27 results on '"Vaman Kulkarni"'
Search Results
2. Are our teachers knowledgeable towards pre hospital emergency care: A study from South India
- Author
-
Nithin Kumar, Ramesh Holla, Noorelle Karim Khan, Prasanna Mithra, Rekha Thapar, Jeedhu Radhakrishnan, Bhaskaran Unnikrishnan, Avinash Kumar, Alok Jindal, Sukanya Basak, Vaman Kulkarni, Darshan Bhagawan, and Koneru Jaswanth
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Allergic reaction ,Epidemiology ,education ,Public Health, Environmental and Occupational Health ,Signs and symptoms ,medicine.disease ,03 medical and health sciences ,School teachers ,0302 clinical medicine ,Infectious Diseases ,Family medicine ,medicine ,030212 general & internal medicine ,Choking ,Psychology ,Personal protective equipment ,First aid - Abstract
Background School children stay a significant hour of the day in their school and are the medium through which information can be carried to their parents and other family members, about basic information regarding Pre-Hospital Care. Objectives To determine the awareness about Pre-Hospital care among school teachers in Mangalore and to determine how many teachers have received formal training in Pre-Hospital care. Methods A descriptive cross-sectional study conducted among school teachers in 5 schools across Mangalore. Convenience sampling was done. Data was obtained from 118 school teachers across five schools in Mangalore, India using a self-administered questionnaire. Results It was observed that 61.9% of teachers knew that personal protective equipment has to be worn while giving first aid to someone. Knowledge of school teachers about choking, allergic reactions, heart attacks and hypoglycemic state was considerably better while 94.9% of school teachers knew how to handle a person in a hypoglycemic state. Most teachers, i.e. 93.2% of teachers knew the signs and symptoms of trauma to the head. However only 49.2% teachers knew how to handle nosebleeds. Only 17.8% teachers knew that an allergic reaction to a bee sting must be washed for at least 30 min. Only 57 participants had received previous training in Pre-hospital care. Out of these, 43.8% received training from nurses and 33.3% from paramedical staff. Conclusion The proportion of school teachers who have received pre hospital training in the recent past was low, their knowledge regarding first aid care was found to be adequate.
- Published
- 2020
3. Factors influencing adherence to anti-diabetes medications among type 2 diabetes patients attending tertiary care hospitals in Mangaluru
- Author
-
Darshan Bhagawan, Nikhita Pujari, Rekha Thapar, Shodhan Aithal, Ramesh Holla, Chaitra Rao, Ayshath Zahida, Sahana Karkera, Nithin Kumar, Vaman Kulkarni, Darshan K. Swamy, Prasanna Mithra, Bhaskaran Unnikrishnan, and Avinash Kumar
- Subjects
Microbiology (medical) ,Blood glucose monitoring ,medicine.medical_specialty ,Univariate analysis ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,Epidemiology ,business.industry ,Cross-sectional study ,Public Health, Environmental and Occupational Health ,Psychological intervention ,Type 2 diabetes ,Disease ,Non-communicable disease ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,Internal medicine ,Diabetes mellitus ,Medicine ,030212 general & internal medicine ,business - Abstract
Background Poor adherence is generally associated with bad outcomes of the disease especially in Non-communicable disease like diabetes. Objectives To study the level of adherence and factors associated with adherence to anti-diabetes medication among patients with diabetes. Method ology: In this cross-sectional study, 124 diabetes patients attending medicine OPDs at hospitals affiliated to Kasturba medical college, Mangaluru were assessed regarding their adherence to anti-diabetes medications using the Morisky 8-Item Medication Adherence scale. Univariate and multivariate analysis was done to determine the factors associated with good adherence. Results The mean age of the patient was 59.8 ± 11.2 years. The median duration of diabetes was 7 (3–12) years. In our study 43.5% (n = 54) of the participants had low adherence to anti diabetes medications. On Univariate analysis, absence of side effects, and regular blood glucose monitoring were found to be significantly associated with good adherence (P Conclusion Absence of side effects is the factor independently associated with good adherence. The interventions planned to combat the problem of non-adherence to medications should be targeted towards reducing the side effects of medication.
- Published
- 2020
4. Determinants of gestational diabetes mellitus: a hospital-based case–control study in coastal South India
- Author
-
B. B. Darshan, Archana Ganapathy, Avinash Kumar, Rekha Thapar, Prasanna Mithra, Nithin Kumar, Ramesh Holla, Vaman Kulkarni, and Bhaskaran Unnikrishnan
- Subjects
medicine.medical_specialty ,Multivariate analysis ,endocrine system diseases ,Obstetrics ,business.industry ,Endocrinology, Diabetes and Metabolism ,Public health ,Case-control study ,nutritional and metabolic diseases ,Type 2 Diabetes Mellitus ,030209 endocrinology & metabolism ,medicine.disease ,female genital diseases and pregnancy complications ,Gestational diabetes ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Population study ,030212 general & internal medicine ,business ,Socioeconomic status - Abstract
A public health problem that has been on the rise in the twenty-first century is gestational diabetes mellitus (GDM). There are serious adverse effects on both maternal and fetal health following GDM. Potential complications can be reduced by early detection of risk factors, which predispose women to GDM. This study aims to identify the risk factors associated with GDM. A case–control study was carried out among antenatal women admitted to hospitals affiliated to Kasturba Medical College, Mangalore. The study population consisted of cases, who were GDM patients, and controls, who were age-matched, non-GDM patients. Statistical Package for Social Sciences (SPSS) version 25.0 was used for entering and analysing data. Both univariate and multivariate analysis was done for determining the factors responsible for GDM. The mean age of cases was 29.54 (± 4.3) years and of controls was also 29.54 (± 4.2). There was no significant difference while comparing the socioeconomic status across the study groups. Irregular menstrual cycle (OR = 2.78, CI = 0.94–08.4, P = 0.06) and history of type 2 diabetes mellitus in first-degree relatives (OR = 5.26, CI = 2.13–12.99, P ≤ 0.001) were found to be significant risk factors. It was found in our study that irregular menstrual history, history of GDM in previous pregnancy, history of type 2 diabetes mellitus in first-degree relative and history of GDM in first-degree relative are all independent risk factors of GDM.
- Published
- 2020
5. Comparative validity of microalbuminuria versus clinical mortality scores to predict pediatric intensive care unit outcomes
- Author
-
B. S. Baliga, Vaman Kulkarni, Suchetha Rao, Gayatri M. Rao, and Shifa Nismath
- Subjects
medicine.medical_specialty ,Urinary system ,030204 cardiovascular system & hematology ,Pediatrics ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Critical Care Medicine ,Interquartile range ,030225 pediatrics ,Risk of mortality ,medicine ,Pediatric intensive care unit ,Creatinine ,business.industry ,Organ dysfunction ,Area under the curve ,creatinine ,lcsh:RJ1-570 ,lcsh:Pediatrics ,albumins ,medicine.disease ,pediatric intensive care units ,mortality ,chemistry ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Microalbuminuria ,Original Article ,medicine.symptom ,business - Abstract
Background: Predicting the prognosis of patients admitted to the pediatric intensive care unit (PICU) is very important in determining further management and resource allocation. The prognostication of critically ill children can be challenging; hence, accurate methods for predicting outcomes are needed. Purpose: To evaluate the role of microalbuminuria at admission as a prognostic marker in comparison to standard Pediatric Risk of Mortality (PRISM) and Pediatric Logistic Organ Dysfunction (PELOD) mortality scores in children admitted to the PICU. Methods: This cross-sectional study was conducted from January 2015 to October 2016. Eighty-four patients aged 1 month to 18 years admitted to the PICU of teaching hospitals for more than 24 hours were enrolled by convenience sampling method. Microalbuminuria was estimated by spot urinary albumin-creatinine ratio. PRISM and PELOD scores were calculated using an online calculator. Outcome measures were PICU length of stay, inotrope usage, multiorgan dysfunction, and survival. ACR was compared with mortality scores for predicting survival. Results: Microalbuminuria was present in 79.8% with a median value of 85 mg/g (interquartile range, 41.5–254 mg/g). A positive correlation was found between albumin-creatinine ratio and PICU length of stay (P=0.013, r=0.271). Albumin-creatinine ratio was significantly associated with organ dysfunction (P= 0.004) and need for inotropes (P=0.006). Eight deaths were observed in the PICU. The area under the curve for mortality for albumin-creatinine ratio (0.822) was comparable to that for PRISM (0.928) and PELOD (0.877). Albumin-creatinine ratio >109 mg/g predicted mortality with a sensitivity of 87.5% and specificity of 63.2%. Conclusion: Microalbuminuria is a good predictor of PICU outcomes comparable with mortality scores
- Published
- 2020
6. Effect of a Single-Session Communication Skills Training on Empathy in Medical Students
- Author
-
Smitha Lamiya Rasquinha, Animesh Jain, Trina Lucille D’souza, Prima Cheryl D’souza, Keshava Pai, and Vaman Kulkarni
- Subjects
Adult ,Male ,Medical curriculum ,medicine.medical_specialty ,Students, Medical ,020205 medical informatics ,media_common.quotation_subject ,education ,Empathy ,02 engineering and technology ,Intervention group ,Education ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Intervention (counseling) ,0202 electrical engineering, electronic engineering, information engineering ,business.product_line ,medicine ,Humans ,030212 general & internal medicine ,Role Playing ,media_common ,Communication ,Medical school ,General Medicine ,Communication skills training ,Psychiatry and Mental health ,Physical therapy ,Female ,Curriculum ,business ,Training program ,Psychology ,Single session ,Education, Medical, Undergraduate - Abstract
Empathy scores have been found to decline over the years spent in medical school. The authors aimed to evaluate the change in empathy levels in medical students following a single-session communication skills training. Eighty-two second-year medical students were randomized into intervention and control groups. The intervention comprised of a single-session empathetic communication skills training using PowerPoint, video clips, and roleplay. Empathy was assessed using the Jefferson Scale of Empathy-Student version (JSE) at baseline, post-intervention (for the intervention group), and at follow up after 3 weeks. The mean JSE score of the intervention group was 109.7 ± 11.8 at baseline, with significant improvement post-intervention (114.2 ± 10.6, p = 0.014). However, the score declined at the 3-week follow-up (106.8 ± 11.8). The mean baseline JSE score of the control group was 107.5 ± 12.4, with a decline at follow-up (101.8 ± 16.0). Though both groups showed a decline in the JSE score at follow-up, the decline was significant only for the control group (p = 0.020), which did not receive the training. The study showed significant improvement immediately, and lower decline at follow-up, in empathy levels following a communication skills training. The findings suggest a need to incorporate a regular training program into the existing medical curriculum, to enhance empathy and prevent its decline over the years.
- Published
- 2019
7. Association between Veterans Aging Cohort Study (VACS) index and neurocognitive function among people living with HIV–a cross sectional study in coastal South India
- Author
-
Priya Rathi, Archana Ganapathy, Nikhil Victor Dsouza, Unnikrishnan Bhaskaran, Vaman Kulkarni, Basavaprabhu Achappa, Deepak Madi, Soundarya Mahalingam, and Ramesh Holla
- Subjects
0301 basic medicine ,Aging ,medicine.medical_specialty ,Cross-sectional study ,CD4 cell count ,India ,HIV Infections ,Comorbidity ,Logistic regression ,Cohort Studies ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Virology ,Internal medicine ,medicine ,Humans ,VACS Index ,Pharmacology (medical) ,Veterans ,business.industry ,Research ,Confounding ,HIV ,Montreal Cognitive Assessment ,RC581-607 ,medicine.disease ,Cross-Sectional Studies ,030104 developmental biology ,Molecular Medicine ,Immunologic diseases. Allergy ,business ,Neurocognitive ,030217 neurology & neurosurgery ,Cohort study - Abstract
Background HIV is an infectious disease affecting 36.7 million people worldwide. In recent times, Antiretroviral Therapy (ART) has become accessible to the majority of People Living with HIV (PLHIV) and this has transformed the course of infection to one that is chronic, characterized by fewer diseases pathognomonic of AIDS. In view of this, there is a pressing need for better markers, apart from the routine HIV indicators, to detect comorbidities such as Neurocognitive Impairment (NCI). The aim of this study was to find out the association between Veterans Aging Cohort Study (VACS) index and Neurocognitive function in HIV positive patients. Methods In our study, we included 97 HIV positive patients and their Neurocognitive function was assessed using a combination of Montreal Cognitive Assessment and Grooved Pegboard Test, while VACS index was calculated using the most recent laboratory values. Binomial Logistics Regression analyses, adjusting for potential confounding variables, was performed to determine the association between VACS score and Neurocognitive Impairment. Results We found that a higher VACS Index was associated with global and domain-wise Neurocognitive impairment (p Conclusion Our findings extend prior research on the use of VACS Index to predict global and domain-wise NCI in HIV-positive patients. However, further research with more comprehensive neurocognitive testing is required in our setting before VACS Index can be used as a tool to screen for neurocognitive dysfunction among PLHIV.
- Published
- 2021
8. Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems
- Author
-
Simachew Animen Bante, Carlo Eduardo Medina-Solís, Rodrigo Sarmiento-Suárez, Deniz Yuce, Ninuk Hariyani, Virginia Núñez-Samudio, Zhi-Jiang Zhang, Lucas Guimarães Abreu, Sindhura Lakshmi Koulmane Laxminarayana, Ejaz Ahmad Khan, Natalie Maria Cormier, Ghulam Mustafa, Arielle Wilder Eagan, Shirin Djalalinia, Jalal Arabloo, Bay Vo, Mukhammad David Naimzada, Farahnaz Joukar, Arvin Haj-Mirzaian, Julia Moreira Pescarini, Getinet Kassahun, Robert Ancuceanu, Mohammad Ali Mansournia, Amin Soheili, Félix Carvalho, Edgar Denova-Gutiérrez, Aubrey J. Cook, Jasvinder A. Singh, Maysaa El Sayed Zaki, Sergio I. Prada, Seyedeh Zahra Masoumi, Rajesh Sagar, Emmanuel Peprah, Fenta Hun Y. Beyene, Mikhail Sergeevich Zastrozhin, Dimas Ria Angga Pribadi, Yun Jin Kim, Maryam Adabi, Feleke Mekonnen Demeke, Valentin Yurievich Skryabin, Mathew M. Baumann, Bárbara Niegia Garcia de Goulart, Ali Kazemi Karyani, Nooshin Abbasi, Eyayou Girma Tadesse, Sanjay Basu, Hadi Hassankhani, Keyghobad Ghadiri, Keshab Deuba, Dilshad Manzar, Robert L. Thompson, Keivan Ahmadi, Rahmatollah Moradzadeh, Shaimaa I. El-Jaafary, Alessandra C. Goulart, Diana Fernanda Bejarano Ramirez, Samata Nepal, Marcos Roberto Tovani-Palone, Gebiyaw Wudie Tsegaye, Irina Filip, Ian D. Letourneau, Ramesh Holla, Neda Kianipour, Maha El Tantawi, Lucas Earl, Paul S. F. Yip, Miguel A Barboza, Rajan Nikbakhsh, Nauman Khalid, Kimberly B. Johnson, Iván Landires, Manasi Kumar, Babak Moazen, Rohol Lah Kalhor, Dinh-Toi Chu, Lauren E. Schaeffer, Nima Rezaei, Alexandre C. Pereira, Susan F. Rumisha, Mehdi Hosseinzadeh, Xuefeng Liu, Feng Sha, Mahaveer Golechha, Davood Anvari, Urvish K Patel, Bing-Fang Hwang, Samath D Dharmaratne, Muhammad Aqeel, Kebede Deribe, Nelsensius Klau Fauk, Lillian Mwanri, Nuruzzaman Khan, Yunquan Zhang, Paula Moraga, Ai Koyanagi, Abdallah M. Samy, Nithin Kumar, Rahul Gupta, Samad Azari, Soheil Hassanipour, Archith Boloor, Kiana Ramezanzadeh, Andrew J. Croneberger, Enrico Rubagotti, Jaykaran Charan, Khezar Hayat, Amir Masoud Rahmani, Kio Mars Sharafi, Ionut Negoi, Simon I. Hay, Deborah Carvalho Malta, Yasser Vasseghian, Yihienew M. Bezabih, Jean Jacques Noubiap, Nazir Fattahi, Adnan Kisa, Alok Atreya, Devasahayam J. Christopher, Ayenew Kassie Tesema, Nuwan Darshana Wickramasinghe, Jaffar Abbas, Daniel Diaz, Desta Debalkie Atnafu, Malke Asaad, Arief Hargono, Zahid A Butt, Dharmesh Kumar Lal, Pankaj Bhardwaj, Amir Radfar, Salman Rawaf, Vardhmaan Jain, Amir Almasi-Hashiani, Krittika Bhattacharyya, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Mohammad Rifat Haider, Emily Haeuser, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Jagadish Rao Padubidri, Carlos Alberto Marrugo Arnedo, Beatriz Paulina Ayala Quintanilla, Tomislav Mestrovic, Hawraz Ibrahim M. Amin, Bhaskaran Unnikrishnan, Seithikurippu R. Pandi-Perumal, Arash Ziapour, Samantha Perkins, Deepa Jahagirdar, Akshaya Srikanth Bhagavathula, Eduarda Fernandes, Nataliya Foigt, Audrey L. Serfes, Fissaha Tekulu Welay, Savita Lasrado, Saad M.A. Dahlawi, Segun Emmanuel Ibitoye, Hedayat Abbastabar, Om P Kurmi, Hung Chak Ho, Faheem Hyder Pottoo, Priya Rathi, Chukwuma David Umeokonkwo, Ali Bijani, Shanshan Li, Reza Rawassizadeh, Vishnu Renjith, Barthelemy Kuate Defo, Giang Thu Vu, Farah Daoud, Tudorel Andrei, Ricardo de Souza Kuchenbecker, Fakher Rahim, Adeyinka Emmanuel Adegbosin, Sezer Kisa, Rajesh Elayedath, Shafiu Mohammed, Vinod C. Nayak, Fisaha Haile Tesfay, Cuong Tat Nguyen, Masoud Foroutan, Mingyou Yang, Yousef Mohammad, Abdul-Aziz Seidu, Benjamin K. Mayala, Diego Augusto Santos Silva, Amin Mousavi Khaneghah, Nikha Bhardwaj, Masoud Moradi, Charles Ugochukwu Ibeneme, Olatunji O. Adetokunboh, Carlo La Vecchia, Tesfay B.B. Gebremariam, Ritesh G. Menezes, Olatunde Aremu, Bogdan Oancea, Mohiuddin Ahsanul Kabir Chowdhury, Stefanie Watson, Yousef Moradi, Souranshu Chatterjee, Ugo Gori, Isabela M. Benseñor, Khem Narayan Pokhrel, Hailay Abrha Gesesew, Paul Ward, Carlos A Castañeda-Orjuela, Usman Iqbal, Rekha Thapar, Naser Mohammad Gholi Mezerji, Yasir Waheed, Ziad A. Memish, Vijay Kumar Chattu, Daiane Borges Machado, Shrikant Pawar, Soosanna Kumary Chattu, Sanni Yaya, Ketema Bizuwork Gebremedhin, Naohiro Yonemoto, Ahmad Ghashghaee, Marcela Agudelo-Botero, Amber Sligar, Nicole Davis Weaver, Kenji Shibuya, Claudiu Herteliu, Andreea Mirica, André Karch, Asif Hanif, Atif Amin Baig, Salah Eddin Karimi, Gulfaraz Khan, David Laith Rawaf, Andrew T Olagunju, Chuanhua Yu, Darshan B B, Olayinka Stephen Ilesanmi, Takeshi Fukumoto, Neeraj Bedi, Claudio Alberto Dávila-Cervantes, Muktar Beshir Ahmed, Deepak Madi, Ione Jayce Ceola Schneider, Masood Ali Shaikh, Juwel Rana, Tanuj Kanchan, Mohamed M. Gad, Syed Amir Gilani, Victor Adekanmbi, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Tadele G. Adal, Mohammad Hifz Ur Rahman, Leila R Kalankesh, Gbenga A. Kayode, Bach Xuan Tran, Ana Isabel Ribeiro, Basavaprabhu Achappa, Andem Effiong, André Faro, Javad Nazari, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Vahid Alipour, Sowmya J. Rao, Rosario Cárdenas, Milena Ilic, Ravi Prakash Jha, Zebenay Workneh Bitew, Nelson Alvis-Guzman, Dian Kusuma, Yum Ing Guo, Mowafa Househ, Arya Haj-Mirzaian, Krista M. Steuben, Hadush Negash, Ahamarshan Jayaraman Nagarajan, Irena Ilic, Laura Dwyer-Lindgren, Godfrey Mutashambara Rwegerera, Florian Fischer, Gebreamlak Gebremedhn Gebremeskel, Kate E. LeGrand, Ravishankar Nagaraja, Reza Mohammadpourhodki, Mark Drew Crosland Guimarães, Kewal Krishan, Maryam Zamanian, Paul H. Lee, Emerito Jose A. Faraon, Rafael Alves Guimarães, Aziz Sheikh, Marwa Rashad Salem, Michael A. Cork, Francesco Saverio Violante, Bright Opoku Ahinkorah, Liliana Preotescu, Somayeh Bohlouli, Aziz Rezapour, Ana Melisa Pardo-Montaño, Huong Lan Thi Nguyen, Khaled Khatab, Teklehaimanot Gereziher Haile, Mohammad Ali Moni, Govinda Prasad Dhungana, Leonardo Roever, Carlos Magis-Rodriguez, Andre R. Brunoni, Nathaniel J. Henry, Brijesh Sathian, Bingyu Li, Maciej Banach, Hasan Yusefzadeh, Nikita Otstavnov, Bruno Ramos Nascimento, Fernando de la Hoz, Georges Nguefack-Tsague, Zulfiqar A Bhutta, Robert Kaba Alhassan, Jae Il Shin, Andre Rodrigues Duraes, Yuan-Pang Wang, Felix Akpojene Ogbo, Mihajlo Jakovljevic, Eman Abu-Gharbieh, Vaman Kulkarni, Anna Aleksandrovna Skryabina, Sait Mentes Birlik, Maarten J. Postma, Chhabi Lal Ranabhat, Walter Mendoza, Yanzhong Wang, Maryam Keramati, Mahesh P A, Ali H. Mokdad, Muhammad Naveed, Nitin Joseph, Ronny Westerman, Bill & Melinda Gates Foundation, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Cork M.A., Henry N.J., Watson S., Croneberger A.J., Baumann M., Letourneau I.D., Yang M., Serfes A.L., Abbas J., Abbasi N., Abbastabar H., Abreu L.G., Abu-Gharbieh E., Achappa B., Adabi M., Adal T.G., Adegbosin A.E., Adekanmbi V., Adetokunboh O.O., Agudelo-Botero M., Ahinkorah B.O., Ahmadi K., Ahmed M.B., Alhassan R.K., Alipour V., Almasi-Hashiani A., Alvis-Guzman N., Ancuceanu R., Andrei T., Anvari D., Aqeel M., Arabloo J., Aremu O., Asaad M., Atnafu D.D., Atreya A., Quintanilla B.P.A., Azari S., B D.B., Baig A.A., Banach M., Bante S.A., Barboza M.A., Basu S., Bedi N., Ramirez D.F.B., Bensenor I.M., Beyene F.-H.Y., Bezabih Y.M., Bhagavathula A.S., Bhardwaj N., Bhardwaj P., Bhattacharyya K., Bhutta Z.A., Bijani A., Birlik S.M., Bitew Z.W., Bohlouli S., Boloor A., Brunoni A.R., Butt Z.A., Cardenas R., Carvalho F., Castaldelli-Maia J.M., Casta-neda-orjuela C.A., Charan J., Chatterjee S., Chattu V.K., Chattu S.K., Chowdhury M.A.K., Christopher D.J., Chu D.-T., Cook A.J., Cormier N.M., Dahlawi S.M.A., Daoud F., Davila-Cervantes C.A., Weaver N.D., De la Hoz F.P., Demeke F.M., Denova-Gutierrez E., Deribe K., Deuba K., Dharmaratne S.D., Dhungana G.P., Diaz D., Djalalinia S., Duraes A.R., Eagan A.W., Earl L., Effiong A., Zaki M.E.S., Tantawi M.E., Elayedath R., El-Jaafary S.I., Faraon E.J.A., Faro A., Fattahi N., Fauk N.K., Fernandes E., Filip I., Fischer F., Foigt N.A., Foroutan M., Fukumoto T., Gad M.M., Gebremariam T.B.B., Gebremed-Hin K.B., Gebremeskel G.G., Gesesew H.A., Ghadiri K., Ghashghaee A., Gilani S.A., Golechha M., Gori U., Goulart A.C., Goulart B.N.G., Gugnani H.C., Guimaraes M.D.C., Guimaraes R.A., Guo Y.-I., Gupta R., Haeuser E., Haider M.R., Haile T.G., Haj-Mirzaian A., Hanif A., Hargono A., Hariyani N., Hassanipour S., Hassankhani H., Hayat K., Herteliu C., Ho H.C., Holla R., Hosseinzadeh M., Househ M., Hwang B.-F., Ibeneme C.U., Ibitoye S.E., Ile-Sanmi O.S., Ilic M.D., Ilic I.M., Iqbal U., Jahagir-Dar D., Jain V., Jakovljevic M., Jha R.P., Johnson K.B., Joseph N., Joukar F., Kalankesh L.R., Kalhor R.-L., Kanchan T., Matin B.K., Karch A., Karimi S.E., Kassahun G., Kayode G.A., Karyani A.K., Keramati M., Khalid N., Khan E.A., Khan G., Khan M.N.N., Khatab K., Kianipour N., Kim Y.J., Kisa S., Kisa A., Kosen S., Laxminarayana S.L.K., Koyanagi A., Krishan K., Defo B.K., Kuchenbecker R.S., Kulkarni V., Kumar N., Kumar M., Kurmi O.P., Kusuma D., Vecchia C.L., Lal D.K., Landires I., Lasrado S., Lee P.H., Legrand K.E., Li B., Li S., Liu X., Amin H.I.M., Machado D.B., Madi D., Magis-Rodriguez C., Malta D.C., Mansournia M.A., Manzar M.D., Arnedo C.A.M., Martins-Melo F.R., Masoumi S.Z., Mayala B.K., Medina-Solis C.E., Memish Z.A., Mendoza W., Menezes R.G., Mestrovic T., Mirica A., Moazen B., Mohammad Y., Mezerji N.M.G., Mohammadian-Hafshejani A., Mohammadpourhodki R., Mohammed S., Mokdad A.H., Moni M.A., Moradi M., Moradi Y., Moradzadeh R., Moraga P., Khaneghah A.M.-S., Mustafa G., Mwanri L., Nagaraja R., Nagarajan A.J., Naim-Zada M.D., Nascimento B.R., Naveed D.M., Nayak V.C., Nazari J., Negash H., Negoi I., Nepal S., Nguefack-Tsague G., Nguyen C.T., Nguyen H.L.T., Nikbakhsh R., Noubiap J.J., Nunez-Samudio V., Oancea B., Ogbo F.A., Olagunju A.T., Otstav-Nov N., A M.P., Padubidri J.R., Pandi-Perumal S.R., Pardo-Montano A.M., Patel U.K., Pawar S., Peprah E.K., Pereira A., Perkins S., Pescarini J.M., Pokhrel K.N., Postma M.J., Pot-Too F.H., Prada S.I., Preotescu L., Pribadi D.R.A., Radfar A., Rahim F., Rahman M.H.U., Rahmani A.M., Ramezanzadeh K., Rana J., Ranabhat C.L., Rao S.J., Rathi P., Rawaf S., Rawaf D.L., Rawassizadeh R., Renjith V., Rezaei N., Rezapour A., Ribeiro A.I., Roever L., Rubagotti E., Rumisha S.F., Rwegerera G.M., Sagar R., Sajadi S.M., Salem M.R., Samy A.M., Sarmiento-Suarez R., Sathian B., Schaeffer L.E., Schneider I.J.C., Seidu A.-A., Sha F., Shaikh M.A., Sharafi K.-M., Sheikh A., Shibuya K., Shin J.I., Silva D.A.S., Singh J.A., Skryabin V.Y., Skryabina A.A., Sligar A., Soheili A., Steuben K.M., Sufiyan M.B., Tadesse E.G., Tesema A.K.T., Tesfay F.H., Thapar R., Thompson R.L., Tovani-Palone M.R., Tran B.X., Tsegaye G.W., Umeokonkwo C.D., Unnikrish-Nan B., Vasseghian Y., Violante F.S., Vo B., Vu G.T., Waheed Y., Wang Y.-P., Wang Y., Ward P., Welay F.T., Westerman R., Wickramasinghe N.D., Yaya S., Yip P., Yonemoto N., Yu C., Yuce D., Yusefzadeh H., Zamanian M., Zastroz-Hin M.S., Zhang Z.-J., Zhang Y., Ziapour A., Hay S.I., Dwyer-Lindgren L., Local Burden of Disease HIV Collaborators, Clinicum, HUS Comprehensive Cancer Center, Cork, Michael A, Henry, Nathaniel J, Watson, Stefanie, Croneberger, Andrew J, Ahmed, Muktar B, Dwyer-Lindgren, Laura, Instituto de Saúde Pública da Universidade do Porto, and Collaborators, Local Burden of Disease HIV
- Subjects
Male ,Latin Americans ,lcsh:Medicine ,LOW-INCOME ,HIV Infections ,HIV mortality ,HIV/AIDS ,Latin America ,Mapping ,Small area estimation ,Spatial statistics ,Vital registration ,Vital registrations ,0302 clinical medicine ,ANTIRETROVIRAL THERAPY ,Medicine ,030212 general & internal medicine ,Registries ,11 Medical and Health Sciences ,media_common ,Mortality rate ,1. No poverty ,DEATH ,Regression analysis ,General Medicine ,Middle Aged ,BRAZIL ,Local Burden of Disease HIV Collaborators ,3. Good health ,AIDS ,SEX ,A990 Medicine and Dentistry not elsewhere classified ,Female ,HEALTH ,0305 other medical science ,Life Sciences & Biomedicine ,Research Article ,Adult ,medicine.medical_specialty ,Inequality ,Adolescent ,media_common.quotation_subject ,TUBERCULOSIS ,Small area estimations ,03 medical and health sciences ,Medicine, General & Internal ,Sex Factors ,Acquired immunodeficiency syndrome (AIDS) ,HIV mortalities ,General & Internal Medicine ,Humans ,Aged ,Science & Technology ,030505 public health ,business.industry ,Public health ,lcsh:R ,Ecological study ,HIV ,Bayes Theorem ,GLOBAL BURDEN ,medicine.disease ,TRENDS ,Vital Statistics ,Spatial statistic ,3121 General medicine, internal medicine and other clinical medicine ,Human medicine ,business ,Demography - Abstract
Background Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. Methods We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. Results All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Conclusions Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.
- Published
- 2021
9. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study
- Author
-
Gregory A. Roth, George A. Mensah, Catherine O. Johnson, Giovanni Addolorato, Enrico Ammirati, Larry M. Baddour, Noël C. Barengo, Andrea Z. Beaton, Emelia J. Benjamin, Catherine P. Benziger, Aimé Bonny, Michael Brauer, Marianne Brodmann, Thomas J. Cahill, Jonathan Carapetis, Alberico L. Catapano, Sumeet S. Chugh, Leslie T. Cooper, Josef Coresh, Michael Criqui, Nicole DeCleene, Kim A. Eagle, Sophia Emmons-Bell, Valery L. Feigin, Joaquim Fernández-Solà, Gerry Fowkes, Emmanuela Gakidou, Scott M. Grundy, Feng J. He, George Howard, Frank Hu, Lesley Inker, Ganesan Karthikeyan, Nicholas Kassebaum, Walter Koroshetz, Carl Lavie, Donald Lloyd-Jones, Hong S. Lu, Antonio Mirijello, Awoke Misganaw Temesgen, Ali Mokdad, Andrew E. Moran, Paul Muntner, Jagat Narula, Bruce Neal, Mpiko Ntsekhe, Glaucia Moraes de Oliveira, Catherine Otto, Mayowa Owolabi, Michael Pratt, Sanjay Rajagopalan, Marissa Reitsma, Antonio Luiz P. Ribeiro, Nancy Rigotti, Anthony Rodgers, Craig Sable, Saate Shakil, Karen Sliwa-Hahnle, Benjamin Stark, Johan Sundström, Patrick Timpel, Imad M. Tleyjeh, Marco Valgimigli, Theo Vos, Paul K. Whelton, Magdi Yacoub, Liesl Zuhlke, Christopher Murray, Valentin Fuster, Noel C. Barengo, Andrea Beaton, Aime Bonny, Jonathan R. Carapetis, Sumeet Chugh, Michael H. Criqui, Nicole K. DeCleene, Joaquim Fernández-Sola, F. Gerry R. Fowkes, Nicholas J. Kassebaum, Walter J. Koroshetz, Awoke T. Misganaw, Ali H. Mokdad, Gláucia M.M. Oliveira, Catherine M. Otto, Mayowa O. Owolabi, Marissa B. Reitsma, Nancy A. Rigotti, Craig A. Sable, Saate S. Shakil, Karen Sliwa, Benjamin A. Stark, Imad I. Tleyjeh, Liesl J. Zuhlke, Mohsen Abbasi-Kangevari, Alireza Abdi, Aidin Abedi, Victor Aboyans, Woldu A. Abrha, Eman Abu-Gharbieh, Abdelrahman I. Abushouk, Dilaram Acharya, Tim Adair, Oladimeji M. Adebayo, Zanfina Ademi, Shailesh M. Advani, Khashayar Afshari, Ashkan Afshin, Gina Agarwal, Pradyumna Agasthi, Sohail Ahmad, Sepideh Ahmadi, Muktar B. Ahmed, Budi Aji, Yonas Akalu, Wuraola Akande-Sholabi, Addis Aklilu, Chisom J. Akunna, Fares Alahdab, Ayman Al-Eyadhy, Khalid F. Alhabib, Sheikh M. Alif, Vahid Alipour, Syed M. Aljunid, François Alla, Amir Almasi-Hashiani, Sami Almustanyir, Rajaa M. Al-Raddadi, Adeladza K. Amegah, Saeed Amini, Arya Aminorroaya, Hubert Amu, Dickson A. Amugsi, Robert Ancuceanu, Deanna Anderlini, Tudorel Andrei, Catalina Liliana Andrei, Alireza Ansari-Moghaddam, Zelalem A. Anteneh, Ippazio Cosimo Antonazzo, Benny Antony, Razique Anwer, Lambert T. Appiah, Jalal Arabloo, Johan Ärnlöv, Kurnia D. Artanti, Zerihun Ataro, Marcel Ausloos, Leticia Avila-Burgos, Asma T. Awan, Mamaru A. Awoke, Henok T. Ayele, Muluken A. Ayza, Samad Azari, Darshan B. B, Nafiseh Baheiraei, Atif A. Baig, Ahad Bakhtiari, Maciej Banach, Palash C. Banik, Emerson A. Baptista, Miguel A. Barboza, Lingkan Barua, Sanjay Basu, Neeraj Bedi, Yannick Béjot, Derrick A. Bennett, Isabela M. Bensenor, Adam E. Berman, Yihienew M. Bezabih, Akshaya S. Bhagavathula, Sonu Bhaskar, Krittika Bhattacharyya, Ali Bijani, Boris Bikbov, Mulugeta M. Birhanu, Archith Boloor, Luisa C. Brant, Hermann Brenner, Nikolay I. Briko, Zahid A. Butt, Florentino Luciano Caetano dos Santos, Leah E. Cahill, Lucero Cahuana-Hurtado, Luis A. Cámera, Ismael R. Campos-Nonato, Carlos Cantu-Brito, Josip Car, Juan J. Carrero, Felix Carvalho, Carlos A. Castañeda-Orjuela, Ferrán Catalá-López, Ester Cerin, Jaykaran Charan, Vijay Kumar Chattu, Simiao Chen, Ken L. Chin, Jee-Young J. Choi, Dinh-Toi Chu, Sheng-Chia Chung, Massimo Cirillo, Sean Coffey, Sara Conti, Vera M. Costa, David K. Cundiff, Omid Dadras, Baye Dagnew, Xiaochen Dai, Albertino A.M. Damasceno, Lalit Dandona, Rakhi Dandona, Kairat Davletov, Vanessa De la Cruz-Góngora, Fernando P. De la Hoz, Jan-Walter De Neve, Edgar Denova-Gutiérrez, Meseret Derbew Molla, Behailu T. Derseh, Rupak Desai, Günther Deuschl, Samath D. Dharmaratne, Meghnath Dhimal, Raja Ram Dhungana, Mostafa Dianatinasab, Daniel Diaz, Shirin Djalalinia, Klara Dokova, Abdel Douiri, Bruce B. Duncan, Andre R. Duraes, Arielle W. Eagan, Sanam Ebtehaj, Aziz Eftekhari, Sahar Eftekharzadeh, Michael Ekholuenetale, Nevine El Nahas, Islam Y. Elgendy, Muhammed Elhadi, Shaimaa I. El-Jaafary, Sadaf Esteghamati, Atkilt E. Etisso, Oghenowede Eyawo, Ibtihal Fadhil, Emerito Jose A. Faraon, Pawan S. Faris, Medhat Farwati, Farshad Farzadfar, Eduarda Fernandes, Carlota Fernandez Prendes, Pietro Ferrara, Irina Filip, Florian Fischer, David Flood, Takeshi Fukumoto, Mohamed M. Gad, Shilpa Gaidhane, Morsaleh Ganji, Jalaj Garg, Abadi K. Gebre, Birhan G. Gebregiorgis, Kidane Z. Gebregzabiher, Gebreamlak G. Gebremeskel, Lemma Getacher, Abera Getachew Obsa, Alireza Ghajar, Ahmad Ghashghaee, Nermin Ghith, Simona Giampaoli, Syed Amir Gilani, Paramjit S. Gill, Richard F. Gillum, Ekaterina V. Glushkova, Elena V. Gnedovskaya, Mahaveer Golechha, Kebebe B. Gonfa, Amir Hossein Goudarzian, Alessandra C. Goulart, Jenny S. Guadamuz, Avirup Guha, Yuming Guo, Rajeev Gupta, Vladimir Hachinski, Nima Hafezi-Nejad, Teklehaimanot G. Haile, Randah R. Hamadeh, Samer Hamidi, Graeme J. Hankey, Arief Hargono, Risky K. Hartono, Maryam Hashemian, Abdiwahab Hashi, Shoaib Hassan, Hamid Y. Hassen, Rasmus J. Havmoeller, Simon I. Hay, Khezar Hayat, Golnaz Heidari, Claudiu Herteliu, Ramesh Holla, Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Mowafa Househ, Junjie Huang, Ayesha Humayun, Ivo Iavicoli, Charles U. Ibeneme, Segun E. Ibitoye, Olayinka S. Ilesanmi, Irena M. Ilic, Milena D. Ilic, Usman Iqbal, Seyed Sina N. Irvani, Sheikh Mohammed Shariful Islam, Rakibul M. Islam, Hiroyasu Iso, Masao Iwagami, Vardhmaan Jain, Tahereh Javaheri, Sathish Kumar Jayapal, Shubha Jayaram, Ranil Jayawardena, Panniyammakal Jeemon, Ravi P. Jha, Jost B. Jonas, Jitendra Jonnagaddala, Farahnaz Joukar, Jacek J. Jozwiak, Mikk Jürisson, Ali Kabir, Tanvir Kahlon, Rizwan Kalani, Rohollah Kalhor, Ashwin Kamath, Ibrahim Kamel, Himal Kandel, Amit Kandel, André Karch, Ayele Semachew Kasa, Patrick D.M.C. Katoto, Gbenga A. Kayode, Yousef S. Khader, Mohammad Khammarnia, Muhammad S. Khan, Md Nuruzzaman Khan, Maseer Khan, Ejaz A. Khan, Khaled Khatab, Gulam M.A. Kibria, Yun Jin Kim, Gyu Ri Kim, Ruth W. Kimokoti, Sezer Kisa, Adnan Kisa, Mika Kivimäki, Dhaval Kolte, Ali Koolivand, Vladimir A. Korshunov, Sindhura Lakshmi Koulmane Laxminarayana, Ai Koyanagi, Kewal Krishan, Vijay Krishnamoorthy, Barthelemy Kuate Defo, Burcu Kucuk Bicer, Vaman Kulkarni, G. Anil Kumar, Nithin Kumar, Om P. Kurmi, Dian Kusuma, Gene F. Kwan, Carlo La Vecchia, Ben Lacey, Tea Lallukka, Qing Lan, Savita Lasrado, Zohra S. Lassi, Paolo Lauriola, Wayne R. Lawrence, Avula Laxmaiah, Kate E. LeGrand, Ming-Chieh Li, Bingyu Li, Shanshan Li, Stephen S. Lim, Lee-Ling Lim, Hualiang Lin, Ziqiang Lin, Ro-Ting Lin, Xuefeng Liu, Alan D. Lopez, Stefan Lorkowski, Paulo A. Lotufo, Alessandra Lugo, Nirmal K. M, Fabiana Madotto, Morteza Mahmoudi, Azeem Majeed, Reza Malekzadeh, Ahmad A. Malik, Abdullah A. Mamun, Navid Manafi, Mohammad Ali Mansournia, Lorenzo G. Mantovani, Santi Martini, Manu R. Mathur, Giampiero Mazzaglia, Suresh Mehata, Man Mohan Mehndiratta, Toni Meier, Ritesh G. Menezes, Atte Meretoja, Tomislav Mestrovic, Bartosz Miazgowski, Tomasz Miazgowski, Irmina Maria Michalek, Ted R. Miller, Erkin M. Mirrakhimov, Hamed Mirzaei, Babak Moazen, Masoud Moghadaszadeh, Yousef Mohammad, Dara K. Mohammad, Shafiu Mohammed, Mohammed A. Mohammed, Yaser Mokhayeri, Mariam Molokhia, Ahmed A. Montasir, Ghobad Moradi, Rahmatollah Moradzadeh, Paula Moraga, Lidia Morawska, Ilais Moreno Velásquez, Jakub Morze, Sumaira Mubarik, Walter Muruet, Kamarul Imran Musa, Ahamarshan J. Nagarajan, Mahdi Nalini, Vinay Nangia, Atta Abbas Naqvi, Sreenivas Narasimha Swamy, Bruno R. Nascimento, Vinod C. Nayak, Javad Nazari, Milad Nazarzadeh, Ruxandra I. Negoi, Sandhya Neupane Kandel, Huong L.T. Nguyen, Molly R. Nixon, Bo Norrving, Jean Jacques Noubiap, Brice E. Nouthe, Christoph Nowak, Oluwakemi O. Odukoya, Felix A. Ogbo, Andrew T. Olagunju, Hans Orru, Alberto Ortiz, Samuel M. Ostroff, Jagadish Rao Padubidri, Raffaele Palladino, Adrian Pana, Songhomitra Panda-Jonas, Utsav Parekh, Eun-Cheol Park, Mojtaba Parvizi, Fatemeh Pashazadeh Kan, Urvish K. Patel, Mona Pathak, Rajan Paudel, Veincent Christian F. Pepito, Arokiasamy Perianayagam, Norberto Perico, Hai Q. Pham, Thomas Pilgrim, Michael A. Piradov, Farhad Pishgar, Vivek Podder, Roman V. Polibin, Akram Pourshams, Dimas R.A. Pribadi, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Ivo Rakovac, Pradhum Ram, Sudha Ramalingam, Juwel Rana, Priyanga Ranasinghe, Sowmya J. Rao, Priya Rathi, Lal Rawal, Wasiq F. Rawasia, Reza Rawassizadeh, Giuseppe Remuzzi, Andre M.N. Renzaho, Aziz Rezapour, Seyed Mohammad Riahi, Ross L. Roberts-Thomson, Leonardo Roever, Peter Rohloff, Michele Romoli, Gholamreza Roshandel, Godfrey M. Rwegerera, Seyedmohammad Saadatagah, Maha M. Saber-Ayad, Siamak Sabour, Simona Sacco, Masoumeh Sadeghi, Sahar Saeedi Moghaddam, Saeed Safari, Amirhossein Sahebkar, Sana Salehi, Hamideh Salimzadeh, Mehrnoosh Samaei, Abdallah M. Samy, Itamar S. Santos, Milena M. Santric-Milicevic, Nizal Sarrafzadegan, Arash Sarveazad, Thirunavukkarasu Sathish, Monika Sawhney, Mete Saylan, Maria I. Schmidt, Aletta E. Schutte, Subramanian Senthilkumaran, Sadaf G. Sepanlou, Feng Sha, Saeed Shahabi, Izza Shahid, Masood A. Shaikh, Mahdi Shamali, Morteza Shamsizadeh, Md Shajedur Rahman Shawon, Aziz Sheikh, Mika Shigematsu, Min-Jeong Shin, Jae Il Shin, Rahman Shiri, Ivy Shiue, Kerem Shuval, Soraya Siabani, Tariq J. Siddiqi, Diego A.S. Silva, Jasvinder A. Singh, Ambrish Singh Mtech, Valentin Y. Skryabin, Anna A. Skryabina, Amin Soheili, Emma E. Spurlock, Leo Stockfelt, Stefan Stortecky, Saverio Stranges, Rizwan Suliankatchi Abdulkader, Hooman Tadbiri, Eyayou G. Tadesse, Degena B. Tadesse, Masih Tajdini, Md Tariqujjaman, Berhane F. Teklehaimanot, Mohamad-Hani Temsah, Ayenew K. Tesema, Bhaskar Thakur, Kavumpurathu R. Thankappan, Rekha Thapar, Amanda G. Thrift, Binod Timalsina, Marcello Tonelli, Mathilde Touvier, Marcos R. Tovani-Palone, Avnish Tripathi, Jaya P. Tripathy, Thomas C. Truelsen, Guesh M. Tsegay, Gebiyaw W. Tsegaye, Nikolaos Tsilimparis, Biruk S. Tusa, Stefanos Tyrovolas, Krishna Kishore Umapathi, Brigid Unim, Bhaskaran Unnikrishnan, Muhammad S. Usman, Muthiah Vaduganathan, Pascual R. Valdez, Tommi J. Vasankari, Diana Z. Velazquez, Narayanaswamy Venketasubramanian, Giang T. Vu, Isidora S. Vujcic, Yasir Waheed, Yanzhong Wang, Fang Wang, Jingkai Wei, Robert G. Weintraub, Abrha H. Weldemariam, Ronny Westerman, Andrea S. Winkler, Charles S. Wiysonge, Charles D.A. Wolfe, Befikadu Legesse Wubishet, Gelin Xu, Ali Yadollahpour, Kazumasa Yamagishi, Lijing L. Yan, Srikanth Yandrapalli, Yuichiro Yano, Hiroshi Yatsuya, Tomas Y. Yeheyis, Yigizie Yeshaw, Christopher S. Yilgwan, Naohiro Yonemoto, Chuanhua Yu, Hasan Yusefzadeh, Geevar Zachariah, Sojib Bin Zaman, Muhammed S. Zaman, Maryam Zamanian, Ramin Zand, Alireza Zandifar, Afshin Zarghi, Mikhail S. Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Yunquan Zhang, Wangjian Zhang, Chenwen Zhong, Zhiyong Zou, Yves Miel H. Zuniga, and Christopher J.L. Murray
- Subjects
BMI, body mass index ,GBD, Global Burden of Diseases, Injuries, and Risk Factors Study ,IS, ischemic stroke ,030204 cardiovascular system & hematology ,MV, mitral valve ,SDI, sociodemographic index ,Global Health ,UI, uncertainty interval ,Global Burden of Disease ,GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group ,0302 clinical medicine ,Cost of Illness ,LDL, low-density lipoprotein ,Case fatality rate ,Global health ,030212 general & internal medicine ,IKF, impaired kidney function ,1102 Cardiorespiratory Medicine and Haematology ,Incidence (epidemiology) ,Health Policy ,IHD, ischemic heart disease ,1. No poverty ,AC, alcoholic cardiomyopathy ,3. Good health ,HICs, high-income countries ,Cardiovascular Diseases ,DALYs, disability-adjusted life years ,TMREL, theoretical minimum risk exposure level ,Public Health ,HHD, hypertensive heart disease ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,AF, atrial fibrillation ,Population health ,CVD, cardiovascular disease ,LMICs, low- and middle-income countries ,PM, particulate matter ,1117 Public Health and Health Services ,03 medical and health sciences ,JACC State-of-the-Art Review ,RHD, rheumatic heart disease ,Environmental health ,medicine ,Humans ,LPA, low physical activity ,YLLs, years of life lost ,Health policy ,Disease burden ,PAD, peripheral artery disease ,business.industry ,SBP, systolic blood pressure ,Public health ,CKD, chronic kidney disease ,The Present and Future ,AFL, atrial flutter ,Correction ,HAP, household air pollution ,ICD, International Classification of Diseases ,CAVD, calcific aortic valve disease ,YLDs, years lived with disability ,Years of potential life lost ,CHA, congenital heart anomalies ,Cardiovascular System & Hematology ,Heart Disease Risk Factors ,business ,population health - Abstract
Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases., Central Illustration, Highlights • The burden of CVD, in number of DALYs and deaths, continues to increase globally. • CVD burden attributable to modifiable risk factors continues to increase globally. • Countries should invest in existing cost-effective public health programs and clinical interventions to target modifiable risks, promote healthy aging across the lifespan, and reduce disability and premature death due to CVD.
- Published
- 2020
10. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019
- Author
-
William M. Gardner, Rawlance Ndejjo, Govinda Prasad Dhungana, Fereshteh Ansari, Kathleen Pillsbury Hopf, João Pedro Silva, M. Mofizul Islam, Cong Zhu, Abdul Hafiz, Irmina Maria Michalek, Syed Mohamed Aljunid, Leonardo Roever, Mustefa Glagn, Davood Anvari, Tessa M. Pilz, Sameer Vali Gopalani, Joel M. Francis, Man Mohan Mehndiratta, Rakhi Dandona, Abbas Sheikhtaheri, Mansour Ghafourifard, Simon Øverland, David Laith Rawaf, Jaykaran Charan, Akram Pourshams, Mostafa Dianatinasab, Morteza Mahmoudi, Alton Lu, Alyssa N. Sbarra, Lorainne Tudor Car, Franz Castro, Hafiz Ansar Rasul Suleria, Luca Ronfani, Marina Pinheiro, Mehran Asadi-Aliabadi, Maziar Moradi-Lakeh, Hoa Thi Do, Whitney L. Teagle, Sofia Androudi, Carl Abelardo T. Antonio, Myron Anthony Godinho, Bhaskaran Unnikrishnan, Oluchi Ezekannagha, Getinet Ayano, Seyyed Shamsadin Athari, Dimas Ria Angga Pribadi, Kyle E. Simpson, Muluken Bekele Sorrie, Vivekanand Jha, Chukwuma David Umeokonkwo, Akshaya Srikanth Bhagavathula, Cuong Tat Nguyen, Amr Hassan, Akine Eshete Abosetugn, Hailay Abrha Gesesew, Anna V. Korotkova, Brijesh Sathian, Marcello Tonelli, Olatunde Aremu, Mohammad Reza Salahshoor, Juan Jesus Carrero, Cameron J. Kneib, Ravi Prakash Jha, David H. Shaw, Hossein Samadi Kafil, Tanuj Kanchan, Khezar Hayat, Hamid Sharifi, Morteza Shamsizadeh, Muktar Omer Omer, Fatemeh Amiri, Hamidreza Pazoki Toroudi, David Edvardsson, Xiu Ju George Zhao, Hannah Han, Leticia Avila-Burgos, Adam E. Berman, Jemal Abdu Mohammed, Thomas Pilgrim, Leila Doshmangir, Mu'awiyyah Babale Sufiyan, David M. Pigott, Hadi Hassankhani, Beatriz Paulina Ayala Quintanilla, Teklemariam Gultie, Arash Ziapour, Seyed Sina Naghibi Irvani, Ilse N. Dippenaar, Jean Jacques Noubiap, Emmanuela Gakidou, Abiyu Mekonnen Gebrehiwot, Maha El Tantawi, Xuefeng Liu, Zulfiqar A. Bhutta, Keyghobad Ghadiri, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Yunquan Zhang, Vera Marisa Costa, Iyad Sultan, Mostafa Hosseini, Abdulaziz Khalid Abu Haimed, Haidong Wang, Kaleab Alemayehu Zewdie, Celine M. Barthelemy, Hosna Janjani, Bartosz Miazgowski, Jobert Richie Nansseu, Arianna Maever L. Amit, John S. Ji, Ata Rafiee, Maria Inês Schmidt, Alireza Rafiei, Somayeh Bohlouli, Joana Morgado-da-Costa, Huong Lan Thi Nguyen, Pradyumna Agasthi, Tiffany K. Gill, Martin McKee, Khaled Khatab, Jae Il Shin, Animut Tagele Tamiru, Giancarlo Logroscino, Hassan Abolhassani, Syed Saoud Zaidi, Sivan Yegnanarayana Iyer Saraswathy, Garumma Tolu Feyissa, Ahmad Daryani, Ziyad Al-Aly, Gebreamlak Gebremedhn Gebremeskel, Michael T. Chung, Amirhossein Sahebkar, Mehedi Hasan, Saeed Shahabi, Diep Ngoc Nguyen, Yohannes Kinfu, Nicholas L S Roberts, Jagadish Rao Padubidri, Mika Shigematsu, Lucero Cahuana-Hurtado, Deepa Jahagirdar, Islam Y. Elgendy, Erkin M. Mirrakhimov, Tanvir M. Huda, Fakher Rahim, Dara K. Mohammad, Yingxi Zhao, Ruxandra Irina Negoi, Vinod C. Nayak, Reinhard Busse, Andrew T. Leever, Muhammad Aziz Rahman, Kathryn Mei Ming Lau, Stefania Mondello, Vivian Chia-Rong Hsieh, Kris J. Krohn, Reza Rawassizadeh, Vishnu Renjith, Jianing Ma, Moses K. Muriithi, Mark G. Shrime, Mayowa O. Owolabi, Nobuyuki Horita, Seyed Hossein Yahyazadeh Jabbari, Daniel Y. Cho, Miloje Savic, Moslem Soofi, Iqbal R. F. Elyazar, Freweini Gebrearegay G. Tela, Jonathan F. Mosser, Palash Chandra Banik, Andre Rodrigues Duraes, Yuan-Pang Wang, Natalie C. Galles, Rashid Abdi Guled, Abdallah M. Samy, Hadi Pourjafar, Roman Topor-Madry, Ayesha Humayun, Leila Zaki, Nuworza Kugbey, Maryam Khayamzadeh, Naznin Hossain, Jiregna Darega Gela, Jordi Alonso, Ruth W Kimokoti, A. A. Fomenkov, Jalal Arabloo, Aletta E. Schutte, Biruk Wogayehu Taddele, Teklehaimanot Gereziher Haile, Diego Augusto Santos Silva, Seyed Mohammad Kazem Aghamir, Maciej Banach, Deanna Anderlini, Moses J. Bockarie, Saleem Muhammad Rana, Randah R. Hamadeh, Farhad Islami, Olalekan A. Uthman, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Kairat Davletov, Soraya Seedat, Alan D. Lopez, Masoud Behzadifar, Benjamin B. Massenburg, Santosh Varughese, Ingan Ukur Tarigan, Amin Soheili, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Caleb Mackay Salpeter Irvine, Mojgan Gitimoghaddam, G Anil Kumar, Rasmus J. Havmoeller, Hiroyasu Iso, Atte Meretoja, Yasir Waheed, João M. Furtado, Christian Razo, Neeti Kapoor, Mowafa Househ, Rajaa Al-Raddadi, Mohammad Khammarnia, Santi Martini, Feng Sha, Marco Vacante, Jacek A. Kopec, Hunduma Amensisa Bojia, Jacob Olusegun Olusanya, Kate E. LeGrand, Nikolay Ivanovich Briko, Robert S. Bernstein, Arun Balachandran, Davoud Adham, Ahad Bakhtiari, Shafiu Mohammed, Leake G. Gebremeskel, Smita Pakhale, Ejaz Ahmad Khan, Daniel Cury Ribeiro, Yousef Mohammad, Bernhard T. Baune, Azeem Majeed, Luis Camera, Mohammad Ali Jahani, Hasan Yusefzadeh, Rahman Shiri, Massimo Cirillo, Nikita Otstavnov, Vahid Yazdi-Feyzabadi, Paolo Lauriola, Irfan Ullah, Aruna M Kamath, Maryam Mirzaei, Zabihollah Yousefi, Iman El Sayed, Mohammad Farahmand, Yetunde O. John-Akinola, Khem Narayan Pokhrel, Felix Akpojene Ogbo, Megan Knight, Nelson J. Alvis-Zakzuk, Teferi Mekonnen, Iván Landires, Robert G. Weintraub, Chukwudi A Nnaji, Lauren E. Schaeffer, Paulo A. Lotufo, Mehdi Naderi, Tomislav Mestrovic, André Faro, Mohsen Bayati, Raffaele Palladino, Shahin Soltani, Vladimir Andreevich Korshunov, Birhanu Geta Meharie, Mihajlo Jakovljevic, Abdiwahab Hashi, Olatunji O. Adetokunboh, Dejana Braithwaite, Sergio I. Prada, Bárbara Niegia Garcia de Goulart, Reza Pourmirza Kalhori, Jee-Young Jasmine Choi, Ernoiz Antriyandarti, Ronny Westerman, Meghdad Pirsaheb, Paul S. F. Yip, Mehdi Mirzaei-Alavijeh, Gebremariam Woldu, Rashmi Gupta, Onome Bright Oghenetega, Shane D. Morrison, Inga Dora Sigfusdottir, Marcel Ausloos, Mehdi Hosseinzadeh, Marcos Roberto Tovani-Palone, K M Shivakumar, Alireza Ansari-Moghaddam, Archith Boloor, Aidin Abedi, Binyam Minuye Birihane, Mohammad Ali Mansournia, Nihad A. Almasri, Simachew Animen Bante, Carlo Eduardo Medina-Solís, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Antonio Biondi, Valentin Yurievich Skryabin, Srinivasa Vittal Katikireddi, Sarika Chaturvedi, Francesco Saverio Violante, Abhay Gaidhane, George A. Mensah, Naohiro Yonemoto, Ahmad Ghashghaee, Ebrahim Babaee, Saman Esmaeilnejad, Sharath Burugina Nagaraja, Avina Vongpradith, Javad Nazari, Amir Khater, Michael K. Hole, Ben Lacey, Razique Anwer, Łukasz Szumowski, Ai Koyanagi, Rajesh Sagar, Ali Rajabpour-Sanati, Seyed M Karimi, Yordanos Gizachew Yeshitila, Mona Pathak, Nithin Kumar, Masoud Foroutan, Mehdi Fazlzadeh, Anusha Ganapati Bhat, Abbas Mosapour, Kebede Deribe, Nermin Ghith, Vaman Kulkarni, Sanjay Zodpey, Asadollah Gholamian, Mohammed Shannawaz, Nancy Fullman, Benn Sartorius, Giulio Castelpietra, Ghulam Mustafa, Silvia Schiavolin, Nelson Alvis-Guzman, Jeffrey D. Stanaway, Rafael Lozano, Christopher J L Murray, Guoqing Hu, Andrew M. Briggs, Ashish Badiye, Yousef Khader, Masoud Moghadaszadeh, Rahmatollah Moradzadeh, Valery L. Feigin, Claudia I. Mastrogiacomo, Emma Smith, Yasser Vasseghian, Saeed Amini, Asif Hanif, Achala Upendra Jayatilleke, Maryam Adabi, Sarah Wulf Hanson, Bhaskar Thakur, Ravi Mehrotra, Virginia Núñez-Samudio, Lalit Dandona, Segun Emmanuel Ibitoye, Simon I. Hay, Kiirithio N. Ngari, Obinna Onwujekwe, Deborah Carvalho Malta, Lorenzo Monasta, Neda Kianipour, Khurshid Alam, Luisa Sorio Flor, Priya Rathi, Ali Bijani, Khalid A Altirkawi, Jaimie Adelson, Hamed Zandian, Frank Tanser, Dharmesh Kumar Lal, John Everett Mumford, Morteza Oladnabi, Telma Zahirian Moghadam, Rodrigo Sarmiento-Suárez, Masoud Moradi, Maseer Khan, Mohammad Ali Sahraian, Amy E. Peden, Dhirendra N Sinha, Shanshan Li, Shailesh Advani, Behshad Naghshtabrizi, Matilde Leonardi, Lope H Barrero, Nicholas Steel, Dinh-Toi Chu, Claudio Alberto Dávila-Cervantes, Pushpendra Singh, Adrian Otoiu, Fabrizio Tediosi, Yonas Getaye Tefera, Pawan Faris, George C. Patton, Christopher Troeger, Mohammed Madadin, Jeffrey V. Lazarus, Paul H. Lee, Mohammad Amin Bahrami, Wondimeneh Shibabaw Shiferaw, Emmanuel Wandera Okunga, Biniyam Sahiledengle Geberemariyam, Samer Hamidi, Young-Ho Khang, Rufus Akinyemi, Farhad Jadidi-Niaragh, Godfrey Mutashambara Rwegerera, Naser Mohammad Gholi Mezerji, Rupak Desai, Eduardo Bernabé, Jamal A. Yearwood, Nima Rezaei, Emerito Jose A. Faraon, Vasily Vlassov, Stanislav S. Otstavnov, Reed J D Sorensen, Elena V. Gnedovskaya, Johan Ärnlöv, Mukhammad David Naimzada, Tahereh Javaheri, Tamer H. Farag, Paolo Cortesi, Gbenga A. Kayode, Lucas Guimarães Abreu, Manu Raj Mathur, Getie Lake Aynalem, Narayanaswamy Venketasubramanian, Doris V.V. Ortega-Altamirano, Giorgia Giussani, Liliana G Ciobanu, Suraj Bhattarai, Basema Saddik, Mustafa Z. Younis, Ensiyeh Jenabi, Ira Martopullo, Mohamed M. Gad, Kanyin L. Ong, Addisu Melese, Fotis Topouzis, Hanne Christensen, In-Hwan Oh, Arash Sarveazad, Shuhei Nomura, Peter Memiah, Sergej M. Ostojic, Santosh Kumar Tadakamadla, Dinesh Bhandari, Ahmed Omar Bali, Farahnaz Joukar, Arielle Wilder Eagan, Emma Elizabeth Spurlock, Ferrán Catalá-López, Caroline Stein, Jonathan M. Kocarnik, Stephen S Lim, Siamak Sabour, Kelly Compton, Shoaib Hassan, Rannveig Sigurvinsdottir, Claudiu Herteliu, Aso Mohammad Darwesh, Muluken Altaye Ayza, Angela Y. Chang, Leila R Kalankesh, Rafael Alves Guimarães, Abdollah Mohammadian-Hafshejani, Lal B. Rawal, Soewarta Kosen, Degena Bahrey Tadesse, Theo Vos, Paula Moraga, Soheil Hassanipour, Abdelrahman Ibrahim Abushouk, Oladimeji Adebayo, Mikk Jürisson, Tuomo J. Meretoja, Ireneous N. Soyiri, Carlo La Vecchia, Khalil Eskandari, Aziz Sheikh, Jagdish Khubchandani, James Leigh, Morteza Arab-Zozani, Sheikh Mohammed Shariful Islam, Stefan Kohler, Olayinka Stephen Ilesanmi, Kazumasa Yamagishi, Michele Romoli, Jasvinder A. Singh, Neeraj Bedi, Ivo Iavicoli, Alyssa Pennini, Subas Neupane, Emmanuel Peprah, Sojib Bin Zaman, Marwa Rashad Salem, Mohammed Ibrahim Mohialdeen Gubari, Ramesh Holla, Bayisa Abdissa Baye, Robert Ancuceanu, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Ettore Beghi, Quique Bassat, B Reshmi, Masood Ali Shaikh, Ionut Negoi, Peter Azzopardi, Florian Fischer, Kerem Shuval, Sorin Hostiuc, Hmwe H Kyu, Ver Bilano, Siddhesh Zadey, Davide Rasella, Vahid Alipour, Sowmya J. Rao, Radoslaw Sierpinski, Irina Filip, Michelle L. Bell, Malke Asaad, Ravensara S. Travillian, Christopher R. Cederroth, Rafael Tabarés-Seisdedos, Ashkan Afshin, Saqib Ali, Mahalaqua Nazli Khatib, Saad M.A. Dahlawi, Hedayat Abbastabar, Zahid A Butt, Sagun Paudel, Vahid Rashedi, B. Suresh Kumar Shetty, Thomas R. Hird, Shokofeh Maleki, Atif Amin Baig, Reza Heidari-Soureshjani, Shaun Wen Huey Lee, Jorge R. Ledesma, Ai-Min Wu, Fablina Sharara, Zemenu Tadesse Tessema, Ratilal Lalloo, Rohollah Kalhor, Rosario Cárdenas, Amir Radfar, Salime Goharinezhad, Fereshteh Mehri, Katarzyna Kissimova-Skarbek, Spencer A. Pease, Diana Silva, Amir Hossein Goudarzian, Samath D Dharmaratne, Darshan B B, Mariya Vladimirovna Titova, Dickson A. Amugsi, Lee Ling Lim, Agegnehu Bante, Charles D.A. Wolfe, Majid A Almadi, Seyed Mohammad Riahi, Nader Jahanmehr, Yuming Guo, Tauseef Ahmad, Platon D. Lopukhov, Takahiro Tabuchi, Nicholas J Kassebaum, Jacek Jerzy Jozwiak, Ritesh G. Menezes, Giovanni Damiani, Delia Hendrie, Mostafa Amini-Rarani, Sanjay Basu, Mohammad Hossein Bakhshaei, Gholamreza Roshandel, Borhan Mansouri, Enrico Rubagotti, Anurag Agrawal, Alireza Esteghamati, Paramjit Gill, Graeme J. Hankey, Mikhail Sergeevich Zastrozhin, Nima Hafezi-Nejad, Bruce Bartholow Duncan, Silvano Gallus, Jeevan Pereira, Ahamarshan Jayaraman Nagarajan, Giulia Carreras, Fariba Dorostkar, Pietro Ferrara, Andrea Farioli, Christoph Nowak, Ahmed I. Hasaballah, Vijay Kumar Chattu, Bolajoko O. Olusanya, Perminder S. Sachdev, Era Upadhyay, Tommi Vasankari, Susan M Sawyer, Adnan Kisa, Farshad Pourmalek, Kiomars Sharafi, Golnaz Heidari, Mohammad Abdollahi, Georges Nguefack-Tsague, Sajid Hameed, Sanni Yaya, Bach Xuan Tran, Ole Frithjof Norheim, Robert Kaba Alhassan, Morenike Oluwatoyin Folayan, Ismail Tareque, Phetole Walter Mahasha, Kewal Krishan, Soraya Siabani, Aleksandr Y. Aravkin, Helena Ullyartha Pangaribuan, Maryam Zamanian, Joshua A. Salomon, Bianca S. Zlavog, Vinay Nangia, Falk Schwendicke, Takeshi Fukumoto, Hung Chak Ho, Jordan Weiss, Maha Atout, Tariku Tesfaye Bekuma, Efat Mohamadi, Nikolaos Dervenis, Joan B. Soriano, Syed Amir Gilani, Victor Adekanmbi, Marina Karanikolos, Alberto Raggi, Michael R.M. Abrigo, Weijia Fu, Reza Shirkoohi, Aditya Prasad Dash, Peng Jia, Masoumeh Sadeghi, Ashraf Nabhan, Isabela M. Benseñor, Morteza Jafarinia, Joht Singh Chandan, Usman Iqbal, Amira Shaheen, Deepak Saxena, Lauren B. Wilner, Nataliya A. Foigt, Jeadran N. Malagón-Rojas, David C. Schwebel, Gail Davey, Milena Ilic, Josep Maria Haro, Peter Njenga Keiyoro, Stein Emil Vollset, Andrea Werdecker, Zahiruddin Quazi Syed, Yared Asmare Aynalem, Entezar Mehrabi Nasab, Yihun Mulugeta Alemu, Muhammad Ali, Mona M. Khater, Ehsan Sadeghi, Thirunavukkarasu Sathish, Pascual R. Valdez, Jennifer Rickard, Mark A. Stokes, Davide Sattin, Ewerton Cousin, Oliver J. Brady, Krittika Bhattacharyya, Mika Kivimäki, Andrew T Olagunju, Jost B. Jonas, Dian Kusuma, Goura Kishor Rath, Alberto Ortiz, Samad Azari, Nayu Ikeda, James L. Fisher, Peng Zheng, Elisabetta Pupillo, Pankaj Bhardwaj, Suzanne Lyn Barker-Collo, Riaz Uddin, Ester Cerin, Amir Taherkhani, Martin Amogre Ayanore, Richard G. Wamai, Anders Larsson, Josephine W. Ngunjiri, Hosni Salem, Hesham M. Al-Mekhlafi, Sharareh Eskandarieh, Taraneh Yousefinezhadi, Srikanta Banerjee, Yang Xie, Yuichiro Yano, Songhomitra Panda-Jonas, Themba G. Ginindza, Manasi Kumar, Babak Moazen, Bing-Fang Hwang, Cristiana Abbafati, Florentino Luciano Caetano dos Santos, Juan Sanabria, Milena Santric-Milicevic, Carla Sofia e.Sá Farinha, Samuel B. Albertson, Chieh Han, Parvaiz A Koul, Foad Abd-Allah, Mojisola Oluwasanu, Mihaela Hostiuc, Chinwe Juliana Iwu, Colm McAlinden, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Jalil Jaafari, Walter Mendoza, Abdulaziz M. Almulhim, Magdalene K. Walters, Ali H. Mokdad, Andre M. N. Renzaho, Catherine M. Antony, Ken Lee Chin, Ali A. Asadi-Pooya, Daniel Diaz, Adrian Pana, Salman Rawaf, Gina Agarwal, Demelash Woldeyohannes Handiso, Savita Lasrado, Amir Almasi-Hashiani, Praveen Hoogar, Srinivasa Rao Bolla, Fares Alahdab, Om P Kurmi, Sonali Kochhar, Van C. Lansingh, François Alla, Ali Almasi, Till Bärnighausen, Michael A. Piradov, Zubair Kabir, Boris Bikbov, Philip B. Mitchell, Amin Mousavi Khaneghah, Yahya Safari, Anirudh Kotlo, Jan-Walter De Neve, Biagio Simonetti, Carlos A Castañeda-Orjuela, Kenji Shibuya, GBD 2019 Universal Health Coverage Collaborator, Violante FS, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Department of Public Health, University of Helsinki, Clinicum, Neurologian yksikkö, HUS Neurocenter, HUS Comprehensive Cancer Center, Helsinki University Hospital Area, GBD 2019 Universal Health Coverage Collaborators, Lozano, Rafael, Fullman, Nancy, Mumford, John Everett, Knight, Megan, Barthelemy, Celine M, Abbafati, Cristiana, Abbastabar, Hedayat, Abd-Allah, Foad, Abdollahi, Mohammad, Abedi, Aidin, Abolhassani, Hassan, Abosetugn, Akine Eshete, Abreu, Lucas Guimarãe, Abrigo, Michael R M, Abu Haimed, Abdulaziz Khalid, Abushouk, Abdelrahman I, Adabi, Maryam, Adebayo, Oladimeji M, Adekanmbi, Victor, Adelson, Jaimie, Adetokunboh, Olatunji O, Adham, Davoud, Advani, Shailesh M, Afshin, Ashkan, Agarwal, Gina, Agasthi, Pradyumna, Aghamir, Seyed Mohammad Kazem, Agrawal, Anurag, Ahmad, Tauseef, Akinyemi, Rufus Olusola, Alahdab, Fare, Al-Aly, Ziyad, Alam, Khurshid, Albertson, Samuel B, Alemu, Yihun Mulugeta, Alhassan, Robert Kaba, Ali, Muhammad, Ali, Saqib, Alipour, Vahid, Aljunid, Syed Mohamed, Alla, Françoi, Almadi, Majid Abdulrahman Hamad, Almasi, Ali, Almasi-Hashiani, Amir, Almasri, Nihad A, Al-Mekhlafi, Hesham M, Almulhim, Abdulaziz M, Alonso, Jordi, Al-Raddadi, Rajaa M, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Alvis-Zakzuk, Nelson J, Amini, Saeed, Amini-Rarani, Mostafa, Amiri, Fatemeh, Amit, Arianna Maever L, Amugsi, Dickson A, Ancuceanu, Robert, Anderlini, Deanna, Andrei, Catalina Liliana, Androudi, Sofia, Ansari, Fereshteh, Ansari-Moghaddam, Alireza, Antonio, Carl Abelardo T, Antony, Catherine M, Antriyandarti, Ernoiz, Anvari, Davood, Anwer, Razique, Arabloo, Jalal, Arab-Zozani, Morteza, Aravkin, Aleksandr Y, Aremu, Olatunde, Ärnlöv, Johan, Asaad, Malke, Asadi-Aliabadi, Mehran, Asadi-Pooya, Ali A, Ashbaugh, Charlie, Athari, Seyyed Shamsadin, Atout, Maha Moh'd Wahbi, Ausloos, Marcel, Avila-Burgos, Leticia, Ayala Quintanilla, Beatriz Paulina, Ayano, Getinet, Ayanore, Martin Amogre, Aynalem, Yared Asmare, Aynalem, Getie Lake, Ayza, Muluken Altaye, Azari, Samad, Azzopardi, Peter S, B, Darshan B, Babaee, Ebrahim, Badiye, Ashish D, Bahrami, Mohammad Amin, Baig, Atif Amin, Bakhshaei, Mohammad Hossein, Bakhtiari, Ahad, Bakkannavar, Shankar M, Balachandran, Arun, Balassyano, Shelly, Banach, Maciej, Banerjee, Srikanta K, Banik, Palash Chandra, Bante, Agegnehu Bante, Bante, Simachew Animen, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barrero, Lope H, Bassat, Quique, Basu, Sanjay, Baune, Bernhard T, Bayati, Mohsen, Baye, Bayisa Abdissa, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Bekuma, Tariku Tesfaye Tesfaye, Bell, Michelle L, Bensenor, Isabela M, Berman, Adam E, Bernabe, Eduardo, Bernstein, Robert S, Bhagavathula, Akshaya Srikanth, Bhandari, Dinesh, Bhardwaj, Pankaj, Bhat, Anusha Ganapati, Bhattacharyya, Krittika, Bhattarai, Suraj, Bhutta, Zulfiqar A, Bijani, Ali, Bikbov, Bori, Bilano, Ver, Biondi, Antonio, Birihane, Binyam Minuye, Bockarie, Moses John, Bohlouli, Somayeh, Bojia, Hunduma Amensisa, Bolla, Srinivasa Rao Rao, Boloor, Archith, Brady, Oliver J, Braithwaite, Dejana, Briant, Paul Svitil, Briggs, Andrew M, Briko, Nikolay Ivanovich, Burugina Nagaraja, Sharath, Busse, Reinhard, Butt, Zahid A, Caetano dos Santos, Florentino Luciano, Cahuana-Hurtado, Lucero, Cámera, Luis Alberto, Cárdenas, Rosario, Carreras, Giulia, Carrero, Juan J, Carvalho, Felix, Castaldelli-Maia, Joao Mauricio, Castañeda-Orjuela, Carlos A, Castelpietra, Giulio, Castro, Franz, Catalá-López, Ferrán, Causey, Kate, Cederroth, Christopher R, Cercy, Kelly M, Cerin, Ester, Chandan, Joht Singh, Chang, Angela Y, Charan, Jaykaran, Chattu, Vijay Kumar, Chaturvedi, Sarika, Chin, Ken Lee, Cho, Daniel Youngwhan, Choi, Jee-Young Jasmine, Christensen, Hanne, Chu, Dinh-Toi, Chung, Michael T, Ciobanu, Liliana G, Cirillo, Massimo, Comfort, Haley, Compton, Kelly, Cortesi, Paolo Angelo, Costa, Vera Marisa, Cousin, Ewerton, Dahlawi, Saad M A, Damiani, Giovanni, Dandona, Lalit, Dandona, Rakhi, Darega Gela, Jiregna, Darwesh, Aso Mohammad, Daryani, Ahmad, Dash, Aditya Prasad, Davey, Gail, Dávila-Cervantes, Claudio Alberto, Davletov, Kairat, De Neve, Jan-Walter, Denova-Gutiérrez, Edgar, Deribe, Kebede, Dervenis, Nikolao, Desai, Rupak, Dharmaratne, Samath Dhamminda, Dhungana, Govinda Prasad, Dianatinasab, Mostafa, Dias da Silva, Diana, Diaz, Daniel, Dippenaar, Ilse N, Do, Hoa Thi, Dorostkar, Fariba, Doshmangir, Leila, Duncan, Bruce B, Duraes, Andre Rodrigue, Eagan, Arielle Wilder, Edvardsson, David, El Sayed, Iman, El Tantawi, Maha, Elgendy, Islam Y, Elyazar, Iqbal RF, Eskandari, Khalil, Eskandarieh, Sharareh, Esmaeilnejad, Saman, Esteghamati, Alireza, Ezekannagha, Oluchi, Farag, Tamer, Farahmand, Mohammad, Faraon, Emerito Jose A, Farinha, Carla Sofia e Sá, Farioli, Andrea, Faris, Pawan Sirwan, Faro, Andre, Fazlzadeh, Mehdi, Feigin, Valery L, Fernandes, Eduarda, Ferrara, Pietro, Feyissa, Garumma Tolu, Filip, Irina, Fischer, Florian, Fisher, James L, Flor, Luisa Sorio, Foigt, Nataliya A, Folayan, Morenike Oluwatoyin, Fomenkov, Artem Alekseevich, Foroutan, Masoud, Francis, Joel Msafiri, Fu, Weijia, Fukumoto, Takeshi, Furtado, João M, Gad, Mohamed M, Gaidhane, Abhay Motiramji, Gakidou, Emmanuela, Galles, Natalie C, Gallus, Silvano, Gardner, William M, Geberemariyam, Biniyam Sahiledengle, Gebrehiwot, Abiyu Mekonnen, Gebremeskel, Leake G, Gebremeskel, Gebreamlak Gebremedhn, Gesesew, Hailay Abrha, Ghadiri, Keyghobad, Ghafourifard, Mansour, Ghashghaee, Ahmad, Ghith, Nermin, Gholamian, Asadollah, Gilani, Syed Amir, Gill, Paramjit Singh, Gill, Tiffany K, Ginindza, Themba G, Gitimoghaddam, Mojgan, Giussani, Giorgia, Glagn, Mustefa, Gnedovskaya, Elena V, Godinho, Myron Anthony, Goharinezhad, Salime, Gopalani, Sameer Vali, Goudarzian, Amir Hossein, Goulart, Bárbara Niegia Garcia, Gubari, Mohammed Ibrahim Mohialdeen, Guimarães, Rafael Alve, Guled, Rashid Abdi, Gultie, Teklemariam, Guo, Yuming, Gupta, Rajeev, Gupta, Rahul, Hafezi-Nejad, Nima, Hafiz, Abdul, Haile, Teklehaimanot Gereziher, Hamadeh, Randah R, Hameed, Sajid, Hamidi, Samer, Han, Chieh, Han, Hannah, Handiso, Demelash Woldeyohanne, Hanif, Asif, Hankey, Graeme J, Haro, Josep Maria, Hasaballah, Ahmed I, Hasan, Md Mehedi, Hashi, Abdiwahab, Hassan, Shoaib, Hassan, Amr, Hassanipour, Soheil, Hassankhani, Hadi, Havmoeller, Rasmus J, Hay, Simon I, Hayat, Khezar, Heidari, Golnaz, Heidari-Soureshjani, Reza, Hendrie, Delia, Herteliu, Claudiu, Hird, Thomas R, Ho, Hung Chak, Hole, Michael K, Holla, Ramesh, Hollingsworth, Bruce, Hoogar, Praveen, Hopf, Kathleen Pillsbury, Horita, Nobuyuki, Hossain, Naznin, Hosseini, Mostafa, Hosseinzadeh, Mehdi, Hostiuc, Mihaela, Hostiuc, Sorin, Househ, Mowafa, Hsieh, Vivian Chia-rong, Hu, Guoqing, Huda, Tanvir M, Humayun, Ayesha, Hwang, Bing-Fang, Iavicoli, Ivo, Ibitoye, Segun Emmanuel, Ikeda, Nayu, Ilesanmi, Olayinka Stephen, Ilic, Irena M, Ilic, Milena D, Inbaraj, Leeberk Raja, Iqbal, Usman, Irvani, Seyed Sina Naghibi, Irvine, Caleb Mackay Salpeter, Islam, M Mofizul, Islam, Sheikh Mohammed Shariful, Islami, Farhad, Iso, Hiroyasu, Iwu, Chinwe Juliana, Iwu, Chidozie C D, Jaafari, Jalil, Jadidi-Niaragh, Farhad, Jafarinia, Morteza, Jahagirdar, Deepa, Jahani, Mohammad Ali, Jahanmehr, Nader, Jakovljevic, Mihajlo, Janjani, Hosna, Javaheri, Tahereh, Jayatilleke, Achala Upendra, Jenabi, Ensiyeh, Jha, Ravi Prakash, Jha, Vivekanand, Ji, John S, Jia, Peng, John-Akinola, Yetunde O, Jonas, Jost B, Joukar, Farahnaz, Jozwiak, Jacek Jerzy, Jürisson, Mikk, Kabir, Zubair, Kalankesh, Leila R, Kalhor, Rohollah, Kamath, Aruna M, Kanchan, Tanuj, Kapoor, Neeti, Karami Matin, Behzad, Karanikolos, Marina, Karimi, Seyed M, Kassebaum, Nicholas J, Katikireddi, Srinivasa Vittal, Kayode, Gbenga A, Keiyoro, Peter Njenga, Khader, Yousef Saleh, Khammarnia, Mohammad, Khan, Maseer, Khan, Ejaz Ahmad, Khang, Young-Ho, Khatab, Khaled, Khater, Amir M, Khater, Mona M, Khatib, Mahalaqua Nazli, Khayamzadeh, Maryam, Khubchandani, Jagdish, Kianipour, Neda, Kim, Young-Eun, Kim, Yun Jin, Kimokoti, Ruth W, Kinfu, Yohanne, Kisa, Adnan, Kissimova-Skarbek, Katarzyna, Kivimäki, Mika, Kneib, Cameron J, Kocarnik, Jonathan M, Kochhar, Sonali, Kohler, Stefan, Kopec, Jacek A, Korotkova, Anna V, Korshunov, Vladimir Andreevich, Kosen, Soewarta, Kotlo, Anirudh, Koul, Parvaiz A, Koyanagi, Ai, Krishan, Kewal, Krohn, Kris J, Kugbey, Nuworza, Kulkarni, Vaman, Kumar, G Anil, Kumar, Nithin, Kumar, Manasi, Kurmi, Om P, Kusuma, Dian, Kyu, Hmwe Hmwe, La Vecchia, Carlo, Lacey, Ben, Lal, Dharmesh Kumar, Lalloo, Ratilal, Landires, Iván, Lansingh, Van Charle, Larsson, Anders O, Lasrado, Savita, Lau, Kathryn Mei-Ming, Lauriola, Paolo, Lazarus, Jeffrey V, Ledesma, Jorge R, Lee, Paul H, Lee, Shaun Wen Huey, Leever, Andrew T, Legrand, Kate E, Leigh, Jame, Leonardi, Matilde, Li, Shanshan, Lim, Stephen S, Lim, Lee-Ling, Liu, Xuefeng, Logroscino, Giancarlo, Lopez, Alan D, Lopukhov, Platon D, Lotufo, Paulo A, Lu, Alton, Ma, Jianing, Madadin, Mohammed, Mahasha, Phetole Walter, Mahmoudi, Morteza, Majeed, Azeem, Malagón-Rojas, Jeadran N, Maleki, Shokofeh, Malta, Deborah Carvalho, Mansouri, Borhan, Mansournia, Mohammad Ali, Martini, Santi, Martins-Melo, Francisco Rogerlândio, Martopullo, Ira, Massenburg, Benjamin Ballard, Mastrogiacomo, Claudia I, Mathur, Manu Raj, Mcalinden, Colm, Mckee, Martin, Medina-Solís, Carlo Eduardo, Meharie, Birhanu Geta, Mehndiratta, Man Mohan, Mehrabi Nasab, Entezar, Mehri, Fereshteh, Mehrotra, Ravi, Mekonnen, Teferi, Melese, Addisu, Memiah, Peter T N, Mendoza, Walter, Menezes, Ritesh G, Mensah, George A, Meretoja, Tuomo J, Meretoja, Atte, Mestrovic, Tomislav, Miazgowski, Bartosz, Michalek, Irmina Maria, Mirrakhimov, Erkin M, Mirzaei, Maryam, Mirzaei-Alavijeh, Mehdi, Mitchell, Philip B, Moazen, Babak, Moghadaszadeh, Masoud, Mohamadi, Efat, Mohammad, Yousef, Mohammad, Dara K, Mohammad Gholi Mezerji, Naser, Mohammadian-Hafshejani, Abdollah, Mohammed, Shafiu, Mohammed, Jemal Abdu, Mokdad, Ali H, Monasta, Lorenzo, Mondello, Stefania, Moradi, Masoud, Moradi-Lakeh, Maziar, Moradzadeh, Rahmatollah, Moraga, Paula, Morgado-da-Costa, Joana, Morrison, Shane Dougla, Mosapour, Abba, Mosser, Jonathan F, Mousavi Khaneghah, Amin, Muriithi, Moses K, Mustafa, Ghulam, Nabhan, Ashraf F, Naderi, Mehdi, Nagarajan, Ahamarshan Jayaraman, Naghavi, Mohsen, Naghshtabrizi, Behshad, Naimzada, Mukhammad David, Nangia, Vinay, Nansseu, Jobert Richie, Nayak, Vinod C, Nazari, Javad, Ndejjo, Rawlance, Negoi, Ionut, Negoi, Ruxandra Irina, Neupane, Suba, Ngari, Kiirithio N, Nguefack-Tsague, George, Ngunjiri, Josephine W, Nguyen, Cuong Tat, Nguyen, Diep Ngoc, Nguyen, Huong Lan Thi, Nnaji, Chukwudi A, Nomura, Shuhei, Norheim, Ole F, Noubiap, Jean Jacque, Nowak, Christoph, Nunez-Samudio, Virginia, Otoiu, Adrian, Ogbo, Felix Akpojene, Oghenetega, Onome Bright, Oh, In-Hwan, Okunga, Emmanuel Wandera, Oladnabi, Morteza, Olagunju, Andrew T, Olusanya, Jacob Olusegun, Olusanya, Bolajoko Olubukunola, Oluwasanu, Mojisola Morenike, Omar Bali, Ahmed, Omer, Muktar Omer, Ong, Kanyin L, Onwujekwe, Obinna E, Ortega-Altamirano, Doris V V, Ortiz, Alberto, Ostojic, Sergej M, Otstavnov, Nikita, Otstavnov, Stanislav S, Øverland, Simon, Owolabi, Mayowa O, Padubidri, Jagadish Rao., Pakhale, Smita, Palladino, Raffaele, Pana, Adrian, Panda-Jonas, Songhomitra, Pangaribuan, Helena Ullyartha, Pathak, Mona, Patton, George C, Paudel, Sagun, Pazoki Toroudi, Hamidreza, Pease, Spencer A, Peden, Amy E, Pennini, Alyssa, Peprah, Emmanuel K, Pereira, Jeevan, Pigott, David M, Pilgrim, Thoma, Pilz, Tessa M, Pinheiro, Marina, Piradov, Michael A, Pirsaheb, Meghdad, Pokhrel, Khem Narayan, Postma, Maarten J, Pourjafar, Hadi, Pourmalek, Farshad, Pourmirza Kalhori, Reza, Pourshams, Akram, Prada, Sergio I, Pribadi, Dimas Ria Angga, Pupillo, Elisabetta, Quazi Syed, Zahiruddin, Radfar, Amir, Rafiee, Ata, Rafiei, Alireza, Raggi, Alberto, Rahim, Fakher, Rahman, Muhammad Aziz, Rajabpour-Sanati, Ali, Rana, Saleem Muhammad, Ranabhat, Chhabi Lal, Rao, Sowmya J, Rasella, Davide, Rashedi, Vahid, Rath, Goura Kishor, Rathi, Priya, Rawaf, Salman, Rawaf, David Laith, Rawal, Lal, Rawassizadeh, Reza, Razo, Christian, Renjith, Vishnu, Renzaho, Andre M N, Reshmi, Bhageerathy, Rezaei, Nima, Riahi, Seyed Mohammad, Ribeiro, Daniel Cury, Rickard, Jennifer, Roberts, Nicholas L S, Roever, Leonardo, Romoli, Michele, Ronfani, Luca, Roshandel, Gholamreza, Rubagotti, Enrico, Rwegerera, Godfrey M, Sabour, Siamak, Sachdev, Perminder S, Saddik, Basema, Sadeghi, Masoumeh, Sadeghi, Ehsan, Safari, Yahya, Sagar, Rajesh, Sahebkar, Amirhossein, Sahraian, Mohammad Ali, Sajadi, S. Mohammad, Salahshoor, Mohammad Reza, Salem, Marwa R Rashad, Salem, Hosni, Salomon, Joshua, Samadi Kafil, Hossein, Samy, Abdallah M, Sanabria, Juan, Santric-Milicevic, Milena M, Saraswathy, Sivan Yegnanarayana Iyer, Sarmiento-Suárez, Rodrigo, Sartorius, Benn, Sarveazad, Arash, Sathian, Brijesh, Sathish, Thirunavukkarasu, Sattin, Davide, Savic, Miloje, Sawyer, Susan M, Saxena, Deepak, Sbarra, Alyssa N, Schaeffer, Lauren E, Schiavolin, Silvia, Schmidt, Maria Inê, Schutte, Aletta Elisabeth, Schwebel, David C, Schwendicke, Falk, Seedat, Soraya, Sha, Feng, Shahabi, Saeed, Shaheen, Amira A, Shaikh, Masood Ali, Shamsizadeh, Morteza, Shannawaz, Mohammed, Sharafi, Kiomar, Sharara, Fablina, Sharifi, Hamid, Shaw, David H, Sheikh, Aziz, Sheikhtaheri, Abba, Shetty, B Suresh Kumar, Shibuya, Kenji, Shiferaw, Wondimeneh Shibabaw, Shigematsu, Mika, Shin, Jae Il, Shiri, Rahman, Shirkoohi, Reza, Shivakumar, K M, Shrime, Mark G, Shuval, Kerem, Siabani, Soraya, Sierpinski, Radoslaw, Sigfusdottir, Inga Dora, Sigurvinsdottir, Rannveig, Silva, Diego Augusto Santo, Silva, João Pedro, Simonetti, Biagio, Simpson, Kyle E, Singh, Jasvinder A, Singh, Pushpendra, Sinha, Dhirendra Narain, Skryabin, Valentin Yurievich, Smith, Emma U R, Soheili, Amin, Soltani, Shahin, Soofi, Moslem, Sorensen, Reed J. D., Soriano, Joan B, Sorrie, Muluken Bekele, Soyiri, Ireneous N, Spurlock, Emma Elizabeth, Sreeramareddy, Chandrashekhar T, Stanaway, Jeffrey D, Steel, Nichola, Stein, Caroline, Stokes, Mark A, Sufiyan, Mu'awiyyah Babale, Suleria, Hafiz Ansar Rasul, Sultan, Iyad, Szumowski, Łukasz, Tabarés-Seisdedos, Rafael, Tabuchi, Takahiro, Tadakamadla, Santosh Kumar, Taddele, Biruk Wogayehu, Tadesse, Degena Bahrey, Taherkhani, Amir, Tamiru, Animut Tagele, Tanser, Frank C, Tareque, Md Ismail, Tarigan, Ingan Ukur, Teagle, Whitney L, Tediosi, Fabrizio, Tefera, Yonas Getaye Getaye, Tela, Freweini Gebrearegay, Tessema, Zemenu Tadesse, Thakur, Bhaskar, Titova, Mariya Vladimirovna, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Tovani-Palone, Marcos Roberto Roberto, Tran, Bach Xuan, Travillian, Ravensara, Troeger, Christopher E, Tudor Car, Lorainne, Uddin, Riaz, Ullah, Irfan, Umeokonkwo, Chukwuma David, Unnikrishnan, Bhaskaran, Upadhyay, Era, Uthman, Olalekan A, Vacante, Marco, Valdez, Pascual R, Varughese, Santosh, Vasankari, Tommi Juhani, Vasseghian, Yasser, Venketasubramanian, Narayanaswamy, Violante, Francesco S, Vlassov, Vasily, Vollset, Stein Emil, Vongpradith, Avina, Vos, Theo, Waheed, Yasir, Walters, Magdalene K, Wamai, Richard G, Wang, Haidong, Wang, Yuan-Pang, Weintraub, Robert G, Weiss, Jordan, Werdecker, Andrea, Westerman, Ronny, Wilner, Lauren B, Woldu, Gebremariam, Wolfe, Charles D A, Wu, Ai-Min, Wulf Hanson, Sarah, Xie, Yang, Xu, Rixing, Yahyazadeh Jabbari, Seyed Hossein, Yamagishi, Kazumasa, Yano, Yuichiro, Yaya, Sanni, Yazdi-Feyzabadi, Vahid, Yearwood, Jamal A, Yeshitila, Yordanos Gizachew, Yip, Paul, Yonemoto, Naohiro, Younis, Mustafa Z, Yousefi, Zabihollah, Yousefinezhadi, Taraneh, Yusefzadeh, Hasan, Zadey, Siddhesh, Zahirian Moghadam, Telma, Zaidi, Syed Saoud, Zaki, Leila, Zaman, Sojib Bin, Zamani, Mohammad, Zamanian, Maryam, Zandian, Hamed, Zastrozhin, Mikhail Sergeevich, Zewdie, Kaleab Alemayehu, Zhang, Yunquan, Zhao, Xiu-Ju George, Zhao, Yingxi, Zheng, Peng, Zhu, Cong, Ziapour, Arash, Zlavog, Bianca S, Zodpey, Sanjay, Murray, Christopher J L, Lacey, B, Sartorius, B, Sálfræðideild (HR), Department of Psychology (RU), Samfélagssvið (HR), School of Social Sciences (RU), Háskólinn í Reykjavík, Reykjavik University, Lozano, R, Fullman, N, Mumford, J, Knight, M, Barthelemy, C, Abbafati, C, Abbastabar, H, Abd-Allah, F, Abdollahi, M, Abedi, A, Abolhassani, H, Abosetugn, A, Abreu, L, Abrigo, M, Abu Haimed, A, Abushouk, A, Adabi, M, Adebayo, O, Adekanmbi, V, Adelson, J, Adetokunboh, O, Adham, D, Advani, S, Afshin, A, Agarwal, G, Agasthi, P, Aghamir, S, Agrawal, A, Ahmad, T, Akinyemi, R, Alahdab, F, Al-Aly, Z, Alam, K, Albertson, S, Alemu, Y, Alhassan, R, Ali, M, Ali, S, Alipour, V, Aljunid, S, Alla, F, Almadi, M, Almasi, A, Almasi-Hashiani, A, Almasri, N, Al-Mekhlafi, H, Almulhim, A, Alonso, J, Al-Raddadi, R, Altirkawi, K, Alvis-Guzman, N, Alvis-Zakzuk, N, Amini, S, Amini-Rarani, M, Amiri, F, Amit, A, Amugsi, D, Ancuceanu, R, Anderlini, D, Andrei, C, Androudi, S, Ansari, F, Ansari-Moghaddam, A, Antonio, C, Antony, C, Antriyandarti, E, Anvari, D, Anwer, R, Arabloo, J, Arab-Zozani, M, Aravkin, A, Aremu, O, Ärnlöv, J, Asaad, M, Asadi-Aliabadi, M, Asadi-Pooya, A, Ashbaugh, C, Athari, S, Atout, M, Ausloos, M, Avila-Burgos, L, Ayala Quintanilla, B, Ayano, G, Ayanore, M, Aynalem, Y, Aynalem, G, Ayza, M, Azari, S, Azzopardi, P, B, D, Babaee, E, Badiye, A, Bahrami, M, Baig, A, Bakhshaei, M, Bakhtiari, A, Bakkannavar, S, Balachandran, A, Balassyano, S, Banach, M, Banerjee, S, Banik, P, Bante, A, Bante, S, Barker-Collo, S, Bärnighausen, T, Barrero, L, Bassat, Q, Basu, S, Baune, B, Bayati, M, Baye, B, Bedi, N, Beghi, E, Behzadifar, M, Bekuma, T, Bell, M, Bensenor, I, Berman, A, Bernabe, E, Bernstein, R, Bhagavathula, A, Bhandari, D, Bhardwaj, P, Bhat, A, Bhattacharyya, K, Bhattarai, S, Bhutta, Z, Bijani, A, Bikbov, B, Bilano, V, Biondi, A, Birihane, B, Bockarie, M, Bohlouli, S, Bojia, H, Bolla, S, Boloor, A, Brady, O, Braithwaite, D, Briant, P, Briggs, A, Briko, N, Burugina Nagaraja, S, Busse, R, Butt, Z, Caetano dos Santos, F, Cahuana-Hurtado, L, Cámera, L, Cárdenas, R, Carreras, G, Carrero, J, Carvalho, F, Castaldelli-Maia, J, Castañeda-Orjuela, C, Castelpietra, G, Castro, F, Catalá-López, F, Causey, K, Cederroth, C, Cercy, K, Cerin, E, Chandan, J, Chang, A, Charan, J, Chattu, V, Chaturvedi, S, Chin, K, Cho, D, Choi, J, Christensen, H, Chu, D, Chung, M, Ciobanu, L, Cirillo, M, Comfort, H, Compton, K, Cortesi, P, Costa, V, Cousin, E, Dahlawi, S, Damiani, G, Dandona, L, Dandona, R, Darega Gela, J, Darwesh, A, Daryani, A, Dash, A, Davey, G, Dávila-Cervantes, C, Davletov, K, De Neve, J, Denova-Gutiérrez, E, Deribe, K, Dervenis, N, Desai, R, Dharmaratne, S, Dhungana, G, Dianatinasab, M, Dias da Silva, D, Diaz, D, Dippenaar, I, Do, H, Dorostkar, F, Doshmangir, L, Duncan, B, Duraes, A, Eagan, A, Edvardsson, D, El Sayed, I, El Tantawi, M, Elgendy, I, Elyazar, I, Eskandari, K, Eskandarieh, S, Esmaeilnejad, S, Esteghamati, A, Ezekannagha, O, Farag, T, Farahmand, M, Faraon, E, Farinha, C, Farioli, A, Faris, P, Faro, A, Fazlzadeh, M, Feigin, V, Fernandes, E, Ferrara, P, Feyissa, G, Filip, I, Fischer, F, Fisher, J, Flor, L, Foigt, N, Folayan, M, Fomenkov, A, Foroutan, M, Francis, J, Fu, W, Fukumoto, T, Furtado, J, Gad, M, Gaidhane, A, Gakidou, E, Galles, N, Gallus, S, Gardner, W, Geberemariyam, B, Gebrehiwot, A, Gebremeskel, L, Gebremeskel, G, Gesesew, H, Ghadiri, K, Ghafourifard, M, Ghashghaee, A, Ghith, N, Gholamian, A, Gilani, S, Gill, P, Gill, T, Ginindza, T, Gitimoghaddam, M, Giussani, G, Glagn, M, Gnedovskaya, E, Godinho, M, Goharinezhad, S, Gopalani, S, Goudarzian, A, Goulart, B, Gubari, M, Guimarães, R, Guled, R, Gultie, T, Guo, Y, Gupta, R, Hafezi-Nejad, N, Hafiz, A, Haile, T, Hamadeh, R, Hameed, S, Hamidi, S, Han, C, Han, H, Handiso, D, Hanif, A, Hankey, G, Haro, J, Hasaballah, A, Hasan, M, Hashi, A, Hassan, S, Hassan, A, Hassanipour, S, Hassankhani, H, Havmoeller, R, Hay, S, Hayat, K, Heidari, G, Heidari-Soureshjani, R, Hendrie, D, Herteliu, C, Hird, T, Ho, H, Hole, M, Holla, R, Hollingsworth, B, Hoogar, P, Hopf, K, Horita, N, Hossain, N, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Hsieh, V, Hu, G, Huda, T, Humayun, A, Hwang, B, Iavicoli, I, Ibitoye, S, Ikeda, N, Ilesanmi, O, Ilic, I, Ilic, M, Inbaraj, L, Iqbal, U, Irvani, S, Irvine, C, Islam, M, Islam, S, Islami, F, Iso, H, Iwu, C, Jaafari, J, Jadidi-Niaragh, F, Jafarinia, M, Jahagirdar, D, Jahani, M, Jahanmehr, N, Jakovljevic, M, Janjani, H, Javaheri, T, Jayatilleke, A, Jenabi, E, Jha, R, Jha, V, Ji, J, Jia, P, John-Akinola, Y, Jonas, J, Joukar, F, Jozwiak, J, Jürisson, M, Kabir, Z, Kalankesh, L, Kalhor, R, Kamath, A, Kanchan, T, Kapoor, N, Karami Matin, B, Karanikolos, M, Karimi, S, Kassebaum, N, Katikireddi, S, Kayode, G, Keiyoro, P, Khader, Y, Khammarnia, M, Khan, M, Khan, E, Khang, Y, Khatab, K, Khater, A, Khater, M, Khatib, M, Khayamzadeh, M, Khubchandani, J, Kianipour, N, Kim, Y, Kimokoti, R, Kinfu, Y, Kisa, A, Kissimova-Skarbek, K, Kivimäki, M, Kneib, C, Kocarnik, J, Kochhar, S, Kohler, S, Kopec, J, Korotkova, A, Korshunov, V, Kosen, S, Kotlo, A, Koul, P, Koyanagi, A, Krishan, K, Krohn, K, Kugbey, N, Kulkarni, V, Kumar, G, Kumar, N, Kumar, M, Kurmi, O, Kusuma, D, Kyu, H, La Vecchia, C, Lal, D, Lalloo, R, Landires, I, Lansingh, V, Larsson, A, Lasrado, S, Lau, K, Lauriola, P, Lazarus, J, Ledesma, J, Lee, P, Lee, S, Leever, A, Legrand, K, Leigh, J, Leonardi, M, Li, S, Lim, S, Lim, L, Liu, X, Logroscino, G, Lopez, A, Lopukhov, P, Lotufo, P, Lu, A, Ma, J, Madadin, M, Mahasha, P, Mahmoudi, M, Majeed, A, Malagón-Rojas, J, Maleki, S, Malta, D, Mansouri, B, Mansournia, M, Martini, S, Martins-Melo, F, Martopullo, I, Massenburg, B, Mastrogiacomo, C, Mathur, M, Mcalinden, C, Mckee, M, Medina-Solís, C, Meharie, B, Mehndiratta, M, Mehrabi Nasab, E, Mehri, F, Mehrotra, R, Mekonnen, T, Melese, A, Memiah, P, Mendoza, W, Menezes, R, Mensah, G, Meretoja, T, Meretoja, A, Mestrovic, T, Miazgowski, B, Michalek, I, Mirrakhimov, E, Mirzaei, M, Mirzaei-Alavijeh, M, Mitchell, P, Moazen, B, Moghadaszadeh, M, Mohamadi, E, Mohammad, Y, Mohammad, D, Mohammad Gholi Mezerji, N, Mohammadian-Hafshejani, A, Mohammed, S, Mohammed, J, Mokdad, A, Monasta, L, Mondello, S, Moradi, M, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Morgado-da-Costa, J, Morrison, S, Mosapour, A, Mosser, J, Mousavi Khaneghah, A, Muriithi, M, Mustafa, G, Nabhan, A, Naderi, M, Nagarajan, A, Naghavi, M, Naghshtabrizi, B, Naimzada, M, Nangia, V, Nansseu, J, Nayak, V, Nazari, J, Ndejjo, R, Negoi, I, Negoi, R, Neupane, S, Ngari, K, Nguefack-Tsague, G, Ngunjiri, J, Nguyen, C, Nguyen, D, Nguyen, H, Nnaji, C, Nomura, S, Norheim, O, Noubiap, J, Nowak, C, Nunez-Samudio, V, Otoiu, A, Ogbo, F, Oghenetega, O, Oh, I, Okunga, E, Oladnabi, M, Olagunju, A, Olusanya, J, Olusanya, B, Oluwasanu, M, Omar Bali, A, Omer, M, Ong, K, Onwujekwe, O, Ortega-Altamirano, D, Ortiz, A, Ostojic, S, Otstavnov, N, Otstavnov, S, Øverland, S, Owolabi, M, Padubidri, J, Pakhale, S, Palladino, R, Pana, A, Panda-Jonas, S, Pangaribuan, H, Pathak, M, Patton, G, Paudel, S, Pazoki Toroudi, H, Pease, S, Peden, A, Pennini, A, Peprah, E, Pereira, J, Pigott, D, Pilgrim, T, Pilz, T, Pinheiro, M, Piradov, M, Pirsaheb, M, Pokhrel, K, Postma, M, Pourjafar, H, Pourmalek, F, Pourmirza Kalhori, R, Pourshams, A, Prada, S, Pribadi, D, Pupillo, E, Quazi Syed, Z, Radfar, A, Rafiee, A, Rafiei, A, Raggi, A, Rahim, F, Rahman, M, Rajabpour-Sanati, A, Rana, S, Ranabhat, C, Rao, S, Rasella, D, Rashedi, V, Rath, G, Rathi, P, Rawaf, S, Rawaf, D, Rawal, L, Rawassizadeh, R, Razo, C, Renjith, V, Renzaho, A, Reshmi, B, Rezaei, N, Riahi, S, Ribeiro, D, Rickard, J, Roberts, N, Roever, L, Romoli, M, Ronfani, L, Roshandel, G, Rubagotti, E, Rwegerera, G, Sabour, S, Sachdev, P, Saddik, B, Sadeghi, M, Sadeghi, E, Safari, Y, Sagar, R, Sahebkar, A, Sahraian, M, Sajadi, S, Salahshoor, M, Salem, M, Salem, H, Salomon, J, Samadi Kafil, H, Samy, A, Sanabria, J, Santric-Milicevic, M, Saraswathy, S, Sarmiento-Suárez, R, Sarveazad, A, Sathian, B, Sathish, T, Sattin, D, Savic, M, Sawyer, S, Saxena, D, Sbarra, A, Schaeffer, L, Schiavolin, S, Schmidt, M, Schutte, A, Schwebel, D, Schwendicke, F, Seedat, S, Sha, F, Shahabi, S, Shaheen, A, Shaikh, M, Shamsizadeh, M, Shannawaz, M, Sharafi, K, Sharara, F, Sharifi, H, Shaw, D, Sheikh, A, Sheikhtaheri, A, Shetty, B, Shibuya, K, Shiferaw, W, Shigematsu, M, Shin, J, Shiri, R, Shirkoohi, R, Shivakumar, K, Shrime, M, Shuval, K, Siabani, S, Sierpinski, R, Sigfusdottir, I, Sigurvinsdottir, R, Silva, D, Silva, J, Simonetti, B, Simpson, K, Singh, J, Singh, P, Sinha, D, Skryabin, V, Smith, E, Soheili, A, Soltani, S, Soofi, M, Sorensen, R, Soriano, J, Sorrie, M, Soyiri, I, Spurlock, E, Sreeramareddy, C, Stanaway, J, Steel, N, Stein, C, Stokes, M, Sufiyan, M, Suleria, H, Sultan, I, Szumowski, Ł, Tabarés-Seisdedos, R, Tabuchi, T, Tadakamadla, S, Taddele, B, Tadesse, D, Taherkhani, A, Tamiru, A, Tanser, F, Tareque, M, Tarigan, I, Teagle, W, Tediosi, F, Tefera, Y, Tela, F, Tessema, Z, Thakur, B, Titova, M, Tonelli, M, Topor-Madry, R, Topouzis, F, Tovani-Palone, M, Tran, B, Travillian, R, Troeger, C, Tudor Car, L, Uddin, R, Ullah, I, Umeokonkwo, C, Unnikrishnan, B, Upadhyay, E, Uthman, O, Vacante, M, Valdez, P, Varughese, S, Vasankari, T, Vasseghian, Y, Venketasubramanian, N, Violante, F, Vlassov, V, Vollset, S, Vongpradith, A, Vos, T, Waheed, Y, Walters, M, Wamai, R, Wang, H, Wang, Y, Weintraub, R, Weiss, J, Werdecker, A, Westerman, R, Wilner, L, Woldu, G, Wolfe, C, Wu, A, Wulf Hanson, S, Xie, Y, Xu, R, Yahyazadeh Jabbari, S, Yamagishi, K, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yearwood, J, Yeshitila, Y, Yip, P, Yonemoto, N, Younis, M, Yousefi, Z, Yousefinezhadi, T, Yusefzadeh, H, Zadey, S, Zahirian Moghadam, T, Zaidi, S, Zaki, L, Zaman, S, Zamani, M, Zamanian, M, Zandian, H, Zastrozhin, M, Zewdie, K, Zhang, Y, Zhao, X, Zhao, Y, Zheng, P, Zhu, C, Ziapour, A, Zlavog, B, Zodpey, S, Murray, C, Tampere University, Health Sciences, 10922180 - Schutte, Aletta Elisabeth, Lozano, R., Fullman, N., Mumford, J. E., Knight, M., Barthelemy, C. M., Abbafati, C., Abbastabar, H., Abd-Allah, F., Abdollahi, M., Abedi, A., Abolhassani, H., Abosetugn, A. E., Abreu, L. G., Abrigo, M. R. M., Abu Haimed, A. K., Abushouk, A. I., Adabi, M., Adebayo, O. M., Adekanmbi, V., Adelson, J., Adetokunboh, O. O., Adham, D., Advani, S. M., Afshin, A., Agarwal, G., Agasthi, P., Aghamir, S. M. K., Agrawal, A., Ahmad, T., Akinyemi, R. O., Alahdab, F., Al-Aly, Z., Alam, K., Albertson, S. B., Alemu, Y. M., Alhassan, R. K., Ali, M., Ali, S., Alipour, V., Aljunid, S. M., Alla, F., Almadi, M. A. H., Almasi, A., Almasi-Hashiani, A., Almasri, N. A., Al-Mekhlafi, H. M., Almulhim, A. M., Alonso, J., Al-Raddadi, R. M., Altirkawi, K. A., Alvis-Guzman, N., Alvis-Zakzuk, N. J., Amini, S., Amini-Rarani, M., Amiri, F., Amit, A. M. L., Amugsi, D. A., Ancuceanu, R., Anderlini, D., Andrei, C. L., Androudi, S., Ansari, F., Ansari-Moghaddam, A., Antonio, C. A. T., Antony, C. M., Antriyandarti, E., Anvari, D., Anwer, R., Arabloo, J., Arab-Zozani, M., Aravkin, A. Y., Aremu, O., Arnlov, J., Asaad, M., Asadi-Aliabadi, M., Asadi-Pooya, A. A., Athari, S. S., Atout, M. M. W., Ausloos, M., Avila-Burgos, L., Ayala Quintanilla, B. P., Ayano, G., Ayanore, M. A., Aynalem, Y. A., Aynalem, G. L., Ayza, M. A., Azari, S., Azzopardi, P. S., B, D. B., Babaee, E., Badiye, A. D., Bahrami, M. A., Baig, A. A., Bakhshaei, M. H., Bakhtiari, A., Bakkannavar, S. M., Balachandran, A., Banach, M., Banerjee, S. K., Banik, P. C., Bante, A. B., Bante, S. A., Barker-Collo, S. L., Barnighausen, T. W., Barrero, L. H., Bassat, Q., Basu, S., Baune, B. T., Bayati, M., Baye, B. A., Bedi, N., Beghi, E., Behzadifar, M., Bekuma, T. T. T., Bell, M. L., Bensenor, I. M., Berman, A. E., Bernabe, E., Bernstein, R. S., Bhagavathula, A. S., Bhandari, D., Bhardwaj, P., Bhat, A. G., Bhattacharyya, K., Bhattarai, S., Bhutta, Z. A., Bijani, A., Bikbov, B., Bilano, V., Biondi, A., Birihane, B. M., Bockarie, M. J., Bohlouli, S., Bojia, H. A., Bolla, S. R. R., Boloor, A., Brady, O. J., Braithwaite, D., Briggs, A. M., Briko, N. I., Burugina Nagaraja, S., Busse, R., Butt, Z. A., Caetano dos Santos, F. L., Cahuana-Hurtado, L., Camera, L. A., Cardenas, R., Carreras, G., Carrero, J. J., Carvalho, F., Castaldelli-Maia, J. M., Castaneda-Orjuela, C. A., Castelpietra, G., Castro, F., Catala-Lopez, F., Cederroth, C. R., Cerin, E., Chandan, J. S., Chang, A. Y., Charan, J., Chattu, V. K., Chaturvedi, S., Chin, K. L., Cho, D. Y., Choi, J. -Y. J., Christensen, H., Chu, D. -T., Chung, M. T., Ciobanu, L. G., Cirillo, M., Compton, K., Cortesi, P. A., Costa, V. M., Cousin, E., Dahlawi, S. M. A., Damiani, G., Dandona, L., Dandona, R., Darega Gela, J., Darwesh, A. M., Daryani, A., Dash, A. P., Davey, G., Davila-Cervantes, C. A., Davletov, K., De Neve, J. -W., Denova-Gutierrez, E., Deribe, K., Dervenis, N., Desai, R., Dharmaratne, S. D., Dhungana, G. P., Dianatinasab, M., Dias da Silva, D., Diaz, D., Dippenaar, I. N., Do, H. T., Dorostkar, F., Doshmangir, L., Duncan, B. B., Duraes, A. R., Eagan, A. W., Edvardsson, D., El Sayed, I., El Tantawi, M., Elgendy, I. Y., Elyazar, I. R., Eskandari, K., Eskandarieh, S., Esmaeilnejad, S., Esteghamati, A., Ezekannagha, O., Farag, T., Farahmand, M., Faraon, E. J. A., Farinha, C. S. E. S., Farioli, A., Faris, P. S., Faro, A., Fazlzadeh, M., Feigin, V. L., Fernandes, E., Ferrara, P., Feyissa, G. T., Filip, I., Fischer, F., Fisher, J. L., Flor, L. S., Foigt, N. A., Folayan, M. O., Fomenkov, A. A., Foroutan, M., Francis, J. M., Fu, W., Fukumoto, T., Furtado, J. M., Gad, M. M., Gaidhane, A. M., Gakidou, E., Galles, N. C., Gallus, S., Gardner, W. M., Geberemariyam, B. S., Gebrehiwot, A. M., Gebremeskel, L. G., Gebremeskel, G. G., Gesesew, H. A., Ghadiri, K., Ghafourifard, M., Ghashghaee, A., Ghith, N., Gholamian, A., Gilani, S. A., Gill, P. S., Gill, T. K., Ginindza, T. G., Gitimoghaddam, M., Giussani, G., Glagn, M., Gnedovskaya, E. V., Godinho, M. A., Goharinezhad, S., Gopalani, S. V., Goudarzian, A. H., Goulart, B. N. G., Gubari, M. I. M., Guimaraes, R. A., Guled, R. A., Gultie, T., Guo, Y., Gupta, R., Hafezi-Nejad, N., Hafiz, A., Haile, T. G., Hamadeh, R. R., Hameed, S., Hamidi, S., Han, C., Han, H., Handiso, D. W., Hanif, A., Hankey, G. J., Haro, J. M., Hasaballah, A. I., Hasan, M. M., Hashi, A., Hassan, S., Hassan, A., Hassanipour, S., Hassankhani, H., Havmoeller, R. J., Hay, S. I., Hayat, K., Heidari, G., Heidari-Soureshjani, R., Hendrie, D., Herteliu, C., Hird, T. R., Ho, H. C., Hole, M. K., Holla, R., Hoogar, P., Hopf, K. P., Horita, N., Hossain, N., Hosseini, M., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Househ, M., Hsieh, V. C. -R., Hu, G., Huda, T. M., Humayun, A., Hwang, B. -F., Iavicoli, I., Ibitoye, S. E., Ikeda, N., Ilesanmi, O. S., Ilic, M. D., Inbaraj, L. R., Iqbal, U., Irvani, S. S. N., Irvine, C. M. S., Islam, M. M., Islam, S. M. S., Islami, F., Iso, H., Iwu, C. J., Jaafari, J., Jadidi-Niaragh, F., Jafarinia, M., Jahagirdar, D., Jahani, M. A., Jahanmehr, N., Jakovljevic, M., Janjani, H., Javaheri, T., Jayatilleke, A. U., Jenabi, E., Jha, R. P., Jha, V., Ji, J. S., Jia, P., John-Akinola, Y. O., Jonas, J. B., Joukar, F., Jozwiak, J. J., Jurisson, M., Kabir, Z., Kalankesh, L. R., Kalhor, R., Kamath, A. M., Kanchan, T., Kapoor, N., Karami Matin, B., Karanikolos, M., Karimi, S. M., Kassebaum, N. J., Katikireddi, S. V., Kayode, G. A., Keiyoro, P. N., Khader, Y. S., Khammarnia, M., Khan, M., Khan, E. A., Khang, Y. -H., Khatab, K., Khater, A. M., Khater, M. M., Khatib, M. N., Khayamzadeh, M., Khubchandani, J., Kianipour, N., Kim, Y. J., Kimokoti, R. W., Kinfu, Y., Kisa, A., Kissimova-Skarbek, K., Kivimaki, M., Kneib, C. J., Kocarnik, J. M., Kochhar, S., Kohler, S., Kopec, J. A., Korotkova, A. V., Korshunov, V. A., Kosen, S., Kotlo, A., Koul, P. A., Koyanagi, A., Krishan, K., Krohn, K. J., Kugbey, N., Kulkarni, V., Kumar, G. A., Kumar, N., Kumar, M., Kurmi, O. P., Kusuma, D., Kyu, H. H., La Vecchia, C., Lacey, B., Lal, D. K., Lalloo, R., Landires, I., Lansingh, V. C., Larsson, A. O., Lasrado, S., Lau, K. M. -M., Lauriola, P., Lazarus, J. V., Ledesma, J. R., Lee, P. H., Lee, S. W. H., Leever, A. T., Legrand, K. E., Leigh, J., Leonardi, M., Li, S., Lim, S. S., Lim, L. -L., Liu, X., Logroscino, G., Lopez, A. D., Lopukhov, P. D., Lotufo, P. A., Lu, A., Ma, J., Madadin, M., Mahasha, P. W., Mahmoudi, M., Majeed, A., Malagon-Rojas, J. N., Maleki, S., Malta, D. C., Mansouri, B., Mansournia, M. A., Martini, S., Martins-Melo, F. R., Martopullo, I., Massenburg, B. B., Mastrogiacomo, C. I., Mathur, M. R., Mcalinden, C., Mckee, M., Medina-Solis, C. E., Meharie, B. G., Mehndiratta, M. M., Mehrabi Nasab, E., Mehri, F., Mehrotra, R., Mekonnen, T., Melese, A., Memiah, P. T. N., Mendoza, W., Menezes, R. G., Mensah, G. A., Meretoja, T. J., Meretoja, A., Mestrovic, T., Miazgowski, B., Michalek, I. M., Mirrakhimov, E. M., Mirzaei, M., Mirzaei-Alavijeh, M., Mitchell, P. B., Moazen, B., Moghadaszadeh, M., Mohamadi, E., Mohammad, Y., Mohammad, D. K., Mohammad Gholi Mezerji, N., Mohammadian-Hafshejani, A., Mohammed, S., Mohammed, J. A., Mokdad, A. H., Monasta, L., Mondello, S., Moradi, M., Moradi-Lakeh, M., Moradzadeh, R., Moraga, P., Morgado-da-Costa, J., Morrison, S. D., Mosapour, A., Mosser, J. F., Mousavi Khaneghah, A., Muriithi, M. K., Mustafa, G., Nabhan, A. F., Naderi, M., Nagarajan, A. J., Naghavi, M., Naghshtabrizi, B., Naimzada, M. D., Nangia, V., Nansseu, J. R., Nayak, V. C., Nazari, J., Ndejjo, R., Negoi, I., Negoi, R. I., Neupane, S., Ngari, K. N., Nguefack-Tsague, G., Ngunjiri, J. W., Nguyen, C. T., Nguyen, D. N., Nguyen, H. L. T., Nnaji, C. A., Nomura, S., Norheim, O. F., Noubiap, J. J., Nowak, C., Nunez-Samudio, V., Otoiu, A., Ogbo, F. A., Oghenetega, O. B., Oh, I. -H., Okunga, E. W., Oladnabi, M., Olagunju, A. T., Olusanya, J. O., Olusanya, B. O., Oluwasanu, M. M., Omar Bali, A., Omer, M. O., Ong, K. L., Onwujekwe, O. E., Ortega-Altamirano, D. V. V., Ortiz, A., Ostojic, S. M., Otstavnov, N., Otstavnov, S. S., Overland, S., Owolabi, M. O., Padubidri, J. R., Pakhale, S., Palladino, R., Pana, A., Panda-Jonas, S., Pangaribuan, H. U., Pathak, M., Patton, G. C., Paudel, S., Pazoki Toroudi, H., Pease, S. A., Peden, A. E., Pennini, A., Peprah, E. K., Pereira, J., Pigott, D. M., Pilgrim, T., Pilz, T. M., Pinheiro, M., Piradov, M. A., Pirsaheb, M., Pokhrel, K. N., Postma, M. J., Pourjafar, H., Pourmalek, F., Pourmirza Kalhori, R., Pourshams, A., Prada, S. I., Pribadi, D. R. A., Pupillo, E., Quazi Syed, Z., Radfar, A., Rafiee, A., Rafiei, A., Raggi, A., Rahim, F., Rahman, M. A., Rajabpour-Sanati, A., Rana, S. M., Ranabhat, C. L., Rao, S. J., Rasella, D., Rashedi, V., Rath, G. K., Rathi, P., Rawaf, S., Rawaf, D. L., Rawal, L., Rawassizadeh, R., Razo, C., Renjith, V., Renzaho, A. M. N., Reshmi, B., Rezaei, N., Riahi, S. M., Ribeiro, D. C., Rickard, J., Roberts, N. L. S., Roever, L., Romoli, M., Ronfani, L., Roshandel, G., Rubagotti, E., Rwegerera, G. M., Sabour, S., Sachdev, P. S., Saddik, B., Sadeghi, M., Sadeghi, E., Safari, Y., Sagar, R., Sahebkar, A., Sahraian, M. A., Sajadi, S. M., Salahshoor, M. R., Salem, M. R. R., Salem, H., Salomon, J., Samadi Kafil, H., Samy, A. M., Sanabria, J., Santric-Milicevic, M. M., Saraswathy, S. Y. I., Sarmiento-Suarez, R., Sartorius, B., Sarveazad, A., Sathian, B., Sathish, T., Sattin, D., Savic, M., Sawyer, S. M., Saxena, D., Sbarra, A. N., Schaeffer, L. E., Schiavolin, S., Schmidt, M. I., Schutte, A. E., Schwebel, D. C., Schwendicke, F., Seedat, S., Sha, F., Shahabi, S., Shaheen, A. A., Shaikh, M. A., Shamsizadeh, M., Shannawaz, M., Sharafi, K., Sharara, F., Sharifi, H., Shaw, D. H., Sheikh, A., Sheikhtaheri, A., Shetty, B. S. K., Shibuya, K., Shiferaw, W. S., Shigematsu, M., Shin, J. I., Shiri, R., Shirkoohi, R., Shivakumar, K. M., Shrime, M. G., Shuval, K., Siabani, S., Sierpinski, R., Sigfusdottir, I. D., Sigurvinsdottir, R., Silva, D. A. S., Silva, J. P., Simonetti, B., Simpson, K. E., Singh, J. A., Singh, P., Sinha, D. N., Skryabin, V. Y., Smith, E. U. R., Soheili, A., Soltani, S., Soofi, M., Sorensen, R. J. D., Soriano, J. B., Sorrie, M. B., Soyiri, I. N., Spurlock, E. E., Sreeramareddy, C. T., Stanaway, J. D., Steel, N., Stein, C., Stokes, M. A., Sufiyan, M. B., Suleria, H. A. R., Sultan, I., Szumowski, L., Tabares-Seisdedos, R., Tabuchi, T., Tadakamadla, S. K., Taddele, B. W., Tadesse, D. B., Taherkhani, A., Tamiru, A. T., Tanser, F. C., Tareque, M. I., Tarigan, I. U., Teagle, W. L., Tediosi, F., Tefera, Y. G. G., Tela, F. G., Tessema, Z. T., Thakur, B., Titova, M. V., Tonelli, M., Topor-Madry, R., Topouzis, F., Tovani-Palone, M. R. R., Tran, B. X., Travillian, R., Troeger, C. E., Tudor Car, L., Uddin, R., Ullah, I., Umeokonkwo, C. D., Unnikrishnan, B., Upadhyay, E., Uthman, O. A., Vacante, M., Valdez, P. R., Varughese, S., Vasankari, T. J., Vasseghian, Y., Venketasubramanian, N., Violante, F. S., Vlassov, V., Vollset, S. E., Vongpradith, A., Vos, T., Waheed, Y., Walters, M. K., Wamai, R. G., Wang, H., Wang, Y. -P., Weintraub, R. G., Weiss, J., Werdecker, A., Westerman, R., Wilner, L. B., Woldu, G., Wolfe, C. D. A., Wu, A. -M., Wulf Hanson, S., Xie, Y., Yahyazadeh Jabbari, S. H., Yamagishi, K., Yano, Y., Yaya, S., Yazdi-Feyzabadi, V., Yearwood, J. A., Yeshitila, Y. G., Yip, P., Yonemoto, N., Younis, M. Z., Yousefi, Z., Yousefinezhadi, T., Yusefzadeh, H., Zadey, S., Zahirian Moghadam, T., Zaidi, S. S., Zaki, L., Zaman, S. B., Zamanian, M., Zandian, H., Zastrozhin, M. S., Zewdie, K. A., Zhang, Y., Zhao, X. -J. G., Zhao, Y., Zheng, P., Zhu, C., Ziapour, A., Zlavog, B. S., Zodpey, S., and Murray, C. J. L.
- Subjects
Index (economics) ,Servicios de Salud ,SUSTAINABLE DEVELOPMENT GOALS ,030204 cardiovascular system & hematology ,universal health coverage ,sustaibale develpment goal ,global burden of disease ,performance ,systematic analysis ,Global Burden of Disease ,0302 clinical medicine ,Universal Health Insurance ,RA0421 ,11. Sustainability ,Per capita ,Medical economics ,Disease ,030212 general & internal medicine ,10. No inequality ,11 Medical and Health Sciences ,effective coverage of health services ,GBD 2019 Universal Health Coverage Collaborators ,education.field_of_study ,Public health ,Medical care ,Sjúkdómar ,4. Education ,1. No poverty ,Health coverage ,Public Health, Global Health, Social Medicine and Epidemiology ,General Medicine ,Hälsovetenskaper ,3142 Public health care science, environmental and occupational health ,Health services ,3. Good health ,Global burden of disease ,Health Expenditures ,Humans ,World Health Organization ,Purchasing power parity ,Scale (social sciences) ,Lýðheilsa ,universal health coverag ,CANCER SURVIVAL ,ACCESS ,Human ,Heilsuhagfræði ,medicine.medical_specialty ,Health coverage, GBD ,GBD ,Universal health ,GBD 2019 ,Population ,Health expenditures ,3122 Cancers ,Population health ,03 medical and health sciences ,Health systems ,Heilbrigðisvísindi ,SDG 3 - Good Health and Well-being ,General & Internal Medicine ,Development economics ,Health Sciences ,medicine ,Heilbrigðisstefna ,Alþjóðaheilbrigðisstofnunin ,QUALITY ,Global Burden of Disease Study ,education ,PROGRESS ,Disease burden ,Health services accessibility ,CARE ,Heilbrigðisþjónusta ,purl.org/pe-repo/ocde/ford#3.02.00 [https] ,Health Expenditure ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,3121 General medicine, internal medicine and other clinical medicine ,Morbility ,Administración de los Servicios de Salud ,Medical policy ,Business ,Heilbrigðiskerfi - Abstract
Publisher's version (útgefin grein), Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (>= 65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2.5th and 97.5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45.8 (95% uncertainty interval 44.2-47.5) in 1990 to 60.3 (58.7-61.9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2.6% [1.9-3.3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0.79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388.9 million (358.6-421.3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3.1 billion (3.0-3.2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968.1 million [903.5-1040.3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC., Lucas Guimaraes Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior -Brasil (Capes) -Finance Code 001, Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) and Fundacao de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG). Olatunji O Adetokunboh acknowledges South African Department of Science & Innovation, and National Research Foundation. Anurag Agrawal acknowledges support from the Wellcome Trust DBT India Alliance Senior Fellowship IA/CPHS/14/1/501489. Rufus Olusola Akinyemi acknowledges Grant U01HG010273 from the National Institutes of Health (NIH) as part of the H3Africa Consortium. Rufus Olusola Akinyemi is further supported by the FLAIR fellowship funded by the UK Royal Society and the African Academy of Sciences. Syed Mohamed Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. Marcel Ausloos, Claudiu Herteliu, and Adrian Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDSUEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Till Winfried Barnighausen acknowledges support from the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. Juan J Carrero was supported by the Swedish Research Council (2019-01059). Felix Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. Vera Marisa Costa acknowledges support from grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundacao para a Ciencia e a Tecnologia (FCT), IP, under the Norma TransitA3ria DL57/2016/CP1334/CT0006. Jan-Walter De Neve acknowledges support from the Alexander von Humboldt Foundation. Kebede Deribe acknowledges support by Wellcome Trust grant number 201900/Z/16/Z as part of his International Intermediate Fellowship. Claudiu Herteliu acknowledges partial support by a grant co-funded by European Fund for Regional Development through Operational Program for Competitiveness, Project ID P_40_382. Praveen Hoogar acknowledges the Centre for Bio Cultural Studies (CBiCS), Manipal Academy of Higher Education(MAHE), Manipal and Centre for Holistic Development and Research (CHDR), Kalghatgi. Bing-Fang Hwang acknowledges support from China Medical University (CMU108-MF-95), Taichung, Taiwan. Mihajlo Jakovljevic acknowledges the Serbian part of this GBD contribution was co-funded through the Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. Aruna M Kamath acknowledges funding from the National Institutes of Health T32 grant (T32GM086270). Srinivasa Vittal Katikireddi acknowledges funding from the Medical Research Council (MC_UU_12017/13 & MC_UU_12017/15), Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15) and an NRS Senior Clinical Fellowship (SCAF/15/02). Yun Jin Kim acknowledges support from the Research Management Centre, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/0001). Kewal Krishan acknowledges support from the DST PURSE grant and UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India. Manasi Kumar acknowledges support from K43 TW010716 Fogarty International Center/NIMH. Ben Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. Ivan Landires is a member of the Sistema Nacional de InvestigaciA3n (SNI), which is supported by the Secretaria Nacional de Ciencia Tecnologia e Innovacion (SENACYT), Panama. Jeffrey V Lazarus acknowledges support by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III/ESF, European Union [CP18/00074]). Peter T N Memiah acknowledges CODESRIA; HISTP. Subas Neupane acknowledges partial support from the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital. Shuhei Nomura acknowledges support from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). Alberto Ortiz acknowledges support by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. George C Patton acknowledges support from a National Health & Medical Research Council Fellowship. Marina Pinheiro acknowledges support from FCT for funding through program DL 57/2016 -Norma transitA3ria. Alberto Raggi, David Sattin, and Silvia Schiavolin acknowledge support by a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4 -Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). Daniel Cury Ribeiro acknowledges support from the Sir Charles Hercus Health Research Fellowship -Health Research Council of New Zealand (18/111). Perminder S Sachdev acknowledges funding from the NHMRC Australia. Abdallah M Samy acknowledges support from a fellowship from the Egyptian Fulbright Mission Program. Milena M Santric-Milicevic acknowledges support from the Ministry of Education, Science and Technological Development of the Republic of Serbia (Contract No. 175087). Rodrigo Sarmiento-Suarez acknowledges institutional support from University of Applied and Environmental Sciences in Bogota, Colombia, and Carlos III Institute of Health in Madrid, Spain. Maria Ines Schmidt acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. Sheikh Mohammed Shariful Islam acknowledges a fellowship from the National Heart Foundation of Australia and Deakin University. Aziz Sheikh acknowledges support from Health Data Research UK. Kenji Shibuya acknowledges Japan Ministry of Education, Culture, Sports, Science and Technology. Joan B Soriano acknowledges support by Centro de Investigacion en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Rafael Tabares-Seisdedos acknowledges partial support from grant PI17/00719 from ISCIII-FEDER. Santosh Kumar Tadakamadla acknowledges support from the National Health and Medical Research Council Early Career Fellowship, Australia. Marcello Tonelli acknowledges the David Freeze Chair in Health Services Research at the University of Calgary, AB, Canada., "Peer Reviewed"
- Published
- 2020
11. Correlation of Clinical Severity and Laboratory Parameters with Various Serotypes in Dengue Virus: A Hospital-Based Study
- Author
-
Achappa Basavaprabhu, Vaman Kulkarni, Suchitra M Shenoy, Pooja Rao, Basavaiah Sridevi Hanaganahalli, and Nikhil Victor Dsouza
- Subjects
0301 basic medicine ,Microbiology (medical) ,Serotype ,medicine.medical_specialty ,Article Subject ,030231 tropical medicine ,030106 microbiology ,Disease ,Dengue virus ,medicine.disease_cause ,Microbiology ,Dengue fever ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Prospective cohort study ,biology ,business.industry ,Medical record ,medicine.disease ,QR1-502 ,Ferritin ,Coinfection ,biology.protein ,business ,Research Article - Abstract
Objectives. Dengue fever, being hyperendemic with analogous presentations as in many other acute febrile illnesses, poses a challenge in diagnosis during the acute stage. Additionally, the coexistence of multiple serotypes further complicates the disease prognosis. The study was undertaken to determine the dengue virus serotypes, clinical, and laboratory markers as predictors in the severity of infection. Methods. A prospective study was conducted among 106 patients admitted with acute febrile illness having positive NS1 antigen/IgM ELISA. Clinical data were extracted from medical records including demographics, presence of comorbid conditions, clinical presentation, laboratory investigations, and course including length of hospital stay and outcome. Detection of dengue serotypes was done by multiplex reverse transcriptase polymerase chain reaction (RT_PCR). Results. Out of 106 RT-PCR-confirmed cases, DENV-3 was the most common serotype found in 56 (52.8%) patients, followed by DENV-3 and DENV-4 coinfection in 27 (25.4%) patients. Coinfection with more than one serotype was witnessed in our study. Raised liver enzymes and increased ferritin are good biomarkers in differentiating dengue from severe dengue with cutoff levels for AST (134 U/L), ALT (88 U/L), and ferritin (3670 ng/ml). Musculoskeletal, followed by gastrointestinal, manifestations were comparatively higher than respiratory and cutaneous manifestations. Conclusion. This study provides more information on the dengue serotypes. The clinical spectrum along with laboratory parameters such as ferritin, liver enzymes, platelet can be used as potential biomarkers in prediction of dengue severity. The data demonstrated will be useful in early detection and monitoring of the disease.
- Published
- 2020
12. Leptospirosis in Coastal South India: A Facility Based Study
- Author
-
Bhaskaran Unnikrishnan, Ramesh Holla, Vaman Kulkarni, Latika Pandey, B. B. Darshan, Rekha Thapar, Nithin Kumar, and Prasanna Mithra
- Subjects
Adult ,Male ,medicine.medical_specialty ,Article Subject ,Adolescent ,030231 tropical medicine ,India ,lcsh:Medicine ,Disease ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Case fatality rate ,Humans ,Medicine ,Leptospirosis ,Registries ,030212 general & internal medicine ,Child ,Aged ,Retrospective Studies ,Subclinical infection ,Aged, 80 and over ,General Immunology and Microbiology ,business.industry ,Public health ,lcsh:R ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Emergency medicine ,Population study ,Female ,business ,Complication ,Research Article - Abstract
Background. Leptospirosis is a major neglected public health problem and is highly underreported in India. The spectrum of clinical features ranges from subclinical infection to multiorgan failure. The burden of leptospirosis is more in developing countries. Objective. The present study was designed to assess the sociodemographic characteristics, clinical feature, and outcome of leptospirosis patients. Methods. This record based retrospective study was conducted in hospitals affiliated to Kasturba Medical College, Mangalore. The registries of the leptospirosis patients during the period of four years between January 2011 and December 2014 were reviewed and the information on demographic and clinical profile of the leptospirosis patients was recorded in the data capture sheet. The information obtained was analyzed using SPSS version 11.5. Results. The study included 202 leptospirosis victims. The mean age of the study population was 40.48 (±14.8) years. Majority of the patients presented with fever (92.1%) at the time of admission. Acute renal failure was found to be the most common complication (79.2%). Case fatality rate was found to be 3.5%. Conclusion. High proportion of cases indirectly reflects the endemic nature of the disease in the study setting. The clinical presentation of the leptospirosis is highly protean and may vary from a mild illness to life-threatening complications as evident from the current study.
- Published
- 2018
13. Assessment of spectrum of mental disorders in cancer patients
- Author
-
Himani Kotian, Vaman Kulkarni, Ayushi Gupta, PU Prakash Saxena, Rekha Thapar, and Keshva Pai
- Subjects
Adult ,Male ,medicine.medical_specialty ,somatization ,Context (language use) ,Generalized Anxiety Disorder 7 ,Anxiety ,lcsh:RC254-282 ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,Neoplasms ,Surveys and Questionnaires ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Depression (differential diagnoses) ,Aged ,business.industry ,Mental Disorders ,Panic ,Cancer ,General Medicine ,Middle Aged ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,030227 psychiatry ,Patient Health Questionnaire ,Patient Health Questionnaire-somatization ,anxiety ,depression screeners ,Cross-Sectional Studies ,Oncology ,030220 oncology & carcinogenesis ,Female ,medicine.symptom ,business ,Somatization - Abstract
Context: Cancer is one of the leading causes of disability worldwide. The psychological factors that significantly affect the functioning of the cancer patients are anxiety, depressive disorders, and somatization. Aims: To find out the spectrum of psychological disorders in cancer patients, also to find the association between sociodemographic variables and stage of tumor, treatment modality with the various psychological problems among cancer patients. Settings and Design: This cross-sectional study was carried out among cancer patients undergoing treatment in our institution. Subjects and Methods: Patient Health Questionnaire (PHQ)-somatization, anxiety, depression screeners is a prevalidated standard questionnaire which is a combination of PHQ-9, generalized anxiety disorder 7, and PHQ-15 plus panic measures from original PHQ. This questionnaire was given to patients and assessed later. Statistical Analysis: The association between variables of interest is tested using Chi-square test. P < 0.05 is be considered statistically significant. The data were analyzed using SPSS version 16 (SPSS for Windows, Version 16.0. Chicago, SPSS Inc.). Results: Patients suffered from depression and also from other psychiatric morbidities. There was significant association among residential addresses and various scale (P < 0.05), PHQ-9 was maximum among radiotherapy patients (P = 0.04). PHQ-15 had association with stage of cancer (P = 0.007). Conclusion: Psychological problems are highest among patients from rural areas and among female patients compared to male. Highest anxiety and somatization was found among patients in Stage II cancer and depression in Stage IV cancer. Among treatment modalities, highest anxiety was found among patients under chemotherapy treatment, somatization among patients under both chemotherapy and radiotherapy, and depression among patients under radiotherapy treatment.
- Published
- 2018
14. HIV-Related Knowledge among PLWHA Attending a Tertiary Care Hospital at Coastal South India—A Facility-Based Study
- Author
-
B. B. Darshan, Arjun Banagi Yathiraj, Rekha Thapar, Ramesh Holla, Vaman Kulkarni, Jayachidambaram Ambalavanan, John T Ramapuram, Bhaskaran Unnikrishnan, Nithin Kumar, Prasanna Mithra, and Deepak Madi
- Subjects
0301 basic medicine ,Univariate analysis ,Multivariate analysis ,business.industry ,Immunology ,Univariate ,Human immunodeficiency virus (HIV) ,virus diseases ,Dermatology ,Odds ratio ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,medicine.disease_cause ,medicine.disease ,030112 virology ,Confidence interval ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,Acquired immunodeficiency syndrome (AIDS) ,Environmental health ,Medicine ,030212 general & internal medicine ,business ,Socioeconomic status - Abstract
Background: Adequate knowledge about HIV/AIDS among people living with HIV (PLHIV) is essential for the prevention of HIV transmission. Methods: A cross-sectional study consisting of 409 PLHIV aged ≥18 years were interviewed regarding their HIV-related knowledge, from April 2014 to April 2015. HIV-related knowledge was assessed using the HIV knowledge questionnaire 18 . Univariate and multivariate analyses were done to determine the factors associated with high HIV-related knowledge. Odds ratios with its corresponding 95% confidence intervals were reported. A value of P < .05 was considered to be statistically significant. Results: Among 409 PLHIV, 46.2% had high HIV-related knowledge. Univariate analysis yields factors like upper socioeconomic status, those who are literates, unemployed, and adherent to antiretroviral therapy (ART) were associated with higher HIV-related knowledge. On multivariate analysis, upper socioeconomic status and adherence to ART were the factors that remained significantly associated with higher HIV-related knowledge. Conclusion: HIV-related knowledge among PLHIV can be improved through HIV educational programs.
- Published
- 2017
15. Profile of cervical cancer patients attending Tertiary Care Hospitals of Mangalore, Karnataka: A 4 year retrospective study
- Author
-
Ramesh Holla, Avinash Kumar, Rekha Thapar, Saad Mujtahedi, Meher Singha, Anshul Chatrath, B. B. Darshan, Nithin Kumar, Prasanna Mithra, Aadhya Sharma, Mallika Sridhar, Unnikrishnan Bhaskaran, and Vaman Kulkarni
- Subjects
medicine.medical_specialty ,India ,Disease ,Tertiary care ,General Biochemistry, Genetics and Molecular Biology ,Late presentation ,03 medical and health sciences ,0302 clinical medicine ,uterine cervical neoplasms ,Cervical carcinoma ,medicine ,risk factors ,Basal cell ,030212 general & internal medicine ,Gynecology ,Cervical cancer ,Obstetrics ,business.industry ,Retrospective cohort study ,General Medicine ,medicine.disease ,retrospective studies ,030220 oncology & carcinogenesis ,Population study ,Original Article ,business - Abstract
Objectives: To describe the sociodemographic characteristics and clinical profile of women presenting with cervical carcinoma and to identify factors associated with the timing of presentation and prognosis. Materials and Methods: A record-based descriptive study was carried out from 1st February to 31st March 2014 at Tertiary Care Hospitals of Mangalore. The study population included women who were diagnosed with cervical carcinoma from January 1, 2010 to December 31, 2013. A pretested data extraction sheet aimed at collecting information from the inpatient records was used as the study instrument. The collected data were entered and analyzed using SPSS version 16.0. Results: A total of 227 patients were included in the study. Mean (Standard Deviation) age of diagnosis of cervical cancer was found to be 55 ± 11 years. Majority of the women were Hindus (88.5%) and 51.0% of the women had occupational activities out of which manual labor was the most common. Forty-eight percent of the patients presented in the late stages. Squamous cell carcinoma was found to be the most common histological type. It was also observed that a slightly higher proportion of women with an age >49 years presented in late stages of the disease (n = 70, 48.6%) compared to women
- Published
- 2017
16. Predictors of mortality among a cohort of HIV/AIDS patients on anti-retroviral therapy in coastal South India
- Author
-
Ramesh Holla, Shodhan Aithal, Rekha Thapar, Vaman Kulkarni, John T Ramapuram, Bhaskaran Unnikrishnan, Nithin Kumar, and Prasanna Mithra
- Subjects
0301 basic medicine ,Univariate analysis ,Pediatrics ,medicine.medical_specialty ,Multivariate analysis ,Epidemiology ,business.industry ,Mortality rate ,030106 microbiology ,Retrospective cohort study ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,Acquired immunodeficiency syndrome (AIDS) ,Cohort ,medicine ,030212 general & internal medicine ,Underweight ,medicine.symptom ,business ,Body mass index - Abstract
Introduction: As the number of patients on anti-retroviral therapy (ART) rises, it is important to identify factors that predict mortality among these patients so that they can be closely monitored. Aim of the study was to determine the mortality rate among a cohort of HIV patients on naive ART and to assess the predictors of mortality among them. Material and methods: In this retrospective study, records of 249 patients living with HIV (PLHIV) who were ART naive, enrolled in the ART centre attached to Kasturba Medical College Hospital, Mangalore from February 2012 to February 2015, were analysed. Univariate and multivariate logistic regression was carried out to assess the factors predicting mortality among these patients. Results: By the end of the study period, 47 out of 249 patients died, giving an overall mortality rate of 18.8%. The mean age of the PLHIV was 43.4 ± 9.1 years. WHO stage 3/4 disease was present in 47.4% of patients. On univariate analysis, mortality was found to be significantly associated with alcohol consumption, being non-ambulatory, underweight (body mass index [BMI] < 18.5 kg/m2), WHO stage 3 or 4 disease, presence of opportunistic infections (OIs), presence of tuberculosis, being on an efavirenz-based regimen, poor adherence (< 95%), CD4 count < 350 cells/mm3, anaemia and raised creatinine levels. However, on multivariate analysis, presence of OIs and low BMI were found to independently predict mortality. Conclusions: Our study identifies lower BMI and presence of OIs as independent risk factors predicting mortality.
- Published
- 2017
17. Clinico-Epidemiological Profile of Children Orphaned due to AIDS Residing in Care Giving Institutions in Coastal South India
- Author
-
Avinash Kumar, Vaman Kulkarni, Bhaskaran Unnikrishnan, Ramesh Holla, Rekha Thapar, B. B. Darshan, Nithin Kumar, Prasanna Mithra, and Meher Singha
- Subjects
lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Article Subject ,Dermatology ,Disease ,Institutional ethics ,Standard score ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,030225 pediatrics ,Health care ,Epidemiology ,medicine ,Immunology and Allergy ,030212 general & internal medicine ,business.industry ,Public Health, Environmental and Occupational Health ,medicine.disease ,Malnutrition ,Infectious Diseases ,Hiv status ,lcsh:RC581-607 ,business ,Demography ,Research Article - Abstract
Background. HIV/AIDS has a greater impact on children. Besides being orphaned by the untimely demise of one or both parents due to the disease, these children are more prone for discrimination by the society.Methods. In this cross-sectional study 86 children orphaned by AIDS residing in care giving institutions for HIV positive children in Mangalore were assessed for their clinico-epidemiological profile and nutritional status. Institutional Ethics Committee clearance was obtained before the commencement of the study. The collected data were analyzed using SPSS (Statistical Package for Social Sciences) version 11.5 and the results expressed in mean (standard deviation) and proportions. BMI was calculated and nutritional status assessed using WHO Z scores (BMI for Age) for children between 5 and 19 years separately for boys and girls.Results. The mean age of the children was 13.2 ± 3 years. Majority (n=56, 65.1%) of the children were double orphans. Most of the children orphaned by AIDS (n=78, 90.7%) had a history of both the parents being HIV positive. The median CD4 count of participants at the time of our study was 853.5 (IQR 552–1092) cells/microliter. A higher percentage of orphans were malnourished compared to nonorphans. (41.1% vs. 36.7%). All the educational institutions, wherein the children orphaned by AIDS were enrolled, were aware about their HIV status. Five of the participants felt discriminated in their schools. Only two of the participants felt discriminated by their friends because of their HIV status.Conclusion. From our study we draw conclusion that even though the children orphaned due to AIDS are rehabilitated in terms of having shelter and provision of education and health care, much needs to be done in terms of improving the nutritional status of these children and alleviating the discriminatory attitude of the society towards them.
- Published
- 2019
18. Depression, anxiety, stress and stigma in informal caregivers of People Living with HIV (PLHIV)
- Author
-
Keshava Pai, Rumana Khan, Vaman Kulkarni, and John T Ramapuram
- Subjects
Adult ,Male ,medicine.medical_specialty ,Health (social science) ,Social Psychology ,Adolescent ,education ,Social Stigma ,Human immunodeficiency virus (HIV) ,Stigma (botany) ,India ,HIV Infections ,Anxiety ,medicine.disease_cause ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Medicine ,Humans ,Family ,030212 general & internal medicine ,Psychiatry ,Depression (differential diagnoses) ,Aged ,030505 public health ,business.industry ,Depression ,Public Health, Environmental and Occupational Health ,Anxiety stress ,Middle Aged ,Cross-Sectional Studies ,Caregivers ,Female ,medicine.symptom ,0305 other medical science ,business ,Stress, Psychological - Abstract
Informal caregivers are unpaid individuals who help friends or family members who cannot fully care for themselves. However fulfilling the act of helping debilitated individuals, exposure to another person's traumatic experiences often results in psychological distress. Caregiver's stigma towards HIV worsens this. Hence, this study aims to assess the effect of stigma on the mental health of caregivers so that their needs for support can be determined. A cross sectional hospital based study was carried out in Mangalore, India on 150 informal caregivers of PLHIV. The HIV Stigma Scale was used to assess stigma and DASS-21 was used to assess depression, anxiety and stress. Of the 150 caregivers, 20% marked one or more items on the stigma scale. Frequency of depression, anxiety and stress was 46%, 27% and 8% respectively. Most caregivers who had stigma and anxiety were of those patients diagnosed for a shorter duration of time (≤5 years) n = 20, p = 0.05 and n = 26, p = 0.03 respectively. Spouses of PLHIV (n = 31, p = 0.005), sero-positive caregivers (n = 25, p = 0.03) and those living with patients (n = 39, p = 0.01) suffered most from anxiety. Stress was significantly associated with depression (83%, p = 0.007) and anxiety (66.6%, p = 0.001) in caregivers. In conclusion, more of depression and anxiety was observed among the participants than stress. Stigma was seen in 20% of the participants. Stigma was not significantly associated with depression anxiety and stress.
- Published
- 2017
19. Factors Influencing Quality of Life among People Living with HIV in Coastal South India
- Author
-
Vaman Kulkarni, Deepak Madi, Bhaskaran Unnikrishnan, Nithin Kumar, Ramesh Holla, Bhagawan Darshan, Prasanna Mithra, Banagi Yathiraj Arjun, Rekha Thapar, and John T Ramapuram
- Subjects
Adult ,Male ,Gerontology ,medicine.medical_specialty ,Opportunistic infection ,Immunology ,Alternative medicine ,Human immunodeficiency virus (HIV) ,India ,HIV Infections ,Dermatology ,lcsh:RC870-923 ,medicine.disease_cause ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Humans ,Medicine ,030212 general & internal medicine ,Socioeconomic status ,030505 public health ,business.industry ,Middle Aged ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Antiretroviral therapy ,humanities ,CD4 Lymphocyte Count ,Cross-Sectional Studies ,Infectious Diseases ,Cohabitation ,Anti-Retroviral Agents ,Socioeconomic Factors ,Quality of Life ,Life expectancy ,Female ,0305 other medical science ,business - Abstract
Background: Antiretroviral therapy (ART) has increased life expectancy of HIV/AIDS patients, but the quality of life (QOL) still remains the same. Methods: In this cross-sectional study, 356 people living with HIV (PLHIV) were interviewed to assess their QOL using WHOQOL-HIV BREF questionnaire. The association between QOL with sociodemographic, clinical and cohabitation status of the participants was tested using ANOVA and Student t-test, and p value < .05 was considered statistically significant. Results: Physical domain of QOL showed maximum score of 16.4, while a minimum score of 12.2 was seen in social relationship domain. Participants with higher socioeconomic status (SES) and self-motivated to take ART had shown better scores across all the domains of QOL ( p < .05). Conclusion: In our study, quality of life was high among males, younger patients, married participants, higher socioeconomic status, longer duration of ART, self-motivation to take ART, absence of opportunistic infection, and with higher CD4 count.
- Published
- 2015
20. Intimate Partner Violence, Depression, and Quality of Life among Women Living with HIV/AIDS in a Coastal City of South India
- Author
-
Mahak Bhandary, Bhaskaran Unnikrishnan, Basavaprabhu Achchappa, Shivani Priyadarshni, Vaman Kulkarni, Anish Bhat, Deepak Maadi, Satish Rao, and John T Ramapuram
- Subjects
Adult ,Male ,Rural Population ,medicine.medical_specialty ,Immunology ,India ,HIV Infections ,Dermatology ,lcsh:RC870-923 ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Quality of life (healthcare) ,Acquired immunodeficiency syndrome (AIDS) ,medicine ,Humans ,Women ,030212 general & internal medicine ,Psychiatry ,Depression (differential diagnoses) ,030505 public health ,Marital Status ,business.industry ,Depression ,Sex Offenses ,Physical health ,Middle Aged ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Infectious Diseases ,Cross-Sectional Studies ,Socioeconomic Factors ,Spouse Abuse ,Quality of Life ,Domestic violence ,Female ,Rural area ,0305 other medical science ,business - Abstract
Background: Intimate partner violence (IPV) is a severe form of abuse prevalent in urban and rural areas of India with its effects on mental and physical health of the person receiving it, leading to a poorer quality of life. Methods: A cross-sectional study was conducted among 99 women living with HIV, and information was collected using abuse assessment scale. The data were entered and analyzed using SPSS version 17.0. Results: The IPV was reported by 19.2% of the respondents, of which psychological (14.1%) was most common followed by physical (4.1%) and sexual abuse (1.0%). The experience of IPV was significantly associated with socioeconomic status, number of children, marital status, and CD4 counts of the participants. Conclusion: The prevalence of IPV in our study was found to be less compared to previous studies, however, there were significant association among factors such as socioeconomic status, CD4 counts, and marital status of the participants.
- Published
- 2017
21. Factors Influencing Adherence to Antiretroviral Therapy among People Living with HIV in Coastal South India
- Author
-
Ramesh Holla, Vaman Kulkarni, Nithin Kumar, Bhaskaran Unnikrishnan, Arjun Banagi Yathiraj, Prasanna Mithra, B. B. Darshan, John T Ramapuram, and Rekha Thapar
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,030106 microbiology ,Immunology ,Human immunodeficiency virus (HIV) ,India ,HIV Infections ,Dermatology ,medicine.disease_cause ,Medication Adherence ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,medicine ,Humans ,030212 general & internal medicine ,Psychiatry ,business.industry ,medicine.disease ,Antiretroviral therapy ,Infectious Diseases ,Cross-Sectional Studies ,Anti-Retroviral Agents ,Family medicine ,Female ,business - Abstract
Background: Antiretroviral Therapy (ART) has transformed life threatening HIV/AIDS scenario into chronic manageable disease. Methodology: In this cross-sectional, 409 People Living with Human Immunodeficiency Virus (PLHIV) aged ≥ 18 years, who were on ART, were assessed regarding the adherence to ART and factors affecting adherence using semi-structured questionnaire. The association between factors affecting adherence and the level of adherence were analyzed using multiple logistic regression model and odds ratio (OR) with 95% confidence intervals (CI) were reported. Results: Among 409 PLHIV, 70.4% showed adherence to ART (≥95%). Univariate analysis yielded many factor associated with adherence ( P < 0.05). However, on multivariate analysis, PLHIV who do not forget to take ART and not consuming alcohol were the factors consistent with adherence to ART ( P < 0.05). Conclusion: Regular patient education and counseling regarding the usage of memory aids and abstinence from alcohol could be useful for adherence and long term success of ART among PLHIV.
- Published
- 2016
22. Perceptions and knowledge toward mobile-health among the college going students in Coastal South India
- Author
-
Nithin Kumar, Ramesh Holla, B. B. Darshan, Rohil Mehta, Elina Geroge, Avinash Kumar, Rekha Thapar, Ratna Jay, Bhaskaran Unnikrishnan, Elizabeth Josy Panikulam, Prajwal Pai, Vaman Kulkarni, and Prasanna Mithra Parthaje
- Subjects
medicine.medical_specialty ,media_common.quotation_subject ,030231 tropical medicine ,computer.software_genre ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,perceptions ,0302 clinical medicine ,Perception ,medicine ,Confidentiality ,030212 general & internal medicine ,mHealth ,mobile phones ,media_common ,Medical education ,Multimedia ,students ,business.industry ,4. Education ,Public health ,South India ,General Medicine ,Knowledge ,Mobile phone ,Original Article ,business ,computer - Abstract
Background: Among the manifold uses of mobile phones, mobile-health (mHealth) has been an important one, which is the practice of public health initiatives by awareness raising and communication campaigns. Optimum utilization of mHealth is possible only through adequate awareness. Hence, we aimed to study the perceptions and knowledge about mHealth among college going students in Mangalore, India. Materials and Methods: A cross-sectional study was conducted in March 2014 among 627 students in selected engineering (302 students) and medical colleges (325 students) in Mangalore, India. Colleges were selected using convenience sampling (nonrandom) method. Data were collected using semi-structured self-administered questionnaire and analyzed. Results: Overall, 48.9% were males, 61.4% belonged to 18-20 years age group. The awareness about mobile phone health utilities among medical and engineering students was found to be similar. Among those who were aware of the concept of mHealth (74 [11.2%]), 40 (54.1%) were medical students. Marginally higher proportion of medical students felt mHealth could be helpful in protecting the patients' confidentiality and would help in better communication with the patients. Conclusion: There was high level of general awareness about mHealth among the subjects. However, many specific areas had limited knowledge among both the streams of students, hence highlighting the need for increasing awareness and sensitization.
- Published
- 2016
23. Stigmatization and Discrimination toward People Living with HIV/AIDS in a Coastal City of South India
- Author
-
Bhaskaran Unnikrishnan, Nithin Kumar, Avinash Kumar, Rekha Thapar, Prasanna Mithra, Vaman Kulkarni, Ramesh Holla, and Darshan Bhagawan
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Immunology ,Social Stigma ,Human immunodeficiency virus (HIV) ,Stigma (botany) ,India ,HIV Infections ,Dermatology ,lcsh:RC870-923 ,medicine.disease_cause ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Discrimination, Psychological ,Acquired immunodeficiency syndrome (AIDS) ,Surveys and Questionnaires ,Health care ,medicine ,Humans ,030212 general & internal medicine ,Psychiatry ,Aged ,Acquired Immunodeficiency Syndrome ,030505 public health ,business.industry ,virus diseases ,Middle Aged ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Infectious Diseases ,Cross-Sectional Studies ,Female ,0305 other medical science ,business ,Prejudice - Abstract
Background: The HIV/AIDS scenario all over the world is complicated by the stigmatic and discriminative attitudes toward the HIV-infected individuals. Methodology: In this facility-based, cross-sectional study, 104 HIV-positive patients were assessed regarding their personal experience with HIV-related stigma and discrimination using a Revised HIV Stigma Scale. The association between stigma and factors such as socioeconomic status and gender was tested using chi-square test, and P < .05 was considered statistically significant. Results: A large proportion (41.3%) of the participants were in the age-group of 26 to 35 years. Confidentiality of the HIV positivity status was maintained only in 14.4% of the participants. Compared to females (48.2%), more than half (51.5%) of the male participants had experienced HIV/AIDS-related personalized stigma ( P > .05). Conclusion: HIV-related stigma and discrimination are the major social determinants driving the epidemic, despite the advances in medical treatment and increases in the awareness about the disease.
- Published
- 2015
24. Perception of HIV Testing and Counseling among Integrated Counseling and Testing Center Clients of Tertiary Level Hospitals
- Author
-
Santosh Bhat Kumar, Vaman Kulkarni, Rekha Thapar, Swathi Maroli, Avinash Kumar, Bhaskaran Unnikrishnan, Ramesh Holla, Shiwani Kamath, Darshan Bhagawana, Rijuta De, Dulakshi Wettasinghe, Prasanna Mithra, and Nithin Kumar
- Subjects
Adult ,Counseling ,Male ,Health Knowledge, Attitudes, Practice ,media_common.quotation_subject ,Immunology ,Human immunodeficiency virus (HIV) ,Vulnerability ,HIV Infections ,Dermatology ,Hiv testing ,medicine.disease_cause ,Tertiary care ,Tertiary Care Centers ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Nursing ,Pregnancy ,Perception ,Medicine ,Humans ,Mass Screening ,030212 general & internal medicine ,Tertiary level ,media_common ,030505 public health ,business.industry ,Infectious Diseases ,Cross-Sectional Studies ,Female ,0305 other medical science ,business - Abstract
Background: The purpose of establishing integrated counseling and testing center (ICTC) is to detect HIV at the earliest time, providing information on modes of transmission and prevention of HIV by promoting behavioral change and reducing vulnerability, and informing individuals on HIV prevention, care, and treatment services. Objective: To know the awareness of the clients about ICTC before pretest counseling. Methods: This facility-based cross-sectional study was conducted among 105 pretest counseling clients who visited ICTC for the first time in 3 ICTCs of tertiary care hospitals attached to a medical college in Mangalore. Result: Majority of the clients were pregnant women (n = 57, 54.30%), and most of the clients were referred by the treating doctor (n = 91, 86.7%). Most of the clients, being unaware of ICTC, are not aware of its functions and activities. Conclusion: Although ICTCs have been functional for nearly a decade, the awareness of ICTC and its functions among the people is poor.
- Published
- 2015
25. How familiar are our doctors towards Rabies prophylaxis- A study from coastal south India
- Author
-
Prasanna Mithra, Salman Anwar, Bhaskaran Unnikrishnan, Astha Guliani, Nithin Kumar, Avinash Kumar, Ramesh Holla, Bhagawan Darshan, Rekha Thapar, and Vaman Kulkarni
- Subjects
Male ,RNA viruses ,Questionnaires ,Health Knowledge, Attitudes, Practice ,Viral Diseases ,medicine.medical_treatment ,Disease ,Pathology and Laboratory Medicine ,Geographical Locations ,Pre-exposure prophylaxis ,0302 clinical medicine ,Surveys and Questionnaires ,Zoonoses ,Medicine and Health Sciences ,Public and Occupational Health ,030212 general & internal medicine ,Young adult ,Vaccines ,lcsh:Public aspects of medicine ,Middle Aged ,Infectious Diseases ,Medical Microbiology ,Research Design ,Viral Pathogens ,Viruses ,Female ,Pathogens ,Post-Exposure Prophylaxis ,Research Article ,Neglected Tropical Diseases ,Adult ,medicine.medical_specialty ,Asia ,lcsh:Arctic medicine. Tropical medicine ,Every 15 minutes ,Infectious Disease Control ,Rabies ,lcsh:RC955-962 ,030231 tropical medicine ,MEDLINE ,India ,Research and Analysis Methods ,Microbiology ,Young Adult ,Rabies Virus ,03 medical and health sciences ,Physicians ,medicine ,Animals ,Humans ,Post-exposure prophylaxis ,Microbial Pathogens ,Survey Research ,Biology and life sciences ,Prophylaxis ,business.industry ,Organisms ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Tropical Diseases ,medicine.disease ,Surgery ,Regimen ,Family medicine ,People and Places ,Lyssavirus ,Pre-Exposure Prophylaxis ,Preventive Medicine ,business - Abstract
Background Rabies, a 100% fatal disease claims more than 59,000 human lives every year globally. One human life is lost every 15 minutes due to this deadly preventable disease. Timely initiation of post exposure prophylaxis following an animal exposure can result in 100% preventability of this fatal disease. Methodology This facility based study was conducted among clinical fraternities of teaching hospitals. A semi structured questionnaire was used for collection of data. Institutional Ethics Committee approval was sought. The study investigators visited the workplace of the participants and distributed the questionnaire. SPSS Ver 16 (Chicago, IL, USA) was used to analyse the data. Findings Most of the participants knew that veterinary groups and zoo-keepers should be given pre-exposure prophylaxis. Many participants knew about the Intra Muscular schedule of anti-rabies vaccine and its site of administration for pre exposure prophylaxis. It was observed that most participants had knowledge regarding correct intramuscular regimen of anti-rabies vaccine for post-exposure prophylaxis but less than half were able to differentiate between the intramuscular and intradermal regimens. Less than half of participants were aware of the fact that local administration of anti-rabies serum is useful. Conclusion The knowledge regarding WHO categorisation of animal exposure and recommended post exposure prophylaxis according to type of exposure observed to be minimal among clinical fraternity., Author summary Rabies is a zoonotic disease. More than 95% of human rabies deaths is dog mediated. Rabies a 100% fatal yet preventable disease; a major public health problem in most of the Asian countries including India. The reduction in human rabies deaths is possible only when our clinical fraternity are aware of WHO recommended rabies post exposure prophylaxis to be offered to animal bite victims. With this in mind, a study was done among clinical fraternities and post graduates of Medicine, Surgery and Paediatrics departments of three tertiary care teaching hospitals affiliated to a medical college. It was observed that, the knowledge regarding reservoir of rabies infection and modes of transmission of rabies infection was satisfactory but the knowledge regarding WHO categorisation of animal exposure and recommended rabies post exposure prophylaxis was inadequate. Bridging this knowledge gap through periodically conducted Continuous Medical Education, Workshops and hands on training is essential for reducing human rabies deaths.
- Published
- 2017
26. Distress and its effect on adherence to antidiabetic medications among Type 2 diabetes patients in coastal South India
- Author
-
Shodhan Aithal, Ramesh Holla, Prasanna Mithra, Nithin Kumar, Rekha Thapar, Vaman Kulkarni, Bhaskaran Unnikrishnan, Darshan Bhagawan, and Avinash Kumar
- Subjects
medicine.medical_specialty ,Multivariate analysis ,030209 endocrinology & metabolism ,Type 2 diabetes ,Disease ,Logistic regression ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,diabetes distress ,Diabetes mellitus ,medicine ,030212 general & internal medicine ,Univariate analysis ,business.industry ,South India ,General Medicine ,medicine.disease ,Distress ,Regimen ,Adherence ,Family medicine ,Physical therapy ,Original Article ,type 2 diabetes ,business ,diabetes distress scale - Abstract
Background: Distress can bring about an unfavorable attitude among the patients toward tackling their disease which can affect adherence to medications. The purpose of this study was to assess the effect of distress on adherence to medication among patients with diabetes. Methodology: In this cross‑sectional study, 124 type 2 diabetes patients above 18 years, attending the hospitals affiliated to Kasturba Medical College, Mangalore, selected using nonprobability sampling were interviewed to assess the presence of diabetes‑related distress (DRD) and their level of adherence to medications. Distress was assessed using diabetes distress scale. Morisky Adherence Questionnaire was used to assess the level of adherence. Approval was obtained from the Institutional Ethics Committee. Multivariate logistic regression was conducted to assess the influence of domains of distress on adherence to antidiabetic medication and P < 0.05 was considered statistically significant. Results: In our study, 41.9% (n = 52) of the participants had high diabetes distress. Exactly 43.5% (n = 54) of the participants had low adherence to antidiabetic medications. On univariate analysis, participants with low regimen distress, low physician distress, and low interpersonal distress were found to have good adherence to antidiabetic medication. However, on multivariate analysis, only low regimen distress was found to be significantly associated with good adherence to medication among the study participants. Conclusion: DRD is a problem in our study participants which affects the adherence to medications. Identifying distress at an early stage can help doctors formulate and implement remedial measures, thereby improving adherence to medications.
- Published
- 2017
27. Perceptions and attitudes towards organ donation among people seeking healthcare in tertiary care centers of coastal south India
- Author
-
Mohan Kumar Papanna, Vaman Kulkarni, Ramesh Holla, Prasanna Mithra, Nithin Kumar, Rekha T, Divyavaraprasad K, Tanuj Kanchan, Bhaskaran Unnikrishnan, and Prithvishree Ravindra
- Subjects
medicine.medical_specialty ,media_common.quotation_subject ,030232 urology & nephrology ,Tertiary care ,Organ transplantation ,Organ donation ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Perception ,Health care ,Perceptions ,Medicine ,030212 general & internal medicine ,Socioeconomic status ,media_common ,lcsh:R5-920 ,business.industry ,South India ,Health Policy ,Public Health, Environmental and Occupational Health ,Awareness ,3. Good health ,Transplantation ,Attitude ,Family medicine ,Donor Cards ,Original Article ,lcsh:Medicine (General) ,business - Abstract
Background: Organ transplantation is the most preferred treatment modality for end-stage organ diseases. The need for the transplants is higher than the availability. Prerequisites for the success of transplantation program include awareness and positive attitudes. Aim: To assess the perceptions and attitudes of the people seeking health care in tertiary care centers towards organ donation in Mangalore, India. Settings and Design: This cross-sectional study included 863 people seeking general healthcare as outpatients. Materials and Methods: Face to face interviews were carried out using pretested tools which included the socio demographic data. Data was analyzed using Statistical Package for Social Sciences version 11.5. Results: Overall, 59.6% participants showed the willingness to donate organs. Females (64.1%) and participants from upper socio economic status (62.7%) had higher willingness rates for organ donations. Hindus (63.6%) and Christians (63.3%) had higher willingness rates for organ donations than Muslims (38.2%). Also, 23.7% participants showed willingness to donate eyes and 33.6% wished to donate any organ after death. Most of the participants (67%) were aware that money should not be accepted for donating organs, and 58.1% were aware that it is an offence to accept any benefit for organ donations. Forty percent participants had perceived risks associated with organ donation. Regarding donor cards, 42.3% of the participants knew about it and 3.7% already possessed it. Conclusion: It is apparent from the study that though there was high level of awareness about organ donation, a high proportion of the participants did not have positive attitudes towards organ donation.
- Published
- 2013
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.