Browsing by Author "Ahmadi, Alireza (56336080700)"
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Publication Erratum: Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017 (The Lancet (2018) 392(10159) (1736–1788)(S0140673618322037)(10.1016/S0140-6736(18)32203-7))(2018) ;Roth, Gregory A. (55074747400) ;Abate, Degu (57204237665) ;Abate, Kalkidan Hassen (57207943858) ;Abay, Solomon M. (35306466900) ;Abbafati, Cristiana (54917122400) ;Abbasi, Nooshin (57212442022) ;Abbastabar, Hedayat (57212441848) ;Abd-Allah, Foad (36503428900) ;Abdela, Jemal (57200613000) ;Abdelalim, Ahmed (7801307783) ;Abdollahpour, Ibrahim (36997151900) ;Abdulkader, Rizwan Suliankatchi (57195295816) ;Abebe, Haftom Temesgen (55950002100) ;Abebe, Molla (57211131124) ;Abebe, Zegeye (57193002719) ;Abejie, Ayenew Negesse (57203015573) ;Abera, Semaw F. (57205180598) ;Abil, Olifan Zewdie (57204558002) ;Abraha, Haftom Niguse (57195289877) ;Abrham, Aklilu Roba (57202704637) ;Abu-Raddad, Laith Jamal (14032724700) ;Accrombessi, Manfred Mario Kokou (55353650500) ;Acharya, Dilaram (56770895600) ;Adamu, Abdu A. (57202024381) ;Adebayo, Oladimeji M. (57194329853) ;Adedoyin, Rufus Adesoji (55947572800) ;Adekanmbi, Victor (53463192900) ;Adetokunboh, Olatunji O. (56598104300) ;Adhena, Beyene Meressa (57322512000) ;Adib, Mina G. (57204560513) ;Admasie, Amha (56609274200) ;Afshin, Ashkan (57217465455) ;Agarwal, Gina (57220151944) ;Agesa, Kareha M. (57204562362) ;Agrawal, Anurag (35214460700) ;Agrawal, Sutapa (57202841733) ;Ahmadi, Alireza (56336080700) ;Ahmadi, Mehdi (16644923000) ;Ahmed, Muktar Beshir (57207802317) ;Ahmed, Sayem (58601030100) ;Aichour, Amani Nidhal (57195486768) ;Aichour, Ibtihel (57195485980) ;Aichour, Miloud Taki Eddine (57195488258) ;Akbari, Mohammad Esmaeil (56666938200) ;Akinyemi, Rufus Olusola (25633566800) ;Akseer, Nadia (57207801968) ;Al-Aly, Ziyad (9738161500) ;Al-Eyadhy, Ayman (24554080400) ;Al-Raddadi, Rajaa M. (57219673720) ;Alahdab, Fares (55135922900) ;Alam, Khurshid (57203681299) ;Alam, Tahiya (57205589820) ;Alebel, Animut (57195961302) ;Alene, Kefyalew Addis (57202583764) ;Alijanzadeh, Mehran (56236864700) ;Alizadeh-Navaei, Reza (36024974700) ;Aljunid, Syed Mohamed (6504304159) ;Alkerwi, Ala'a (57197724313) ;Alla, Francois (6701580827) ;Allebeck, Peter (7005187575) ;Alonso, Jordi (7403482329) ;Altirkawi, Khalid (57202762923) ;Alvis-Guzman, Nelson (57210741239) ;Amare, Azmeraw T. (57202220009) ;Aminde, Leopold N. (56287711300) ;Amini, Erfan (35073393800) ;Ammar, Walid (57208159281) ;Amoako, Yaw Ampem (44960986700) ;Anber, Nahla Hamed (57202351369) ;Andrei, Catalina Liliana (36543507200) ;Androudi, Sofia (6603286512) ;Animut, Megbaru Debalkie (57204558749) ;Anjomshoa, Mina (57204563282) ;Ansari, Hossein (56919376000) ;Ansha, Mustafa Geleto (57195329453) ;Antonio, Carl Abelardo T. (55247644500) ;Anwari, Palwasha (57217465526) ;Aremu, Olatunde (57214958833) ;Arnlov, Johan (6602512227) ;Arora, Amit (36676951800) ;Arora, Monika (8700408200) ;Artaman, Al (57217223811) ;Aryal, Krishna K. (57203859052) ;Asayesh, Hamid (55334322800) ;Asfaw, Ephrem Tsegay (57203306449) ;Ataro, Zerihun (57204563849) ;Atique, Suleman (56505419100) ;Atre, Sachin R. (22933845900) ;Ausloos, Marcel (7101798907) ;Avokpaho, Euripide F.G.A. 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(57202798676) ;Eshrati, Babak (16030619200) ;Eskandarieh, Sharareh (57211720158) ;Esmaeili, Reza (57193352042) ;Esteghamati, Alireza (11240321100) ;Fakhar, Mahdi (24168542800) ;Fakhim, Hamed (56532027000) ;Faramarzi, Mahbobeh (8928307700) ;Fareed, Mohammad (24491815600) ;Farhadi, Farzaneh (55869726400) ;Farinha, Carla Sofia Esá (57190279273) ;Faro, Andre (36770969600) ;Farvid, Maryam S. (57216534761) ;Farzadfar, Farshad (57195049611) ;Farzaei, Mohammad Hosein (36458335600) ;Feigin, Valery L. (57203677957) ;Feigl, Andrea B. (57202461042) ;Fentahun, Netsanet (56394665400) ;Fereshtehnejad, Seyed-Mohammad (57202557520) ;Fernandes, Eduarda (34770207500) ;Fernandes, Joao C. (35274726800) ;Ferrari, Alize J. (57195348907) ;Feyissa, Garumma Tolu (55504728900) ;Filip, Irina (55570061400) ;Finegold, Samuel (57195558156) ;Fischer, Florian (55508208800) ;Fitzmaurice, Christina (57212628757) ;Foigt, Nataliya A. (57216998893) ;Foreman, Kyle J. (57209064414) ;Fornari, Carla (15022250200) ;Frank, Tahvi D. (57203197110) ;Fukumoto, Takeshi (26531100300) ;Fuller, John E. (57204565664) ;Fullman, Nancy (57211064970) ;Furst, Thomas (57208431345) ;Furtado, Joao M. (36801755000) ;Futran, Neal D. (35554564000) ;Gallus, Silvano (7005387365) ;Garcia-Basteiro, Alberto L. (57200187168) ;Garcia-Gordillo, Miguel A. (55930749500) ;Gardner, William M. (57204566870) ;Gebre, Abadi Kahsu (59426751000) ;Gebrehiwot, Tsegaye Tewelde (57216482917) ;Gebremedhin, Amanuel Tesfay (57202566187) ;Gebremichael, Bereket (57191254167) ;Gebremichael, Teklu Gebrehiwo (57204566728) ;Gelano, Tilayie Feto (57200628899) ;Geleijnse, Johanna M. (35195702500) ;Genova-Maleras, Ricard (15070563900) ;Geramo, Yilma Chisha Dea (57204563310) ;Gething, Peter W. (57193559189) ;Gezae, Kebede Embaye (57204561611) ;Ghadami, Mohammad Rasoul (57204797800) ;Ghadimi, Reza (57202290802) ;Ghasemi Falavarjani, Khalil (15724975400) ;Ghasemi-Kasman, Maryam (55371171100) ;Ghimire, Mamata (57190385188) ;Gibney, Katherine B. (57202564104) ;Gill, Paramjit Singh (7202766660) ;Gill, Tiffany K. (8545441900) ;Gillum, Richard F. (7103181331) ;Ginawi, Ibrahim Abdelmageed (57192378390) ;Giroud, Maurice (7203027541) ;Giussani, Giorgia (57200843076) ;Goenka, Shifalika (57217111080) ;Goldberg, Ellen M. (57191842703) ;Goli, Srinivas (39761832500) ;Gomez-Dantes, Hector (57202555692) ;Gona, Philimon N. (57219703762) ;Gopalani, Sameer Vali (57190277891) ;Gorman, Taren M. (57204559340) ;Goto, Atsushi (57193212299) ;Goulart, Alessandra C. (57201181348) ;Gnedovskaya, Elena V. (56806916500) ;Grada, Ayman (55797741000) ;Grosso, Giuseppe (57196998256) ;Gugnani, Harish Chander (7005567008) ;Guimaraes, Andre Luiz Sena (7102920800) ;Guo, Yuming (55712472800) ;Gupta, Prakash C. 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(7006079405) ;Weldegebreal, Fitsum (56112812300) ;Weldegwergs, Kidu Gidey (57203308107) ;Werdecker, Andrea (57208964895) ;Werkneh, Adhena Ayaliew (57195675398) ;West, T. Eoin (57756844000) ;Westerman, Ronny (57218361023) ;Whiteford, Harvey A. (55906494000)Widecka, Justyna (15047205800)GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1736–88—The bottom row in figure 7 was cut off. This correction has been made to the online version as of Nov 9, 2018, and has been made to the printed Article. © 2018 Elsevier Ltd - Some of the metrics are blocked by yourconsent settings
Publication Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 (The Lancet (2018) 392(10159) (1923–1994), (S0140673618322256), (10.1016/S0140-6736(18)32225-6))(2019) ;Stanaway, Jeffrey D. (57201210928) ;Afshin, Ashkan (57217465455) ;Gakidou, Emmanuela (57202567277) ;Lim, Stephen S. (7404081544) ;Abate, Degu (57204237665) ;Abate, Kalkidan Hassen (57207943858) ;Abbafati, Cristiana (54917122400) ;Abbasi, Nooshin (57212442022) ;Abbastabar, Hedayat (57212441848) ;Abd-Allah, Foad (36503428900) ;Abdela, Jemal (57200613000) ;Abdelalim, Ahmed (7801307783) ;Abdollahpour, Ibrahim (36997151900) ;Abdulkader, Rizwan Suliankatchi (57195295816) ;Abebe, Molla (57211131124) ;Abebe, Zegeye (57193002719) ;Abera, Semaw F. 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(6505920990) ;Tabarés-Seisdedos, Rafael (6602981102) ;Tabuchi, Takahiro (55177892400) ;Tadakamadla, Santosh Kumar (57207799926) ;Takahashi, Ken (55741242600) ;Tandon, Nikhil (7101833756) ;Tassew, Segen Gebremeskel (57204569108) ;Tavakkoli, Mohammad (57202524239) ;Taveira, Nuno (6602731390) ;Tehrani-Banihashemi, Arash (57204006020) ;Tekalign, Tigist Gashaw (57204558037) ;Tekelemedhin, Shishay Wahdey (57204566273) ;Tekle, Merhawi Gebremedhin (57204237146) ;Temesgen, Habtamu (57205011874) ;Temsah, Mohamad-Hani (56115852000) ;Temsah, Omar (57204559820) ;Terkawi, Abdullah Sulieman (57211144258) ;Tessema, Belay (20735503600) ;Teweldemedhin, Mebrahtu (57193667629) ;Thankappan, Kavumpurathu Raman (57202955435) ;Theis, Andrew (57196076787) ;Thirunavukkarasu, Sathish (54407369300) ;Thomas, Hannah J. (55925904000) ;Thomas, Matthew Lloyd (57191835351) ;Thomas, Nihal (7401830494) ;Thurston, George D. (7102270013) ;Tilahun, Binyam (57212075730) ;Tillmann, Taavi (57190211142) ;To, Quyen G. (55827789100) ;Tobollik, Myriam (56549045300) ;Tonelli, Marcello (7103102534) ;Topor-Madry, Roman (57211182892) ;Torre, Anna E. (57196074351) ;Tortajada-Girbés, Miguel (16242320900) ;Touvier, Mathilde (8877033300) ;Tovani-Palone, Marcos Roberto (56644977900) ;Towbin, Jeffrey A. (7102520568) ;Tran, Bach Xuan (57209107515) ;Tran, Khanh Bao (57201651536) ;Truelsen, Thomas Clement (57202824565) ;Truong, Nu Thi (57204178907) ;Tsadik, Afewerki Gebremeskel (57204562442) ;Tudor Car, Lorainne (48561867100) ;Tuzcu, E. Murat (7005951350) ;Tymeson, Hayley D. (57194139009) ;Tyrovolas, Stefanos (57207793475) ;Ukwaja, Kingsley N. (57202824584) ;Ullah, Irfan (56992676600) ;Updike, Rachel L. (57204698680) ;Usman, Muhammad Shariq (57203046075) ;Uthman, Olalekan A. (23026328100) ;Vaduganathan, Muthiah (16417973600) ;Vaezi, Afsane (55698015300) ;Valdez, Pascual R. (57202115577) ;Van Donkelaar, Aaron (15926418500) ;Varavikova, Elena (7801408611) ;Varughese, Santosh (22942817500) ;Vasankari, Tommi Juhani (23096834700) ;Venkateswaran, Vidhya (59829999400) ;Venketasubramanian, Narayanaswamy (56804702100) ;Villafaina, Santos (57195804127)Violante, Francesco S. (7003555890)Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. - Some of the metrics are blocked by yourconsent settings
Publication Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019(2020) ;Abbafati, Cristiana (54917122400) ;Abbas, Kaja M. (57190285707) ;Abbasi, Mohammad (57221004192) ;Abbasifard, Mitra (37053407900) ;Abbasi-Kangevari, Mohsen (57193543882) ;Abbastabar, Hedayat (57212441848) ;Abd-Allah, Foad (36503428900) ;Abdelalim, Ahmed (7801307783) ;Abdollahi, Mohammad (57940559800) ;Abdollahpour, Ibrahim (36997151900) ;Abedi, Aidin (56673854800) ;Abedi, Parisa (57219860997) ;Abegaz, Kedir Hussein (57200726326) ;Abolhassani, Hassan (58597704600) ;Abosetugn, Akine Eshete (57041277200) ;Aboyans, Victor (56214736500) ;Abrams, Elissa M. (53363080800) ;Abreu, Lucas Guimarães (55937631400) ;Abrigo, Michael R.M. (56018773400) ;Abu Haimed, Abdulaziz Khalid (57218875672) ;Abualhasan, Ahmed (57211135523) ;Abu-Gharbieh, Eman (24586714800) ;Abu-Raddad, Laith Jamal (14032724700) ;Abushouk, Abdelrahman I. 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(57215198193) ;McKee, Martin (7202304775) ;Medina-Solís, Carlo Eduardo (8530789600) ;Meharie, Birhanu Geta (57217083932) ;Mehndiratta, Man Mohan (57202557864) ;Mehrabi Nasab, Entezar (56062744400) ;Mehri, Fereshteh (57211542603) ;Mehrotra, Ravi (7203045563) ;Mehta, Kala M. (7201939418) ;Meitei, Wahengbam Bigyananda (57209140259) ;Mekonnen, Teferi (57215662987) ;Melese, Addisu (56901393600) ;Memiah, Peter T.N. (57217207827) ;Memish, Ziad A. (7005059350) ;Mendoza, Walter (57216905642) ;Menezes, Ritesh G. (55517099900) ;Mengesha, Endalkachew Worku (57216203521) ;Mengesha, Meresa Berwo (57210570181) ;Mensah, George A. (57196028147) ;Mereke, Alibek (57205595662) ;Mereta, Seid Tiku (57203628211) ;Meretoja, Atte (12775885500) ;Meretoja, Tuomo J. (57219008708) ;Mestrovic, Tomislav (6507240107) ;Miazgowski, Bartosz (56857536900) ;Miazgowski, Tomasz (6701404689) ;Michalek, Irmina Maria (56982945900) ;Mihretie, Kebadnew Mulatu (57214781514) ;Miller, Ted R. (7403948600) ;Mills, Edward J. (57205301363) ;Milne, George J. (9434770500) ;Mini, G.K. (12800865800) ;Miri, Mohammad (56938228400) ;Mirica, Andreea (57188983765) ;Mirrakhimov, Erkin M. (57508336100) ;Mirzaei, Hamed (37034594600) ;Mirzaei, Maryam (56902299800) ;Mirzaei, Roya (55745833800) ;Mirzaei-Alavijeh, Mehdi (57201700997) ;Misganaw, Awoke Temesgen (57202808713) ;Mitchell, Philip B. (35354747000) ;Mithra, Prasanna (36018632500) ;Moazen, Babak (57204324006) ;Moghadaszadeh, Masoud (57200791890) ;Mohajer, Bahram (57039225300) ;Mohamad, Osama (36342663600) ;Mohamadi, Efat (57202198397) ;Mohammad, Dara K. (43161421200)Mohammad, Yousef (6603403710)Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license - Some of the metrics are blocked by yourconsent settings
Publication Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016(2017) ;Naghavi, Mohsen (57207906323) ;Abajobir, Amanuel Alemu (57203613441) ;Abbafati, Cristiana (54917122400) ;Abbas, Kaja M. 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(57204092789) ;Updike, Rachel (57204698680) ;Uthman, Olalekan A. (23026328100) ;Uzochukwu, Benjamin S. Chudi (57211633289) ;Van Boven, Job F.M. (53464198500) ;Vasankari, Tommi (57200592416) ;Venketasubramanian, Narayanaswamy (56804702100) ;Violante, Francesco S. (7003555890) ;Vlassov, Vasiliy Victorovich (57211633239) ;Vollset, Stein Emil (57196315778) ;Vos, Theo (57223885848) ;Wakayo, Tolassa (57205609717) ;Wallin, Mitchell T. (57201573668) ;Wang, Yuan-Pang (8576812100) ;Weiderpass, Elisabete (57205018947) ;Weintraub, Robert G. (7006079405) ;Weiss, Daniel J. (8609275600) ;Werdecker, Andrea (57208964895) ;Westerman, Ronny (57218361023) ;Whetter, Brian (57201998502) ;Whiteford, Harvey A. (55906494000) ;Wijeratne, Tissa (14051317700) ;Wiysonge, Charles Shey (6507441509) ;Woldeyes, Belete Getahun (57195329524) ;Wolfe, Charles D.A. (57202754705) ;Woodbrook, Rachel (57200298006) ;Workicho, Abdulhalik (56720337100) ;Xavier, Denis (55403963100) ;Xiao, Qingyang (59797114300) ;Xu, Gelin (57203583113) ;Yaghoubi, Mohsen (57212400558) ;Yakob, Bereket (57203811497) ;Yano, Yuichiro (57196965200) ;Yaseri, Mehdi (23029507000) ;Yimam, Hassen Hamid (57196325590) ;Yonemoto, Naohiro (57204947657) ;Yoon, Seok-Jun (24823148900) ;Yotebieng, Marcel (26325950800) ;Younis, Mustafa Z. (8549393000) ;Zaidi, Zoubida (57197376721) ;El Sayed Zaki, Maysaa (57203666922) ;Zegeye, Elias Asfaw (57209171278) ;Zenebe, Zerihun Menlkalew (57200737185) ;Zerfu, Taddese Alemu (55358278900) ;Zhang, Anthony Lin (56391112900) ;Zhang, Xueying (56283378700) ;Zipkin, Ben (57200737130) ;Zodpey, Sanjay (7003415080) ;Lopez, Alan D. (7401455668)Murray, Christopher J.L. (55481130700)Background: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specifc mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. Methods: We estimated cause-specifc deaths and years of life lost (YLLs) by age, sex, geography, and year. YLLs were calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage coding; and other sources including surveys and surveillance systems for specifc causes such as maternal mortality. To facilitate assessment of quality, we reported on the fraction of deaths assigned to GBD Level 1 or Level 2 causes that cannot be underlying causes of death (major garbage codes) by location and year. Based on completeness, garbage coding, cause list detail, and time periods covered, we provided an overall data quality rating for each location with scores ranging from 0 stars (worst) to 5 stars (best). We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to generate estimates for each location, year, age, and sex. We assessed observed and expected levels and trends of cause-specifc deaths in relation to the Socio-demographic Index (SDI), a summary indicator derived from measures of average income per capita, educational attainment, and total fertility, with locations grouped into quintiles by SDI. Relative to GBD 2015, we expanded the GBD cause hierarchy by 18 causes of death for GBD 2016. Findings: The quality of available data varied by location. Data quality in 25 countries rated in the highest category (5 stars), while 48, 30, 21, and 44 countries were rated at each of the succeeding data quality levels. Vital registration or verbal autopsy data were not available in 27 countries, resulting in the assignment of a zero value for data quality. Deaths from non-communicable diseases (NCDs) represented 72·3% (95% uncertainty interval [UI] 71·2-73·2) of deaths in 2016 with 19·3% (18·5-20·4) of deaths in that year occurring from communicable, maternal, neonatal, and nutritional (CMNN) diseases and a further 8·43% (8·00-8·67) from injuries. Although age-standardised rates of death from NCDs decreased globally between 2006 and 2016, total numbers of these deaths increased; both numbers and age-standardised rates of death from CMNN causes decreased in the decade 2006-16 - age-standardised rates of deaths from injuries decreased but total numbers varied little. In 2016, the three leading global causes of death in children under-5 were lower respiratory infections, neonatal preterm birth complications, and neonatal encephalopathy due to birth asphyxia and trauma, combined resulting in 1·80 million deaths (95% UI 1·59 million to 1·89 million). Between 1990 and 2016, a profound shift toward deaths at older ages occurred with a 178% (95% UI 176-181) increase in deaths in ages 90-94 years and a 210% (208-212) increase in deaths older than age 95 years. The ten leading causes by rates of age-standardised YLL signifcantly decreased from 2006 to 2016 (median annualised rate of change was a decrease of 2·89%); the median annualised rate of change for all other causes was lower (a decrease of 1·59%) during the same interval. Globally, the fve leading causes of total YLLs in 2016 were cardiovascular diseases; diarrhoea, lower respiratory infections, and other common infectious diseases; neoplasms; neonatal disorders; and HIV/AIDS and tuberculosis. At a fner level of disaggregation within cause groupings, the ten leading causes of total YLLs in 2016 were ischaemic heart disease, cerebrovascular disease, lower respiratory infections, diarrhoeal diseases, road injuries, malaria, neonatal preterm birth complications, HIV/AIDS, chronic obstructive pulmonary disease, and neonatal encephalopathy due to birth asphyxia and trauma. Ischaemic heart disease was the leading cause of total YLLs in 113 countries for men and 97 countries for women. Comparisons of observed levels of YLLs by countries, relative to the level of YLLs expected on the basis of SDI alone, highlighted distinct regional patterns including the greater than expected level of YLLs from malaria and from HIV/AIDS across sub-Saharan Africa; diabetes mellitus, especially in Oceania; interpersonal violence, notably within Latin America and the Caribbean; and cardiomyopathy and myocarditis, particularly in eastern and central Europe. The level of YLLs from ischaemic heart disease was less than expected in 117 of 195 locations. Other leading causes of YLLs for which YLLs were notably lower than expected included neonatal preterm birth complications in many locations in both south Asia and southeast Asia, and cerebrovascular disease in western Europe. Interpretation: The past 37 years have featured declining rates of communicable, maternal, neonatal, and nutritional diseases across all quintiles of SDI, with faster than expected gains for many locations relative to their SDI. A global shift towards deaths at older ages suggests success in reducing many causes of early death. YLLs have increased globally for causes such as diabetes mellitus or some neoplasms, and in some locations for causes such as drug use disorders, and confict and terrorism. Increasing levels of YLLs might refect outcomes from conditions that required high levels of care but for which efective treatments remain elusive, potentially increasing costs to health systems. Copyright © 2017 The Author(s). Published by Elsevier Ltd. - Some of the metrics are blocked by yourconsent settings
Publication Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017(2018) ;Dicker, Daniel (57196026676) ;Nguyen, Grant (57191591002) ;Abate, Degu (57204237665) ;Abate, Kalkidan Hassen (57207943858) ;Abay, Solomon M. 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(57204703404) ;Shukla, Sharvari Rahul (55760856000)Si, Si (56706979500)Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. © 2018 The Author(s). - Some of the metrics are blocked by yourconsent settings
Publication Global, regional, and national burden of meningitis, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016(2018) ;Zunt, Joseph Raymond (6602746216) ;Kassebaum, Nicholas J (57202562224) ;Blake, Natacha (57204638181) ;Glennie, Linda (6508220161) ;Wright, Claire (55453633000) ;Nichols, Emma (57205756163) ;Abd-Allah, Foad (36503428900) ;Abdela, Jemal (57200613000) ;Abdelalim, Ahmed (7801307783) ;Adamu, Abdu A (57202024381) ;Adib, Mina G (57204560513) ;Ahmadi, Alireza (56336080700) ;Ahmed, Muktar Beshir (57207802317) ;Aichour, Amani Nidhal (57195486768) ;Aichour, Ibtihel (57195485980) ;Aichour, Miloud Taki Eddine (57195488258) ;Akseer, Nadia (57207801968) ;Al-Raddadi, Rajaa M (57219673720) ;Alahdab, Fares (55135922900) ;Alene, Kefyalew Addis (57202583764) ;Aljunid, Syed Mohamed (6504304159) ;AlMazora, Mohammad A (35572530900) ;Khalid (57202762923) ;Alvis-Guzman, Nelson (57210741239) ;Animut, Megbaru Debalkie (57204558749) ;Anjomshoa, Mina (57204563282) ;Ansha, Mustafa Geleto (57195329453) ;Asghar, Rana Jawad (57209013760) ;Avokpaho, Euripide F G A (57209842037) ;Awasthi, Ashish (58420926700) ;Badali, Hamid (15123728900) ;Barac, Aleksandra (55550748700) ;Bärnighausen, Till Winfried (23011726900) ;Bassat, Quique (23024176000) ;Bedi, Neeraj (57988442200) ;Belachew, Abate Bekele (57201657313) ;Bhattacharyya, Krittika (57204647266) ;Bhutta, Zulfiqar A (24342648300) ;Bijani, Ali (23134684900) ;Butt, Zahid A (57202522739) ;Carvalho, Félix (7103070417) ;Castañeda-Orjuela, Carlos A (35769124700) ;Chitheer, Abdulaal (57209314488) ;Choi, Jee-Young J (57209706428) ;Christopher, Devasahayam J (57209863533) ;Dang, Anh Kim (57195728465) ;Daryani, Ahmad (16021522200) ;Demoz, Gebre Teklemariam (57202214514) ;Djalalinia, Shirin (37113718000) ;Do, Huyen Phuc (57200737094) ;Dubey, Manisha (57219898654) ;Dubljanin, Eleonora (55957442600) ;Duken, Eyasu Ejeta (57204560558) ;El Sayed Zaki, Maysaa (57203666922) ;Elyazar, Iqbal Rf (6506894785) ;Fakhim, Hamed (56532027000) ;Fernandes, Eduarda (34770207500) ;Fischer, Florian (55508208800) ;Fukumoto, Takeshi (26531100300) ;Ganji, Morsaleh (57211874807) ;Gebre, Abadi Kahsu (59426751000) ;Gebremeskel, Afewerki (57204644046) ;Gessner, Bradford D (7005779769) ;Gopalani, Sameer Vali (57190277891) ;Guo, Yuming (55712472800) ;Gupta, Rahul (57204120071) ;Hailu, Gessessew Bugssa (57219637263) ;Haj-Mirzaian, Arvin (57210768364) ;Hamidi, Samer (24366336000) ;Hay, Simon I (7101875313) ;Henok, Andualem (57196451824) ;Irvani, Seyed Sina Naghibi (57202975543) ;Jha, Ravi Prakash (58586863400) ;Jürisson, Mikk (55547524800) ;Kahsay, Amaha (57216608121) ;Karami, Manoochehr (26655761400) ;Karch, André (57223444197) ;Kasaeian, Amir (57195540738) ;Kassa, Getachew Mullu (56229895500) ;Kassa, Tesfaye Dessale (58686045600) ;Kefale, Adane Teshome (57194507694) ;Khader, Yousef Saleh (55654192600) ;Khalil, Ibrahim A (58255049500) ;Khan, Ejaz Ahmad (57218791274) ;Khang, Young-Ho (57198904674) ;Khubchandani, Jagdish (57211720011) ;Kimokoti, Ruth W (8647554600) ;Kisa, Adnan (6603346067) ;Lami, Faris Hasan (57200737005) ;Levi, Miriam (54893035000) ;Li, Shanshan (57216631901) ;Loy, Clement T (7003650959) ;Majdan, Marek (36147855100) ;Majeed, Azeem (7102027801) ;Mantovani, Lorenzo Giovanni (7006357517) ;Martins-Melo, Francisco Rogerlândio (57204796807) ;McAlinden, Colm (35325278500) ;Mehta, Varshil (57158753300) ;Melese, Addisu (56901393600) ;Memish, Ziad A (7005059350) ;Mengistu, Desalegn Tadese (57194776802) ;Mengistu, Getnet (57193539632) ;Mestrovic, Tomislav (6507240107) ;Mezgebe, Haftay Berhane (57222113213) ;Miazgowski, Bartosz (56857536900) ;Milosevic, Branko (57204639427) ;Mokdad, Ali H (7004813962) ;Monasta, Lorenzo (7801520497) ;Moradi, Ghobad (48161434000) ;Moraga, Paula (46761426800) ;Mousavi, Seyyed Meysam (56165159700) ;Mueller, Ulrich Otto (8512347500) ;Murthy, Srinivas (36247670800) ;Mustafa, Ghulam (57190395960) ;Naghavi, Mohsen (59116090300) ;Naheed, Aliya (57202560989) ;Naik, Gurudatta (56020694000) ;Newton, Charles Richard James (35465836500) ;Nirayo, Yirga Legesse (57201651103) ;Nixon, Molly R (57204562047) ;Ofori-Asenso, Richard (57209300265) ;Ogbo, Felix Akpojene (57217186813) ;Olagunju, Andrew T (26029995700) ;Olagunju, Tinuke O (57203076824) ;Olusanya, Bolajoko Olubukunola (57218504682) ;Ortiz, Justin R (57201758478) ;Owolabi, Mayowa Ojo (57222581892) ;Patel, Shanti (57072227700) ;Pinilla-Monsalve, Gabriel D (57201459168) ;Postma, Maarten J (7006296502) ;Qorbani, Mostafa (57218161293) ;Rafiei, Alireza (13205769200) ;Rahimi-Movaghar, Vafa (6507646446) ;Reiner, Robert C (57203229088) ;Renzaho, Andre M N (6505786588) ;Rezai, Mohammad Sadegh (55273796300) ;Roba, Kedir Teji (57203667432) ;Ronfani, Luca (58842981900) ;Roshandel, Gholamreza (14034446800) ;Rostami, Ali (59144808300) ;Safari, Hosein (57204236925) ;Safari, Saeed (55549255200) ;Safiri, Saeid (56009654100) ;Sagar, Rajesh (26643103100) ;Samy, Abdallah M (36973661300) ;Milicevic, Milena M Santric (57211144346) ;Sartorius, Benn (12788526800) ;Sarvi, Shahabeddin (56168398100) ;Sawhney, Monika (57217153893) ;Saxena, Sonia (57203151746) ;Shafieesabet, Azadeh (56964338900) ;Shaikh, Masood Ali (57203122601) ;Sharif, Mehdi (16022734200) ;Shigematsu, Mika (23968093000) ;Si, Si (56706979500) ;Skiadaresi, Eirini (37100428500) ;Smith, Mari (57195484737) ;Somayaji, Ranjani (6507727557) ;Sufiyan, Mu'Awiyyah Babale (58294633600) ;Tawye, Nega Yimer (57204567080) ;Temsah, Mohamad-Hani (56115852000) ;Tortajada-Girbés, Miguel (16242320900) ;Tran, Bach Xuan (57209107515) ;Tran, Khanh Bao (57201651536) ;Ukwaja, Kingsley Nnanna (57202824584) ;Ullah, Irfan (56992676600) ;Vujcic, Isidora S (55957120100) ;Wagnew, Fasil (57200917385) ;Waheed, Yasir (35303643700) ;Weldegwergs, Kidu Gidey (57203308107) ;Winkler, Andrea Sylvia (59223872200) ;Wiyeh, Alison B (57196222987) ;Wiysonge, Charles Shey (6507441509) ;Wyper, Grant M A (56503829800) ;Yimer, Ebrahim M (57204849530) ;Yonemoto, Naohiro (57204947657) ;Zaidi, Zoubida (57197376721) ;Zenebe, Zerihun Menlkalew (57200737185) ;Feigin, Valery L (57218666683) ;Vos, Theo (57223885848)Murray, Christopher J L (55481130700)Background: Acute meningitis has a high case-fatality rate and survivors can have severe lifelong disability. We aimed to provide a comprehensive assessment of the levels and trends of global meningitis burden that could help to guide introduction, continuation, and ongoing development of vaccines and treatment programmes. Methods: The Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2016 study estimated meningitis burden due to one of four types of cause: pneumococcal, meningococcal, Haemophilus influenzae type b, and a residual category of other causes. Cause-specific mortality estimates were generated via cause of death ensemble modelling of vital registration and verbal autopsy data that were subject to standardised data processing algorithms. Deaths were multiplied by the GBD standard life expectancy at age of death to estimate years of life lost, the mortality component of disability-adjusted life-years (DALYs). A systematic analysis of relevant publications and hospital and claims data was used to estimate meningitis incidence via a Bayesian meta-regression tool. Meningitis deaths and cases were split between causes with meta-regressions of aetiological proportions of mortality and incidence, respectively. Probabilities of long-term impairment by cause of meningitis were applied to survivors and used to estimate years of life lived with disability (YLDs). We assessed the relationship between burden metrics and Socio-demographic Index (SDI), a composite measure of development based on fertility, income, and education. Findings: Global meningitis deaths decreased by 21·0% from 1990 to 2016, from 403 012 (95% uncertainty interval [UI] 319 426–458 514) to 318 400 (265 218–408 705). Incident cases globally increased from 2·50 million (95% UI 2·19–2·91) in 1990 to 2·82 million (2·46–3·31) in 2016. Meningitis mortality and incidence were closely related to SDI. The highest mortality rates and incidence rates were found in the peri-Sahelian countries that comprise the African meningitis belt, with six of the ten countries with the largest number of cases and deaths being located within this region. Haemophilus influenzae type b was the most common cause of incident meningitis in 1990, at 780 070 cases (95% UI 613 585–978 219) globally, but decreased the most (–49·1%) to become the least common cause in 2016, with 397 297 cases (291 076–533 662). Meningococcus was the leading cause of meningitis mortality in 1990 (192 833 deaths [95% UI 153 358–221 503] globally), whereas other meningitis was the leading cause for both deaths (136 423 [112 682–178 022]) and incident cases (1·25 million [1·06–1·49]) in 2016. Pneumococcus caused the largest number of YLDs (634 458 [444 787–839 749]) in 2016, owing to its more severe long-term effects on survivors. Globally in 2016, 1·48 million (1·04—1·96) YLDs were due to meningitis compared with 21·87 million (18·20—28·28) DALYs, indicating that the contribution of mortality to meningitis burden is far greater than the contribution of disabling outcomes. Interpretation: Meningitis burden remains high and progress lags substantially behind that of other vaccine-preventable diseases. Particular attention should be given to developing vaccines with broader coverage against the causes of meningitis, making these vaccines affordable in the most affected countries, improving vaccine uptake, improving access to low-cost diagnostics and therapeutics, and improving support for disabled survivors. Substantial uncertainty remains around pathogenic causes and risk factors for meningitis. Ongoing, active cause-specific surveillance of meningitis is crucial to continue and to improve monitoring of meningitis burdens and trends throughout the world. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license - Some of the metrics are blocked by yourconsent settings
Publication Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016(2019) ;Feigin, Valery L. (57203677957) ;Nichols, Emma (57205756163) ;Alam, Tahiya (57205589820) ;Bannick, Marlena S. (57206834518) ;Beghi, Ettore (7004809655) ;Blake, Natacha (57204638181) ;Culpepper, William J. (36130126400) ;Dorsey, E Ray (23102496300) ;Elbaz, Alexis (7003618656) ;Ellenbogen, Richard G. (7007098380) ;Fisher, James L. (7404013876) ;Fitzmaurice, Christina (57212628757) ;Giussani, Giorgia (57200843076) ;Glennie, Linda (6508220161) ;James, Spencer L. (57202557998) ;Johnson, Catherine Owens (57212301236) ;Kassebaum, Nicholas J. (57202562224) ;Logroscino, Giancarlo (7004888005) ;Marin, Benoît (8436867400) ;Mountjoy-Venning, W Cliff (57204289549) ;Nguyen, Minh (58203329200) ;Ofori-Asenso, Richard (57209300265) ;Patel, Anoop P. (59630658400) ;Piccininni, Marco (57195956329) ;Roth, Gregory A. 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(55906494000) ;Wijeratne, Tissa (14051317700) ;Winkler, Andrea Sylvia (58323746700) ;Wiysonge, Charles Shey (6507441509) ;Wolfe, Charles D A. (57202754705) ;Xu, Gelin (57203583113) ;Yadollahpour, Ali (57204564896) ;Yamada, Tomohide (37662679800) ;Yano, Yuichiro (57196965200) ;Yaseri, Mehdi (23029507000) ;Yatsuya, Hiroshi (6603908304) ;Yimer, Ebrahim M. (57204849530) ;Yip, Paul (7102503720) ;Yisma, Engida (55556060700) ;Yonemoto, Naohiro (57204947657) ;Yousefifard, Mahmoud (57204566585) ;Yu, Chuanhua (57208140344) ;Zaidi, Zoubida (57197376721) ;Zaman, Sojib Bin (57193070058) ;Zamani, Mohammad (57096222300) ;Zandian, Hamed (57205175627) ;Zare, Zohreh (35436578700) ;Zhang, Yunquan (56568510200) ;Zodpey, Sanjay (7003415080) ;Naghavi, Mohsen (57207906323) ;Murray, Christopher J L. (55481130700)Vos, Theo (57223885848)Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders. Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach. Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable). Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies. Funding: Bill & Melinda Gates Foundation. © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license - Some of the metrics are blocked by yourconsent settings
Publication Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017(2018) ;Kyu, Hmwe Hmwe (57217040073) ;Abate, Degu (57204237665) ;Abate, Kalkidan Hassen (57207943858) ;Abay, Solomon M. (35306466900) ;Abbafati, Cristiana (54917122400) ;Abbasi, Nooshin (57212442022) ;Abbastabar, Hedayat (57212441848) ;Abd-Allah, Foad (36503428900) ;Abdela, Jemal (57200613000) ;Abdelalim, Ahmed (7801307783) ;Abdollahpour, Ibrahim (36997151900) ;Abdulkader, Rizwan Suliankatchi (57195295816) ;Abebe, Molla (57211131124) ;Abebe, Zegeye (57193002719) ;Abil, Olifan Zewdie (57204558002) ;Aboyans, Victor (56214736500) ;Abrham, Aklilu Roba (57202704637) ;Abu-Raddad, Laith Jamal (14032724700) ;Abu-Rmeileh, Niveen M.E. 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(55481130700)Background: How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted lifeyears (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severityof ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-speci?c mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Sociodemographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the ?ve leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2). Interpretation With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. - Some of the metrics are blocked by yourconsent settings
Publication Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: A systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017(2019) ;Frank, Tahvi D. (57203197110) ;Carter, Austin (57201756395) ;Jahagirdar, Deepa (57213764835) ;Biehl, Molly H. (57196041812) ;Douwes-Schultz, Dirk (57196081398) ;Larson, Samantha Leigh (57204569813) ;Arora, Megha (57196080797) ;Dwyer-Lindgren, Laura (50461317900) ;Steuben, Krista M. (57208867341) ;Abbastabar, Hedayat (57212441848) ;Abu-Raddad, Laith Jamal (14032724700) ;Abyu, Direslgne Misker (56507277900) ;Adabi, Maryam (57190491886) ;Adebayo, Oladimeji M. (57194329853) ;Adekanmbi, Victor (53463192900) ;Adetokunboh, Olatunji O. 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(55481130700)Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package - a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce agesex- specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87-2·04) and has since decreased to 0·95 million deaths (0·91-1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79-3·67) and since then have gradually decreased to 1·94 million (1·63-2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8-39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact. © 2019 The Author(s). - Some of the metrics are blocked by yourconsent settings
Publication Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: A systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017(2019) ;Frank, Tahvi D. (57203197110) ;Carter, Austin (57201756395) ;Jahagirdar, Deepa (57213764835) ;Biehl, Molly H. (57196041812) ;Douwes-Schultz, Dirk (57196081398) ;Larson, Samantha Leigh (57204569813) ;Arora, Megha (57196080797) ;Dwyer-Lindgren, Laura (50461317900) ;Steuben, Krista M. (57208867341) ;Abbastabar, Hedayat (57212441848) ;Abu-Raddad, Laith Jamal (14032724700) ;Abyu, Direslgne Misker (56507277900) ;Adabi, Maryam (57190491886) ;Adebayo, Oladimeji M. (57194329853) ;Adekanmbi, Victor (53463192900) ;Adetokunboh, Olatunji O. 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(55481130700)Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package - a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce agesex- specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87-2·04) and has since decreased to 0·95 million deaths (0·91-1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79-3·67) and since then have gradually decreased to 1·94 million (1·63-2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8-39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact. © 2019 The Author(s). - Some of the metrics are blocked by yourconsent settings
Publication Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017(2018) ;James, Spencer L. (57202557998) ;Abate, Degu (57204237665) ;Abate, Kalkidan Hassen (57207943858) ;Abay, Solomon M. (35306466900) ;Abbafati, Cristiana (54917122400) ;Abbasi, Nooshin (57212442022) ;Abbastabar, Hedayat (57212441848) ;Abd-Allah, Foad (36503428900) ;Abdela, Jemal (57200613000) ;Abdelalim, Ahmed (7801307783) ;Abdollahpour, Ibrahim (36997151900) ;Abdulkader, Rizwan Suliankatchi (57195295816) ;Abebe, Zegeye (57193002719) ;Abera, Semaw F. (57205180598) ;Abil, Olifan Zewdie (57204558002) ;Abraha, Haftom Niguse (57195289877) ;Abu-Raddad, Laith Jamal (14032724700) ;Abu-Rmeileh, Niveen M.E. (57216675148) ;Accrombessi, Manfred Mario Kokou (55353650500) ;Acharya, Dilaram (56770895600) ;Acharya, Pawan (56435749900) ;Ackerman, Ilana N. 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(57201445180) ;Wang, Yafeng (57208674780) ;Wang, Yuan-Pang (8576812100) ;Weiderpass, Elisabete (57205018947) ;Weintraub, Robert G. (7006079405) ;Weiss, Daniel J. (8609275600) ;Weldegebreal, Fitsum (56112812300) ;Weldegwergs, Kidu Gidey (57203308107) ;Werdecker, Andrea (57208964895) ;West, T. Eoin (57756844000) ;Whiteford, Harvey A. (55906494000) ;Widecka, Justyna (15047205800) ;Wijeratne, Tissa (14051317700) ;Wilner, Lauren B. (57193699787) ;Wilson, Shadrach (57204557765) ;Winkler, Andrea Sylvia (58323746700) ;Wiyeh, Alison B. (57196222987) ;Wiysonge, Charles Shey (6507441509) ;Wolfe, Charles D.A. (57202754705) ;Woolf, Anthony D. (7102882171) ;Wu, Shouling (57744442000) ;Wu, Yun-Chun (56095674500) ;Wyper, Grant M.A. (56503829800) ;Xavier, Denis (55403963100) ;Xu, Gelin (57203583113) ;Yadgir, Simon (57192837280) ;Yadollahpour, Ali (57204564896) ;Yahyazadeh Jabbari, Seyed Hossein (26029029100) ;Yamada, Tomohide (37662679800) ;Yan, Lijing L. (57198311895) ;Yano, Yuichiro (57196965200) ;Yaseri, Mehdi (23029507000) ;Yasin, Yasin Jemal (57204565144) ;Yeshaneh, Alex (57204564144) ;Yimer, Ebrahim M. (57202256312) ;Yip, Paul (7102503720) ;Yisma, Engida (55556060700) ;Yonemoto, Naohiro (57204947657) ;Yoon, Seok-Jun (24823148900) ;Yotebieng, Marcel (26325950800) ;Younis, Mustafa Z. (8549393000) ;Yousefifard, Mahmoud (57204566585) ;Yu, Chuanhua (57208140344) ;Zadnik, Vesna (57202975428) ;Zaidi, Zoubida (57197376721) ;Zaman, Sojib Bin (57193070058) ;Zamani, Mohammad (59866744200) ;Zare, Zohreh (35436578700)Zeleke, Ayalew Jejaw (57193096860)Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. - Some of the metrics are blocked by yourconsent settings
Publication Healthcare access and quality index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: A novel analysis from the global burden of disease study 2015(2017) ;Barber, Ryan M. (57202560423) ;Fullman, Nancy (57211064970) ;Sorensen, Reed J.D. (57196918748) ;Bollyky, Thomas (36677045500) ;McKee, Martin (7202304775) ;Nolte, Ellen (7005556106) ;Abajobir, Amanuel Alemu (57203613441) ;Abate, Kalkidan Hassen (57207943858) ;Abbafati, Cristiana (54917122400) ;Abbas, Kaja M. (57190285707) ;Abd-Allah, Foad (36503428900) ;Abdulle, Abdishakur M. (6603592018) ;Abdurahman, Ahmed Abdulahi (56677630600) ;Abera, Semaw Ferede (57205180598) ;Abraham, Biju (57202568691) ;Abreha, Girmatsion Fisseha (6504124710) ;Adane, Kelemework (57202841698) ;Adelekan, Ademola Lukman (57216109261) ;Adetifa, Ifedayo Morayo O. 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(57202594826) ;Setegn, Tesfaye (37075667700) ;Shackelford, Katya Anne (57202959163) ;Shaheen, Amira (57202560956) ;Shahraz, Saeid (57215142060) ;Shaikh, Masood Ali (57203122601) ;Shakh-Nazarova, Marina (56133525500) ;Shamsipour, Mansour (57197846052) ;Shariful Islam, Sheikh Mohammed (56400111100) ;Sharma, Jayendra (57195329457) ;Sharma, Rajesh (58228412600) ;She, Jun (57209122131) ;Sheikhbahaei, Sara (57219637352) ;Shen, Jiabin (57199271940) ;Shi, Peilin (57203064901) ;Shigematsu, Mika (23968093000) ;Shin, Min-Jeong (7401536640) ;Shiri, Rahman (57200737050) ;Shoman, Haitham (57208324664) ;Shrime, Mark G. (57204703404) ;Sibamo, Ephrem Lejore Sibamo (57195508024) ;Sigfusdottir, Inga Dora (57195363778) ;Silva, Diego Augusto Santos (36985158000) ;Silveira, Dayane Gabriele Alves (57190284103) ;Sindi, Shireen (57209045912) ;Singh, Abhishek (59639211800) ;Singh, Jasvinder A. (7404421736) ;Singh, Om Prakash (57207807888) ;Singh, Prashant Kumar (57208090732) ;Singh, Virendra (57191848598) ;Sinke, Abiy Hiruye (57195329519) ;Sinshaw, Aklilu Endalamaw (57202040629) ;Skirbekk, Vegard (57202564482) ;Sliwa, Karen (57207223988) ;Smith, Alison (57191843859) ;Sobngwi, Eugene (6701427993) ;Soneji, Samir (57204096389) ;Soriano, Joan B. (7101973935) ;Sousa, Tatiane Cristina Moraes (57195329460) ;Sposato, Luciano A. (25640261000) ;Sreeramareddy, Chandrashekhar T. (57212263335) ;Stathopoulou, Vasiliki (57195644148) ;Steel, Nicholas (6603791873) ;Steiner, Caitlyn (57205358084) ;Steinke, Sabine (57203777687) ;Stokes, Mark Andrew (7102859000) ;Stranges, Saverio (7003835008) ;Strong, Mark (12783473200) ;Stroumpoulis, Konstantinos (57211777127) ;Sturua, Lela (37662283900) ;Sufiyan, Muawiyyah Babale (58294633600) ;Suliankatchi, Rizwan Abdulkader (57195295816) ;Sun, Jiandong (55547135892) ;Sur, Patrick (57218360398) ;Swaminathan, Soumya (7102380757) ;Sykes, Bryan L. (57211183396) ;Tabarés-Seisdedos, Rafael (6602981102) ;Tabb, Karen M. (51162023700) ;Taffere, Getachew Redae (59807215200) ;Talongwa, Roberto Tchio (57195568335) ;Tarajia, Musharaf (56041372500) ;Tavakkoli, Mohammad (57202524239) ;Taveira, Nuno (6602731390) ;Teeple, Stephanie (57191850890) ;Tegegne, Teketo Kassaw (57216998561) ;Tehrani-Banihashemi, Arash (57204006020) ;Tekelab, Tesfalidet (56721378300) ;Tekle, Dejen Yemane (57191848698) ;Temam Shifa, Girma (57217000284) ;Terkawi, Abdullah Sulieman (57211144258) ;Tesema, Azeb Gebresilassie (57194530110) ;Thakur, J.S. (57204002123) ;Thomson, Alan J. (57969994200) ;Tillmann, Taavi (57190211142) ;Tiruye, Tenaw Yimer (57194055872) ;Tobe-Gai, Ruoyan (57209276611) ;Tonelli, Marcello (7103102534) ;Topor-Madry, Roman (57211182892) ;Tortajada, Miguel (16242320900) ;Troeger, Christopher (57195223624) ;Truelsen, Thomas (57202824565) ;Tura, Abera Kenay (57195623051) ;Uchendu, Uche S. (56328470200) ;Ukwaja, Kingsley N. (57202824584) ;Undurraga, Eduardo A. (57204092789) ;Uneke, Chigozie Jesse (57202824589) ;Uthman, Olalekan A. (23026328100) ;Van Boven, Job F.M. (53464198500) ;Van Dingenen, Rita (57203088526) ;Varughese, Santosh (22942817500) ;Vasankari, Tommi (57200592416) ;Venketasubramanian, Narayanaswamy (56804702100) ;Violante, Francesco S. (7003555890) ;Vladimirov, Sergey K. (57195959162) ;Vlassov, Vasiliy Victorovich (57211633239) ;Vollset, Stein Emil (57196315778) ;Vos, Theo (57223885848) ;Wagner, Joseph A. (56990441500) ;Wakayo, Tolassa (57205609717) ;Waller, Stephen G. (57201445180) ;Walson, Judd L. (57203254111) ;Wang, Haidong (16507828100) ;Wang, Yuan-Pang (8576812100) ;Watkins, David A. (35207242300) ;Weiderpass, Elisabete (57205018947) ;Weintraub, Robert G. (7006079405) ;Wen, Chi-Pang (58460870400) ;Werdecker, Andrea (57208964895) ;Wesana, Joshua (56688521300) ;Westerman, Ronny (57218361023) ;Whiteford, Harvey A. (55906494000) ;Wilkinson, James D. (57207903571) ;Wiysonge, Charles Shey (6507441509) ;Woldeyes, Belete Getahun (57195329524) ;Wolfe, Charles D.A. (57202754705) ;Won, Sungho (57207796874) ;Workicho, Abdulhalik (56720337100) ;Workie, Shimelash Bitew (57191837199) ;Wubshet, Mamo (54409732600) ;Xavier, Denis (55403963100) ;Xu, Gelin (57203583113) ;Yadav, Ajit Kumar (57197675591) ;Yaghoubi, Mohsen (56402926900) ;Yakob, Bereket (57203811497) ;Yan, Lijing L. (57198311895) ;Yano, Yuichiro (57196965200) ;Yaseri, Mehdi (23029507000) ;Yimam, Hassen Hamid (57196325590) ;Yip, Paul (7102503720) ;Yonemoto, Naohiro (57204947657) ;Yoon, Seok-Jun (24823148900) ;Younis, Mustafa Z. (8549393000) ;Yu, Chuanhua (57201889726) ;Zaidi, Zoubida (57197376721) ;El Sayed Zaki, Maysaa (57203666922) ;Zambrana-Torrelio, Carlos (57193255530) ;Zapata, Tomas (57194968519) ;Zenebe, Zerihun Menlkalew (57200737185) ;Zodpey, Sanjay (7003415080) ;Zoeckler, Leo (57203905510) ;Zuhlke, Liesl Joanna (57209027746)Murray, Christopher J.L. (55481130700)Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0-42·8) in 1990 to 53·7 (52·2-55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Copyright © The Author(s). Published by Elsevier Ltd. - Some of the metrics are blocked by yourconsent settings
Publication Maternal mortality and morbidity burden in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study(2018) ;Mokdad, Ali H. (7004813962) ;Khalil, Ibrahim (58255049500) ;Collison, Michael (57202309052) ;El Bcheraoui, Charbel (25027689700) ;Charara, Raghid (56514085300) ;Moradi-Lakeh, Maziar (35617421300) ;Afshin, Ashkan (57217465455) ;Chew, Adrienne (57209171085) ;Daoud, Farah (57201079837) ;Krohn, Kristopher J. (57194138806) ;Colombara, Danny (37025591000) ;Ehrenkranz, Rebecca (57194229299) ;Kutz, Michael (57195617315) ;Wang, Haidong (16507828100) ;Abajobir, Amanuel Alemu (57203613441) ;Abd-Allah, Foad (36503428900) ;Abraha, Haftom Niguse (57195289877) ;Abu-Raddad, Laith J. (14032724700) ;Kiadaliri, Aliasghar Ahmad (57199100665) ;Ahmadi, Alireza (56336080700) ;Ahmed, Kedir Yimam (57190386244) ;Ahmed, Muktar Beshir (57207802317) ;Al Lami, Faris Hasan (57200737005) ;Alam, Khurshid (57203681299) ;Alasfoor, Deena (57211114684) ;Alizadeh-Navaei, Reza (57226214128) ;Alkaabi, Juma M. (57202957220) ;Al-Maskari, Fatma (25824744400) ;Al-Raddadi, Rajaa (57219673720) ;Altirkawi, Khalid A. (57202762923) ;Anber, Nahla (57202351369) ;Ansari, Hossein (56919376000) ;Asayesh, Hamid (55334322800) ;Asghar, Rana Jawad (57209013760) ;Atey, Tesfay Mehari (57209784978) ;Ayele, Tadesse Awoke (55431232600) ;Bärnighausen, Till (23011726900) ;Bacha, Umar (57200173721) ;Barac, Aleksandra (55550748700) ;Barker-Collo, Suzanne L. (57193065514) ;Baune, Bernhard T. (6603807336) ;Bazargan-Hejazi, Shahrzad (57205912040) ;Bedi, Neeraj (57988442200) ;Bensenor, Isabela M. (7004830338) ;Berhane, Adugnaw (57200410735) ;Beyene, Addisu Shunu (57209036705) ;Bhutta, Zulfiqar A. (24342648300) ;Boneya, Dube Jara (57194067231) ;Borschmann, Rohan (35091024300) ;Breitborde, Nicholas J. K. (6603260895) ;Butt, Zahid A. (57202522739) ;Catalá-López, Ferrán (57202553733) ;Ciobanu, Liliana G. (57201603453) ;Danawi, Hadi (57201079895) ;Deribew, Amare (25625914400) ;Dharmaratne, Samath D. (57216324802) ;Doyle, Kerrie E. (55693710800) ;Endries, Aman Yesuf (57216324852) ;Faraon, Emerito Jose Aquino (57195414019) ;Faro, André (36770969600) ;Farvid, Maryam S. (57216534761) ;Fekadu, Wubalem (56955761700) ;Fereshtehnejad, Seyed-Mohammad (57202557520) ;Fischer, Florian (55508208800) ;Gebrehiwot, Tsegaye Tewelde (57216482917) ;Giref, Ababi Zergaw (57219994468) ;Gishu, Melkamu Dedefo (57202568734) ;Goulart, Alessandra Carvalho (57201181348) ;Habtewold, Tesfa Dejenie (57079013900) ;Hamadeh, Randah Ribhi (57202769526) ;Hambisa, Mitiku Teshome (57203666810) ;Hamidi, Samer (24366336000) ;Haro, Josep Maria (57215877903) ;Hassanvand, Mohammad Sadegh (35085056400) ;Horita, Nobuyuki (57217110823) ;Hsairi, Mohamed (57209033943) ;Huang, Hsiang (57216594251) ;Husseini, Abdullatif (6603689690) ;Jakovljevic, Mihajlo B. (14318929700) ;James, Spencer Lewis (57202557998) ;Jonas, Jost B. (7202492953) ;Kasaeian, Amir (57195540738) ;Khader, Yousef Saleh (55654192600) ;Khan, Ejaz Ahmad (57218791274) ;Khoja, Abdullah Tawfih Abdullah (57203306097) ;Khosravi, Ardeshir (57201190837) ;Khubchandani, Jagdish (57211720011) ;Kim, Daniel (57223019104) ;Kim, Yun Jin (57211086375) ;Kokubo, Yoshihiro (56155004000) ;Koyanagi, Ai (57197741912) ;Defo, Barthelemy Kuate (6602271655) ;Larson, Heidi J. (57202559142) ;Latif, Asma Abdul (57201620992) ;Lee, Paul H. (57200302692) ;Leshargie, Cheru Tesema (57195295462) ;Leung, Ricky (56276497100) ;Lo, Loon-Tzian (57214204231) ;Lunevicius, Raimundas (57216165063) ;El Razek, Hassan Magdy Abd (57195948985) ;El Razek, Mohammed Magdy Abd (57216629996) ;Majdzadeh, Reza (9246620000) ;Majeed, Azeem (7102027801) ;Malekzadeh, Reza (7005197760) ;Martinez-Raga, Jose (57202861191) ;Farid, Habibolah Masoudi (57191592768) ;Mazidi, Mohsen (57200232563) ;McGrath, John J. (57215198193) ;Memish, Ziad A. (7005059350) ;Mendoza, Walter (57216905642) ;Mengesha, Melkamu Merid (57192953602) ;Mengistie, Mubarek Abera (56045752700) ;Mensah, George A. (57196028147) ;Mezgebe, Haftay Berhane (57222113213) ;Miller, Ted R. (7403948600) ;Mitchell, Philip B. (35354747000) ;Mohammadi, Alireza (58896815600) ;Mohammed, Shafiu (57838689000) ;Obermeyer, Carla Makhlouf (57209300189) ;Ogbo, Felix Akpojene (57200737136) ;Castillo, Elizabeth Palomares (57709413500) ;Papachristou, Christina (7005498635) ;Patten, Scott B. (57201492915) ;Patton, George C. (7102184358) ;Pereira, David M. (57200690024) ;Pervaiz, Aslam (57202521714) ;Phillips, Michael Robert (57206972395) ;Pourmalek, Farshad (8309390500) ;Qorbani, Mostafa (24831040300) ;Radfar, Amir (57194428768) ;Rafay, Anwar (57212263323) ;Rahimi-Movaghar, Vafa (6507646446) ;Rai, Rajesh Kumar (51864423900) ;Rawaf, David Laith (57209228052) ;Rawaf, Salman (6602475959) ;Refaat, Amany H. (57216641565) ;Rezaei, Satar (55791003000) ;Rezai, Mohammad Sadegh (55273796300) ;Roshandel, Gholamreza (14034446800) ;Safdarian, Mahdi (57203849024) ;Safiabadi, Mahdi (57191540063) ;Safiri, Saeid (56009654100) ;Sagar, Rajesh (26643103100) ;Sahraian, Mohammad Ali (55886074600) ;Salamati, Payman (14045860600) ;Samy, Abdallah M. (36973661300) ;Sartorius, Benn (12788526800) ;Saylan, Mete I. (56253241700) ;Seedat, Soraya (7003445887) ;Sepanlou, Sadaf G. (36248136000) ;Shaikh, Masood Ali (57203122601) ;Shamsizadeh, Morteza (57195940127) ;Silva, Diego Augusto Santos (36985158000) ;Singh, Jasvinder A. (7404421736) ;Sobaih, Badr H. A. (56677563500) ;Sreeramareddy, Chandrashekhar T. (57212263335) ;Stein, Dan J. (55769747595) ;Abdulkader, Rizwan Suliankatchi (57195295816) ;Sykes, Bryan L. (57211183396) ;Tabarés-Seisdedos, Rafael (6602981102) ;Sufiyan, Muawiyyah (58294633600) ;Tabb, Karen M. (51162023700) ;Tehrani-Banihashemi, Arash (57204006020) ;Temsah, Mohamad-Hani (56115852000) ;Terkawi, Abdullah Sulieman (57211144258) ;Topor-Madry, Roman (57211182892) ;Ukwaja, Kingsley Nnanna (57202824584) ;Uthman, Olalekan A. (23026328100) ;Vollset, Stein Emil (57196315778) ;Wakayo, Tolassa (57205609717) ;Wang, Yuan-Pang (8576812100) ;Werdecker, Andrea (57208964895) ;Westerman, Ronny (57218361023) ;Workicho, Abdulhalik (56720337100) ;Yaghoubi, Mohsen (57212400558) ;Yimam, Hassen Hamid (57196325590) ;Yonemoto, Naohiro (57204947657) ;Younis, Mustafa Z. (8549393000) ;Yu, Chuanhua (57201889726) ;Zaki, Maysaa El Sayed (57203666922) ;Jumaan, Aisha O. (6603612494) ;Vos, Theo (57223885848) ;Hay, Simon I. (7101875313) ;Naghavi, Mohsen (57207906323) ;Kassebaum, Nicholas J. (57202562224)Murray, Christopher J. L. (55481130700)Objectives: Assessing the burden of maternal mortality is important for tracking progress and identifying public health gaps. This paper provides an overview of the burden of maternal mortality in the Eastern Mediterranean Region (EMR) by underlying cause and age from 1990 to 2015. Methods: We used the results of the Global Burden of Disease 2015 study to explore maternal mortality in the EMR countries. Results: The maternal mortality ratio in the EMR decreased 16.3% from 283 (241–328) maternal deaths per 100,000 live births in 1990 to 237 (188–293) in 2015. Maternal mortality ratio was strongly correlated with socio-demographic status, where the lowest-income countries contributed the most to the burden of maternal mortality in the region. Conclusion: Progress in reducing maternal mortality in the EMR has accelerated in the past 15 years, but the burden remains high. Coordinated and rigorous efforts are needed to make sure that adequate and timely services and interventions are available for women at each stage of reproductive life. © 2017, The Author(s). - Some of the metrics are blocked by yourconsent settings
Publication Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017(2018) ;Murray, Christopher J.L. (55481130700) ;Callender, Charlton S.K.H. (57195560691) ;Kulikoff, Xie Rachel (57191837748) ;Srinivasan, Vinay (57196077031) ;Abate, Degu (57204237665) ;Abate, Kalkidan Hassen (57207943858) ;Abay, Solomon M. (35306466900) ;Abbasi, Nooshin (57212442022) ;Abbastabar, Hedayat (57212441848) ;Abdela, Jemal (57200613000) ;Abdelalim, Ahmed (7801307783) ;Abdel-Rahman, Omar (55777635800) ;Abdi, Alireza (56845014200) ;Abdoli, Nasrin (44560890300) ;Abdollahpour, Ibrahim (36997151900) ;Abdulkader, Rizwan Suliankatchi (57195295816) ;Abebe, Haftom Temesgen (55950002100) ;Abebe, Molla (57211131124) ;Abebe, Zegeye (57193002719) ;Abebo, Teshome Abuka (57195738441) ;Abejie, Ayenew Negesse (57203015573) ;Aboyans, Victor (56214736500) ;Abraha, Haftom Niguse (57195289877) ;Abreu, Daisy Maria Xavier (9747083200) ;Abrham, Aklilu Roba (57202704637) ;Abu-Raddad, Laith Jamal (14032724700) ;Abu-Rmeileh, Niveen M.E. (57216675148) ;Accrombessi, Manfred Mario Kokou (55353650500) ;Acharya, Pawan (56435749900) ;Adamu, Abdu A. (57202024381) ;Adebayo, Oladimeji M. (57194329853) ;Adedeji, Isaac Akinkunmi (57208456508) ;Adekanmbi, Victor (53463192900) ;Adetokunboh, Olatunji O. 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(7003331101) ;Lozano, Rafael (7102198442) ;Lunevicius, Raimundas (57216165063) ;Mabika, Crispin Mabika (56208601300) ;Macarayan, Erlyn Rachelle King (56330601800) ;Mackay, Mark T. (7103172855) ;Madotto, Fabiana (16029150500) ;Mahmood, Tarek Abd Elaziz (57204558136) ;Mahotra, Narayan Bahadur (55924241300) ;Majdan, Marek (36147855100) ;Majdzadeh, Reza (9246620000) ;Majeed, Azeem (7102027801) ;Malekzadeh, Reza (7005197760) ;Malik, Manzoor Ahmad (57210016163) ;Mamun, Abdullah A. (55666602500) ;Manamo, Wondimu Ayele (57191836792) ;Manda, Ana-Laura (57204567674) ;Mangalam, Srikanth (57200611404) ;Mansournia, Mohammad Ali (34570618600) ;Mantovani, Lorenzo Giovanni (7006357517) ;Mapoma, Chabila Christopher (57208956832) ;Marami, Dadi (57200546490) ;Maravilla, Joemer C. (57008289000) ;Marcenes, Wagner (7005668102) ;Marina, Shakhnazarova (57204569175) ;Martins-Melo, Francisco Rogerlândio (57204796807) ;März, Winfried (57220877383) ;Marzan, Melvin B. (57200737144) ;Mashamba-Thompson, Tivani Phosa (56281917500) ;Masiye, Felix (57216327983) ;Mason-Jones, Amanda J. (7201563263) ;Massenburg, Benjamin Ballard (55859007400) ;Mathur, Manu Raj (55270329300) ;Maulik, Pallab K. (7005919685) ;Mazidi, Mohsen (57200232563) ;McGrath, John J. (57202560550) ;Mehata, Suresh (57211773159) ;Mehendale, Sanjay Madhav (7005739578) ;Mehndiratta, Man Mohan (57202557864) ;Mehrotra, Ravi (7203045563) ;Mehrzadi, Saeed (56034736000) ;Mehta, Kala M. (7201939418) ;Mehta, Varshil (57158753300) ;Mekonnen, Tefera C. (57193872649) ;Meles, Hagazi Gebre (57204559084) ;Meles, Kidanu Gebremariam (57951018400) ;Melese, Addisu (56901393600) ;Melku, Mulugeta (56032188500) ;Memiah, Peter T.N. (57217207827) ;Memish, Ziad A. (7005059350) ;Mendoza, Walter (57216905642) ;Mengesha, Melkamu Merid (57192953602) ;Mengistu, Desalegn Tadese (57194776802) ;Mengistu, Getnet (57193539632) ;Mensah, George A. (57196028147) ;Mereta, Seid Tiku (57203628211) ;Meretoja, Atte (12775885500) ;Meretoja, Tuomo J. (57202554188) ;Mestrovic, Tomislav (6507240107) ;Mezgebe, Haftay Berhane (57222113213) ;Miangotar, Yode (57197736129) ;Miazgowski, Bartosz (56857536900) ;Miazgowski, Tomasz (6701404689) ;Miller, Ted R. (7403948600) ;Miller-Petrie, Molly Katherine (56387657900) ;Mini, G.K. (12800865800) ;Mirabi, Parvaneh (51864302500) ;Mirica, Andreea (57188983765) ;Mirrakhimov, Erkin M. (57216202888) ;Misganaw, Awoke Temesgen (57202808713) ;Moazen, Babak (57204324006) ;Mohammad, Karzan Abdulmuhsin (57205300378) ;Mohammadi, Moslem (56274033300) ;Mohammadifard, Noushin (23110866700) ;Mohammadi-Khanaposhtani, Maryam (56497918100) ;Mohammed, Mohammed A. (57196575014) ;Mohammed, Shafiu (57838689000) ;Mokdad, Ali H. 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(6701544088) ;Nagel, Gabriele (7103201623) ;Naghavi, Mohsen (57207906323) ;Naheed, Aliya (57202560989) ;Nahvijou, Azin (18837247000) ;Naik, Gurudatta (56020694000) ;Naik, Paulami (57219571661) ;Najafi, Farid (21743304900) ;Naldi, Luigi (7004954781) ;Nangia, Vinay (57201490837) ;Nansseu, Jobert Richie (55548984700) ;Nascimento, Bruno Ramos (14424406800) ;Nawaz, Haseeb (57211774152) ;Ncama, Busisiwe P. (22980862000) ;Neamati, Nahid (57204566952) ;Negoi, Ionut (57200640014) ;Negoi, Ruxandra Irina (55566106200) ;Neupane, Subas (57215632313) ;Newton, Charles Richard James (35465836500) ;Ngalesoni, Frida N. (57219463339) ;Ngunjiri, Josephine W. (57195296110) ;Nguyen, Grant (57191591002) ;Nguyen, Long Hoang (56567321800) ;Nguyen, Trang Huyen (59142352200) ;Ningrum, Dina Nur Anggraini (57195329470) ;Nirayo, Yirga Legesse (57201651103) ;Nisar, Muhammad Imran (57191774461) ;Nixon, Molly R. 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(57196078769) ;Razo-García, Christian (57191620919) ;Reiner, Robert C. (57203229088) ;Reis, Cesar (56611469700) ;Remuzzi, Giuseppe (56466188600) ;Renzaho, Andre M.N. (6505786588) ;Resnikoff, Serge (7006012071) ;Rezaei, Satar (55791003000) ;Rezaeian, Shahab (55214334100) ;Rezai, Mohammad Sadegh (55273796300) ;Riahi, Seyed Mohammad (57193205976) ;Rios-Blancas, Maria Jesus (57208577330) ;Roba, Kedir Teji (57203667432) ;Roberts, Nicholas L.S. (57204562597) ;Roever, Leonardo (56641632800) ;Ronfani, Luca (6602565620) ;Roshandel, Gholamreza (14034446800) ;Rostami, Ali (59144808300) ;Rubagotti, Enrico (57208389589) ;Ruhago, George Mugambage (50761517500) ;Sabde, Yogesh Damodar (54793337800) ;Sachdev, Perminder S. (7102284091) ;Saddik, Basema (23020079300) ;Moghaddam, Sahar Saeedi (56071020000) ;Safari, Hosein (57204236925) ;Safari, Yahya (55700424100) ;Safari-Faramani, Roya (57210821203) ;Safdarian, Mahdi (57203849024) ;Safi, Sare (57219477293) ;Safiri, Saeid (56009654100) ;Sagar, Rajesh (26643103100) ;Sahebkar, Amirhossein (26639699900) ;Sahraian, Mohammad Ali (55886074600) ;Sajadi, Haniye Sadat (57190919153) ;Salahshoor, Mohamadreza (55580011800) ;Salam, Nasir (23992664500) ;Salama, Joseph S. (57202975625) ;Salamati, Payman (14045860600) ;Saldanha, Raphael De Freitas (57193063393) ;Saleem, Zikria (56179814800) ;Salimi, Yahya (54421017000) ;Salimzadeh, Hamideh (23052386900) ;Salomon, Joshua A. (56745638600) ;Salvi, Sundeep Santosh (7005258777) ;Salz, Inbal (57199623777) ;Sambala, Evanson Zondani (36718133800) ;Samy, Abdallah M. (36973661300) ;Sanabria, Juan (7006262917) ;Sanchez-Niño, Maria Dolores (57202569015) ;Santos, Itamar S. (57198312911) ;Santric Milicevic, Milena M. (57211144346) ;Sao Jose, Bruno Piassi (57204561719) ;Sardana, Mayank (56992882500) ;Sarker, Abdur Razzaque (55908816200) ;Sarmiento-Suárez, Rodrigo (57204744430) ;Saroshe, Satish (36125578600) ;Sarrafzadegan, Nizal (6701751316) ;Sartorius, Benn (12788526800) ;Sarvi, Shahabeddin (56168398100) ;Sathian, Brijesh (27467953500) ;Satpathy, Maheswar (57202563691) ;Sawant, Arundhati R. (57204568004) ;Sawhney, Monika (57217153893) ;Saxena, Sonia (57203151746) ;Schaeffner, Elke (6507021741) ;Schelonka, Kathryn (57195377099) ;Schneider, Ione J.C. (57201292772) ;Schwebel, David C. (6603681532) ;Schwendicke, Falk (55639536600) ;Seedat, Soraya (7003445887) ;Sekerija, Mario (30268005400) ;Sepanlou, Sadaf G. (36248136000) ;Serván-Mori, Edson (57202594826) ;Shabaninejad, Hosein (56047947500) ;Shackelford, Katya Anne (57202959163) ;Shafieesabet, Azadeh (56964338900) ;Shaheen, Amira A. (57202560956) ;Shaikh, Masood Ali (57203122601) ;Shakir, Raad A. (55374140100) ;Shams-Beyranvand, Mehran (57193608415) ;Shamsi, Mohammadbagher (57204557980) ;Shamsizadeh, Morteza (57195940127) ;Sharafi, Heidar (57322506400) ;Sharafi, Kiomars (57194516056) ;Sharif, Mehdi (16022734200) ;Sharif-Alhoseini, Mahdi (35108018000) ;Sharma, Jayendra (57195329457) ;Sharma, Rajesh (58228412600) ;She, Jun (57209122131) ;Sheikh, Aziz (7202522962) ;Shi, Peilin (57203064901) ;Shibuya, Kenji (8948057900) ;Shigematsu, Mika (23968093000) ;Shiri, Rahman (57200737050) ;Shirkoohi, Reza (12776374400) ;Shiue, Ivy (35811219800) ;Shokraneh, Farhad (36146063000) ;Shukla, Sharvari Rahul (55760856000) ;Si, Si (56706979500) ;Siabani, Soraya (25227131300) ;Sibai, Abla Mehio (7005466998) ;Siddiqi, Tariq J. (57193718539) ;Sigfusdottir, Inga Dora (57195363778) ;Sigurvinsdottir, Rannveig (56006396200) ;Silpakit, Naris (57202401404) ;Silva, Diego Augusto Santos (36985158000) ;Silva, João Pedro (7403023631) ;Silveira, Dayane Gabriele Alves (57190284103) ;Singam, Narayana Sarma Venkata (57204560563) ;Singh, Jasvinder A. (7404421736) ;Singh, Narinder Pal (57211864736) ;Singh, Virendra (57191848598) ;Sinha, Dhirendra Narain (7201637609) ;Sliwa, Karen (57207223988) ;Soares Filho, Adauto Martins (49961178500) ;Sobaih, Badr Hasan (57202564080) ;Sobhani, Soheila (57193095221) ;Soofi, Moslem (56373891000) ;Soriano, Joan B. (7101973935) ;Soyiri, Ireneous N. (15052406400) ;Sreeramareddy, Chandrashekhar T. (57212263335) ;Starodubov, Vladimir I. (6701820838) ;Steiner, Caitlyn (57205358084) ;Stewart, Leo G. (57204565284) ;Stokes, Mark A. (7102859000) ;Strong, Mark (12783473200) ;Subart, Michelle L. (57194140438) ;Sufiyan, Mu'awiyyah Babale (58294633600) ;Sulo, Gerhard (16242476100) ;Sunguya, Bruno F. (57209060557) ;Sur, Patrick John (57218360398) ;Sutradhar, Ipsita (57202349742) ;Sykes, Bryan L. (57211183396) ;Sylaja, P.N. (12787344300) ;Sylte, Dillon O. (57211183601) ;Szoeke, Cassandra E.I. (6505920990) ;Tabarés-Seisdedos, Rafael (6602981102) ;Tabb, Karen M. (51162023700) ;Tadakamadla, Santosh Kumar (57207799926) ;Tandon, Nikhil (7101833756) ;Tassew, Aberash Abay (57204559404) ;Tassew, Segen Gebremeskel (57204569108) ;Taveira, Nuno (6602731390) ;Tawye, Nega Yimer (57204567080) ;Tehrani-Banihashemi, Arash (57204006020) ;Tekalign, Tigist Gashaw (57204558037) ;Tekle, Merhawi Gebremedhin (57204237146) ;Temsah, Mohamad-Hani (56115852000) ;Terkawi, Abdullah Sulieman (57211144258) ;Teshale, Manaye Yihune (57204566390) ;Tessema, Belay (20735503600) ;Teweldemedhin, Mebrahtu (57193667629) ;Thakur, Jarnail Singh (57204002123) ;Thankappan, Kavumpurathu Raman (57202955435) ;Thirunavukkarasu, Sathish (54407369300) ;Thomas, Nihal (7401830494) ;Thomson, Alan J. (57969994200) ;Tilahun, Binyam (57212075730) ;To, Quyen G. (55827789100) ;Tonelli, Marcello (7103102534) ;Topor-Madry, Roman (57211182892) ;Torre, Anna E. (57196074351) ;Tortajada-Girbés, Miguel (16242320900) ;Tovani-Palone, Marcos Roberto (56644977900) ;Toyoshima, Hideaki (7103228330) ;Tran, Bach Xuan (57209107515) ;Tran, Khanh Bao (57201651536) ;Tripathy, Srikanth Prasad (35461478100) ;Truelsen, Thomas Clement (57202824565) ;Truong, Nu Thi (57204178907) ;Tsadik, Afewerki Gebremeskel (57204562442) ;Tsegay, Amanuel (57207624804) ;Tsilimparis, Nikolaos (17435999400) ;Car, Lorainne Tudor (48561867100) ;Ukwaja, Kingsley N. (57202824584) ;Ullah, Irfan (56992676600) ;Usman, Muhammad Shariq (57203046075) ;Uthman, Olalekan A. (23026328100) ;Uzun, Selen Begüm (57200327315) ;Vaduganathan, Muthiah (16417973600) ;Vaezi, Afsane (55698015300) ;Vaidya, Gaurang (55551507300) ;Valdez, Pascual R. (57202115577) ;Varavikova, Elena (7801408611) ;Varughese, Santosh (22942817500) ;Vasankari, Tommi Juhani (57200592416) ;Vasconcelos, Ana Maria Nogales (57208202014) ;Venketasubramanian, Narayanaswamy (56804702100) ;Villafaina, Santos (57195804127) ;Violante, Francesco S. (7003555890) ;Vladimirov, Sergey Konstantinovitch (57195959162) ;Vlassov, Vasily (57211633239) ;Vollset, Stein Emil (57196315778) ;Vos, Theo (57223885848) ;Vosoughi, Kia (56199294900) ;Vujcic, Isidora S. (55957120100) ;Wagnew, Fasil Shiferaw (57200917385) ;Waheed, Yasir (35303643700) ;Walson, Judd L. (57203254111) ;Wang, Yanping (57215440165) ;Wang, Yuan-Pang (8576812100) ;Weiderpass, Elisabete (57205018947) ;Weintraub, Robert G. (7006079405) ;Weldegwergs, Kidu Gidey (57203308107) ;Werdecker, Andrea (57208964895) ;Westerman, Ronny (57218361023) ;Whiteford, Harvey (55906494000) ;Widecka, Justyna (15047205800) ;Widecka, Katarzyna (36761868700) ;Wijeratne, Tissa (14051317700) ;Winkler, Andrea Sylvia (58323746700) ;Wiysonge, Charles Shey (6507441509) ;Wolfe, Charles D.A. (57202754705) ;Wu, Shouling (57744442000) ;Wyper, Grant M.A. (56503829800) ;Xu, Gelin (57203583113) ;Yamada, Tomohide (37662679800) ;Yano, Yuichiro (57196965200) ;Yaseri, Mehdi (23029507000) ;Yasin, Yasin Jemal (57204565144) ;Ye, Pengpeng (57202839295) ;Yentür, Gökalp Kadri (57211728019) ;Yeshaneh, Alex (57204564144) ;Yimer, Ebrahim M. (57202256312) ;Yip, Paul (7102503720) ;Yisma, Engida (55556060700) ;Yonemoto, Naohiro (57204947657) ;Yoon, Seok-Jun (24823148900) ;Yotebieng, Marcel (26325950800) ;Younis, Mustafa Z. (8549393000) ;Yousefifard, Mahmoud (57204566585) ;Yu, Chuanhua (57208140344)Zadnik, Vesna (57202975428)Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license - Some of the metrics are blocked by yourconsent settings
Publication Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years: an analysis of the Global Burden of Disease Study 2017(2020) ;Troeger, Christopher E (57195223624) ;Khalil, Ibrahim A (58255049500) ;Blacker, Brigette F (57202420381) ;Biehl, Molly H (57196041812) ;Albertson, Samuel B (57204573505) ;Zimsen, Stephanie R M (57196078433) ;Rao, Puja C (57191835613) ;Abate, Degu (57204237665) ;Ahmadi, Alireza (56336080700) ;Ahmed, Mohamed Lemine Cheikh Brahim (57258605600) ;Akal, Chalachew Genet (57205385708) ;Alahdab, Fares (55135922900) ;Alam, Noore (57202437697) ;Alene, Kefyalew Addis (57202583764) ;Alipour, Vahid (56436629300) ;Aljunid, Syed Mohamed (6504304159) ;Al-Raddadi, Rajaa M (57219673720) ;Alvis-Guzman, Nelson (57210741239) ;Amini, Saeed (57210811281) ;Anber, Nahla Hamed (57202351369) ;Anjomshoa, Mina (57204563282) ;Antonio, Carl Abelardo T (55247644500) ;Arabloo, Jalal (57208760927) ;Aremu, Olatunde (57214958833) ;Atalay, Hagos Tasew (57203535974) ;Atique, Suleman (56505419100) ;Avokpaho, Euripide F G A (57209842037) ;Awad, Samah (57192660810) ;Awasthi, Ashish (58420926700) ;Badawi, Alaa (57216776029) ;Balakrishnan, Kalpana (7103222725) ;Banoub, Joseph Adel Mattar (57204568975) ;Barac, Aleksandra (55550748700) ;Bassat, Quique (23024176000) ;Bedi, Neeraj (57988442200) ;Bennett, Derrick A (57650836400) ;Bhattacharyya, Krittika (57204647266) ;Bhutta, Zulfiqar A (24342648300) ;Bijani, Ali (23134684900) ;Car, Josip (6701783618) ;Carvalho, Félix (7103070417) ;Castañeda-Orjuela, Carlos A (35769124700) ;Christopher, Devasahayam J (57209863533) ;Dandona, Lalit (7007017243) ;Dandona, Rakhi (57203043697) ;Daryani, Ahmad (16021522200) ;Demeke, Feleke Mekonnen (57204717669) ;Deshpande, Aniruddha (57208579336) ;Djalalinia, Shirin (37113718000) ;Dubey, Manisha (57219898654) ;Dubljanin, Eleonora (55957442600) ;Duken, Eyasu Ejeta (57204560558) ;El Sayed Zaki, Maysaa (57203666922) ;Endries, Aman Yesuf (57216324852) ;Fernandes, Eduarda (34770207500) ;Fischer, Florian (55508208800) ;Fullman, Nancy (57211064970) ;Gardner, William M (57204566870) ;Geta, Birhanu (57208190927) ;Ghadiri, Keyghobad (55409170000) ;Gorini, Giuseppe (56509988200) ;Goulart, Alessandra C (57201181348) ;Guo, Yuming (55712472800) ;Hailu, Gessessew Bugssa (57219637263) ;Haj-Mirzaian, Arvin (57210768364) ;Haj-Mirzaian, Arya (57226201352) ;Hamidi, Samer (24366336000) ;Hassen, Hamid Yimam (57188660707) ;Hoang, Chi Linh (57205123375) ;Hostiuc, Mihaela (51763789200) ;Hussain, Zakir (59269161900) ;Irvani, Seyed Sina Naghibi (57202975543) ;James, Spencer L (57202557998) ;Jha, Ravi Prakash (58586863400) ;Jonas, Jost B (7202492953) ;Karch, André (55917217700) ;Kasaeian, Amir (57195540738) ;Kassa, Tesfaye Dessale (58686045600) ;Kassebaum, Nicholas J (57202562224) ;Kefale, Adane Teshome (57194507694) ;Khader, Yousef Saleh (55654192600) ;Khan, Ejaz Ahmad (57218791274) ;Khan, Md Nuruzzaman (57209404949) ;Khang, Young-Ho (57198904674) ;Khoja, Abdullah T (57194229795) ;Kimokoti, Ruth W (8647554600) ;Kisa, Adnan (6603346067) ;Kisa, Sezer (14030019900) ;Kissoon, Niranjan (7006364038) ;Kochhar, Sonali (57214107714) ;Kosen, Soewarta (57211346192) ;Koyanagi, Ai (57197741912) ;Defo, Barthelemy Kuate (6602271655) ;Kumar, G Anil (57139550500) ;Lal, Dharmesh Kumar (57222488984) ;Leshargie, Cheru Tesema (57195295462) ;Li, Shanshan (57216631901) ;Lodha, Rakesh (7007019609) ;MacArayan, Erlyn Rachelle King (56330601800) ;Majdan, Marek (36147855100) ;Mamun, Abdullah A (55666602500) ;Manguerra, H. (57208121153) ;Melese, Addisu (56901393600) ;Memish, Ziad A (7005059350) ;Mengistu, Desalegn Tadese (57194776802) ;Meretoja, Tuomo J (57202554188) ;Mestrovic, Tomislav (6507240107) ;Miazgowski, Bartosz (56857536900) ;Mirrakhimov, Erkin M (57216202888) ;Moazen, Babak (57204324006) ;Mohammad, Karzan Abdulmuhsin (57205300378) ;Mohammed, Shafiu (57838689000) ;Monasta, Lorenzo (7801520497) ;Moore, Catrin E (57195934063) ;Mosser, Jonathan F (56111776300) ;Mousavi, Seyyed Meysam (56165159700) ;Murthy, Srinivas (36247670800) ;Mustafa, Ghulam (57190395960) ;Nazari, Javad (57207759174) ;Nguyen, Cuong Tat (56531347200) ;Nguyen, Long Hoang (56567321800) ;Nisar, Muhammad Imran (57191774461) ;Nixon, Molly R (57204562047) ;Ogbo, Felix Akpojene (57200737136) ;Okoro, Anselm (54682112200) ;Olagunju, Andrew T (26029995700) ;Olagunju, Tinuke O (57203076824) ;Mahesh, P.A. (57202421244) ;Pakhale, Smita (57220937499) ;Postma, Maarten J (7006296502) ;Qorbani, Mostafa (24831040300) ;Quansah, Reginald (14825606700) ;Rafiei, Alireza (13205769200) ;Rahim, Fakher (23052247800) ;Rahimi-Movaghar, Vafa (6507646446) ;Rai, Rajesh Kumar (51864423900) ;Rezai, Mohammad Sadegh (55273796300) ;Rezapour, Aziz (55548281300) ;Rios-Blancas, Maria Jesus (57208577330) ;Ronfani, Luca (6602565620) ;Rosettie, Katherine (57202512228) ;Rothenbacher, Dietrich (7004765162) ;Safari, Saeed (55549255200) ;Saleem, Zikria (56179814800) ;Sambala, Evanson Zondani (36718133800) ;Samy, Abdallah M (36973661300) ;Milicevic, Milena M Santric (57211144346) ;Sartorius, Benn (12788526800) ;Sawhney, Monika (57217153893) ;Seyedmousavi, Seyedmojtaba (57204698893) ;Shaikh, Masood Ali (57203122601) ;Sheikh, Aziz (7202522962) ;Shigematsu, Mika (23968093000) ;Smith, David L (55574206203) ;Soriano, Joan B (7101973935) ;Sreeramareddy, Chandrashekhar T (57212263335) ;Stanaway, Jeffrey D (57201210928) ;Sufiyan, Mu'Awiyyah Babale (58294633600) ;Teklu, Teklay G E (59429585700) ;Temsah, Mohamad-Hani (56115852000) ;Tessema, Belay (20735503600) ;Tran, Bach Xuan (57209107515) ;Tran, Khanh Bao (57201651536) ;Ullah, Irfan (56992676600) ;Updike, Rachel L (57204698680) ;Vasankari, Tommi Juhani (57200592416) ;Veisani, Yousef (55370882600) ;Wada, Fiseha Wadilo (57194049305) ;Waheed, Yasir (35303643700) ;Weaver, Marcia (7201548872) ;Wiens, Kirsten E (55515807800) ;Wiysonge, Charles Shey (6507441509) ;Yimer, Ebrahim M (57204849530) ;Yonemoto, Naohiro (57204947657) ;Zaidi, Zoubida (57197376721) ;Zar, Heather J (7006236599) ;Zarghi, Afshin (7003559162) ;Lim, Stephen S (57201800433) ;Vos, Theo (57223885848) ;Mokdad, Ali H (7004813962) ;Murray, Christopher J L (55481130700) ;Kyu, Hmwe Hmwe (57217040073) ;Hay, Simon I (7101875313)Reiner, Robert C (57203229088)Background: Many countries have shown marked declines in diarrhoeal disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. Methods: This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. Findings: Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162–593 145) among children younger than 5 years globally in 2017, a rate of 78·4 deaths (70·1–87·1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69·6% (63·1–74·6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13·3% decrease, 11·2–15·5), childhood wasting (9·9% decrease, 9·6–10·2), and low use of oral rehydration solution (6·9% decrease, 4·8–8·4). Interpretation: Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors—particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution—appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license - Some of the metrics are blocked by yourconsent settings
Publication Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years: an analysis for the Global Burden of Disease Study 2017(2020) ;Troeger, Christopher E. (57195223624) ;Khalil, Ibrahim A. (58255049500) ;Blacker, Brigette F. (57202420381) ;Biehl, Molly H. (57196041812) ;Albertson, Samuel B. (57204573505) ;Zimsen, Stephanie R.M. (57196078433) ;Rao, Puja C. (57191835613) ;Abate, Degu (57204237665) ;Admasie, Amha (56609274200) ;Ahmadi, Alireza (56336080700) ;Ahmed, Mohamed Lemine Cheikh Brahim (57258605600) ;Akal, Chalachew Genet (57205385708) ;Alahdab, Fares (55135922900) ;Alam, Noore (57202437697) ;Alene, Kefyalew Addis (57202583764) ;Alipour, Vahid (56436629300) ;Aljunid, Syed Mohamed (6504304159) ;Al-Raddadi, Rajaa M. (57219673720) ;Alvis-Guzman, Nelson (57210741239) ;Amini, Saeed (57210811281) ;Anjomshoa, Mina (57204563282) ;Antonio, Carl Abelardo T. (55247644500) ;Arabloo, Jalal (57208760927) ;Aremu, Olatunde (57214958833) ;Atalay, Hagos Tasew (57203535974) ;Atique, Suleman (56505419100) ;Avokpaho, Euripide F.G.A. (57209842037) ;Awad, Samah (57192660810) ;Awasthi, Ashish (58420926700) ;Badawi, Alaa (57216776029) ;Balakrishnan, Kalpana (7103222725) ;Banoub, Joseph Adel Mattar (57204568975) ;Barac, Aleksandra (55550748700) ;Bassat, Quique (23024176000) ;Bedi, Neeraj (57988442200) ;Bennett, Derrick A. (57650836400) ;Bhattacharyya, Krittika (57204647266) ;Bhutta, Zulfiqar A. (24342648300) ;Bijani, Ali (23134684900) ;Bills, Corey B. (24528417100) ;Car, Josip (6701783618) ;Carvalho, Félix (7103070417) ;Castañeda-Orjuela, Carlos A. (35769124700) ;Causey, Kate (57204560479) ;Christopher, Devasahayam J. (57209863533) ;Cohen, Aaron J. (7404780942) ;Dandona, Lalit (7007017243) ;Dandona, Rakhi (57203043697) ;Daryani, Ahmad (16021522200) ;Demeke, Feleke Mekonnen (57204717669) ;Djalalinia, Shirin (37113718000) ;Dubey, Manisha (57219898654) ;Dubljanin, Eleonora (55957442600) ;Duken, Eyasu Ejeta (57204560558) ;Zaki, Maysaa El Sayed (57203666922) ;Endries, Aman Yesuf (57216324852) ;Fernandes, Eduarda (34770207500) ;Fischer, Florian (55508208800) ;Frostad, Joseph (57222306717) ;Fullman, Nancy (57211064970) ;Gardner, William M. (57204566870) ;Geta, Birhanu (57208190927) ;Ghadiri, Keyghobad (55409170000) ;Gorini, Giuseppe (56509988200) ;Goulart, Alessandra C. (57201181348) ;Guo, Yuming (55712472800) ;Hailu, Gessessew Bugssa (57219637263) ;Haj-Mirzaian, Arvin (57210768364) ;Haj-Mirzaian, Arya (57226201352) ;Hamidi, Samer (24366336000) ;Hassen, Hamid Yimam (57188660707) ;Hoang, Chi Linh (57205123375) ;Horita, Nobuyuki (57217110823) ;Hostiuc, Mihaela (51763789200) ;Hussain, Zakir (59269161900) ;Irvani, Seyed Sina Naghibi (57202975543) ;James, Spencer L. (57202557998) ;Jha, Ravi Prakash (58586863400) ;Jonas, Jost B. (7202492953) ;Karch, André (57223444197) ;Kasaeian, Amir (57195540738) ;Kassa, Tesfaye Dessale (58686045600) ;Kassebaum, Nicholas J. (57202562224) ;Kefale, Adane Teshome (57194507694) ;Khader, Yousef Saleh (55654192600) ;Khan, Ejaz Ahmad (57218791274) ;Khan, Gulfaraz (6701635515) ;Khan, Md Nuruzzaman (57209404949) ;Khang, Young-Ho (57198904674) ;Khoja, Abdullah T. (57203306097) ;Kimokoti, Ruth W. (8647554600) ;Kisa, Adnan (6603346067) ;Kisa, Sezer (14030019900) ;Kissoon, Niranjan (7006364038) ;Knibbs, Luke D. (16313525200) ;Kochhar, Sonali (57214107714) ;Kosen, Soewarta (57211346192) ;Koul, Parvaiz A. (14022262900) ;Koyanagi, Ai (57197741912) ;Defo, Barthelemy Kuate (6602271655) ;Anil Kumar, G. (57139550500) ;Lal, Dharmesh Kumar (57222488984) ;Leshargie, Cheru Tesema (57195295462) ;Lewycka, Sonia (57212496031) ;Li, Shanshan (57216631901) ;Lodha, Rakesh (7007019609) ;MacArayan, Erlyn Rachelle King (56330601800) ;Majdan, Marek (36147855100) ;Mamun, Abdullah A. (55666602500) ;Manguerra, Helena (57208121153) ;Mehta, Varshil (57158753300) ;Melese, Addisu (56901393600) ;Memish, Ziad A. (7005059350) ;Mengistu, Desalegn Tadese (57194776802) ;Meretoja, Tuomo J. (57202554188) ;Mestrovic, Tomislav (6507240107) ;Miazgowski, Bartosz (56857536900) ;Mirrakhimov, Erkin M. (57216202888) ;Moazen, Babak (57204324006) ;Mohammad, Karzan Abdulmuhsin (57205300378) ;Mohammed, Shafiu (57838689000) ;Monasta, Lorenzo (7801520497) ;Moore, Catrin E. (57195934063) ;Morawska, Lidia (7004773965) ;Mosser, Jonathan F. (56111776300) ;Mousavi, Seyyed Meysam (56165159700) ;Murthy, Srinivas (36247670800) ;Mustafa, Ghulam (57190395960) ;Nazari, Javad (57207759174) ;Nguyen, Cuong Tat (56531347200) ;Nguyen, Huong Lan Thi (57226837406) ;Nguyen, Long Hoang (56567321800) ;Nguyen, Son Hoang (59662830400) ;Nielsen, Katie R. (59847898200) ;Nisar, Muhammad Imran (57191774461) ;Nixon, Molly R. (57204562047) ;Ogbo, Felix Akpojene (57200737136) ;Okoro, Anselm (54682112200) ;Olagunju, Andrew T. (26029995700) ;Olagunju, Tinuke O. (57203076824) ;Oren, Eyal (36815569400) ;Ortiz, Justin R. (57201758478) ;Mahesh, P.A. (57202421244) ;Pakhale, Smita (57220937499) ;Postma, Maarten J. (7006296502) ;Qorbani, Mostafa (24831040300) ;Quansah, Reginald (14825606700) ;Rafiei, Alireza (13205769200) ;Rahim, Fakher (23052247800) ;Rahimi-Movaghar, Vafa (6507646446) ;Rai, Rajesh Kumar (51864423900) ;Reitsma, Marissa Bettay (57208766315) ;Rezai, Mohammad Sadegh (55273796300) ;Rezapour, Aziz (55548281300) ;Rios-Blancas, Maria Jesus (57208577330) ;Ronfani, Luca (6602565620) ;Rothenbacher, Dietrich (7004765162) ;Rubino, Salvatore (55240504800) ;Saleem, Zikria (56179814800) ;Sambala, Evanson Zondani (36718133800) ;Samy, Abdallah M. (36973661300) ;Milicevic, Milena M. Santric (57211144346) ;Sarmiento-Suárez, Rodrigo (57204744430) ;Sartorius, Benn (12788526800) ;Savic, Miloje (57204524150) ;Sawhney, Monika (57217153893) ;Saxena, Sonia (57203151746) ;Sbarra, Alyssa (57200546253) ;Seyedmousavi, Seyedmojtaba (57204698893) ;Shaikh, Masood Ali (57203122601) ;Sheikh, Aziz (7202522962) ;Shigematsu, Mika (23968093000) ;Smith, David L. (55574206203) ;Sreeramareddy, Chandrashekhar T. (57212263335) ;Stanaway, Jeffrey D. (57201210928) ;Sufiyan, Mu awiyyah Babale (58294633600) ;Temsah, Mohamad-Hani (56115852000) ;Tessema, Belay (20735503600) ;Tran, Bach Xuan (57209107515) ;Tran, Khanh Bao (57201651536) ;Tsadik, Afewerki Gebremeskel (57204562442) ;Ullah, Irfan (56992676600) ;Updike, Rachel L. (57204698680) ;Vasankari, Tommi Juhani (57200592416) ;Veisani, Yousef (55370882600) ;Wada, Fiseha Wadilo (57194049305) ;Waheed, Yasir (35303643700) ;Welgan, Katie (57212487910) ;Wiens, Kirsten E. (55515807800) ;Wiysonge, Charles Shey (6507441509) ;Yimer, Ebrahim M. (57204849530) ;Yonemoto, Naohiro (57204947657) ;Zaidi, Zoubida (57197376721) ;Zar, Heather J. (7006236599) ;Lim, Stephen S. (57201800433) ;Vos, Theo (57223885848) ;Mokdad, Ali H. (7004813962) ;Murray, Christopher J.L. (55481130700) ;Kyu, Hmwe Hmwe (57217040073) ;Hay, Simon I. (7101875313)Reiner, Robert C. (57203229088)Background: Despite large reductions in under-5 lower respiratory infection (LRI) mortality in many locations, the pace of progress for LRIs has generally lagged behind that of other childhood infectious diseases. To better inform programmes and policies focused on preventing and treating LRIs, we assessed the contributions and patterns of risk factor attribution, intervention coverage, and sociodemographic development in 195 countries and territories by drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) LRI estimates. Methods: We used four strategies to model LRI burden: the mortality due to LRIs was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive ensemble modelling tool; the incidence of LRIs was modelled using population representative surveys, health-care utilisation data, and scientific literature in a compartmental meta-regression tool; the attribution of risk factors for LRI mortality was modelled in a counterfactual framework; and trends in LRI mortality were analysed applying changes in exposure to risk factors over time. In GBD, infectious disease mortality, including that due to LRI, is among HIV-negative individuals. We categorised locations based on their burden in 1990 to make comparisons in the changing burden between 1990 and 2017 and evaluate the relative percent change in mortality rate, incidence, and risk factor exposure to explain differences in the health loss associated with LRIs among children younger than 5 years. Findings: In 2017, LRIs caused 808 920 deaths (95% uncertainty interval 747 286–873 591) in children younger than 5 years. Since 1990, there has been a substantial decrease in the number of deaths (from 2 337 538 to 808 920 deaths; 65·4% decrease, 61·5–68·5) and in mortality rate (from 362·7 deaths [330·1–392·0] per 100 000 children to 118·9 deaths [109·8–128·3] per 100 000 children; 67·2% decrease, 63·5–70·1). LRI incidence declined globally (32·4% decrease, 27·2–37·5). The percent change in under-5 mortality rate and incidence has varied across locations. Among the risk factors assessed in this study, those responsible for the greatest decrease in under-5 LRI mortality between 1990 and 2017 were increased coverage of vaccination against Haemophilus influenza type b (11·4% decrease, 0·0–24·5), increased pneumococcal vaccine coverage (6·3% decrease, 6·1–6·3), and reductions in household air pollution (8·4%, 6·8–9·2). Interpretation: Our findings show that there have been substantial but uneven declines in LRI mortality among countries between 1990 and 2017. Although improvements in indicators of sociodemographic development could explain some of these trends, changes in exposure to modifiable risk factors are related to the rates of decline in LRI mortality. No single intervention would universally accelerate reductions in health loss associated with LRIs in all settings, but emphasising the most dominant risk factors, particularly in countries with high case fatality, can contribute to the reduction of preventable deaths. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4·0 license - Some of the metrics are blocked by yourconsent settings
Publication Trends in HIV/AIDS morbidity and mortality in Eastern Mediterranean countries, 1990–2015: findings from the Global Burden of Disease 2015 study(2018) ;Mokdad, Ali H. (7004813962) ;El Bcheraoui, Charbel (25027689700) ;Wang, Haidong (16507828100) ;Khalil, Ibrahim (58255049500) ;Afshin, Ashkan (57217465455) ;Collison, Michael (57202309052) ;Daoud, Farah (57201079837) ;Chew, Adrienne (57209171085) ;Krohn, Kristopher J. (57194138806) ;Carter, Austin (57201756395) ;Foreman, Kyle J. (57209064414) ;He, Fei (59031207400) ;Kassebaum, Nicholas J. (57202562224) ;Kutz, Michael (57195617315) ;Mirarefin, Mojde (57222113397) ;Nguyen, Grant (57191591002) ;Silpakit, Naris (57202401404) ;Sligar, Amber (57190284582) ;Larson, Heidi J. (57202559142) ;Vollset, Stein Emil (57196315778) ;Vos, Theo (57223885848) ;Hay, Simon I. (7101875313) ;Naghavi, Mohsen (57207906323) ;Murray, Christopher J. L. (55481130700) ;Rawaf, David Laith (57209228052) ;Rawaf, Salman (6602475959) ;Charara, Raghid (56514085300) ;Moradi-Lakeh, Maziar (35617421300) ;Abajobir, Amanuel Alemu (57203613441) ;Abate, Kalkidan Hassen (57207943858) ;Gebrehiwot, Tsegaye Tewelde (57216482917) ;Gesesew, Hailay Abrha (56412148300) ;Wakayo, Tolassa (57205609717) ;Workicho, Abdulhalik (56720337100) ;Abbas, Kaja M. (57190285707) ;Abd-Allah, Foad (36503428900) ;Abera, Semaw Ferede (57205180598) ;Adane, Kelemework (57202841698) ;Agarwal, Arnav (57214768208) ;Kiadaliri, Aliasghar Ahmad (57199100665) ;Ahmadi, Alireza (56336080700) ;Ahmed, Muktar Beshir (57207802317) ;Al Lami, Faris Hasan (57200737005) ;Alam, Khurshid (57203681299) ;Mekonnen, Alemayehu B. (57200179648) ;Alasfoor, Deena (57211114684) ;Alizadeh-Navaei, Reza (57226214128) ;Al-Maskari, Fatma (25824744400) ;Al-Raddadi, Rajaa (57219673720) ;Altirkawi, Khalid A. (57202762923) ;Sobaih, Badr H. A. (57202564080) ;Temsah, Mohamad-Hani (56115852000) ;Alvis-Guzman, Nelson (57210741239) ;Ammar, Walid (57208159281) ;Harb, Hilda L. (57221443122) ;Anber, Nahla (57202351369) ;Antonio, Carl Abelardo T. (55247644500) ;Anwari, Palwasha (57217465526) ;Asayesh, Hamid (55334322800) ;Asghar, Rana Jawad (57209013760) ;Atey, Tesfay Mehari (57209784978) ;Hailu, Gessessew Bugssa (57219637263) ;Mezgebe, Haftay Berhane (57222113213) ;Yalew, Ayalnesh Zemene (57190286375) ;Arthur Avokpaho, Euripide Frinel G. (57202307726) ;Ayele, Tadesse Awoke (55431232600) ;Tesssema, Belay (57195294962) ;Azzopardi, Peter (56861081000) ;Bacha, Umar (57200173721) ;Barac, Aleksandra (55550748700) ;Bärnighausen, Till (23011726900) ;Bazargan-Hejazi, Shahrzad (57205912040) ;Bedi, Neeraj (57202557520) ;Bensenor, Isabela M. (7004830338) ;Berhane, Adugnaw (57200410735) ;Bessong, Pascal Obong (6506832973) ;Beyene, Addisu Shunu (57209036705) ;Bhutta, Zulfiqar A. (24342648300) ;Birungi, Charles (57195448297) ;Bidgoli, Hassan Haghparast (57201491554) ;Butt, Zahid A. (57202522739) ;Cahuana-Hurtado, Lucero (57207890731) ;Danawi, Hadi (57201079895) ;Neves, Josédas (57208073193) ;Deribe, Kebede (57193912587) ;Deribew, Amare (25625914400) ;Des Jarlais, Don C. (56990451200) ;Dharmaratne, Samath D. (57226838689) ;Djalalinia, Shirin (37113718000) ;Doyle, Kerrie E. (55693710800) ;Endries, Aman Yesuf (57216324852) ;Shifa, Girma Temam (57211793093) ;Hareri, Habtamu Abera (57195292447) ;Kassaw, Nigussie Assefa (57196473578) ;Woldu, Minyahil Alebachew (55648411900) ;Eshrati, Babak (16030619200) ;Faraon, Emerito Jose Aquino (57195414019) ;Farvid, Maryam S. (57216534761) ;Feyissa, Tesfaye Regassa (57222562476) ;Tekelab, Tesfalidet (56721378300) ;Fischer, Florian (55508208800) ;Garcia-Basteiro, Alberto L. (57200187168) ;Gishu, Melkamu Dedefo (57202568734) ;Glaser, Elizabeth (56133254300) ;Gona, Philimon N. (57219703762) ;Gugnani, Harish Chander (7005567008) ;Gupta, Rahul (57204120071) ;Hamadeh, Randah Ribhi (57202769526) ;Hambisa, Mitiku Teshome (57203666810) ;Mengesha, Melkamu Merid (57192953602) ;Roba, Hirbo Shore (7102027801) ;Hamidi, Samer (24366336000) ;Horita, Nobuyuki (57217110823) ;Husseini, Abdullatif (6603689690) ;Ibrahim, Ahmed (59644932100) ;James, Spencer Lewis (57202557998) ;Jonas, Jost B. (7202492953) ;Kasaeian, Amir (57195540738) ;Khader, Yousef Saleh (55654192600) ;Khan, Ejaz Ahmad (57218791274) ;Khan, Gulfaraz (6701635515) ;Khoja, Abdullah Tawfih Abdullah (57194229795) ;Khubchandani, Jagdish (57211720011) ;Kim, Yun Jin (57211086375) ;Koyanagi, Ai (59269920500) ;Defo, Barthelemy Kuate (6602271655) ;Latif, Asma Abdul (57201620992) ;Leshargie, Cheru Tesema (57195295462) ;Tegegne, Teketo Kassaw (57216998561) ;Lunevicius, Raimundas (57216165063) ;El Razek, Mohammed Magdy Abd (57216629996) ;Majdzadeh, Reza (9246620000) ;Majeed, Azeem (57217722657) ;Malekzadeh, Reza (7005197760) ;Roshandel, Gholamreza (14034446800) ;Sepanlou, Sadaf G. (36248136000) ;Manyazewal, Tsegahun (57204150906) ;Markos, Desalegn (57210741352) ;Farid, Habibolah Masoudi (57191592768) ;Mehari, Alem (57211114616) ;Memiah, Peter (57217207827) ;Memish, Ziad A. (7005059350) ;Mendoza, Walter (57216905642) ;Mengistu, Desalegn Tadese (57194776802) ;Mhimbira, Francis Apolinary (57207789910) ;Miller, Ted R. (7403948600) ;Moore, Ami R. (57216303682) ;Mumtaz, Ghina R. (57191452190) ;Natarajan, Gopalakrishnan (55804491100) ;Negin, Joel (25937447400) ;Obermeyer, Carla Makhlouf (57209300189) ;Ogbo, Felix Akpojene (57217186813) ;Oh, In-Hwan (57204090669) ;Ota, Erika (57202554474) ;Pereira, David M. (57200690024) ;Pourmalek, Farshad (8309390500) ;Qorbani, Mostafa (24831040300) ;Radfar, Amir (57194428768) ;Rafay, Anwar (57212263323) ;Rahimi-Movaghar, Vafa (6507646446) ;Salamati, Payman (14045860600) ;Rai, Rajesh Kumar (51864423900) ;Ram, Usha (26653819000) ;Renzaho, Andre M. N. (6505786588) ;Rezaei, Satar (55791003000) ;Rezai, Mohammad Sadegh (55273796300) ;Safdarian, Mahdi (57203849024) ;Safiri, Saeid (56009654100) ;Sahraian, Mohammad Ali (55886074600) ;Samy, Abdallah M. (36973661300) ;Sartorius, Benn (12788526800) ;Shaikh, Masood Ali (57203122601) ;Shamsizadeh, Morteza (57195940127) ;Sibamo, Ephrem Lejore Sibamo (57195508024) ;Wadilo, Fiseha (57194049305) ;Workie, Shimelash Bitew (57191837199) ;Singh, Jasvinder A. (7404421736) ;Soshnikov, Sergey (57195195606) ;Sufiyan, Muawiyyah Babale (58294633600) ;Sykes, Bryan L. (57218362022) ;Taveira, Nuno (6602731390) ;Tehrani-Banihashemi, Arash (57204006020) ;Topor-Madry, Roman (57211182892) ;Ukwaja, Kingsley Nnanna (57202824584) ;Uthman, Olalekan A. (23026328100) ;Yaghoubi, Mohsen (56402926900) ;Yimam, Hassen Hamid (57196325590) ;Yonemoto, Naohiro (57204947657) ;Yoon, Seok-Jun (24823148900) ;Yotebieng, Marcel (26325950800) ;Younis, Mustafa Z. (8549393000) ;Zaki, Maysaa El Sayed (57203666922)Jumaan, Aisha O. (6603612494)Objectives: We used the results of the Global Burden of Disease 2015 study to estimate trends of HIV/AIDS burden in Eastern Mediterranean Region (EMR) countries between 1990 and 2015. Methods: Tailored estimation methods were used to produce final estimates of mortality. Years of life lost (YLLs) were calculated by multiplying the mortality rate by population by age-specific life expectancy. Years lived with disability (YLDs) were computed as the prevalence of a sequela multiplied by its disability weight. Results: In 2015, the rate of HIV/AIDS deaths in the EMR was 1.8 (1.4–2.5) per 100,000 population, a 43% increase from 1990 (0.3; 0.2–0.8). Consequently, the rate of YLLs due to HIV/AIDS increased from 15.3 (7.6–36.2) per 100,000 in 1990 to 81.9 (65.3–114.4) in 2015. The rate of YLDs increased from 1.3 (0.6–3.1) in 1990 to 4.4 (2.7–6.6) in 2015. Conclusions: HIV/AIDS morbidity and mortality increased in the EMR since 1990. To reverse this trend and achieve epidemic control, EMR countries should strengthen HIV surveillance, and scale up HIV antiretroviral therapy and comprehensive prevention services. © 2017, The Author(s).
