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1. Substantial increase in stillbirth rate during the COVID-19 pandemic: results from a population-based study in the Indian state of Bihar

Author: Lalit Dandona, Rakhi Dandona, G Anil Kumar, Vimal Kumar, Sibin George, Md Akbar, Dinesh Bhatt, Moutushi Majumder, S Siva Prasad Dora, Arpita Paul, Arup Kumar Das, and Debrupa Bhattacharjee
Subjects: Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216
Abstract: Introduction We report on the stillbirth rate (SBR) and associated risk factors for births during the COVID-19 pandemic, and change in SBR between prepandemic (2016) and pandemic periods in the Indian state of Bihar.Methods Births between July 2020 and June 2021 (91.5% participation) representative of Bihar were listed. Stillbirth was defined as fetal death with gestation period of ≥7 months where the fetus did not show any sign of life. Detailed interviews were conducted for all stillbirths and neonatal deaths, and for 25% random sample of surviving live births. We estimated overall SBR, and during COVID-19 peak and non-peak periods per 1000 births. Multiple logistic regression models were run to assess risk factors for stillbirth. The change in SBR for Bihar from 2016 to 2020–2021 was estimated.Results We identified 582 stillbirths in 30 412 births with an estimated SBR of 19.1 per 1000 births (95% CI 17.7 to 20.7); SBR was significantly higher in private facility (38.4; 95% CI 34.3 to 43.0) than in public facility (8.6; 95% CI 7.3 to 10.1) births, and for COVID-19 peak (21.2; 95% CI 19.2 to 23.4) than non-peak period (16.3; 95% CI 14.2 to 18.6) births. Pregnancies with the last pregnancy trimester during the COVID-19 peak period had 40.4% (95% CI 10.3% to 70.4%) higher SBR than those who did not. Risk factor associations for stillbirths were similar between the COVID-19 peak and non-peak periods, with gestation age of
Published: 2023
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2. Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026

Author: Angela E Micah, Kayleigh Bhangdia, Ian E Cogswell, Dylan Lasher, Brendan Lidral-Porter, Emilie R Maddison, Trang Nhu Ngoc Nguyen, Nishali Patel, Paola Pedroza, Juan Solorio, Hayley Stutzman, Golsum Tsakalos, Yifeng Wang, Wesley Warriner, Yingxi Zhao, Bianca S Zlavog, Cristiana Abbafati, Jaffar Abbas, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Michael Abdelmasseh, Deldar Morad Abdulah, Aidin Abedi, Kedir Hussein Abegaz, E S Abhilash, Richard Gyan Aboagye, Hassan Abolhassani, Michael R M Abrigo, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Mohammed Hussien Adem, Muhammad Sohail Afzal, Ali Ahmadi, Haroon Ahmed, Tarik Ahmed Rashid, Budi Aji, Hossein Akbarialiabad, Yibeltal Akelew, Hanadi Al Hamad, Khurshid Alam, Fahad Mashhour Alanezi, Turki M Alanzi, Mohammed Khaled Al-Hanawi, Robert Kaba Alhassan, Syed Mohamed Aljunid, Sami Almustanyir, Rajaa M Al-Raddadi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Azmeraw T Amare, Edward Kwabena Ameyaw, Mostafa Amini-Rarani, Hubert Amu, Robert Ancuceanu, Tudorel Andrei, Sumadi Lukman Anwar, Francis Appiah, Muhammad Aqeel, Jalal Arabloo, Morteza Arab-Zozani, Aleksandr Y Aravkin, Olatunde Aremu, Raphael Taiwo Aruleba, Seyyed Shamsadin Athari, Leticia Avila-Burgos, Martin Amogre Ayanore, Samad Azari, Atif Amin Baig, Abere Tilahun Bantie, Amadou Barrow, Pritish Baskaran, Sanjay Basu, Abdul-Monim Mohammad Batiha, Bernhard T Baune, Zombor Berezvai, Nikha Bhardwaj, Pankaj Bhardwaj, Sonu Bhaskar, Micheal Kofi Boachie, Virginia Bodolica, João Silva Botelho Botelho, Dejana Braithwaite, Nicholas J K Breitborde, Reinhard Busse, Lucero Cahuana-Hurtado, Ferrán Catalá-López, Collins Chansa, Jaykaran Charan, Vijay Kumar Chattu, Simiao Chen, Isaac Sunday Chukwu, Omid Dadras, Lalit Dandona, Rakhi Dandona, Abdollah Dargahi, Sisay Abebe Debela, Edgar Denova-Gutiérrez, Belay Desye, Samath Dhamminda Dharmaratne, Nancy Diao, Linh Phuong Doan, Milad Dodangeh, Wendel Mombaque dos Santos, Leila Doshmangir, John Dube, Ebrahim Eini, Maysaa El Sayed Zaki, Maha El Tantawi, Daniel Berhanie Enyew, Sharareh Eskandarieh, Mohamad Ezati Asar, Adeniyi Francis Fagbamigbe, Emerito Jose A Faraon, Ali Fatehizadeh, Hamed Fattahi, Ginenus Fekadu, Florian Fischer, Nataliya A Foigt, Kayode Raphael Fowobaje, Alberto Freitas, Takeshi Fukumoto, Nancy Fullman, Peter Andras Gaal, Amiran Gamkrelidze, M A Garcia-Gordillo, Mesfin Gebrehiwot, Urge Gerema, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Reza Ghanbari, Ahmad Ghashghaee, Ali Gholamrezanezhad, Mahaveer Golechha, Davide Golinelli, Yitayal Ayalew Goshu, Girma Garedew Goyomsa, Avirup Guha, Damitha Asanga Gunawardane, Bhawna Gupta, Samer Hamidi, Harapan Harapan, Reza Hashempour, Khezar Hayat, Golnaz Heidari, Ileana Heredia-Pi, Claudiu Herteliu, Demisu Zenbaba Heyi, Kamal Hezam, Yuta Hiraike, Mbuzeleni Mbuzeleni Hlongwa, Ramesh Holla, Mohammad Enamul Hoque, Mehdi Hosseinzadeh, Sorin Hostiuc, Salman Hussain, Olayinka Stephen Ilesanmi, Mustapha Immurana, Arnaud Iradukunda, Nahlah Elkudssiah Ismail, Gaetano Isola, Linda Merin J, Mihajlo Jakovljevic, Mahsa Jalili, Manthan Dilipkumar Janodia, Tahereh Javaheri, Sathish Kumar Jayapal, Digisie Mequanint Jemere, Tamas Joo, Nitin Joseph, Jacek Jerzy Jozwiak, Mikk Jürisson, Billingsley Kaambwa, Vidya Kadashetti, Rajendra Kadel, Dler Hussein Kadir, Laleh R Kalankesh, Rajesh Kamath, Himal Kandel, Rami S Kantar, Shama D Karanth, Ibraheem M Karaye, Salah Eddin Karimi, Bekalu Getnet Kassa, Gbenga A Kayode, Leila Keikavoosi-Arani, Vikash Ranjan Keshri, Cumali Keskin, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Himanshu Khajuria, Hamid Reza Khayat Kashani, Zemene Demelash Kifle, Hanna Kim, Jihee Kim, Min Seo Kim, Yun Jin Kim, Adnan Kisa, Stefan Kohler, Farzad Kompani, Soewarta Kosen, Sindhura Lakshmi Koulmane Laxminarayana, Ai Koyanagi, Kewal Krishan, Dian Kusuma, Judit Lám, Demetris Lamnisos, Anders O Larsson, Sang-woong Lee, Shaun Wen Huey Lee, Wei-Chen Lee, Yo Han Lee, Jacopo Lenzi, Lee-Ling Lim, László Lorenzovici, Rafael Lozano, Vanessa Sintra Machado Machado, Farzan Madadizadeh, Mohammed Magdy Abd El Razek, Razzagh Mahmoudi, Azeem Majeed, Mohammad-Reza Malekpour, Ana Laura Manda, Borhan Mansouri, Mohammad Ali Mansournia, Lorenzo Giovanni Mantovani, Carlos Alberto Marrugo Arnedo, Miquel Martorell, Ali Masoud, Elezebeth Mathews, Richard James Maude, Enkeleint A Mechili, Entezar Mehrabi Nasab, José João João Mendes Mendes, Atte Meretoja, Tuomo J Meretoja, Mohamed Kamal Mesregah, Tomislav Mestrovic, Andreea Mirica, Erkin M Mirrakhimov, Mizan Kiros Mirutse, Moonis Mirza, Mohammad Mirza-Aghazadeh-Attari, Awoke Misganaw, Marcello Moccia, Javad Moghadasi, Esmaeil Mohammadi, Mokhtar Mohammadi, Abdollah Mohammadian-Hafshejani, Marita Mohammadshahi, Shafiu Mohammed, Mohammad Mohseni, Ali H Mokdad, Lorenzo Monasta, Elias Mossialos, Ebrahim Mostafavi, Haleh Mousavi Isfahani, Christine Mpundu-Kaambwa, Shruti Murthy, Saravanan Muthupandian, Ahamarshan Jayaraman Nagarajan, Kovin S Naidoo, Mukhammad David Naimzada, Vinay Nangia, Atta Abbas Naqvi, Biswa Prakash Nayak, Rawlance Ndejjo, Trang Huyen Nguyen, Nafise Noroozi, Jean Jacques Noubiap, Khan M Nuruzzaman, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, Felix Chukwudi Abrahams Obi, Abiola Ogunkoya, In-Hwan Oh, Osaretin Christabel Okonji, Andrew T Olagunju, Tinuke O Olagunju, Babayemi Oluwaseun Olakunde, Ahmed Omar Bali, Obinna E Onwujekwe, John Nelson Opio, Adrian Otoiu, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Tamás Palicz, Raffaele Palladino, Adrian Pana, Tarang Parekh, Deepak Kumar Pasupula, Jay Patel, George C Patton, Uttam Paudel, Mihaela Paun, Shrikant Pawar, Simone Perna, Navaraj Perumalsamy, Ionela-Roxana Petcu, Zahra Zahid Piracha, Mohsen Poursadeqiyan, Naeimeh Pourtaheri, Sergio I Prada, Sima Rafiei, Pankaja Raghav Raghav, Fakher Rahim, Mohammad Hifz Ur Rahman, Mosiur Rahman, Amir Masoud Rahmani, Chhabi Lal Ranabhat, Temam Beshir Raru, Sina Rashedi, Mohammad-Mahdi Rashidi, Ramin Ravangard, Salman Rawaf, Reza Rawassizadeh, Elrashdy Moustafa Mohamed Redwan, Robert C Reiner, Jr., Andre M N Renzaho, Maryam Rezaei, Nazila Rezaei, Mavra A Riaz, Jefferson Antonio Buendia Rodriguez, Aly M A Saad, Basema Saddik, Saeid Sadeghian, Mohammad Reza Saeb, Umar Saeed, Maitreyi Sahu, Morteza Saki, Payman Salamati, Hedayat Salari, Sana Salehi, Abdallah M Samy, Juan Sanabria, Francesco Sanmarchi, João Vasco Santos, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Yaser Sarikhani, Brijesh Sathian, Maheswar Satpathy, Miloje Savic, Yaser Sayadi, Falk Schwendicke, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Naomi Setshegetso, Allen Seylani, Saeed Shahabi, Masood Ali Shaikh, Murad Ziyaudinovich Shakhmardanov, Mohd Shanawaz, Mequannent Melaku Sharew Sharew, Nigussie Tadesse Sharew, Rajesh Sharma, Maryam Shayan, Aziz Sheikh, Suchitra M Shenoy, Adithi Shetty, Pavanchand H Shetty, K M Shivakumar, Luís Manuel Lopes Rodrigues Silva, Wudneh Simegn, Jasvinder A Singh, Kuldeep Singh, Natia Skhvitaridze, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Yonatan Solomon, Suhang Song, Simona Cătălina Ștefan, Muhammad Suleman, Rafael Tabarés-Seisdedos, Nathan Y Tat, Vivian Y Tat, Belay Negash Tefera, Ales Tichopad, Ruoyan Tobe-Gai, Marcos Roberto Tovani-Palone, Lorainne Tudor Car, Derara Girma Tufa, Tommi Juhani Vasankari, Milena Vasic, Dominique Vervoort, Vasily Vlassov, Bay Vo, Linh Gia Vu, Yasir Waheed, Richard G Wamai, Cong Wang, Gizachew Tadesse Wassie, Nuwan Darshana Wickramasinghe, Sanni Yaya, Arzu Yigit, Vahit Yiğit, Naohiro Yonemoto, Mustafa Z Younis, Chuanhua Yu, Ismaeel Yunusa, Leila Zaki, Burhan Abdullah Zaman, Alireza Zangeneh, Ali Zare Dehnavi, Mikhail Sergeevich Zastrozhin, Wu Zeng, Zhi-Jiang Zhang, Liesl J Zuhlke, Yves Miel H Zuniga, Simon I Hay, Christopher J L Murray, and Joseph L Dieleman
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods: In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings: In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95% uncertainty interval [UI] 9·1–9·3) was spent on health worldwide. We found great disparities in the amount of resources devoted to health, with high-income countries spending $7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the $24·8 billion (95% UI 24·3–25·3) spent by low-income countries in 2019. That same year, $43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and $37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation: There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained. Funding: Bill & Melinda Gates Foundation.
Published: 2023
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3. Assessment of quality of antenatal care services in public sector facilities in India

Author: Lalit Dandona, Rakhi Dandona, G Anil Kumar, Debarshi Bhattacharya, Priya Nanda, Md Akbar, and Moutushi Majumder
Subjects: Medicine
Abstract: Objectives We undertook assessment of quality of antenatal care (ANC) services in public sector facilities in the Indian state of Bihar state delivered under the national ANC programme (Pradhan Mantri Surakshit Matritva Abhiyan, PMSMA).Setting Three community health centres and one subdistrict hospital each in two randomly selected districts of Bihar.Participants Pregnant women who sought ANC services under PMSMA irrespective of the pregnancy trimester.Primary and secondary measures Quality ANC services were considered if a woman received all of these services in that visit—weight, blood pressure and abdomen check, urine and blood sample taken, and were given iron and folic acid and calcium tablets. The process of ANC service provision was documented.Results Eight hundred and fourteen (94.5% participation) women participated. Coverage of quality ANC services was 30.4% (95% CI 27.3% to 33.7%) irrespective of pregnancy trimester, and was similar in both districts and ranged 3%–83.1% across the facilities. Quality ANC service coverage was significantly lower for women in the first trimester of pregnancy (6.8%, 95% CI 3.3% to 13.6%) as compared with those in the second (34.4%, 95% CI 29.9% to 39.1%) and third (32.9%, 95% CI 27.9% to 38.3%) trimester of pregnancy. Individually, the coverage of weight and blood pressure check-up, receipt of iron folic acid (IFA) and calcium tablets, and blood sample collection was >85%. The coverage of urine sample collection was 46.3% (95% CI 42.9% to 49.7%) and of abdomen check-up was 62% (95% CI 58.6% to 65.3%). Poor information sharing post check-up was done with the pregnant women. Varied implementation of ANC service provision was seen in the facilities as compared with the PMSMA guidelines, in particular with laboratory diagnostics and doctor consultation. Task shifting from doctors to ANMs was observed in all facilities.Conclusions Grossly inadequate quality ANC services under the PMSMA needs urgent attention to improve maternal and neonatal health outcomes.
Published: 2022
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4. Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000–18: a geospatial modelling study

Author: Joseph Jon Frostad, QuynhAnh P Nguyen, Mathew M Baumann, Brigette F Blacker, Laurie B Marczak, Aniruddha Deshpande, Kirsten E Wiens, Kate E LeGrand, Kimberly B Johnson, Mohsen Abbasi-Kangevari, Amir Abdoli, Hassan Abolhassani, Lucas Guimarães Abreu, Michael R M Abrigo, Niveen ME Abu-Rmeileh, Victor Adekanmbi, Anurag Agrawal, Muktar Beshir Ahmed, Ziyad Al-Aly, Fahad Mashhour Alanezi, Jacqueline Elizabeth Alcalde-Rabanal, Vahid Alipour, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Adeladza Kofi Amegah, Saeed Amini, Fatemeh Amiri, Dickson A Amugsi, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Ernoiz Antriyandarti, Davood Anvari, Jalal Arabloo, Morteza Arab-Zozani, Seyyed Shamsadin Athari, Marcel Ausloos, Getinet Ayano, Yared Asmare Aynalem, Samad Azari, Ashish D Badiye, Atif Amin Baig, Kalpana Balakrishnan, Maciej Banach, Sanjay Basu, Neeraj Bedi, Michelle L Bell, Derrick A Bennett, Krittika Bhattacharyya, Zulfiqar A Bhutta, Sadia Bibi, Somayeh Bohlouli, Soufiane Boufous, Nicola Luigi Bragazzi, Dejana Braithwaite, Sharath Burugina Nagaraja, Zahid A Butt, Florentino Luciano Caetano dos Santos, Josip Car, Rosario Cárdenas, Felix Carvalho, Joao Mauricio Castaldelli-Maia, Carlos A Castañeda-Orjuela, Ester Cerin, Soosanna Kumary Chattu, Vijay Kumar Chattu, Pankaj Chaturvedi, Sarika Chaturvedi, Simiao Chen, Dinh-Toi Chu, Sheng-Chia Chung, Saad M A Dahlawi, Giovanni Damiani, Lalit Dandona, Rakhi Dandona, Aso Mohammad Darwesh, Jai K Das, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Diego De Leo, Jan-Walter De Neve, Getu Debalkie Demissie, Edgar Denova-Gutiérrez, Sagnik Dey, Samath Dhamminda Dharmaratne, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Fariba Dorostkar, Leila Doshmangir, Andre Rodrigues Duraes, Hisham Atan Edinur, Ferry Efendi, Maha El Tantawi, Sharareh Eskandarieh, Ibtihal Fadhil, Nazir Fattahi, Nelsensius Klau Fauk, Seyed-Mohammad Fereshtehnejad, Morenike Oluwatoyin Folayan, Masoud Foroutan, Takeshi Fukumoto, Abhay Motiramji Gaidhane, Mansour Ghafourifard, Ahmad Ghashghaee, Syed Amir Gilani, Tiffany K Gill, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Mohammed Ibrahim Mohialdeen Gubari, Davide Guido, Yuming Guo, Rajat Das Gupta, Rajeev Gupta, Reyna Alma Gutiérrez, Nima Hafezi-Nejad, Randah R Hamadeh, Ahmed I Hasaballah, Soheil Hassanipour, Khezar Hayat, Behzad Heibati, Reza Heidari-Soureshjani, Nathaniel J Henry, Claudiu Herteliu, Mehdi Hosseinzadeh, Mohamed Hsairi, Guoqing Hu, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Chidozie C D Iwu, Jalil Jaafari, Mihajlo Jakovljevic, Tahereh Javaheri, Ravi Prakash Jha, John S Ji, Jost B Jonas, Ali Kabir, Zubair Kabir, Rohollah Kalhor, Naser Kamyari, Tanuj Kanchan, Umesh Kapil, Neeti Kapoor, Gbenga A Kayode, Peter Njenga Keiyoro, Yousef Saleh Khader, Nauman Khalid, Ejaz Ahmad Khan, Maseer Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Mahalaqua Nazli Khatib, Maryam Khayamzadeh, Jagdish Khubchandani, Gyu Ri Kim, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Luke D Knibbs, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Faris Hasan Lami, Qing Lan, Savita Lasrado, Paolo Lauriola, Paul H Lee, Sonia Lewycka, Shanshan Li, Daiane Borges Machado, Phetole Walter Mahasha, Mina Maheri, Azeem Majeed, Afshin Maleki, Reza Malekzadeh, Deborah Carvalho Malta, Borhan Mansouri, Mohammad Ali Mansournia, Natalie Maria Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Benjamin K Mayala, Man Mohan Mehndiratta, Walter Mendoza, Ritesh G Menezes, Endalkachew Worku Mengesha, Tuomo J Meretoja, Tomislav Mestrovic, Irmina Maria Michalek, Erkin M Mirrakhimov, Maryam Mirzaei, Roya Mirzaei, Babak Moazen, Yousef Mohammad, Abdollah Mohammadian-Hafshejani, Shafiu Mohammed, Ali H Mokdad, Lorenzo Monasta, Maziar Moradi-Lakeh, Paula Moraga, Lidia Morawska, Abbas Mosapour, Simin Mouodi, Amin Mousavi Khaneghah, Satinath Mukhopadhyay, Sandra B Munro, Christopher J L Murray, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Sanjeev Nair, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Ionut Negoi, Henok Biresaw Netsere, Josephine W Ngunjiri, Huong Lan Thi Nguyen, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Ahmed Omar Bali, Obinna E Onwujekwe, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Mahesh P A, Anamika Pandey, Eun-Cheol Park, Eun-Kee Park, Sangram Kishor Patel, Hai Quang Pham, Thomas Pilgrim, Meghdad Pirsaheb, Khem Narayan Pokhrel, Maarten J Postma, Zahiruddin Quazi Syed, Navid Rabiee, Amir Radfar, Fakher Rahim, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Chhabi Lal Ranabhat, Sowmya J Rao, Davide Rasella, Prateek Rastogi, Goura Kishor Rath, David Laith Rawaf, Salman Rawaf, Lal Rawal, Reza Rawassizadeh, Andre M N Renzaho, Bhageerathy Reshmi, Negar Rezaei, Nima Rezaei, Aziz Rezapour, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Morteza Rostamian, Enrico Rubagotti, Godfrey M Rwegerera, Basema Saddik, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Rajesh Sagar, Amirhossein Sahebkar, Biniyam Sahiledengle, Marwa Rashad Salem, Abdallah M Samy, Milena M Santric-Milicevic, Sivan Yegnanarayana Iyer Saraswathy, Brijesh Sathian, Thirunavukkarasu Sathish, David C Schwebel, Sadaf G Sepanlou, Saeed Shahabi, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, Mohammed Shannawaz, Kiomars Sharafi, Aziz Sheikh, Sara Sheikhbahaei, Ranjitha S Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, K M Shivakumar, Soraya Siabani, Tariq Jamal Siddiqi, Balbir Bagicha Singh, Jasvinder A Singh, Yitagesu Sintayehu, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Leo Stockfelt, Mu'awiyyah Babale Sufiyan, Rizwan Suliankatchi Abdulkader, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Amir Taherkhani, Mohamad-Hani Temsah, Kavumpurathu Raman Thankappan, Marcos Roberto Tovani-Palone, Eugenio Traini, Saif Ullah, Bhaskaran Unnikrishnan, Era Upadhyay, Sahel Valadan Tahbaz, Santosh Varughese, Francesco S Violante, Bay Vo, Giang Thu Vu, Yasir Waheed, Yuan-Pang Wang, Catherine A Welgan, Andrea Werdecker, Seyed Hossein Yahyazadeh Jabbari, Sanni Yaya, Vahid Yazdi-Feyzabadi, Mekdes Tigistu Yilma, Naohiro Yonemoto, Mustafa Z Younis, Taraneh Yousefinezhadi, Chuanhua Yu, Yong Yu, Sojib Bin Zaman, Yunquan Zhang, Zhi-Jiang Zhang, Michael Brauer, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. Methods: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. Findings: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000–257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. Interpretation: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Funding: Bill & Melinda Gates Foundation.
Published: 2022
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5. Implications of the availability and distribution of birth weight on addressing neonatal mortality: population-based assessment from Bihar state of India

Author: Lalit Dandona, Rakhi Dandona, G Anil Kumar, Debarshi Bhattacharya, Sibin George, Priya Nanda, and Md Akbar
Subjects: Medicine
Published: 2022
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6. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019

Author: Emma Nichols, Jaimie D Steinmetz, Stein Emil Vollset, Kai Fukutaki, Julian Chalek, Foad Abd-Allah, Amir Abdoli, Ahmed Abualhasan, Eman Abu-Gharbieh, Tayyaba Tayyaba Akram, Hanadi Al Hamad, Fares Alahdab, Fahad Mashhour Alanezi, Vahid Alipour, Sami Almustanyir, Hubert Amu, Iman Ansari, Jalal Arabloo, Tahira Ashraf, Thomas Astell-Burt, Getinet Ayano, Jose L Ayuso-Mateos, Atif Amin Baig, Anthony Barnett, Amadou Barrow, Bernhard T Baune, Yannick Béjot, Woldesellassie M Mequanint Bezabhe, Yihienew Mequanint Bezabih, Akshaya Srikanth Bhagavathula, Sonu Bhaskar, Krittika Bhattacharyya, Ali Bijani, Atanu Biswas, Srinivasa Rao Bolla, Archith Boloor, Carol Brayne, Hermann Brenner, Katrin Burkart, Richard A Burns, Luis Alberto Cámera, Chao Cao, Felix Carvalho, Luis F S Castro-de-Araujo, Ferrán Catalá-López, Ester Cerin, Prachi P Chavan, Nicolas Cherbuin, Dinh-Toi Chu, Vera Marisa Costa, Rosa A S Couto, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Vanessa De la Cruz-Góngora, Deepak Dhamnetiya, Diana Dias da Silva, Daniel Diaz, Abdel Douiri, David Edvardsson, Michael Ekholuenetale, Iman El Sayed, Shaimaa I El-Jaafary, Khalil Eskandari, Sharareh Eskandarieh, Saman Esmaeilnejad, Jawad Fares, Andre Faro, Umar Farooque, Valery L Feigin, Xiaoqi Feng, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Pietro Ferrara, Irina Filip, Howard Fillit, Florian Fischer, Shilpa Gaidhane, Lucia Galluzzo, Ahmad Ghashghaee, Nermin Ghith, Alessandro Gialluisi, Syed Amir Gilani, Ionela-Roxana Glavan, Elena V Gnedovskaya, Mahaveer Golechha, Rajeev Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Mohammad Rifat Haider, Brian J Hall, Samer Hamidi, Asif Hanif, Graeme J Hankey, Shafiul Haque, Risky Kusuma Hartono, Ahmed I Hasaballah, M Tasdik Hasan, Amr Hassan, Simon I Hay, Khezar Hayat, Mohamed I Hegazy, Golnaz Heidari, Reza Heidari-Soureshjani, Claudiu Herteliu, Mowafa Househ, Rabia Hussain, Bing-Fang Hwang, Licia Iacoviello, Ivo Iavicoli, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Seyed Sina Naghibi Irvani, Hiroyasu Iso, Masao Iwagami, Roxana Jabbarinejad, Louis Jacob, Vardhmaan Jain, Sathish Kumar Jayapal, Ranil Jayawardena, Ravi Prakash Jha, Jost B Jonas, Nitin Joseph, Rizwan Kalani, Amit Kandel, Himal Kandel, André Karch, Ayele Semachew Kasa, Gizat M Kassie, Pedram Keshavarz, Moien AB Khan, Mahalaqua Nazli Khatib, Tawfik Ahmed Muthafer Khoja, Jagdish Khubchandani, Min Seo Kim, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Mika Kivimäki, Walter J Koroshetz, Ai Koyanagi, G Anil Kumar, Manasi Kumar, Hassan Mehmood Lak, Matilde Leonardi, Bingyu Li, Stephen S Lim, Xuefeng Liu, Yuewei Liu, Giancarlo Logroscino, Stefan Lorkowski, Giancarlo Lucchetti, Ricardo Lutzky Saute, Francesca Giulia Magnani, Ahmad Azam Malik, João Massano, Man Mohan Mehndiratta, Ritesh G Menezes, Atte Meretoja, Bahram Mohajer, Norlinah Mohamed Ibrahim, Yousef Mohammad, Arif Mohammed, Ali H Mokdad, Stefania Mondello, Mohammad Ali Ali Moni, Md Moniruzzaman, Tilahun Belete Mossie, Gabriele Nagel, Muhammad Naveed, Vinod C Nayak, Sandhya Neupane Kandel, Trang Huyen Nguyen, Bogdan Oancea, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Songhomitra Panda-Jonas, Fatemeh Pashazadeh Kan, Maja Pasovic, Urvish K Patel, Mona Pathak, Mario F P Peres, Arokiasamy Perianayagam, Carrie B Peterson, Michael R Phillips, Marina Pinheiro, Michael A Piradov, Constance Dimity Pond, Michele H Potashman, Faheem Hyder Pottoo, Sergio I Prada, Amir Radfar, Alberto Raggi, Fakher Rahim, Mosiur Rahman, Pradhum Ram, Priyanga Ranasinghe, David Laith Rawaf, Salman Rawaf, Nima Rezaei, Aziz Rezapour, Stephen R Robinson, Michele Romoli, Gholamreza Roshandel, Ramesh Sahathevan, Amirhossein Sahebkar, Mohammad Ali Sahraian, Brijesh Sathian, Davide Sattin, Monika Sawhney, Mete Saylan, Silvia Schiavolin, Allen Seylani, Feng Sha, Masood Ali Shaikh, KS Shaji, Mohammed Shannawaz, Jeevan K Shetty, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Diego Augusto Santos Silva, João Pedro Silva, Renata Silva, Jasvinder A Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Amanda E Smith, Sergey Soshnikov, Emma Elizabeth Spurlock, Dan J Stein, Jing Sun, Rafael Tabarés-Seisdedos, Bhaskar Thakur, Binod Timalsina, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Gebiyaw Wudie Tsegaye, Sahel Valadan Tahbaz, Pascual R Valdez, Narayanaswamy Venketasubramanian, Vasily Vlassov, Giang Thu Vu, Linh Gia Vu, Yuan-Pang Wang, Anders Wimo, Andrea Sylvia Winkler, Lalit Yadav, Seyed Hossein Yahyazadeh Jabbari, Kazumasa Yamagishi, Lin Yang, Yuichiro Yano, Naohiro Yonemoto, Chuanhua Yu, Ismaeel Yunusa, Siddhesh Zadey, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Christopher J L Murray, and Theo Vos
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. Methods: We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. Findings: We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4–65·1) million cases globally in 2019 to 152·8 (130·8–175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [–7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64–1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52–1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41–67]) and western Europe (74% [58–90]), and the largest in north Africa and the Middle East (367% [329–403]) and eastern sub-Saharan Africa (357% [323–395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. Interpretation: Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. Funding: Bill & Melinda Gates Foundation and Gates Ventures.
Published: 2022
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7. Challenges in estimating the burden of neurological disorders across Indian states – Authors' reply

Author: Lalit Dandona and Gagandeep Singh
Subjects: Public aspects of medicine, RA1-1270
Published: 2021
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8. Global, regional and national burden of bladder cancer and its attributable risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease study 2019

Author: Azeem Majeed, Jasvinder A Singh, Vesna Zadnik, Mohammad Ali Mansournia, Alessandra Lugo, Silvano Gallus, Amir Almasi-Hashiani, Saeid Safiri, Mahdi Sepidarkish, Mohsen Naghavi, Fares Alahdab, Félix Carvalho, Lalit Dandona, Rakhi Dandona, Farshad Farzadfar, Eduarda Fernandes, Irina Filip, Samer Hamidi, Simon I Hay, Reza Malekzadeh, Tomislav Mestrovic, Shafiu Mohammed, Ali H Mokdad, Lorenzo Monasta, Huong Lan Thi Nguyen, Amir Radfar, Alireza Rafiei, Gholamreza Roshandel, Khanh Bao Tran, Ahmad Ghashghaee, Giuseppe Gorini, Mariam Molokhia, Ahad Ashrafi-Asgarabad, Salman Rawaf, Dejana Braithwaite, Nicholas L S Roberts, Vahid Alipour, Jalal Arabloo, Ali Bijani, Mowafa Househ, Olayinka Stephen Ilesanmi, Bartosz Miazgowski, Abdollah Mohammadian-Hafshejani, Reza Mohammadpourhodki, Cuong Tat Nguyen, Navid Rabiee, David Laith Rawaf, Abdallah M Samy, Sadaf G Sepanlou, Bach Xuan Tran, Zhi-Jiang Zhang, Giulia Carreras, Masood Ali Shaikh, Hai Quang Pham, Faris Hasan Lami, Stanislav S Otstavnov, Rajan Nikbakhsh, Roman Topor-Madry, G Anil Kumar, Tone Bjørge, Nima Hafezi-Nejad, Dinh-Toi Chu, Farahnaz Joukar, Mukhammad David Naimzada, Ali-Asghar Kolahi, Amir Abdoli, Atif Amin Baig, Mansour Ghafourifard, Soheil Hassanipour, Segun Emmanuel Ibitoye, Milena D Ilic, Carlo La Vecchia, Masoud Moghadaszadeh, Priya Rathi, Feng Sha, Maryam Zamanian, Mahaveer Golechha, Shailesh M Advani, Akshaya Srikanth Bhagavathula, Artem Alekseevich Fomenkov, Rahmatollah Moradzadeh, Mariya Vladimirovna Titova, Yohannes Tekalegn, Xiaochen Dai, Yonas Getaye Tefera, Bingyu Li, Iman El Sayed, Seyed Aria Nejadghaderi, Mark J M Sullman, Eman Abu-Gharbieh, Erfan Amini, Etsay Woldu Anbesu, Jason A Anderson, Atalel Fentahun Awedew, Antonio Biondi, Florentino Luciano Caetano dos Santos, Kelly Compton, Vera Marisa Costa, Meseret Derbew Molla, Abebaw Alemayehu Desta, Mostafa Dianatinasab, Hedyeh Ebrahimi, Sahar Eftekharzadeh, Babak Eshrati, Berhanu Elfu Feleke, Kebebe Bekele Gonfa, James D Harvey, Hannah Jacqueline Henrikson, Irena M Ilic, Seyedeh-Sanam Ladi-Seyedian, Iván Landires, Irmina Maria Michalek, Osama Mohamad, Behnam Nabavizadeh, Mohammad Reza Nowroozi, Virginia Nuñez-Samudio, Majid Pirestani, Faheem Hyder Pottoo, Nima Rezaei, Sara Sheikhbahaei, Sudeep K Siddappa Malleshappa, Emma Elizabeth Spurlock, Eyayou Girma Tadesse, Eugenio Traini, Ravensara S Travillian, Marco Vacante, Rixing Xu, and Yordanos Gizachew Yeshitila
Subjects: Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216
Abstract: Introduction The current study determined the level and trends associated with the incidence, death and disability rates for bladder cancer and its attributable risk factors in 204 countries and territories, from 1990 to 2019, by age, sex and sociodemographic index (SDI; a composite measure of sociodemographic factors).Methods Various data sources from different countries, including vital registration and cancer registries were used to generate estimates. Mortality data and incidence data transformed to mortality estimates using the mortality to incidence ratio (MIR) were used in a cause of death ensemble model to estimate mortality. Mortality estimates were divided by the MIR to produce incidence estimates. Prevalence was calculated using incidence and MIR-based survival estimates. Age-specific mortality and standardised life expectancy were used to estimate years of life lost (YLLs). Prevalence was multiplied by disability weights to estimate years lived with disability (YLDs), while disability-adjusted life years (DALYs) are the sum of the YLLs and YLDs. All estimates were presented as counts and age-standardised rates per 100 000 population.Results Globally, there were 524 000 bladder cancer incident cases (95% uncertainty interval 476 000 to 569 000) and 229 000 bladder cancer deaths (211 000 to 243 000) in 2019. Age-standardised death rate decreased by 15.7% (8.6 to 21.0), during the period 1990–2019. Bladder cancer accounted for 4.39 million (4.09 to 4.70) DALYs in 2019, and the age-standardised DALY rate decreased significantly by 18.6% (11.2 to 24.3) during the period 1990–2019. In 2019, Monaco had the highest age-standardised incidence rate (31.9 cases (23.3 to 56.9) per 100 000), while Lebanon had the highest age-standardised death rate (10.4 (8.1 to 13.7)). Cabo Verde had the highest increase in age-standardised incidence (284.2% (214.1 to 362.8)) and death rates (190.3% (139.3 to 251.1)) between 1990 and 2019. In 2019, the global age-standardised incidence and death rates were higher among males than females, across all age groups and peaked in the 95+ age group. Globally, 36.8% (28.5 to 44.0) of bladder cancer DALYs were attributable to smoking, more so in males than females (43.7% (34.0 to 51.8) vs 15.2% (10.9 to 19.4)). In addition, 9.1% (1.9 to 19.6) of the DALYs were attributable to elevated fasting plasma glucose (FPG) (males 9.3% (1.6 to 20.9); females 8.4% (1.6 to 19.1)).Conclusions There was considerable variation in the burden of bladder cancer between countries during the period 1990–2019. Although there was a clear global decrease in the age-standardised death, and DALY rates, some countries experienced an increase in these rates. National policy makers should learn from these differences, and allocate resources for preventative measures, based on their country-specific estimates. In addition, smoking and elevated FPG play an important role in the burden of bladder cancer and need to be addressed with prevention programmes.
Published: 2021
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9. Distinct mortality patterns at 0–2 days versus the remaining neonatal period: results from population-based assessment in the Indian state of Bihar

Author: Rakhi Dandona, G. Anil Kumar, Debarshi Bhattacharya, Md. Akbar, Yamini Atmavilas, Priya Nanda, and Lalit Dandona
Subjects: Bihar, Birth asphyxia, Death, India, Preterm, Meningitis, Medicine
Abstract: Abstract Background The objectives of this study were to understand the differences in mortality rate, risk factors for mortality, and cause of death distribution in three neonatal age sub-groups (0–2, 3–7, and 8–27 days) and assess the change in mortality rate with previous assessments to inform programmatic decision-making in the Indian state of Bihar, a large state with a high burden of newborn deaths. Methods Detailed interviews were conducted in a representative sample of 23,602 live births between January and December 2016 (96.2% participation) in Bihar state. We estimated the neonatal mortality rate (NMR) for the three age sub-groups and explored the association of these deaths with a variety of risk factors using a hierarchical logistic regression model approach. Verbal autopsies were conducted using the PHMRC questionnaire and the cause of death assigned using the SmartVA automated algorithm. Change in NMR from 2011 to 2016 was estimated by comparing it with a previous assessment. Results The NMR 0–2-day, 3–7-day, and 8–27-day mortality estimates in 2016 were 24.7 (95% CI 21.8–28.0), 13.2 (11.1 to 15.7), 5.8 (4.4 to 7.5), and 5.8 (4.5 to 7.5) per 1000 live births, respectively. A statistically significant reduction of 23.3% (95% CI 9.2% to 37.3) was seen in NMR from 2011 to 2016, driven by a reduction of 35.3% (95% CI 18.4% to 52.2) in 0–2-day mortality. In the final regression model, the highest odds for mortality in 0–2 days were related to the gestation period of ≤ 8 months (OR 16.5, 95% CI 11.9–22.9) followed by obstetric complications, no antiseptic cord care, and delivery at a private health facility or home. The 3–7- and 8–27-day mortality was driven by illness in the neonatal period (OR 10.33, 95% CI 6.31–16.90, and OR 4.88, 95% CI 3.13–7.61, respectively) and pregnancy with multiple foetuses (OR 5.15, 95% CI 2.39–11.10, and OR 11.77, 95% CI 6.43–21.53, respectively). Birth asphyxia (61.1%) and preterm delivery (22.1%) accounted for most of 0–2-day deaths; pneumonia (34.5%), preterm delivery (33.7%), and meningitis/sepsis (20.1%) accounted for the majority of 3–7-day deaths; meningitis/sepsis (30.6%), pneumonia (29.1%), and preterm delivery (26.2%) were the leading causes of death at 8–27 days. Conclusions To our knowledge, this is the first study to report a detailed neonatal epidemiology by age sub-groups for a major Indian state, which has highlighted the distinctly different mortality rate, risk factors, and causes of death at 0–2 days versus the rest of the neonatal period. Monitoring mortality at 0–2 and 3–7 days separately in the traditional early neonatal period of 0–7 days would enable more effective programming to reduce neonatal mortality.
Published: 2019
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10. Deferred and referred deliveries contribute to stillbirths in the Indian state of Bihar: results from a population-based survey of all births

Author: Rakhi Dandona, G. Anil Kumar, Md. Akbar, Debarshi Bhattacharya, Priya Nanda, and Lalit Dandona
Subjects: Antepartum, Deferred delivery, India, Intrapartum, Rate, Stillbirth, Medicine
Abstract: Abstract Background The India Newborn Action Plan (INAP) aims for
Published: 2019
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11. Health and economic impact of air pollution in the states of India: the Global Burden of Disease Study 2019

Author: Anamika Pandey, Michael Brauer, Maureen L Cropper, Kalpana Balakrishnan, Prashant Mathur, Sagnik Dey, Burak Turkgulu, G Anil Kumar, Mukesh Khare, Gufran Beig, Tarun Gupta, Rinu P Krishnankutty, Kate Causey, Aaron J Cohen, Stuti Bhargava, Ashutosh N Aggarwal, Anurag Agrawal, Shally Awasthi, Fiona Bennitt, Sadhana Bhagwat, P Bhanumati, Katrin Burkart, Joy K Chakma, Thomas C Chiles, Sourangsu Chowdhury, D J Christopher, Subhojit Dey, Samantha Fisher, Barbara Fraumeni, Richard Fuller, Aloke G Ghoshal, Mahaveer J Golechha, Prakash C Gupta, Rachita Gupta, Rajeev Gupta, Shreekant Gupta, Sarath Guttikunda, David Hanrahan, Sivadasanpillai Harikrishnan, Panniyammakal Jeemon, Tushar K Joshi, Rajni Kant, Surya Kant, Tanvir Kaur, Parvaiz A Koul, Praveen Kumar, Rakesh Kumar, Samantha L Larson, Rakesh Lodha, Kishore K Madhipatla, P A Mahesh, Ridhima Malhotra, Shunsuke Managi, Keith Martin, Matthews Mathai, Joseph L Mathew, Ravi Mehrotra, B V Murali Mohan, Viswananthan Mohan, Satinath Mukhopadhyay, Parul Mutreja, Nitish Naik, Sanjeev Nair, Jeyaraj D Pandian, Pallavi Pant, Arokiasamy Perianayagam, Dorairaj Prabhakaran, Poornima Prabhakaran, Goura K Rath, Shamika Ravi, Ambuj Roy, Yogesh D Sabde, Sundeep Salvi, Sankar Sambandam, Bhavay Sharma, Meenakshi Sharma, Shweta Sharma, R S Sharma, Aakash Shrivastava, Sujeet Singh, Virendra Singh, Rodney Smith, Jeffrey D Stanaway, Gabrielle Taghian, Nikhil Tandon, J S Thakur, Nihal J Thomas, G S Toteja, Chris M Varghese, Chandra Venkataraman, Krishnan N Venugopal, Katherine D Walker, Alexandrea Y Watson, Sarah Wozniak, Denis Xavier, Gautam N Yadama, Geetika Yadav, D K Shukla, Hendrik J Bekedam, K Srinath Reddy, Randeep Guleria, Theo Vos, Stephen S Lim, Rakhi Dandona, Sunil Kumar, Pushpam Kumar, Philip J Landrigan, and Lalit Dandona
Subjects: Environmental sciences, GE1-350
Abstract: Summary: Background: The association of air pollution with multiple adverse health outcomes is becoming well established, but its negative economic impact is less well appreciated. It is important to elucidate this impact for the states of India. Methods: We estimated exposure to ambient particulate matter pollution, household air pollution, and ambient ozone pollution, and their attributable deaths and disability-adjusted life-years in every state of India as part of the Global Burden of Disease Study (GBD) 2019. We estimated the economic impact of air pollution as the cost of lost output due to premature deaths and morbidity attributable to air pollution for every state of India, using the cost-of-illness method. Findings: 1·67 million (95% uncertainty interval 1·42–1·92) deaths were attributable to air pollution in India in 2019, accounting for 17·8% (15·8–19·5) of the total deaths in the country. The majority of these deaths were from ambient particulate matter pollution (0·98 million [0·77–1·19]) and household air pollution (0·61 million [0·39–0·86]). The death rate due to household air pollution decreased by 64·2% (52·2–74·2) from 1990 to 2019, while that due to ambient particulate matter pollution increased by 115·3% (28·3–344·4) and that due to ambient ozone pollution increased by 139·2% (96·5–195·8). Lost output from premature deaths and morbidity attributable to air pollution accounted for economic losses of US$28·8 billion (21·4–37·4) and $8·0 billion (5·9–10·3), respectively, in India in 2019. This total loss of $36·8 billion (27·4–47·7) was 1·36% of India's gross domestic product (GDP). The economic loss as a proportion of the state GDP varied 3·2 times between the states, ranging from 0·67% (0·47–0·91) to 2·15% (1·60–2·77), and was highest in the low per-capita GDP states of Uttar Pradesh, Bihar, Rajasthan, Madhya Pradesh, and Chhattisgarh. Delhi had the highest per-capita economic loss due to air pollution, followed by Haryana in 2019, with 5·4 times variation across all states. Interpretation: The high burden of death and disease due to air pollution and its associated substantial adverse economic impact from loss of output could impede India's aspiration to be a $5 trillion economy by 2024. Successful reduction of air pollution in India through state-specific strategies would lead to substantial benefits for both the health of the population and the economy. Funding: UN Environment Programme; Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
Published: 2021
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12. Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000–17

Author: Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. Bennett, Habib Benzian, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Krittika Bhattacharyya, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Muhammad Shahdaat Bin Sayeed, Raaj Kishore Biswas, Somayeh Bohlouli, Soufiane Boufous, Oliver J Brady, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Alexandria Brown, Sharath Burugina Nagaraja, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Carlos A Castañeda-Orjuela, Franz Castro, Ester Cerin, Binaya Chalise, Vijay Kumar Chattu, Ken Lee Chin, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Elizabeth A Cromwell, Abel Fekadu Fekadu Dadi, Tukur Dahiru, Saad M A Dahlawi, Rakhi Dandona, Lalit Dandona, Anh Kim Dang, Farah Daoud, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Nicole Davis Weaver, Fernando Pio De la Hoz, Jan-Walter De Neve, Dereje Bayissa Demissie, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Hoa Thi Do, Christiane Dolecek, Kerrie E Doyle, Eleonora Dubljanin, Andre Rodrigues Duraes, Hisham Atan Edinur, Andem Effiong, Aziz Eftekhari, Nevine El Nahas, Maysaa El Sayed Zaki, Maha El Tantawi, Hala Rashad Elhabashy, Shaimaa I. El-Jaafary, Ziad El-Khatib, Hajer Elkout, Aisha Elsharkawy, Shymaa Enany, Daniel Adane Endalew, Babak Eshrati, Sharareh Eskandarieh, Arash Etemadi, Oluchi Ezekannagha, Emerito Jose A. Faraon, Mohammad Fareed, Andre Faro, Farshad Farzadfar, Alebachew Fasil Fasil, Mehdi Fazlzadeh, Valery L. Feigin, Wubalem Fekadu, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Carsten Flohr, Nataliya A. Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Mohamed M Gad, Gregory M Garcia, Augustine Mwangi Gatotoh, Reta Tsegaye Gayesa, Ketema Bizuwork Gebremedhin, Yilma Chisha Dea Geramo, Hailay Abrha Gesesew, Kebede Embaye Gezae, Ahmad Ghashghaee, Farzaneh Ghazi Sherbaf, Tiffany K Gill, Paramjit Singh Gill, Themba G Ginindza, Alem Girmay, Zemichael Gizaw, Amador Goodridge, Sameer Vali Gopalani, Bárbara Niegia Garcia Goulart, Alessandra C Goulart, Ayman Grada, Manfred S Green, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Rajeev Gupta, Rahul Gupta, Giang Hai Ha, Juanita A. Haagsma, Nima Hafezi-Nejad, Dessalegn H Haile, Michael Tamene Haile, Brian J. Hall, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Hamid Yimam Hassen, Desta Haftu Hayelom, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru, Thomas R Hird, Chi Linh Hoang, Gillian I Hollerich, Praveen Hoogar, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Mamusha Aman A Hussen, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Milena D. Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Rebecca Q Ivers, Chinwe Juliana Iwu, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Tanuj Kanchan, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A. Kayode, Mihiretu M Kebede, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Junaid Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Amir M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Sonali Kochhar, Tufa Kolola, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, Nuworza Kugbey, Pushpendra Kumar, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Hilton Lam, Faris Hasan Lami, Van Charles Lansingh, Savita Lasrado, Georgy Lebedev, Paul H Lee, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Aubrey J Levine, Sonia Lewycka, Shanshan Li, Shai Linn, Shiwei Liu, Jaifred Christian F Lopez, Platon D Lopukhov, Muhammed Magdy Abd El Razek, D.R. Mahadeshwara Prasad, Phetole Walter Mahasha, Narayan B. Mahotra, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Navid Manafi, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Gabriel Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Kala M Mehta, Teferi Mekonnen, Tefera Chane Mekonnen, Gebrekiros Gebremichael Meles, Hagazi Gebre Meles, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Tomislav Mestrovic, Workua Mekonnen Metekiya, Bartosz Miazgowski, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Yousef Mohammad, Dara K. Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Shafiu Mohammed, Jemal Abdu Mohammed, Hassen Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Paula Moraga, Linda Morales, Abbas Mosapour, Jonathan F. Mosser, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor, Sandra B Munro, Moses K. Muriithi, Christopher J L Murray, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Gurudatta Naik, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Duduzile Edith Ndwandwe, Ionut Negoi, Henok Biresaw Netsere, Josephine W. Ngunjiri, Cuong Tat Nguyen, Huong Lan Thi Nguyen, QuynhAnh P Nguyen, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Ole F Norheim, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Jacob Olusegun Olusanya, Bolajoko Olubukunola Olusanya, Obinna E Onwujekwe, Doris V. Ortega-Altamirano, Osayomwanbo Osarenotor, Frank B Osei, Mayowa O Owolabi, Mahesh P A, Jagadish Rao. 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Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Nizal Sarrafzadegan, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Maheswar Satpathy, Monika Sawhney, Mehdi Sayyah, Alyssa N Sbarra, Lauren E Schaeffer, David C Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Azadeh Shafieesabet, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Rajesh Sharma, Aziz Sheikh, B Suresh Kumar Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Si Si, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Virendra Singh, Narinder Pal Singh, Balbir Bagicha Singh Singh, Jasvinder A. Singh, Ambrish Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L Smith, Adauto Martins Soares Filho, Mohammad Reza Sobhiyeh, Anton Sokhan, Joan B Soriano, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Ingan Ukur Tarigan, Bineyam Taye, Yonatal Mesfin Tefera, Arash Tehrani-Banihashemi, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Akhil Soman ThekkePurakkal, Nihal Thomas, Robert L Thompson, Alan J Thomson, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Olalekan A Uthman, Benjamin S. Chudi Uzochukwu, Pascual R Valdez, Santosh Varughese, Yousef Veisani, Francesco S Violante, Sebastian Vollmer, Feleke Gebremeskel W/hawariat, Yasir Waheed, Mitchell Taylor Wallin, Yuan-Pang Wang, Yafeng Wang, Kinley Wangdi, Daniel J Weiss, Girmay Teklay Weldesamuel, Adhena Ayaliew Werkneh, Ronny Westerman, Taweewat Wiangkham, Kirsten E Wiens, Tissa Wijeratne, Charles Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Getasew Taddesse Worku, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Hiroshi Yatsuya, Alex Yeshaneh, Mekdes Tigistu Yilma, Paul Yip, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Telma Zahirian Moghadam, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Taddese Alemu Zerfu, Yunquan Zhang, Arash Ziapour, Sanjay Zodpey, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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13. The global distribution of lymphatic filariasis, 2000–18: a geospatial analysis

Author: Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. 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El-Jaafary, Ziad El-Khatib, Hajer Elkout, Aisha Elsharkawy, Shymaa Enany, Daniel Adane Endalew, Babak Eshrati, Sharareh Eskandarieh, Arash Etemadi, Oluchi Ezekannagha, Emerito Jose A. Faraon, Mohammad Fareed, Andre Faro, Farshad Farzadfar, Alebachew Fasil Fasil, Mehdi Fazlzadeh, Valery L. Feigin, Wubalem Fekadu, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Carsten Flohr, Nataliya A. Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Mohamed M Gad, Gregory M Garcia, Augustine Mwangi Gatotoh, Reta Tsegaye Gayesa, Ketema Bizuwork Gebremedhin, Yilma Chisha Dea Geramo, Hailay Abrha Gesesew, Kebede Embaye Gezae, Ahmad Ghashghaee, Farzaneh Ghazi Sherbaf, Tiffany K Gill, Paramjit Singh Gill, Themba G Ginindza, Alem Girmay, Zemichael Gizaw, Amador Goodridge, Sameer Vali Gopalani, Bárbara Niegia Garcia Goulart, Alessandra C Goulart, Ayman Grada, Manfred S Green, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Rajeev Gupta, Rahul Gupta, Giang Hai Ha, Juanita A. Haagsma, Nima Hafezi-Nejad, Dessalegn H Haile, Michael Tamene Haile, Brian J. Hall, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Hamid Yimam Hassen, Desta Haftu Hayelom, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru, Thomas R Hird, Chi Linh Hoang, Gillian I Hollerich, Praveen Hoogar, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Mamusha Aman A Hussen, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Milena D. Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Rebecca Q Ivers, Chinwe Juliana Iwu, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Tanuj Kanchan, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A. Kayode, Mihiretu M Kebede, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Junaid Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Amir M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Sonali Kochhar, Tufa Kolola, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, Nuworza Kugbey, Pushpendra Kumar, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Hilton Lam, Faris Hasan Lami, Van Charles Lansingh, Savita Lasrado, Georgy Lebedev, Paul H Lee, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Aubrey J Levine, Sonia Lewycka, Shanshan Li, Shai Linn, Shiwei Liu, Jaifred Christian F Lopez, Platon D Lopukhov, Muhammed Magdy Abd El Razek, D.R. Mahadeshwara Prasad, Phetole Walter Mahasha, Narayan B. Mahotra, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Navid Manafi, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Gabriel Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Kala M Mehta, Teferi Mekonnen, Tefera Chane Mekonnen, Gebrekiros Gebremichael Meles, Hagazi Gebre Meles, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Tomislav Mestrovic, Workua Mekonnen Metekiya, Bartosz Miazgowski, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Yousef Mohammad, Dara K. Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Shafiu Mohammed, Jemal Abdu Mohammed, Hassen Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Paula Moraga, Linda Morales, Abbas Mosapour, Jonathan F. Mosser, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor, Sandra B Munro, Moses K. Muriithi, Christopher J L Murray, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Gurudatta Naik, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Duduzile Edith Ndwandwe, Ionut Negoi, Henok Biresaw Netsere, Josephine W. Ngunjiri, Cuong Tat Nguyen, Huong Lan Thi Nguyen, QuynhAnh P Nguyen, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Ole F Norheim, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Jacob Olusegun Olusanya, Bolajoko Olubukunola Olusanya, Obinna E Onwujekwe, Doris V. Ortega-Altamirano, Osayomwanbo Osarenotor, Frank B Osei, Mayowa O Owolabi, Mahesh P A, Jagadish Rao. Padubidri, Smita Pakhale, Adrian Pana, Eun-Kee Park, Sangram Kishor Patel, Ashish Pathak, Ajay Patle, Kebreab Paulos, Veincent Christian Filipino Pepito, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Konrad Pesudovs, Hai Quang Pham, David M Pigott, Thomas Pilgrim, Meghdad Pirsaheb, Mario Poljak, Ian Pollock, Maarten J Postma, Farshad Pourmalek, Akram Pourshams, Sergio I Prada, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Siavash Rahimi, Vafa Rahimi-Movaghar, Muhammad Aziz Rahman, Mohammad Hifz Ur Rahman, Fatemeh Rajati, Chhabi Lal Ranabhat, Puja C Rao, Davide Rasella, Goura Kishor Rath, Salman Rawaf, Lal Rawal, Wasiq Faraz Rawasia, Giuseppe Remuzzi, Vishnu Renjith, Andre M.N. Renzaho, Serge Resnikoff, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Siamak Sabour, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Yahya Safari, Rajesh Sagar, Mohammad Ali Sahraian, S. Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Ahsan Saleem, Hosni Salem, Marwa Rashad Salem, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Itamar S Santos, Milena M. Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Nizal Sarrafzadegan, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Maheswar Satpathy, Monika Sawhney, Mehdi Sayyah, Alyssa N Sbarra, Lauren E Schaeffer, David C Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Azadeh Shafieesabet, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Rajesh Sharma, Aziz Sheikh, B Suresh Kumar Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Si Si, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Virendra Singh, Narinder Pal Singh, Balbir Bagicha Singh Singh, Jasvinder A. Singh, Ambrish Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L Smith, Adauto Martins Soares Filho, Mohammad Reza Sobhiyeh, Anton Sokhan, Joan B Soriano, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Ingan Ukur Tarigan, Bineyam Taye, Yonatal Mesfin Tefera, Arash Tehrani-Banihashemi, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Akhil Soman ThekkePurakkal, Nihal Thomas, Robert L Thompson, Alan J Thomson, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Olalekan A Uthman, Benjamin S. Chudi Uzochukwu, Pascual R Valdez, Santosh Varughese, Yousef Veisani, Francesco S Violante, Sebastian Vollmer, Feleke Gebremeskel W/hawariat, Yasir Waheed, Mitchell Taylor Wallin, Yuan-Pang Wang, Yafeng Wang, Kinley Wangdi, Daniel J Weiss, Girmay Teklay Weldesamuel, Adhena Ayaliew Werkneh, Ronny Westerman, Taweewat Wiangkham, Kirsten E Wiens, Tissa Wijeratne, Charles Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Getasew Taddesse Worku, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Hiroshi Yatsuya, Alex Yeshaneh, Mekdes Tigistu Yilma, Paul Yip, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Telma Zahirian Moghadam, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Taddese Alemu Zerfu, Yunquan Zhang, Arash Ziapour, Sanjay Zodpey, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection. Methods: A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000–18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected. Findings: We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174–234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6–5·7 million) in the region of the Americas to 107 million (91–134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43–63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination. Interpretation: Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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14. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Author: Kirsten E Wiens, Paulina A Lindstedt, Brigette F Blacker, Kimberly B Johnson, Mathew M Baumann, Lauren E Schaeffer, Hedayat Abbastabar, Sr, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R M Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Maryam Adabi, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Sr, Victor Adekanmbi, Olatunji O Adetokunboh, Sr, Beyene Meressa Adhena, Mohsen Afarideh, Sohail Ahmad, Keivan Ahmadi, Anwar E Ahmed, Muktar Beshir Ahmed, Rushdia Ahmed, Temesgen Yihunie Akalu, Fares Alahdab, Ziyad Al-Aly, Noore Alam, Sr, Samiah Alam, Genet Melak Alamene, Turki M Alanzi, Jacqueline Elizabeth Alcalde-Rabanal, Beriwan Abdulqadir Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Sr, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Saeed Amini, Sr, Arianna Maever L Amit, Sr, Catalina Liliana Andrei, Sr, Mina Anjomshoa, Amir Anoushiravani, Sr, Fereshteh Ansari, Carl Abelardo T Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Sr, Olatunde Aremu, Bahram Armoon, Amit Arora, Sr, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Hagos Tasew Atalay, Seyyed Shamsadin Athari, Sr, Seyyede Masoume Athari, Sachin R Atre, Marcel Ausloos, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Sr, Yared Asmare Aynalem IV, Samad Azari, Peter S Azzopardi, Ebrahim Babaee, Tesleem Kayode Babalola, Alaa Badawi, Sr, Mohan Bairwa, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Ayele Geleto Bali, Maciej Banach, Sr, Joseph Adel Mattar Banoub, Sr, Aleksandra Barac, Till Winfried Bärnighausen, Huda Basaleem, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Estifanos Baye, Neeraj Bedi, Mahya Mahya Beheshti Beheshti, Masoud Behzadifar, Meysam Behzadifar, Bayu Begashaw Bekele, Yaschilal Muche Belayneh, Michellr L Bell, Sr, Derrick A Bennett, Sr, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Sr, Krittika Bhattacharyya, Sr, Suraj Bhattarai, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Binyam Minuye Birihane IV, Raaj Kishore Biswas, Somayeh Bohlouli, Hunduma Amensisa Amensisa Bojia I, Soufiane Boufous, Oliver J Brady, Nicola Luigi Bragazzi, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Sharath Burugina Nagaraja, Sr, Reinhard Busse, Sr, Zahid A Butt, Luis LA Alberto Cámera, Sr, Ismael R Campos-Nonato, Sr, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Sr, Carlos A Castañeda-Orjuela, Sr, Franz Castro, Wagaye Fentahun Chanie, Sr, Pranab Chatterjee, Vijay Kumar Chattu, Tesfaye Yitna Yitna Chichiabellu, Jr, Ken Lee Chin, Sr, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Carlos Culquichicon, Matiwos Soboka Daba, Giovanni Damiani, Sr, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Sr, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Gail Davey, Claudio Alberto Dávila-Cervantes, Adrian C Davis, Sr, Dragos Virgil Davitoiu, Fernando Pio De la Hoz, Asmamaw Bizuneh Demis, Dereje Bayissa Demissie, Getu Debalkie Demissie, Gebre Teklemariam Demoz, Sr, Edgar Denova-Gutiérrez, Sr, Kebede Deribe, Sr, Assefa Desalew, Aniruddha Deshpande, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Sr, Isaac Oluwafemi Dipeolu, Shirin Djalalinia, Kerrie E Doyle, Eleonora Dubljanin, Bereket Duko, Andre Rodrigues Duraes, Mohammad Ebrahimi Kalan, Hisham Atan Edinur, Sr, Andem Effiong, Sr, Aziz Eftekhari, Nevine El Nahas, Iman El Sayed, Maysaa El Sayed Zaki, Maha El Tantawi, Teshome Bekele Elema I, Hala Rashad Elhabashy, Sr, Shaimaa I El-Jaafary, Hajer Elkout, Aisha Elsharkawy, Iqbal RF Elyazar, Aklilu Endalamaw, Daniel Adane Endalew, Sr, Sharareh Eskandarieh, Alireza Esteghamati, Sadaf Esteghamati, Sr, Arash Etemadi, Oluchi Ezekannagha, Mohammad Fareed, Roghiyeh Faridnia, Farshad Farzadfar, Mehdi Fazlzadeh, Valery L Feigin, Sr, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Sr, Masoud Foroutan, Richard Charles Franklin, Takeshi Fukumoto, Mohamed M Gad, Reta Tsegaye Gayesa, Teshome Gebre, Sr, Ketema Bizuwork Gebremedhin, Gebreamlak Gebremedhn Gebremeskel, Sr, Hailay Abrha Gesesew, Kebede Embaye Gezae, Keyghobad Ghadiri, Sr, Ahmad Ghashghaee, Pramesh Raj Ghimire, Sr, Paramjit Singh Gill, Sr, Tiffany K Gill, Themba G G Ginindza, Nelson G M Gomes, Sameer Vali Gopalani, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Sr, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Sr, Rajeev Gupta, Nima Hafezi-Nejad, Dessalegn H Haile, Sr, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Sr, Ninuk Hariyani, Ahmed I Hasaballah, Md Mehedi Hasan, Edris Hasanpoor, Amir Hasanzadeh, Hadi Hassankhani, Hamid Yimam Hassen, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Sr, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru I, Thomas R Hird, Chi Linh Hoang, Enayatollah Homaie Rad, Praveen Hoogar, Mohammad Hoseini, Naznin Hossain, Mostafa Hosseini, Mehdi Hosseinzadeh, Mowafa Househ, Mohamed Hsairi, Sr, Guoqing Hu, Mohammedaman Mama Hussen, Segun Emmanuel Ibitoye, Ehimario U Igumbor, Sr, Olayinka Stephen Ilesanmi, Milena D Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Chinwe Juliana Iwu, Neda Izadi, Sr, Anelisa Jaca, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Sr, Jost B Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Sr, Amaha Kahsay, Hamed Kalani, Tanuj Kanchan, Behzad Karami Matin, André Karch, Mohd Anisul Karim, Hamidreza Karimi-Sari, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Yawukal chane Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A Kayode, Ali Kazemi Karyani, Mihiretu M Kebede, Peter Njenga Keiyoro, Abraham Getachew Kelbore, Sr, Andre Pascal Kengne, Sr, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Sr, Junaid Khan, Md Nuruzzaman Khan I, Muhammad Shahzeb Khan, Khaled Khatab, Sr, Amir M Khater, Mona M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Salman Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Niranjan Kissoon, Sr, Shivakumar KM Marulasiddaiah M KMShivakumar, Sr, Sonali Kochhar, Tufa Kolola, Sr, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Moritz U G Kraemer, Kewal Krishan, Nuworza Kugbey, G Anil Kumar, Manasi Kumar, Sr, Pushpendra Kumar, Vivek Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Sheetal D Lad, Dharmesh Kumar Lal, Felix Lam, Faris Hasan Lami, Sr, Prabhat Lamichhane, Van Charles Lansingh, Savita Lasrado, Avula Laxmaiah, Paul H Lee, Sr, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Sr, Aubrey J Levine, Shanshan Li, Sr, Shai Linn, Shiwei Liu, Simin Liu, Rakesh Lodha, Joshua Longbottom, Jaifred Christian F Lopez, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, D R Mahadeshwara Prasad, Phetole Walter Mahasha, Sr, Narayan B Mahotra, Azeem Majeed, Reza Malekzadeh, Sr, Deborah Carvalho Malta, Abdullah A Mamun, Sr, Navid Manafi, Sr, Ana Laura Manda, Narendar Dawani Dawanu Manohar, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Joemer C Maravilla, Gabriel Martinez, Sr, Santi Martini, Francisco Rogerlândio Martins-Melo, Anthony Masaka, Benjamin Ballard Massenburg, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Sr, Kala M Mehta, Tefera C Chane Mekonnen, Gebrekiros Gebremichael Meles, Peter T N Memiah, Ziad A Memish, Sr, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Sr, Tomislav Mestrovic, Bartosz Miazgowski, Kebadnew Mulatu Mihretie, Sr, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Amjad Mohamadi-Bolbanabad, Dara K Mohammad, Karzan Abdulmuhsin Mohammad, Yousef Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Noushin Mohammadifard, Jemal Abdu Mohammed, Sr, Shafiu Mohammed, Farnam Mohebi, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Yoshan Moodley, Sr, Catrin E Moore, Sr, Ghobad Moradi, Masoud Moradi, Mohammad Moradi-Joo, Maziar Moradi-Lakeh, Paula Moraga, Linda Morales, Ilais Moreno Velásquez, Abbas Mosapour, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor I, Kindie Fentahun Muchie, Sr, Getahun Fentaw Mulaw, Sr, Sandra B Munro, Moses K Muriithi, Christopher J L Murray, GVS Murthy, Kamarul Imran Musa, Ghulam Mustafa, Sr, Saravanan Muthupandian, Sr, Ashraf F Nabhan, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Kovin S Naidoo, Gurudatta Naik, Farid Najafi, Vinay Nangia, Sr, Jobert Richie Nansseu, Bruno Ramos Nascimento, Sr, Javad Nazari, Duduzile Edith Ndwandwe, Sr, Ionut Negoi, Sr, Henok Biresaw Netsere Netsere, Sr, Josephine W Ngunjiri, Sr, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Dabere Nigatu, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Vuong Minh Nong, Ole F Norheim, Sr, Jean Jacques Noubiap, Soraya Nouraei Motlagh, Bogdan Oancea, Okechukwu Samuel Ogah, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Tinuke O Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Obinna E Onwujekwe, Sr, Eyal Oren, Doris V V Ortega-Altamirano, Sr, Osayomwanbo Osarenotor, Frank B Osei, Sr, Mayowa O Owolabi, Mahesh P A, Sr, Jagadish Rao Padubidri, Smita Pakhale, Sangram Kishor Patel, Angel J Paternina-Caicedo, Sr, Ashish Pathak, Sr, George C Patton, Deepak Paudel, Sr, Kebreab Paulos, Sr, Veincent Christian Filipino Pepito, Alexandre Pereira, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Bakhtiar Piroozi, Meghdad Pirsaheb, Maarten J Postma, Hadi Pourjafar, Farshad Pourmalek, Sr, Akram Pourshams, Hossein Poustchi, Sergio I Prada, Sr, Narayan Prasad, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, SHAFIUR Rahman, Fatemeh Rajati, Sr, Saleem Muhammad Rana, Sr, Chhabi Lal Ranabhat, Davide Rasella, David Laith Rawaf, Salman Rawaf, Sr, Lal Rawal, Wasiq Faraz Rawasia, Vishnu Renjith, Andre M N Renzaho, Sr, Serge Resnikoff, Sr, Melese Abate Reta, Negar Rezaei, Mohammad sadegh Rezai, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Sr, Maria Rios-Blancas, Leonardo Roever, Luca Ronfani, Elias Merdassa Roro, Sr, Jennifer M Ross, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Yogesh Damodar Sabde, Siamak Sabour, Ehsan Sadeghi, Sr, Yahya Safari, Roya Safari-Faramani, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, S Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Sr, Payman Salamati, Hosni Salem, Marwa R Rashad Salem I, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Sr, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Kaushik Sarkar, Sr, Abdur Razzaque Sarker, Nizal Sarrafzadegan I, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Monika Sawhney, Sonia Saxena, Sr, David C Schwebel, Sr, Anbissa Muleta Senbeta IV, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Sr, Hosein Shabaninejad, Azadeh Shafieesabet, Sr, Masood Ali Shaikh, Ali S Shalash, Sr, Seifadin Ahmed Shallo, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Hamid Sharifi, Hatem Samir Shehata, Sr, Aziz Sheikh, B Suresh Kumar Shetty, Sr, Kenji Shibuya, Sr, Wondimeneh Shibabaw Shiferaw, Sr, Desalegn Markos Shifti, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Sr, Reza Shirkoohi, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Ambrish Singh, Jasvinder A Singh, Narinder Pal Singh, Virendra Singh, Malede Mequanent Sisay, Eirini Skiadaresi, Mohammad Reza Sobhiyeh, Sr, Anton Sokhan, Shahin Soltani, Ranjani Somayaji, Moslem Soofi, Muluken Bekele Sorrie, Sr, Ireneous N Soyiri, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Sr, Hafiz Ansar Rasul Suleria, Marufa Sultana, Bruno Fokas Sunguya, Bryan L Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Jr, Ingan Ukur Tarigan, Aberash Abay Tasew, Yonatal Mesfin Tefera, Sr, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay I, Fisaha Haile Haile Tesfay, Belay Tessema, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Nihal Thomas, Alemayehu Toma Toma, Sr, Roman Topor-Madry, Marcos Roberto Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Sr, Benjamin S Chudi Uzochukwu, Sr, Pascual R Valdez, Santosh Varughese, Sr, Francesco S Violante, Sr, Sebastian Vollmer, Sr, Feleke Gebremeskel W/hawariat, Sr, Yasir Waheed, Mitchell Taylor Wallin, Yafeng Wang, Yuan-Pang Wang, Marcia Weaver, Bedilu Girma Weji, Girmay Teklay Weldesamuel, Catherine A Welgan, Andrea Werdecker, Ronny Westerman, Sr, Taweewat Wiangkham, Charles Shey Wiysonge, Sr, Haileab Fekadu Wolde, Sr, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Sr, Getasew Taddesse Worku, Sr, Ai-Min Wu, Gelin Xu, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Sr, Hiroshi Yatsuya, Alex Yeshaneh, Christopher Sabo Yilgwan, Mekdes Tigistu Yilma, Paul Yip, Sr, Engida Yisma, Naohiro Yonemoto, Sr, Seok-Jun Yoon, Mustafa Z Younis, Mahmoud Yousefifard, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Nejimu Biza Zepro, Taddese Alemu Zerfu, Yunquan Zhang, Xiu-Ju George Zhao, Arash Ziapour, Sanjay Zodpey, Sr, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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15. Mapping of variations in child stunting, wasting and underweight within the states of India: the Global Burden of Disease Study 2000–2017

Author: Rajkumar Hemalatha, Anamika Pandey, Damaris Kinyoki, Siddarth Ramji, Rakesh Lodha, G. Anil Kumar, Nicholas J. Kassebaum, Elaine Borghi, Deepti Agrawal, Subodh S. Gupta, Avula Laxmaiah, Anita Kar, Matthews Mathai, Chris M. Varghese, Shally Awasthi, Priyanka G. Bansal, Joy K. Chakma, Michael Collison, Supriya Dwivedi, Mahaveer J. Golechha, Zaozianlungliu Gonmei, Suparna G. Jerath, Rajni Kant, Ajay K. Khera, Rinu P. Krishnankutty, Anura V. Kurpad, Laishram Ladusingh, Ridhima Malhotra, Raja S. Mamidi, Helena Manguerra, Joseph L. Mathew, Parul Mutreja, Arlappa Nimmathota, Ashalata Pati, Manorama Purwar, Kankipati V. Radhakrishna, Neena Raina, Mari J. Sankar, Deepika S. Saraf, Megan Schipp, R.S. Sharma, Chander Shekhar, Anju Sinha, V. Sreenivas, K. Srinath Reddy, Hendrik J. Bekedam, Soumya Swaminathan, Stephen S. Lim, Rakhi Dandona, Christopher J.L. Murray, Simon I. Hay, G.S. Toteja, and Lalit Dandona
Subjects: Child growth failure, District-level, Geospatial mapping, Inequality, National Nutrition Mission, Prevalence, Medicine (General), R5-920
Abstract: Background: To inform actions at the district level under the National Nutrition Mission (NNM), we assessed the prevalence trends of child growth failure (CGF) indicators for all districts in India and inequality between districts within the states. Methods: We assessed the trends of CGF indicators (stunting, wasting and underweight) from 2000 to 2017 across the districts of India, aggregated from 5 × 5 km grid estimates, using all accessible data from various surveys with subnational geographical information. The states were categorised into three groups using their Socio-demographic Index (SDI) levels calculated as part of the Global Burden of Disease Study based on per capita income, mean education and fertility rate in women younger than 25 years. Inequality between districts within the states was assessed using coefficient of variation (CV). We projected the prevalence of CGF indicators for the districts up to 2030 based on the trends from 2000 to 2017 to compare with the NNM 2022 targets for stunting and underweight, and the WHO/UNICEF 2030 targets for stunting and wasting. We assessed Pearson correlation coefficient between two major national surveys for district-level estimates of CGF indicators in the states. Findings: The prevalence of stunting ranged 3.8-fold from 16.4% (95% UI 15.2–17.8) to 62.8% (95% UI 61.5–64.0) among the 723 districts of India in 2017, wasting ranged 5.4-fold from 5.5% (95% UI 5.1–6.1) to 30.0% (95% UI 28.2–31.8), and underweight ranged 4.6-fold from 11.0% (95% UI 10.5–11.9) to 51.0% (95% UI 49.9–52.1). 36.1% of the districts in India had stunting prevalence 40% or more, with 67.0% districts in the low SDI states group and only 1.1% districts in the high SDI states with this level of stunting. The prevalence of stunting declined significantly from 2010 to 2017 in 98.5% of the districts with a maximum decline of 41.2% (95% UI 40.3–42.5), wasting in 61.3% with a maximum decline of 44.0% (95% UI 42.3–46.7), and underweight in 95.0% with a maximum decline of 53.9% (95% UI 52.8–55.4). The CV varied 7.4-fold for stunting, 12.2-fold for wasting, and 8.6-fold for underweight between the states in 2017; the CV increased for stunting in 28 out of 31 states, for wasting in 16 states, and for underweight in 20 states from 2000 to 2017. In order to reach the NNM 2022 targets for stunting and underweight individually, 82.6% and 98.5% of the districts in India would need a rate of improvement higher than they had up to 2017, respectively. To achieve the WHO/UNICEF 2030 target for wasting, all districts in India would need a rate of improvement higher than they had up to 2017. The correlation between the two national surveys for district-level estimates was poor, with Pearson correlation coefficient of 0.7 only in Odisha and four small north-eastern states out of the 27 states covered by these surveys. Interpretation: CGF indicators have improved in India, but there are substantial variations between the districts in their magnitude and rate of decline, and the inequality between districts has increased in a large proportion of the states. The poor correlation between the national surveys for CGF estimates highlights the need to standardise collection of anthropometric data in India. The district-level trends in this report provide a useful reference for targeting the efforts under NNM to reduce CGF across India and meet the Indian and global targets.
Published: 2020
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16. Mortality due to road injuries in the states of India: the Global Burden of Disease Study 1990–2017

Author: Rakhi Dandona, G Anil Kumar, Gopalkrishna Gururaj, Spencer James, Joy K Chakma, J S Thakur, Amar Srivastava, Girikumar Kumaresh, Scott D Glenn, Gaurav Gupta, Rinu P Krishnankutty, Rajesh Malhotra, W Cliff Mountjoy-Venning, Parul Mutreja, Anamika Pandey, D K Shukla, Chris M Varghese, Geetika Yadav, K Srinath Reddy, Soumya Swaminathan, Hendrik J Bekedam, Theo Vos, Mohsen Naghavi, Christopher J L Murray, R S Dhaliwal, and Lalit Dandona
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: A systematic understanding of population-level trends in deaths due to road injuries at the subnational level over time for India's 1·4 billion people, by age, sex, and type of road user is not readily available; we aimed to fill this knowledge gap. Methods: As part of the Global Burden of Diseases, Injuries, and Risk Factors Study, we estimated the rate of deaths due to road injuries in each state of India from 1990 to 2017 based on several verbal autopsy data sources. We calculated the number of deaths and death rate for road injuries by type of road user, and assessed the age and sex distribution of these deaths over time. Based on the trends of the age-standardised death rate from 1990 to 2017, we projected the age-standardised death rate to 2030 to assess if the states of India would meet the Sustainable Development Goal (SDG) target to halve the death rate for road injuries from 2015 by 2020 or 2030. We calculated 95% uncertainty intervals (UIs) for the point estimates. Findings: In 2017, 218 876 deaths (95% UI 201 734 to 231 141) due to road injuries occurred in India, with an age-standardised death rate for road injuries of 17·2 deaths (15·7 to 18·1) per 100 000 population, which was much higher in males (25·7 deaths [23·5 to 27·4] per 100 000) than in females (8·5 deaths [7·2 to 9·1] per 100 000). The number of deaths due to road injuries in India increased by 58·7% (43·6 to 74·7) from 1990 to 2017, but the age-standardised death rate decreased slightly, by 9·2% (0·6 to 18·3). In 2017, pedestrians accounted for 76 729 (35·1%) of all deaths due to road injuries, motorcyclists accounted for 67 524 (30·9%), motor vehicle occupants accounted for 57 802 (26·4%), and cyclists accounted for 15 324 (7·0%). India had a higher age-standardised death rate for road injury among motorcyclists (4·9 deaths [3·9–5·4] per 100 000 population) and cyclists (1·2 deaths [0·9–1·4] per 100 000 population) than the global average. Road injury was the leading cause of death in males aged 15 to 39 years in India in 2017, and the second leading cause in this age group for both sexes combined. The overall age-standardised death rate for road injuries varied by up to 2·6 times between states in 2017. Wide variations were seen between the states in the percentage change in age-standardised death rate for road injuries from 1990 to 2017, ranging from a reduction of 38·2% (22·3 to 51·7) in Delhi to an increase of 17·0% (0·6 to 34·7) in Odisha. If the trends estimated up to 2017 were to continue, no state in India or India overall would achieve the SDG 2020 target in 2020 or even in 2030. Interpretation: India's contribution to the global number of deaths due to road injuries is increasing, and the country is unlikely to meet the SDG targets if the trends up to 2017 continue. India needs to implement evidence-based road safety interventions, promote strong policies and traffic law enforcement, have better road and vehicle design, and improve care for road injuries at the state level to meet the SDG goal. Funding: Bill & Melinda Gates Foundation and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
Published: 2020
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17. India's disability estimates: Limitations and way forward.

Author: Rakhi Dandona, Anamika Pandey, Sibin George, G Anil Kumar, and Lalit Dandona
Subjects: Medicine, Science
Abstract: BACKGROUND:With India preparing for the next decennial Census in 2021, we compared the disability estimates and data collection methodology between the Census 2011 and the most recent population-level survey for India and its states, to highlight the issues to be addressed to improve robustness of the disability estimates in the upcoming Census. METHODS:Data from the Census 2011 and from two complementary nationally representative household surveys that covered all Indian states with the same methodology and survey instruments-the District-Level Household Survey-4 (DLHS-4, 2012-2013) and the Annual Health Surveys (AHS three rounds, 2010-11, 2011-12 and 2012-13) were used. Data from DLHS-4 and AHS 2012-13 round were pooled to generate estimates for the year 2012-13. Data collection methodology between the sources was compared, including the review of definitions of each type of disability. The overall, mental, visual, hearing, speech, and movement disability rate (DR) per 100,000 population were compared between the sources for India and for each state, and the percent difference in the respective rates was calculated. We explored the reliability of these estimates comparing yearly data from the AHS for three successive rounds. RESULTS:Survey data were collected through proxy reporting, however, it is not entirely clear whether the data were proxy- or self-reported or a mix of both in the Census. The overall DR was 25.1% higher in the Census (2,242; 95% CI 2,241-2,243) than the survey (1,791; 95% CI 1,786-1,797) per 100,000 population, with the state-level difference ranging from -64% in Tamil Nadu to 107% in Sikkim state. Despite both sources using nearly similar definitions for overall disability and disability by type, the difference in DR was 125.5%, 54.2%, -25.7%, -19.7%, and 21.9% for hearing, speech, mental, movement, and visual DR, respectively. At the state-level, the difference in disability-specific estimates ranged from -84% to 450%. The extent of variations in the disability-specific estimates in AHS successive rounds ranged from -25% to 929% at the state-level. CONCLUSIONS:There is momentum globally towards building disability measurement that is consistent with the data required for monitoring of the Sustainable Development Goals to ensure robust estimation of disability. The current estimates from the Census and surveys seem much lower than would be expected at the population level. We make recommendations that India needs to take serious note of in order to improve the validity and reliability of India's disability estimates.
Published: 2019
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18. The impact of air pollution on deaths, disease burden, and life expectancy across the states of India: the Global Burden of Disease Study 2017

Author: Kalpana Balakrishnan, Sagnik Dey, Tarun Gupta, R S Dhaliwal, Michael Brauer, Aaron J Cohen, Jeffrey D Stanaway, Gufran Beig, Tushar K Joshi, Ashutosh N Aggarwal, Yogesh Sabde, Harsiddha Sadhu, Joseph Frostad, Kate Causey, William Godwin, D K Shukla, G Anil Kumar, Chris M Varghese, Pallavi Muraleedharan, Anurag Agrawal, R M Anjana, Anil Bhansali, Deeksha Bhardwaj, Katrin Burkart, Kelly Cercy, Joy K Chakma, Sourangsu Chowdhury, D J Christopher, Eliza Dutta, Melissa Furtado, Santu Ghosh, Aloke G Ghoshal, Scott D Glenn, Randeep Guleria, Rajeev Gupta, Panniyammakal Jeemon, Rajni Kant, Surya Kant, Tanvir Kaur, Parvaiz A Koul, Varsha Krish, Bhargav Krishna, Samantha L Larson, Kishore Madhipatla, P A Mahesh, Viswanathan Mohan, Satinath Mukhopadhyay, Parul Mutreja, Nitish Naik, Sanjeev Nair, Grant Nguyen, Christopher M Odell, Jeyaraj D Pandian, Dorairaj Prabhakaran, Poornima Prabhakaran, Ambuj Roy, Sundeep Salvi, Sankar Sambandam, Deepika Saraf, Meenakshi Sharma, Aakash Shrivastava, Virendra Singh, Nikhil Tandon, Nihal J Thomas, Anna Torre, Denis Xavier, Geetika Yadav, Sujeet Singh, Chander Shekhar, Theo Vos, Rakhi Dandona, K Srinath Reddy, Stephen S Lim, Christopher J L Murray, S Venkatesh, and Lalit Dandona
Subjects: Environmental sciences, GE1-350
Abstract: Summary: Background: Air pollution is a major planetary health risk, with India estimated to have some of the worst levels globally. To inform action at subnational levels in India, we estimated the exposure to air pollution and its impact on deaths, disease burden, and life expectancy in every state of India in 2017. Methods: We estimated exposure to air pollution, including ambient particulate matter pollution, defined as the annual average gridded concentration of PM2.5, and household air pollution, defined as percentage of households using solid cooking fuels and the corresponding exposure to PM2.5, across the states of India using accessible data from multiple sources as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. The states were categorised into three Socio-demographic Index (SDI) levels as calculated by GBD 2017 on the basis of lag-distributed per-capita income, mean education in people aged 15 years or older, and total fertility rate in people younger than 25 years. We estimated deaths and disability-adjusted life-years (DALYs) attributable to air pollution exposure, on the basis of exposure–response relationships from the published literature, as assessed in GBD 2017; the proportion of total global air pollution DALYs in India; and what the life expectancy would have been in each state of India if air pollution levels had been less than the minimum level causing health loss. Findings: The annual population-weighted mean exposure to ambient particulate matter PM2·5 in India was 89·9 μg/m3 (95% uncertainty interval [UI] 67·0–112·0) in 2017. Most states, and 76·8% of the population of India, were exposed to annual population-weighted mean PM2·5 greater than 40 μg/m3, which is the limit recommended by the National Ambient Air Quality Standards in India. Delhi had the highest annual population-weighted mean PM2·5 in 2017, followed by Uttar Pradesh, Bihar, and Haryana in north India, all with mean values greater than 125 μg/m3. The proportion of population using solid fuels in India was 55·5% (54·8–56·2) in 2017, which exceeded 75% in the low SDI states of Bihar, Jharkhand, and Odisha. 1·24 million (1·09–1·39) deaths in India in 2017, which were 12·5% of the total deaths, were attributable to air pollution, including 0·67 million (0·55–0·79) from ambient particulate matter pollution and 0·48 million (0·39–0·58) from household air pollution. Of these deaths attributable to air pollution, 51·4% were in people younger than 70 years. India contributed 18·1% of the global population but had 26·2% of the global air pollution DALYs in 2017. The ambient particulate matter pollution DALY rate was highest in the north Indian states of Uttar Pradesh, Haryana, Delhi, Punjab, and Rajasthan, spread across the three SDI state groups, and the household air pollution DALY rate was highest in the low SDI states of Chhattisgarh, Rajasthan, Madhya Pradesh, and Assam in north and northeast India. We estimated that if the air pollution level in India were less than the minimum causing health loss, the average life expectancy in 2017 would have been higher by 1·7 years (1·6–1·9), with this increase exceeding 2 years in the north Indian states of Rajasthan, Uttar Pradesh, and Haryana. Interpretation: India has disproportionately high mortality and disease burden due to air pollution. This burden is generally highest in the low SDI states of north India. Reducing the substantial avoidable deaths and disease burden from this major environmental risk is dependent on rapid deployment of effective multisectoral policies throughout India that are commensurate with the magnitude of air pollution in each state. Funding: Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
Published: 2019
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19. The burden of chronic respiratory diseases and their heterogeneity across the states of India: the Global Burden of Disease Study 1990–2016

Author: Sundeep Salvi, G Anil Kumar, R S Dhaliwal, Katherine Paulson, Anurag Agrawal, Parvaiz A Koul, P A Mahesh, Sanjeev Nair, Virendra Singh, Ashutosh N Aggarwal, D J Christopher, Randeep Guleria, B V Murali Mohan, Surya K Tripathi, Aloke G Ghoshal, R Vijai Kumar, Ravi Mehrotra, D K Shukla, Eliza Dutta, Melissa Furtado, Deeksha Bhardwaj, Mari Smith, Rizwan S Abdulkader, Monika Arora, Kalpana Balakrishnan, Joy K Chakma, Pankaj Chaturvedi, Sagnik Dey, Deesha Ghorpade, Scott Glenn, Prakash C Gupta, Tarun Gupta, Sarah C Johnson, Tushar K Joshi, Michael Kutz, Manu R Mathur, Prashant Mathur, Pallavi Muraleedharan, Christopher M Odell, Sanghamitra Pati, Yogesh Sabde, Dhirendra N Sinha, K R Thankappan, Chris M Varghese, Geetika Yadav, Stephen S Lim, Mohsen Naghavi, Rakhi Dandona, K Srinath Reddy, Theo Vos, Christopher J L Murray, Soumya Swaminathan, and Lalit Dandona
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: India has 18% of the global population and an increasing burden of chronic respiratory diseases. However, a systematic understanding of the distribution of chronic respiratory diseases and their trends over time is not readily available for all of the states of India. Our aim was to report the trends in the burden of chronic respiratory diseases and the heterogeneity in their distribution in all states of India between 1990 and 2016. Methods: Using all accessible data from multiple sources, we estimated the prevalence of major chronic respiratory diseases and the deaths and disability-adjusted life-years (DALYs) caused by them for every state of India from 1990 to 2016 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016. We assessed heterogeneity in the burden of chronic obstructive pulmonary disease (COPD) and asthma across the states of India. The states were categorised into four groups based on their epidemiological transition level (ETL). ETL was defined as the ratio of DALYs from communicable diseases to those from non-communicable diseases and injuries combined, with a low ratio denoting high ETL and vice versa. We also assessed the contribution of risk factors to DALYs due to COPD. We compared the burden of chronic respiratory diseases in India against the global average in GBD 2016. We calculated 95% uncertainty intervals (UIs) for the point estimates. Findings: The contribution of chronic respiratory diseases to the total DALYs in India increased from 4·5% (95% UI 4·0–4·9) in 1990 to 6·4% (5·8–7·0) in 2016. Of the total global DALYs due to chronic respiratory diseases in 2016, 32·0% occurred in India. COPD and asthma were responsible for 75·6% and 20·0% of the chronic respiratory disease DALYs, respectively, in India in 2016. The number of cases of COPD in India increased from 28·1 million (27·0–29·2) in 1990 to 55·3 million (53·1–57·6) in 2016, an increase in prevalence from 3·3% (3·1–3·4) to 4·2% (4·0–4·4). The age-standardised COPD prevalence and DALY rates in 2016 were highest in the less developed low ETL state group. There were 37·9 million (35·7–40·2) cases of asthma in India in 2016, with similar prevalence in the four ETL state groups, but the highest DALY rate was in the low ETL state group. The highest DALY rates for both COPD and asthma in 2016 were in the low ETL states of Rajasthan and Uttar Pradesh. The DALYs per case of COPD and asthma were 1·7 and 2·4 times higher in India than the global average in 2016, respectively; most states had higher rates compared with other locations worldwide at similar levels of Socio-demographic Index. Of the DALYs due to COPD in India in 2016, 53·7% (43·1–65·0) were attributable to air pollution, 25·4% (19·5–31·7) to tobacco use, and 16·5% (14·1–19·2) to occupational risks, making these the leading risk factors for COPD. Interpretation: India has a disproportionately high burden of chronic respiratory diseases. The increasing contribution of these diseases to the overall disease burden across India and the high rate of health loss from them, especially in the less developed low ETL states, highlights the need for focused policy interventions to address this significant cause of disease burden in India. Funding: Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
Published: 2018
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20. The increasing burden of diabetes and variations among the states of India: the Global Burden of Disease Study 1990–2016

Author: Nikhil Tandon, Ranjit M Anjana, Viswanathan Mohan, Tanvir Kaur, Ashkan Afshin, Kanyin Ong, Satinath Mukhopadhyay, Nihal Thomas, Eesh Bhatia, Anand Krishnan, Prashant Mathur, R S Dhaliwal, D K Shukla, Anil Bhansali, Dorairaj Prabhakaran, Paturi V Rao, Chittaranjan S Yajnik, G Anil Kumar, Chris M Varghese, Melissa Furtado, Sanjay K Agarwal, Megha Arora, Deeksha Bhardwaj, Joy K Chakma, Leslie Cornaby, Eliza Dutta, Scott Glenn, N Gopalakrishnan, Rajeev Gupta, Panniyammakal Jeemon, Sarah C Johnson, Tripti Khanna, Sanjay Kinra, Michael Kutz, Pallavi Muraleedharan, Nitish Naik, Chrisopher M Odell, Anu M Oommen, Jeyaraj D Pandian, Sreejith Parameswaran, Sanghamitra Pati, Narayan Prasad, D Sreebhushan Raju, Ambuj Roy, Meenakshi Sharma, Chander Shekhar, Sharvari R Shukla, Narinder P Singh, J S Thakur, Ranjit Unnikrishnan, Santosh Varughese, Denis Xavier, Geevar Zachariah, Stephen S Lim, Mohsen Naghavi, Rakhi Dandona, Theo Vos, Christopher J L Murray, K Srinath Reddy, Soumya Swaminathan, and Lalit Dandona
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: The burden of diabetes is increasing rapidly in India but a systematic understanding of its distribution and time trends is not available for every state of India. We present a comprehensive analysis of the time trends and heterogeneity in the distribution of diabetes burden across all states of India between 1990 and 2016. Methods: We analysed the prevalence and disability-adjusted life-years (DALYs) of diabetes in the states of India from 1990 to 2016 using all available data sources that could be accessed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, and assessed heterogeneity across the states. The states were placed in four groups based on epidemiological transition level (ETL), defined on the basis of the ratio of DALYs from communicable diseases to those from non-communicable diseases and injuries combined, with a low ratio denoting high ETL and vice versa. We assessed the contribution of risk factors to diabetes DALYs and the relation of overweight (body-mass index 25 kg/m2 or more) with diabetes prevalence. We calculated 95% uncertainty intervals (UIs) for the point estimates. Findings: The number of people with diabetes in India increased from 26·0 million (95% UI 23·4–28·6) in 1990 to 65·0 million (58·7–71·1) in 2016. The prevalence of diabetes in adults aged 20 years or older in India increased from 5·5% (4·9–6·1) in 1990 to 7·7% (6·9–8·4) in 2016. The prevalence in 2016 was highest in Tamil Nadu and Kerala (high ETL) and Delhi (higher-middle ETL), followed by Punjab and Goa (high ETL) and Karnataka (higher-middle ETL). The age-standardised DALY rate for diabetes increased in India by 39·6% (32·1–46·7) from 1990 to 2016, which was the highest increase among major non-communicable diseases. The age-standardised diabetes prevalence and DALYs increased in every state, with the percentage increase among the highest in several states in the low and lower-middle ETL state groups. The most important risk factor for diabetes in India was overweight to which 36·0% (22·6–49·2) of the diabetes DALYs in 2016 could be attributed. The prevalence of overweight in adults in India increased from 9·0% (8·7–9·3) in 1990 to 20·4% (19·9–20·8) in 2016; this prevalence increased in every state of the country. For every 100 overweight adults aged 20 years or older in India, there were 38 adults (34–42) with diabetes, compared with the global average of 19 adults (17–21) in 2016. Interpretation: The increase in health loss from diabetes since 1990 in India is the highest among major non-communicable diseases. With this increase observed in every state of the country, and the relative rate of increase highest in several less developed low ETL states, policy action that takes these state-level differences into account is needed urgently to control this potentially explosive public health situation. Funding: Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
Published: 2018
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21. The changing patterns of cardiovascular diseases and their risk factors in the states of India: the Global Burden of Disease Study 1990–2016

Author: Dorairaj Prabhakaran, Panniyammakal Jeemon, Meenakshi Sharma, Gregory A Roth, Catherine Johnson, Sivadasanpillai Harikrishnan, Rajeev Gupta, Jeyaraj D Pandian, Nitish Naik, Ambuj Roy, R S Dhaliwal, Denis Xavier, Raman K Kumar, Nikhil Tandon, Prashant Mathur, D K Shukla, Ravi Mehrotra, K Venugopal, G Anil Kumar, Chris M Varghese, Melissa Furtado, Pallavi Muraleedharan, Rizwan S Abdulkader, Tahiya Alam, Ranjit M Anjana, Monika Arora, Anil Bhansali, Deeksha Bhardwaj, Eesh Bhatia, Joy K Chakma, Pankaj Chaturvedi, Eliza Dutta, Scott Glenn, Prakash C Gupta, Sarah C Johnson, Tanvir Kaur, Sanjay Kinra, Anand Krishnan, Michael Kutz, Manu R Mathur, Viswanathan Mohan, Satinath Mukhopadhyay, Minh Nguyen, Christopher M Odell, Anu M Oommen, Sanghamitra Pati, Martin Pletcher, Kameshwar Prasad, Paturi V Rao, Chander Shekhar, Dhirendra N Sinha, P N Sylaja, J S Thakur, Kavumpurathu R Thankappan, Nihal Thomas, Simon Yadgir, Chittaranjan S Yajnik, Geevar Zachariah, Ben Zipkin, Stephen S Lim, Mohsen Naghavi, Rakhi Dandona, Theo Vos, Christopher J L Murray, K Srinath Reddy, Soumya Swaminathan, and Lalit Dandona
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: The burden of cardiovascular diseases is increasing in India, but a systematic understanding of its distribution and time trends across all the states is not readily available. In this report, we present a detailed analysis of how the patterns of cardiovascular diseases and major risk factors have changed across the states of India between 1990 and 2016. Methods: We analysed the prevalence and disability-adjusted life-years (DALYs) due to cardiovascular diseases and the major component causes in the states of India from 1990 to 2016, using all accessible data sources as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016. We placed states into four groups based on epidemiological transition level (ETL), defined using the ratio of DALYs from communicable diseases to those from non-communicable diseases and injuries combined, with a low ratio denoting high ETL and vice versa. We assessed heterogeneity in the burden of major cardiovascular diseases across the states of India, and the contribution of risk factors to cardiovascular diseases. We calculated 95% uncertainty intervals (UIs) for the point estimates. Findings: Overall, cardiovascular diseases contributed 28·1% (95% UI 26·5–29·1) of the total deaths and 14·1% (12·9–15·3) of the total DALYs in India in 2016, compared with 15·2% (13·7–16·2) and 6·9% (6·3–7·4), respectively, in 1990. In 2016, there was a nine times difference between states in the DALY rate for ischaemic heart disease, a six times difference for stroke, and a four times difference for rheumatic heart disease. 23·8 million (95% UI 22·6–25·0) prevalent cases of ischaemic heart disease were estimated in India in 2016, and 6·5 million (6·3–6·8) prevalent cases of stroke, a 2·3 times increase in both disorders from 1990. The age-standardised prevalence of both ischaemic heart disease and stroke increased in all ETL state groups between 1990 and 2016, whereas that of rheumatic heart disease decreased; the increase for ischaemic heart disease was highest in the low ETL state group. 53·4% (95% UI 52·6–54·6) of crude deaths due to cardiovascular diseases in India in 2016 were among people younger than 70 years, with a higher proportion in the low ETL state group. The leading overlapping risk factors for cardiovascular diseases in 2016 included dietary risks (56·4% [95% CI 48·5–63·9] of cardiovascular disease DALYs), high systolic blood pressure (54·6% [49·0–59·8]), air pollution (31·1% [29·0–33·4]), high total cholesterol (29·4% [24·3–34·8]), tobacco use (18·9% [16·6–21·3]), high fasting plasma glucose (16·7% [11·4–23·5]), and high body-mass index (14·7% [8·3–22·0]). The prevalence of high systolic blood pressure, high total cholesterol, and high fasting plasma glucose increased generally across all ETL state groups from 1990 to 2016, but this increase was variable across the states; the prevalence of smoking decreased during this period in all ETL state groups. Interpretation: The burden from the leading cardiovascular diseases in India—ischaemic heart disease and stroke—varies widely between the states. Their increasing prevalence and that of several major risk factors in every part of India, especially the highest increase in the prevalence of ischaemic heart disease in the less developed low ETL states, indicates the need for urgent policy and health system response appropriate for the situation in each state. Funding: Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
Published: 2018
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22. Gender differentials and state variations in suicide deaths in India: the Global Burden of Disease Study 1990–2016

Author: Rakhi Dandona, G Anil Kumar, R S Dhaliwal, Mohsen Naghavi, Theo Vos, D K Shukla, Lakshmi Vijayakumar, G Gururaj, J S Thakur, Atul Ambekar, Rajesh Sagar, Megha Arora, Deeksha Bhardwaj, Joy K Chakma, Eliza Dutta, Melissa Furtado, Scott Glenn, Caitlin Hawley, Sarah C Johnson, Tripti Khanna, Michael Kutz, W Cliff Mountjoy-Venning, Pallavi Muraleedharan, Thara Rangaswamy, Chris M Varghese, Mathew Varghese, K Srinath Reddy, Christopher J L Murray, Soumya Swaminathan, and Lalit Dandona
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: A systematic understanding of suicide mortality trends over time at the subnational level for India's 1·3 billion people, 18% of the global population, is not readily available. Thus, we aimed to report time trends of suicide deaths, and the heterogeneity in its distribution between the states of India from 1990 to 2016. Methods: As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016, we estimated suicide death rates (SDRs) for both sexes in each state of India from 1990 to 2016. We used various data sources for estimating cause-specific mortality in India. For suicide mortality in India before 2000, estimates were based largely on GBD covariates. For each state, we calculated the ratio of the observed SDR to the rate expected in geographies globally with similar GBD Socio-demographic Index in 2016 (ie, the observed-to-expected ratio); and assessed the age distribution of suicide deaths, and the men-to-women ratio of SDR over time. Finally, we assessed the probability for India and the states of reaching the Sustainable Development Goal (SDG) target of a one-third reduction in SDR from 2015 to 2030, using location-wise trends of the age-standardised SDR from 1990 to 2016. We calculated 95% uncertainty intervals (UIs) for the point estimates. Findings: There were 230 314 (95% UI 194 058–250 260) suicide deaths in India in 2016. India's contribution to global suicide deaths increased from 25·3% in 1990 to 36·6% in 2016 among women, and from 18·7% to 24·3% among men. Age-standardised SDR among women in India reduced by 26·7% from 20·0 (95% UI 16·5–23·5) in 1990 to 14·7 (13·1–16·2) per 100 000 in 2016, but the age-standardised SDR among men was the same in 1990 (22·3 [95% UI 14·4–27·4] per 100 000) and 2016 (21·2 [14·6–23·6] per 100 000). SDR in women was 2·1 times higher in India than the global average in 2016, and the observed-to-expected ratio was 2·74, ranging from 0·45 to 4·54 between the states. SDR in men was 1·4 times higher in India than the global average in 2016, with an observed-to-expected ratio of 1·31, ranging from 0·40 to 2·42 between the states. There was a ten-fold variation between the states in the SDR for women and six-fold variation for men in 2016. The men-to-women ratio of SDR for India was 1·34 in 2016, ranging from 0·97 to 4·11 between the states. The highest age-specific SDRs among women in 2016 were for ages 15–29 years and 75 years or older, and among men for ages 75 years or older. Suicide was the leading cause of death in India in 2016 for those aged 15–39 years; 71·2% of the suicide deaths among women and 57·7% among men were in this age group. If the trends observed up to 2016 continue, the probability of India achieving the SDG SDR reduction target in 2030 is zero, and the majority of the states with 81·3% of India's population have less than 10% probability, three states have a probability of 10·3–15·0%, and six have a probability of 25·1–36·7%. Interpretation: India's proportional contribution to global suicide deaths is high and increasing. SDR in India is higher than expected for its Socio-Demographic Index level, especially for women, with substantial variations in the magnitude and men-to-women ratio between the states. India must develop a suicide prevention strategy that takes into account these variations in order to address this major public health problem. Funding: Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
Published: 2018
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23. Decreasing cost of public sector first-line ART services in India from 2007-2008 to 2015-2016.

Author: G Anil Kumar, Rakhi Dandona, Bharat B Rewari, S G Prem Kumar, Sukarma Tanwar, Marielle C Gagnier, Venkata S Vishnumolakala, and Lalit Dandona
Subjects: Medicine, Science
Abstract: INTRODUCTION:India has scaled-up antiretroviral treatment (ART) in public sector facilities, but data to understand time trends of average cost of ART are limited. MATERIALS AND METHODS:Cost and output data were collected at all public sector ART centres in undivided Andhra Pradesh (high-HIV burden state) and Rajasthan (low-HIV burden state) in India from fiscal year 2007-2008 to 2012-2013. Average cost per patient for first-line ART, and its relation with scale of services, were assessed. Using data on scale of services, the average cost was estimated up to 2015-2016. Break-even point was estimated from average and marginal cost functions. Costs were adjusted to 2015 constant price. RESULTS:The average cost per patient alive and on ART in 2015-2016 was US$162 in undivided Andhra Pradesh and US$186 in Rajasthan, which was 51.4% and 35.8% lower than in 2007-2008, respectively. Average ART drug cost declined by 27.2% during this period, and was 70.9% and 61.5% of the total ART cost in the two states in 2015-2016. The average cost other than ART drugs declined by 73.1% and 45.7%, with the number of patients served increasing 7 and 14.2 times, respectively. Average cost other than ART drugs had a significant negative relation with scale (R2 = 86.4%-82.8%, p
Published: 2018
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24. Mortality due to snakebite and other venomous animals in the Indian state of Bihar: Findings from a representative mortality study.

Author: Rakhi Dandona, G Anil Kumar, Archana Kharyal, Sibin George, Md Akbar, and Lalit Dandona
Subjects: Medicine, Science
Abstract: BACKGROUND:Animal bites and stings contribute significantly to mortality in certain parts of the world. India accounts for the highest number of snakebites and related mortality globally. We report on mortality due to bite or sting of a venomous animal from a population-based study in the Indian state of Bihar which estimated the causes of death using verbal autopsy. METHODOLOGY/PRINCIPAL FINDINGS:Interviews were conducted for all deaths that occurred from January 2012 to March 2014 in 109,689 households (87.1% participation) covering 627,658 population in 1,017 clusters representative of the state using the Population Health Metrics Research Consortium shortened verbal autopsy questionnaire. Cause of death was assigned using the SmartVA automated algorithm. The annualized mortality rate per 100,000 population due to snakebite, scorpion sting and other animals adjusted for age, sex and urban-rural population distribution of the state; and detailed contextual information on snakebites are reported. Deaths due to bite/sting of a venomous animal accounted for 10.7% of all deaths due to unintentional injuries, with an adjusted mortality rate of 6.2 (95% CI 6.0-6.3) per 100,000 population. The adjusted snakebite mortality rate was 4.4 (95% CI 4.3-4.6) which was significantly higher in the rural areas (4.8, 95% CI 4.7-5.0) and in females (5.5, 95% CI 5.3-5.7). Snakebites accounted for 7.6% of all unintentional injury deaths across all ages but for 33.3% of the deaths in 10-14 years age group. A similar proportion of snakebite deaths occurred while sleeping (30.2%), playing (30.2%) and during field/outdoor activities (27.9%). In these cases, 8.2% people were already dead when found, 34.7% had died before treatment could be provided, and 28 (57.1%) had died post treatment among whom 46.4% had sought treatment at a health facility, 25% with a traditional healer, and the rest from both. Death before reaching a health provider, non-availability of medicines or doctor, referral patterns, and sex-differentials in the context of snakebite deaths are reported. None of the verbatim specifically mentioned anti-venom being used for treatment. The adjusted mortality rate for scorpion sting was 0.9 (95% CI 0.8-0.9). CONCLUSIONS:The findings from this large representative sample documents the magnitude of snakebite mortality in Bihar and highlight the circumstances surrounding the snakebite events that could facilitate prevention and intervention opportunities.
Published: 2018
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25. Variations in catastrophic health expenditure across the states of India: 2004 to 2014.

Author: Anamika Pandey, G Anil Kumar, Rakhi Dandona, and Lalit Dandona
Subjects: Medicine, Science
Abstract: BACKGROUND:Financial protection is a key dimension of universal health coverage. Catastrophic health expenditure (CHE) has increased in India over time. The overall figures mask the subnational heterogeneity crucial for designing insurance coverage for 1.3 billion population across India. We estimated CHE in every state of India and the changes over a decade. METHODS:We used National Sample Survey data on health care utilisation in 2004 and 2014. The states were placed in four groups based on epidemiological transition level (ETL), defined on the basis of ratio of disability-adjusted life-years from communicable diseases to those from non-communicable diseases and injuries combined, with a low ratio denoting high ETL state group. CHE was defined as the proportion of households that had out-of-pocket payments for health care equalling or exceeding 10% of the household expenditure. We assessed variation in the magnitude and distribution of CHE between ETL state groups and between states of India. RESULTS:In 2014, CHE was higher in the high (30.3%, 95% confidence interval: 28.5 to 32.1) and higher-middle (27.4%, 26.3 to 28.6) ETL state groups than the low (21.8%, 20.8 to 22.8) and lower-middle (19.0%, 17.1 to 21.0) groups. From 2004 to 2014, CHE increased only in the high and higher-middle ETL groups (1.19 and 1.34 times, respectively). However, the individual states with substantial increase in CHE were spread across all ETL groups. The gap between the highest CHE of an individual state and the lowest was 8-fold in 2014. CHE was disproportionately concentrated among the rich in 2004 for most of India, but in 2014 CHE was distributed equally among the rich and poor because of the substantial increase in CHE among the poor over time. CONCLUSIONS:Better provision of quality health care should be accompanied by financial protection measures to safeguard the poor from increasing CHE in India. The state-specific CHE trends can provide useful input for the planning of the recently launched National Health Protection Mission such that it meets the requirement of each state.
Published: 2018
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26. Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis

Author: Seth R Flaxman, PhD, Rupert R A Bourne, ProfMD, Serge Resnikoff, ProfMD, Peter Ackland, MPhil, Tasanee Braithwaite, MPH, Maria V Cicinelli, MD, Aditi Das, MD, Jost B Jonas, ProfMD, Jill Keeffe, ProfPhD, John H Kempen, MD, Janet Leasher, ProfOD, Hans Limburg, PhD, Kovin Naidoo, PhD, Konrad Pesudovs, ProfPhD, Alex Silvester, MD, Gretchen A Stevens, D.Sc, Nina Tahhan, PhD, Tien Y Wong, ProfPhD, Hugh R Taylor, MD, Rupert Bourne, Peter Ackland, Aries Arditi, Yaniv Barkana, Banu Bozkurt, Tasanee Braithwaite, Alain Bron, Donald Budenz, Feng Cai, Robert Casson, Usha Chakravarthy, Jaewan Choi, Maria Vittoria Cicinelli, Nathan Congdon, Reza Dana, Rakhi Dandona, Lalit Dandona, Aditi Das, Iva Dekaris, Monte Del Monte, Jenny deva, Laura Dreer, Leon Ellwein, Marcela Frazier, Kevin Frick, David Friedman, Joao Furtado, Hua Gao, Gus Gazzard, Ronnie George, Stephen Gichuhi, Victor Gonzalez, Billy Hammond, Mary Elizabeth Hartnett, Minguang He, James Hejtmancik, Flavio Hirai, John Huang, April Ingram, Jonathan Javitt, Jost Jonas, Charlotte Joslin, Jill Keeffe, John Kempen, Moncef Khairallah, Rohit Khanna, Judy Kim, George Lambrou, Van Charles Lansingh, Paolo Lanzetta, Janet Leasher, Jennifer Lim, Hans LIMBURG, Kaweh Mansouri, Anu Mathew, Alan Morse, Beatriz Munoz, David Musch, Kovin Naidoo, Vinay Nangia, Maria Palaiou, Maurizio Battaglia Parodi, Fernando Yaacov Pena, Konrad Pesudovs, Tunde Peto, Harry Quigley, Murugesan Raju, Pradeep Ramulu, Zane Rankin, Serge Resnikoff, Dana Reza, Alan Robin, Luca Rossetti, Jinan Saaddine, Mya Sandar, Janet Serle, Tueng Shen, Rajesh Shetty, Pamela Sieving, Juan Carlos Silva, Alex Silvester, Rita S. Sitorus, Dwight Stambolian, Gretchen Stevens, Hugh Taylor, Jaime Tejedor, James Tielsch, Miltiadis Tsilimbaris, Jan van Meurs, Rohit Varma, Gianni Virgili, Ya Xing Wang, Ning-Li Wang, Sheila West, Peter Wiedemann, Tien Wong, Richard Wormald, and Yingfeng Zheng
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Contemporary data for causes of vision impairment and blindness form an important basis of recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modelling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020. Methods: In this systematic review and meta-analysis, we analysed published and unpublished population-based data for the causes of vision impairment and blindness from 1980 to 2014. We identified population-based studies published before July 8, 2014, by searching online databases with no language restrictions (MEDLINE from Jan 1, 1946, and Embase from Jan 1, 1974, and the WHO Library Database). We fitted a series of regression models to estimate the proportion of moderate or severe vision impairment (defined as presenting visual acuity of 14% of blindness) as causes in the high-income subregions. Blindness and vision impairment at all ages in 2015 due to diabetic retinopathy (odds ratio 2·52 [1·48–3·73]) and cataract (1·21 [1·17–1·25]) were more common among women than among men, whereas blindness and vision impairment due to glaucoma (0·71 [0·57–0·86]) and corneal opacity (0·54 [0·43–0·66]) were more common among men than among women, with no sex difference related to age-related macular degeneration (0·91 [0·70–1·14]). Interpretation: The number of people affected by the common causes of vision loss has increased substantially as the population increases and ages. Preventable vision loss due to cataract (reversible with surgery) and refractive error (reversible with spectacle correction) continue to cause most cases of blindness and moderate or severe vision impairment in adults aged 50 years and older. A large scale-up of eye care provision to cope with the increasing numbers is needed to address avoidable vision loss. Funding: Brien Holden Vision Institute.
Published: 2017
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27. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis

Author: Prof Rupert R A Bourne, MD, Seth R Flaxman, BA, Tasanee Braithwaite, MPH, Maria V Cicinelli, MD, Aditi Das, MD, Jost B Jonas, MD, Jill Keeffe, PhD, John H Kempen, MD, Janet Leasher, OD, Hans Limburg, PhD, Kovin Naidoo, PhD, Konrad Pesudovs, PhD, Serge Resnikoff, MD, Alex Silvester, MD, Gretchen A Stevens, DSc, Nina Tahhan, PhD, Tien Y Wong, PhD, Hugh R Taylor, MD, Rupert Bourne, Peter Ackland, Aries Arditi, Yaniv Barkana, Banu Bozkurt, TASANEE BRAITHWAITE, Alain Bron, Donald Budenz, Feng Cai, Robert Casson, Usha Chakravarthy, Jaewan Choi, Maria Vittoria Cicinelli, Nathan Congdon, Reza Dana, Rakhi Dandona, Lalit Dandona, Aditi Das, Iva Dekaris, Monte Del Monte, Jenny Deva, Laura Dreer, Leon Ellwein, Marcela Frazier, Kevin Frick, David Friedman, Joao Furtado, Hua Gao, Gus Gazzard, Ronnie George, Stephen Gichuhi, Victor Gonzalez, Billy Hammond, Mary Elizabeth Hartnett, Minguang He, James Hejtmancik, Flavio Hirai, John Huang, April Ingram, Jonathan Javitt, Jost Jonas, Charlotte Joslin, Jill Keeffe, John Kempen, Moncef Khairallah, Rohit Khanna, Judy Kim, George Lambrou, Van Charles Lansingh, Paolo Lanzetta, Janet Leasher, Jennifer Lim, Hans LIMBURG, Kaweh Mansouri, Anu Mathew, Alan Morse, Beatriz Munoz, David Musch, Kovin Naidoo, Vinay Nangia, MARIA PALAIOU, Maurizio Battaglia Parodi, Fernando Yaacov Pena, Konrad Pesudovs, Tunde Peto, Harry Quigley, Murugesan Raju, Pradeep Ramulu, Serge Resnikoff, Alan Robin, Luca Rossetti, Jinan Saaddine, MYA SANDAR, Janet Serle, Tueng Shen, Rajesh Shetty, Pamela Sieving, Juan Carlos Silva, Alex Silvester, Rita S Sitorus, Dwight Stambolian, Gretchen Stevens, Hugh Taylor, Jaime Tejedor, James Tielsch, Miltiadis Tsilimbaris, Jan van Meurs, Rohit Varma, Gianni Virgili, Jimmy Volmink, Ya Xing Wang, Ning-Li Wang, Sheila West, Peter Wiedemann, Tien Wong, Richard Wormald, and Yingfeng Zheng
Subjects: Public aspects of medicine, RA1-1270
Abstract: Background: Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment. Methods: We did a systematic review and meta-analysis of population-based datasets relevant to global vision impairment and blindness that were published between 1980 and 2015. We fitted hierarchical models to estimate the prevalence (by age, country, and sex), in 2015, of mild visual impairment (presenting visual acuity worse than 6/12 to 6/18 inclusive), moderate to severe visual impairment (presenting visual acuity worse than 6/18 to 3/60 inclusive), blindness (presenting visual acuity worse than 3/60), and functional presbyopia (defined as presenting near vision worse than N6 or N8 at 40 cm when best-corrected distance visual acuity was better than 6/12). Findings: Globally, of the 7·33 billion people alive in 2015, an estimated 36·0 million (80% uncertainty interval [UI] 12·9–65·4) were blind (crude prevalence 0·48%; 80% UI 0·17–0·87; 56% female), 216·6 million (80% UI 98·5–359·1) people had moderate to severe visual impairment (2·95%, 80% UI 1·34–4·89; 55% female), and 188·5 million (80% UI 64·5–350·2) had mild visual impairment (2·57%, 80% UI 0·88–4·77; 54% female). Functional presbyopia affected an estimated 1094·7 million (80% UI 581·1–1686·5) people aged 35 years and older, with 666·7 million (80% UI 364·9–997·6) being aged 50 years or older. The estimated number of blind people increased by 17·6%, from 30·6 million (80% UI 9·9–57·3) in 1990 to 36·0 million (80% UI 12·9–65·4) in 2015. This change was attributable to three factors, namely an increase because of population growth (38·4%), population ageing after accounting for population growth (34·6%), and reduction in age-specific prevalence (−36·7%). The number of people with moderate and severe visual impairment also increased, from 159·9 million (80% UI 68·3–270·0) in 1990 to 216·6 million (80% UI 98·5–359·1) in 2015. Interpretation: There is an ongoing reduction in the age-standardised prevalence of blindness and visual impairment, yet the growth and ageing of the world's population is causing a substantial increase in number of people affected. These observations, plus a very large contribution from uncorrected presbyopia, highlight the need to scale up vision impairment alleviation efforts at all levels. Funding: Brien Holden Vision Institute.
Published: 2017
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28. Identification of factors associated with stillbirth in the Indian state of Bihar using verbal autopsy: A population-based study.

Author: Rakhi Dandona, G Anil Kumar, Amit Kumar, Priyanka Singh, Sibin George, Mohammad Akbar, and Lalit Dandona
Subjects: Medicine
Abstract: India was estimated to have the largest numbers of stillbirths globally in 2015, and the Indian government has adopted a target of
Published: 2017
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29. Improving the estimation of the tuberculosis burden in India

Author: Krycia Cowling, Rakhi Dandona, and Lalit Dandona
Subjects: Public aspects of medicine, RA1-1270
Abstract: Although India is considered to be the country with the greatest tuberculosis burden, estimates of the disease’s incidence, prevalence and mortality in India rely on sparse data with substantial uncertainty. The relevant available data are less reliable than those from countries that have recently improved systems for case reporting or recently invested in national surveys of tuberculosis prevalence. We explored ways to improve the estimation of the tuberculosis burden in India. We focused on case notification data – among the most reliable data available – and ways to investigate the associated level of underreporting, as well as the need for a national tuberculosis prevalence survey. We discuss several recent developments – i.e. changes in national policies relating to tuberculosis, World Health Organization guidelines for the investigation of the disease, and a rapid diagnostic test – that should improve data collection for the estimation of the tuberculosis burden in India and elsewhere. We recommend the implementation of an inventory study in India to assess the underreporting of tuberculosis cases, as well as a national survey of tuberculosis prevalence. A national assessment of drug resistance in Indian strains of Mycobacterium tuberculosis should also be considered. The results of such studies will be vital for the accurate monitoring of tuberculosis control efforts in India and globally.
Published: 2014
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30. Variations in catastrophic health expenditure estimates from household surveys in India

Author: Magdalena Z Raban, Rakhi Dandona, and Lalit Dandona
Subjects: Public aspects of medicine, RA1-1270
Abstract: Objective To assess the comparability of out-of-pocket (OOP) payment and catastrophic health expenditure (CHE) estimates from different household surveys in India. Methods Data on CHE, outpatient and inpatient OOP payments and other expenditure from all major national or multi-state surveys since 2000 were compared. These included two consumer expenditure surveys (the National Sample Survey for 2004–05 [NSS 2004–05] and 2009–10 [NSS 2009–10]) and three health-focused surveys (the World Health Survey 2003 [WHS 2003]; the National Sample Survey on Morbidity, Health Care and the Condition of the Aged 2004 [NSS 2004]; and the Study on Global Ageing and Adult Health 2007–08 [SAGE 2007–08]). All but the NSS 2004–05 and the NSS 2009–10 used different questionnaires. Findings CHE estimates from WHS 2003 and SAGE 2007–08 were twice as high as those from NSS 2004–05, NSS 2009–10 and NSS 2004. Inpatient OOP payment estimates were twice as high in WHS 2003 and SAGE 2007–08 because in these surveys a much higher proportion of households reported such payments. However, estimates of expenditures on other items were half as high in WHS 2003 as in the other surveys because a very small number of items was used to capture these expenditures. Conclusion The wide variations observed in CHE and OOP payment estimates resulted from methodological differences. Survey methods used to assess CHE in India need to be standardized and validated to accurately track CHE and assess the impact of recent policies to reduce it.
Published: 2013
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31. Availability of data for monitoring noncommunicable disease risk factors in India

Author: Magdalena Z Raban, Rakhi Dandona, and Lalit Dandona
Subjects: Public aspects of medicine, RA1-1270
Abstract: OBJECTIVE: To examine the availability of data measuring noncommunicable disease (NCD) risk factor indicators from household surveys conducted in India from 2000 to 2009. METHODS: Questionnaires and publications used in household surveys were identified through internet and PubMed searches and examined to determine which core NCD risk factor indicators recommended by the World Health Organization (WHO) for NCD monitoring were being measured. Surveys with a sample size of 5000 or more were included to ensure a certain level of precision. The completeness of core indicator measurement and the geographical representativeness of the surveys were assessed. FINDINGS: Twenty six surveys met the inclusion criteria. Among the WHO-recommended core behavioural risk factor indicators, those monitoring tobacco use were measured completely in national and subnational surveys; those assessing dietary intake and physical inactivity were measured only in subnational surveys, and those assessing alcohol use were not measured at all. Among WHO-recommended core biological risk factors, only body mass index was measured in national and subnational surveys, whereas blood pressure, fasting blood glucose and blood cholesterol were measured only in subnational surveys. Due to the use of non-standard indicator definitions, measurement of core indicators in some of the national and subnational surveys was incomplete. CONCLUSION: The availability of data on core risk factor indicators to monitor the increasing burden of NCDs is inadequate in India. These indicators using standardized definitions should be included in the periodic national household health surveys to provide data at the national and disaggregated levels.
Published: 2012

32. Social sector expenditure and child mortality in India: a state-level analysis from 1997 to 2009.

Author: Susanna M Makela, Rakhi Dandona, T R Dilip, and Lalit Dandona
Subjects: Medicine, Science
Abstract: BACKGROUND: India is unlikely to meet the Millennium Development Goal for child mortality. As public policy impacts child mortality, we assessed the association of social sector expenditure with child mortality in India. METHODS AND FINDINGS: Mixed-effects regression models were used to assess the relationship of state-level overall social sector expenditure and its major components (health, health-related, education, and other) with mortality by sex among infants and children aged 1-4 years from 1997 to 2009, adjusting for potential confounders. Counterfactual models were constructed to estimate deaths averted due to overall social sector increases since 1997. Increases in per capita overall social sector expenditure were slightly higher in less developed than in more developed states from 1997 to 2009 (2.4-fold versus 2-fold), but the level of expenditure remained 36% lower in the former in 2009. Increase in public expenditure on health was not significantly associated with mortality reduction in infants or at ages 1-4 years, but a 10% increase in health-related public expenditure was associated with a 3.6% mortality reduction (95% confidence interval 0.2-6.9%) in 1-4 years old boys. A 10% increase in overall social sector expenditure was associated with a mortality reduction in both boys (6.8%, 3.5-10.0%) and girls (4.1%, 0.8-7.5%) aged 1-4 years. We estimated 119,807 (95% uncertainty interval 53,409-214,662) averted deaths in boys aged 1-4 years and 94,037 (14,725-206,684) in girls in India in 2009 that could be attributed to increases in overall social sector expenditure since 1997. CONCLUSIONS: Further reduction in child mortality in India would be facilitated if policymakers give high priority to the social sector as a whole for resource allocation in the country's 5-year plan for 2012-2017, as public expenditure on health alone has not had major impact on reducing child mortality.
Published: 2013
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33. Correction: Social Sector Expenditure and Child Mortality in India: A State-Level Analysis from 1997 to 2009.

Author: Susanna M. Makela, Rakhi Dandona, T. R. Dilip, and Lalit Dandona
Subjects: Medicine, Science
Published: 2013
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34. Estimation of global visual impairment due to uncorrected refractive error

Author: Lalit Dandona and Rakhi Dandona
Subjects: Public aspects of medicine, RA1-1270
Published: 2008

35. Verbal autopsy coding: are multiple coders better than one?

Author: Rohina Joshi, Alan D Lopez, Stephen MacMahon, Srinath Reddy, Rakhi Dandona, Lalit Dandona, and Bruce Neal
Subjects: Public aspects of medicine, RA1-1270
Abstract: OBJECTIVE: To assess the impact on the reported cause-of-death patterns of a verbal autopsy coding strategy based on a review of every death by multiple coders versus a single coder. METHODS: Deaths in 45 villages (total population 180 162) in southern India were documented during 12 months in 2003-2004, and a standard verbal autopsy questionnaire was completed for each death. Two physician coders, each unaware of the other's decisions, assigned an underlying cause of death in accordance with the causes listed in the chapter headings of the International classification of diseases and related health problems, 10th revision (ICD-10). For the three chapter headings that applied to more than 100 of the deaths, agreement for subsets of causes of death within the chapter was also analysed. In the event of discrepancies, a third coder was used to finalize a cause of death. Cohen's kappa statistic (K) was used to measure levels of agreement between the two physician coders. FINDINGS: In total, 1354 deaths were documented, and a verbal autopsy was completed for 1329 (98%) of them. At the chapter heading level of the ICD-10, physician coders assigned the same cause to 1255 deaths (94%) (K = 0.93; 95% confidence interval: 0.92-0.94). The patterns of death derived from the causes assigned by each physician were all very similar to the patterns obtained through the consensus process, with the rank order of the 10 leading causes of death being the same for all three coding methods. CONCLUSION: Duplicate coding of verbal autopsy results has little advantage over a single-coder system for mortality surveillance or for identifying population patterns of death. Resources could be better diverted to other parts of the mortality surveillance process, such as validation.
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36. Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050

Author: Manuela L Ferreira, Katie de Luca, Lydia M Haile, Jaimie D Steinmetz, Garland T Culbreth, Marita Cross, Jacek A Kopec, Paulo H Ferreira, Fiona M Blyth, Rachelle Buchbinder, Jan Hartvigsen, Ai-Min Wu, Saeid Safiri, Anthony D Woolf, Gary S Collins, Kanyin Liane Ong, Stein Emil Vollset, Amanda E Smith, Jessica A Cruz, Kai Glenn Fukutaki, Semagn Mekonnen Abate, Mitra Abbasifard, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Ahmed Abdelalim, Aidin Abedi, Hassan Abidi, Qorinah Estiningtyas Sakilah Adnani, Ali Ahmadi, Rufus Olusola Akinyemi, Abayneh Tadesse Alamer, Adugnaw Zeleke Alem, Yousef Alimohamadi, Mansour Abdullah Alshehri, Mohammed Mansour Alshehri, Hosam Alzahrani, Saeed Amini, Sohrab Amiri, Hubert Amu, Catalina Liliana Andrei, Tudorel Andrei, Benny Antony, Jalal Arabloo, Judie Arulappan, Ashokan Arumugam, Tahira Ashraf, Seyyed Shamsadin Athari, Nefsu Awoke, Sina Azadnajafabad, Till Winfried Bärnighausen, Lope H Barrero, Amadou Barrow, Akbar Barzegar, Lindsay M Bearne, Isabela M Bensenor, Alemshet Yirga Berhie, Bharti Bhandari Bhandari, Vijayalakshmi S Bhojaraja, Ali Bijani, Belay Boda Abule Bodicha, Srinivasa Rao Bolla, Javier Brazo-Sayavera, Andrew M Briggs, Chao Cao, Periklis Charalampous, Vijay Kumar Chattu, Flavia M Cicuttini, Benjamin Clarsen, Sarah Cuschieri, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Azizallah Dehghan, Takele Gezahegn G Demie, Edgar Denova-Gutiérrez, Syed Masudur Rahman Dewan, Samath Dhamminda Dharmaratne, Mandira Lamichhane Dhimal, Meghnath Dhimal, Daniel Diaz, Mojtaba Didehdar, Lankamo Ena Digesa, Mengistie Diress, Hoa Thi Do, Linh Phuong Doan, Michael Ekholuenetale, Muhammed Elhadi, Sharareh Eskandarieh, Shahriar Faghani, Jawad Fares, Ali Fatehizadeh, Getahun Fetensa, Irina Filip, Florian Fischer, Richard Charles Franklin, Balasankar Ganesan, Belete Negese Belete Gemeda, Motuma Erena Getachew, Ahmad Ghashghaee, Tiffany K Gill, Mahaveer Golechha, Pouya Goleij, Bhawna Gupta, Nima Hafezi-Nejad, Arvin Haj-Mirzaian, Pawan Kumar Hamal, Asif Hanif, Netanja I Harlianto, Hamidreza Hasani, Simon I Hay, Jeffrey J Hebert, Golnaz Heidari, Mohammad Heidari, Reza Heidari-Soureshjani, Mbuzeleni Mbuzeleni Hlongwa, Mohammad-Salar Hosseini, Alexander Kevin Hsiao, Ivo Iavicoli, Segun Emmanuel Ibitoye, Irena M Ilic, Milena D Ilic, Sheikh Mohammed Shariful Islam, Manthan Dilipkumar Janodia, Ravi Prakash Jha, Har Ashish Jindal, Jost B Jonas, Gebisa Guyasa Kabito, Himal Kandel, Rimple Jeet Kaur, Vikash Ranjan Keshri, Yousef Saleh Khader, Ejaz Ahmad Khan, Md Jobair Khan, Moien AB Khan, Hamid Reza Khayat Kashani, Jagdish Khubchandani, Yun Jin Kim, Adnan Kisa, Jitka Klugarová, Ali-Asghar Kolahi, Hamid Reza Koohestani, Ai Koyanagi, G Anil Kumar, Narinder Kumar, Tea Lallukka, Savita Lasrado, Wei-Chen Lee, Yo Han Lee, Ata Mahmoodpoor, Jeadran N Malagón-Rojas, Mohammad-Reza Malekpour, Reza Malekzadeh, Narges Malih, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Ritesh G Menezes, Alexios-Fotios A Mentis, Mohamed Kamal Mesregah, Ted R Miller, Mohammad Mirza-Aghazadeh-Attari, Maryam Mobarakabadi, Yousef Mohammad, Esmaeil Mohammadi, Shafiu Mohammed, Ali H Mokdad, Sara Momtazmanesh, Lorenzo Monasta, Mohammad Ali Moni, Ebrahim Mostafavi, Christopher J L Murray, Tapas Sadasivan Nair, Javad Nazari, Seyed Aria Nejadghaderi, Subas Neupane, Sandhya Neupane Kandel, Cuong Tat Nguyen, Ali Nowroozi, Hassan Okati-Aliabad, Emad Omer, Abderrahim Oulhaj, Mayowa O Owolabi, Songhomitra Panda-Jonas, Anamika Pandey, Eun-Kee Park, Shrikant Pawar, Paolo Pedersini, Jeevan Pereira, Mario F P Peres, Ionela-Roxana Petcu, Mohammadreza Pourahmadi, Amir Radfar, Shahram Rahimi-Dehgolan, Vafa Rahimi-Movaghar, Mosiur Rahman, Amir Masoud Rahmani, Nazanin Rajai, Chythra R Rao, Vahid Rashedi, Mohammad-Mahdi Rashidi, Zubair Ahmed Ratan, David Laith Rawaf, Salman Rawaf, Andre M N Renzaho, Negar Rezaei, Zahed Rezaei, Leonardo Roever, Guilherme de Andrade Ruela, Basema Saddik, Amirhossein Sahebkar, Sana Salehi, Francesco Sanmarchi, Sadaf G Sepanlou, Saeed Shahabi, Shayan Shahrokhi, Elaheh Shaker, MohammadBagher Shamsi, Mohammed Shannawaz, Saurab Sharma, Maryam Shaygan, Rahim Ali Sheikhi, Jeevan K Shetty, Rahman Shiri, Siddharudha Shivalli, Parnian Shobeiri, Migbar Mekonnen Sibhat, Ambrish Singh, Jasvinder A Singh, Helen Slater, Marco Solmi, Ranjani Somayaji, Ker-Kan Tan, Rekha Thapar, Seyed Abolfazl Tohidast, Sahel Valadan Tahbaz, Rohollah Valizadeh, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Vasily Vlassov, Bay Vo, Yuan-Pang Wang, Taweewat Wiangkham, Lalit Yadav, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Lin Yang, Fereshteh Yazdanpanah, Naohiro Yonemoto, Mustafa Z Younis, Iman Zare, Armin Zarrintan, Mohammad Zoladl, Theo Vos, Lyn M March, Surgery, Erasmus MC other, Public Health, and Pharmacy
Subjects: Rheumatology, Immunology, Immunology and Allergy
Abstract: Background: Low back pain is highly prevalent and the main cause of years lived with disability (YLDs). We present the most up-to-date global, regional, and national data on prevalence and YLDs for low back pain from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. Methods: Population-based studies from 1980 to 2019 identified in a systematic review, international surveys, US medical claims data, and dataset contributions by collaborators were used to estimate the prevalence and YLDs for low back pain from 1990 to 2020, for 204 countries and territories. Low back pain was defined as pain between the 12th ribs and the gluteal folds that lasted a day or more; input data using alternative definitions were adjusted in a network meta-regression analysis. Nested Bayesian meta-regression models were used to estimate prevalence and YLDs by age, sex, year, and location. Prevalence was projected to 2050 by running a regression on prevalence rates using Socio-demographic Index as a predictor, then multiplying them by projected population estimates. Findings: In 2020, low back pain affected 619 million (95% uncertainty interval 554–694) people globally, with a projection of 843 million (759–933) prevalent cases by 2050. In 2020, the global age-standardised rate of YLDs was 832 per 100 000 (578–1070). Between 1990 and 2020, age-standardised rates of prevalence and YLDs decreased by 10·4% (10·9–10·0) and 10·5% (11·1–10·0), respectively. A total of 38·8% (28·7–47·0) of YLDs were attributed to occupational factors, smoking, and high BMI. Interpretation: Low back pain remains the leading cause of YLDs globally, and in 2020, there were more than half a billion prevalent cases of low back pain worldwide. While age-standardised rates have decreased modestly over the past three decades, it is projected that globally in 2050, more than 800 million people will have low back pain. Challenges persist in obtaining primary country-level data on low back pain, and there is an urgent need for more high-quality, primary, country-level data on both prevalence and severity distributions to improve accuracy and monitor change. Funding: Bill and Melinda Gates Foundation.
Published: 2023
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37. Estimation of global visual impairment due to uncorrected refractive error

Author: Lalit Dandona and Rakhi Dandona
Subjects: Public aspects of medicine, RA1-1270
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38. Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Rajesh Sharma, Mohsen Abbasi-Kangevari, Rami Abd-Rabu, Hassan Abidi, Eman Abu-Gharbieh, Juan Manuel Acuna, Sangeet Adhikari, Shailesh M Advani, Muhammad Sohail Afzal, Mohamad Aghaie Meybodi, Bright Opoku Ahinkorah, Sajjad Ahmad, Ali Ahmadi, Sepideh Ahmadi, Haroon Ahmed, Luai A Ahmed, Muktar Beshir Ahmed, Hanadi Al Hamad, Fares Alahdab, Fahad Mashhour Alanezi, Turki M Alanzi, Fadwa Alhalaiqa Naji Alhalaiqa, Yousef Alimohamadi, Vahid Alipour, Syed Mohamed Aljunid, Motasem Alkhayyat, Sami Almustanyir, Rajaa M Al-Raddadi, Saba Alvand, Nelson Alvis-Guzman, Saeed Amini, Robert Ancuceanu, Amir Anoushiravani, Ali Arash Anoushirvani, Alireza Ansari-Moghaddam, Jalal Arabloo, Armin Aryannejad, Mohammad Asghari Jafarabadi, Seyyed Shamsadin Athari, Floriane Ausloos, Marcel Ausloos, Atalel Fentahun Awedew, Mamaru Ayenew Awoke, Tegegn Mulatu Ayana, Sina Azadnajafabad, Hiva Azami, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Ashish D Badiye, Sara Bagherieh, Saeed Bahadory, Atif Amin Baig, Jennifer L Baker, Maciej Banach, Amadou Barrow, Alemshet Yirga Berhie, Sima Besharat, Devidas S Bhagat, Akshaya Srikanth Bhagavathula, Neeraj Bhala, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Sadia Bibi, Ali Bijani, Antonio Biondi, Tone Bjørge, Belay Boda Abule Bodicha, Dejana Braithwaite, Hermann Brenner, Daniela Calina, Chao Cao, Yin Cao, Giulia Carreras, Felix Carvalho, Ester Cerin, Raja Chandra Chakinala, William C S Cho, Dinh-Toi Chu, Joao Conde, Vera Marisa Costa, Natália Cruz-Martins, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Anna Danielewicz, Feleke Mekonnen Demeke, Getu Debalkie Demissie, Rupak Desai, Deepak Dhamnetiya, Mostafa Dianatinasab, Daniel Diaz, Mojtaba Didehdar, Saeid Doaei, Linh Phuong Doan, Milad Dodangeh, Fatemeh Eghbalian, Debela Debela Ejeta, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Iman El Sayed, Muhammed Elhadi, Daniel Berhanie Enyew, Tahir Eyayu, Rana Ezzeddini, Ildar Ravisovich Fakhradiyev, Umar Farooque, Hossein Farrokhpour, Farshad Farzadfar, Ali Fatehizadeh, Hamed Fattahi, Nima Fattahi, Masood Fereidoonnezhad, Eduarda Fernandes, Getahun Fetensa, Irina Filip, Florian Fischer, Masoud Foroutan, Peter Andras Gaal, Mohamed M Gad, Silvano Gallus, Tushar Garg, Tamiru Getachew, Seyyed-Hadi Ghamari, Ahmad Ghashghaee, Nermin Ghith, Maryam Gholamalizadeh, Jamshid Gholizadeh Navashenaq, Abraham Tamirat Gizaw, James C Glasbey, Mahaveer Golechha, Pouya Goleij, Kebebe Bekele Gonfa, Giuseppe Gorini, Avirup Guha, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Rasool Haddadi, Nima Hafezi-Nejad, Arvin Haj-Mirzaian, Rabih Halwani, Shafiul Haque, Sanam Hariri, Ahmed I Hasaballah, Soheil Hassanipour, Simon I Hay, Claudiu Herteliu, Ramesh Holla, Mohammad-Salar Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Mowafa Househ, Junjie Huang, Ayesha Humayun, Ivo Iavicoli, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Farhad Islami, Masao Iwagami, Mohammad Ali Jahani, Mihajlo Jakovljevic, Tahereh Javaheri, Ranil Jayawardena, Rime Jebai, Ravi Prakash Jha, Tamas Joo, Nitin Joseph, Farahnaz Joukar, Jacek Jerzy Jozwiak, Ali Kabir, Rohollah Kalhor, Ashwin Kamath, Neeti Kapoor, Ibraheem M Karaye, Amirali Karimi, Joonas H Kauppila, Asma Kazemi, Mohammad Keykhaei, Yousef Saleh Khader, Himanshu Khajuria, Rovshan Khalilov, Javad Khanali, Maryam Khayamzadeh, Mahmoud Khodadost, Hanna Kim, Min Seo Kim, Adnan Kisa, Sezer Kisa, Ali-Asghar Kolahi, Hamid Reza Koohestani, Jacek A Kopec, Rajasekaran Koteeswaran, Ai Koyanagi, Yuvaraj Krishnamoorthy, G Anil Kumar, Manoj Kumar, Vivek Kumar, Carlo La Vecchia, Faris Hasan Lami, Iván Landires, Caterina Ledda, Sang-woong Lee, Wei-Chen Lee, Yeong Yeh Lee, Elvynna Leong, Bingyu Li, Stephen S Lim, Stany W Lobo, Joana A Loureiro, Raimundas Lunevicius, Farzan Madadizadeh, Ata Mahmoodpoor, Azeem Majeed, Mohammad-Reza Malekpour, Reza Malekzadeh, Ahmad Azam Malik, Fariborz Mansour-Ghanaei, Lorenzo Giovanni Mantovani, Miquel Martorell, Sahar Masoudi, Prashant Mathur, Jitendra Kumar Meena, Entezar Mehrabi Nasab, Walter Mendoza, Alexios-Fotios A Mentis, Tomislav Mestrovic, Junmei Miao Jonasson, Bartosz Miazgowski, Tomasz Miazgowski, Gelana Fekadu Worku Mijena, Seyyedmohammadsadeq Mirmoeeni, Mohammad Mirza-Aghazadeh-Attari, Hamed Mirzaei, Sanjeev Misra, Karzan Abdulmuhsin Mohammad, Esmaeil Mohammadi, Saeed Mohammadi, Seyyede Momeneh Mohammadi, Abdollah Mohammadian-Hafshejani, Shafiu Mohammed, Teroj Abdulrahman Mohammed, Nagabhishek Moka, Ali H Mokdad, Zeinab Mokhtari, Mariam Molokhia, Sara Momtazmanesh, Lorenzo Monasta, Ghobad Moradi, Rahmatollah Moradzadeh, Paula Moraga, Joana Morgado-da-Costa, Sumaira Mubarik, Francesk Mulita, Mohsen Naghavi, Mukhammad David Naimzada, Hae Sung Nam, Zuhair S Natto, Biswa Prakash Nayak, Javad Nazari, Ehsan Nazemalhosseini-Mojarad, Ionut Negoi, Cuong Tat Nguyen, Son Hoang Nguyen, Nurulamin M Noor, Maryam Noori, Seyyed Mohammad Ali Noori, Virginia Nuñez-Samudio, Chimezie Igwegbe Nzoputam, Bogdan Oancea, Oluwakemi Ololade Odukoya, Ayodipupo Sikiru Oguntade, Hassan Okati-Aliabad, Andrew T Olagunju, Tinuke O Olagunju, Sokking Ong, Samuel M Ostroff, Alicia Padron-Monedero, Reza Pakzad, Adrian Pana, Anamika Pandey, Fatemeh Pashazadeh Kan, Urvish K Patel, Uttam Paudel, Renato B Pereira, Navaraj Perumalsamy, Richard G Pestell, Zahra Zahid Piracha, Richard Charles G Pollok, Akram Pourshams, Naeimeh Pourtaheri, Akila Prashant, Mohammad Rabiee, Navid Rabiee, Amir Radfar, Sima Rafiei, Mosiur Rahman, Amir Masoud Rahmani, Vahid Rahmanian, Nazanin Rajai, Aashish Rajesh, Vajiheh Ramezani-Doroh, Kiana Ramezanzadeh, Kamal Ranabhat, Sina Rashedi, Amirfarzan Rashidi, Mahsa Rashidi, Mohammad-Mahdi Rashidi, Mandana Rastegar, David Laith Rawaf, Salman Rawaf, Reza Rawassizadeh, Mohammad Sadegh Razeghinia, Andre M N Renzaho, Negar Rezaei, Nima Rezaei, Saeid Rezaei, Mohsen Rezaeian, Sahba Rezazadeh-Khadem, Gholamreza Roshandel, Maha Mohamed Saber-Ayad, Bahar Saberzadeh-Ardestani, Basema Saddik, Hossein Sadeghi, Umar Saeed, Maryam Sahebazzamani, Amirhossein Sahebkar, Amir Salek Farrokhi, Amir Salimi, Hamideh Salimzadeh, Pouria Samadi, Mehrnoosh Samaei, Abdallah M Samy, Juan Sanabria, Milena M Santric-Milicevic, Muhammad Arif Nadeem Saqib, Arash Sarveazad, Brijesh Sathian, Maheswar Satpathy, Ione Jayce Ceola Schneider, Mario Šekerija, Sadaf G Sepanlou, Allen Seylani, Feng Sha, Sayed Mohammad Shafiee, Zahra Shaghaghi, Saeed Shahabi, Elaheh Shaker, Maedeh Sharifian, Javad Sharifi-Rad, Sara Sheikhbahaei, Jeevan K Shetty, Reza Shirkoohi, Parnian Shobeiri, Sudeep K Siddappa Malleshappa, Diego Augusto Santos Silva, Guilherme Silva Julian, Achintya Dinesh Singh, Jasvinder A Singh, Md Shahjahan Siraj, Gholam Reza Sivandzadeh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Marco Solmi, Mohammad Sadegh Soltani-Zangbar, Suhang Song, Viktória Szerencsés, Miklós Szócska, Rafael Tabarés-Seisdedos, Elnaz Tabibian, Majid Taheri, Yasaman TaheriAbkenar, Amir Taherkhani, Iman M Talaat, Ker-Kan Tan, Abdelghani Tbakhi, Bekele Tesfaye, Amir Tiyuri, Daniel Nigusse Tollosa, Mathilde Touvier, Bach Xuan Tran, Biruk Shalmeno Tusa, Irfan Ullah, Saif Ullah, Marco Vacante, Sahel Valadan Tahbaz, Massimiliano Veroux, Bay Vo, Theo Vos, Cong Wang, Ronny Westerman, Melat Woldemariam, Seyed Hossein Yahyazadeh Jabbari, Lin Yang, Fereshteh Yazdanpanah, Chuanhua Yu, Deniz Yuce, Ismaeel Yunusa, Vesna Zadnik, Mazyar Zahir, Iman Zare, Zhi-Jiang Zhang, Mohammad Zoladl, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Sharma, Rajesh, Abbasi-Kangevari, Mohsen, Abd-Rabu, Rami, Abidi, Hassan, Ahmed, Muktar Beshir, Zoladl, Mohammad, GBD 2019 Colorectal Cancer Collaborators, Sharma, R, Abbasi-Kangevari, M, Abd-Rabu, R, Abidi, H, Abu-Gharbieh, E, Manuel Acuna, J, Adhikari, S, M Advani, S, Sohail Afzal, M, Aghaie Meybodi, M, Opoku Ahinkorah, B, Ahmad, S, Ahmadi, A, Ahmadi, S, Ahmed, H, A Ahmed, L, Beshir Ahmed, M, Al Hamad, H, Alahdab, F, Mashhour Alanezi, F, M Alanzi, T, Alhalaiqa Naji Alhalaiqa, F, Alimohamadi, Y, Alipour, V, Mohamed Aljunid, S, Alkhayyat, M, Almustanyir, S, M Al-Raddadi, R, Alvand, S, Alvis-Guzman, N, Amini, S, Ancuceanu, R, Anoushiravani, A, Arash Anoushirvani, A, Ansari-Moghaddam, A, Arabloo, J, Aryannejad, A, Asghari Jafarabadi, M, Shamsadin Athari, S, Ausloos, F, Ausloos, M, Fentahun Awedew, A, Ayenew Awoke, M, Mulatu Ayana, T, Azadnajafabad, S, Azami, H, Azangou-Khyavy, M, Azari Jafari, A, D Badiye, A, Bagherieh, S, Bahadory, S, Amin Baig, A, L Baker, J, Banach, M, Barrow, A, Yirga Berhie, A, Besharat, S, S Bhagat, D, Srikanth Bhagavathula, A, Bhala, N, Bhattacharyya, K, S Bhojaraja, V, Bibi, S, Bijani, A, Biondi, A, Bj??rge, T, Boda Abule Bodicha, B, Braithwaite, D, Brenner, H, Calina, D, Cao, C, Cao, Y, Carreras, G, Carvalho, F, Cerin, E, Chandra Chakinala, R, S Cho, W, Chu, D, Conde, J, Marisa Costa, V, Cruz-Martins, N, Dadras, O, Dai, X, Dandona, L, Dandona, R, Danielewicz, A, Mekonnen Demeke, F, Debalkie Demissie, G, Desai, R, Dhamnetiya, D, Dianatinasab, M, Diaz, D, Didehdar, M, Doaei, S, Phuong Doan, L, Dodangeh, M, Eghbalian, F, Debela Ejeta, D, Ekholuenetale, M, Cyrus Ekundayo, T, El Sayed, I, Elhadi, M, Berhanie Enyew, D, Eyayu, T, Ezzeddini, R, Ravisovich Fakhradiyev, I, Farooque, U, Farrokhpour, H, Farzadfar, F, Fatehizadeh, A, Fattahi, H, Fattahi, N, Fereidoonnezhad, M, Fernandes, E, Fetensa, G, Filip, I, Fischer, F, Foroutan, M, Andras Gaal, P, M Gad, M, Gallus, S, Garg, T, Getachew, T, Ghamari, S, Ghashghaee, A, Ghith, N, Gholamalizadeh, M, Gholizadeh Navashenaq, J, Tamirat Gizaw, A, C Glasbey, J, Golechha, M, Goleij, P, Bekele Gonfa, K, Gorini, G, Guha, A, Gupta, S, Bala Gupta, V, Kumar Gupta, V, Haddadi, R, Hafezi-Nejad, N, Haj-Mirzaian, A, Halwani, R, Haque, S, Hariri, S, I Hasaballah, A, Hassanipour, S, I Hay, S, Herteliu, C, Holla, R, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Househ, M, Huang, J, Humayun, A, Iavicoli, I, Stephen Ilesanmi, O, M Ilic, I, D Ilic, M, Islami, F, Iwagami, M, Ali Jahani, M, 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Mohammad, K, Mohammadi, E, Mohammadi, S, Momeneh Mohammadi, S, Mohammadian-Hafshejani, A, Mohammed, S, Abdulrahman Mohammed, T, Moka, N, H Mokdad, A, Mokhtari, Z, Molokhia, M, Momtazmanesh, S, Monasta, L, Moradi, G, Moradzadeh, R, Moraga, P, Morgado-da-Costa, J, Mubarik, S, Mulita, F, Naghavi, M, David Naimzada, M, Sung Nam, H, S Natto, Z, Prakash Nayak, B, Nazari, J, Nazemalhosseini-Mojarad, E, Negoi, I, Tat Nguyen, C, Hoang Nguyen, S, M Noor, N, Noori, M, Mohammad Ali Noori, S, Nu??ez-Samudio, V, Igwegbe Nzoputam, C, Oancea, B, Ololade Odukoya, O, Sikiru Oguntade, A, Okati-Aliabad, H, T Olagunju, A, O Olagunju, T, Ong, S, M Ostroff, S, Padron-Monedero, A, Pakzad, R, Pana, A, Pandey, A, Pashazadeh Kan, F, K Patel, U, Paudel, U, B Pereira, R, Perumalsamy, N, G Pestell, R, Zahid Piracha, Z, G Pollok, R, Pourshams, A, Pourtaheri, N, Prashant, A, Rabiee, M, Rabiee, N, Radfar, A, Rafiei, S, Rahman, M, Masoud Rahmani, A, Rahmanian, V, Rajai, N, Rajesh, A, Ramezani-Doroh, V, Ramezanzadeh, K, 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M., Adhikari, S., Advani, S. M., Afzal, M. S., Aghaie Meybodi, M., Ahinkorah, B. O., Ahmad, S., Ahmadi, A., Ahmadi, S., Ahmed, H., Ahmed, L. A., Ahmed, M. B., Al Hamad, H., Alahdab, F., Alanezi, F. M., Alanzi, T. M., Alhalaiqa, F. A. N., Alimohamadi, Y., Alipour, V., Aljunid, S. M., Alkhayyat, M., Almustanyir, S., Al-Raddadi, R. M., Alvand, S., Alvis-Guzman, N., Amini, S., Ancuceanu, R., Anoushiravani, A., Anoushirvani, A. A., Ansari-Moghaddam, A., Arabloo, J., Aryannejad, A., Asghari Jafarabadi, M., Athari, S. S., Ausloos, F., Ausloos, M., Awedew, A. F., Awoke, M. A., Ayana, T. M., Azadnajafabad, S., Azami, H., Azangou-Khyavy, M., Azari Jafari, A., Badiye, A. D., Bagherieh, S., Bahadory, S., Baig, A. A., Baker, J. L., Banach, M., Barrow, A., Berhie, A. Y., Besharat, S., Bhagat, D. S., Bhagavathula, A. S., Bhala, N., Bhattacharyya, K., Bhojaraja, V. S., Bibi, S., Bijani, A., Biondi, A., Bjorge, T., Bodicha, B. B. A., Braithwaite, D., Brenner, H., Calina, D., Cao, C., Cao, Y., Carreras, G., Carvalho, F., Cerin, E., Chakinala, R. C., Cho, W. C. S., Chu, D. -T., Conde, J., Costa, V. M., Cruz-Martins, N., Dadras, O., Dai, X., Dandona, L., Dandona, R., Danielewicz, A., Demeke, F. M., Demissie, G. D., Desai, R., Dhamnetiya, D., Dianatinasab, M., Diaz, D., Didehdar, M., Doaei, S., Doan, L. P., Dodangeh, M., Eghbalian, F., Ejeta, D. D., Ekholuenetale, M., Ekundayo, T. C., El Sayed, I., Elhadi, M., Enyew, D. B., Eyayu, T., Ezzeddini, R., Fakhradiyev, I. R., Farooque, U., Farrokhpour, H., Farzadfar, F., Fatehizadeh, A., Fattahi, H., Fattahi, N., Fereidoonnezhad, M., Fernandes, E., Fetensa, G., Filip, I., Fischer, F., Foroutan, M., Gaal, P. A., Gad, M. M., Gallus, S., Garg, T., Getachew, T., Ghamari, S. -H., Ghashghaee, A., Ghith, N., Gholamalizadeh, M., Gholizadeh Navashenaq, J., Gizaw, A. T., Glasbey, J. C., Golechha, M., Goleij, P., Gonfa, K. B., Gorini, G., Guha, A., Gupta, S., Gupta, V. B., Gupta, V. K., Haddadi, R., Hafezi-Nejad, N., Haj-Mirzaian, A., Halwani, R., Haque, S., Hariri, S., Hasaballah, A. I., Hassanipour, S., Hay, S. I., Herteliu, C., Holla, R., Hosseini, M. -S., Hosseinzadeh, M., Hostiuc, M., Househ, M., Huang, J., Humayun, A., Iavicoli, I., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Islami, F., Iwagami, M., Jahani, M. A., Jakovljevic, M., Javaheri, T., Jayawardena, R., Jebai, R., Jha, R. P., Joo, T., Joseph, N., Joukar, F., Jozwiak, J. J., Kabir, A., Kalhor, R., Kamath, A., Kapoor, N., Karaye, I. M., Karimi, A., Kauppila, J. H., Kazemi, A., Keykhaei, M., Khader, Y. S., Khajuria, H., Khalilov, R., Khanali, J., Khayamzadeh, M., Khodadost, M., Kim, H., Kim, M. S., Kisa, A., Kisa, S., Kolahi, A. -A., Koohestani, H. R., Kopec, J. A., Koteeswaran, R., Koyanagi, A., Krishnamoorthy, Y., Kumar, G. A., Kumar, M., Kumar, V., La Vecchia, C., Lami, F. H., Landires, I., Ledda, C., Lee, S. -W., Lee, W. -C., Lee, Y. Y., Leong, E., Li, B., Lim, S. S., Lobo, S. W., Loureiro, J. A., Lunevicius, R., Madadizadeh, F., Mahmoodpoor, A., Majeed, A., Malekpour, M. -R., Malekzadeh, R., Malik, A. A., Mansour-Ghanaei, F., Mantovani, L. G., Martorell, M., Masoudi, S., Mathur, P., Meena, J. K., Mehrabi Nasab, E., Mendoza, W., Mentis, A. -F. A., Mestrovic, T., Miao Jonasson, J., Miazgowski, B., Miazgowski, T., Mijena, G. F. W., Mirmoeeni, S., Mirza-Aghazadeh-Attari, M., Mirzaei, H., Misra, S., Mohammad, K. A., Mohammadi, E., Mohammadi, S., Mohammadi, S. M., Mohammadian-Hafshejani, A., Mohammed, S., Mohammed, T. A., Moka, N., Mokdad, A. H., Mokhtari, Z., Molokhia, M., Momtazmanesh, S., Monasta, L., Moradi, G., Moradzadeh, R., Moraga, P., Morgado-da-Costa, J., Mubarik, S., Mulita, F., Naghavi, M., Naimzada, M. D., Nam, H. S., Natto, Z. S., Nayak, B. P., Nazari, J., Nazemalhosseini-Mojarad, E., Negoi, I., Nguyen, C. T., Nguyen, S. H., Noor, N. M., Noori, M., Noori, S. M. A., Nunez-Samudio, V., Nzoputam, C. I., Oancea, B., Odukoya, O. O., Oguntade, A. S., Okati-Aliabad, H., Olagunju, A. T., Olagunju, T. O., Ong, S., Ostroff, S. M., Padron-Monedero, A., Pakzad, R., Pana, A., Pandey, A., Pashazadeh Kan, F., Patel, U. K., Paudel, U., Pereira, R. B., Perumalsamy, N., Pestell, R. G., Piracha, Z. Z., Pollok, R. C. G., Pourshams, A., Pourtaheri, N., Prashant, A., Rabiee, M., Rabiee, N., Radfar, A., Rafiei, S., Rahman, M., Rahmani, A. M., Rahmanian, V., Rajai, N., Rajesh, A., Ramezani-Doroh, V., Ramezanzadeh, K., Ranabhat, K., Rashedi, S., Rashidi, A., Rashidi, M., Rashidi, M. -M., Rastegar, M., Rawaf, D. L., Rawaf, S., Rawassizadeh, R., Razeghinia, M. S., Renzaho, A. M. N., Rezaei, N., Rezaei, S., Rezaeian, M., Rezazadeh-Khadem, S., Roshandel, G., Saber-Ayad, M. M., Saberzadeh-Ardestani, B., Saddik, B., Sadeghi, H., Saeed, U., Sahebazzamani, M., Sahebkar, A., Salek Farrokhi, A., Salimi, A., Salimzadeh, H., Samadi, P., Samaei, M., Samy, A. M., Sanabria, J., Santric-Milicevic, M. M., Saqib, M. A. N., Sarveazad, A., Sathian, B., Satpathy, M., Schneider, I. J. C., Sekerija, M., Sepanlou, S. G., Seylani, A., Sha, F., Shafiee, S. M., Shaghaghi, Z., Shahabi, S., Shaker, E., Sharifian, M., Sharifi-Rad, J., Sheikhbahaei, S., Shetty, J. K., Shirkoohi, R., Shobeiri, P., Siddappa Malleshappa, S. K., Silva, D. A. S., Silva Julian, G., Singh, A. D., Singh, J. A., Siraj, M. S., Sivandzadeh, G. R., Skryabin, V. Y., Skryabina, A. A., Socea, B., Solmi, M., Soltani-Zangbar, M. S., Song, S., Szerencses, V., Szocska, M., Tabares-Seisdedos, R., Tabibian, E., Taheri, M., Taheriabkenar, Y., Taherkhani, A., Talaat, I. M., Tan, K. -K., Tbakhi, A., Tesfaye, B., Tiyuri, A., Tollosa, D. N., Touvier, M., Tran, B. X., Tusa, B. S., Ullah, I., Ullah, S., Vacante, M., Valadan Tahbaz, S., Veroux, M., Vo, B., Vos, T., Wang, C., Westerman, R., Woldemariam, M., Yahyazadeh Jabbari, S. H., Yang, L., Yazdanpanah, F., Yu, C., Yuce, D., Yunusa, I., Zadnik, V., Zahir, M., Zare, I., Zhang, Z. -J., Zoladl, M., Epidemiologie, RS: NUTRIM - R3 - Respiratory & Age-related Health, and Bill & Melinda Gates Foundation
Subjects: Adult, MED/42 - IGIENE GENERALE E APPLICATA, IMPACT, colorectal cancer, Colorectal Neoplasm, GBD 2019 Colorectal Cancer Collaborators, HEREDITARY, Global Burden of Disease, Cancer screening, DISPARITIES, SDG 3 - Good Health and Well-being, Cancer treatment strategies, Risk Factors, Quality-Adjusted Life Year, COLON, Global studies, DALY, GBD, colorectal cancer, risk factors, Humans, Global Burden of Disease Study, Early Detection of Cancer, Hepatology, MORTALITY, Gastroenterology, Cancer incidence rates, Middle Aged, Cancer burden, SURVIVAL, SEX, GENDER, Quality-Adjusted Life Years, Colorectal Neoplasms, Human
Abstract: Correction to Lancet Gastroenterol Hepatol 2022; 7: 627-47. Lancet Gastroenterol Hepatol. 2022 Aug;7(8):704. doi: 10.1016/S2468-1253(22)00210-2. PMID: 35809605. Background: Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. Methods: Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. Findings: Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408-868 574) to 2·17 million (2·00-2·34), and deaths increased from 518 126 (493 682-537 877) to 1·09 million (1·02-1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3-23·0) per 100 000 to 26·7 (24·6-28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5-14·9) per 100 000 to 13·7 (12·6-14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7-320·7) per 100 000 to 295·5 (275·2-313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9-80·0] per 100 000), Monaco (60·7 [48·5-73·6] per 100 000), and Andorra (56·6 [42·8-71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0-37·1] per 100 000), Brunei (30·3 [26·6-34·1] per 100 000), and Hungary (28·6 [23·6-34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age
Published: 2022
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39. Assessment of quality of antenatal care services in public sector facilities in India

Author: Rakhi Dandona, Moutushi Majumder, Md Akbar, Debarshi Bhattacharya, Priya Nanda, G Anil Kumar, and Lalit Dandona
Subjects: Calcium, Dietary, Public Sector, Folic Acid, Pregnancy, Infant, Newborn, Humans, India, Female, Prenatal Care, Calcium, General Medicine
Abstract: ObjectivesWe undertook assessment of quality of antenatal care (ANC) services in public sector facilities in the Indian state of Bihar state delivered under the national ANC programme (Pradhan Mantri Surakshit Matritva Abhiyan, PMSMA).SettingThree community health centres and one subdistrict hospital each in two randomly selected districts of Bihar.ParticipantsPregnant women who sought ANC services under PMSMA irrespective of the pregnancy trimester.Primary and secondary measuresQuality ANC services were considered if a woman received all of these services in that visit—weight, blood pressure and abdomen check, urine and blood sample taken, and were given iron and folic acid and calcium tablets. The process of ANC service provision was documented.ResultsEight hundred and fourteen (94.5% participation) women participated. Coverage of quality ANC services was 30.4% (95% CI 27.3% to 33.7%) irrespective of pregnancy trimester, and was similar in both districts and ranged 3%–83.1% across the facilities. Quality ANC service coverage was significantly lower for women in the first trimester of pregnancy (6.8%, 95% CI 3.3% to 13.6%) as compared with those in the second (34.4%, 95% CI 29.9% to 39.1%) and third (32.9%, 95% CI 27.9% to 38.3%) trimester of pregnancy. Individually, the coverage of weight and blood pressure check-up, receipt of iron folic acid (IFA) and calcium tablets, and blood sample collection was >85%. The coverage of urine sample collection was 46.3% (95% CI 42.9% to 49.7%) and of abdomen check-up was 62% (95% CI 58.6% to 65.3%). Poor information sharing post check-up was done with the pregnant women. Varied implementation of ANC service provision was seen in the facilities as compared with the PMSMA guidelines, in particular with laboratory diagnostics and doctor consultation. Task shifting from doctors to ANMs was observed in all facilities.ConclusionsGrossly inadequate quality ANC services under the PMSMA needs urgent attention to improve maternal and neonatal health outcomes.
Published: 2022

40. Global, regional, and national burden of respiratory tract cancers and associated risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Chi Linh Hoang, Christopher J L Murray, Faheem Hyder Pottoo, Feng Sha, Simon I. Hay, Jianrong Zhang, Nikita Otstavnov, Eman Abu-Gharbieh, Azeem Majeed, Lorenzo Monasta, Jasvinder A. Singh, Zhi-Jiang Zhang, Jalal Arabloo, Jonathan M. Kocarnik, Sadaf G. Sepanlou, Rahmatollah Moradzadeh, Freddy Sitas, Sanjeev Misra, Lisa M. Force, Irina Filip, Rafael Tabarés-Seisdedos, Shahabeddin Rezaei, Amir Radfar, Luca Ronfani, Iván Landires, Rovshan Khalilov, Brijesh Sathian, Bingyu Li, Farhad Pishgar, Mario Šekerija, Priya Rathi, Catalina Liliana Andrei, Michael T. Chung, Ali Bijani, Ritesh G. Menezes, Odgerel Chimed-Ochir, Ken Takahashi, Nobuyuki Horita, Supreet Kaur, Rakhi Dandona, Alan D. Lopez, Alireza Rafiei, Joana Morgado-da-Costa, Kelly Compton, Akram Pourshams, G Anil Kumar, Dinh-Toi Chu, Deniz Yuce, Huong Lan Thi Nguyen, Virginia Núñez-Samudio, Ahmad Ghashghaee, Cuong Tat Nguyen, Kazem Zendehdel, Maria Teresa Bustamante-Teixeira, Aaron Cohen, Mohsen Naghavi, Mukhammad David Naimzada, Lalit Dandona, Pradhum Ram, Ione Jayce Ceola Schneider, Thomas Roberts, Michael Brauer, Meseret Derbew Molla, Vesna Zadnik, Syed Mohamed Aljunid, Morteza Arab-Zozani, Lidia Morawska, Abebaw Alemayehu Desta, Qing Lan, Rajesh Sharma, Mahesh P A, David Laith Rawaf, Ali H. Mokdad, Tomasz Miazgowski, Zabihollah Yousefi, Seyed Sina Naghibi Irvani, Reza Malekzadeh, Paul J. Villeneuve, Masood Ali Shaikh, Muhammad Aziz Rahman, Sohail Ahmad, Abdollah Mohammadian-Hafshejani, Gholamreza Roshandel, Atalel Fentahun Awedew, Hassan Abolhassani, Hermann Brenner, Sara Sheikhbahaei, Elvynna Leong, Mohammad Rabiee, Abdallah M. Samy, Eyayou Girma Tadesse, Milena Santric-Milicevic, Silvano Gallus, Carlos A Castañeda-Orjuela, Mowafa Househ, Xiaochen Dai, Marco Vacante, Mihaela Hostiuc, Adrian Pana, Salman Rawaf, Sahar Saeedi Moghaddam, Francesco Saverio Violante, Weijia Fu, Paschalis Steiropoulos, Vahid Alipour, Tone Bjørge, Savita Lasrado, Burcu Kucuk Bicer, Farshad Farzadfar, Shafiu Mohammed, Fares Alahdab, Paolo Lauriola, Saeed Amini, Eugenio Traini, Maryam Zamanian, Samer Hamidi, Rajan Nikbakhsh, Pawan Faris, Birhan Gebresillassie Gebregiorgis, Emerito Jose A. Faraon, Stanislav S. Otstavnov, Shane D. Morrison, Marcel Ausloos, Aziz Sheikh, Eun-Kee Park, Antonio Biondi, Zahra Aryan, Claudiu Herteliu, Ivo Iavicoli, Hedyeh Ebrahimi, Nicholas L S Roberts, Navid Rabiee, Tudorel Andrei, Catherine Bisignano, Giulia Carreras, Andrew T Olagunju, Ejaz Ahmad Khan, Dejana Braithwaite, Alex Molassiotis, Kebebe Bekele Gonfa, Bárbara Niegia Garcia de Goulart, Javad Nazari, Giuseppe Gorini, Mahaveer Golechha, Bach Xuan Tran, Ravensara S. Travillian, Zahid A Butt, Baye Dagnew, Atif Amin Baig, Nima Rezaei, Nima Hafezi-Nejad, Khanh Bao Tran, Malke Asaad, Tim Driscoll, Navid Manafi, Frances E. Dean, Shailesh Advani, Stephen S Lim, Robert Ancuceanu, Milena Ilic, Maximiliano Ribeiro Guerra, Ashwin Kamath, Carlo La Vecchia, Farhad Islami, Sudeep K Siddappa Malleshappa, Irena Ilic, Emma Elizabeth Spurlock, Florian Fischer, GBD 2019 Respiratory Tract Cancer Collaborator, and Francesco S. Violante
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, CELL LUNG-CANCER, EGFR, Respiratory System, GBD 2019 Respiratory Tract Cancers Collaborators, Global Burden of Disease, 1117 Public Health and Health Services, Critical Care Medicine, Risk Factors, Neoplasms, General & Internal Medicine, Internal medicine, Tobacco Smoking, Humans, Medicine, Risk factor, Lung cancer, Bronchus, Science & Technology, SARS-CoV-2, MUTATIONS, business.industry, Risk Factor, MORTALITY, Incidence, Mortality rate, Incidence (epidemiology), cancer, GBD, respiratory tract, Smoking, COVID-19, Cancer, 1103 Clinical Sciences, Articles, AIR-POLLUTION, respiratory system, medicine.disease, Respiratory Tract Neoplasms, Respiratory Tract Neoplasm, medicine.anatomical_structure, Years of potential life lost, Socioeconomic Factors, Relative risk, CIGARETTE-SMOKING, business, Life Sciences & Biomedicine, Human, SMOKERS, 1199 Other Medical and Health Sciences
Abstract: Summary Background Prevention, control, and treatment of respiratory tract cancers are important steps towards achieving target 3.4 of the UN Sustainable Development Goals (SDGs)—a one-third reduction in premature mortality due to non-communicable diseases by 2030. We aimed to provide global, regional, and national estimates of the burden of tracheal, bronchus, and lung cancer and larynx cancer and their attributable risks from 1990 to 2019. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 methodology, we evaluated the incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) of respiratory tract cancers (ie, tracheal, bronchus, and lung cancer and larynx cancer). Deaths from tracheal, bronchus, and lung cancer and larynx cancer attributable to each risk factor were estimated on the basis of risk exposure, relative risks, and the theoretical minimum risk exposure level input from 204 countries and territories, stratified by sex and Socio-demographic Index (SDI). Trends were estimated from 1990 to 2019, with an emphasis on the 2010–19 period. Findings Globally, there were 2·26 million (95% uncertainty interval 2·07 to 2·45) new cases of tracheal, bronchus, and lung cancer, and 2·04 million (1·88 to 2·19) deaths and 45·9 million (42·3 to 49·3) DALYs due to tracheal, bronchus, and lung cancer in 2019. There were 209 000 (194 000 to 225 000) new cases of larynx cancer, and 123 000 (115 000 to 133 000) deaths and 3·26 million (3·03 to 3·51) DALYs due to larynx cancer globally in 2019. From 2010 to 2019, the number of new tracheal, bronchus, and lung cancer cases increased by 23·3% (12·9 to 33·6) globally and the number of larynx cancer cases increased by 24·7% (16·0 to 34·1) globally. Global age-standardised incidence rates of tracheal, bronchus, and lung cancer decreased by 7·4% (−16·8 to 1·6) and age-standardised incidence rates of larynx cancer decreased by 3·0% (−10·5 to 5·0) in males over the past decade; however, during the same period, age-standardised incidence rates in females increased by 0·9% (−8·2 to 10·2) for tracheal, bronchus, and lung cancer and decreased by 0·5% (−8·4 to 8·1) for larynx cancer. Furthermore, although age-standardised incidence and death rates declined in both sexes combined from 2010 to 2019 at the global level for tracheal, bronchus, lung and larynx cancers, some locations had rising rates, particularly those on the lower end of the SDI range. Smoking contributed to an estimated 64·2% (61·9–66·4) of all deaths from tracheal, bronchus, and lung cancer and 63·4% (56·3–69·3) of all deaths from larynx cancer in 2019. For males and for both sexes combined, smoking was the leading specific risk factor for age-standardised deaths from tracheal, bronchus, and lung cancer per 100 000 in all SDI quintiles and GBD regions in 2019. However, among females, household air pollution from solid fuels was the leading specific risk factor in the low SDI quintile and in three GBD regions (central, eastern, and western sub-Saharan Africa) in 2019. Interpretation The numbers of incident cases and deaths from tracheal, bronchus, and lung cancer and larynx cancer increased globally during the past decade. Even more concerning, age-standardised incidence and death rates due to tracheal, bronchus, lung cancer and larynx cancer increased in some populations—namely, in the lower SDI quintiles and among females. Preventive measures such as smoking control interventions, air quality management programmes focused on major air pollution sources, and widespread access to clean energy should be prioritised in these settings. Funding Bill & Melinda Gates Foundation.
Published: 2021
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41. Global, regional, and national burden of bone fractures in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

Author: Gdiom Gebreheat Abady, Hadis Pourchamani, Ali Bijani, Hai Quang Pham, Mehdi Naderi, Jagadish Rao Padubidri, Navid Rabiee, Rosa A. S. Couto, Marina Pinheiro, Luis Camera, Marcos Roberto Tovani-Palone, David Laith Rawaf, Irina Filip, Ratilal Lalloo, Spencer L. James, Suzanne Polinder, Rohollah Kalhor, Tanuj Kanchan, Ali Manafi, Eman Abu-Gharbieh, Bach Xuan Tran, Mohammad Hifz Ur Rahman, Navid Manafi, Saeed Shahabi, Tiffany K. Gill, Vijay Krishnamoorthy, Samer Hamidi, Zhi-Jiang Zhang, Ejaz Ahmad Khan, Cuong Tat Nguyen, Diana Zuleika Velazquez, Simon I. Hay, Ravensara S. Travillian, Michael T. Chung, Narinder Kumar, Daniel Y. Cho, David C. Schwebel, Milena Ilic, Tommi Vasankari, Jeevan Pereira, Ai-Min Wu, Zichen Liu, Rafael Tabarés-Seisdedos, Jalal Arabloo, Stanislav S. Otstavnov, Bhawna Gupta, Giang Thu Vu, G Anil Kumar, Atalel Fentahun Awedew, Ali H. Mokdad, Narayanaswamy Venketasubramanian, Amir Radfar, Rakhi Dandona, Bartosz Miazgowski, Irena Ilic, Mukhammad David Naimzada, Amin Soheili, Malke Asaad, Catherine Bisignano, Masood Ali Shaikh, Lalit Dandona, Lidia Sanchez Riera, Rajan Nikbakhsh, Maciej Banach, Xiaochen Dai, Ritesh G. Menezes, Abdollah Mohammadian-Hafshejani, Vinod C Nayak, Arvin Haj-Mirzaian, Mikk Jürisson, Florian Fischer, Salman Rawaf, Aidin Abedi, Andrew T Olagunju, Nikita Otstavnov, Rovshan Khalilov, Ted R. Miller, Rebecca Ivers, Savita Lasrado, Vahid Alipour, Srinivasa Rao Bolla, Stephen S Lim, Srikanta Banerjee, A. A. Fomenkov, Jung-Chen Chang, Mohammad Reza Saeb, Theo Vos, Taras Kavetskyy, Tuomo J. Meretoja, Yousef Mohammad, Farshad Farzadfar, Tesega Tesega Mengistu Birhanu, Robert Kaba Alhassan, Wondwossen Niguse Asmare, Pascual R. Valdez, Abdallah M. Samy, Christopher J L Murray, Juanita A. Haagsma, Maseer Khan, Cameron J. Kneib, HUS Comprehensive Cancer Center, and University of Helsinki
Subjects: Burden of disease, EXCESS MORTALITY, medicine.medical_specialty, Health (social science), Population, Osteoporosis, UNITED-STATES, OSTEOPOROSIS, Global Burden of Disease, 03 medical and health sciences, Fractures, Bone, 0302 clinical medicine, Age groups, Epidemiology, INJURY, medicine, Prevalence, EPIDEMIOLOGY, Humans, Disabled Persons, education, Aged, 030222 orthopedics, education.field_of_study, Hip fracture, business.industry, Public health, Incidence (epidemiology), Incidence, HIP FRACTURE, Articles, medicine.disease, NONUNION, 3. Good health, LIFE, Psychiatry and Mental health, 3121 General medicine, internal medicine and other clinical medicine, 030220 oncology & carcinogenesis, Geriatrics and Gerontology, Family Practice, business, COSTS, Osteoporotic Fractures, Demography
Abstract: Background Bone fractures are a global public health issue; however, to date, no comprehensive study of their incidence and burden has been done. We aimed to measure the global, regional, and national incidence, prevalence, and years lived with disability (YLDs) of fractures from 1990 to 2019. Methods Using the framework of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we compared numbers and age-standardised rates of global incidence, prevalence, and YLDs of fractures across the 21 GBD regions and 204 countries and territories, by age, sex, and year, from 1990 to 2019. We report estimates with 95% uncertainty intervals (UIs). Findings Globally, in 2019, there were 178 million (95% UI 162-196) new fractures (an increase of 33.4% [30.1-37.0] since 1990), 455 million (428-484) prevalent cases of acute or long-term symptoms of a fracture (an increase of 70.1% [67.5-72.5] since 1990), and 25.8 million (17.8-35.8) YLDs (an increase of 65.3% [62.4-68.0] since 1990). The age-standardised rates of fractures in 2019 were 2296.2 incident cases (2091.1-2529.5) per 100 000 population (a decrease of 9.6% [8.1-11.1] since 1990), 5614.3 prevalent cases (5286.1-5977.5) per 100 000 population (a decrease of 6.7% [5.7-7.6] since 1990), and 319.0 YLDs (220.1-442.5) per 100 000 population (a decrease of 8.4% [7.2-9.5] since 1990). Lower leg fractures of the patella, tibia or fibula, or ankle were the most common and burdensome fracture in 2019, with an age-standardised incidence rate of 419.9 cases (345.8-512.0) per 100 000 population and an age-standardised rate of YLDs of 190.4 (125.0-276.9) per 100 000 population. In 2019, age-specific rates of fracture incidence were highest in the oldest age groups, with, for instance, 15 381.5 incident cases (11 245.3-20 651.9) per 100 000 population in those aged 95 years and older. Interpretation The global age-standardised rates of incidence, prevalence, and YLDs for fractures decreased slightly from 1990 to 2019, but the absolute counts increased substantially. Older people have a particularly high risk of fractures, and more widespread injury-prevention efforts and access to screening and treatment of osteoporosis for older individuals should help to reduce the overall burden. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
Published: 2021

42. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

Author: Dana Bryazka, Marissa B Reitsma, Max G Griswold, Kalkidan Hassen Abate, Cristiana Abbafati, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Amir Abdoli, Mohammad Abdollahi, Abu Yousuf Md Abdullah, E S Abhilash, Eman Abu-Gharbieh, Juan Manuel Acuna, Giovanni Addolorato, Oladimeji M Adebayo, Victor Adekanmbi, Kishor Adhikari, Sangeet Adhikari, Qorinah Estiningtyas Sakilah Adnani, Saira Afzal, Wubetu Yimam Agegnehu, Manik Aggarwal, Bright Opoku Ahinkorah, Araz Ramazan Ahmad, Sajjad Ahmad, Tauseef Ahmad, Ali Ahmadi, Sepideh Ahmadi, Haroon Ahmed, Tarik Ahmed Rashid, Chisom Joyqueenet Akunna, Hanadi Al Hamad, Md Zakiul Alam, Dejene Tsegaye Alem, Kefyalew Addis Alene, Yousef Alimohamadi, Atiyeh Alizadeh, Kasim Allel, Jordi Alonso, Saba Alvand, Nelson Alvis-Guzman, Firehiwot Amare, Edward Kwabena Ameyaw, Sohrab Amiri, Robert Ancuceanu, Jason A Anderson, Catalina Liliana Andrei, Tudorel Andrei, Jalal Arabloo, Muhammad Arshad, Anton A Artamonov, Zahra Aryan, Malke Asaad, Mulusew A Asemahagn, Thomas Astell-Burt, Seyyed Shamsadin Athari, Desta Debalkie Atnafu, Prince Atorkey, Alok Atreya, Floriane Ausloos, Marcel Ausloos, Getinet Ayano, Martin Amogre ayanore Ayanore, Olatunde O Ayinde, Jose L Ayuso-Mateos, Sina Azadnajafabad, Melkalem Mamuye Azanaw, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Ahmed Y Azzam, Ashish D Badiye, Nasser Bagheri, Sara Bagherieh, Mohan Bairwa, Shankar M Bakkannavar, Ravleen Kaur Bakshi, Awraris Hailu Balchut/Bilchut, Till Winfried Bärnighausen, Fabio Barra, Amadou Barrow, Pritish Baskaran, Luis Belo, Derrick A Bennett, Isabela M Benseñor, Akshaya Srikanth Bhagavathula, Neeraj Bhala, Ashish Bhalla, Nikha Bhardwaj, Pankaj Bhardwaj, Sonu Bhaskar, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Bagas Suryo Bintoro, Elena A Elena Blokhina, Belay Boda Abule Bodicha, Archith Boloor, Cristina Bosetti, Dejana Braithwaite, Hermann Brenner, Nikolay Ivanovich Briko, Andre R Brunoni, Zahid A Butt, Chao Cao, Yin Cao, Rosario Cárdenas, 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(Australia), South African Medical Research Council, National Natural Science Foundation of China, Charles Sturt University (Australia), Ain Shams University (Egipto), Mizoram University (India), Kasturba Medical College (India), Manipal Academy of Higher Education (India), Coordenação de Aperfeicoamento de Pessoal de Nível Superior (Brasil), Ministerio de Ciencia e Innovación (España), Collaborators, GBD 2020 Alcohol, Bryazka, Dana, Reitsma, Marissa B, Griswold, Max G, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbasi-Kangevari, Mohsen, Abbasi-Kangevari, Zeinab, Abdoli, Amir, Abdollahi, Mohammad, Abdullah, Abu Yousuf Md, Abhilash, E S, Abu-Gharbieh, Eman, Acuna, Juan Manuel, Addolorato, Giovanni, Adebayo, Oladimeji M, Adekanmbi, Victor, Adhikari, Kishor, Adhikari, Sangeet, Adnani, Qorinah Estiningtyas Sakilah, Afzal, Saira, Agegnehu, Wubetu Yimam, Aggarwal, Manik, Ahinkorah, Bright Opoku, Ahmad, Araz Ramazan, Ahmad, Sajjad, Ahmad, Tauseef, Ahmadi, Ali, Ahmadi, Sepideh, Ahmed, 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Subjects: Adult, Male, Alcohol Drinking, CONTROL POLICIES, adult, Child, Preschool, Female, Geography, Global Burden of Disease, Global Health, Humans, Middle Aged, Quality-Adjusted Life Years, Risk Factors, NDAS, ALL-CAUSE, GUIDELINES, GBD 2020 Alcohol Collaborators, COST-EFFECTIVENESS, Medicine, General & Internal, DRINKING, SDG 3 - Good Health and Well-being, RA0421, General & Internal Medicine, Quality-Adjusted Life Year, RA0421 Public health. Hygiene. Preventive Medicine, DRINKERS, Child, Preschool, 11 Medical and Health Sciences, METAANALYSIS, MCC, Science & Technology, global burden of disease, Risk Factor, General Medicine, CANCER, alcohol drinking, AC, 3121 General medicine, internal medicine and other clinical medicine, REDUCED MORTALITY, Life Sciences & Biomedicine, Human
Abstract: Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Research reported in this publication was supported by the Bill & Melinda Gates Foundation. S Afzal acknowledges the support for intellectual contributions to this manuscript by the Department of Community Medicine and Epidemiology at King Edward Medical University, Lahore, Pakistan. T Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. L Belo acknowledges support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. D Bennett is supported by the UK Medical Research Council Population Health Research Unit at the University of Oxford (Oxford, UK). M Carvalho acknowledges support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. L Castro-de-Araujo was funded by the Medical Research Council (UK), Grant no. MR/T03355X/1 and by the National Institute of Mental Health Grant no. R01MH128911. FJ Elgar is supported by the Canada Research Chairs program. F Greaves acknowledges support from the NIHR Applied Research Collaboration for NW London. V K Gupta acknowledges funding support from the National Health and Medical Research Council (NHMRC), Australia. VB Gupta acknowledges funding support from the National Health and Medical Research Council (NHMRC), Australia. C Herteliu is partially supported by a grant from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. C Herteliu is partially supported by a grant from the Romanian Ministry of Research Innovation and Digitalization, MCID, project number ID-585-CTR-42-PFE-2021. S Hussain was supported by the Operational Programme Research, Development and Education –Project, Postdoc2MUNI “(No. CZ.02.2.69/0.0/0.0/18_053/0016952). S M S Islam is funded by the National Health and Medical Research Council and received funding from the National Heart Foundation of Australia. The Serbian part of this GBD-related contribution has been co-financed through Grant OI 175 014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. M Kivimaki was supported by the Wellcome Trust (221854/Z/20/Z), the UK Medical Research Council (MR/S011676/1), the US National Institute on Aging (R01AG056477), and the Academy of Finland (350426). K Krishan is supported by the UGC Centre of Advanced Study (Phase II), awarded to the Department of Anthropology, Panjab University, Chandigarh, India. B Lacey acknowledges support from the UK Biobank, funded largely by the UK Medical Research Council and Wellcome. S Lorkowski acknowledges institutional support from the Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig (Germany; German Federal Ministry of Education and Research; grant agreement number 01EA1808A). G Lucchetti received a productivity scholarship from the Brazilian National Council for Scientific and Technological Development — CNPq (Level 1D). J McGrath was supported by the Danish National Research Foundation (Niels Bohr Professor). J McGrath is employed by the Queensland Centre for Mental Health Research (Australia), which receives support from the Queensland Health Department. C Parry acknowleges the South African Medical Research Council. A Peden is supported by a National Health and Medical Research Council Emerging Leadership Fellowship (Grant ID: APP2009306). M R Phillips was supported in part by the Global Alliance for Chronic Diseases - National Natural Science Foundation of China (NSFC. No. 81761128031). M Pinheiro acknowledges FCT for funding through program DL 57/2016 – Norma transitória. A Rahman acknowledges the support from the Data Science Research Unit in Charles Sturt University (Bathurst, NSW, Australia). U Saeed would like to acknowledge the International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan. A M Samy acknowledges support from Ain Shams University (Cairo, Egypt) and the Egyptian Fulbright Mission Program. N Senthil Kumar acknowledges the DBT, New Delhi sponsored Advanced State Level Biotech Hub (BT/NER/143/SP44475/2021), Mizoram University (Aizawl, Mizoram, India) for facilitating this work. F Sha is supported by the Shenzhen Science and Technology Program (Grant No. KQTD20190929172835662). A Shetty acknowledges Kasturba Medical College (Mangalore, India) and Manipal Academy of Higher Education (Manipal, India) for all the academic support. R Shrestha acknowledges a career development award from the National Institutes of Health (K01DA051346). D Silva was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brazil (CAPES)-Finance Code 001 and is supported in part by CNPq - Brazil (309589/2021-5). D Sleet acknowledges partial support from Veritas Management Group, Inc and The Bizzell Group, LLC. S Trias-Llimós acknowledges research funding from the Juan de la Cierva-Formación program of the Spanish Ministry of Science and Innovation (FJC-2019-039314-I). Sí
Published: 2022

43. Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019

Author: Ewerton Cousin, Bruce B Duncan, Caroline Stein, Kanyin Liane Ong, Theo Vos, Cristiana Abbafati, Mohsen Abbasi-Kangevari, Michael Abdelmasseh, Amir Abdoli, Rami Abd-Rabu, Hassan Abolhassani, Eman Abu-Gharbieh, Manfred Mario Kokou Accrombessi, Qorinah Estiningtyas Sakilah Adnani, Muhammad Sohail Afzal, Gina Agarwal, Krishna K Agrawaal, Marcela Agudelo-Botero, Bright Opoku Ahinkorah, Sajjad Ahmad, Tauseef Ahmad, Keivan Ahmadi, Sepideh Ahmadi, Ali Ahmadi, Ali Ahmed, Yusra Ahmed Salih, Wuraola Akande-Sholabi, Tayyaba Akram, Hanadi Al Hamad, Ziyad Al-Aly, Jacqueline Elizabeth Alcalde-Rabanal, Vahid Alipour, Syed Mohamed Aljunid, Rajaa M Al-Raddadi, Nelson Alvis-Guzman, Saeed Amini, Robert Ancuceanu, Tudorel Andrei, Catalina Liliana Andrei, Ranjit Mohan Anjana, Adnan Ansar, Ippazio Cosimo Antonazzo, Benny Antony, Anayochukwu Edward Anyasodor, Jalal Arabloo, Damian Arizmendi, Benedetta Armocida, Anton A Artamonov, Judie Arulappan, Zahra Aryan, Samaneh Asgari, Tahira Ashraf, Thomas Astell-Burt, Prince Atorkey, Maha Moh'd Wahbi Atout, Martin Amogre Ayanore, Ashish D Badiye, Atif Amin Baig, Mohan Bairwa, Jennifer L Baker, Ovidiu Constantin Baltatu, Palash Chandra Banik, Anthony Barnett, Mark Thomaz Ugliara Barone, Francesco Barone-Adesi, Amadou Barrow, Neeraj Bedi, Rebuma Belete, Uzma Iqbal Belgaumi, Arielle Wilder Bell, Derrick A Bennett, Isabela M Bensenor, David Beran, Akshaya Srikanth Bhagavathula, Sonu Bhaskar, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Ali Bijani, Boris Bikbov, Setognal Birara, Virginia Bodolica, Aime Bonny, Hermann Brenner, Nikolay Ivanovich Briko, Zahid A Butt, Florentino Luciano Caetano dos Santos, Luis Alberto Cámera, Ismael R Campos-Nonato, Yin Cao, Chao Cao, Ester Cerin, Promit Ananyo Chakraborty, Joht Singh Chandan, Vijay Kumar Chattu, Simiao Chen, Jee-Young Jasmine Choi, Sonali Gajanan Choudhari, Enayet Karim Chowdhury, Dinh-Toi Chu, Barbara Corso, Omid Dadras, Xiaochen Dai, Albertino Antonio Moura Damasceno, Lalit Dandona, Rakhi Dandona, Claudio Alberto Dávila-Cervantes, Jan-Walter De Neve, Edgar Denova-Gutiérrez, Deepak Dhamnetiya, Daniel Diaz, Sanam Ebtehaj, Hisham Atan Edinur, Sahar Eftekharzadeh, Iman El Sayed, Islam Y Elgendy, Muhammed Elhadi, Mohamed A Elmonem, Mohammed Faisaluddin, Umar Farooque, Xiaoqi Feng, Eduarda Fernandes, Florian Fischer, David Flood, Marisa Freitas, Peter Andras Gaal, Mohamed M Gad, Piyada Gaewkhiew, Lemma Getacher, Mansour Ghafourifard, Reza Ghanei Gheshlagh, Ahmad Ghashghaee, Nermin Ghith, Ghozali Ghozali, Paramjit Singh Gill, Ibrahim Abdelmageed Ginawi, Ekaterina Vladimirovna Glushkova, Mahaveer Golechha, Sameer Vali Gopalani, Rafael Alves Guimarães, Rajat Das Gupta, Rajeev Gupta, Vivek Kumar Gupta, Veer Bala Gupta, Sapna Gupta, Tesfa Dejenie Habtewold, Nima Hafezi-Nejad, Rabih Halwani, Asif Hanif, Graeme J Hankey, Shafiul Haque, Ahmed I Hasaballah, Syed Shahzad Hasan, Abdiwahab Hashi, Soheil Hassanipour, Simon I Hay, Khezar Hayat, Mohammad Heidari, Mohammad Bellal Hossain Hossain, Sahadat Hossain, Mostafa Hosseini, Soodabeh Hoveidamanesh, Junjie Huang, Ayesha Humayun, Rabia Hussain, Bing-Fang Hwang, Segun Emmanuel Ibitoye, Kevin S Ikuta, Leeberk Raja Inbaraj, Usman Iqbal, Md Shariful Islam, Sheikh Mohammed Shariful Islam, Rakibul M Islam, Nahlah Elkudssiah Ismail, Gaetano Isola, Ramaiah Itumalla, Masao Iwagami, Ihoghosa Osamuyi Iyamu, Mohammad Ali Jahani, Mihajlo Jakovljevic, Ranil Jayawardena, Ravi Prakash Jha, Oommen John, Jost B Jonas, Tamas Joo, Ali Kabir, Rohollah Kalhor, Ashwin Kamath, Tanuj Kanchan, Himal Kandel, Neeti Kapoor, Gbenga A Kayode, Sewnet Adem Kebede, Pedram Keshavarz, Mohammad Keykhaei, Yousef Saleh Khader, Himanshu Khajuria, Moien AB Khan, Md Nuruzzaman Khan, Maseer Khan, Amir M Khater, Tawfik Ahmed Muthafer Khoja, Jagdish Khubchandani, Min Seo Kim, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Mika Kivimäki, Vladimir Andreevich Korshunov, Oleksii Korzh, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, G Anil Kumar, Nithin Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Anders O Larsson, Savita Lasrado, Wei-Chen Lee, Chiachi Bonnie Lee, Paul H Lee, Shaun Wen Huey Lee, Ming-Chieh Li, Stephen S Lim, Lee-Ling Lim, Giancarlo Lucchetti, Azeem Majeed, Ahmad Azam Malik, Borhan Mansouri, Lorenzo Giovanni Mantovani, Santi Martini, Prashant Mathur, Colm McAlinden, Nafiul Mehedi, Teferi Mekonnen, Ritesh G Menezes, Amanual Getnet Mersha, Junmei Miao Jonasson, Tomasz Miazgowski, Irmina Maria Michalek, Andreea Mirica, Erkin M Mirrakhimov, Agha Zeeshan Mirza, Prasanna Mithra, Abdollah Mohammadian-Hafshejani, Reza Mohammadpourhodki, Arif Mohammed, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Mohammad Ali Moni, Farhad Moradpour, Rahmatollah Moradzadeh, Ebrahim Mostafavi, Ulrich Otto Mueller, Christopher J L Murray, Ahmad Mustafa, Gabriele Nagel, Vinay Nangia, Atta Abbas Naqvi, Biswa Prakash Nayak, Javad Nazari, Rawlance Ndejjo, Ruxandra Irina Negoi, Sandhya Neupane Kandel, Cuong Tat Nguyen, Huong Lan 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Mosfequr Rahman, Mosiur Rahman, Setyaningrum Rahmawaty, Nazanin Rajai, Pradhum Ram, Juwel Rana, Kamal Ranabhat, Priyanga Ranasinghe, Chythra R Rao, Satish Rao, Salman Rawaf, David Laith Rawaf, Lal Rawal, Andre M N Renzaho, Nima Rezaei, Aziz Rezapour, Seyed Mohammad Riahi, Daniela Ribeiro, Jefferson Antonio Buendia Rodriguez, Leonardo Roever, Peter Rohloff, Godfrey M Rwegerera, Paul MacDaragh Ryan, Maha Mohamed Saber-Ayad, Siamak Sabour, Basema Saddik, Sahar Saeedi Moghaddam, Amirhossein Sahebkar, Harihar Sahoo, KM Saif-Ur-Rahman, Hamideh Salimzadeh, Mehrnoosh Samaei, Juan Sanabria, Milena M Santric-Milicevic, Brijesh Sathian, Thirunavukkarasu Sathish, Markus P Schlaich, Abdul-Aziz Seidu, Mario Šekerija, Nachimuthu Senthil Kumar, Allen Seylani, Masood Ali Shaikh, Hina Shamshad, Md Shajedur Rahman Shawon, Sara Sheikhbahaei, Jeevan K Shetty, Rahman Shiri, K M Shivakumar, Kerem Shuval, Jasvinder A Singh, Ambrish Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Ahmad Sofi-Mahmudi, Amin Soheili, Jing Sun, Viktória Szerencsés, Miklós Szócska, Rafael Tabarés-Seisdedos, Hooman Tadbiri, Eyayou Girma Tadesse, Md. 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B., Stein, C., Ong, K. L., Vos, T., Abbafati, C., Abbasi-Kangevari, M., Abdelmasseh, M., Abdoli, A., Abd-Rabu, R., Abolhassani, H., Abu-Gharbieh, E., Accrombessi, M. M. K., Adnani, Q. E. S., Afzal, M. S., Agarwal, G., Agrawaal, K. K., Agudelo-Botero, M., Ahinkorah, B. O., Ahmad, S., Ahmad, T., Ahmadi, K., Ahmadi, S., Ahmadi, A., Ahmed, A., Ahmed Salih, Y., Akande-Sholabi, W., Akram, T., Al Hamad, H., Al-Aly, Z., Alcalde-Rabanal, J. E., Alipour, V., Aljunid, S. M., Al-Raddadi, R. M., Alvis-Guzman, N., Amini, S., Ancuceanu, R., Andrei, T., Andrei, C. L., Anjana, R. M., Ansar, A., Antonazzo, I. C., Antony, B., Anyasodor, A. E., Arabloo, J., Arizmendi, D., Armocida, B., Artamonov, A. A., Arulappan, J., Aryan, Z., Asgari, S., Ashraf, T., Astell-Burt, T., Atorkey, P., Atout, M. M. W., Ayanore, M. A., Badiye, A. D., Baig, A. A., Bairwa, M., Baker, J. L., Baltatu, O. C., Banik, P. C., Barnett, A., Barone, M. T. U., Barone-Adesi, F., Barrow, A., Bedi, N., Belete, R., Belgaumi, U. I., Bell, A. 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I., Collaborators, GBD 2019 Diabetes Mortality, and Lacey, BWH
Subjects: Adult, Endocrinology, Diabetes and Metabolism, CHILDHOOD, universal health coverage, Global Health, 3121 Internal medicine, Global Burden of Disease, 1117 Public Health and Health Services, Endocrinology, SDG 3 - Good Health and Well-being, Risk Factors, RA0421, Internal Medicine, Humans, Diabetes mortality, diabetes, mortality, global burden of disease, under 25 years, COHORT, health care services, COMPLICATIONS, CHALLENGES, Diabetes, Mortality trends, Age-specific diabetes, 1103 Clinical Sciences, Public Health, Global Health, Social Medicine and Epidemiology, BRAZIL, Type I Diabetes, INSULIN, 3142 Public health care science, environmental and occupational health, the Socio-demographic Index, Treatment, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, 1101 Medical Biochemistry and Metabolomics, diabete, 3121 General medicine, internal medicine and other clinical medicine, ACCESS, RA, RC
Abstract: Background:Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods:We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings:In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (−28·4 to −2·9) for all diabetes, and by 21·0% (–33·0 to −5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (−13·6% [–28·4 to 3·4]) and for type 1 diabetes (−13·6% [–29·3 to 8·9]). Interpretation:Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. Funding: Bill & Melinda Gates Foundation.
Published: 2022
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44. Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Sharma, R, Abbasi-Kangevari, M, Abd-Rabu, R, Abidi, H, Abu-Gharbieh, E, Manuel Acuna, J, Adhikari, S, M Advani, S, Sohail Afzal, M, Aghaie Meybodi, M, Opoku Ahinkorah, B, Ahmad, S, Ahmadi, A, Ahmadi, S, Ahmed, H, A Ahmed, L, Beshir Ahmed, M, Al Hamad, H, Alahdab, F, Mashhour Alanezi, F, M Alanzi, T, Alhalaiqa Naji Alhalaiqa, F, Alimohamadi, Y, Alipour, V, Mohamed Aljunid, S, Alkhayyat, M, Almustanyir, S, M Al-Raddadi, R, Alvand, S, Alvis-Guzman, N, Amini, S, Ancuceanu, R, Anoushiravani, A, Arash Anoushirvani, A, Ansari-Moghaddam, A, Arabloo, J, Aryannejad, A, Asghari Jafarabadi, M, Shamsadin Athari, S, Ausloos, F, Ausloos, M, Fentahun Awedew, A, Ayenew Awoke, M, Mulatu Ayana, T, Azadnajafabad, S, Azami, H, Azangou-Khyavy, M, Azari Jafari, A, D Badiye, A, Bagherieh, S, Bahadory, S, Amin Baig, A, L Baker, J, Banach, M, Barrow, A, Yirga Berhie, A, Besharat, S, S Bhagat, D, Srikanth Bhagavathula, A, Bhala, N, Bhattacharyya, K, S Bhojaraja, V, Bibi, S, Bijani, A, Biondi, A, Bj??rge, 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Brijesh Sathian, Maheswar Satpathy, Ione Jayce Ceola Schneider, Mario ??ekerija, Sadaf G Sepanlou, Allen Seylani, Feng Sha, Sayed Mohammad Shafiee, Zahra Shaghaghi, Saeed Shahabi, Elaheh Shaker, Maedeh Sharifian, Javad Sharifi-Rad, Sara Sheikhbahaei, Jeevan K Shetty, Reza Shirkoohi, Parnian Shobeiri, Sudeep K Siddappa Malleshappa, Diego Augusto Santos Silva, Guilherme Silva Julian, Achintya Dinesh Singh, Jasvinder A Singh, Md Shahjahan Siraj, Gholam Reza Sivandzadeh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Marco Solmi, Mohammad Sadegh Soltani-Zangbar, Suhang Song, Vikt??ria Szerencs??s, Mikl??s Sz??cska, Rafael Tabar??s-Seisdedos, Elnaz Tabibian, Majid Taheri, Yasaman TaheriAbkenar, Amir Taherkhani, Iman M Talaat, Ker-Kan Tan, Abdelghani Tbakhi, Bekele Tesfaye, Amir Tiyuri, Daniel Nigusse Tollosa, Mathilde Touvier, Bach Xuan Tran, Biruk Shalmeno Tusa, Irfan Ullah, Saif Ullah, Marco Vacante, Sahel Valadan Tahbaz, Massimiliano Veroux, Bay Vo, Theo Vos, 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Nadeem Saqib, M, Sarveazad, A, Sathian, B, Satpathy, M, Jayce Ceola Schneider, I, ??ekerija, M, G Sepanlou, S, Seylani, A, Sha, F, Mohammad Shafiee, S, Shaghaghi, Z, Shahabi, S, Shaker, E, Sharifian, M, Sharifi-Rad, J, Sheikhbahaei, S, K Shetty, J, Shirkoohi, R, Shobeiri, P, K Siddappa Malleshappa, S, Augusto Santos Silva, D, Silva Julian, G, Dinesh Singh, A, A Singh, J, Shahjahan Siraj, M, Reza Sivandzadeh, G, Yurievich Skryabin, V, Aleksandrovna Skryabina, A, Socea, B, Solmi, M, Sadegh Soltani-Zangbar, M, Song, S, Szerencs??s, V, Sz??cska, M, Tabar??s-Seisdedos, R, Tabibian, E, Taheri, M, Taheriabkenar, Y, Taherkhani, A, M Talaat, I, Tan, K, Tbakhi, A, Tesfaye, B, Tiyuri, A, Nigusse Tollosa, D, Touvier, M, Xuan Tran, B, Shalmeno Tusa, B, Ullah, I, Ullah, S, Vacante, M, Valadan Tahbaz, S, Veroux, M, Vo, B, Vos, T, Wang, C, Westerman, R, Woldemariam, M, Hossein Yahyazadeh Jabbari, S, Yang, L, Yazdanpanah, F, Yu, C, Yuce, D, Yunusa, I, Zadnik, V, Zahir, M, Zare, I, Zhang, Z, Zoladl, M, 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Jennifer L Baker, Maciej Banach, Amadou Barrow, Alemshet Yirga Berhie, Sima Besharat, Devidas S Bhagat, Akshaya Srikanth Bhagavathula, Neeraj Bhala, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Sadia Bibi, Ali Bijani, Antonio Biondi, Tone Bj??rge, Belay Boda Abule Bodicha, Dejana Braithwaite, Hermann Brenner, Daniela Calina, Chao Cao, Yin Cao, Giulia Carreras, Felix Carvalho, Ester Cerin, Raja Chandra Chakinala, William C S Cho, Dinh-Toi Chu, Joao Conde, Vera Marisa Costa, Nat??lia Cruz-Martins, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Anna Danielewicz, Feleke Mekonnen Demeke, Getu Debalkie Demissie, Rupak Desai, Deepak Dhamnetiya, Mostafa Dianatinasab, Daniel Diaz, Mojtaba Didehdar, Saeid Doaei, Linh Phuong Doan, Milad Dodangeh, Fatemeh Eghbalian, Debela Debela Ejeta, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Iman El Sayed, Muhammed Elhadi, Daniel Berhanie Enyew, Tahir Eyayu, Rana Ezzeddini, Ildar Ravisovich Fakhradiyev, Umar Farooque, Hossein Farrokhpour, 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Jayawardena, Rime Jebai, Ravi Prakash Jha, Tamas Joo, Nitin Joseph, Farahnaz Joukar, Jacek Jerzy Jozwiak, Ali Kabir, Rohollah Kalhor, Ashwin Kamath, Neeti Kapoor, Ibraheem M Karaye, Amirali Karimi, Joonas H Kauppila, Asma Kazemi, Mohammad Keykhaei, Yousef Saleh Khader, Himanshu Khajuria, Rovshan Khalilov, Javad Khanali, Maryam Khayamzadeh, Mahmoud Khodadost, Hanna Kim, Min Seo Kim, Adnan Kisa, Sezer Kisa, Ali-Asghar Kolahi, Hamid Reza Koohestani, Jacek A Kopec, Rajasekaran Koteeswaran, Ai Koyanagi, Yuvaraj Krishnamoorthy, G Anil Kumar, Manoj Kumar, Vivek Kumar, Carlo La Vecchia, Faris Hasan Lami, Iv??n Landires, Caterina Ledda, Sang-woong Lee, Wei-Chen Lee, Yeong Yeh Lee, Elvynna Leong, Bingyu Li, Stephen S Lim, Stany W Lobo, Joana A Loureiro, Raimundas Lunevicius, Farzan Madadizadeh, Ata Mahmoodpoor, Azeem Majeed, Mohammad-Reza Malekpour, Reza Malekzadeh, Ahmad Azam Malik, Fariborz Mansour-Ghanaei, Lorenzo Giovanni Mantovani, Miquel Martorell, Sahar Masoudi, Prashant Mathur, Jitendra Kumar Meena, Entezar Mehrabi Nasab, Walter Mendoza, Alexios-Fotios A Mentis, Tomislav Mestrovic, Junmei Miao Jonasson, Bartosz Miazgowski, Tomasz Miazgowski, Gelana Fekadu Worku Mijena, Seyyedmohammadsadeq Mirmoeeni, Mohammad Mirza-Aghazadeh-Attari, Hamed Mirzaei, Sanjeev Misra, Karzan Abdulmuhsin Mohammad, Esmaeil Mohammadi, Saeed Mohammadi, Seyyede Momeneh Mohammadi, Abdollah Mohammadian-Hafshejani, Shafiu Mohammed, Teroj Abdulrahman Mohammed, Nagabhishek Moka, Ali H Mokdad, Zeinab Mokhtari, Mariam Molokhia, Sara Momtazmanesh, Lorenzo Monasta, Ghobad Moradi, Rahmatollah Moradzadeh, Paula Moraga, Joana Morgado-da-Costa, Sumaira Mubarik, Francesk Mulita, Mohsen Naghavi, Mukhammad David Naimzada, Hae Sung Nam, Zuhair S Natto, Biswa Prakash Nayak, Javad Nazari, Ehsan Nazemalhosseini-Mojarad, Ionut Negoi, Cuong Tat Nguyen, Son Hoang Nguyen, Nurulamin M Noor, Maryam Noori, Seyyed Mohammad Ali Noori, Virginia Nu??ez-Samudio, Chimezie Igwegbe Nzoputam, Bogdan Oancea, Oluwakemi Ololade Odukoya, Ayodipupo Sikiru Oguntade, Hassan Okati-Aliabad, Andrew T Olagunju, Tinuke O Olagunju, Sokking Ong, Samuel M Ostroff, Alicia Padron-Monedero, Reza Pakzad, Adrian Pana, Anamika Pandey, Fatemeh Pashazadeh Kan, Urvish K Patel, Uttam Paudel, Renato B Pereira, Navaraj Perumalsamy, Richard G Pestell, Zahra Zahid Piracha, Richard Charles G Pollok, Akram Pourshams, Naeimeh Pourtaheri, Akila Prashant, Mohammad Rabiee, Navid Rabiee, Amir Radfar, Sima Rafiei, Mosiur Rahman, Amir Masoud Rahmani, Vahid Rahmanian, Nazanin Rajai, Aashish Rajesh, Vajiheh Ramezani-Doroh, Kiana Ramezanzadeh, Kamal Ranabhat, Sina Rashedi, Amirfarzan Rashidi, Mahsa Rashidi, Mohammad-Mahdi Rashidi, Mandana Rastegar, David Laith Rawaf, Salman Rawaf, Reza Rawassizadeh, Mohammad Sadegh Razeghinia, Andre M N Renzaho, Negar Rezaei, Nima Rezaei, Saeid Rezaei, Mohsen Rezaeian, Sahba Rezazadeh-Khadem, Gholamreza Roshandel, Maha Mohamed Saber-Ayad, Bahar Saberzadeh-Ardestani, Basema Saddik, Hossein Sadeghi, Umar Saeed, Maryam Sahebazzamani, Amirhossein Sahebkar, Amir Salek Farrokhi, Amir Salimi, Hamideh Salimzadeh, Pouria Samadi, Mehrnoosh Samaei, Abdallah M Samy, Juan Sanabria, Milena M Santric-Milicevic, Muhammad Arif Nadeem Saqib, Arash Sarveazad, Brijesh Sathian, Maheswar Satpathy, Ione Jayce Ceola Schneider, Mario ??ekerija, Sadaf G Sepanlou, Allen Seylani, Feng Sha, Sayed Mohammad Shafiee, Zahra Shaghaghi, Saeed Shahabi, Elaheh Shaker, Maedeh Sharifian, Javad Sharifi-Rad, Sara Sheikhbahaei, Jeevan K Shetty, Reza Shirkoohi, Parnian Shobeiri, Sudeep K Siddappa Malleshappa, Diego Augusto Santos Silva, Guilherme Silva Julian, Achintya Dinesh Singh, Jasvinder A Singh, Md Shahjahan Siraj, Gholam Reza Sivandzadeh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Marco Solmi, Mohammad Sadegh Soltani-Zangbar, Suhang Song, Vikt??ria Szerencs??s, Mikl??s Sz??cska, Rafael Tabar??s-Seisdedos, Elnaz Tabibian, Majid Taheri, Yasaman TaheriAbkenar, Amir Taherkhani, Iman M Talaat, Ker-Kan Tan, Abdelghani Tbakhi, Bekele Tesfaye, Amir Tiyuri, Daniel Nigusse Tollosa, Mathilde Touvier, Bach Xuan Tran, Biruk Shalmeno Tusa, Irfan Ullah, Saif Ullah, Marco Vacante, Sahel Valadan Tahbaz, Massimiliano Veroux, Bay Vo, Theo Vos, Cong Wang, Ronny Westerman, Melat Woldemariam, Seyed Hossein Yahyazadeh Jabbari, Lin Yang, Fereshteh Yazdanpanah, Chuanhua Yu, Deniz Yuce, Ismaeel Yunusa, Vesna Zadnik, Mazyar Zahir, Iman Zare, Zhi-Jiang Zhang, and Mohammad Zoladl
Abstract: Background: Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. Methods: Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990–2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. Findings: Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408–868 574) to 2·17 million (2·00–2·34), and deaths increased from 518 126 (493 682–537 877) to 1·09 million (1·02–1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3–23·0) per 100 000 to 26·7 (24·6–28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5–14·9) per 100 000 to 13·7 (12·6–14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7–320·7) per 100 000 to 295·5 (275·2–313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9–80·0] per 100 000), Monaco (60·7 [48·5–73·6] per 100 000), and Andorra (56·6 [42·8–71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0–37·1] per 100 000), Brunei (30·3 [26·6–34·1] per 100 000), and Hungary (28·6 [23·6–34·0] per 100 000) had the highest age-standardised mortality rates. From 199
Published: 2022

45. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019

Author: Nichols, E, D Steinmetz, J, Emil Vollset, S, Fukutaki, K, Chalek, J, Abd-Allah, F, Abdoli, A, Abualhasan, A, Abu-Gharbieh, E, Tayyaba Akram, T, Al Hamad, H, Alahdab, F, Mashhour Alanezi, F, Alipour, V, Almustanyir, S, Amu, H, Ansari, I, Arabloo, J, Ashraf, T, Astell-Burt, T, Ayano, G, L Ayuso-Mateos, J, Amin Baig, A, Barnett, A, Barrow, A, T Baune, B, Béjot, Y, M Mequanint Bezabhe, W, Mequanint Bezabih, Y, Srikanth Bhagavathula, A, Bhaskar, S, Bhattacharyya, K, Bijani, A, Biswas, A, Rao Bolla, S, Boloor, A, Brayne, C, Brenner, H, Burkart, K, A Burns, R, Alberto Cámera, L, Cao, C, Carvalho, F, S Castro-de-Araujo, L, Catalá-López, F, Cerin, E, P Chavan, P, Cherbuin, N, Chu, D, Marisa Costa, V, S Couto, R, Dadras, O, Dai, X, Dandona, L, Dandona, R, De la Cruz-Góngora, V, Dhamnetiya, D, Dias da Silva, D, Diaz, D, Douiri, A, Edvardsson, D, Ekholuenetale, M, El Sayed, I, I El-Jaafary, S, Eskandari, K, Eskandarieh, S, Esmaeilnejad, S, Fares, J, Faro, A, Farooque, U, L Feigin, V, Feng, X, Fereshtehnejad, S, Fernandes, E, Ferrara, P, Filip, I, Fillit, H, Fischer, F, Gaidhane, S, Galluzzo, L, Ghashghaee, A, Ghith, N, Gialluisi, A, Amir Gilani, S, Glăvan, I, V Gnedovskaya, E, Golechha, M, Gupta, R, Bala Gupta, V, Kumar Gupta, V, Rifat Haider, M, J Hall, B, Hamidi, S, Hanif, A, J Hankey, G, Haque, S, Kusuma Hartono, R, I Hasaballah, A, Tasdik Hasan, M, Hassan, A, I Hay, S, Hayat, K, I Hegazy, M, Heidari, G, Heidari-Soureshjani, R, Herteliu, C, Househ, M, Hussain, R, Hwang, B, Iacoviello, L, Iavicoli, I, Stephen Ilesanmi, O, M Ilic, I, D Ilic, M, Sina Naghibi Irvani, S, Iso, H, Iwagami, M, Jabbarinejad, R, Jacob, L, Jain, V, Kumar Jayapal, S, Jayawardena, R, Prakash Jha, R, B Jonas, J, Joseph, N, Kalani, R, Kandel, A, Kandel, H, Karch, A, Semachew Kasa, A, M Kassie, G, Keshavarz, P, B Khan, M, Nazli Khatib, M, Ahmed Muthafer Khoja, T, Khubchandani, J, Seo Kim, M, Jin Kim, Y, Kisa, A, Kisa, S, Kivimäki, M, J Koroshetz, W, Koyanagi, A, Anil Kumar, G, Kumar, M, Mehmood Lak, H, Leonardi, M, Li, B, S Lim, S, Liu, X, Liu, Y, Logroscino, G, Lorkowski, S, Lucchetti, G, Lutzky Saute, R, Giulia Magnani, F, Azam Malik, A, Massano, J, Mohan Mehndiratta, M, G Menezes, R, Meretoja, A, Mohajer, B, Mohamed Ibrahim, N, Mohammad, Y, Mohammed, A, H Mokdad, A, Mondello, S, Ali Moni, M, Moniruzzaman, M, Belete Mossie, T, Nagel, G, Naveed, M, C Nayak, V, Neupane Kandel, S, Huyen Nguyen, T, Oancea, B, Otstavnov, N, S Otstavnov, S, O Owolabi, M, Panda-Jonas, S, Pashazadeh Kan, F, Pasovic, M, K Patel, U, Pathak, M, P Peres, M, Perianayagam, A, B Peterson, C, R Phillips, M, Pinheiro, M, A Piradov, M, Dimity Pond, C, H Potashman, M, Hyder Pottoo, F, I Prada, S, Radfar, A, Raggi, A, Rahim, F, Rahman, M, Ram, P, Ranasinghe, P, Laith Rawaf, D, Rawaf, S, Rezaei, N, Rezapour, A, R Robinson, S, Romoli, M, Roshandel, G, Sahathevan, R, Sahebkar, A, Ali Sahraian, M, Sathian, B, Sattin, D, Sawhney, M, Saylan, M, Schiavolin, S, Seylani, A, Sha, F, Ali Shaikh, M, S Shaji, K, Shannawaz, M, K Shetty, J, Shigematsu, M, Il Shin, J, Shiri, R, Augusto Santos Silva, D, Pedro Silva, J, Silva, R, A Singh, J, Yurievich Skryabin, V, Aleksandrovna Skryabina, A, E Smith, A, Soshnikov, S, Elizabeth Spurlock, E, J Stein, D, Sun, J, Tabarés-Seisdedos, R, Thakur, B, Timalsina, B, Roberto Tovani-Palone, M, Xuan Tran, B, Wudie Tsegaye, G, Valadan Tahbaz, S, R Valdez, P, Venketasubramanian, N, Vlassov, V, Thu Vu, G, Gia Vu, L, Wang, Y, Wimo, A, Sylvia Winkler, A, Yadav, L, Hossein Yahyazadeh Jabbari, S, Yamagishi, K, Yang, L, Yano, Y, Yonemoto, N, Yu, C, Yunusa, I, Zadey, S, Sergeevich Zastrozhin, M, Zastrozhina, A, Zhang, Z, L Murray, C, Vos, T, Emma Nichols, Jaimie D Steinmetz, Stein Emil Vollset, Kai Fukutaki, Julian Chalek, Foad Abd-Allah, Amir Abdoli, Ahmed Abualhasan, Eman Abu-Gharbieh, Tayyaba Tayyaba Akram, Hanadi Al Hamad, Fares Alahdab, Fahad Mashhour Alanezi, Vahid Alipour, Sami Almustanyir, Hubert Amu, Iman Ansari, Jalal Arabloo, Tahira Ashraf, Thomas Astell-Burt, Getinet Ayano, Jose L Ayuso-Mateos, Atif Amin Baig, Anthony Barnett, Amadou Barrow, Bernhard T Baune, Yannick Béjot, Woldesellassie M Mequanint Bezabhe, Yihienew Mequanint Bezabih, Akshaya Srikanth Bhagavathula, Sonu Bhaskar, Krittika Bhattacharyya, Ali Bijani, Atanu Biswas, Srinivasa Rao Bolla, Archith Boloor, Carol Brayne, Hermann Brenner, Katrin Burkart, Richard A Burns, Luis Alberto Cámera, Chao Cao, Felix Carvalho, Luis F S Castro-de-Araujo, Ferrán Catalá-López, Ester Cerin, Prachi P Chavan, Nicolas Cherbuin, Dinh-Toi Chu, Vera Marisa Costa, Rosa A S Couto, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Vanessa De la Cruz-Góngora, Deepak Dhamnetiya, Diana Dias da Silva, Daniel Diaz, Abdel Douiri, David Edvardsson, Michael Ekholuenetale, Iman El Sayed, Shaimaa I El-Jaafary, Khalil Eskandari, Sharareh Eskandarieh, Saman Esmaeilnejad, Jawad Fares, Andre Faro, Umar Farooque, Valery L Feigin, Xiaoqi Feng, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Pietro Ferrara, Irina Filip, Howard Fillit, Florian Fischer, Shilpa Gaidhane, Lucia Galluzzo, Ahmad Ghashghaee, Nermin Ghith, Alessandro Gialluisi, Syed Amir Gilani, Ionela-Roxana Glăvan, Elena V Gnedovskaya, Mahaveer Golechha, Rajeev Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Mohammad Rifat Haider, Brian J Hall, Samer Hamidi, Asif Hanif, Graeme J Hankey, Shafiul Haque, Risky Kusuma Hartono, Ahmed I Hasaballah, M Tasdik Hasan, Amr Hassan, Simon I Hay, Khezar Hayat, Mohamed I Hegazy, Golnaz Heidari, Reza Heidari-Soureshjani, Claudiu Herteliu, Mowafa Househ, Rabia Hussain, Bing-Fang Hwang, Licia Iacoviello, Ivo Iavicoli, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Seyed Sina Naghibi Irvani, Hiroyasu Iso, Masao Iwagami, Roxana Jabbarinejad, Louis Jacob, Vardhmaan Jain, Sathish Kumar Jayapal, Ranil Jayawardena, Ravi Prakash Jha, Jost B Jonas, Nitin Joseph, Rizwan Kalani, Amit Kandel, Himal Kandel, André Karch, Ayele Semachew Kasa, Gizat M Kassie, Pedram Keshavarz, Moien A B Khan, Mahalaqua Nazli Khatib, Tawfik Ahmed Muthafer Khoja, Jagdish Khubchandani, Min Seo Kim, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Mika Kivimäki, Walter J Koroshetz, Ai Koyanagi, G Anil Kumar, Manasi Kumar, Hassan Mehmood Lak, Matilde Leonardi, Bingyu Li, Stephen S Lim, Xuefeng Liu, Yuewei Liu, Giancarlo Logroscino, Stefan Lorkowski, Giancarlo Lucchetti, Ricardo Lutzky Saute, Francesca Giulia Magnani, Ahmad Azam Malik, João Massano, Man Mohan Mehndiratta, Ritesh G Menezes, Atte Meretoja, Bahram Mohajer, Norlinah Mohamed Ibrahim, Yousef Mohammad, Arif Mohammed, Ali H Mokdad, Stefania Mondello, Mohammad Ali Moni, Md Moniruzzaman, Tilahun Belete Mossie, Gabriele Nagel, Muhammad Naveed, Vinod C Nayak, Sandhya Neupane Kandel, Trang Huyen Nguyen, Bogdan Oancea, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Songhomitra Panda-Jonas, Fatemeh Pashazadeh Kan, Maja Pasovic, Urvish K Patel, Mona Pathak, Mario F P Peres, Arokiasamy Perianayagam, Carrie B Peterson, Michael R Phillips, Marina Pinheiro, Michael A Piradov, Constance Dimity Pond, Michele H Potashman, Faheem Hyder Pottoo, Sergio I Prada, Amir Radfar, Alberto Raggi, Fakher Rahim, Mosiur Rahman, Pradhum Ram, Priyanga Ranasinghe, David Laith Rawaf, Salman Rawaf, Nima Rezaei, Aziz Rezapour, Stephen R Robinson, Michele Romoli, Gholamreza Roshandel, Ramesh Sahathevan, Amirhossein Sahebkar, Mohammad Ali Sahraian, Brijesh Sathian, Davide Sattin, Monika Sawhney, Mete Saylan, Silvia Schiavolin, Allen Seylani, Feng Sha, Masood Ali Shaikh, K S Shaji, Mohammed Shannawaz, Jeevan K Shetty, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Diego Augusto Santos Silva, João Pedro Silva, Renata Silva, Jasvinder A Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Amanda E Smith, Sergey Soshnikov, Emma Elizabeth Spurlock, Dan J Stein, Jing Sun, Rafael Tabarés-Seisdedos, Bhaskar Thakur, Binod Timalsina, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Gebiyaw Wudie Tsegaye, Sahel Valadan Tahbaz, Pascual R Valdez, Narayanaswamy Venketasubramanian, Vasily Vlassov, Giang Thu Vu, Linh Gia Vu, Yuan-Pang Wang, Anders Wimo, Andrea Sylvia Winkler, Lalit Yadav, Seyed Hossein Yahyazadeh Jabbari, Kazumasa Yamagishi, Lin Yang, Yuichiro Yano, Naohiro Yonemoto, Chuanhua Yu, Ismaeel Yunusa, Siddhesh Zadey, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Christopher J L Murray, Theo Vos, Nichols, E, D Steinmetz, J, Emil Vollset, S, Fukutaki, K, Chalek, J, Abd-Allah, F, Abdoli, A, Abualhasan, A, Abu-Gharbieh, E, Tayyaba Akram, T, Al Hamad, H, Alahdab, F, Mashhour Alanezi, F, Alipour, V, Almustanyir, S, Amu, H, Ansari, I, Arabloo, J, Ashraf, T, Astell-Burt, T, Ayano, G, L Ayuso-Mateos, J, Amin Baig, A, Barnett, A, Barrow, A, T Baune, B, Béjot, Y, M Mequanint Bezabhe, W, Mequanint Bezabih, Y, Srikanth Bhagavathula, A, Bhaskar, S, Bhattacharyya, K, Bijani, A, Biswas, A, Rao Bolla, S, Boloor, A, Brayne, C, Brenner, H, Burkart, K, A Burns, R, Alberto Cámera, L, Cao, C, Carvalho, F, S Castro-de-Araujo, L, Catalá-López, F, Cerin, E, P Chavan, P, Cherbuin, N, Chu, D, Marisa Costa, V, S Couto, R, Dadras, O, Dai, X, Dandona, L, Dandona, R, De la Cruz-Góngora, V, Dhamnetiya, D, Dias da Silva, D, Diaz, D, Douiri, A, Edvardsson, D, Ekholuenetale, M, El Sayed, I, I El-Jaafary, S, Eskandari, K, Eskandarieh, S, Esmaeilnejad, S, Fares, J, Faro, A, Farooque, U, L Feigin, V, Feng, X, Fereshtehnejad, S, Fernandes, E, Ferrara, P, Filip, I, Fillit, H, Fischer, F, Gaidhane, S, Galluzzo, L, Ghashghaee, A, Ghith, N, Gialluisi, A, Amir Gilani, S, Glăvan, I, V Gnedovskaya, E, Golechha, M, Gupta, R, Bala Gupta, V, Kumar Gupta, V, Rifat Haider, M, J Hall, B, Hamidi, S, Hanif, A, J Hankey, G, Haque, S, Kusuma Hartono, R, I Hasaballah, A, Tasdik Hasan, M, Hassan, A, I Hay, S, Hayat, K, I Hegazy, M, Heidari, G, Heidari-Soureshjani, R, Herteliu, C, Househ, M, Hussain, R, Hwang, B, Iacoviello, L, Iavicoli, I, Stephen Ilesanmi, O, M Ilic, I, D Ilic, M, Sina Naghibi Irvani, S, Iso, H, Iwagami, M, Jabbarinejad, R, Jacob, L, Jain, V, Kumar Jayapal, S, Jayawardena, R, Prakash Jha, R, B Jonas, J, Joseph, N, Kalani, R, Kandel, A, Kandel, H, Karch, A, Semachew Kasa, A, M Kassie, G, Keshavarz, P, B Khan, M, Nazli Khatib, M, Ahmed Muthafer Khoja, T, Khubchandani, J, Seo Kim, M, Jin Kim, Y, Kisa, A, Kisa, S, Kivimäki, M, J Koroshetz, W, Koyanagi, A, Anil Kumar, G, Kumar, M, Mehmood Lak, H, Leonardi, M, Li, B, S Lim, S, Liu, X, Liu, Y, Logroscino, G, Lorkowski, S, Lucchetti, G, Lutzky Saute, R, Giulia Magnani, F, Azam Malik, A, Massano, J, Mohan Mehndiratta, M, G Menezes, R, Meretoja, A, Mohajer, B, Mohamed Ibrahim, N, Mohammad, Y, Mohammed, A, H Mokdad, A, Mondello, S, Ali Moni, M, Moniruzzaman, M, Belete Mossie, T, Nagel, G, Naveed, M, C Nayak, V, Neupane Kandel, S, Huyen Nguyen, T, Oancea, B, Otstavnov, N, S Otstavnov, S, O Owolabi, M, Panda-Jonas, S, Pashazadeh Kan, F, Pasovic, M, K Patel, U, Pathak, M, P Peres, M, Perianayagam, A, B Peterson, C, R Phillips, M, Pinheiro, M, A Piradov, M, Dimity Pond, C, H Potashman, M, Hyder Pottoo, F, I Prada, S, Radfar, A, Raggi, A, Rahim, F, Rahman, M, Ram, P, Ranasinghe, P, Laith Rawaf, D, Rawaf, S, Rezaei, N, Rezapour, A, R Robinson, S, Romoli, M, Roshandel, G, Sahathevan, R, Sahebkar, A, Ali Sahraian, M, Sathian, B, Sattin, D, Sawhney, M, Saylan, M, Schiavolin, S, Seylani, A, Sha, F, Ali Shaikh, M, S Shaji, K, Shannawaz, M, K Shetty, J, Shigematsu, M, Il Shin, J, Shiri, R, Augusto Santos Silva, D, Pedro Silva, J, Silva, R, A Singh, J, Yurievich Skryabin, V, Aleksandrovna Skryabina, A, E Smith, A, Soshnikov, S, Elizabeth Spurlock, E, J Stein, D, Sun, J, Tabarés-Seisdedos, R, Thakur, B, Timalsina, B, Roberto Tovani-Palone, M, Xuan Tran, B, Wudie Tsegaye, G, Valadan Tahbaz, S, R Valdez, P, Venketasubramanian, N, Vlassov, V, Thu Vu, G, Gia Vu, L, Wang, Y, Wimo, A, Sylvia Winkler, A, Yadav, L, Hossein Yahyazadeh Jabbari, S, Yamagishi, K, Yang, L, Yano, Y, Yonemoto, N, Yu, C, Yunusa, I, Zadey, S, Sergeevich Zastrozhin, M, Zastrozhina, A, Zhang, Z, L Murray, C, Vos, T, Emma Nichols, Jaimie D Steinmetz, Stein Emil Vollset, Kai Fukutaki, Julian Chalek, Foad Abd-Allah, Amir Abdoli, Ahmed Abualhasan, Eman Abu-Gharbieh, Tayyaba Tayyaba Akram, Hanadi Al Hamad, Fares Alahdab, Fahad Mashhour Alanezi, Vahid Alipour, Sami Almustanyir, Hubert Amu, Iman Ansari, Jalal Arabloo, Tahira Ashraf, Thomas Astell-Burt, Getinet Ayano, Jose L Ayuso-Mateos, Atif Amin Baig, Anthony Barnett, Amadou Barrow, Bernhard T Baune, Yannick Béjot, Woldesellassie M Mequanint Bezabhe, Yihienew Mequanint Bezabih, Akshaya Srikanth Bhagavathula, Sonu Bhaskar, Krittika Bhattacharyya, Ali Bijani, Atanu Biswas, Srinivasa Rao Bolla, Archith Boloor, Carol Brayne, Hermann Brenner, Katrin Burkart, Richard A Burns, Luis Alberto Cámera, Chao Cao, Felix Carvalho, Luis F S Castro-de-Araujo, Ferrán Catalá-López, Ester Cerin, Prachi P Chavan, Nicolas Cherbuin, Dinh-Toi Chu, Vera Marisa Costa, Rosa A S Couto, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Vanessa De la Cruz-Góngora, Deepak Dhamnetiya, Diana Dias da Silva, Daniel Diaz, Abdel Douiri, David Edvardsson, Michael Ekholuenetale, Iman El Sayed, Shaimaa I El-Jaafary, Khalil Eskandari, Sharareh Eskandarieh, Saman Esmaeilnejad, Jawad Fares, Andre Faro, Umar Farooque, Valery L Feigin, Xiaoqi Feng, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Pietro Ferrara, Irina Filip, Howard Fillit, Florian Fischer, Shilpa Gaidhane, Lucia Galluzzo, Ahmad Ghashghaee, Nermin Ghith, Alessandro Gialluisi, Syed Amir Gilani, Ionela-Roxana Glăvan, Elena V Gnedovskaya, Mahaveer Golechha, Rajeev Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Mohammad Rifat Haider, Brian J Hall, Samer Hamidi, Asif Hanif, Graeme J Hankey, Shafiul Haque, Risky Kusuma Hartono, Ahmed I Hasaballah, M Tasdik Hasan, Amr Hassan, Simon I Hay, Khezar Hayat, Mohamed I Hegazy, Golnaz Heidari, Reza Heidari-Soureshjani, Claudiu Herteliu, Mowafa Househ, Rabia Hussain, Bing-Fang Hwang, Licia Iacoviello, Ivo Iavicoli, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Seyed Sina Naghibi Irvani, Hiroyasu Iso, Masao Iwagami, Roxana Jabbarinejad, Louis Jacob, Vardhmaan Jain, Sathish Kumar Jayapal, Ranil Jayawardena, Ravi Prakash Jha, Jost B Jonas, Nitin Joseph, Rizwan Kalani, Amit Kandel, Himal Kandel, André Karch, Ayele Semachew Kasa, Gizat M Kassie, Pedram Keshavarz, Moien A B Khan, Mahalaqua Nazli Khatib, Tawfik Ahmed Muthafer Khoja, Jagdish Khubchandani, Min Seo Kim, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Mika Kivimäki, Walter J Koroshetz, Ai Koyanagi, G Anil Kumar, Manasi Kumar, Hassan Mehmood Lak, Matilde Leonardi, Bingyu Li, Stephen S Lim, Xuefeng Liu, Yuewei Liu, Giancarlo Logroscino, Stefan Lorkowski, Giancarlo Lucchetti, Ricardo Lutzky Saute, Francesca Giulia Magnani, Ahmad Azam Malik, João Massano, Man Mohan Mehndiratta, Ritesh G Menezes, Atte Meretoja, Bahram Mohajer, Norlinah Mohamed Ibrahim, Yousef Mohammad, Arif Mohammed, Ali H Mokdad, Stefania Mondello, Mohammad Ali Moni, Md Moniruzzaman, Tilahun Belete Mossie, Gabriele Nagel, Muhammad Naveed, Vinod C Nayak, Sandhya Neupane Kandel, Trang Huyen Nguyen, Bogdan Oancea, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Songhomitra Panda-Jonas, Fatemeh Pashazadeh Kan, Maja Pasovic, Urvish K Patel, Mona Pathak, Mario F P Peres, Arokiasamy Perianayagam, Carrie B Peterson, Michael R Phillips, Marina Pinheiro, Michael A Piradov, Constance Dimity Pond, Michele H Potashman, Faheem Hyder Pottoo, Sergio I Prada, Amir Radfar, Alberto Raggi, Fakher Rahim, Mosiur Rahman, Pradhum Ram, Priyanga Ranasinghe, David Laith Rawaf, Salman Rawaf, Nima Rezaei, Aziz Rezapour, Stephen R Robinson, Michele Romoli, Gholamreza Roshandel, Ramesh Sahathevan, Amirhossein Sahebkar, Mohammad Ali Sahraian, Brijesh Sathian, Davide Sattin, Monika Sawhney, Mete Saylan, Silvia Schiavolin, Allen Seylani, Feng Sha, Masood Ali Shaikh, K S Shaji, Mohammed Shannawaz, Jeevan K Shetty, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Diego Augusto Santos Silva, João Pedro Silva, Renata Silva, Jasvinder A Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Amanda E Smith, Sergey Soshnikov, Emma Elizabeth Spurlock, Dan J Stein, Jing Sun, Rafael Tabarés-Seisdedos, Bhaskar Thakur, Binod Timalsina, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Gebiyaw Wudie Tsegaye, Sahel Valadan Tahbaz, Pascual R Valdez, Narayanaswamy Venketasubramanian, Vasily Vlassov, Giang Thu Vu, Linh Gia Vu, Yuan-Pang Wang, Anders Wimo, Andrea Sylvia Winkler, Lalit Yadav, Seyed Hossein Yahyazadeh Jabbari, Kazumasa Yamagishi, Lin Yang, Yuichiro Yano, Naohiro Yonemoto, Chuanhua Yu, Ismaeel Yunusa, Siddhesh Zadey, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Christopher J L Murray, and Theo Vos
Abstract: BACKGROUND: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. METHODS: We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. FINDINGS: We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4-65·1) million cases globally in 2019 to 152·8 (130·8-175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [-7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64-1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52-1·85]). There was geographical heterogeneity in the projected inc
Published: 2022

46. Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years

Author: Tesfaye Dessale Kassa, Félix Carvalho, Luke D. Knibbs, Sonia Lewycka, Sonali Kochhar, Aaron Cohen, Luca Ronfani, Ebrahim M Yimer, Srinivas Murthy, Ejaz Ahmad Khan, Josip Car, Rodrigo Sarmiento-Suarez, Babak Moazen, Mostafa Qorbani, Javad Nazari, Nancy Fullman, Niranjan Kissoon, Keyghobad Ghadiri, Marissa B Reitsma, Benn Sartorius, Ashish Awasthi, Aman Yesuf Endries, Christopher Troeger, Evanson Z. Sambala, Nelson Alvis-Guzman, Alessandra C. Goulart, Erlyn Rachelle King Macarayan, Ahmad Daryani, Fakher Rahim, Fiseha Wadilo Wada, Yuming Guo, Sonia Saxena, Justin R. Ortiz, Monika Sawhney, Eyal Oren, Alaa Badawi, Tomislav Mestrovic, Sezer Kisa, Cheru Tesema Leshargie, Ai Koyanagi, Long Hoang Nguyen, Alireza Rafiei, Aziz Rezapour, Huong Lan Thi Nguyen, Abdallah M. Samy, Catrin E. Moore, André Karch, Seyyed Meysam Mousavi, Chi Linh Hoang, Katie R Nielsen, Eleonora Dubljanin, Giuseppe Gorini, Charles Shey Wiysonge, Bach Xuan Tran, Christopher J L Murray, Khanh Bao Tran, Maarten J. Postma, Mohammad Sadegh Rezai, Bartosz Miazgowski, Hagos Tasew Atalay, Aziz Sheikh, Reginald Quansah, Kirsten E. Wiens, Mika Shigematsu, Devasahayam J. Christopher, Hamid Yimam Hassen, Yasir Waheed, Robert Reiner, Smita Pakhale, Joseph Adel Mattar Banoub, Fares Alahdab, Vafa Rahimi-Movaghar, Mahesh P A, Ruth W Kimokoti, Feleke Mekonnen Demeke, Mohamad-Hani Temsah, Zakir Hussain, Naohiro Yonemoto, Noore Alam, Mu'awiyyah Babale Sufiyan, Lidia Morawska, Adane Teshome Kefale, Ali H. Mokdad, Rachel L Updike, Amir Kasaeian, Yousef Veisani, Rajesh Kumar Rai, Jeffrey D. Stanaway, Mina Anjomshoa, Corey B. Bills, Puja C Rao, Euripide Frinel G Arthur Avokpaho, Lorenzo Monasta, Zoubida Zaidi, Yousef Khader, Heather J. Zar, Ali Bijani, Tommi Vasankari, Kefyalew Addis Alene, Young-Ho Khang, Afewerki Gebremeskel Tsadik, Joseph Frostad, Ghulam Mustafa, Jalal Arabloo, Rajaa Al-Raddadi, Shanshan Li, David L. Smith, Maria Jesus Rios-Blancas, Carlos A Castañeda-Orjuela, Syed Mohamed Aljunid, Andrew T Olagunju, Suleman Atique, Abdullah T Khoja, Ibrahim A Khalil, William M. Gardner, Zikria Saleem, Addisu Melese, Stephen S Lim, Eyasu Ejeta Duken, Erkin M. Mirrakhimov, Gessessew Bugssa Hailu, Hmwe H Kyu, Seyedmojtaba Seyedmousavi, Aleksandra Barac, Spencer L. James, Salvatore Rubino, Lalit Dandona, Arya Haj-Mirzaian, Kate Causey, Nicholas J Kassebaum, Simon I. Hay, Ravi Prakash Jha, Karzan Abdulmuhsin Mohammad, Son Hoang Nguyen, Belay Tessema, Muhammad Imran Nisar, Barthelemy Kuate Defo, Alireza Ahmadi, Theo Vos, Krittika Bhattacharyya, Irfan Ullah, Molly H Biehl, Kalpana Balakrishnan, Tinuke O Olagunju, Florian Fischer, Olatunde Aremu, Brigette F. Blacker, Derrick A Bennett, Vahid Alipour, Carl Abelardo T. Antonio, Manisha Dubey, Tuomo J. Meretoja, G Anil Kumar, Varshil Mehta, Molly R Nixon, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Anselm Okoro, Zulfiqar A Bhutta, Maysaa El Sayed Zaki, Shafiu Mohammed, Nuruzzaman Khan, Jost B. Jonas, Samah Awad, Miloje Savic, Soewarta Kosen, Quique Bassat, Amha Admasie, Cuong Tat Nguyen, Chalachew Genet Akal, Milena M Santric Milicevic, Adnan Kisa, Arvin Haj-Mirzaian, Jonathan F. Mosser, Stephanie R M Zimsen, Dharmesh Kumar Lal, Birhanu Geta, Nobuyuki Horita, Gulfaraz Khan, Saeed Amini, Ziad A. Memish, Rakhi Dandona, Alyssa N. Sbarra, Dietrich Rothenbacher, Samer Hamidi, Felix Akpojene Ogbo, Helena Manguerra, Shirin Djalalinia, Degu Abate, Rakesh Lodha, Samuel B. Albertson, Seyed Sina Naghibi Irvani, Abdullah Al Mamun, Neeraj Bedi, Parvaiz A Koul, Desalegn Tadese Mengistu, Katie Welgan, Masood Ali Shaikh, Marek Majdan, Mihaela Hostiuc, Mohamed Lemine Cheikh brahim Ahmed, Public Health, GBD Lower Resp Infect, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Collaborators, GBD 2017 Lower Respiratory Infections, Clinicum, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, II kirurgian klinikka, and Department of Oncology
Subjects: Male, Psychological intervention, Global Health, Global Burden of Disease, 0302 clinical medicine, Risk Factors, Case fatality rate, Medicine, 030212 general & internal medicine, Respiratory Tract Infections, INFLUENZAE TYPE-B, education.field_of_study, NUTRITION TRANSITION, CHALLENGES, Trastornos respiratorios, Incidence (epidemiology), Mortality rate, Incidence, Enfermedades en niños, CHILDHOOD PNEUMONIA, Children younger than 5 years, 3. Good health, Infectious Diseases, Child, Preschool, Child Mortality, Female, TERRITORIES, CONJUGATE VACCINE, 030231 tropical medicine, Population, 195 COUNTRIES, Infections, Article, CHINA, 03 medical and health sciences, Age Distribution, Nutrition transition, SYSTEMATIC ANALYSIS, Humans, Risk factor, education, Lower respiratory, Models, Statistical, business.industry, AIR-POLLUTION, Verbal autopsy, Enfermedades respiratorias, Socioeconomic Factors, 3121 General medicine, internal medicine and other clinical medicine, Human medicine, business, Demography
Abstract: Background Despite large reductions in under-5 lower respiratory infection (LRI) mortality in many locations, the pace of progress for LRIs has generally lagged behind that of other childhood infectious diseases. To better inform programmes and policies focused on preventing and treating LRIs, we assessed the contributions and patterns of risk factor attribution, intervention coverage, and sociodemographic development in 195 countries and territories by drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) LRI estimates. Methods We used four strategies to model LRI burden: the mortality due to LRIs was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive ensemble modelling tool; the incidence of LRIs was modelled using population representative surveys, health-care utilisation data, and scientific literature in a compartmental meta-regression tool; the attribution of risk factors for LRI mortality was modelled in a counterfactual framework; and trends in LRI mortality were analysed applying changes in exposure to risk factors over time. In GBD, infectious disease mortality, including that due to LRI, is among HIV-negative individuals. We categorised locations based on their burden in 1990 to make comparisons in the changing burden between 1990 and 2017 and evaluate the relative percent change in mortality rate, incidence, and risk factor exposure to explain differences in the health loss associated with LRIs among children younger than 5 years. Findings In 2017, LRIs caused 808 920 deaths (95% uncertainty interval 747 286–873 591) in children younger than 5 years. Since 1990, there has been a substantial decrease in the number of deaths (from 2 337 538 to 808 920 deaths; 65·4% decrease, 61·5–68·5) and in mortality rate (from 362·7 deaths [330·1–392·0] per 100 000 children to 118·9 deaths [109·8–128·3] per 100 000 children; 67·2% decrease, 63·5–70·1). LRI incidence declined globally (32·4% decrease, 27·2–37·5). The percent change in under-5 mortality rate and incidence has varied across locations. Among the risk factors assessed in this study, those responsible for the greatest decrease in under-5 LRI mortality between 1990 and 2017 were increased coverage of vaccination against Haemophilus influenza type b (11·4% decrease, 0·0–24·5), increased pneumococcal vaccine coverage (6·3% decrease, 6·1–6·3), and reductions in household air pollution (8·4%, 6·8–9·2). Interpretation Our findings show that there have been substantial but uneven declines in LRI mortality among countries between 1990 and 2017. Although improvements in indicators of sociodemographic development could explain some of these trends, changes in exposure to modifiable risk factors are related to the rates of decline in LRI mortality. No single intervention would universally accelerate reductions in health loss associated with LRIs in all settings, but emphasising the most dominant risk factors, particularly in countries with high case fatality, can contribute to the reduction of preventable deaths. Funding Bill & Melinda Gates Foundation.
Published: 2020
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47. The burden of mental disorders across the states of India: the Global Burden of Disease Study 1990–2017

Author: Chris M Varghese, JS Thakur, Akhil Soman ThekkePurakkal, Atul Ambekar, Christopher M Odell, Rajesh Sagar, Rajesh Dhaliwal, Christopher J L Murray, Joy K Chakma, Parul Mutreja, Sanjay Prakash, Lalit Dandona, Scott D Glenn, Soumya Swaminathan, Ana Maria Mantilla Herrera, K. Srinath Reddy, Harvey Whiteford, Neerja Chowdhary, Fiona J Charlson, Alize J. Ferrari, Hendrik J Bekedam, Lakshmi Vijayakumar, G Anil Kumar, Holly E. Erskine, Varsha Krish, Pramod Kumar Pal, Theo Vos, Thara Rangaswamy, Tarun Dua, Mathew Varghese, Atreyi Ganguli, Rinu P Krishnankutty, Rakhi Dandona, Rohit Bhatia, Vivek Agarwal, Aditya Singh, Gopalkrishna Gururaj, D K Shukla, K S Shaji, R K Lenin Singh, Ravinder Singh, and Damian Santomauro
Subjects: Adult, Male, Adolescent, Persons with Mental Disabilities, India, Article, Global Burden of Disease, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Prevalence of mental disorders, Sex Factors, Cost of Illness, Intellectual disability, Suicide, Completed, Prevalence, Medicine, Humans, 030212 general & internal medicine, Bipolar disorder, Biological Psychiatry, Disease burden, Aged, Aged, 80 and over, Depressive Disorder, business.industry, Mental Disorders, Malaysia, Middle Aged, medicine.disease, Anxiety Disorders, 030227 psychiatry, Psychiatry and Mental health, Eating disorders, Socioeconomic Factors, Conduct disorder, Schizophrenia, Anxiety, Female, Quality-Adjusted Life Years, medicine.symptom, business, Demography
Abstract: Summary Background Mental disorders are among the leading causes of non-fatal disease burden in India, but a systematic understanding of their prevalence, disease burden, and risk factors is not readily available for each state of India. In this report, we describe the prevalence and disease burden of each mental disorder for the states of India, from 1990 to 2017. Methods We used all accessible data from multiple sources to estimate the prevalence of mental disorders, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) caused by these disorders for all the states of India from 1990 to 2017, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We assessed the heterogeneity and time trends of mental disorders across the states of India. We grouped states on the basis of their Socio-demographic Index (SDI), which is a composite measure of per-capita income, mean education, and fertility rate in women younger than 25 years. We also assessed the association of major mental disorders with suicide deaths. We calculated 95% uncertainty intervals (UIs) for the point estimates. Findings In 2017, 197·3 million (95% UI 178·4–216·4) people had mental disorders in India, including 45·7 million (42·4–49·8) with depressive disorders and 44·9 million (41·2–48·9) with anxiety disorders. We found a significant, but modest, correlation between the prevalence of depressive disorders and suicide death rate at the state level for females (r2=0·33, p=0·0009) and males (r2=0·19, p=0·015). The contribution of mental disorders to the total DALYs in India increased from 2·5% (2·0–3·1) in 1990 to 4·7% (3·7–5·6) in 2017. In 2017, depressive disorders contributed the most to the total mental disorders DALYs (33·8%, 29·5–38·5), followed by anxiety disorders (19·0%, 15·9–22·4), idiopathic developmental intellectual disability (IDID; 10·8%, 6·3–15·9), schizophrenia (9·8%, 7·7–12·4), bipolar disorder (6·9%, 4·9–9·6), conduct disorder (5·9%, 4·0–8·1), autism spectrum disorders (3·2%, 2·7–3·8), eating disorders (2·2%, 1·7–2·8), and attention-deficit hyperactivity disorder (ADHD; 0·3%, 0·2–0·5); other mental disorders comprised 8·0% (6·1–10·1) of DALYs. Almost all (>99·9%) of these DALYs were made up of YLDs. The DALY rate point estimates of mental disorders with onset predominantly in childhood and adolescence (IDID, conduct disorder, autism spectrum disorders, and ADHD) were higher in low SDI states than in middle SDI and high SDI states in 2017, whereas the trend was reversed for mental disorders that manifest predominantly during adulthood. Although the prevalence of mental disorders with onset in childhood and adolescence decreased in India from 1990 to 2017, with a stronger decrease in high SDI and middle SDI states than in low SDI states, the prevalence of mental disorders that manifest predominantly during adulthood increased during this period. Interpretation One in seven Indians were affected by mental disorders of varying severity in 2017. The proportional contribution of mental disorders to the total disease burden in India has almost doubled since 1990. Substantial variations exist between states in the burden from different mental disorders and in their trends over time. These state-specific trends of each mental disorder reported here could guide appropriate policies and health system response to more effectively address the burden of mental disorders in India. Funding Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
Published: 2020

48. Monitoring the health-related Sustainable Development Goals: lessons learned and recommendations for improved measurement

Author: Michael J. Ryan, Elena Varavikova, Somnath Chatterji, Samira Asma, Rafael Lozano, Soumya Swaminathan, Awoke Misganaw, Ren Minghui, Maria Fatima Marinho, Naoko Yamamoto, Christopher J L Murray, and Lalit Dandona
Subjects: Sustainable development, Geography, MEDLINE, Global health, Health Status Indicators, Humans, Organizational Objectives, Health related, General Medicine, Healthcare Disparities, Sustainable Development, Global Health, Environmental planning
Published: 2020
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49. The global burden of cancer attributable to risk factors, 2010–19 : A systematic analysis for the Global Burden of Disease Study 2019

Author: Khanh Bao Tran, Justin J Lang, Kelly Compton, Rixing Xu, Alistair R Acheson, Hannah Jacqueline Henrikson, Jonathan M Kocarnik, Louise Penberthy, Amirali Aali, Qamar Abbas, Behzad Abbasi, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Michael Abdelmasseh, Sherief Abd-Elsalam, Ahmed Abdelwahab Abdelwahab, Gholamreza Abdoli, Hanan Abdulkadir Abdulkadir, Aidin Abedi, Kedir Hussein Abegaz, Hassan Abidi, Richard Gyan Aboagye, Hassan Abolhassani, Abdorrahim Absalan, Yonas Derso Abtew, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Basavaprabhu Achappa, Juan Manuel Acuna, Daniel Addison, Isaac Yeboah Addo, Oyelola A Adegboye, Miracle Ayomikun Adesina, Mohammad Adnan, Qorinah Estiningtyas Sakilah Adnani, Shailesh M Advani, Sumia Afrin, Muhammad Sohail Afzal, Manik Aggarwal, Bright Opoku Ahinkorah, Araz Ramazan Ahmad, Rizwan Ahmad, Sajjad Ahmad, Sohail Ahmad, Sepideh Ahmadi, Haroon Ahmed, Luai A Ahmed, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Wajeeha Aiman, Marjan Ajami, Gizachew Taddesse Akalu, Mostafa Akbarzadeh-Khiavi, Addis Aklilu, Maxwell Akonde, Chisom Joyqueenet Akunna, Hanadi Al Hamad, Fares Alahdab, Fahad Mashhour Alanezi, Turki M Alanzi, Saleh Ali Alessy, Abdelazeem M Algammal, Mohammed Khaled Al-Hanawi, Robert Kaba Alhassan, Beriwan Abdulqadir Ali, Liaqat Ali, Syed Shujait Ali, Yousef Alimohamadi, Vahid Alipour, Syed Mohamed Aljunid, Motasem Alkhayyat, Sadeq Ali Ali Al-Maweri, Sami Almustanyir, Nivaldo Alonso, Shehabaldin Alqalyoobi, Rajaa M Al-Raddadi, Rami H Hani Al-Rifai, Salman Khalifah Al-Sabah, Ala'a B Al-Tammemi, Haya Altawalah, Nelson Alvis-Guzman, Firehiwot Amare, Edward Kwabena Ameyaw, Javad Javad Aminian Dehkordi, Mohammad Hosein Amirzade-Iranaq, Hubert Amu, Ganiyu Adeniyi Amusa, Robert Ancuceanu, Jason A Anderson, Yaregal Animut Animut, Amir Anoushiravani, Ali Arash Anoushirvani, Alireza Ansari-Moghaddam, Mustafa Geleto Ansha, Benny Antony, Maxwell Hubert Antwi, Sumadi Lukman Anwar, Razique Anwer, Anayochukwu Edward Anyasodor, Jalal Arabloo, Morteza Arab-Zozani, Olatunde Aremu, Ayele Mamo Argaw, Hany Ariffin, Timur Aripov, Muhammad Arshad, Al Artaman, Judie Arulappan, Raphael Taiwo Aruleba, Armin Aryannejad, Malke Asaad, Mulusew A Asemahagn, Zatollah Asemi, Mohammad Asghari-Jafarabadi, Tahira Ashraf, Reza Assadi, Mohammad Athar, Seyyed Shamsadin Athari, Maha Moh'd Wahbi Atout, Sameh Attia, Avinash Aujayeb, Marcel Ausloos, Leticia Avila-Burgos, Atalel Fentahun Awedew, Mamaru Ayenew Awoke, Tewachew Awoke, Beatriz Paulina Ayala Quintanilla, Tegegn Mulatu Ayana, Solomon Shitu Ayen, Davood Azadi, Sina Azadnajafabad, Saber Azami-Aghdash, Melkalem Mamuye Azanaw, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Hosein Azizi, Ahmed Y Y Azzam, Amirhesam Babajani, Muhammad Badar, Ashish D Badiye, Nayereh Baghcheghi, Nader Bagheri, Sara Bagherieh, Saeed Bahadory, Atif Amin Baig, Jennifer L Baker, Ahad Bakhtiari, Ravleen Kaur Bakshi, Maciej Banach, Indrajit Banerjee, Mainak Bardhan, Francesco Barone-Adesi, Fabio Barra, Amadou Barrow, Nasir Z Bashir, Azadeh Bashiri, Saurav Basu, Abdul-Monim Mohammad Batiha, Aeysha Begum, Alehegn Bekele Bekele, Alemayehu Sayih Belay, Melaku Ashagrie Belete, Uzma Iqbal Belgaumi, Arielle Wilder Bell, Luis Belo, Habib Benzian, Alemshet Yirga Berhie, Amiel Nazer C Bermudez, Eduardo Bernabe, Akshaya Srikanth Bhagavathula, Neeraj Bhala, Bharti Bhandari Bhandari, Nikha Bhardwaj, Pankaj Bhardwaj, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Soumitra S Bhuyan, Sadia Bibi, Awraris Hailu Bilchut, Bagas Suryo Bintoro, Antonio Biondi, Mesfin Geremaw Birega Birega, Habitu Eshetu Birhan, Tone Bjørge, Oleg Blyuss, Belay Boda Abule Bodicha, Srinivasa Rao Bolla, Archith Boloor, Cristina Bosetti, Dejana Braithwaite, Michael Brauer, Hermann Brenner, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Christina Maree Buchanan, Norma B Bulamu, Maria Teresa Bustamante-Teixeira, Muhammad Hammad Butt, Nadeem Shafique Butt, Zahid A Butt, Florentino Luciano Caetano dos Santos, Luis Alberto Cámera, Chao Cao, Yin Cao, Giulia Carreras, Márcia Carvalho, Francieli Cembranel, Ester Cerin, Promit Ananyo Chakraborty, Periklis Charalampous, Vijay Kumar Chattu, Odgerel Chimed-Ochir, Jesus Lorenzo Chirinos-Caceres, Daniel Youngwhan Cho, William C S Cho, Devasahayam J Christopher, Dinh-Toi Chu, Isaac Sunday Chukwu, Aaron J Cohen, Joao Conde, Sandra Cortés, Vera Marisa Costa, Natália Cruz-Martins, Garland T Culbreth, Omid Dadras, Fentaw Teshome Dagnaw, Saad M A Dahlawi, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Parnaz Daneshpajouhnejad, Anna Danielewicz, An Thi Minh Dao, Reza Darvishi Cheshmeh Soltani, Aso Mohammad Darwesh, Saswati Das, Dragos Virgil Davitoiu, Elham Davtalab Esmaeili, Fernando Pio De la Hoz, Sisay Abebe Debela, Azizallah Dehghan, Biniyam Demisse, Fitsum Wolde Demisse, Edgar Denova-Gutiérrez, Afshin Derakhshani, Meseret Derbew Molla, Diriba Dereje, Kalkidan Solomon Deribe, Rupak Desai, Markos Desalegn Desalegn, Fikadu Nugusu Dessalegn, Samuel Abebe A Dessalegni, Gashaw Dessie, Abebaw Alemayehu Desta, Syed Masudur Rahman Dewan, Samath Dhamminda Dharmaratne, Meghnath Dhimal, Mostafa Dianatinasab, Nancy Diao, Daniel Diaz, Lankamo Ena Digesa, Shilpi Gupta Dixit, Saeid Doaei, Linh Phuong Doan, Paul Narh Doku, Deepa Dongarwar, Wendel Mombaque dos Santos, Tim Robert Driscoll, Haneil Larson Dsouza, Oyewole Christopher Durojaiye, Sareh Edalati, Fatemeh Eghbalian, Elham Ehsani-Chimeh, Ebrahim Eini, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Donatus U Ekwueme, Maha El Tantawi, Mostafa Ahmed Elbahnasawy, Iffat Elbarazi, Hesham Elghazaly, Muhammed Elhadi, Waseem El-Huneidi, Mohammad Hassan Emamian, Luchuo Engelbert Bain, Daniel Berhanie Enyew, Ryenchindorj Erkhembayar, Tegegne Eshetu, Babak Eshrati, Sharareh Eskandarieh, Juan Espinosa-Montero, Farshid Etaee, Azin Etemadimanesh, Tahir Eyayu, Ifeanyi Jude Ezeonwumelu, Sayeh Ezzikouri, Adeniyi Francis Fagbamigbe, Saman Fahimi, Ildar Ravisovich Fakhradiyev, Emerito Jose A Faraon, Jawad Fares, Abbas Farmany, Umar Farooque, Hossein Farrokhpour, Abidemi Omolara Fasanmi, Ali Fatehizadeh, Wafa Fatima, Hamed Fattahi, Ginenus Fekadu, Berhanu Elfu Feleke, Allegra Allegra Ferrari, Simone Ferrero, Lorenzo Ferro Desideri, Irina Filip, Florian Fischer, Roham Foroumadi, Masoud Foroutan, Takeshi Fukumoto, Peter Andras Gaal, Mohamed M Gad, Muktar A Gadanya, Abduzhappar Gaipov, Nasrin Galehdar, Silvano Gallus, Tushar Garg, Mariana Gaspar Fonseca, Yosef Haile Gebremariam, Teferi Gebru Gebremeskel, Mathewos Alemu Gebremichael, Yohannes Fikadu Geda, Yibeltal Yismaw Gela, Belete Negese Belete Gemeda, Melaku Getachew, Motuma Erena Getachew, Kazem Ghaffari, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Mohammad Ghasemi Nour, Fariba Ghassemi, Ajnish Ghimire, Nermin Ghith, Maryam Gholamalizadeh, Jamshid Gholizadeh Navashenaq, Sherief Ghozy, Syed Amir Gilani, Paramjit Singh Gill, Themba G Ginindza, Abraham Tamirat T Gizaw, James C Glasbey, Justyna Godos, Amit Goel, Mahaveer Golechha, Pouya Goleij, Davide Golinelli, Mohamad Golitaleb, Giuseppe Gorini, Bárbara Niegia Garcia Goulart, Giuseppe Grosso, Habtamu Alganeh Guadie, Mohammed Ibrahim Mohialdeen Gubari, Temesgen Worku Gudayu, Maximiliano Ribeiro Guerra, Damitha Asanga Gunawardane, Bhawna Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Mekdes Kondale Gurara, Alemu Guta, Parham Habibzadeh, Atlas Haddadi Avval, Nima Hafezi-Nejad, Adel Hajj Ali, Arvin Haj-Mirzaian, Esam S Halboub, Aram Halimi, Rabih Halwani, Randah R Hamadeh, Sajid Hameed, Samer Hamidi, Asif Hanif, Sanam Hariri, Netanja I Harlianto, Josep Maria Haro, Risky Kusuma Hartono, Ahmed I Hasaballah, S M Mahmudul Hasan, Hamidreza Hasani, Seyedeh Melika Hashemi, Abbas M Hassan, Soheil Hassanipour, Khezar Hayat, Golnaz Heidari, Mohammad Heidari, Zahra Heidarymeybodi, Brenda Yuliana Herrera-Serna, Claudiu Herteliu, Kamal Hezam, Yuta Hiraike, Mbuzeleni Mbuzeleni Hlongwa, Ramesh Holla, Marianne Holm, Nobuyuki Horita, Mohammad Hoseini, Md Mahbub Hossain, Mohammad Bellal Hossain Hossain, Mohammad-Salar Hosseini, Ali Hosseinzadeh, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Mowafa Househ, Junjie Huang, Fernando N Hugo, Ayesha Humayun, Salman Hussain, Nawfal R Hussein, Bing-Fang Hwang, Segun Emmanuel Ibitoye, Pulwasha Maria Iftikhar, Kevin S Ikuta, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Mustapha Immurana, Kaire Innos, Pooya Iranpour, Lalu Muhammad Irham, Md Shariful Islam, Rakibul M Islam, Farhad Islami, Nahlah Elkudssiah Ismail, Gaetano Isola, Masao Iwagami, Linda Merin J, Abhishek Jaiswal, Mihajlo Jakovljevic, Mahsa Jalili, Shahram Jalilian, Elham Jamshidi, Sung-In Jang, Chinmay T Jani, Tahereh Javaheri, Umesh Umesh Jayarajah, Shubha Jayaram, Seyed Behzad Jazayeri, Rime Jebai, Bedru Jemal, Wonjeong Jeong, Ravi Prakash Jha, Har Ashish Jindal, Yetunde O John-Akinola, Jost B Jonas, Tamas Joo, Nitin Joseph, Farahnaz Joukar, Jacek Jerzy Jozwiak, Mikk Jürisson, Ali Kabir, Salah Eddine Oussama Kacimi, Vidya Kadashetti, Farima Kahe, Pradnya Vishal Kakodkar, Laleh R Kalankesh, Leila R Kalankesh, Rohollah Kalhor, Vineet Kumar Kamal, Farin Kamangar, Ashwin Kamath, Tanuj Kanchan, Eswar Kandaswamy, Himal Kandel, HyeJung Kang, Girum Gebremeskel Kanno, Neeti Kapoor, Sitanshu Sekhar Kar, Shama D Karanth, Ibraheem M Karaye, André Karch, Amirali Karimi, Bekalu Getnet Kassa, Patrick DMC Katoto, Joonas H Kauppila, Harkiran Kaur, Abinet Gebremickael Kebede, Leila Keikavoosi-Arani, Gemechu Gemechu Kejela, Phillip M Kemp Bohan, Maryam Keramati, Mohammad Keykhaei, Himanshu Khajuria, Abbas Khan, Abdul Aziz Khan Khan, Ejaz Ahmad Khan, Gulfaraz Khan, Md Nuruzzaman Khan, Moien AB Khan, Javad Khanali, Khaled Khatab, Moawiah Mohammad Khatatbeh, Mahalaqua Nazli Khatib, Maryam Khayamzadeh, Hamid Reza Khayat Kashani, Mohammad Amin Khazeei Tabari, Mehdi Khezeli, Mahmoud Khodadost, Min Seo Kim, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Miloslav Klugar, Jitka Klugarová, Ali-Asghar Kolahi, Pavel Kolkhir, Farzad Kompani, Parvaiz A Koul, Sindhura 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Melinda Gates Foundation, Kuwait University (Kuwait), Ministry of Higher Education (Malasia), Lega Italiana per la Lotta ai Tumori, Health Effects Institute (Estados Unidos), Unión Europea. Comisión Europea. European Research Council (ERC), Unión Europea. Comisión Europea. H2020, Fundação para a Ciência e Tecnologia (Portugal), African-German Network of Excellence in Science (AGNES), Federal Ministry of Education & Research (Alemania), Alexander von Humboldt Foundation, Novo Nordisk Foundation, National Institute for Health Research (Reino Unido), National Health and Medical Research Council (Australia), Romanian National Authority for Scientific Research and Innovation, Romanian Ministry of Research Innovation and Digitalization, Ministry of Education, Science and Technological Development (Serbia), Sigrid Jusélius Foundation, Finnish Cancer Foundation, Datta Meghe Institute of Medical Sciences (India), Xiamen University (Malasia), Manipal Academy of Higher Education (India), Panjab University (India), Sistema Nacional de Investigación (Panamá), Secretaría Nacional de Ciencia, Tecnología e Innovación (Panamá), Ministry of Science and Technology (Taiwan), Lung Foundation Australia, National Natural Science Foundation of China, Wellcome Trust, UNSW Sydney (Australia), ICMR - National Institute of Epidemiology (India), University of Tasmania (Australia), National Council for Scientific and Technological Development (Brasil), Coordenação de Aperfeicoamento de Pessoal de Nível Superior (Brasil), Institute for Advanced Studies in Basic Sciences (Irán), Ain Shams University (Egipto), International Center of Medical Sciences Research (Islamabad), National Institutes of Health (Estados Unidos), University of Oxford (Reino Unido), National Institute of Genetic Engineering and Biotechnology (Irán), Marga und Walter Boll - Stiftung, Ministero della Salute (Italia), IRCCS Materno Infantile Burlo Garofolo (Italia), King College London, Wellcome Trust/DBT India Alliance (India), Public Health, University of St Andrews. School of Medicine, and University of St Andrews. Population and Behavioural Science Division
Subjects: Male, DEATHS, DALY, cancer, risk factors, Medizin, systematic analysis, Global Health, Risk Assessment, Cancer prevention, Global Burden of Disease, RC0254, Risk-attributable cancer deaths, SDG 3 - Good Health and Well-being, RA0421, Risk Factors, RA0421 Public health. Hygiene. Preventive Medicine, Quality-Adjusted Life Year, Neoplasms, cancer, Humans, Global Burden of Disease Study, UK, Medicine(all), MCC, RC0254 Neoplasms. Tumors. Oncology (including Cancer), Risk Factor, Smoking, COVID-19, 3rd-DAS, General Medicine, Disability-adjusted life-years, SOCIAL DETERMINANTS, Risk assessments, risk factor, Cardiovascular and Metabolic Diseases, 3121 General medicine, internal medicine and other clinical medicine, OBESITY, Cancer burden, Neoplasm, Female, LIFE-STYLE, Quality-Adjusted Life Years, HEALTH, RA, Human, RC
Abstract: Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01-4·94) deaths and 105 million (95·0-116) DALYs for both sexes combined, representing 44·4% (41·3-48·4) of all cancer deaths and 42·0% (39·1-45·6) of all DALYs. There were 2·88 million (2·60-3·18) risk-attributable cancer deaths in males (50·6% [47·8-54·1] of all male cancer deaths) and 1·58 million (1·36-1·84) risk-attributable cancer deaths in females (36·3% [32·5-41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6-28·4) and DALYs by 16·8% (8·8-25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9-42·8] and 33·3% [25·8-42·0]). Interpretation: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. We are grateful to the surveillance systems, including cancer registries, that generated and shared observed cancer burden data. S M Aljunid acknowledges the Department of Health Policy and Management, College of Public Health, Kuwait University for the approval and support to participate in this research project. H Ariffin acknowledges support from the Ministry of Higher Education, Malaysia (grant FRGS/1/2021/SKK0/UM/01/1). F Barra acknowledges support from Lega Italiana per la Lotta contro i Tumori - LILT - Bando 5 x 1000 anno 2019. L Belo and M Carvalho acknowledge the support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. A J Cohen was supported by the Health Effects Institute, Boston, MA, USA. J Conde acknowledges financial support from the European Research Council - ERC Starting Grant 848325. V M Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. T C Ekundayo was supported by the African-German Network of Excellence in Science (AGNES), the Federal Ministry of Education and Research (BMBF) and the Alexander von Humboldt Foundation (AvH). N Ghith acknowledges support from a grant from Novo Nordisk Foundation (NNF16OC0021856). J C Glasbey is support by a Doctoral Research Fellowship from the National Institute of Health Research (NIHR300175). V K Gupta and V B Gupta acknowledge funding support from National Health and Medical Research Council (NHMRC), Australia. C Herteliu, A Pana, and M Ausloos acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. C Herteliu is also partially supported by a grant of the Romanian Ministry of Research Innovation and Digitalization, MCID, project number ID-585-CTR-42-PFE-2021. S Hussain was supported from Operational Programme Research, Development and Education–Project, Postdoc2MUNI (number CZ.02.2. 69/0.0/0.0/18_053/0016952). M Jakovljevic acknowledges partial support through the grant OI 175 014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. J H Kauppila acknowledges research grants from Sigrid Jusélius Foundation and the Finnish Cancer Foundation. M N Khatib acknowledges support from Datta Meghe Institute of Medical Sciences (deemed-to-be-university). Y J Kim was supported by the Research Management Centre, Xiamen University Malaysia [XMUMRF/2020-C6/ITCM/0004]. S L Koulmane Laxminarayana acknowledges institutional assistance by Manipal Academy of Higher Education, Manipal. K Krishan is supported by the UGC Centre of Advanced Study (Phase II), awarded to the Department of Anthropology, Panjab University, Chandigarh, India. I Landires is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). M-C Li was supported by the Ministry of Science and Technology, Taiwan (MOST 110-2314-B-003-001). G Liu acknowledges support from the CREATE Hope scientific fellowship from Lung Foundation Australia. J Liu acknowledges support from the National Natural Science Foundation (72122001). J A Loureiro was supported by Scientific Employment Stimulus (FCT; CEECINST/00049/2018). E Mathews is supported by a Clinical and Public Health Early Career Fellowship (grant number IA/CPHE/17/1/503345) from the DBT India Alliance/Wellcome Trust Department of Biotechnology, India Alliance (2018–2023). T J Meretoja was supported by an unrestricted grant from Cancer Foundation Finland sr. S Mohammed acknowledges a fellowship grant from Alexander von Humboldt Foundation, outside the submitted work. M Molokhia is supported by the National Institute for Health Research Biomedical Research Center at Guy’s and St Thomas’ National Health Service Foundation Trust and King’s College London. L Monasta received support from the Italian Ministry of Health at the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste - Italy (RC 34/2017). U Mons is supported by the Marga and Walter Boll Foundation, Kerpen, Germany. M A Moosavi acknowledges the financial support of National Institute of Genetics Engineering and Biotechnology (NIGEB). J Musa acknowledges support from the NIH/FICK43TW011416 for research-protected time for cervical cancer research and career development at University of Jos. V Nuñez-Samudio is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). O O Odukoya acknowledges support by the Fogarty International Center of the National Institutes of Health under the award number K43TW010704 for research-protected time. The content is solely the responsibility of all the authors and does not necessarily represent the official views of the National Institutes of Health. A S Oguntade acknowledges funding by a doctoral scholarship from the Nuffield Department of Population Health, University of Oxford (Oxford Population Health). J R Padubidri acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal for their constant support in research collaborations. R G Pestell acknowledges support from NIH grant W81XWH1810605 Breast Cancer Research, Breakthrough Grant R21 CA235139-01. Z Z Piracha acknowledges the International Center of Medical Sciences Research (ICMSR), Islamabad (44000), Pakistan. R A Radhakrishnan acknowledges support from Wellcome Trust/DBT India Alliance - IA/CPHI/18/1/503927. U Saeed acknowledges the International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan. A M Samy acknowledges the support from Ain Shams University and the Egyptian Fulbright Mission Program. F Sha was supported by the Shenzhen Science and Technology Program (grant number KQTD20190929172835662). H R Shahsavari acknowledges the Institute for Advanced Studies in Basic Sciences (IASBS) Research Council. A Shetty acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal for all the academic support. D A S Silva acknowledges financing in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Finance Code 001 and D A S Silva is supported in part by CNPq-Brazil (309589/2021-5). L M L R Silva was supported by project CENTRO-04-3559-FSE-000162, Fundo Social Europeu (FSE). Am Singh is supported by the International Graduate Research Scholarship, University of Tasmania. R Suliankatchi Abdulkader acknowledges support from ICMR—National Institute of Epidemiology. B Unnikrishnan acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. H Xiao acknowledges support from the Public Health Sciences Division of the Fred Hutchinson Cancer Research Center. X Xu is supported by the University of New South Wales (Australia) Scientia Program. C Yu was supported by the National Natural Science Foundation of China (grant number 82173626) and Wuhan Medical Research Program of Joint Fund of Hubei Health Committee (grant number WJ2019H304). Sí
Published: 2022
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50. Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Brittney S Sheena, Lindsey Hiebert, Hannah Han, Helen Ippolito, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Amir Abdoli, Hiwa Abubaker Ali, Mesafint Molla Adane, Oyelola A Adegboye, Qorinah Estiningtyas Sakilah Adnani, Shailesh M Advani, Muhammad Sohail Afzal, Saira Afzal, Mohamad Aghaie Meybodi, Bahman Ahadinezhad, Bright Opoku Ahinkorah, Sajjad Ahmad, Tauseef Ahmad, Sepideh Ahmadi, Haroon Ahmed, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Gizachew Taddesse Akalu, Addis Aklilu, Tayyaba Akram, Hanadi Al Hamad, Fares Alahdab, Adugnaw Zeleke Alem, Dejene Tsegaye Alem, Fadwa Alhalaiqa Naji Alhalaiqa, Robert Kaba Alhassan, Liaqat Ali, Muhammad Ashar Ali, Yousef Alimohamadi, Vahid Alipour, Motasem Alkhayyat, Sami Almustanyir, Rajaa M Al-Raddadi, Haya Altawalah, Saeed Amini, Hubert Amu, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Amir Anoushiravani, Adnan Ansar, Anayochukwu Edward Anyasodor, Jalal Arabloo, Morteza Arab-Zozani, Ayele Mamo Argaw, Zeleke Gebru Argaw, Muhammad Arshad, Anton A Artamonov, Tahira Ashraf, Daniel Atlaw, Floriane Ausloos, Marcel Ausloos, Sina Azadnajafabad, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Ghasem Azarian, Sayna Bagheri, Saeed Bahadory, Atif Amin Baig, Maciej Banach, Nastaran Barati, Amadou Barrow, Abdul-Monim Mohammad Batiha, Diana Fernanda Bejarano Ramirez, Uzma Iqbal Belgaumi, Alemshet Yirga Berhie, Devidas S Bhagat, Nikha Bhardwaj, Pankaj Bhardwaj, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Ali Bijani, Antonio Biondi, Belay Boda Abule Bodicha, Hunduma Amensisa Bojia, Archith Boloor, Cristina Bosetti, Dejana Braithwaite, Nikolay Ivanovich Briko, Zahid A Butt, Luis Alberto Cámera, Raja Chandra Chakinala, Promit Ananyo Chakraborty, Jaykaran Charan, Shu Chen, Jee-Young Jasmine Choi, Sonali Gajanan Choudhari, Fazle Rabbi Chowdhury, Dinh-Toi Chu, Sheng-Chia Chung, Paolo Angelo Cortesi, Benjamin C Cowie, Garland T Culbreth, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Fernando Pio De la Hoz, Sisay Abebe Debela, Mohammed Gebre Dedefo, Feleke Mekonnen Demeke, Takele Gezahegn G Demie, Getu Debalkie Demissie, Meseret Derbew Molla, Abebaw Alemayehu Desta, Deepak Dhamnetiya, Mandira Lamichhane Dhimal, Meghnath Dhimal, Mojtaba Didehdar, Linh Phuong Doan, Fariba Dorostkar, Thomas M Drake, Fatemeh Eghbalian, Michael Ekholuenetale, Iman El Sayed, Maysaa El Sayed Zaki, Muhammed Elhadi, Mohamed A Elmonem, Aisha Elsharkawy, Shymaa Enany, Daniel Berhanie Enyew, Ryenchindorj Erkhembayar, Sharareh Eskandarieh, Firooz Esmaeilzadeh, Sayeh Ezzikouri, Hossein Farrokhpour, Getahun Fetensa, Florian Fischer, Masoud Foroutan, Mohamed M Gad, Abhay Motiramji Gaidhane, Shilpa Gaidhane, Natalie C Galles, Silvano Gallus, Teferi Gebru Gebremeskel, Eyob Alemayehu Gebreyohannes, Keyghobad Ghadiri, Kazem Ghaffari, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Ahmad Ghashghaee, Ali Gholami, Abdolmajid Gholizadeh, Aima Gilani, Amit Goel, Mahaveer Golechha, Pouya Goleij, Davide 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Y., Ismail, N. E., Jacobsen, K. H., Jadidi-Niaragh, F., Javadi Mamaghani, A., Jayaram, S., Jayawardena, R., Jebai, R., Jha, R. P., Joseph, N., Joukar, F., Kaambwa, B., Kabir, A., Kabir, Z., Kalhor, R., Kandel, H., Kanko, T. K. T., Kantar, R. S., Karaye, I. M., Kassa, B. G., Kemp Bohan, P. M., Keykhaei, M., Khader, Y. S., Khajuria, H., Khan, G., Khan, I. A., Khan, J., Khan, M. A., Khanali, J., Khater, A. M., Khatib, M. N., Khodadost, M., Khoja, A. T., Khosravizadeh, O., Khubchandani, J., Kim, G. R., Kim, H., Kim, M. S., Kim, Y. J., Kocarnik, J. M., Kolahi, A. -A., Koteeswaran, R., Kumar, G. A., La Vecchia, C., Lal, D. K., Landires, I., Lasrado, S., Lazarus, J. V., Ledda, C., Lee, D. W., Lee, S. -W., Lee, Y. Y., Levi, M., Li, J., Lim, S. S., Lobo, S. W., Lopukhov, P. D., Loureiro, J. A., Maclachlan, J. H., Magdy Abd El Razek, H., Magdy Abd El Razek, M., Majeed, A., Makki, A., Malekpour, M. -R., Malekzadeh, R., Malik, A. A., Mansour-Ghanaei, F., Mansournia, M. A., Martins-Melo, F. R., Matthews, P. C., Mendoza, W., Menezes, R. G., Meretoja, T. J., Mersha, A. G., Mestrovic, T., Miller, T. R., Minh, L. H. N., Mirica, A., Mirmoeeni, S., Mirrakhimov, E. M., Misra, S., Mithra, P., Moazen, B., Mohamadkhani, A., Mohammadi, M., Mohammed, S., Moka, N., Mokdad, A. H., Moludi, J., Momtazmanesh, S., Monasta, L., Moradi, G., Moradzadeh, M., Moradzadeh, R., Moraga, P., Mostafavi, E., Mubarik, S., Muniyandi, M., Murray, C. J. L., Naghavi, M., Naimzada, M. D., Narasimha Swamy, S., Natto, Z. S., Nayak, B. P., Nazari, J., Negoi, I., Negru, S. M., Nejadghaderi, S. A., Neupane Kandel, S., Nguyen, H. L. T., Ngwa, C. H., Niazi, R. K., Nnaji, C. A., Noubiap, J. J., Nowroozi, A., Nunez-Samudio, V., Oancea, B., Ochir, C., Odukoya, O. O., Oh, I. -H., Olagunju, A. T., Olakunde, B. O., Omar Bali, A., Omer, E., Otstavnov, S. S., Oumer, B., Padubidri, J. R., Pana, A., Pandey, A., Park, E. -C., Pashazadeh Kan, F., Patel, U. K., Paudel, U., Petcu, I. -R., Piracha, Z. Z., Pollok, R. C. G., Postma, M. J., Pourshams, A., Poustchi, H., Rabiee, M., Rabiee, N., Rafiei, A., Rafiei, S., Raghuram, P. M., Rahman, M., Rahmani, A. M., Rahmawaty, S., Rajesh, A., Ranasinghe, P., Rao, C. R., Rao, S. J., Rashidi, M., Rashidi, M. -M., Rawaf, D. L., Rawaf, S., Rawassizadeh, R., Rezaei, N., Rezapour, A., Rezazadeh-Khadem, S., Rodriguez, J. A. B., Rwegerera, G. M., Sabour, S., Saddik, B., Saeb, M. R., Saeed, U., Sahebkar, A., Saif-Ur-Rahman, K. M., Salahi, S., Salimzadeh, H., Sampath, C., Samy, A. M., Sanabria, J., Sanmarchi, F., Santric-Milicevic, M. M., Sarveazad, A., Sathian, B., Sawhney, M., Seidu, A. -A., Sepanlou, S. G., Seylani, A., Shahabi, S., Shaikh, M. A., Shaker, E., Shakhmardanov, M. Z., Shannawaz, M., Shenoy, S. M., Shetty, J. K., Shetty, P. H., Shibuya, K., Shin, J. I., Shobeiri, P., Sibhat, M. M., Singh, A. D., Singh, J. A., Singh, S., Skryabin, V. Y., Skryabina, A. A., Sohrabpour, A. A., Song, S., Tabaeian, S. P., Tadesse, E. G., Taheri, M., Tampa, M., Tan, K. -K., Tavakoli, A., Tbakhi, A., Tefera, B. N., Tehrani-Banihashemi, A., Tesfaw, H. M., Thapar, R., Thavamani, A., Tohidast, S. A., Tollosa, D. N., Tosti, M. E., Tovani-Palone, M. R., Traini, E., Tran, M. T. N., Trihandini, I., Tusa, B. S., Ullah, I., Vacante, M., Valadan Tahbaz, S., Valdez, P. R., Varthya, S. B., Vo, B., Waheed, Y., Weldesenbet, A. B., Woldemariam, M., Xu, S., Yahyazadeh Jabbari, S. H., Yaseri, M., Yeshaw, Y., Yigit, V., Yirdaw, B. W., Yonemoto, N., Yu, C., Yunusa, I., Zahir, M., Zaki, L., Zamani, M., Zamanian, M., Zastrozhin, M. S., Vos, T., Ward, J. W., and Dirac, M. A.
Subjects: Liver Cirrhosis, Hepatology, Seroepidemiologic Studies, 3121 General medicine, internal medicine and other clinical medicine, Liver Neoplasms, Gastroenterology, Humans, Bayes Theorem, HBV, Global burden of diseases, HCC, Cirrhosis, Child, Hepatitis B, Global Burden of Disease
Abstract: Publisher Copyright: © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods: The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings: In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 000 global deaths (487 000 to 630 000) in 2019. The number of HBV-related deaths increased between 1990 and 2019 (by 5·9% [–5·6 to 19·2]) and between 2015 and 2019 (by 2·9% [–5·9 to 11·3]). By contrast, all-age and age-standardised death rates due to HBV-related diseases decreased during these periods. We compared estimates for 2019 in 194 WHO locations to WHO-GHSS 2020 targets, and found that four countries achieved a 10% reduction in deaths, 15 countries achieved a 30% reduction in new cases, and 147 countries achieved a 1% prevalence in children younger than 5 years. As of 2019, 68 of 194 countries had already achieved the 2030 target proposed in WHO Interim Guidance of an all-age HBV-related death rate of four per 100 000. Interpretation: The prevalence of chronic HBV infection declined over time, particularly in children younger than 5 years, since the introduction of hepatitis B vaccination. HBV-related death rates also decreased, but HBV-related death counts increased as a result of population growth, ageing, and cohort effects. By 2019, many countries had met the interim seroprevalence target for children younger than 5 years, but few countries had met the WHO-GHSS interim targets for deaths and new cases. Progress according to all indicators must be accelerated to meet 2030 targets, and there are marked disparities in burden and progress across the world. HBV interventions, such as vaccination, testing, and treatment, must be strategically supported and scaled up to achieve elimination. Funding: Bill & Melinda Gates Foundation.
Published: 2022

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