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Purpose:Methods:Results:Conclusion:This study analyzes the prevalence, causes, and distribution of blindness and moderate-to-severe vision impairment (MSVI) in the Middle East and North Africa (MENA) using the Global Burden of Disease (GBD) 2019 dataset.The GBD 2019 dataset was used to analyze vision impairment across 21 countries in MENA according to the Snellen chart classification (moderate vision impairment with presenting visual acuity worse than 6/18, severe impairment worse than 6/60, blindness worse than 3/60). Age-standardized prevalence and regional variations were compared to global averages. An exponential linear regression model was used to forecast MSVI and blindness in the year 2050.As of 2019, approximately 37.2 million people in MENA experienced blindness or vision loss. Although the age-standardized prevalence of vision impairment and blindness in MENA decreased from 1990 to 2019 due to improvements in healthcare, the absolute number has almost doubled (18.58 million in 1990 to 37.19 million in 2019) due to population growth and aging. Between 1990 to 2019, the population aged 70 and older in MENA grew from 7.2 million to over 19.2 million. Lastly, our predictions indicate an 86% increase in the number of individuals with vision loss by 2050.The largest causes of moderate vision loss were refractive errors and cataracts, respectively, while the major causes of blindness were cataracts and glaucoma, respectively. The projection of increased vision impairment by 2050 underscores the urgent need for policy changes and efficient resource distribution to improve healthcare access and interventions. [ABSTRACT FROM AUTHOR]

Background: This study assessed the global trends and burden of severe chest injury, including rib fractures, lung contusions, and heart injuries from 1990 to 2019. Herein, we predicted the burden patterns and temporal trends of severe chest injuries to provide epidemiological evidence globally and in China. Methods: In our analysis, the age-standardized incidence rate (ASIR), prevalence rate (ASPR), and years lived with disability rate (ASYR) of severe chest injury were analyzed by gender, age, sociodemographic index, and geographical region between 1990 and 2019 using data from the Global Burden of Disease study 2019. Trends were depicted by calculating the estimated annual percentage changes (EAPCs). The impact of age, period, and cohort factors was assessed using an Age-Period-Cohort model. Autoregressive integrated moving average (ARIMA) model was employed to predict severe chest injury trends from 2020 to 2050. Results: In 2019, the global number of severe chest injury cases reached 7.95 million, with the highest incidence rate observed in Central Europe (209.61). Afghanistan had the highest ASIRs at 277.52, while North Korea had the lowest ASIRs at 41.02. From 1990 to 2019, the Syrian Arab Republic saw significant increases in ASIR, ASPR, and ASYR, with EAPCs of 10.4%, 9.31%, and 10.3%, respectively. Burundi experienced a decrease in ASIR with an EAPC of − 6.85% (95% confidence interval [CI] − 11.11, − 2.37), while Liberia's ASPR and ASYR declined with EAPCs of − 3.22% (95% CI − 4.73, − 1.69) and − 5.67% (95% CI − 8.00, − 3.28), respectively. Falls and road injuries remained the most common causes. The relative risk of severe chest injury by age, period, and cohort demonstrated a complex effect globally and in China. The ARIMA model forecasted a steady increase in global numbers from 2020 to 2050, while in China, it forecasted an increase in incidence, a decrease in ASIR and ASYR, and an increase in ASPR. Conclusions: This study provides a groundbreaking analysis of global severe chest injury, shedding light on its measures and impact. These findings highlight the need for timely, specialized care and addressing regional disparities to mitigate the severe chest injury burden. [ABSTRACT FROM AUTHOR]

Background Dental caries is one of the most common noncommunicable diseases worldwide, affecting more than one-third of the global population. The analysis of the current situation and trends in the disease burden of dental caries may provide a reference for the prevention and control strategies of dental caries. Objective To analyze the current situation and trends in the incidence, prevalence and years lived with disability (YLD) of dental caries in China and provide a reference for the development of the prevention and control of dental caries. Methods Data on the incidence, prevalence and YLD of caries of deciduous teeth and permanent teeth between 1990 and 2019 in China were extracted from the 2019 Global Burden of Disease (GBD) study. The percentage change in the counts of incident cases, prevalent cases and YLD of caries of deciduous teeth and permanent teeth from 1990 to 2019 was calculated, and Joinpoint regression model was used to analyze the annual percentage change (APC) and average APC (AAPC) in age-standardized rates of incidence, prevalence and YLD between 1990 and 2019 in China. Results Compared with 1990, the counts of incident cases, prevalent cases and YLD of caries of deciduous teeth in China in 2019 decreased by 25.69%, 28.74% and 28.63%, respectively; the counts of incident cases, prevalent cases and YLD of caries of permanent teeth in China in 2019 increased by 17.41%, 15.84% and 15.07%, respectively. In all age groups in 2019, the highest incidence rate (118.96%) of caries of deciduous teeth was observed in children aged 5 to 9 years, as well as the highest prevalence rate (53.08%) and YLD rate (20.40/100, 000) of caries of deciduous teeth in children aged 1 to 4 years. The highest incidence rate (62.30%), prevalence rate (32.19%), and YLD rate (32.41/100 000) of caries of permanent teeth were observed in adults aged 20 to 24 years in 2019. Joinpoint regression analysis showed that the age-standardized rates of incidence (AAPC=0.21%, 95%CI=0.19% to 0.22%), prevalence (AAPC=0.03%, 95%CI=0.01% to 0.05%) and YLD (AAPC=0.03%, 95%CI=0.01% to 0.05%) of caries of deciduous teeth showed an overall upward trend in China between 1990 and 2019, and the age-standardized rates of incidence (AAPC=-0.05%, 95%CI=-0.05% to -0.04%), prevalence (AAPC=-0.23%, 95%CI=-0.32% to -0.14%) and YLD (AAPC=-0.22%, 95%CI=-0.31% to -0.13%) of caries of permanent teeth showed a downward trend in China between 1990 and 2019. Conclusion From 1990 to 2019, the burdens in caries of deciduous teeth in China showed an increasing trend, while the burdens in caries of permanent teeth caries showed a decreasing trend but remained serious in China. Caries prevention should not only be limited to children, but should include people of all age groups.

Abstract Background This study aimed to assess the global, regional, and national burden of liver cirrhosis and other chronic liver diseases between 1990 and 2019, considering five etiologies (hepatitis B, hepatitis C, alcohol use, NAFLD and other causes), age, gender, and sociodemographic index (SDI). Methods Data on liver cirrhosis and other chronic liver diseases mortality, incidence, and disability-adjusted life years (DALYs) were collected from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2019. Results In 2019, liver cirrhosis and other chronic liver diseases accounted for 1,472,011 (95% UI 1,374,608-1,578,731) deaths worldwide, compared to 1,012,975 (948,941-1,073,877) deaths in 1990. Despite an increase in absolute deaths, the age-standardized death rate declined from 24.43 (22.93–25.73) per 100,000 population in 1990 to 18.00 (19.31–16.80) per 100,000 population in 2019. Eastern sub-Saharan Africa exhibited the highest age-standardized death rate (44.15 [38.47–51.91] per 100,000 population), while Australasia had the lowest rate (5.48 [5.05–5.93] deaths per 100,000 population in 2019). The age-standardized incidence rate of liver cirrhosis and other chronic liver diseases attributed to hepatitis B virus has declined since 1990, but incidence rates for other etiologies have increased. Age-standardized death and DALYs rates progressively decreased with higher SDI across different GBD regions and countries. Mortality due to liver cirrhosis and other chronic liver diseases increased with age in 2019, and the death rate among males was estimated 1.51 times higher than that among females globally. Conclusion Liver cirrhosis and other chronic liver diseases continues to pose a significant global public health challenge. Effective disease control, prevention, and treatment strategies should account for variations in risk factors, age, gender, and regional disparities.

Background: This study aimed to assess the global, regional, and national burden of liver cirrhosis and other chronic liver diseases between 1990 and 2019, considering five etiologies (hepatitis B, hepatitis C, alcohol use, NAFLD and other causes), age, gender, and sociodemographic index (SDI). Methods: Data on liver cirrhosis and other chronic liver diseases mortality, incidence, and disability-adjusted life years (DALYs) were collected from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2019. Results: In 2019, liver cirrhosis and other chronic liver diseases accounted for 1,472,011 (95% UI 1,374,608-1,578,731) deaths worldwide, compared to 1,012,975 (948,941-1,073,877) deaths in 1990. Despite an increase in absolute deaths, the age-standardized death rate declined from 24.43 (22.93–25.73) per 100,000 population in 1990 to 18.00 (19.31–16.80) per 100,000 population in 2019. Eastern sub-Saharan Africa exhibited the highest age-standardized death rate (44.15 [38.47–51.91] per 100,000 population), while Australasia had the lowest rate (5.48 [5.05–5.93] deaths per 100,000 population in 2019). The age-standardized incidence rate of liver cirrhosis and other chronic liver diseases attributed to hepatitis B virus has declined since 1990, but incidence rates for other etiologies have increased. Age-standardized death and DALYs rates progressively decreased with higher SDI across different GBD regions and countries. Mortality due to liver cirrhosis and other chronic liver diseases increased with age in 2019, and the death rate among males was estimated 1.51 times higher than that among females globally. Conclusion: Liver cirrhosis and other chronic liver diseases continues to pose a significant global public health challenge. Effective disease control, prevention, and treatment strategies should account for variations in risk factors, age, gender, and regional disparities. [ABSTRACT FROM AUTHOR]

Abstract Sodium intake shows a positive correlation with blood pressure, resulting in an increased risk for cardiovascular diseases (CVD). Salt reduction is a key step toward the WHO's goal of 25% reduction in mortality from non‐communicable diseases (NCDs) by 2025. This study aims to assess the current condition and temporal changes of the global CVD burden due to high sodium intake (HSI). We extracted data from the Global Burden of Disease (GBD) study 2019. The numbers and age‐standardized rates of mortality and disability‐adjusted life‐years (DALYs), stratified by location, sex, and socio‐demographic Index (SDI), were used to assess the high sodium intake attributable CVD burden from 1990 to 2019. The relationship between the DALYs rates and related factors was evaluated by stepwise multiple linear regression analysis. Globally, in 2019, the deaths and DALYs of HSI‐related CVD were 1.72 million and 40.54 million, respectively, increasing by 41.08% and 33.06% from 1990. Meanwhile, the corresponding mortality and DALYs rates dropped by 35.1% and 35.2%, respectively. The high‐middle and middle SDI quintiles bore almost two‐thirds of CVD burden caused by HSI. And the leading cause of HSI attributable CVD burden was ischemic heart disease. Universal health coverage (UHC) was associated with the DALYs rates after adjustment. From 1990 to 2019, the global CVD burden attributable to HSI has declined with spatiotemporal and sexual heterogeneity. However, it remains a major public health challenge because of the increasing absolute numbers. Improving UHC serves as an effective strategy to reduce the HSI‐related CVD burden.

Objective: Esophageal cancer (EC) poses a persistent threat to the health of non-elderly adults. This study aims to elucidate the temporal trends of EC-related mortality and investigate the impact of various risk factors on such deaths in the age group of 20–59 years, spanning 3 decades. Methods: Data on EC deaths were acquired from the Global Burden of Disease, Injuries, and Risk Factors (GBD) study. We employed estimated average percentage change (EAPC) and linear mixed-effects (LME) models to analyze mortality trends and pertinent risk factors for EC. Results: Between 1990 and 2019, EC mortality showed a downward trend, and the global number of deaths from EC among non-elderly adults surged by 24.37%. During this period, mortality rates saw an increase in only two regions—the Caribbean and Western Sub-Saharan Africa (EAPCs > 0). For male deaths, smoking and alcohol use emerged as the primary risk factors, while high body mass index (BMI) stood out as the main risk factor for female deaths. Furthermore, the LME model identified male sex, advancing age, alcohol use, smoking, and chewing tobacco as factors associated with an additional rise in EC deaths. Conclusion: EC continues to exert a substantial toll on mortality among young and middle-aged adults globally. Implementing targeted interventions are significant in alleviating the burden of this disease within this population. [ABSTRACT FROM AUTHOR]

Background: In the context of the population growing and aging worldwide, the incidence of non-rheumatic valvular heart disease increased rapidly. This study aimed to describe the burden of non-rheumatic valvular heart disease, providing an up-to-date and comprehensive analysis on the global and regional levels and time trends from 1900 to 2019. Methods: The Global Burden of Disease 2019 was used to obtain data for this analysis. Non-rheumatic valvular heart disease in the Global Burden of Disease study includes both non-rheumatic calcific aortic valve disease and non-rheumatic degenerative mitral valve disease. The incidence, mortality, and disability-adjusted life year in 204 countries from 1990 to 2019 were analyzed by location, year, sex, age, and socio-demographic index. Estimated annual percentage change was calculated to represent the temporal trends from 1990 to 2019. Spearman's rank order correlation was used to determine the correlation between socio-demographic index and the incidence and burden of non-rheumatic valvular heart disease. Results: Globally, there were 1.65 million (95% uncertainty interval, 1.56–1.76 million) incident cases, 0.16 million (95% uncertainty interval, 0.14–0.18 million) death cases, and 2.79 million (95% uncertainty interval, 2.52–3.31 million) disability-adjusted life years of non-rheumatic valvular heart disease. Compared with 1990, the number of incident cases, death cases, and disability-adjusted life years in 2019 increased by 104.58%, 210.60%, and 167.62%, respectively, the age-standardized incidence rate (estimated annual percentage change, 0.39; 95% confidence interval, 0.29 to 0.49) increased due to population growth, and the age-standardized death rates (estimated annual percentage change, −0.32; 95% confidence interval, −0.39 to −0.25) and age-standardized disability-adjusted life year rate (estimated annual percentage change, −0.81; 95% confidence interval, −0.87 to −0.74) decreased during this period. Regarding the socio-demographic index, the highest age-standardized incidence, death, and disability-adjusted life year rates of non-rheumatic valvular heart disease were found in high-socio-demographic index countries in 2019. Meantime, the age-standardized incidence rate remained increased from 1990 to 2019, while significant decreases were found in the age-standardized death rate and age-standardized disability-adjusted life year rate. Females have higher age-standardized incidence rate, while higher age-standardized death rate and age-standardized disability-adjusted life year rate belong to males globally during the period of 1990–2019. Increasing trends were observed for both incidence, death, and disability-adjusted life year rates with age. High systolic blood pressure was the leading cause for non-rheumatic valvular heart disease across all ages. Conclusions: From 1990 to 2019, the age-standardized incidence rate of non-rheumatic valvular heart disease remained increased, while age-standardized death rate and age-standardized disability-adjusted life year rate decreased, resulting from the growing population worldwide and improving medical resources. The aged, who has high systolic blood pressure and diet high in sodium, should pay more attention to, especially in high-socio-demographic index regions. With the population aging, the number of patients who require heart valve replacement is estimated to increase significantly in the future. Effective measures are warranted to control and treat the incidence and burden of non-rheumatic valvular heart disease. [ABSTRACT FROM AUTHOR]

Sodium intake shows a positive correlation with blood pressure, resulting in an increased risk for cardiovascular diseases (CVD). Salt reduction is a key step toward the WHO's goal of 25% reduction in mortality from non‐communicable diseases (NCDs) by 2025. This study aims to assess the current condition and temporal changes of the global CVD burden due to high sodium intake (HSI). We extracted data from the Global Burden of Disease (GBD) study 2019. The numbers and age‐standardized rates of mortality and disability‐adjusted life‐years (DALYs), stratified by location, sex, and socio‐demographic Index (SDI), were used to assess the high sodium intake attributable CVD burden from 1990 to 2019. The relationship between the DALYs rates and related factors was evaluated by stepwise multiple linear regression analysis. Globally, in 2019, the deaths and DALYs of HSI‐related CVD were 1.72 million and 40.54 million, respectively, increasing by 41.08% and 33.06% from 1990. Meanwhile, the corresponding mortality and DALYs rates dropped by 35.1% and 35.2%, respectively. The high‐middle and middle SDI quintiles bore almost two‐thirds of CVD burden caused by HSI. And the leading cause of HSI attributable CVD burden was ischemic heart disease. Universal health coverage (UHC) was associated with the DALYs rates after adjustment. From 1990 to 2019, the global CVD burden attributable to HSI has declined with spatiotemporal and sexual heterogeneity. However, it remains a major public health challenge because of the increasing absolute numbers. Improving UHC serves as an effective strategy to reduce the HSI‐related CVD burden. [ABSTRACT FROM AUTHOR]

Background Population growth, aging, and major alterations in epidemiologic trends inadvertently modulate the status of rheumatic heart disease (RHD) epidemiology. This investigation predicted RHD burden pattern and temporal trends to provide epidemiologic evidence. Methods and Results Prevalence, mortality, and disability‐adjusted life‐years data for RHD were obtained from the GBD (Global Burden of Disease) study. We performed decomposition analysis and frontier analysis to assess variations and burden in RHD from 1990 to 2019. In 2019, there were >40.50 million RHD cases worldwide, along with nearly 0.31 million RHD‐related deaths and 10.67 million years of healthy life lost to RHD. The RHD burden was commonly concentrated within lower sociodemographic index regions and countries. RHD primarily affects women (22.52 million cases in 2019), and the largest age‐specific prevalence rate was at 25 to 29 years in women and 20 to 24 years in men. Multiple reports demonstrated prominent downregulation of RHD‐related mortality and disability‐adjusted life‐years at the global, regional, and national levels. Decomposition analysis revealed that the observed improvements in RHD burden were primarily due to epidemiological alteration; however, it was negatively affected by population growth and aging. Frontier analysis revealed that the age‐standardized prevalence rates were negatively linked to sociodemographic index, whereas Somalia and Burkina Faso, with lower sociodemographic index, showed the lowest overall difference from the frontier boundaries of mortality and disability‐adjusted life‐years. Conclusions RHD remains a major global public health issue. Countries such as Somalia and Burkina Faso are particularly successful in managing adverse outcomes from RHD and may serve as a template for other countries.

In China, chronic obstructive pulmonary disease (COPD) was accounted for a quarter of the global COPD population and has become a large economic burden. However, the comprehensive picture of the COPD burden, which could inform health policy, is not readily available for all of the provinces of China. Here, we aimed to describe the burden of COPD in China, providing an up-to-date and comprehensive analysis at the national and provincial levels, and time trends from 1990 to 2019. Following the methodology framework and general analytical strategies used in the GBD 2019, we analyzed the incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years with life lost (YLLs) attributable to COPD across China and the corresponding time trends from 1990 to 2019, stratified by age and province. In order to quantify the secular trends of the burden of COPD, the estimated annual percentage changes were calculated by the linear regression model of age-standardized rates (ASRs) and calendar years. We also presented the contribution of risk factors to COPD-related mortality and DALYs. The association between COPD burden and socio-demographic index (SDI) were also evaluated. From 1990 to 2019, the incidence and prevalence numbers of COPD increased by 61.2 and 67.8%, respectively, whereas the number of deaths and DALYs owing to COPD decreased. The ASRs of COPD burden, including incidence, prevalence, mortality, DALYs, YLDs, and YLLs continuously decreased from 1990 to 2019. The crude rates of COPD burden dramatically increased with age and reached a peak in the older than 95 years age group. In 2019, the leading risk factor for COPD mortality and DALYs was tobacco use in the whole population, but ambient particulate matter pollution was the most significant risk factor in females. At the provincial level, the ASRs of COPD burden was significantly associated with the SDIs, with the highest ASRs in the western provinces with low SDIs. Collectively, our study indicated that COPD remains an important public health problem in China. Geographically targeted considerations should be developed to enhance COPD health and reduce the COPD burden throughout China and in specific provinces.