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Kidney cancer, a type of urogenital cancer, imposes a high burden on patients. Despite this, no recent research has evaluated the burden of this type of cancer in the Middle East and North Africa (MENA) region. This study explored the burden of kidney cancer from 1990 to 2019 according to age, sex and socio-demographic index (SDI). The Global Burden of Disease (GBD) 2019 data was utilized to estimate the incidence, death, and disability-adjusted life-years (DALYs) caused by kidney cancer. These estimates were reported as counts and as age-standardised rates with 95% uncertainty intervals (UIs). The estimated age-standardised incidence, mortality, and DALY rates of kidney cancer in 2019 were 3.2 (2.8–3.6), 1.4 (1.2–1.6), and 37.2 (32.0–42.6) per 100,000, respectively. Over the period from 1990 to 2019, these rates have increased by 98.0%, 48.9%, and 37.7%, respectively. In 2019, the United Arab Emirates, Qatar, and Lebanon had the largest age-standardised incidence, mortality, and DALY rates. The smallest age-standardised incidence rates were seen in Yemen, Afghanistan, and the Syrian Arab Republic. Additionally, the smallest age-standardised mortality and DALY rates were observed in the Syrian Arab Republic, Yemen, and Morocco. The highest incidence rates were found among individuals aged 75–79 in both males and females. In 2019, the MENA/Global DALY ratio exceeded one for females aged 5–19 age and males aged 5–14, compared to 1990age groups in males. The burden of kidney cancer consistently rose with increasing SDI levels from 1990 to 2019. The increasing burden of kidney cancer highlights the urgent need for interventions aimed at improving early diagnosis and treatment in the region. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is one of the leading causes of disability. We aimed to report the MDD-attributable prevalence, incidence and years lived with disability (YLDs) in the Middle East and North Africa (MENA) region from 1990 to 2019 by age, sex and socio-demographic index (SDI). Methods: Publicly available data on the burden of MDD were retrieved from the Global Burden of Disease (GBD) study 2019 for the 21 countries in MENA. The counts and age-standardised rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals. Results: In 2019, MDD had an age-standardised point prevalence of 3322.1 and an incidence rate of 4921.7 per 100,000 population in MENA. Furthermore, there were 4.1 million YLDs in 2019. However, there were no substantial changes in the MDD burden over the period 1990–2019. In 2019, Palestine had the highest burden of MDD. The highest prevalence, incidence and YLDs attributable to MDD were found in the 35–39 age group. In 2019, the YLD rate in MENA was higher than the global rate for almost all age groups. Furthermore, there was a broadly negative association between the YLD rate and SDI. Conclusion: The study highlights the need to prevent the disorder using a multidisciplinary approach and for the provision of cost-effective treatments for those affected, in order to increase their quality of life. [ABSTRACT FROM AUTHOR]

Background: There are several types of dermatitis, each capable of causing enduring changes that extend beyond physical discomfort. In severe cases, dermatitis can significantly affect mental health, social interactions, and the overall quality of life. This study reports the burden of dermatitis in the Middle East and North Africa (MENA) region from 1990 to 2019, according to sex, age category, and socio-demographic index (SDI). Methods: Publicly available data regarding the point prevalence, incidence, and years lived with disability (YLDs) were collected from the Global Burden of Disease 2019 study for both the MENA region and its constituent countries. The point prevalence, incidence, and YLDs of dermatitis were represented as counts and age-standardised rates with 95% uncertainty intervals (UIs). Results: In 2019, the age-standardised point prevalence of dermatitis was 2744.6 (2517.8–3003.1) per 100,000 population, which was 2.3% lower than in 1990. The YLD rate was 92.3 (55.6–143.4) per 100,000 population, which was 3.1% lower than in 1990. The largest point prevalence rates were observed among those aged 70–74, for both sexes. The 2019 MENA/Global DALY ratio was not above one in any age group for either sex. During the period 1990 to 2019, there was no clear correlation between the burden of dermatitis and the SDI level. Conclusion: The dermatitis burden in the MENA region remained relatively stable from 1990 to 2019. Future prevention efforts should focus on improving healthcare access, health education, and workplace safety regulations. [ABSTRACT FROM AUTHOR]

Background: Neck pain is a complex musculoskeletal disorder that can result in substantial morbidity. The present article presents the neck pain burden in Iranians who were at least 70 years old, from 1990 to 2019, by sex, age group, and province. Methods: Publicly available information on the prevalence, incidence, and years lived with disability (YLD) caused by neck pain was extracted from the Global Burden of Disease study 2019. The estimates were all provided as counts and age‐standardized rates (per 100,000), and included 95% uncertainty intervals. Results: The point prevalence of neck pain in 2019 was 8710.6, while the incidence rate was 1334.7 per 100,000 population. That same year, there were number of 27.8 thousand YLDs and an YLD rate of 801.7 per 100,000. The prevalence, incidence, and YLD rates did not change substantially over the measurement period (1990–2019). The highest YLD rate was found in Tehran (960.9 per 100,000), while Kohgiluyeh and Boyer‐Ahmad had the lowest (730.5 per 100,000). Females had slightly higher prevalent cases, incident cases, and YLDs, as well as their corresponding rates in 2019. In 2019, the number of prevalent cases, incident cases, and YLDs peaked in the 70–74 age group, for both sexes, and in all cases they reduced with age. In both 1990 and 2019, Iran had a higher YLD rate than that found among elderly adults in the Middle East and North Africa region. Conclusions: The burden of neck pain in Iran has decreased slightly over the last three decades, but it still imposes a substantial burden and is higher than that found in the rest of the region. Therefore, preventive programs should be initiated at a young age to reduce the attributable burden later in life. [ABSTRACT FROM AUTHOR]

Objective: To report the burden of ADHD in the Middle East and North Africa (MENA) region from 1990 to 2019. Methods: Publicly available data on the burden of ADHD were retrieved from the Global Burden of Disease study 2019. The counts and age-standardized rates (per 100,000) were presented. Results: In 2019, ADHD had an age-standardized point prevalence of 1245.1 and a years lived with disability (YLD) rate of 15.1 per 100,000 in MENA, which were 7.2% (−11 to −3.3) and 7.2% (−11.2 to −2.7) lower, respectively, than in 1990. The highest YLD rate of ADHD was found in the 10 to 14 age group and there were no remarkable differences between males and females. No clear association was found between the YLD rate and the socio-demographic index. Conclusion: The burden of ADHD in the MENA region decreased over the period 1990 to 2019, and regularly updating the epidemiological information is suggested. [ABSTRACT FROM AUTHOR]

Background: The loss of vision is a substantial public health concern that has important implications for an individual's quality of life. The primary objective of this research was to document the burden of vision loss in the Middle East and North Africa (MENA) region, spanning the years 1990–2019, by age group, sex, underlying cause and sociodemographic index (SDI). Methods: Publicly available data concerning the burden of vision loss were acquired from the Global Burden of Disease study 2019. The data encompassed all 21 countries within the MENA region for the period spanning 1990 to 2019. The estimates were reported as raw counts and age-standardised rates per 100,000, accompanied by their corresponding 95% uncertainty intervals (UIs). Results: In 2019, MENA had an age-standardised point prevalence of 7040.0 (95% UI: 6195.0, 8002.7) and an YLD rate of 314.5 (222.1, 427.6) per 100,000 for vision loss, which were 11.1% (-12.5, -9.7) and 24.3% (-27.6, -20.8) lower, respectively, than in 1990. In 2019, Afghanistan [469.6 (333.0, 632.8)] had the largest age-standardised YLD rate and Turkey [210.7 (145.3, 290.9)] had the lowest. All countries showed a decrease in the age-standardised point prevalence and YLD rate between 1990 and 2019, except for Oman, Afghanistan, and Yemen. Furthermore, in 2019 the largest number of prevalent cases and YLDs were found in the 65–69 age group. Also in 2019, the age-standardised YLD rates in MENA exceeded the global averages for most age groups, for both males and females. In 2019, refractive disorders were the most common types of vision loss among children, adolescents, and middle-age adults in MENA, while near vision loss and cataracts were the most common among older adults. Finally, the burden of vision loss had a slightly negatively association with SDI over the period 1990–2019. Conclusion: Although the burden of vision loss has decreased over the last three decades, the prevalence remains high. These results underscore the importance of healthcare policymakers taking action to implement preventive measures, especially among the elderly and those living in low socioeconomic countries, to decrease the attributable burden in MENA. [ABSTRACT FROM AUTHOR]

Background and Aim: Globally, pancreatic cancer is recognized as one of the most lethal types of cancers. We report the burden of pancreatic cancer and its attributable risk factors in the Middle East and North Africa (MENA) region, from 1990 to 2019, by age, sex, and socio‐demographic index. Methods: Publicly available data from the Global Burden of Disease 2019 study were used to report the incidence, deaths, and disability‐adjusted life years (DALYs) attributable to pancreatic cancer, as counts and age‐standardized rates with 95% uncertainty intervals. Results: In 2019, pancreatic cancer had an age‐standardized incidence rate of 5.3 and a death rate of 5.5 (per 100 000) in MENA, which have increased by 97.5% and 93.4%, respectively, since 1990. There were 563.6 thousand DALYs attributable to pancreatic cancer in 2019, with an age‐standardized DALY rate of 123.0, which has increased by 84.9% since 1990. The highest number of incident cases was found in the 60–64 and 65–69 age groups, among male and female, respectively. In addition, the MENA/global DALY ratios were higher in all age groups for both sexes in 2019, than they were in 1990. There was a positive association between socio‐demographic index and the burden of pancreatic cancer. Smoking, high fasting plasma glucose, and high body mass index were responsible for 19.2%, 9.3%, and 9.3% of the attributable DALYs in 2019, respectively. Conclusions: There was a clear and substantial increase in the burden of pancreatic cancer in the MENA region. Prevention programs should be implemented in the region that target these three risk factors. [ABSTRACT FROM AUTHOR]

Background: The present study reported the cancer deaths and disability‐adjusted life years (DALYs) that were attributable to high fasting plasma glucose (HFPG) in the Middle East and North Africa (MENA) region by country, age, sex, cancer type and Socio‐demographic Index (SDI), from 1990 to 2019. Methods: Global Burden of Disease (GBD) 2019 data were used to report the cancer‐related deaths and DALYs that were attributable to HFPG, for all MENA countries over the period 1990–2019. The results were presented as numbers, population attributable fractions (PAFs) and rates (per 100,000) with 95% uncertainty intervals. Results: In 2019, there were an estimated 19.8 thousand (5.5–40.2) cancer deaths attributable to HFPG in MENA, which represents 4.7% (1.3–9.3) of all cancer‐related deaths. The number of regional DALYs due to HFPG‐related cancers was 462.2 thousand (127.3–959.5), which represents 3.8% (1.1–7.6) of all cancer‐related DALYs in 2019. From 1990 to 2019, the age‐standardized DALY rate of cancers attributable to HFPG (per 100,000) grew from 56.3 (14.6–121.1) to 107.0 (29.8–220.8), which was a 90.1% (64.4–127.8) increase. In 2019, the highest age‐standardized DALY rate of cancers attributable to HFPG was in Qatar (270.4) and the lowest was in Sudan (75.3). The DALY rate of cancers attributable to HFPG increased with age, peaking for males in the 70–74 age group and for females in the 75–79 age group, and then decreased for both sexes. A broadly positive relationship was found between the national SDI and the national age‐standardized DALY rate of all cancers attributable to FPG over the measurement period. Conclusions: The burden of HFPG‐related cancers has increased over the past three decades in MENA, and was higher than the global average in multiple age groups. Implementing a battery of preventive measures and therapeutic interventions is suggested to address the adverse effects of this modifiable risk factor. [ABSTRACT FROM AUTHOR]

Objective: We aimed to report the burden of bulimia nervosa (BN) in the Middle East and North Africa (MENA) region by age, sex, and sociodemographic index (SDI), for the period 1990–2019. Methods: Estimates of the prevalence, incidence, and disability‐adjusted life‐years (DALYs) attributable to BN were retrieved from the Global Burden of Disease study 2019, between 1990 and 2019, for the 21 countries in the MENA region. The counts and age‐standardized rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals. Results: In 2019, the estimated regional age‐standardized point prevalence and incidence rates of BN were 168.3 (115.0–229.6) and 178.6 (117.0–255.6) per 100,000, which represented 22.0% (17.5–27.2) and 10.4% (7.1–14.7) increases, respectively, since 1990. Moreover, in 2019 the regional age‐standardized DALY rate was 35.5 (20.6–55.5) per 100,000, which was 22.2% (16.7–28.2) higher than in 1990. In 2019, Qatar (58.6 [34.3–92.5]) and Afghanistan (18.4 [10.6–29.2]) had the highest and lowest age‐standardized DALY rates, respectively. Regionally, the age‐standardized point prevalence of BN peaked in the 30–34 age group and was more prevalent among women. In addition, there was a generally positive association between SDI and the burden of BN across the measurement period. Discussion: In the MENA region, the burden of BN has increased over the last three decades. Cost‐effective preventive measures are needed in the region, especially in the high SDI countries. Public Significance: This study reports the estimated burden of BN in the MENA region and shows that its burden has increased over the last three decades. [ABSTRACT FROM AUTHOR]

Background: Low back pain (LBP) is the most common musculoskeletal disorder globally. Providing region- and national-specific information on the burden of low back pain is critical for local healthcare policy makers. The present study aimed to report, compare, and contextualize the prevalence, incidence and years lived with disability (YLDs) of low back pain in the Middle East and North Africa (MENA) region by age, sex and sociodemographic index (SDI), from 1990 to 2019. Methods: Publicly available data were obtained from the Global Burden of Disease (GBD) study 2019. The burden of LBP was reported for the 21 countries located in the MENA region, from 1990 to 2019. All estimates were reported as counts and age-standardised rates per 100,000 population, together with their corresponding 95% uncertainty intervals (UIs). Results: In 2019, the age-standardised point prevalence and incidence rate per 100,000 in MENA were 7668.2 (95% UI 6798.0 to 8363.3) and 3215.9 (95%CI 2838.8 to 3638.3), which were 5.8% (4.3 to 7.4) and 4.4% (3.4 to 5.5) lower than in 1990, respectively. Furthermore, the regional age-standardised YLD rate in 2019 was 862.0 (605.5 to 1153.3) per 100,000, which was 6.0% (4.2 to 7.7) lower than in 1990. In 2019, Turkey [953.6 (671.3 to 1283.5)] and Lebanon [727.2 (511.5 to 966.0)] had the highest and lowest age-standardised YLD rates, respectively. There was no country in the MENA region that showed increases in the age-standardised prevalence, incidence or YLD rates of LBP over the measurement period. Furthermore, in 2019 the number of prevalent cases were highest in the 35–39 age group, with males having a higher number of cases in all age groups. In addition, the age-standardised YLD rates for males in the MENA region were higher than the global estimates in almost all age groups, in both 1990 and 2019. Furthermore, the burden of LBP was not associated with the level of socio-economic development during the measurement period. Conclusion: The burden attributable to LBP in the MENA region decreased slightly from 1990 to 2019. Furthermore, the burden among males was higher than the global average. Consequently, more integrated healthcare interventions are needed to more effectively alleviate the burden of low back pain in this region. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) remains a common disabling progressive neurodegenerative disorder. We aimed to report the prevalence, death and disability-adjusted life-years (DALYs) attributable to PD in the Middle East and North Africa (MENA) region and its 21 countries by age, sex and socio-demographic index (SDI), between 1990 and 2019. Methods: Publicly available data on the burden of PD in the MENA countries were retrieved from the Global Burden of Disease (GBD) 2019 project. The results are presented with age-standardised numbers and rates per 100,000 population, along with their corresponding 95% uncertainty intervals (UIs). Results: In 2019, PD had an age-standardised point prevalence of 82.6 per 100,000 population in MENA and an age-standardised death rate of 5.3, which have increased from 1990 to 2019 by 15.4% and 2.3%, respectively. In 2019, the age-standardised DALY rate of PD was 84.4, which was 0.9% higher than in 1990. The highest and lowest age-standardised DALY rates of PD in 2019 were found in Qatar and Kuwait, respectively. Also in 2019, the highest number of prevalent cases and number of DALYs were found in the 75–79 age group for both sexes. In 2019, females in MENA had an overall higher DALY rate. Furthermore, from 1990 to 2019 the burden of PD generally decreased with increasing socio-economic development, up to an SDI of around 0.4, and then increased with higher levels of SDI. Conclusion: An upward trend was observed in the point prevalence of PD over the last three decades. This highlights the need to allocate more resources for research. Furthermore, properly equipped healthcare services are needed for the increasing number of patients with PD. [ABSTRACT FROM AUTHOR]

Background: Lower respiratory infections (LRIs) cause substantial mortality and morbidity. The present study reported and analysed the burden of LRIs in the Middle East and North Africa (MENA) region between 1990 and 2019, by age, sex, etiology, and socio-demographic index (SDI). Methods: The data used in this study were sourced from the Global Burden of Disease (GBD) study 2019. The annual incidence, deaths, and disability-adjusted life-years (DALYs) due to LRIs were presented as counts and age-standardised rates per 100,000 population, along with their 95% uncertainty intervals (UIs). The average annual percent changes (AAPC) in the age-standardised incidence, death and DALYs rates were calculated using Joinpoint software and correlations (Pearson's correlation coefficient) between the AAPCs and SDIs were calculated using Stata software. Results: In 2019, there were 34.1 million (95% UI 31.7–36.8) incident cases of LRIs in MENA, with an age-standardised rate of 6510.2 (95% UI 6063.6–6997.8) per 100,000 population. The number of regional DALYs was 4.7 million (95% UI 3.9–5.4), with an age-standardised rate of 888.5 (95% UI 761.1–1019.9) per 100,000 population, which has decreased since 1990. Furthermore, Egypt [8150.8 (95% UI 7535.8–8783.5)] and Afghanistan [61.9 (95% UI 52.1–72.6)] had the highest age-standardised incidence and death rates, respectively. In 2019, the regional incidence and DALY rates were highest in the 1–4 age group, in both females and males. In terms of deaths, pneumococcus and H. influenza type B were the most and least common types of LRIs, respectively. From 1990 to 2019, the burden of LRIs generally decreased with increasing SDI. There were significant positive correlations between SDI and the AAPCs for the age-standardised incidence, death and DALY rates (p < 0.05). Over the 1990–2019 period, the regional incidence, deaths and DALYs attributable to LRIs decreased with AAPCs of − 1.19% (− 1.25 to − 1.13), − 2.47% (− 2.65 to − 2.28) and − 4.21% (− 4.43 to − 3.99), respectively. Conclusions: The LRI-associated burden in the MENA region decreased between 1990 and 2019. SDI had a significant positive correlation with the AAPC and pneumococcus was the most common underlying cause of LRIs. Afghanistan, Yemen and Egypt had the largest burdens in 2019. Further studies are needed to investigate the effectiveness of healthcare interventions and programs to control LRIs and their risk factors. [ABSTRACT FROM AUTHOR]

Objective. This study reported the burden of gout and its attributable risk factors in the Middle East and North Africa (MENA) region between 1990 and 2019 by age, sex, and sociodemographic index (SDI). Methods. Data on the prevalence, incidence, and years lived with disability (YLD) due to gout were obtained from the Global Burden of Disease 2019 study for the 21 countries in the MENA region, from 1990 to 2019. Results. In 2019, the regional age-standardized point prevalence and annual incidence rates of gout were 509.1 and 97.7 per 100,000 population, which represent a 12% and 11.1% increase since 1990, respectively. Moreover, in 2019 the regional age-standardized YLD rate was 15.8 per 100,000 population, an 11.7% increase since 1990. In 2019, Qatar and Afghanistan had the highest and lowest age-standardized YLD rates, respectively. Regionally, the age-standardized point prevalence of gout increased with age up to the oldest age group, and it was more prevalent among males in all age groups. In addition, there was an overall positive association between SDI and the burden of gout between 1990 and 2019. In 2019, high BMI (46.1%) was the largest contributor to the burden of gout in the MENA region. Conclusion. There were large intercountry variations in the burden of gout, but in general, it has increased in MENA over the last 3 decades. This increase is in line with the global trends of gout. However, the age-standardized YLD rate change was higher in MENA than at the global level. [ABSTRACT FROM AUTHOR]

Background: Anorexia nervosa (AN) is a complex and heritable psychiatric disorder, which imposes significant mortality and morbidity on sufferers globally. We aimed to report the prevalence, incidence and disability-adjusted life-years (DALYs) attributable to AN in the Middle East and North Africa (MENA) region by age, sex and socio-demographic index (SDI), between 1990 and 2019. Methods: The disease burden attributable to AN was obtained for the 21 countries located in the MENA region between 1990 and 2019 using publicly available data from the Global Burden of Disease (GBD) 2019 study. All estimates were provided as counts and age-standardized rates per 100,000 population, along with 95% uncertainty intervals (UIs). Results: In 2019, the estimated age-standardised point prevalence and incidence rate of AN (per 100,000) in MENA were 49.3 (95% UI: 34.6–70.4) and 16.0 (11.3–22.0), which were 11.4% (7.3–15.4) and 5.9% (2.6–9.1) higher than in 1990, respectively. Furthermore, the regional age-standardised DALY rate was 10.6 (6.3–17.0) per 100,000 in 2019, which was 11.8% (5.2–19.1) higher than in 1990. In 2019, Kuwait [17.3 (10.3-27.9)] and Afghanistan [6.3 (3.7-10.3)] had the highest and lowest age-standardised DALY rates, respectively. In addition, Iran showed the largest increases in the age-standardised point prevalence [30.0% (24.1–36.2)], incidence [24.6% (18.6–30.4)] and DALY [30.5% (22.6–38.9)] rates between 1990 and 2019. In 2019, the number of prevalent cases and prevalence estimates peaked in the 15–19 age group for males and the 20–24 age group for females, with females having a higher number of cases and prevalence in all age groups. In 2019, the age-standardised DALY rates in MENA were higher than the global rates among males aged 10–34 years, but were lower than the global estimates among females in almost all age groups. In addition, the burden of AN was positively associated with the level of socio-economic development during the measurement period. Conclusions: The burden of AN in the MENA region increased between 1990 and 2019, which indicates that it is likely to become a more serious public health issue in the future. Up-to-date information about the epidemiological trends in the region would allow health policymakers to make informed and appropriate decisions to help address this issue. Plain English summary: The findings of the present study showed that the point prevalence and incidence rate of anorexia nervosa have increased in the Middle East and North Africa region between 1990 and 2019. The highest burden in 2019 was found in Kuwait, while Afghanistan had the lowest attributable burden. In addition, between 1990 and 2019 Iran had the largest increase in the point prevalence of anorexia nervosa. Also in 2019, anorexia nervosa was more prevalent in females and peaked in the 15–19 age group for males and the 20–24 age group for females. Furthermore, as the level of socioeconomic development increased, so did the burden attributable to anorexia nervosa. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease that is characterised by persistent respiratory symptoms and airflow limitation. The present study reported the burden of COPD, and its attributable risk factors, in the Middle East and North Africa (MENA) region between 1990 and 2019, by age, sex and socio-demographic index (SDI).Methods: Data from the Global Burden of Disease (GBD) 2019 study were used to report the burden of COPD in the MENA countries. The prevalence, deaths, and disability-adjusted life-years (DALYs) were presented as counts and age-standardised rates per 100,000 population, with their associated 95% uncertainty intervals (UIs).Results: In 2019, the regional age-standardised point prevalence and rates of death due to COPD were 2333.9 (2230.1, 2443.6) and 26.1 (22.2, 29.5) per 100,000, which represent a 30.6% (28.2%, 33.0%) increase and an 18.0% (2.8%, 30.9%) decrease, respectively, since 1990. The regional age-standardised DALY rate in 2019 was 649.1 (574.6, 717.7) per 100,000, which had decreased by 11.8% (0.9%, 21.1%) since 1990. Turkey had the highest age-standardised point prevalence in 2019 [3287.1 (3187.4, 3380.3)], while Afghanistan had the highest age-standardised death [40.4 (24.2, 52.6)] and DALY [964.5 (681.8, 1203.2)] rates. The regional age-standardised point prevalence, death and DALY rates in 2019 increased with advancing age and were higher in males in almost all age groups. There was a U-shaped association between SDI and the burden of COPD over the period 1990 to 2019. Moreover, in 2019 smoking (43.7%), ambient particulate matter pollution (22.8%) and occupational particulate matter (11.4%) had the largest proportion of attributable DALYs for both sexes.Conclusions: COPD is one of the leading causes of death and disability in the MENA region, although the age-standardised burden has decreased over the last 30 years. Nevertheless, COPD accounted for a substantial number of deaths and DALYs, especially among the elderly. Programs targeting risk factors, like smoking, should be taken into consideration. [ABSTRACT FROM AUTHOR]

Alcohol consumption is associated with a number of diseases and injuries, including cardiovascular diseases, cancers, mental and neurological disorders, as well as transport-related injuries. This article reports the alcohol-attributable burden of diseases and injuries at the regional and national levels in the Middle East and North Africa (MENA) region between 1990 and 2019, by sex, age, underlying cause, and Socio-demographic Index (SDI). The regional deaths and disability-adjusted life-years (DALYs) attributable to alcohol consumption were reported for the MENA region, between 1990 and 2019, using the methodological framework and analytical strategies adopted by the Global Burden of Disease (GBD) study 2019. The estimates were all reported as counts, population-attributable fractions, and age-standardised rates per 100,000 population, along with their corresponding 95% uncertainty intervals (UIs). Also, the average annual percentage changes were used to represent the trends of age-standardised rates. In 2019, there were an estimated 22.0 thousand deaths (95% UI: 16.1–29.4) and 1.1 million DALYs (0.8–1.3) attributable to alcohol consumption in the MENA region. The number of DALYs attributable to alcohol consumption were much higher in men (878.0 thousand, 691.4–1104.8) than among women (181.8, 138.6–232.0). The overall age-standardised death and DALY rates attributable to alcohol consumption decreased by 34.5% (13.2–48.3) and 31.9% (16.9–42.5), respectively, over the study period. Egypt (10.1 [5.7–16.6]) and Kuwait (1.1 [0.8–1.5]) had the highest and lowest age-standardised death rates attributable to alcohol consumption, respectively. In 2019, the number of deaths and DALYs in the MENA region were highest in those aged 60–64 and 50–54 years, respectively. A negative association was observed between a country's SDI and their corresponding age-standardised DALY rates over the period 1990 to 2019. Digestive diseases were the main contributor to the alcohol-attributable burden. Over 1990–2019, the regional deaths and DALYs of diseases and injuries attributable to alcohol consumption decreased with AAPC of − 1.45 (− 1.78 to − 1.12) and − 1.31 (− 1.46 to − 1.15), respectively. The death and DALY rates attributable to alcohol consumption in the MENA region have decreased over the past three decades. Further decreases can be facilitated by implementing country-level policies and increasing public awareness. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease. The present study reported the burden of RA in the Middle East and North Africa (MENA) region from 1990 to 2019 by age, sex, and socio-demographic index (SDI). Publicly available data from the Global Burden of Disease (GBD) 2019 study was used to report the modelled point prevalence, annual incidence, and disability-adjusted life-years (DALYs) of RA, as counts and age-standardised rates with their corresponding 95% uncertainty intervals (UIs). In 2019, RA had an age-standardised point prevalence of 120.6 per 100,000 population (107.0–135.7) and an annual incidence rate of 5.9 (5.2–6.6) in MENA, which have increased 28.3% and 25.2%, respectively, since 1990. In 2019, the number of DALYs due to RA in the region was 103.6 thousand (74.2–136.7), with an age-standardised rate of 19.0 (13.9–24.9) DALYs per 100,000 population, which has increased by 18.6% since 1990 (6.7–28.2). The highest point prevalence was found in females aged 50–54, and in males aged 45–49. The highest number of DALYs was observed in the 50–54 age group. The MENA DALY rate was lower than the global rate (19.0 vs. 39.6 per 100,000), but the rate was higher in all age groups in 2019, when compared with 1990. In addition, from 1990 to 2019 an increased burden from RA was associated with an increase in SDI. In line with global trends, the burden of RA in the MENA region showed a steady increase from 1990 to 2019. This highlights the increasing need for updating the available health data to design more accurate guidelines to enable the early detection and treatment of RA in the MENA countries. [ABSTRACT FROM AUTHOR]

Introduction: Tension-type headache (TTH) is the most prevalent neurological disorder. As there is a gap in the literature regarding the disease burden attributable to TTH in the Middle East and North Africa (MENA) region, the aim of the present study was to report the epidemiological indicators of TTH in MENA, from 1990 to 2019, by sex, age and socio-demographic index (SDI). Methods: Publicly available data on the point prevalence, annual incidence and years lived with disability (YLDs) were retrieved from the global burden of disease (GBD) 2019 study for the 21 countries and territories in MENA, between 1990 and 2019. The results were presented with numbers and age-standardised rates per 100000 population, along with their corresponding 95% uncertainty intervals (UIs). Results: In 2019, the age-standardised point prevalence and annual incidence rates for TTH in the MENA region were 24504.5 and 8680.1 per 100000, respectively, which represents a 2.0% and a 0.9% increase over 1990-2019, respectively. The age-standardised YLD rate of TTH in this region in 2019 was estimated to be 68.1 per 100000 population, which has increased 1.0% since 1990. Iran [29640.4] had the highest age-standardised point prevalence rate for TTH, while Turkey [21726.3] had the lowest. In 2019, the regional point prevalence of TTH was highest in the 35-39 and 70-74 age groups, for males and females, respectively. Furthermore, the number of prevalent cases was estimated to be highest in those aged 35-39 and 25-29 years, in both males and females, respectively. Moreover, the burden of TTH was not observed to have a clear association with SDI. Conclusions: While the prevalence of TTH in the MENA region increased from 1990 to 2019, the incidence rate did not change. In addition, the burden of TTH in MENA was higher than at the global level for both sexes and all age groups. Therefore, prevention of TTH would help alleviate the attributable burden imposed on the hundreds of millions of people suffering from TTH around the region. [ABSTRACT FROM AUTHOR]

Background: There is no region-specific publication investigating the attributable burden of breast cancer, particularly among females. This article reported the burden of female breast cancer in the Middle East and North Africa (MENA) region, and its attributable risk factors between 1990 and 2019, by age, sex, and socio-demographic index (SDI). Methods: Publicly available data on the incidence, death and disability-adjusted life years (DALY) were retrieved from the Global Burden of Disease (GBD) 2019 study for the 21 countries and territories in MENA, between 1990 and 2019, along with 95% uncertainty intervals (UIs). The relationship between the burden of female breast cancer, in terms of DALYs, and the SDI were also assessed using Smoothing Spline models. Results: In 2019, the regional age-standardised incidence and death rates of female breast cancer were 37.5 and 15.2 per 100,000, which represent a 90.9 and 24.0% increase since 1990, respectively. In addition, in 2019 the regional age-standardised DALY rate was 472.7 per 100,000, which was 19.5% higher than in 1990. In 2019, the death rate increased steadily with advancing age, while the DALY rate increased steeply with age and reached its peak in the 70–74 age group. There was a positive association between SDI and the burden of breast cancer over the period 1990 to 2019. Moreover, in 2019 high fasting plasma glucose (6.9%) contributed to the largest proportion of attributable DALYs for female breast cancer in the MENA region. Conclusions: There was a significant increase in the incidence rate of female breast cancer in MENA over the past three decades, although the death and DALY rates were both largely unchanged. Preventive programs targeting the major risk factors should be implemented in the region. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is one of the most important contributing factors to infertility. In this study, we report the burden of PCOS by age and sociodemographic index (SDI) for the 21 countries in the Middle East and North Africa (MENA) region. Publicly available data on the point prevalence, incidence and years lived with disability (YLDs), from 1990 to 2019, were retrieved from the Global Burden of Disease (GBD) 2019 study for the 21 countries in MENA. The results are presented with age-standardised numbers and rates per 100,000 population, along with their corresponding 95% uncertainty intervals (UIs). In 2019, the age-standardised point prevalence and incidence rate for PCOS in the MENA region were 2079.7 (95% UI: 1392.0 to 2812.3) and 77.2 (95% UI: 51.6 to 105.4) per 100,000, respectively, which represents a 37.9% (95% UI: 31.7 to 45.0) and a 33.7% (95% UI: 27.7 to 40.3) increase since 1990, respectively. Also in 2019, the age-standardised YLD rate of PCOS in this region was 18.7 (95% UI: 7.8 to 37.9) per 100,000 women, which has increased by 36.1% (95% UI: 29.4 to 43.4) since 1990. Kuwait [25.4 (10.7, 51.2)] had the highest age-standardised YLD rate, while Afghanistan [10.8 (10.1, 49.2)] had the lowest. Moreover, the largest increase in the YLD rate, from 1990 to 2019, was seen in Sudan [90.3% (64.1, 120.9)], whereas no country decreased during the measurement period. The total prevalent number and point prevalence of PCOS (per 100,000) were both highest in the 20–24 age group. The prevalence of PCOS was highest among women of reproductive age, but decreased rapidly after 45 years of age. Moreover, at the country level there was a positive association between SDI and the age-standardised YLD rates of PCOS. The growing prevalence and burden of PCOS in the MENA region highlights the need to implement cost-effective preventive programs, especially for women in their third decade of life, and in MENA countries with higher SDI levels. [ABSTRACT FROM AUTHOR]

Stroke is one of the leading causes of mortality and morbidity across the globe. Providing comprehensive data on the burden of stroke in the Middle East and North Africa (MENA) could be useful for health policy makers in the region. Therefore, this article reported the burden of stroke and its attributable risk factors between 1990 and 2019 by age, sex, type of stroke, and socio-demographic index. Data on the point prevalence, death, and disability-adjusted life-years (DALYs), due to stroke, were retrieved from the Global Burden of Disease study 2019 for the 21 countries located in the MENA region from 1990 to 2019. The counts and age-standardised rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals (UIs). In 2019, the regional age-standardised point prevalence and death rates of stroke were 1537.5 (95% UI: 1421.9–1659.9) and 87.7 (78.2–97.6) per 100,000, which represent a 0.5% (− 2.3 to 1.1) and 27.8% (− 35.4 to − 16) decrease since 1990, respectively. Moreover, the regional age-standardised DALY rate in 2019 was 1826.2 (1635.3–2026.2) per 100,000, a 32.0% (− 39.1 to − 23.3) decrease since 1990. In 2019, Afghanistan [3498.2 (2508.8–4500.4)] and Lebanon [752.9 (593.3–935.9)] had the highest and lowest age-standardised DALY rates, respectively. Regionally, the total number of stroke cases were highest in the 60–64 age group and was more prevalent in women in all age groups. In addition, there was a general negative association between SDI and the burden of stoke from 1990 to 2019. Also, in 2019, high systolic blood pressure [53.5%], high body mass index [39.4%] and ambient particulate air pollution [27.1%] made the three largest contributions to the burden of stroke in the MENA region. The stroke burden has decreased in the MENA region over the last three decades, although there are large inter-country differences. Preventive programs should be implemented which focus on metabolic risk factors, especially among older females in low SDI countries. [ABSTRACT FROM AUTHOR]

Background: Transport-related injuries (TIs) are a substantial public health concern for all regions of the world. The present study quantified the burden of TIs and deaths in the Eastern Mediterranean region (EMR) in 2017 by sex and age. Methods: TIs and deaths were estimated by age, sex, country, and year using Cause of Death Ensemble modelling (CODEm) and DisMod-MR 2.1. Disability-adjusted life years (DALYs), which quantify the total burden of years lost due to premature death or disability, were also estimated per 100 000 population. All estimates were reported along with their corresponding 95% uncertainty intervals (UIs). Results: In 2017, there were 5.5 million (UI 4.9-6.2) transport-related incident cases in the EMR -- a substantial increase from 1990 (2.8 million; UI 2.5-3.1). The age-standardized incidence rate for the EMR in 2017 was 787 (UI 705.5-876.2) per 100 000, which has not changed significantly since 1990 (-0.9%; UI -4.7 to 3). These rates differed remarkably between countries, such that Oman (1303.9; UI 1167.3-1441.5) and Palestine (486.5; UI 434.5-545.9) had the highest and lowest age-standardized incidence rates per 100 000, respectively. In 2017, there were 185.3 thousand (UI 170.8-200.6) transport-related fatalities in the EMR -- a substantial increase since 1990 (140.4 thousand; UI 118.7-156.9). The age-standardized death rate for the EMR in 2017 was 29.5 (UI 27.1-31.9) per 100 000, which was 30.5% lower than that found in 1990 (42.5; UI 36.8-47.3). In 2017, Somalia (54; UI 30-77.4) and Lebanon (7.1; UI 4.8-8.6) had the highest and lowest age-standardized death rates per 100,000, respectively. The age-standardised DALY rate for the EMR in 2017 was 1,528.8 (UI 1412.5-1651.3) per 100 000, which was 34.4% lower than that found in 1990 (2,331.3; UI 1,993.1-2,589.9). In 2017, the highest DALY rate was found in Pakistan (3 454 121; UI 2 297 890-4 342 908) and the lowest was found in Bahrain (8616; UI 7670-9751). Conclusion: The present study shows that while road traffic has become relatively safer (measured by deaths and DALYs per 100 000 population), the number of transport-related fatalities in the EMR is growing and needs to be addressed urgently. [ABSTRACT FROM AUTHOR]

The article presents correction to one of the published article in the journal which discussed burden of tension-type headache in the Middle East and North Africa region, from 1990-2019; the authors reported that in the Methods section, several citations to references were incorrect.

High systolic blood pressure (HSBP) is associated with several metabolic and non-metabolic disorders. This research aimed to document the deaths and disability-adjusted life-years (DALYs) attributable to HSBP in the Middle East and North Africa (MENA) region between 1990 and 2019, by age, sex, underlying cause and socio-demographic index (SDI). We used the methodological framework and data drawn from the Global Burden of Disease study 2019 to identify the burden of diseases attributable to HSBP, from 1990 to 2019, in the MENA region. The estimates reported were presented as counts, population-attributable fractions, and age-standardised rates (per 100,000), along with 95% uncertainty intervals. In 2019, 803.6 thousand (687.1 to 923.8) deaths were attributed to HSBP in MENA, which accounted for 25.9% (22.9-28.6%) of all deaths. The number of regional DALYs caused by HSBP in 2019 was 19.0 million (16.3-21.9 million), which accounted for 11.6% (10.1-13.3%) of all DALYs, and was 23.4% (15.9-31.5%) lower than in 1990. The highest age-standardised DALY rate for 2019 was observed in Afghanistan, with the lowest in Kuwait. Additionally, the DALY rate in MENA rose with age for both sexs. Furthermore, a negative linear relationship was found between SDI and the age-standardised DALY rates. The region has a substantial HSBP-related burden. Policymakers and healthcare professionals should prioritize interventions that effectively promote the early detection of HSBP, access to quality healthcare, and lifestyle modifications to mitigate the HSBP burden in the MENA countries., (© 2024. The Author(s).)

Schizophrenia ranks as the third-most common cause of disability among mental disorders globally. This study presents findings on the prevalence, incidence and years lived with disability (YLDs) as a result of schizophrenia in the Middle East and North Africa (MENA), stratified by age, sex and sociodemographic index (SDI). We collected publicly accessible data from the Global Burden of Disease (GBD) study 2019. This study reports the burden of schizophrenia, from 1990 to 2019, for the 21 countries that comprise MENA. In 2019, MENA exhibited an age-standardised point prevalence of 248.2, an incidence rate of 14.7 and an YLD rate of 158.7 per 100,000, which have not changed substantially between 1990 and 2019. In 2019, the age-standardised YLD rate was highest in Qatar and lowest in Afghanistan. No MENA countries demonstrated noteworthy changes in the burden of schizophrenia from 1990 to 2019. Furthermore, in 2019, the highest number of prevalent cases and the point prevalence were observed among those aged 35-39, with a higher prevalence among males in almost all age categories. Additionally, in 2019, the age-standardised YLD rates in MENA were below the worldwide average. Finally, there was a positive correlation between the burden of schizophrenia and the SDI from 1990 to 2019. The disease burden of schizophrenia has remained relatively stable over the past thirty years. Nevertheless, as the regional life-expectancy continues to increase, the burden of schizophrenia is also expected to rise. Therefore, early planning for the increase in the burden of the disease is urgently needed in the region., (© 2024. The Author(s).)

Background: Rheumatic heart disease (RHD) is a treatable and preventable condition resulting from acute rheumatic fever., Aim: To report the prevalence, mortality and disability-adjusted life-years (DALY) due to RHD in the Middle East and North Africa (MENA) region from 1990 to 2019, by sex, age group, country and sociodemographic index (SDI)., Methods: Information on the prevalence, mortality and DALY associated with RHD were obtained from the Global Burden of Disease Study 2019. Data were gathered for all countries in the MENA region over the period 1990-2019. These data included counts and age-standardized rates per 100,000, accompanied by 95% uncertainty intervals (UIs)., Results: The MENA region had an age-standardized point prevalence of 388.9 per 100,000 in 2019, which was 5.4% higher than in 1990. The annual incidence rate was 1.6, which was 63.4% lower than in 1990. There were 379.4 thousand DALY attributable to RHD in 2019, with an age-standardized rate of 67.1, which was 61.3% lower than in 1990. In 2019, an estimated 7.4 thousand deaths were due to RHD, and the age-standardized death rate was 63.4% lower in 2019 than in 1990. DALY rates rose steadily with increasing age in both males and females. The SDI correlated negatively with the rate of DALY for RHD throughout the study period., Conclusion: The burden of RHD in MENA declined from 1990 to 2019, demonstrating the importance of regularly updating health data and identifying risk factors, and developing effective guidelines on prevention., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

High body mass index (BMI), or excess body weight (EBW), represents a significant risk factor for a range of diseases, including cardiovascular diseases and cancers. The study sought to determine the burden of diseases attributable to EBW in the Middle East and North Africa (MENA) region from 1990 and 2019. The analysis also included an exploration of this burden by age, sex, underlying cause, and sociodemographic index (SDI). We utilized publicly available data from the Global Burden of Disease (GBD) study 2019 to identify the deaths and disability-adjusted life-years (DALYs) of diseases associated with EBW in MENA, spanning the period from 1990 to 2019. The GBD estimated the mean BMI and the prevalence of EBW using hierarchical mixed-effects regression, followed by spatiotemporal Gaussian process regression to determine the most accurate BMI distribution through comparison with actual data. In 2019, there were an estimated 538.4 thousand deaths (95% UI 369.9-712.3) and 17.9 million DALYs (12.9-23.1) attributable to EBW in the region. The DALYs attributable to EBW were higher in men (9.3 million [6.5-12.4]) than in women (8.5 million [6.4-10.8]). The age-standardized death and DALY rates for the diseases associated with EBW increased by 5.1% (- 9.0-25.9) and 8.3% (- 6.5-28.8), respectively, during the study period which was not significant. Egypt had the highest age-standardized mortality rate due to EBW (217.7 [140.0, 307.8]), while Yemen (88.6 [45.9, 143.5]) had the lowest. In 2019, the highest number of DALYs occurred among individuals aged 60 to 64 years old. Furthermore, we found a positive association between a nation's SDI and the age-standardized DALY rate linked to EBW. Cardiovascular disease emerged as the leading contributor to the EBW burden in MENA. The disease burden attributable to EBW showed a non-significant increase in MENA from 1990 to 2019., (© 2023. The Author(s).)

Background: Alzheimer's disease (AD) is the most common cause of dementia and this progressive neurological disorder is associated with substantial mortality and morbidity. We aimed to report the burden of AD and other types of dementia in the Middle East and North Africa (MENA) region, by age, sex and sociodemographic index (SDI), for the period 1990-2019., Methods: publicly accessible data on the prevalence, death and disability-adjusted life years (DALYs) because of AD, and other types of dementia, were retrieved from the global burden of disease 2019 project for all MENA countries from 1990 to 2019., Results: in 2019, the age-standardised point prevalence of dementia was 777.6 per 100,000 populations in MENA, which was 3.0% higher than in 1990. The age-standardised death and DALY rates of dementia were 25.5 and 387.0 per 100,000, respectively. In 2019, the highest DALY rate was observed in Afghanistan and the lowest rate was in Egypt. That same year, the age-standardised point prevalence, death and DALY rates increased with advancing age and were higher for females of all age groups. From 1990 to 2019, the DALY rate of dementia decreased with increasing SDI up to 0.4, then slightly increased up to an SDI of 0.75, followed by a decrease for the remaining SDI levels., Conclusions: the point prevalence of AD and other types of dementia has increased over the past three decades, and in 2019, the corresponding regional burden was higher than the global average., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: The present study aims to investigate the knowledge and attitudes towards antibiotics among students studying medicine, dentistry, and pharmacy at the Near East University in Northern Cyprus. The influence of personality characteristics on antibiotic use were also evaluated, in order to identify predictors of antibiotic misuse., Methods: Students were enrolled in the study during the 2020-2021 academic year. Study participants were asked to complete an online questionnaire that measured their knowledge, attitudes and practice (KAP) towards antibiotic use and antibiotic resistance. The KAP of students from the three faculties were compared using Kruskall-Wallis H statistics, Mann-Whitney U statistics, and Spearman's rho. The influence of personality traits on the propensity to use antibiotics without a prescription, as well as their attitudes and knowledge of antibiotic use and misuse, were also investigated., Results: In total, 314 students completed the survey, 52% of which were female. The mean age of the students was 20.5 years. The results showed that among the different disciplines, medical students were significantly more knowledgeable about pharmacological agents, compared to dentistry and pharmacy students, while pharmacy students were more knowledgeable about the effectiveness of antibiotics against different pathogenic microorganisms. All student groups were aware of how antibiotic resistance develops and their role as healthcare personnel in implementing measures against resistance. Appropriate antibiotic use among the student community correlated with study year, highlighting the importance of knowledge and education in the prevention of antibiotic resistance. Personality traits were found to be a contributing factor in students' tendency to use antibiotics without a prescription., Conclusion: This study demonstrates the importance of conveying knowledge about antimicrobials in the education programmes of future dentists, pharmacists and physicians., (© 2022. The Author(s).)