Factor, Medicine (all), Public Health, Global Health, Social Medicine and Epidemiology, Articles, Cost of Illne, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Disabled Person, Quality-Adjusted Life Years, Universal Coverage, Goals, Human
Abstract: Summary Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. Findings In 2015, the median health-related SDG index was 59·3 (95% uncertainty interval 56·8–61·8) and varied widely by country, ranging from 85·5 (84·2–86·5) in Iceland to 20·4 (15·4–24·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r2=0·88) and the MDG index (r2=0·92), whereas the non-MDG index had a weaker relation with SDI (r2=0·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7·9 (IQR 5·0–10·4), and gains on the MDG index (a median change of 10·0 [6·7–13·1]) exceeded that of the non-MDG index (a median change of 5·5 [2·1–8·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs. Funding Bill & Melinda Gates Foundation.
Published: 2016

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1. Provider adherence to clinical care recommendations for infants and children who died in seven low- and middle-income countries in the Child Health and Mortality Prevention Surveillance (CHAMPS) networkResearch in context

2. Clinical outcomes of intrauterine device insertions by newly trained providers: The ECHO trial experience

3. Cost of pre-exposure prophylaxis delivery in family planning clinics to prevent HIV acquisition among adolescent girls and young women in Kisumu, Kenya.

4. Demographic, psychosocial and clinical factors associated with postpartum depression in Kenyan women

5. The global burden of disease study 2013: What does it mean for the NTDs?

6. Surveillance of ADHD Among Children in the United States: Validity and Reliability of Parent Report of Provider Diagnosis

7. Stability of mental disorder prevalence estimates among school-aged children and adolescents: findings from the community-based project to learn about youth-mental health (PLAY-MH) and replication-PLAY-MH (Re-PLAY-MH), 2014–2017

8. Notes From the Field: Prevalence of Previous Dengue Virus Infection Among Children and Adolescents — U.S. Virgin Islands, 2022

9. Long-Term Symptoms Among Adults Tested for SARS-CoV-2 — United States, January 2020–April 2021

10. Factors Associated With Severe Illness in Patients Aged21 Years Hospitalized for COVID-19

11. Post-COVID conditions and healthcare utilization among adults with and without disabilities—2021 Porter Novelli FallStyles survey

12. Children, adolescents, and young adults hospitalized with COVID-19 and diabetes in summer 2021

13. Brief Report: Bacterial Vaginosis and Risk of HIV Infection in the Context of CD101 Gene Variation

14. Prevalence of Select New Symptoms and Conditions Among Persons Aged Younger Than 20 Years and 20 Years or Older at 31 to 150 Days After Testing Positive or Negative for SARS-CoV-2

15. Perceived Racial/Ethnic Discrimination, Physical and Mental Health Conditions in Childhood, and the Relative Role of Other Adverse Experiences

16. Kidney injury biomarkers during exposure to tenofovir-based preexposure prophylaxis

17. Outcomes Among Patients Referred to Outpatient Rehabilitation Clinics After COVID-19 diagnosis — United States, January 2020–March 2021

18. Obesity, chronic job discrimination and social support

19. Cost of pre-exposure prophylaxis delivery in family planning clinics to prevent HIV acquisition among adolescent girls and young women in Kisumu, Kenya

20. Sexual behavior and perceived HIV risk among HIV-negative members of serodiscordant couples in East Africa

21. Uptake and impact of facility-based HIV self-testing on PrEP delivery: a pilot study among young women in Kisumu, Kenya

22. Covariate-adjusted Spearman's rank correlation with probability-scale residuals

23. Impact of Tenofovir-Based Pre-exposure Prophylaxis on Biomarkers of Bone Formation, Bone Resorption, and Bone Mineral Metabolism in HIV-Negative Adults

24. Demographic, psychosocial and clinical factors associated with postpartum depression in Kenyan women

25. Genomewide association study of tenofovir pharmacokinetics and creatinine clearance in AIDS Clinical Trials Group protocol A5202

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

27. Probability-Scale Residuals in HIV/AIDS Research: Diagnostics and Inference

28. The global burden of disease study 2013: What does it mean for the NTDs?

29. Covariate-adjusted Spearman's rank correlation with probability-scale residuals

30. Global burden of cutaneous leishmaniasis

31. Global burden of cutaneous leishmaniasis: a cross-sectional analysis from the Global Burden of Disease Study 2013

32. 200 Global burden of cutaneous leishmaniasis

33. Improving the large scale purification of the HIV microbicide, griffithsin

34. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015

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