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1. Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Kassebaum, Nicholas J, Bertozzi-Villa, Amelia, Coggeshall, Megan S, Shackelford, Katya A, Steiner, Caitlyn, Heuton, Kyle R, Gonzalez-Medina, Diego, Barber, Ryan, Huynh, Chantal, Dicker, Daniel, Templin, Tara, Wolock, Timothy M, Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw Ferede, Abubakar, Ibrahim, Achoki, Tom, Adelekan, Ademola, Ademi, Zanfina, Adou, Arsène Kouablan, Adsuar, José C, Agardh, Emilie E, Akena, Dickens, Alasfoor, Deena, Alemu, Zewdie Aderaw, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Al Kahbouri, Mazin J, Alla, François, Allen, Peter J, AlMazroa, Mohammad A, Alsharif, Ubai, Alvarez, Elena, Alvis-Guzmán, Nelson, Amankwaa, Adansi A, Amare, Azmeraw T, Amini, Hassan, Ammar, Walid, Antonio, Carl AT, Anwari, Palwasha, Arnlöv, Johan, Arsenijevic, Valentina S Arsic, Artaman, Ali, Asad, Majed Masoud, Asghar, Rana J, Assadi, Reza, Atkins, Lydia S, Badawi, Alaa, Balakrishnan, Kalpana, Basu, Arindam, Basu, Sanjay, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Bernabe, Eduardo, Beyene, Tariku J, Bhutta, Zulfiqar, Bin Abdulhak, Aref, Blore, Jed D, Basara, Berrak Bora, Bose, Dipan, Breitborde, Nicholas, Cárdenas, Rosario, Castañeda-Orjuela, Carlos A, Castro, Ruben Estanislao, Catalá-López, Ferrán, Cavlin, Alanur, Chang, Jung-Chen, Che, Xuan, Christophi, Costas A, Chugh, Sumeet S, Cirillo, Massimo, Colquhoun, Samantha M, Cooper, Leslie Trumbull, Cooper, Cyrus, da Costa Leite, Iuri, Dandona, Lalit, Dandona, Rakhi, Davis, Adrian, Dayama, Anand, Degenhardt, Louisa, De Leo, Diego, del Pozo-Cruz, Borja, Deribe, Kebede, Dessalegn, Muluken, deVeber, Gabrielle A, Dharmaratne, Samath D, Dilmen, Uğur, Ding, Eric L, Dorrington, Rob E, Driscoll, Tim R, Ermakov, Sergei Petrovich, Esteghamati, Alireza, Faraon, Emerito Jose A, Farzadfar, Farshad, Felicio, Manuela Mendonca, Fereshtehnejad, Seyed-Mohammad, and de Lima, Graça Maria Ferreira

Subjects
2.4 Surveillance and distribution, Aetiology, Infection, Reproductive health and childbirth, Good Health and Well Being, Age Distribution, Cause of Death, Female, Global Health, HIV Infections, Humans, Maternal Mortality, Models, Statistical, Organizational Objectives, Pregnancy, Pregnancy Complications, Infectious, Risk Factors, Socioeconomic Factors, Time Factors, Medical and Health Sciences, General & Internal Medicine
Abstract

BackgroundThe fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.MethodsWe used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values.Findings292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland.InterpretationGlobal rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.FundingBill & Melinda Gates Foundation.

Published
2014

2. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Murray, Christopher JL, Ortblad, Katrina F, Guinovart, Caterina, Lim, Stephen S, Wolock, Timothy M, Roberts, D Allen, Dansereau, Emily A, Graetz, Nicholas, Barber, Ryan M, Brown, Jonathan C, Wang, Haidong, Duber, Herbert C, Naghavi, Mohsen, Dicker, Daniel, Dandona, Lalit, Salomon, Joshua A, Heuton, Kyle R, Foreman, Kyle, Phillips, David E, Fleming, Thomas D, Flaxman, Abraham D, Phillips, Bryan K, Johnson, Elizabeth K, Coggeshall, Megan S, Abd-Allah, Foad, Abera, Semaw Ferede, Abraham, Jerry P, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen Me, Achoki, Tom, Adeyemo, Austine Olufemi, Adou, Arsène Kouablan, Adsuar, José C, Agardh, Emilie Elisabet, Akena, Dickens, Al Kahbouri, Mazin J, Alasfoor, Deena, Albittar, Mohammed I, Alcalá-Cerra, Gabriel, Alegretti, Miguel Angel, Alemu, Zewdie Aderaw, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Alla, Francois, Allen, Peter J, Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amankwaa, Adansi A, Amare, Azmeraw T, Amini, Hassan, Ammar, Walid, Anderson, Benjamin O, Antonio, Carl Abelardo T, Anwari, Palwasha, Arnlöv, Johan, Arsenijevic, Valentina S Arsic, Artaman, Ali, Asghar, Rana J, Assadi, Reza, Atkins, Lydia S, Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Basu, Sanjay, Beardsley, Justin, Bekele, Tolesa, Bell, Michelle L, Bernabe, Eduardo, Beyene, Tariku Jibat, Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A, Abdulhak, Aref Bin, Binagwaho, Agnes, Blore, Jed D, Basara, Berrak Bora, Bose, Dipan, Brainin, Michael, Breitborde, Nicholas, Castañeda-Orjuela, Carlos A, Catalá-López, Ferrán, Chadha, Vineet K, Chang, Jung-Chen, Chiang, Peggy Pei-Chia, Chuang, Ting-Wu, Colomar, Mercedes, Cooper, Leslie Trumbull, Cooper, Cyrus, Courville, Karen J, Cowie, Benjamin C, Criqui, Michael H, Dandona, Rakhi, Dayama, Anand, De Leo, Diego, Degenhardt, Louisa, Del Pozo-Cruz, Borja, and Deribe, Kebede

Subjects
HIV/AIDS, Prevention, Rare Diseases, Vector-Borne Diseases, Infectious Diseases, 2.2 Factors relating to the physical environment, 2.4 Surveillance and distribution, Aetiology, Infection, Good Health and Well Being, Age Distribution, Epidemics, Female, Global Health, HIV Infections, Humans, Incidence, Malaria, Male, Mortality, Organizational Objectives, Sex Distribution, Tuberculosis, Medical and Health Sciences, General & Internal Medicine
Abstract

BackgroundThe Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration.MethodsTo estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets.FindingsGlobally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990.InterpretationOur estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action.FundingBill & Melinda Gates Foundation.

Published
2014

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

Author

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

Subjects
Pediatrics, Time Factors, Nutrition and Disease, hiv-infection, immunodeficiency virus-1 infection, peripartum cardiomyopathy, Poison control, HIV Infections, IMMUNODEFICIENCY VIRUS-1 INFECTION, Socioeconomic Factor, Global Health, 0302 clinical medicine, PERIPARTUM CARDIOMYOPATHY, pregnancy-related mortality, Risk Factors, Pregnancy, Voeding en Ziekte, Cause of Death, Global health, HIV Infection, 030212 general & internal medicine, Pregnancy Complications, Infectious, 10. No inequality, Cause of death, 030219 obstetrics & reproductive medicine, south-africa, Medicine (all), 1. No poverty, WOMEN, PREGNANCY-RELATED MORTALITY, health initiatives, General Medicine, SOUTH-AFRICA, 3. Good health, Maternal Mortality, World Health, CHILD SURVIVAL, Female, Maternal death, women, Human, medicine.medical_specialty, Time Factor, DEATHS, child survival, Article, adult mortality, 03 medical and health sciences, Age Distribution, HEALTH INITIATIVES, SDG 3 - Good Health and Well-being, HIV-INFECTION, ADULT MORTALITY, Injury prevention, medicine, Organizational Objectives, Organizational Objective, Humans, VLAG, Models, Statistical, business.industry, Risk Factor, medicine.disease, deaths, Standardized mortality ratio, Socioeconomic Factors, Relative risk, Pregnancy Complications, Infectiou, business, Demography
Abstract

BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.METHODS: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values.FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland.INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.FUNDING: Bill & Melinda Gates Foundation.

Published
2016

4. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

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

Subjects
Gerontology, SEVERE FEBRILE ILLNESS, Male, verbal autopsy, Nutrition and Disease, Cost effectiveness, MILLENNIUM DEVELOPMENT GOALS, HIV Infections, active antiretroviral therapy, Global Health, COST-EFFECTIVENESS, 0302 clinical medicine, Voeding en Ziekte, Global health, HIV Infection, 030212 general & internal medicine, 0303 health sciences, ACTIVE ANTIRETROVIRAL THERAPY, Incidence (epidemiology), Medicine (all), Incidence, General Medicine, Millennium Development Goals, 3. Good health, middle-income countries, projection package, World Health, VERBAL AUTOPSY, Female, Human, Tuberculosis, Tuberculosi, PROJECTION PACKAGE, prospective cohort, Epidemic, millennium development goals, 03 medical and health sciences, Age Distribution, Acquired immunodeficiency syndrome (AIDS), SDG 3 - Good Health and Well-being, MIDDLE-INCOME COUNTRIES, medicine, Organizational Objective, Humans, Organizational Objectives, FEMALE SEX WORKERS, Mortality, Sex Distribution, Epidemics, cost-effectiveness, female sex workers, 030304 developmental biology, VLAG, business.industry, plasmodium-falciparum malaria, PLASMODIUM-FALCIPARUM MALARIA, medicine.disease, Verbal autopsy, Malaria, PROSPECTIVE COHORT, severe febrile illness, business, Demography
Abstract

BACKGROUND: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration.METHODS: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets.FINDINGS: Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990.INTERPRETATION: Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action.FUNDING: Bill & Melinda Gates Foundation.

Published
2014

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