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1. Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under Option B+: an exploratory study

Author

Nachega JB, Skinner D, Jennings L, Magidson JF, Altice FL, Burke JG, Lester RT, Uthman OA, Knowlton AR, Cotton MF, Anderson JR, and Theron GB

Subjects
ART, mHealth, adherence, PMTCT, South Africa, pregnant women, Medicine (General), R5-920
Abstract

Jean B Nachega,1,2 Donald Skinner,3 Larissa Jennings,4 Jessica F Magidson,5 Frederick L Altice,6 Jessica G Burke,7 Richard T Lester,8 Olalekan A Uthman,9,10 Amy R Knowlton,11 Mark F Cotton,12 Jean R Anderson,13 Gerhard B Theron14 1Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; 2Department of Medicine, Centre for Infectious Diseases, and ACTG Clinical Trial Unit (CTU)/Family Clinical Research Unit (FAMCRU), 3Research on Health and Society, Department of Interdisciplinary Health Studies, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 4Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 5Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 6Division of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, 7Department of Behavioral and Community Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; 8Department of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, BC, Canada; 9Warwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK; 10Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 11Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 12Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 13Department of Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; 14Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Objective: To examine the acceptability and feasibility of mobile health (mHealth)/short message service (SMS) and community-based directly observed antiretroviral therapy (cDOT) as interventions to improve antiretroviral therapy (ART) adherence for preventing mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT). Design and methods: A mixed-method approach was used. Two qualitative focus group discussions with HIV-infected pregnant women (n=20) examined the acceptability and feasibility of two ART adherence interventions for PMTCT: 1) SMS text messaging and 2) patient-nominated cDOT supporters. Additionally, 109 HIV-infected, pregnant South African women (18–30 years old) receiving PMTCT services under single-tablet antiretroviral therapy regimen during pregnancy and breastfeeding and continuing for life (“Option B+”) were interviewed about mobile phone access, SMS use, and potential treatment supporters. Setting: A community primary care clinic in Cape Town, South Africa. Participants: HIV-infected pregnant women. Main outcomes: Acceptability and feasibility of mHealth and cDOT interventions. Results: Among the 109 women interviewed, individual mobile phone access and SMS use were high (>90%), and 88.1% of women were interested in receiving SMS ART adherence support messages such as reminders, motivation, and medication updates. Nearly all women (95%) identified at least one person close to them to whom they had disclosed their HIV status and would nominate as a cDOT supporter. Focus group discussions revealed that cDOT supporters and adherence text messages were valued, but some concerns regarding supporter time availability and risk of unintended HIV status disclosure were expressed. Conclusion: mHealth and/or cDOT supporter as interventions to improve ART adherence are feasible in this setting. However, safe HIV status disclosure to treatment supporters and confidentiality of text messaging content about HIV and ART were deemed crucial. Keywords: HIV, AIDS, pregnancy, short messaging system, social support

Published
2016

2. Risk factors for suboptimal antiretroviral therapy adherence in HIV-infected adolescents in Gaborone, Botswana: a pilot cross-sectional study

Author

Ndiaye M, Nyasulu P, Nguyen H, Lowenthal ED, Gross R, Mills EJ, and Nachega JB

Subjects
Medicine (General), R5-920
Abstract

Maimouna Ndiaye,1,2 Peter Nyasulu,1 Hoang Nguyen,6,7 Elizabeth D Lowenthal,8,9 Robert Gross,10 Edward J Mills,3 Jean B Nachega4–6 1School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Central Medical Stores, Ministry of Health, Gaborone, Botswana; 3Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; 4Department of Medicine and Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 5Department of Epidemiology, Infectious Disease Epidemiology Research Program, Pittsburgh University Graduate School of Public Health, Pittsburgh, PA, USA; 6Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 7Tay Ho Clinics, Department of Medicine, Hanoi Health Services, Hanoi, Vietnam; 8Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; 9Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 10Departments of Medicine and Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Objective: Little is known about factors associated with suboptimal antiretroviral treatment (ART) adherence among adolescents in Sub-Saharan Africa. Our objective was to determine the level of ART adherence and predictors of non-adherence among human immunodeficiency virus (HIV)-infected adolescents at the Botswana-Baylor Children's Clinical Centre of Excellence in Gaborone, Botswana. Methods: In a cross-sectional study, 82 HIV-infected adolescents receiving ART and their caregivers were administered a structured questionnaire. The patient's clinical information was retrieved from medical records. Outcome measures included excellent pill count ART adherence (>95%) and virologic suppression (HIV viral load

Published
2013

3. Impact of immune reconstitution inflammatory syndrome on antiretroviral therapy adherence

Author

Nachega JB, Morroni C, Chaisson RE, Goliath R, Efron A, Ram M, and Maartens G

Subjects
Medicine (General), R5-920
Abstract

Jean B Nachega,1,2,4 Chelsea Morroni,1 Richard E Chaisson,2–4 Rene Goliath,1 Anne Efron,4 Malathi Ram,2 Gary Maartens11University of Cape Town, Department of Medicine, Division of Clinical Pharmacology, Cape Town, South Africa; 2Johns Hopkins University, Bloomberg School of Public Health, Departments of International Health and Epidemiology, 3Johns Hopkins University, School of Medicine, Department of Medicine, Division of Infectious Diseases, 4Johns Hopkins University, Center for Tuberculosis Research, Baltimore, Maryland, USAObjective: We determined the impact of immune reconstitution inflammatory syndrome (IRIS) on antiretroviral therapy (ART) adherence in a cohort of 274 human immunodeficiency virus (HIV)-infected South African adults initiating ART.Methods: We carried out a secondary analysis of data from a randomized controlled trial of partially supervised ART in Cape Town, South Africa. Monthly pill count adherence, viral suppression (HIV viral load < 50 c/mL), and IRIS events were documented. Poisson regression was used to identify variables associated with ART adherence below the median in the first 6 months of ART.Results: We enrolled 274 patients: 58% women, median age 34 years, median CD4 count 98 cells/µL, 46% World Health Organization clinical stage IV, and 40% on treatment for tuberculosis (TB). IRIS and TB-IRIS developed in 8.4% and 6.6% of patients, respectively. The median cumulative adherence at 6 months for those with an IRIS event vs no IRIS was 95.5% vs 98.2% (P = 0.04). Although not statistically significant, patients developing IRIS had a lower 6-month viral load suppression than those without IRIS (68% vs 80%, P = 0.32). ART adherence below the median of 98% was independently associated with alcohol abuse (relative risk [RR] 1.5; 95% confidence interval [CI] 1.2–1.9; P = 0.003) and IRIS events (RR 1.7; 95% CI 1.2–2.2; P = 0.001).Conclusion: Although IRIS events were associated with slightly lower adherence rates, overall adherence to ART remained high in this study population. Concerns about IRIS should not deter clinicians from early ART initiation.Keywords: ART, adherence, TB, HIV/AIDS, IRIS

Published
2012

4. Cross-cultural adaptation and validation of the self-reporting questionnaire among HIV+ individuals in a rural ART program in southern Uganda

Author

Mojtabai R, Alexandre PK, Katabira E, Musisi S, Nachega JB, Bass JK, and Nakimuli-Mpungu E

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

Etheldreda Nakimuli-Mpungu1,3, Ramin Mojtabai1, Pierre K Alexandre1, Elly Katabira4, Seggane Musisi3, Jean B Nachega2,5, Judith K Bass11Department of Mental Health, 2Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 3Department of Psychiatry, 4Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda; 5Department of Medicine and Centre for Infectious Diseases, Stellenbosch University, Faculty of Health Sciences, Cape Town, South AfricaBackground: HIV treatment programs are in need of brief, valid instruments to identify common mental disorders such as depression.Aim: To translate and culturally adapt the Self-Reporting Questionnaire (SRQ-20) for use in Uganda and to investigate its psychometric properties in this setting.Methods: Following an initial translation of the SRQ-20 from English to Luganda, key informant interviews and focus-group discussions were used to produce a culturally adapted version of the instrument. The adapted SRQ-20 was administered to 200 HIV-positive individuals in a rural antiretroviral therapy program in southern Uganda. All study participants were also evaluated by a psychiatric clinical officer with the Mini International Neuropsychiatric Interview (MINI). Receiver-operating-characteristic analysis was used to examine the sensitivity and specificity of the SRQ-20 compared to the clinical diagnosis generated by the MINI.Results: The prevalence estimates of any depressive disorder and current depression were 24% (n = 48) and 12% (n = 24), respectively. The SRQ-20 scores discriminated well between subjects with and without current depression based on the MINI, with an area under the curve of 0.92, as well as between subjects with and without any current or past depressive disorder, with an area under the curve of 0.75. A score of 6 or more had 84% sensitivity and 93% specificity for current depression, and 75% sensitivity and 90% specificity for any depressive disorder.Conclusion: The SRQ-20 appears to be a reliable and valid screening measure for depression among rural HIV-positive individuals in southern Uganda. The use of this screening instrument can potentially improve detection and management of depression in this setting.Keywords: depression, HIV/AIDS, Self-Reporting Questionnaire, cross-cultural adaptation and validation, Uganda

Published
2012

5. Boceprevir and telaprevir for the treatment of chronic hepatitis C genotype 1 infection: an indirect comparison meta-analysis

Author

Cooper CL, Druyts E, Thorlund K, Nachega JB, El Khoury AC, O'Regan C, and Mills EJ

Subjects
Therapeutics. Pharmacology, RM1-950
Abstract

Curtis L Cooper1, Eric Druyts2, Kristian Thorlund3, Jean B Nachega4, Antoine C El Khoury5, Christopher O'Regan6, Edward J Mills2,31Division of Infectious Diseases, Faculty of Medicine, 2Faculty of Health Sciences, University of Ottawa, Ottawa, 3Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; 4Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 5Merck and Co, Inc, Whitehouse Station, NJ, 6Merck Sharp and Dohme Ltd, Hoddesdon, Hertfordshire, United KingdomBackground: The aim of this study was to examine the relative efficacy and safety of boceprevir and telaprevir, when used in combination with pegylated interferon alpha and ribavirin, using an indirect comparison meta-analysis.Methods: Published phase II and phase III randomized placebo-controlled trials examining the efficacy of boceprevir and telaprevir in chronic hepatitis C virus genotype 1 infected adult populations were included. The primary outcomes were sustained virologic response, relapse, and discontinuation of all study drugs. Secondary outcomes included the adverse events of anemia, neutropenia, rash, and pruritus. Results: Four boceprevir trials and six telaprevir trials were included. No significant differences were observed for sustained virologic response among either naïve (relative risk [RR] 1.14, 95% confidence interval [CI] 0.93–1.37, P = 0.20) or experienced patients (RR 0.81, 95% CI 0.52–1.23, P = 0.30). Similarly, for relapse among naïve (RR 0.80, 95% CI 0.18–3.45, P = 0.77) and experienced patients (RR 1.71, 95% CI 0.90–3.24, P = 0.10), or discontinuation of therapy for naïve (RR 0.80, 95% CI 0.28–2.29, P = 0.72) and experienced patients (RR 0.88, 95% CI 0.69–1.12, P = 0.30). Telaprevir was more likely to be associated with rash and pruritus, and boceprevir was more likely to be associated with neutropenia in certain patient populations.Conclusion: Boceprevir and telaprevir appear comparable in terms of sustained virologic response, relapse, or discontinuation of therapy for patients treated with standard-dose therapy durations and response-guided therapy durations.Keywords: direct-acting antivirals, boceprevir, telaprevir, hepatitis C, meta-analysis

Published
2012

6. Twice-daily versus once-daily antiretroviral therapy and coformulation strategies in HIV-infected adults: benefits, risks, or burden?

Author

Nachega JB, Rosenkranz B, and Pham PA

Subjects
Medicine (General), R5-920
Abstract

Jean B Nachega1–3, Bernd Rosenkranz4, Paul A Pham51Department of International Health, 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 3Department of Medicine and Centre for Infectious Diseases, 4Division of Pharmacology, Department of Medicine, Faculty of Health Sciences, University of Stellenbosch, Capetown, South Africa; 5Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: The recent development of once-daily antiretroviral agents and fixed-dose combination formulations has been an important development in antiretroviral regimen simplification. Recent studies indicate that once-daily antiretroviral regimens improve adherence, especially in antiretroviral-naïve patients and in difficult-to-treat populations, such as the homeless or marginally housed. However, there are potential risks with the higher peak and lower trough plasma drug concentrations that may result from certain once-daily formulations. Due to the multifactorial and complex nature of adherence behavior, clinicians’ efforts to improve patient adherence should not be limited to prescribing once-daily regimens, but should also consider social support, side effect management, and adherence support tools, such as pillbox organizers and other targeted interventions. Additional research will clarify the benefits of once-daily and fixed-dose combination regimens on clinical and virologic outcomes. Comprehensive cost-benefit analysis of regimen simplification could help facilitate evidence-based decisions regarding antiretroviral regimen choices.Keywords: regimen adherence, regimen simplification, health care costs, fixed-dose combination, once-daily antiretroviral drugs

Published
2011

7. Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs

Author

Vitória M, Zeier M, Mugavero MJ, Nachega JB, and Gallant JE

Subjects
Medicine (General), R5-920
Abstract

Jean B Nachega1–3, Michael J Mugavero4, Michele Zeier2, Marco Vitória5, Joel E Gallant3,61Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 2Department of Medicine and Centre for Infectious Diseases (CID), Stellenbosch University, Faculty of Health Sciences, Cape Town, South Africa; 3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 4Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; 5HIV Department, World Health Organization, Geneva, Switzerland; 6Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: Since the advent of highly active antiretroviral therapy (HAART), the treatment of human immunodeficiency virus (HIV) infection has become more potent and better tolerated. While the current treatment regimens still have limitations, they are more effective, more convenient, and less toxic than regimens used in the early HAART era, and new agents, formulations and strategies continue to be developed. Simplification of therapy is an option for many patients currently being treated with antiretroviral therapy (ART). The main goals are to reduce pill burden, improve quality of life and enhance medication adherence, while minimizing short- and long-term toxicities, reducing the risk of virologic failure and maximizing cost-effectiveness. ART simplification strategies that are currently used or are under study include the use of once-daily regimens, less toxic drugs, fixed-dose coformulations and induction-maintenance approaches. Improved adherence and persistence have been observed with the adoption of some of these strategies. The role of regimen simplification has implications not only for individual patients, but also for health care policy. With increased interest in ART regimen simplification, it is critical to study not only implications for individual tolerability, toxicity, adherence, persistence and virologic efficacy, but also cost, scalability, and potential for dissemination and implementation, such that limited human and financial resources are optimally allocated for maximal efficiency, coverage and sustainability of global HIV/AIDS treatment.Keywords: ART, simplification, adherence, persistence, once-daily, coformulations, healthcare cost, quality of lifeVideo Abstract: http://dvpr.es/nachega

Published
2011

8. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Bikbov, B, Purcell, CA, Levey, AS, Smith, M, Abdoli, A, Abebe, M, Adebayo, OM, Afarideh, M, Agarwal, SK, Agudelo-Botero, M, Ahmadian, E, Al-Aly, Z, Alipour, V, Almasi-Hashiani, A, Al-Raddadi, RM, Alvis-Guzman, N, Amini, S, Andrei, T, Andrei, CL, Andualem, Z, Anjomshoa, M, Arabloo, J, Ashagre, AF, Asmelash, D, Ataro, Z, Atout, MMW, Ayanore, MA, Badawi, A, Bakhtiari, A, Ballew, SH, Balouchi, A, Banach, M, Barquera, S, Basu, S, Bayih, MT, Bedi, N, Bello, AK, Bensenor, IM, Bijani, A, Boloor, A, Borzì, AM, Cámera, LA, Carrero, JJ, Carvalho, F, Castro, F, Catalá-López, F, Chang, AR, Chin, KL, Chung, SC, Cirillo, M, Cousin, E, Dandona, L, Dandona, R, Daryani, A, Das Gupta, R, Demeke, FM, Demoz, GT, Desta, DM, Do, HP, Duncan, BB, Eftekhari, A, Esteghamati, A, Fatima, SS, Fernandes, JC, Fernandes, E, Fischer, F, Freitas, M, Gad, MM, Gebremeskel, GG, Gebresillassie, BM, Geta, B, Ghafourifard, M, Ghajar, A, Ghith, N, Gill, PS, Ginawi, IA, Gupta, R, Hafezi-Nejad, N, Haj-Mirzaian, A, Hariyani, N, Hasan, M, Hasankhani, M, Hasanzadeh, A, Hassen, HY, Hay, SI, Heidari, B, Herteliu, C, Hoang, CL, Hosseini, M, Hostiuc, M, Irvani, SSN, Islam, SMS, Jafari Balalami, N, James, SL, Jassal, SK, Jha, V, Jonas, JB, Joukar, F, Jozwiak, JJ, Kabir, A, Kahsay, A, Kasaeian, A, Kassa, TD, Kassaye, HG, Khader, YS, Khalilov, R, Khan, EA, Khan, MS, Khang, YH, Kisa, A, Kovesdy, CP, Kuate Defo, B, Kumar, GA, Larsson, AO, Lim, LL, Lopez, AD, Lotufo, PA, Majeed, A, Malekzadeh, R, März, W, Masaka, A, Meheretu, HAA, Miazgowski, T, Mirica, A, Mirrakhimov, EM, Mithra, P, Moazen, B, Mohammad, DK, Mohammadpourhodki, R, Mohammed, S, Mokdad, AH, Morales, L, Moreno Velasquez, I, Mousavi, SM, Mukhopadhyay, S, Nachega, JB, Nadkarni, GN, Nansseu, JR, Natarajan, G, Nazari, J, Neal, B, Negoi, RI, Nguyen, CT, Nikbakhsh, R, Noubiap, JJ, Nowak, C, Olagunju, AT, Ortiz, A, Owolabi, MO, Palladino, R, Pathak, M, Poustchi, H, Prakash, S, Prasad, N, Rafiei, A, Raju, SB, Ramezanzadeh, K, Rawaf, S, Rawaf, DL, Rawal, L, Reiner RC, Rezapour, A, Ribeiro, DC, Roever, L, Rothenbacher, D, Rwegerera, GM, Saadatagah, S, Safari, S, Sahle, BW, Salem, H, Sanabria, J, Santos, IS, Sarveazad, A, Sawhney, M, Schaeffner, E, Schmidt, MI, Schutte, AE, Sepanlou, SG, Shaikh, MA, Sharafi, Z, Sharif, M, Sharifi, A, Silva, DAS, Singh, JA, Singh, NP, Sisay, MMM, Soheili, A, Sutradhar, I, Teklehaimanot, BF, Tesfay, BE, Teshome, GF, Thakur, JS, Tonelli, M, Tran, KB, Tran, BX, Tran Ngoc, C, Ullah, I, Valdez, PR, Varughese, S, Vos, T, Vu, LG, Waheed, Y, Werdecker, A, Wolde, HF, Wondmieneh, AB, Wulf Hanson, S, Yamada, T, Yeshaw, Y, Yonemoto, N, Yusefzadeh, H, Zaidi, Z, Zaki, L, Zaman, SB, Zamora, N, Zarghi, A, Zewdie, KA, Ärnlöv, J, Coresh, J, Perico, N, Remuzzi, G, Murray, CJL, Vos, T., Veritati - Repositório Institucional da Universidade Católica Portuguesa, Bikbov, B, Purcell, Ca, Levey, A, Smith, M, Abdoli, A, Abebe, M, Adebayo, Om, Afarideh, M, Agarwal, Sk, Agudelo-Botero, M, Ahmadian, E, Al-Aly, Z, Alipour, V, Almasi-Hashiani, A, Al-Raddadi, Rm, Alvis-Guzman, N, Amini, S, Andrei, T, Andrei, Cl, Andualem, Z, Anjomshoa, M, Arabloo, J, Ashagre, Af, Asmelash, D, Ataro, Z, Atout, Mmw, Ayanore, Ma, Badawi, A, Bakhtiari, A, Ballew, Sh, Balouchi, A, Banach, M, Barquera, S, Basu, S, Bayih, Mt, Bedi, N, Bello, Ak, Bensenor, Im, Bijani, A, Boloor, A, Borzì, Am, Cámera, La, Carrero, Jj, Carvalho, F, Castro, F, Catalá-López, F, Chang, Ar, Chin, Kl, Chung, Sc, Cirillo, M, Cousin, E, Dandona, L, Dandona, R, Daryani, A, Das, Gupta, R, Demeke, Fm, Demoz, Gt, Desta, Dm, Do, Hp, Duncan, Bb, Eftekhari, A, Esteghamati, A, Fatima, S, Fernandes, Jc, Fernandes, E, Fischer, F, Freitas, M, Gad, Mm, Gebremeskel, Gg, Gebresillassie, Bm, Geta, B, Ghafourifard, M, Ghajar, A, Ghith, N, Gill, P, Ginawi, Ia, Gupta, R, Hafezi-Nejad, N, Haj-Mirzaian, A, Hariyani, N, Hasan, M, Hasankhani, M, Hasanzadeh, A, Hassen, Hy, Hay, Si, Heidari, B, Herteliu, C, Hoang, Cl, Hosseini, M, Hostiuc, M, Irvani, Ssn, Islam, Sm, Jafari, Balalami, N, James, Sl, Jassal, Sk, Jha, V, Jonas, Jb, Joukar, F, Jozwiak, Jj, Kabir, A, Kahsay, A, Kasaeian, A, Kassa, Td, Kassaye, Hg, Khader, Y, Khalilov, R, Khan, Ea, Khan, M, Khang, Yh, Kisa, A, Kovesdy, Cp, Kuate, Defo, B, Kumar, Ga, Larsson, Ao, Lim, Ll, Lopez, Ad, Lotufo, Pa, Majeed, A, Malekzadeh, R, März, W, Masaka, A, Meheretu, Haa, Miazgowski, T, Mirica, A, Mirrakhimov, Em, Mithra, P, Moazen, B, Mohammad, Dk, Mohammadpourhodki, R, Mohammed, S, Mokdad, Ah, Morales, L, Moreno, Velasquez, I, Mousavi, Sm, Mukhopadhyay, S, Nachega, Jb, Nadkarni, Gn, Nansseu, Jr, Natarajan, G, Nazari, J, Neal, B, Negoi, Ri, Nguyen, Ct, Nikbakhsh, R, Noubiap, Jj, Nowak, C, Olagunju, At, Ortiz, A, Owolabi, Mo, Palladino, R, Pathak, M, Poustchi, H, Prakash, S, Prasad, N, Rafiei, A, Raju, Sb, Ramezanzadeh, K, Rawaf, S, Rawaf, Dl, Rawal, L, Reiner, Rc, Jr, Rezapour, A, Ribeiro, Dc, Roever, L, Rothenbacher, D, Rwegerera, Gm, Saadatagah, S, Safari, S, Sahle, Bw, Salem, H, Sanabria, J, Santos, I, Sarveazad, A, Sawhney, M, Schaeffner, E, Schmidt, Mi, Schutte, Ae, Sepanlou, Sg, Shaikh, Ma, Sharafi, Z, Sharif, M, Sharifi, A, Silva, Da, Singh, Ja, Singh, Np, Sisay, Mmm, Soheili, A, Sutradhar, I, Teklehaimanot, Bf, Tesfay, Be, Teshome, Gf, Thakur, J, Tonelli, M, Tran, Kb, Tran, Bx, Tran, Ngoc, Ullah, I, Valdez, Pr, Varughese, S, Vos, T, Vu, Lg, Waheed, Y, Werdecker, A, Wolde, Hf, Wondmieneh, Ab, Wulf, Hanson, S, Yamada, T, Yeshaw, Y, Yonemoto, N, Yusefzadeh, H, Zaidi, Z, Zaki, L, Zaman, Sb, Zamora, N, Zarghi, A, Zewdie, Ka, Ärnlöv, J, Coresh, J, Perico, N, Remuzzi, G, Murray, Cjl, Vos, T., and GBD Chronic Kidney Disease Collaboration

Subjects
Systems Analysis, Gout, Cost effectiveness, 030204 cardiovascular system & hematology, Global Health, GLOMERULAR-FILTRATION-RATE, Global Burden of Disease, COST-EFFECTIVENESS, 0302 clinical medicine, Cause of Death, Prevalence, Global health, Diabetic Nephropathies, Registries, 030212 general & internal medicine, SUB-SAHARAN AFRICA, 11 Medical and Health Sciences, Incidence, Mortality rate, 1. No poverty, General Medicine, Hälsovetenskaper, GBD Chronic Kidney Disease Collaboration, CKD-EPI EQUATION, 3. Good health, Europe, Cardiovascular Diseases, Quality-Adjusted Life Years, Life Sciences & Biomedicine, Asia, Oceania, 195 COUNTRIES, ATHEROSCLEROSIS RISK, CARDIOVASCULAR OUTCOMES, Risk Assessment, Article, 03 medical and health sciences, Medicine, General & Internal, SDG 3 - Good Health and Well-being, RISK-FACTOR, General & Internal Medicine, Environmental health, Health Sciences, medicine, Humans, GBD, chronic kidney disease, Mortality, Risk factor, Renal Insufficiency, Chronic, Disease burden, QM, Science & Technology, Australasia, business.industry, PERIPHERAL ARTERIAL-DISEASE, Bayes Theorem, medicine.disease, Health Surveys, Quality-adjusted life year, RENAL-DISEASE, Latin America, Years of potential life lost, Africa, North America, Human medicine, business, RC, Kidney disease
Abstract

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and induded incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017,1.2 million (95% uncertainty interval [UI] 1.2 to 1.3) people died from CKD. The global all-age mortality rate from CKD increased 41.5% (95% UI 35.2 to 46.5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2.8%, -1.5 to 6.3). In 2017,697.5 million (95% UI 649.2 to 752.0) cases of all-stage CKD were recorded, for a global prevalence of 9.1% (8.5 to 9.8). The global all-age prevalence of CKD increased 29.3% (95% UI 26.4 to 32.6) since 1990, whereas the age-standardised prevalence remained stable (1.2%, -1.1 to 3.5). CKD resulted in 35.8 million (95% UI 33.7 to 38.0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1.4 million (95% UI 1.2 to 1.6) cardiovascular disease-related deaths and 25.3 million (22.2 to 28.9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.

Published
2020

9. Better virological outcomes amongst people living with HIV initiating early antiretroviral treatment (CD4 counts ≥ 500 cells/µL) in the HPTN 071 (PopART) trial in South Africa

Author

Fatti, G, Grimwood, A, Nachega, JB, Nelson, JA, LaSorda, K, Zyl, GV, Grobbelaar, N, Ayles, H, Hayes, R, Beyers, N, Fidler, S, Bock, P, HPTN 071 (PopART) study team, National Institutes of Health, Imperial College Healthcare NHS Trust- BRC Funding, Medical Research Council (MRC), and Department for International Development (UK) (DFI

Subjects
Adult, Anti-HIV Agents, Immunology, HIV Infections, LYMPHOCYTES, Microbiology, THERAPY, South Africa, Antiretroviral Therapy, Highly Active, FAILURE, Humans, Prospective Studies, 11 Medical and Health Sciences, HPTN 071 (PopART) Trial, Science & Technology, virological outcomes, HIV, baseline CD4 cell count, Viral Load, 06 Biological Sciences, CD4 Lymphocyte Count, early antiretroviral treatment, Infectious Diseases, HIV/AIDS, Life Sciences & Biomedicine, VIRAL SUPPRESSION
Abstract

BACKGROUND: There have been concerns about reduced adherence and HIV virological suppression (VS) amongst clinically well people living with HIV initiating antiretroviral treatment (ART) with high pre-ART CD4 cell counts. We compared virological outcomes by pre-ART CD4 count, where universal ART initiation was provided in the HPTN 071 (PopART) trial in South Africa prior to routine national and international implementation. METHODS: This prospective cohort study included adults initiating ART at facilities providing ART irrespective of CD4 count since January 2014. VS (1000 copies/ml) and viral rebound were compared between participants in strata of baseline CD4 count. RESULTS: The sample included 1901 participants. VS was 94% or greater amongst participants with baseline CD4 count ≥500 cells/µL at all six-monthly intervals to 30 months of ART. The risk of an elevated viral load (≥400 copies/ml) was independently lower amongst participants with baseline CD4 count ≥500 cells/µL (3.3%) compared to those with CD4 count 200-499 cell/µL (9.2%) between months 18-30, adjusted relative risk=0.30 (95% CI: 0.12-0.74, P=0.010). The incidence rate of VF was 7.0, 2.0 and 0.5 per 100 person-years amongst participants with baseline CD4 count

Published
2019

10. The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017

Author

Stanaway, JD, Reiner, RC, Blacker, BF, Goldberg, EM, Khalil, IA, Troeger, CE, Andrews, JR, Bhutta, ZA, Crump, JA, Im, J, Marks, F, Mintz, E, Park, SE, Zaidi, AKM, Abebe, Z, Abejie, AN, Adedeji, IA, Ali, BA, Amare, AT, Atalay, HT, Avokpaho, EFGA, Bacha, U, Barac, A, Bedi, N, Berhane, A, Browne, AJ, Chirinos, JL, Chitheer, A, Dolecek, C, Zaki, MES, Eshrati, B, Foreman, KJ, Gemechu, A, Gupta, R, Hailu, GB, Henok, A, Hibstu, DT, Chi, LH, Ilesanmi, OS, Iyer, VJ, Kahsay, A, Kasaeian, A, Kassa, TD, Khan, EA, Khang, Y-H, El Razek, HMA, Melku, M, Mengistu, DT, Mohammad, KA, Mohammed, S, Mokdad, AH, Nachega, JB, Naheed, A, Cuong, TN, Huong, LTN, Long, HN, Nam, BN, Trang, HN, Nirayo, YL, Pangestu, T, Patton, GC, Qorbani, M, Rai, RK, Rana, SM, Ranabhat, CL, Roba, KT, Roberts, NLS, Rubino, S, Safiri, S, Sartorius, B, Sawhney, M, Shiferaw, MS, Smith, DL, Sykes, BL, Bach, XT, Tung, TT, Ukwaja, KN, Giang, TV, Linh, GV, Weldegebreal, F, Yenit, MK, Murray, CJL, Hay, SI, Stanaway, JD, Reiner, RC, Blacker, BF, Goldberg, EM, Khalil, IA, Troeger, CE, Andrews, JR, Bhutta, ZA, Crump, JA, Im, J, Marks, F, Mintz, E, Park, SE, Zaidi, AKM, Abebe, Z, Abejie, AN, Adedeji, IA, Ali, BA, Amare, AT, Atalay, HT, Avokpaho, EFGA, Bacha, U, Barac, A, Bedi, N, Berhane, A, Browne, AJ, Chirinos, JL, Chitheer, A, Dolecek, C, Zaki, MES, Eshrati, B, Foreman, KJ, Gemechu, A, Gupta, R, Hailu, GB, Henok, A, Hibstu, DT, Chi, LH, Ilesanmi, OS, Iyer, VJ, Kahsay, A, Kasaeian, A, Kassa, TD, Khan, EA, Khang, Y-H, El Razek, HMA, Melku, M, Mengistu, DT, Mohammad, KA, Mohammed, S, Mokdad, AH, Nachega, JB, Naheed, A, Cuong, TN, Huong, LTN, Long, HN, Nam, BN, Trang, HN, Nirayo, YL, Pangestu, T, Patton, GC, Qorbani, M, Rai, RK, Rana, SM, Ranabhat, CL, Roba, KT, Roberts, NLS, Rubino, S, Safiri, S, Sartorius, B, Sawhney, M, Shiferaw, MS, Smith, DL, Sykes, BL, Bach, XT, Tung, TT, Ukwaja, KN, Giang, TV, Linh, GV, Weldegebreal, F, Yenit, MK, Murray, CJL, and Hay, SI

Abstract

BACKGROUND: Efforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, and the approach taken to produce them. METHODS: For this systematic analysis we broke down the relative contributions of typhoid and paratyphoid fevers by country, year, and age, and analysed trends in incidence and mortality. We modelled the combined incidence of typhoid and paratyphoid fevers and split these total cases proportionally between typhoid and paratyphoid fevers using aetiological proportion models. We estimated deaths using vital registration data for countries with sufficiently high data completeness and using a natural history approach for other locations. We also estimated disability-adjusted life-years (DALYs) for typhoid and paratyphoid fevers. FINDINGS: Globally, 14·3 million (95% uncertainty interval [UI] 12·5-16·3) cases of typhoid and paratyphoid fevers occurred in 2017, a 44·6% (42·2-47·0) decline from 25·9 million (22·0-29·9) in 1990. Age-standardised incidence rates declined by 54·9% (53·4-56·5), from 439·2 (376·7-507·7) per 100 000 person-years in 1990, to 197·8 (172·0-226·2) per 100 000 person-years in 2017. In 2017, Salmonella enterica serotype Typhi caused 76·3% (71·8-80·5) of cases of enteric fever. We estimated a global case fatality of 0·95% (0·54-1·53) in 2017, with higher case fatality estimates among children and older adults, and among those living in lower-income countries. We therefore estimated 135·9 thousand (76·9-218·9) deaths from typhoid and paratyphoid fever globally in 2017, a 41·0% (33·6-48·3) decline from 230·5 thousand (131·2-372·6) in 1990. Overall, typhoid and paratyphoid fevers were responsible for 9·8 million (5·6-15·8) DALYs in 2017, down 43·0% (35·5-50·6) from 17·2 million (9·9-27·8) DALYs in 1990. I

Published
2019

11. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015

Author

Barber, RM, Fullman, N, Sorensen, RJD, Bollyky, T, McKee, M, Nolte, E, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulle, AM, Abdurahman, AA, Abera, SF, Abraham, B, Abreha, GF, Adane, K, Adelekan, AL, Adetifa, IMO, Afshin, A, Agarwal, A, Agarwal, SK, Agarwal, S, Agrawal, A, Kiadaliri, AA, Ahmadi, A, Ahmed, KY, Ahmed, MB, Akinyemi, RO, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alam, SS, Alemu, ZA, Alene, KA, Alexander, L, Ali, R, Ali, SD, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Amo-Adjei, J, Amoako, YA, Anderson, BO, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Ärnlöv, J, Artaman, A, Asayesh, H, Assadi, R, Astatkie, A, Atey, TM, Atique, S, Atnafu, NT, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Quintanilla, BPA, Awasthi, A, Ayele, NN, Azzopardi, P, Saleem, HOB, Bärnighausen, T, Bacha, U, Badawi, A, Banerjee, A, Barac, A, Barboza, MA, Barker-Collo, SL, Barrero, LH, Basu, S, Baune, BT, Baye, K, Bayou, YT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Béjot, Y, Bello, AK, Bennett, DA, Bensenor, IM, Berhane, A, Bernabé, E, Bernal, OA, Beyene, AS, Beyene, TJ, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bose, D, Brainin, M, Brauer, M, Brazinova, A, Breitborde, NJK, Brenner, H, Butt, ZA, Cárdenas, R, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Carrero, JJ, Casey, D, Caso, V, Castañeda-Orjuela, CA, Rivas, JC, Catalá-López, F, Cecilio, P, Cercy, K, Charlson, FJ, Chen, AZ, Chew, A, Chibalabala, M, Chibueze, CE, Chisumpa, VH, Chitheer, AA, Chowdhury, R, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coggeshall, MS, Cooper, LT, Cortinovis, M, Crump, JA, Dalal, K, Danawi, H, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, De Leo, D, Del Gobbo, LC, del Pozo-Cruz, B, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dicker, D, Ding, EL, Dokova, K, Dorsey, ER, Doyle, KE, Dubey, M, Ehrenkranz, R, Ellingsen, CL, Elyazar, I, Enayati, A, Ermakov, SP, Eshrati, B, Esteghamati, A, Estep, K, Fürst, T, Faghmous, IDA, Fanuel, FBB, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Feigl, AB, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Fischer, F, Fitzmaurice, C, Fleming, TD, Foigt, N, Foreman, KJ, Forouzanfar, MH, Franklin, RC, Frostad, J, G/hiwot, TT, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gao, W, Garcia-Basteiro, AL, Gebre, T, Gebremedhin, AT, Gebremichael, MW, Gebru, AA, Gelaye, AA, Geleijnse, JM, Genova-Maleras, R, Gibney, KB, Giref, AZ, Gishu, MD, Giussani, G, Godwin, WW, Gold, A, Goldberg, EM, Gona, PN, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Greaves, F, Griswold, M, Guban, PI, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Habtewold, TD, Hafezi-Nejad, N, Haile, D, Hailu, AD, Hailu, GB, Hakuzimana, A, Hamadeh, RR, Hambisa, MT, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, Hendrie, D, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huntley, BM, Huynh, C, Iburg, KM, Ileanu, BV, Innos, K, Irenso, AA, Jahanmehr, N, Jakovljevic, MB, James, P, James, SL, Javanbakht, M, Jayaraman, SP, Jayatilleke, AU, Jeemon, P, Jha, V, John, D, Johnson, C, Johnson, SC, Jonas, JB, Juel, K, Kabir, Z, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Kasaeian, A, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kazanjan, K, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Kerbo, AA, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khan, G, Khang, Y-H, Khoja, ATA, Khonelidze, I, Khubchandani, J, Kibret, GD, Kim, D, Kim, P, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kissoon, N, Kivipelto, M, Kokubo, Y, Kolk, A, Kolte, D, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krishnaswami, S, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulkarni, VS, Kumar, GA, Kumsa, FA, Kutz, M, Kyu, HH, Lager, ACJ, Lal, A, Lal, DK, Lalloo, R, Lallukka, T, Lan, Q, Langan, SM, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Latif, AA, Lawrynowicz, AEB, Leasher, JL, Leigh, J, Leinsalu, M, Leshargie, CT, Leung, J, Leung, R, Levi, M, Liang, X, Lim, SS, Lind, M, Linn, S, Lipshultz, SE, Liu, P, Liu, Y, Lo, L-T, Logroscino, G, Lopez, AD, Lorch, SA, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Macarayan, ERK, Mackay, MT, El Razek, HMA, El Razek, MMA, Mahdavi, M, Majeed, A, Malekzadeh, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marcenes, W, Marks, GB, Marquez, N, Martinez-Raga, J, Marzan, MB, Massano, J, Mathur, MR, Maulik, PK, Mazidi, M, McAlinden, C, McGrath, JJ, McNellan, C, Meaney, PA, Mehari, A, Mehndiratta, MM, Meier, T, Mekonnen, AB, Meles, KG, Memish, ZA, Mengesha, MM, Mengiste, DT, Mengistie, MA, Menota, BG, Mensah, GA, Mereta, ST, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Millear, A, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Mock, CN, Mohammad, KA, Mohammed, S, Mohanty, SK, Mokdad, AH, Mola, GLD, Molokhia, M, Monasta, L, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Mori, R, Moses, M, Mueller, UO, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naheed, A, Naldi, L, Nangia, V, Nascimento, BR, Negoi, I, Neupane, SP, Newton, CR, Ng, M, Ngalesoni, FN, Ngunjiri, JW, Nguyen, G, Ningrum, DNA, Nolte, S, Nomura, M, Norheim, OF, Norrving, B, Noubiap, JJN, Obermeyer, CM, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olivares, PR, Olsen, HE, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ortiz, A, Osborne, RH, Osman, M, Owolabi, MO, PA, M, Pain, AW, Pakhale, S, Castillo, EP, Pana, A, Papachristou, C, Parsaeian, M, Patel, T, Patton, GC, Paudel, D, Paul, VK, Pearce, N, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pigott, DM, Pillay, JD, Pinho, C, Polinder, S, Pond, CD, Prakash, V, Purwar, M, Qorbani, M, Quistberg, DA, Radfar, A, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rai, RK, Ram, U, Rana, SM, Rankin, Z, Rao, PV, Rao, PC, Rawaf, S, Rego, MAS, Reitsma, M, Remuzzi, G, Renzaho, AMNN, Resnikoff, S, Rezaei, S, Rezai, MS, Ribeiro, AL, Roba, HS, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, NK, Sachdev, PS, Sackey, BB, Saeedi, MY, Safiri, S, Sagar, R, Sahraian, MA, Saleh, MM, Salomon, JA, Samy, AM, Sanabria, JR, Sanchez-Niño, MD, Sandar, L, Santos, IS, Santos, JV, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Savic, M, Sawhney, M, Saylan, MI, Schöttker, B, Schutte, AE, Schwebel, DC, Seedat, S, Seid, AM, Seifu, CN, Sepanlou, SG, Serdar, B, Servan-Mori, EE, Setegn, T, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shakh-Nazarova, M, Shamsipour, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shi, P, Shigematsu, M, Shin, M-J, Shiri, R, Shoman, H, Shrime, MG, Sibamo, ELS, Sigfusdottir, ID, Silva, DAS, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, OP, Singh, PK, Singh, V, Sinke, AH, Sinshaw, AE, Skirbekk, V, Sliwa, K, Smith, A, Sobngwi, E, Soneji, S, Soriano, JB, Sousa, TCM, Sposato, LA, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Steiner, C, Steinke, S, Stokes, MA, Stranges, S, Strong, M, Stroumpoulis, K, Sturua, L, Sufiyan, MB, Suliankatchi, RA, Sun, J, Sur, P, Swaminathan, S, Sykes, BL, Tabarés-Seisdedos, R, Tabb, KM, Taffere, GR, Talongwa, RT, Tarajia, M, Tavakkoli, M, Taveira, N, Teeple, S, Tegegne, TK, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Terkawi, AS, Tesema, AG, Thakur, JS, Thomson, AJ, Tillmann, T, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Tortajada, M, Troeger, C, Truelsen, T, Tura, AK, Uchendu, US, Ukwaja, KN, Undurraga, EA, Uneke, CJ, Uthman, OA, van Boven, JFM, Van Dingenen, R, Varughese, S, Vasankari, T, Venketasubramanian, N, Violante, FS, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Wagner, JA, Wakayo, T, Waller, SG, Walson, JL, Wang, H, Wang, Y-P, Watkins, DA, Weiderpass, E, Weintraub, RG, Wen, C-P, Werdecker, A, Wesana, J, Westerman, R, Whiteford, HA, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Won, S, Workicho, A, Workie, SB, Wubshet, M, Xavier, D, Xu, G, Yadav, AK, Yaghoubi, M, Yakob, B, Yan, LL, Yano, Y, Yaseri, M, Yimam, HH, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zambrana-Torrelio, C, Zapata, T, Zenebe, ZM, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Murray, CJL, Barber, RM, Fullman, N, Sorensen, RJD, Bollyky, T, McKee, M, Nolte, E, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulle, AM, Abdurahman, AA, Abera, SF, Abraham, B, Abreha, GF, Adane, K, Adelekan, AL, Adetifa, IMO, Afshin, A, Agarwal, A, Agarwal, SK, Agarwal, S, Agrawal, A, Kiadaliri, AA, Ahmadi, A, Ahmed, KY, Ahmed, MB, Akinyemi, RO, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alam, SS, Alemu, ZA, Alene, KA, Alexander, L, Ali, R, Ali, SD, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Amo-Adjei, J, Amoako, YA, Anderson, BO, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Ärnlöv, J, Artaman, A, Asayesh, H, Assadi, R, Astatkie, A, Atey, TM, Atique, S, Atnafu, NT, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Quintanilla, BPA, Awasthi, A, Ayele, NN, Azzopardi, P, Saleem, HOB, Bärnighausen, T, Bacha, U, Badawi, A, Banerjee, A, Barac, A, Barboza, MA, Barker-Collo, SL, Barrero, LH, Basu, S, Baune, BT, Baye, K, Bayou, YT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Béjot, Y, Bello, AK, Bennett, DA, Bensenor, IM, Berhane, A, Bernabé, E, Bernal, OA, Beyene, AS, Beyene, TJ, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bose, D, Brainin, M, Brauer, M, Brazinova, A, Breitborde, NJK, Brenner, H, Butt, ZA, Cárdenas, R, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Carrero, JJ, Casey, D, Caso, V, Castañeda-Orjuela, CA, Rivas, JC, Catalá-López, F, Cecilio, P, Cercy, K, Charlson, FJ, Chen, AZ, Chew, A, Chibalabala, M, Chibueze, CE, Chisumpa, VH, Chitheer, AA, Chowdhury, R, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coggeshall, MS, Cooper, LT, Cortinovis, M, Crump, JA, Dalal, K, Danawi, H, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, De Leo, D, Del Gobbo, LC, del Pozo-Cruz, B, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dicker, D, Ding, EL, Dokova, K, Dorsey, ER, Doyle, KE, Dubey, M, Ehrenkranz, R, Ellingsen, CL, Elyazar, I, Enayati, A, Ermakov, SP, Eshrati, B, Esteghamati, A, Estep, K, Fürst, T, Faghmous, IDA, Fanuel, FBB, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Feigl, AB, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Fischer, F, Fitzmaurice, C, Fleming, TD, Foigt, N, Foreman, KJ, Forouzanfar, MH, Franklin, RC, Frostad, J, G/hiwot, TT, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gao, W, Garcia-Basteiro, AL, Gebre, T, Gebremedhin, AT, Gebremichael, MW, Gebru, AA, Gelaye, AA, Geleijnse, JM, Genova-Maleras, R, Gibney, KB, Giref, AZ, Gishu, MD, Giussani, G, Godwin, WW, Gold, A, Goldberg, EM, Gona, PN, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Greaves, F, Griswold, M, Guban, PI, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Habtewold, TD, Hafezi-Nejad, N, Haile, D, Hailu, AD, Hailu, GB, Hakuzimana, A, Hamadeh, RR, Hambisa, MT, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, Hendrie, D, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huntley, BM, Huynh, C, Iburg, KM, Ileanu, BV, Innos, K, Irenso, AA, Jahanmehr, N, Jakovljevic, MB, James, P, James, SL, Javanbakht, M, Jayaraman, SP, Jayatilleke, AU, Jeemon, P, Jha, V, John, D, Johnson, C, Johnson, SC, Jonas, JB, Juel, K, Kabir, Z, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Kasaeian, A, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kazanjan, K, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Kerbo, AA, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khan, G, Khang, Y-H, Khoja, ATA, Khonelidze, I, Khubchandani, J, Kibret, GD, Kim, D, Kim, P, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kissoon, N, Kivipelto, M, Kokubo, Y, Kolk, A, Kolte, D, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krishnaswami, S, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulkarni, VS, Kumar, GA, Kumsa, FA, Kutz, M, Kyu, HH, Lager, ACJ, Lal, A, Lal, DK, Lalloo, R, Lallukka, T, Lan, Q, Langan, SM, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Latif, AA, Lawrynowicz, AEB, Leasher, JL, Leigh, J, Leinsalu, M, Leshargie, CT, Leung, J, Leung, R, Levi, M, Liang, X, Lim, SS, Lind, M, Linn, S, Lipshultz, SE, Liu, P, Liu, Y, Lo, L-T, Logroscino, G, Lopez, AD, Lorch, SA, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Macarayan, ERK, Mackay, MT, El Razek, HMA, El Razek, MMA, Mahdavi, M, Majeed, A, Malekzadeh, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marcenes, W, Marks, GB, Marquez, N, Martinez-Raga, J, Marzan, MB, Massano, J, Mathur, MR, Maulik, PK, Mazidi, M, McAlinden, C, McGrath, JJ, McNellan, C, Meaney, PA, Mehari, A, Mehndiratta, MM, Meier, T, Mekonnen, AB, Meles, KG, Memish, ZA, Mengesha, MM, Mengiste, DT, Mengistie, MA, Menota, BG, Mensah, GA, Mereta, ST, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Millear, A, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Mock, CN, Mohammad, KA, Mohammed, S, Mohanty, SK, Mokdad, AH, Mola, GLD, Molokhia, M, Monasta, L, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Mori, R, Moses, M, Mueller, UO, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naheed, A, Naldi, L, Nangia, V, Nascimento, BR, Negoi, I, Neupane, SP, Newton, CR, Ng, M, Ngalesoni, FN, Ngunjiri, JW, Nguyen, G, Ningrum, DNA, Nolte, S, Nomura, M, Norheim, OF, Norrving, B, Noubiap, JJN, Obermeyer, CM, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olivares, PR, Olsen, HE, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ortiz, A, Osborne, RH, Osman, M, Owolabi, MO, PA, M, Pain, AW, Pakhale, S, Castillo, EP, Pana, A, Papachristou, C, Parsaeian, M, Patel, T, Patton, GC, Paudel, D, Paul, VK, Pearce, N, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pigott, DM, Pillay, JD, Pinho, C, Polinder, S, Pond, CD, Prakash, V, Purwar, M, Qorbani, M, Quistberg, DA, Radfar, A, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rai, RK, Ram, U, Rana, SM, Rankin, Z, Rao, PV, Rao, PC, Rawaf, S, Rego, MAS, Reitsma, M, Remuzzi, G, Renzaho, AMNN, Resnikoff, S, Rezaei, S, Rezai, MS, Ribeiro, AL, Roba, HS, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, NK, Sachdev, PS, Sackey, BB, Saeedi, MY, Safiri, S, Sagar, R, Sahraian, MA, Saleh, MM, Salomon, JA, Samy, AM, Sanabria, JR, Sanchez-Niño, MD, Sandar, L, Santos, IS, Santos, JV, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Savic, M, Sawhney, M, Saylan, MI, Schöttker, B, Schutte, AE, Schwebel, DC, Seedat, S, Seid, AM, Seifu, CN, Sepanlou, SG, Serdar, B, Servan-Mori, EE, Setegn, T, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shakh-Nazarova, M, Shamsipour, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shi, P, Shigematsu, M, Shin, M-J, Shiri, R, Shoman, H, Shrime, MG, Sibamo, ELS, Sigfusdottir, ID, Silva, DAS, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, OP, Singh, PK, Singh, V, Sinke, AH, Sinshaw, AE, Skirbekk, V, Sliwa, K, Smith, A, Sobngwi, E, Soneji, S, Soriano, JB, Sousa, TCM, Sposato, LA, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Steiner, C, Steinke, S, Stokes, MA, Stranges, S, Strong, M, Stroumpoulis, K, Sturua, L, Sufiyan, MB, Suliankatchi, RA, Sun, J, Sur, P, Swaminathan, S, Sykes, BL, Tabarés-Seisdedos, R, Tabb, KM, Taffere, GR, Talongwa, RT, Tarajia, M, Tavakkoli, M, Taveira, N, Teeple, S, Tegegne, TK, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Terkawi, AS, Tesema, AG, Thakur, JS, Thomson, AJ, Tillmann, T, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Tortajada, M, Troeger, C, Truelsen, T, Tura, AK, Uchendu, US, Ukwaja, KN, Undurraga, EA, Uneke, CJ, Uthman, OA, van Boven, JFM, Van Dingenen, R, Varughese, S, Vasankari, T, Venketasubramanian, N, Violante, FS, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Wagner, JA, Wakayo, T, Waller, SG, Walson, JL, Wang, H, Wang, Y-P, Watkins, DA, Weiderpass, E, Weintraub, RG, Wen, C-P, Werdecker, A, Wesana, J, Westerman, R, Whiteford, HA, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Won, S, Workicho, A, Workie, SB, Wubshet, M, Xavier, D, Xu, G, Yadav, AK, Yaghoubi, M, Yakob, B, Yan, LL, Yano, Y, Yaseri, M, Yimam, HH, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zambrana-Torrelio, C, Zapata, T, Zenebe, ZM, Zodpey, S, Zoeckler, L, Zuhlke, LJ, and Murray, CJL

Published
2017

12. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Wang, H, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adedoyin, RA, Adetifa, IMO, Adetokunboh, O, Afshin, A, Aggarwal, R, Agrawal, A, Agrawal, S, Kiadaliri, AA, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Aiyar, S, Akanda, S, Akinyemiju, TF, Akseer, N, Al-Eyadhy, A, Al Lami, FH, Alabed, S, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Aldridge, RW, Alene, KA, Alhabib, S, Ali, R, Alizadeh-Navaei, R, Aljunid, SM, Alkaabi, JM, Alkerwi, A, Alla, F, Allam, SD, Allebeck, P, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Ameh, EA, Amini, E, Ammar, W, Amoako, YA, Anber, N, Andrei, CL, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Anwari, P, Arnlov, J, Arora, M, Al, A, Aryal, KK, Asayesh, H, Asgedom, SW, Asghar, RJ, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Babalola, TK, Bacha, U, Badawi, A, Balakrishnan, K, Balalla, S, Barac, A, Barber, RM, Barboza, MA, Barker-Collo, SL, Barnighausen, T, Barquera, S, Barregard, L, Barrero, LH, Baune, BT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Bejot, Y, Bekele, BB, Bell, ML, Bello, AK, Bennett, DA, Bennett, JR, Bensenor, IM, Benson, J, Berhane, A, Berhe, DF, Bernabe, E, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhaumik, S, Bhutta, ZA, Bikbov, B, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bjerregaard, P, Blosser, CD, Boneya, DJ, Boufous, S, Bourne, RRA, Brazinova, A, Breitborde, NJK, Brenner, H, Brugha, TS, Bukhman, G, Negesa, L, Bulto, B, Bumgarner, BR, Burch, M, Butt, ZA, Cahill, LE, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Car, M, Crdenas, R, Carpenter, DO, Carrero, JJ, Carter, A, Castaneda-Orjuela, CA, Rivas, JC, Castro, FF, Castro, RE, Catala-Lopez, F, Chen, H, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Chitheer, AA, Choi, J-YJ, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Cohen, AJ, Colquhoun, SM, Coresh, J, Criqui, MH, Cromwell, EA, Crump, JA, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, de Courten, B, De Leo, D, Degenhardt, L, Deiparine, S, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dherani, MK, Diaz-Torne, C, Ding, EL, Dixit, P, Djalalinia, S, Huyen, PD, Doku, DT, Donnelly, CA, Priscila, K, dos Santos, B, Douwes-Schultz, D, Driscoll, TR, Duan, L, Dubey, M, Duncan, BB, Dwivedi, LK, Ebrahimi, H, El Bcheraoui, C, Ellingsen, CL, Enayati, A, Endries, AY, Ermakov, SP, Eshetie, S, Eshrati, B, Eskandarieh, S, Esteghamati, A, Estep, K, Fanuel, BBF, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Filip, I, Fischer, F, Foigt, N, Foreman, KJ, Frank, T, Franklin, RC, Fraser, M, Friedman, J, Frostad, JJ, Fullman, N, Furst, T, Furtado, JM, Futran, ND, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gankpe, FG, Garcia-Basteiro, AL, Gebregergs, GB, Gebrehiwot, TT, Gebrekidan, KG, Gebremichael, MW, Gelaye, AA, Geleijnse, JM, Gemechu, BL, Gemechu, KS, Genova-Maleras, R, Gesesew, HA, Gething, PW, Gibney, KB, Gill, PS, Gillum, RF, Giref, AZ, Girma, BW, Giussani, G, Goenka, S, Gomez, B, Gona, PN, Gopalani, SV, Goulart, AC, Graetz, N, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Haagsma, JA, Hafezi-Nejad, N, Bidgoli, HH, Hakuzimana, A, Halasa, YA, Hamadeh, RR, Hambisa, MT, Hamidi, S, Hammami, M, Hancock, J, Handal, AJ, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Harikrishnan, S, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, He, F, Heredia-Pi, IB, Herteliu, C, Hilawe, EH, Hoek, HW, Horita, N, Hosgood, HD, Hostiuc, S, Hotez, PJ, Hoy, DG, Hsairi, M, Htet, AS, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Igumbor, EU, Ileanu, BV, Inoue, M, Irenso, AA, Irvine, CMS, Islam, N, Jacobsen, KH, Jaenisch, T, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jensen, PN, Jha, V, Jin, Y, John, D, John, O, Johnson, SC, Jonas, JB, Jurisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Karthikeyan, G, Kasaeian, A, Kassaw, NA, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kaul, A, Kawakami, N, Kazanjan, K, Keiyoro, PN, Kelbore, SG, Kemp, AH, Kengne, AP, Keren, A, Kereselidze, M, Kesavachandran, CN, Ketema, EB, Khader, YS, Khalil, IA, Khan, EA, Khan, G, Khang, Y-H, Khera, S, Khoja, ATA, Khosravi, MH, Kibret, GD, Kieling, C, Kim, C-I, Kim, D, Kim, P, Kim, S, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kishawi, S, Kissimova-Skarbek, KA, Kissoon, N, Kivimaki, M, Knudsen, AK, Kokubo, Y, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulikoff, XR, Kulkarni, VS, Kumar, GA, Kumar, P, Kumsa, FA, Kutz, M, Lachat, C, Lagat, AK, Lager, ACJ, Lal, DK, Lalloo, R, Lambert, N, Lan, Q, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Lavados, PM, Laxmaiah, A, Lee, PH, Leigh, J, Leung, J, Leung, R, Levi, M, Li, Y, Liao, Y, Liben, ML, Lim, SS, Linn, S, Lipshultz, SE, Liu, S, Lodha, R, Logroscino, G, Lorch, SA, Lorkowski, S, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Ma, S, Macarayan, ERK, Machado, IE, Mackay, MT, Abd el Razek, MM, Magis-Rodriguez, C, Mahdavi, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marczak, LB, Marks, GB, Martinez-Raga, J, Martins-Melo, FR, Massano, J, Maulik, PK, Mayosi, BM, Mazidi, M, McAlinden, C, McGarvey, ST, McGrath, JJ, Mckee, M, Mehata, S, Mehndiratta, MM, Mehta, KM, Meier, T, Mekonnen, TC, Meles, KG, Memiah, P, Memish, ZA, Mendoza, W, Mengesha, MM, Mengistie, MA, Tadese, D, Menon, MGR, Menota, BG, Mensah, GA, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Mikesell, J, Miller, TR, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Misganaw, A, Mishra, SR, Mohammad, KA, Mohammadi, A, Mohammed, KESM, Mohan, MBV, Mohanty, SK, Mokdad, AH, Assaye, AM, Mollenkopf, SK, Molokhia, M, Monasta, L, Hernandez, JCM, Montico, M, Mooney, MD, Moore, AR, Moradi-Lakeh, M, Moraga, P, Morawska, L, Velasquez, IM, Mori, R, Morrison, SD, Mruts, KB, Mueller, UO, Mullany, E, Muller, K, Venkata, G, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naidoo, KS, Nanda, L, Nangia, V, Nascimento, BR, Natarajan, G, Negoi, I, Cuong, TN, Ningrum, DNA, Nisar, MI, Nomura, M, Vuong, MN, Norheim, OF, Norrving, B, Noubiap, JJN, Nyakarahuka, L, Obermeyer, CM, O'Donnell, MJ, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olusanya, BO, Olusanya, JO, Oren, E, Ortiz, A, Osgood-Zimmerman, A, Ota, E, Owolabi, MO, Oyekale, AS, Pa, M, Pacella, RE, Pakhale, S, Pana, A, Panda, BK, Panda-Jonas, S, Park, E-K, Parsaeian, M, Patel, T, Patten, SB, Patton, GC, Paudel, D, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pervaiz, A, Pesudovs, K, Peterson, CB, Petri, WA, Petzold, M, Phillips, MR, Piel, FB, Pigott, DM, Pishgar, F, Plass, D, Polinder, S, Popova, S, Postma, MJ, Poulton, RG, Pourmalek, F, Prasad, N, Purwar, M, Qorbani, M, Rabiee, RHS, Radfar, A, Rafay, A, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Ranabhat, CL, Rao, PV, Rawaf, S, Ray, SE, Rego, MAS, Rehm, J, Reiner, RC, Remuzzi, G, Renzaho, AMNN, Resnikoff, S, Rezaei, S, Rezai, MS, Ribeiro, AL, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, A, Rubagotti, E, Ruhago, GM, Saadat, S, Sabde, YD, Sachdev, PS, Sadat, N, Safdarian, M, Safiri, SSS, Sagar, R, Sahathevan, R, Sahebkar, A, Sahraian, MA, Salama, J, Salamati, P, Salomon, JA, Salvi, SS, Samy, AM, Sanabria, JR, Sanchez-Nino, MD, Santos, IS, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Sawhney, M, Saxena, S, Saylan, MI, Schmidt, MI, Schneider, IJC, Schutte, AE, Schwebel, DC, Schwendicke, F, Seedat, S, Seid, AM, Sepanlou, SG, Servan-Mori, EE, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shamsipour, M, Shamsizadeh, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Shen, J, Shetty, BP, Shi, P, Shibuya, K, Shigematsu, M, Shiri, R, Shiue, I, Shrime, MG, Sigfusdottir, ID, Silberberg, DH, Silpakit, N, Silva, DAS, Silva, JP, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, PK, Singh, V, Sinha, DN, Skiadaresi, E, Sligar, A, Smith, DL, Sobaih, BHA, Sobngwi, E, Soneji, S, Soriano, JB, Sreeramareddy, CT, Srinivasan, V, Stathopoulou, V, Steel, N, Stein, DJ, Steiner, C, Stockl, H, Stokes, MA, Strong, M, Sufiyan, MB, Suliankatchi, RA, Sunguya, BF, Sur, PJ, Swaminathan, S, Sykes, BL, Szoeke, CEI, Tabares-Seisdedos, R, Tadakamadla, SK, Tadese, F, Tandon, N, Tanne, D, Tarajia, M, Tavakkoli, M, Taveira, N, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Temsah, M-H, Terkawi, AS, Tesema, CL, Tesssema, B, Theis, A, Thomas, N, Thompson, AH, Thomson, AJ, Thrift, AG, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Topouzis, F, Tortajada, M, Tran, BX, Trujillo, TTU, Tsilimparis, N, Tuem, KB, Tuzcu, EM, Tyrovolas, S, Ukwaja, KN, Undurraga, EA, Uthman, OA, Uzochukwu, BSC, van Boven, JFM, Varakin, YY, Varughese, S, Vasankari, T, Vasconcelos, AMN, Venketasubramanian, N, Vidavalur, R, Violante, FS, Vishnu, A, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Waid, JL, Wakayo, T, Wang, Y-P, Weichenthal, S, Weiderpass, E, Weintraub, RG, Werdecker, A, Wesana, J, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Workicho, A, Workie, SB, Xavier, D, Xu, G, Yaghoubi, M, Yakob, B, Yalew, AZ, Yan, LL, Yano, Y, Yaseri, M, Ye, P, Yimam, HH, Yip, P, Yirsaw, BD, Yonemoto, N, Yoon, S-J, Yotebieng, M, Younis, MZ, Zaidi, Z, Zaki, MES, Zeeb, H, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zodpey, S, Zuhlke, LJ, Lopez, AD, Murray, CJL, Wang, H, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adedoyin, RA, Adetifa, IMO, Adetokunboh, O, Afshin, A, Aggarwal, R, Agrawal, A, Agrawal, S, Kiadaliri, AA, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Aiyar, S, Akanda, S, Akinyemiju, TF, Akseer, N, Al-Eyadhy, A, Al Lami, FH, Alabed, S, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Aldridge, RW, Alene, KA, Alhabib, S, Ali, R, Alizadeh-Navaei, R, Aljunid, SM, Alkaabi, JM, Alkerwi, A, Alla, F, Allam, SD, Allebeck, P, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Ameh, EA, Amini, E, Ammar, W, Amoako, YA, Anber, N, Andrei, CL, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Anwari, P, Arnlov, J, Arora, M, Al, A, Aryal, KK, Asayesh, H, Asgedom, SW, Asghar, RJ, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Babalola, TK, Bacha, U, Badawi, A, Balakrishnan, K, Balalla, S, Barac, A, Barber, RM, Barboza, MA, Barker-Collo, SL, Barnighausen, T, Barquera, S, Barregard, L, Barrero, LH, Baune, BT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Bejot, Y, Bekele, BB, Bell, ML, Bello, AK, Bennett, DA, Bennett, JR, Bensenor, IM, Benson, J, Berhane, A, Berhe, DF, Bernabe, E, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhaumik, S, Bhutta, ZA, Bikbov, B, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bjerregaard, P, Blosser, CD, Boneya, DJ, Boufous, S, Bourne, RRA, Brazinova, A, Breitborde, NJK, Brenner, H, Brugha, TS, Bukhman, G, Negesa, L, Bulto, B, Bumgarner, BR, Burch, M, Butt, ZA, Cahill, LE, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Car, M, Crdenas, R, Carpenter, DO, Carrero, JJ, Carter, A, Castaneda-Orjuela, CA, Rivas, JC, Castro, FF, Castro, RE, Catala-Lopez, F, Chen, H, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Chitheer, AA, Choi, J-YJ, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Cohen, AJ, Colquhoun, SM, Coresh, J, Criqui, MH, Cromwell, EA, Crump, JA, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, de Courten, B, De Leo, D, Degenhardt, L, Deiparine, S, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dherani, MK, Diaz-Torne, C, Ding, EL, Dixit, P, Djalalinia, S, Huyen, PD, Doku, DT, Donnelly, CA, Priscila, K, dos Santos, B, Douwes-Schultz, D, Driscoll, TR, Duan, L, Dubey, M, Duncan, BB, Dwivedi, LK, Ebrahimi, H, El Bcheraoui, C, Ellingsen, CL, Enayati, A, Endries, AY, Ermakov, SP, Eshetie, S, Eshrati, B, Eskandarieh, S, Esteghamati, A, Estep, K, Fanuel, BBF, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Filip, I, Fischer, F, Foigt, N, Foreman, KJ, Frank, T, Franklin, RC, Fraser, M, Friedman, J, Frostad, JJ, Fullman, N, Furst, T, Furtado, JM, Futran, ND, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gankpe, FG, Garcia-Basteiro, AL, Gebregergs, GB, Gebrehiwot, TT, Gebrekidan, KG, Gebremichael, MW, Gelaye, AA, Geleijnse, JM, Gemechu, BL, Gemechu, KS, Genova-Maleras, R, Gesesew, HA, Gething, PW, Gibney, KB, Gill, PS, Gillum, RF, Giref, AZ, Girma, BW, Giussani, G, Goenka, S, Gomez, B, Gona, PN, Gopalani, SV, Goulart, AC, Graetz, N, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Haagsma, JA, Hafezi-Nejad, N, Bidgoli, HH, Hakuzimana, A, Halasa, YA, Hamadeh, RR, Hambisa, MT, Hamidi, S, Hammami, M, Hancock, J, Handal, AJ, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Harikrishnan, S, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, He, F, Heredia-Pi, IB, Herteliu, C, Hilawe, EH, Hoek, HW, Horita, N, Hosgood, HD, Hostiuc, S, Hotez, PJ, Hoy, DG, Hsairi, M, Htet, AS, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Igumbor, EU, Ileanu, BV, Inoue, M, Irenso, AA, Irvine, CMS, Islam, N, Jacobsen, KH, Jaenisch, T, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jensen, PN, Jha, V, Jin, Y, John, D, John, O, Johnson, SC, Jonas, JB, Jurisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Karthikeyan, G, Kasaeian, A, Kassaw, NA, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kaul, A, Kawakami, N, Kazanjan, K, Keiyoro, PN, Kelbore, SG, Kemp, AH, Kengne, AP, Keren, A, Kereselidze, M, Kesavachandran, CN, Ketema, EB, Khader, YS, Khalil, IA, Khan, EA, Khan, G, Khang, Y-H, Khera, S, Khoja, ATA, Khosravi, MH, Kibret, GD, Kieling, C, Kim, C-I, Kim, D, Kim, P, Kim, S, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kishawi, S, Kissimova-Skarbek, KA, Kissoon, N, Kivimaki, M, Knudsen, AK, Kokubo, Y, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulikoff, XR, Kulkarni, VS, Kumar, GA, Kumar, P, Kumsa, FA, Kutz, M, Lachat, C, Lagat, AK, Lager, ACJ, Lal, DK, Lalloo, R, Lambert, N, Lan, Q, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Lavados, PM, Laxmaiah, A, Lee, PH, Leigh, J, Leung, J, Leung, R, Levi, M, Li, Y, Liao, Y, Liben, ML, Lim, SS, Linn, S, Lipshultz, SE, Liu, S, Lodha, R, Logroscino, G, Lorch, SA, Lorkowski, S, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Ma, S, Macarayan, ERK, Machado, IE, Mackay, MT, Abd el Razek, MM, Magis-Rodriguez, C, Mahdavi, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marczak, LB, Marks, GB, Martinez-Raga, J, Martins-Melo, FR, Massano, J, Maulik, PK, Mayosi, BM, Mazidi, M, McAlinden, C, McGarvey, ST, McGrath, JJ, Mckee, M, Mehata, S, Mehndiratta, MM, Mehta, KM, Meier, T, Mekonnen, TC, Meles, KG, Memiah, P, Memish, ZA, Mendoza, W, Mengesha, MM, Mengistie, MA, Tadese, D, Menon, MGR, Menota, BG, Mensah, GA, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Mikesell, J, Miller, TR, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Misganaw, A, Mishra, SR, Mohammad, KA, Mohammadi, A, Mohammed, KESM, Mohan, MBV, Mohanty, SK, Mokdad, AH, Assaye, AM, Mollenkopf, SK, Molokhia, M, Monasta, L, Hernandez, JCM, Montico, M, Mooney, MD, Moore, AR, Moradi-Lakeh, M, Moraga, P, Morawska, L, Velasquez, IM, Mori, R, Morrison, SD, Mruts, KB, Mueller, UO, Mullany, E, Muller, K, Venkata, G, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naidoo, KS, Nanda, L, Nangia, V, Nascimento, BR, Natarajan, G, Negoi, I, Cuong, TN, Ningrum, DNA, Nisar, MI, Nomura, M, Vuong, MN, Norheim, OF, Norrving, B, Noubiap, JJN, Nyakarahuka, L, Obermeyer, CM, O'Donnell, MJ, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olusanya, BO, Olusanya, JO, Oren, E, Ortiz, A, Osgood-Zimmerman, A, Ota, E, Owolabi, MO, Oyekale, AS, Pa, M, Pacella, RE, Pakhale, S, Pana, A, Panda, BK, Panda-Jonas, S, Park, E-K, Parsaeian, M, Patel, T, Patten, SB, Patton, GC, Paudel, D, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pervaiz, A, Pesudovs, K, Peterson, CB, Petri, WA, Petzold, M, Phillips, MR, Piel, FB, Pigott, DM, Pishgar, F, Plass, D, Polinder, S, Popova, S, Postma, MJ, Poulton, RG, Pourmalek, F, Prasad, N, Purwar, M, Qorbani, M, Rabiee, RHS, Radfar, A, Rafay, A, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Ranabhat, CL, Rao, PV, Rawaf, S, Ray, SE, Rego, MAS, Rehm, J, Reiner, RC, Remuzzi, G, Renzaho, AMNN, Resnikoff, S, Rezaei, S, Rezai, MS, Ribeiro, AL, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, A, Rubagotti, E, Ruhago, GM, Saadat, S, Sabde, YD, Sachdev, PS, Sadat, N, Safdarian, M, Safiri, SSS, Sagar, R, Sahathevan, R, Sahebkar, A, Sahraian, MA, Salama, J, Salamati, P, Salomon, JA, Salvi, SS, Samy, AM, Sanabria, JR, Sanchez-Nino, MD, Santos, IS, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Sawhney, M, Saxena, S, Saylan, MI, Schmidt, MI, Schneider, IJC, Schutte, AE, Schwebel, DC, Schwendicke, F, Seedat, S, Seid, AM, Sepanlou, SG, Servan-Mori, EE, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shamsipour, M, Shamsizadeh, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Shen, J, Shetty, BP, Shi, P, Shibuya, K, Shigematsu, M, Shiri, R, Shiue, I, Shrime, MG, Sigfusdottir, ID, Silberberg, DH, Silpakit, N, Silva, DAS, Silva, JP, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, PK, Singh, V, Sinha, DN, Skiadaresi, E, Sligar, A, Smith, DL, Sobaih, BHA, Sobngwi, E, Soneji, S, Soriano, JB, Sreeramareddy, CT, Srinivasan, V, Stathopoulou, V, Steel, N, Stein, DJ, Steiner, C, Stockl, H, Stokes, MA, Strong, M, Sufiyan, MB, Suliankatchi, RA, Sunguya, BF, Sur, PJ, Swaminathan, S, Sykes, BL, Szoeke, CEI, Tabares-Seisdedos, R, Tadakamadla, SK, Tadese, F, Tandon, N, Tanne, D, Tarajia, M, Tavakkoli, M, Taveira, N, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Temsah, M-H, Terkawi, AS, Tesema, CL, Tesssema, B, Theis, A, Thomas, N, Thompson, AH, Thomson, AJ, Thrift, AG, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Topouzis, F, Tortajada, M, Tran, BX, Trujillo, TTU, Tsilimparis, N, Tuem, KB, Tuzcu, EM, Tyrovolas, S, Ukwaja, KN, Undurraga, EA, Uthman, OA, Uzochukwu, BSC, van Boven, JFM, Varakin, YY, Varughese, S, Vasankari, T, Vasconcelos, AMN, Venketasubramanian, N, Vidavalur, R, Violante, FS, Vishnu, A, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Waid, JL, Wakayo, T, Wang, Y-P, Weichenthal, S, Weiderpass, E, Weintraub, RG, Werdecker, A, Wesana, J, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Workicho, A, Workie, SB, Xavier, D, Xu, G, Yaghoubi, M, Yakob, B, Yalew, AZ, Yan, LL, Yano, Y, Yaseri, M, Ye, P, Yimam, HH, Yip, P, Yirsaw, BD, Yonemoto, N, Yoon, S-J, Yotebieng, M, Younis, MZ, Zaidi, Z, Zaki, MES, Zeeb, H, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zodpey, S, Zuhlke, LJ, Lopez, AD, and Murray, CJL

Published
2017

13. Global, regional, and national levels of maternal mortality, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Kassebaum, NJ, Barber, RM, Bhutta, ZA, Dandona, L, Gething, PW, Hay, SI, Kinfu, Y, Larson, HJ, Liang, X, Lim, SS, Lopez, AD, Lozano, R, Mensah, GA, Mokdad, AH, Naghavi, M, Pinho, C, Salomon, JA, Steiner, C, Vos, T, Wang, H, Abajobir, AA, Abate, KH, Abbas, KM, Abd-Allah, F, Abdallat, MA, Abdulle, AM, Abera, SF, Aboyans, V, Abubakar, I, Abu-Rmeileh, NME, Achoki, T, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adou, AK, Afanvi, KA, Agarwal, A, Kiadaliri, AA, Ajala, ON, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, NKM, Alasfoor, D, Aldhahri, SF, Aldridge, RW, Alhabib, S, Ali, R, Alkerwi, A, Alla, F, Al-Raddadi, R, Alsharif, U, Martin, EA, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Andersen, HH, Anderson, GM, Antoine, RM, Antonio, CAT, Aregay, AF, Arnlov, J, Arora, M, Arsenijevic, VSA, Al, A, Asayesh, H, Atique, S, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Azzopardi, P, Bacha, U, Badawi, A, Bahit, MC, Balakrishnan, K, Banerjee, A, Barac, A, Barker-Collo, SL, Barnighausen, T, Basu, S, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, NW, Bekele, T, Bell, ML, Bennett, DA, Bensenor, IM, Berhane, A, Bernabe, E, Betsu, BD, Beyene, AS, Biadgilign, S, Bikbov, B, Bin Abdulhak, AA, Biroscak, BJ, Biryukov, S, Bisanzio, D, Bjertness, E, Blore, JD, Brainin, M, Brazinova, A, Breitborde, NJK, Brugha, TS, Butt, ZA, Campos-Nonato, IR, Campuzano, JC, Cardenas, R, Carrero, JJ, Carter, A, Casey, DC, Castaneda-Oquela, CA, Castro, RE, Catala-Lopez, F, Cavalleri, F, Chang, H-Y, Chang, J-C, Chavan, L, Chibueze, CE, Chisumpa, VH, Choi, J-YJ, Chowdhury, R, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coates, MM, Coggeshall, M, Colistro, V, Colquhoun, SM, Cooper, C, Cooper, LT, Cortinovis, M, Dahiru, T, Damasceno, A, Danawi, H, Dandona, R, Das Neves, J, De Leo, D, Dellavalle, RP, Deribe, K, Deribew, A, Jarlais, DCD, Dharmaratne, SD, Dicker, DJ, Ding, EL, Dossou, E, Dubey, M, Ebel, BE, Ellingsen, CL, Elyazar, I, Endries, AY, Ermakov, SP, Eshrati, B, Esteghamati, A, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Fereshtehnejad, S-M, Fernandes, JC, Fischer, F, Fitchett, JRA, Fleming, T, Gt, NF, Franca, EB, Franklin, RC, Fraser, MS, Friedman, J, Pullman, N, Furst, T, Futran, ND, Gambashidze, K, Gamkrelidze, A, Gebre, T, Gebrehiwot, TT, Gebremedhin, AT, Gebremedhin, M, Gebru, AA, Geleijnse, JM, Gibney, KB, Giref, AZ, Giroud, M, Gishu, MD, Glaser, E, Goenka, S, Gomez-Dantes, H, Gona, P, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Gugnani, HC, Guo, Y, Gupta, R, Gupta, V, Hafezi-Nejad, N, Hailu, AD, Hailu, GB, Hamadeh, RR, Hamidi, S, Hancock, J, Handal, AJ, Hankey, GJ, Harb, HL, Harikrishnan, S, Harun, KM, Havmoeller, R, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Hoy, DG, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huybrechts, I, Huynh, C, Iannarone, M, Iburg, KM, Idrisov, BT, Iyer, VJ, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jee, SH, Jeemon, P, Jha, V, Jiang, G, Jiang, Y, Jibat, T, Jonas, JB, Kabir, Z, Kamal, R, Kan, H, Karch, A, Karletsos, D, Kasaeian, A, Kaul, A, Kawakami, N, Kayibanda, JF, Kazanjan, K, Kazi, DS, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Keren, A, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khan, AR, Khan, EA, Khang, Y-H, Khonelidze, I, Khosravi, A, Khubchandani, J, Kim, YJ, Kivipelto, M, Knibbs, LD, Kokubo, Y, Kosen, S, Koul, PA, Koyanagi, A, Krishnaswami, S, Defo, BK, Bicer, BK, Kudom, AA, Kulikoff, XR, Kulkarni, C, Kumar, GA, Kutz, MJ, Lal, DK, Lalloo, R, Lam, H, Lamadrid-Figueroa, H, Lan, Q, Larsson, A, Laryea, DO, Leigh, J, Leung, R, Li, Y, Lipshultz, SE, Liu, PY, Liu, S, Liu, Y, Lloyd, BK, Lotufo, PA, Lunevicius, R, Ma, S, El Razek, HMA, El Razek, MMA, Majdan, M, Majeed, A, Malekzadeh, R, Mapoma, CC, Marcenes, W, Margolis, DJ, Marquez, N, Masiye, F, Marzan, MB, Mason-Jones, AJ, Mazorodze, TT, Meaney, PA, Mehari, A, Mehndiratta, MM, Mena-Rodriguez, F, Mekonnen, AB, Melaku, YA, Memish, ZA, Mendoza, W, Meretoja, A, Meretoja, TJ, Mhimbira, FA, Miller, TR, Mills, EJ, Mirarefin, M, Misganaw, A, Ibrahim, NM, Mohammad, KA, Mohammadi, A, Mohammed, S, Mola, GLD, Monasta, L, Monis, JDLC, Hernandez, JCM, Montero, P, Montico, M, Mooney, MD, Moore, AR, Moradi-Lakeh, M, Morawska, L, Mori, R, Mueller, U, Murthy, GVS, Murthy, S, Nachega, JB, Naheed, A, Naldi, L, Nand, D, Nangia, V, Nash, D, Neupane, S, Newton, JN, Ng, M, Ngalesoni, FN, Nguhiu, P, Nguyen, G, Le Nguyen, Q, Nisar, MI, Nomura, M, Norheim, OF, Norman, RE, Nyakarahuka, L, Obermeyer, CM, Ogbo, FA, Oh, I-H, Ojelabi, FA, Olivares, PR, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ota, E, Oyekale, AS, Pa, M, Pain, A, Papantoniou, N, Park, E-K, Park, H-Y, Caicedo, AJP, Patten, SB, Paul, VK, Pereira, DM, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pillay, JD, Pishgar, F, Polinder, S, Pope, D, Pourmalek, F, Qorbani, M, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Ram, U, Ranabhat, CL, Rangaswamy, T, Rao, PV, Refaat, AH, Remuzzi, G, Violante, FS, Kassebaum, NJ, Barber, RM, Bhutta, ZA, Dandona, L, Gething, PW, Hay, SI, Kinfu, Y, Larson, HJ, Liang, X, Lim, SS, Lopez, AD, Lozano, R, Mensah, GA, Mokdad, AH, Naghavi, M, Pinho, C, Salomon, JA, Steiner, C, Vos, T, Wang, H, Abajobir, AA, Abate, KH, Abbas, KM, Abd-Allah, F, Abdallat, MA, Abdulle, AM, Abera, SF, Aboyans, V, Abubakar, I, Abu-Rmeileh, NME, Achoki, T, Adebiyi, AO, Adedeji, IA, Adelekan, AL, Adou, AK, Afanvi, KA, Agarwal, A, Kiadaliri, AA, Ajala, ON, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, NKM, Alasfoor, D, Aldhahri, SF, Aldridge, RW, Alhabib, S, Ali, R, Alkerwi, A, Alla, F, Al-Raddadi, R, Alsharif, U, Martin, EA, Alvis-Guzman, N, Amare, AT, Amberbir, A, Amegah, AK, Ammar, W, Amrock, SM, Andersen, HH, Anderson, GM, Antoine, RM, Antonio, CAT, Aregay, AF, Arnlov, J, Arora, M, Arsenijevic, VSA, Al, A, Asayesh, H, Atique, S, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Azzopardi, P, Bacha, U, Badawi, A, Bahit, MC, Balakrishnan, K, Banerjee, A, Barac, A, Barker-Collo, SL, Barnighausen, T, Basu, S, Bayou, TA, Bayou, YT, Bazargan-Hejazi, S, Beardsley, J, Bedi, NW, Bekele, T, Bell, ML, Bennett, DA, Bensenor, IM, Berhane, A, Bernabe, E, Betsu, BD, Beyene, AS, Biadgilign, S, Bikbov, B, Bin Abdulhak, AA, Biroscak, BJ, Biryukov, S, Bisanzio, D, Bjertness, E, Blore, JD, Brainin, M, Brazinova, A, Breitborde, NJK, Brugha, TS, Butt, ZA, Campos-Nonato, IR, Campuzano, JC, Cardenas, R, Carrero, JJ, Carter, A, Casey, DC, Castaneda-Oquela, CA, Castro, RE, Catala-Lopez, F, Cavalleri, F, Chang, H-Y, Chang, J-C, Chavan, L, Chibueze, CE, Chisumpa, VH, Choi, J-YJ, Chowdhury, R, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coates, MM, Coggeshall, M, Colistro, V, Colquhoun, SM, Cooper, C, Cooper, LT, Cortinovis, M, Dahiru, T, Damasceno, A, Danawi, H, Dandona, R, Das Neves, J, De Leo, D, Dellavalle, RP, Deribe, K, Deribew, A, Jarlais, DCD, Dharmaratne, SD, Dicker, DJ, Ding, EL, Dossou, E, Dubey, M, Ebel, BE, Ellingsen, CL, Elyazar, I, Endries, AY, Ermakov, SP, Eshrati, B, Esteghamati, A, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Fereshtehnejad, S-M, Fernandes, JC, Fischer, F, Fitchett, JRA, Fleming, T, Gt, NF, Franca, EB, Franklin, RC, Fraser, MS, Friedman, J, Pullman, N, Furst, T, Futran, ND, Gambashidze, K, Gamkrelidze, A, Gebre, T, Gebrehiwot, TT, Gebremedhin, AT, Gebremedhin, M, Gebru, AA, Geleijnse, JM, Gibney, KB, Giref, AZ, Giroud, M, Gishu, MD, Glaser, E, Goenka, S, Gomez-Dantes, H, Gona, P, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Gugnani, HC, Guo, Y, Gupta, R, Gupta, V, Hafezi-Nejad, N, Hailu, AD, Hailu, GB, Hamadeh, RR, Hamidi, S, Hancock, J, Handal, AJ, Hankey, GJ, Harb, HL, Harikrishnan, S, Harun, KM, Havmoeller, R, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Hoy, DG, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huybrechts, I, Huynh, C, Iannarone, M, Iburg, KM, Idrisov, BT, Iyer, VJ, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jee, SH, Jeemon, P, Jha, V, Jiang, G, Jiang, Y, Jibat, T, Jonas, JB, Kabir, Z, Kamal, R, Kan, H, Karch, A, Karletsos, D, Kasaeian, A, Kaul, A, Kawakami, N, Kayibanda, JF, Kazanjan, K, Kazi, DS, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Keren, A, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khan, AR, Khan, EA, Khang, Y-H, Khonelidze, I, Khosravi, A, Khubchandani, J, Kim, YJ, Kivipelto, M, Knibbs, LD, Kokubo, Y, Kosen, S, Koul, PA, Koyanagi, A, Krishnaswami, S, Defo, BK, Bicer, BK, Kudom, AA, Kulikoff, XR, Kulkarni, C, Kumar, GA, Kutz, MJ, Lal, DK, Lalloo, R, Lam, H, Lamadrid-Figueroa, H, Lan, Q, Larsson, A, Laryea, DO, Leigh, J, Leung, R, Li, Y, Lipshultz, SE, Liu, PY, Liu, S, Liu, Y, Lloyd, BK, Lotufo, PA, Lunevicius, R, Ma, S, El Razek, HMA, El Razek, MMA, Majdan, M, Majeed, A, Malekzadeh, R, Mapoma, CC, Marcenes, W, Margolis, DJ, Marquez, N, Masiye, F, Marzan, MB, Mason-Jones, AJ, Mazorodze, TT, Meaney, PA, Mehari, A, Mehndiratta, MM, Mena-Rodriguez, F, Mekonnen, AB, Melaku, YA, Memish, ZA, Mendoza, W, Meretoja, A, Meretoja, TJ, Mhimbira, FA, Miller, TR, Mills, EJ, Mirarefin, M, Misganaw, A, Ibrahim, NM, Mohammad, KA, Mohammadi, A, Mohammed, S, Mola, GLD, Monasta, L, Monis, JDLC, Hernandez, JCM, Montero, P, Montico, M, Mooney, MD, Moore, AR, Moradi-Lakeh, M, Morawska, L, Mori, R, Mueller, U, Murthy, GVS, Murthy, S, Nachega, JB, Naheed, A, Naldi, L, Nand, D, Nangia, V, Nash, D, Neupane, S, Newton, JN, Ng, M, Ngalesoni, FN, Nguhiu, P, Nguyen, G, Le Nguyen, Q, Nisar, MI, Nomura, M, Norheim, OF, Norman, RE, Nyakarahuka, L, Obermeyer, CM, Ogbo, FA, Oh, I-H, Ojelabi, FA, Olivares, PR, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ota, E, Oyekale, AS, Pa, M, Pain, A, Papantoniou, N, Park, E-K, Park, H-Y, Caicedo, AJP, Patten, SB, Paul, VK, Pereira, DM, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pillay, JD, Pishgar, F, Polinder, S, Pope, D, Pourmalek, F, Qorbani, M, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Ram, U, Ranabhat, CL, Rangaswamy, T, Rao, PV, Refaat, AH, Remuzzi, G, and Violante, FS

Abstract

BACKGROUND: In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. METHODS: We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10-54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. FINDINGS: Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy

Published
2016

14. Burden of Diarrhea in the Eastern Mediterranean Region, 1990-2013: Findings from the Global Burden of Disease Study 2013

Author

Khalil, I, Colombara, DV, Forouzanfar, MH, Troeger, C, Daoud, F, Moradi-Lakeh, M, El Bcheraoui, C, Rao, PC, Afshin, A, Charara, R, Abate, KH, Abd El Razek, MM, Abd-Allah, F, Abu-Elyazeed, R, Kiadaliri, AA, Akanda, AS, Akseer, N, Alam, K, Alasfoor, D, Ali, R, AlMazroa, MA, Alomari, MA, Al-Raddadi, RMS, Alsharif, U, Alsowaidi, S, Altirkawi, KA, Alvis-Guzman, N, Ammar, W, Antonio, CAT, Asayesh, H, Asghar, RJ, Atique, S, Awasthi, A, Bacha, U, Badawi, A, Barac, A, Bedi, N, Bekele, T, Bensenor, IM, Betsu, BD, Bhutta, Z, Bin Abdulhak, AA, Butt, ZA, Danawi, H, Dubey, M, Endries, AY, Faghmous, IDA, Farid, T, Farvid, MS, Farzadfar, F, Fereshtehnejad, S-M, Fischer, F, Fitchett, JRA, Gibney, KB, Ginawi, IAM, Gishu, MD, Gugnani, HC, Gupta, R, Hailu, GB, Hamadeh, RR, Hamidi, S, Harb, HL, Hedayati, MT, Hsairi, M, Husseini, A, Jahanmehr, N, Javanbakht, M, Jibat, T, Jonas, JB, Kasaeian, A, Khader, YS, Khan, AR, Khan, EA, Khan, G, Khoja, TAM, Kinfu, Y, Kissoon, N, Koyanagi, A, La, A, Latif, AAA, Lunevicius, R, Abd El Razek, HM, Majeed, A, Malekzadeh, R, Mehari, A, Mekonnen, AB, Melaku, YA, Memish, ZA, Mendoza, W, Misganaw, A, Mohamed, LAI, Nachega, JB, Quyen, LN, Nisar, MI, Peprah, EK, Platts-Mills, JA, Pourmalek, F, Qorbani, M, Rafay, A, Rahimi-Movaghar, V, Rahman, SU, Rai, RK, Rana, SM, Ranabhat, CL, Rao, SR, Refaat, AH, Riddle, M, Roshandel, G, Ruhago, GM, Saleh, MM, Sanabria, JR, Sawhney, M, Sepanlou, SG, Setegn, T, Sliwa, K, Sreeramareddy, CT, Sykes, BL, Tavakkoli, M, Tedla, BA, Terkawi, AS, Ukwaja, K, Uthman, OA, Westerman, R, Wubshet, M, Yenesew, MA, Yonemoto, N, Younis, MZ, Zaidi, Z, Zaki, MES, Al Rabeeah, AA, Wang, H, Naghavi, M, Vos, T, Lopez, AD, Murray, CJL, Mokdad, AH, Khalil, I, Colombara, DV, Forouzanfar, MH, Troeger, C, Daoud, F, Moradi-Lakeh, M, El Bcheraoui, C, Rao, PC, Afshin, A, Charara, R, Abate, KH, Abd El Razek, MM, Abd-Allah, F, Abu-Elyazeed, R, Kiadaliri, AA, Akanda, AS, Akseer, N, Alam, K, Alasfoor, D, Ali, R, AlMazroa, MA, Alomari, MA, Al-Raddadi, RMS, Alsharif, U, Alsowaidi, S, Altirkawi, KA, Alvis-Guzman, N, Ammar, W, Antonio, CAT, Asayesh, H, Asghar, RJ, Atique, S, Awasthi, A, Bacha, U, Badawi, A, Barac, A, Bedi, N, Bekele, T, Bensenor, IM, Betsu, BD, Bhutta, Z, Bin Abdulhak, AA, Butt, ZA, Danawi, H, Dubey, M, Endries, AY, Faghmous, IDA, Farid, T, Farvid, MS, Farzadfar, F, Fereshtehnejad, S-M, Fischer, F, Fitchett, JRA, Gibney, KB, Ginawi, IAM, Gishu, MD, Gugnani, HC, Gupta, R, Hailu, GB, Hamadeh, RR, Hamidi, S, Harb, HL, Hedayati, MT, Hsairi, M, Husseini, A, Jahanmehr, N, Javanbakht, M, Jibat, T, Jonas, JB, Kasaeian, A, Khader, YS, Khan, AR, Khan, EA, Khan, G, Khoja, TAM, Kinfu, Y, Kissoon, N, Koyanagi, A, La, A, Latif, AAA, Lunevicius, R, Abd El Razek, HM, Majeed, A, Malekzadeh, R, Mehari, A, Mekonnen, AB, Melaku, YA, Memish, ZA, Mendoza, W, Misganaw, A, Mohamed, LAI, Nachega, JB, Quyen, LN, Nisar, MI, Peprah, EK, Platts-Mills, JA, Pourmalek, F, Qorbani, M, Rafay, A, Rahimi-Movaghar, V, Rahman, SU, Rai, RK, Rana, SM, Ranabhat, CL, Rao, SR, Refaat, AH, Riddle, M, Roshandel, G, Ruhago, GM, Saleh, MM, Sanabria, JR, Sawhney, M, Sepanlou, SG, Setegn, T, Sliwa, K, Sreeramareddy, CT, Sykes, BL, Tavakkoli, M, Tedla, BA, Terkawi, AS, Ukwaja, K, Uthman, OA, Westerman, R, Wubshet, M, Yenesew, MA, Yonemoto, N, Younis, MZ, Zaidi, Z, Zaki, MES, Al Rabeeah, AA, Wang, H, Naghavi, M, Vos, T, Lopez, AD, Murray, CJL, and Mokdad, AH

Abstract

Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0-1) in Bahrain and Oman to 471 (95% UI = 245-763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520-989) in Syria to 40,869 (95% UI = 21,540-65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden.

Published
2016

15. The prevalence of refractive error in three communities of Cape Town, South Africa

Author

Nachega Jb, Harvey J, Otutu M, and David Meyer

Subjects
Refractive error, genetic structures, business.industry, Astigmatism, Eye care, medicine.disease, Subjective refraction, eye diseases, Confidence interval, cross sectional study: refraction, prevalence of refractive error, lcsh:Ophthalmology, lcsh:RE1-994, Informed consent, Cape, Structured interview, Medicine, Optometry, business, Demography
Abstract

The prevalence, distribution and demographic associations of refractive error in three communities in Cape Town, South Africa were assessed. In this cross-sectional study, a clustered random sampling procedure was used to recruit participants (n=176; age=40.6±14.7 years; males=76, females=96) from Khayelitsha, Milnerton, and Mitchell’s Plain. From March to May 2010, participants underwent autore-fraction and subjective refraction eye examinations.A structured interview was used to collect data on sociodemographics, age, gender, level of education, employment and race. Participants younger than 15 years, non-residents, or residents for less than six months, who declined signing the informed consent forms were excluded from the study. In this study myopia was defined as the spherical equivalent value in the better eye of −1.00D or worse and hyperopia as the spherical equivalent value in the better eye of ≥1.00D. Astigmatism was defined as −0.50 cylinder or worse in the better eye. The prevalence of myopia was 17.4% with a 90% confidence interval (CI) of 12.65-22.15, hyperopia was 13.4% (90% CI 9.13-17.67), and astigmatism was 60% (90% CI 53.86-66.14). Myopia was found to be significantly associated with race and age; while hyperopia was significantly associated with age, employment and race. The results of this study may assist in planning for eye care on district level. (S Afr Optom 2012 71(1) 32-38)

Published
2012

17. Update on World Health Organization HIV drug resistance prevention and assessment strategy: 2004-2011

Author

Jordan, Mr, Bennett, De, Wainberg, Ma, Havlir, D, Hammer, S, Yang, C, Morris, L, Peeters, M, Wensing, Am, Parkin, N, Nachega, Jb, Phillips, A, De Luca, Andrea, Geng, E, Calmy, A, Raizes, E, Sandstrom, P, Archibald, Cp, Perriëns, J, Mcclure, Cm, Hong, Sy, Mcmahon, Jh, Dedes, N, Sutherland, D, Bertagnolio, S., De Luca, Andrea (ORCID:0000-0002-8311-6935), Jordan, Mr, Bennett, De, Wainberg, Ma, Havlir, D, Hammer, S, Yang, C, Morris, L, Peeters, M, Wensing, Am, Parkin, N, Nachega, Jb, Phillips, A, De Luca, Andrea, Geng, E, Calmy, A, Raizes, E, Sandstrom, P, Archibald, Cp, Perriëns, J, Mcclure, Cm, Hong, Sy, Mcmahon, Jh, Dedes, N, Sutherland, D, Bertagnolio, S., and De Luca, Andrea (ORCID:0000-0002-8311-6935)

Abstract

The HIV drug resistance (HIVDR) prevention and assessment strategy, developed by the World Health Organization (WHO) in partnership with HIVResNet, includes monitoring of HIVDR early warning indicators, surveys to assess acquired and transmitted HIVDR, and development of an accredited HIVDR genotyping laboratory network to support survey implementation in resource-limited settings. As of June 2011, 52 countries had implemented at least 1 element of the strategy, and 27 laboratories had been accredited. As access to antiretrovirals expands under the WHO/Joint United Nations Programme on HIV/AIDS Treatment 2.0 initiative, it is essential to strengthen HIVDR surveillance efforts in the face of increasing concern about HIVDR emergence and transmission.

Published
2012

18. Chronic dissection of the thoracic aorta in a patient with tuberculous pleuro-pericarditis

Author

UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, UCL - MD/CHIR - Département de chirurgie, Nachega, JB, Vandercam, Bernard, Verhelst, Robert, Jacquet, Luc-Marie, d'Udekem, Y, Dion, R., Goenen, Martin, UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, UCL - MD/CHIR - Département de chirurgie, Nachega, JB, Vandercam, Bernard, Verhelst, Robert, Jacquet, Luc-Marie, d'Udekem, Y, Dion, R., and Goenen, Martin

Abstract

We describe a case of chronic dissection of thoracic aorta presumed to be due to tuberculosis from pleuro-pericarditis foci and who was cured by antituberculous therapy and surgery. With the recent increase of tuberculosis cases, tuberculous aortitis might become less rare and the clinicians should suspect this diagnosis in subjects with aortic dissection and history of tuberculosis.

Published
1998

19. Adherence to nonnucleoside reverse transcriptase inhibitor-based HIV therapy and virologic outcomes.

Author

Nachega JB, Hislop M, Dowdy DW, Chaisson RE, Regensberg L, Maartens G, Nachega, Jean B, Hislop, Michael, Dowdy, David W, Chaisson, Richard E, Regensberg, Leon, and Maartens, Gary

Abstract

Background: Adherence of 95% or more to unboosted protease regimens is required for optimal virologic suppression in HIV-1-infected patients. Whether the same is true for nonnucleoside reverse transcriptase inhibitor (NNRTI)-based therapy is unclear.Objective: To assess the relationship between adherence to NNRTI-based therapy and viral load in treatment-naive patients.Design: Observational cohort study.Setting: Private-sector HIV and AIDS disease management program in South Africa.Patients: 2821 adults infected with HIV who began NNRTI-based therapy between January 1998 and March 2003 (2764 patients [98%] were enrolled after December 2000).Measurements: Adherence was assessed by monthly pharmacy claims. The primary end point was sustained viral load suppression (<400 copies/mL) in 100% of recorded viral load measurements throughout follow-up. Secondary end points included time to initial viral load suppression and time to subsequent virologic failure (>400 copies/mL).Results: The median follow-up period was 2.2 years (interquartile range, 1.7 to 2.7 years). The proportion of patients with sustained viral load suppression ranged from 13% (41 of 325 patients) in patients who filled less than 50% of antiretroviral drug prescriptions to 73% (725 of 997 patients) in those who filled 100% of antiretroviral drug prescriptions. Each 10% increase in pharmacy claim adherence greater than 50% was associated with a mean absolute increase of 0.10 in the proportion of patients with sustained virologic suppression (P < 0.001). Predictors for shorter time to virologic failure after initial suppression in multivariable Cox regression included CD4+ T-cell counts of 0.50 x 10(9) cells/L or less (hazard ratio, 1.60 [95% CI, 1.22 to 2.10] vs. CD4+ T-cell counts >0.20 x 10(9) cells/L), baseline viral load greater than 10(5) copies/mL (hazard ratio, 1.39 [CI, 1.14 to 1.70]), nevirapine-based regimen (hazard ratio, 1.43 [CI, 1.16 to 1.75]), and low pharmacy claim adherence (hazard ratio, 1.58 [CI, 1.48 to 1.69], per 10% decrease in adherence to 50%).Limitations: Observational study with adherence stratification at study end and lack of standardized timing for outcome measurement.Conclusion: Virologic outcomes improve in a linear dose-response manner as adherence to NNRTI-based regimens increases beyond 50%. [ABSTRACT FROM AUTHOR]

Published
2007
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20. Successful treatment of Acanthamoeba rhinosinusitis in a patient with AIDS.

Author

Nachega JB, Rombaux P, Weynand B, Thomas G, and Zech F

Abstract

Acanthamoeba infection is a rare, difficult-to-treat, and often fatal, opportunistic parasitic infection in immunocompromised hosts, such as patients infected with HIV. We describe an aggressive nasal and sinus infection by Acanthamoeba spp. in a person with AIDS. The resolution of this Acanthamoeba infection was secondary to a multidisciplinary treatment approach involving a combination of surgery as well as high-dose amphotericin B plus 5-fluorocytosine. In the era of the HIV/AIDS pandemic, the present report underscores the need for early identification and prompt aggressive treatment to ensure successful management of this rare but potentially fatal opportunistic infection. [ABSTRACT FROM AUTHOR]

Published
2005
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22. Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

Author

Lozano, Rafael, Fullman, Nancy, Abate, Degu, Abay, Solomon M, Abbafati, Cristiana, Abbasi, Nooshin, Abbastabar, Hedayat, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abdel-Rahman, Omar, Abdi, Alireza, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abebe, Nebiyu Dereje, Abebe, Zegeye, Abejie, Ayenew Negesse, Abera, Semaw F, Abil, Olifan Zewdie, Aboyans, Victor, Abraha, Haftom Niguse, Abrham, Aklilu Roba, Abu-Raddad, Laith Jamal, Abu-Rmeileh, Niveen Me, Abyu, Gebre Y, Accrombessi, Manfred Mario Kokou, Acharya, Dilaram, Acharya, Pawan, Adamu, Abdu A, Adebayo, Oladimeji M, Adedeji, Isaac Akinkunmi, Adedoyin, Rufus Adesoji, Adekanmbi, Victor, Adetokunboh, Olatunji O, Adhena, Beyene Meressa, Adhikari, Tara Ballav, Adib, Mina G, Adou, Arsène Kouablan, Adsuar, Jose C, Afarideh, Mohsen, Afshari, Mahdi, Afshin, Ashkan, Agarwal, Gina, Aghayan, Sargis Aghasi, Agius, Dominic, Agrawal, Anurag, Agrawal, Sutapa, Ahmadi, Alireza, Ahmadi, Mehdi, Ahmadieh, Hamid, Ahmed, Muktar Beshir, Ahmed, Sayem, Akalu, Temesgen Yihunie, Akanda, Ali S, Akbari, Mohammad Esmaeil, Akibu, Mohammed, Akinyemi, Rufus Olusola, Akinyemiju, Tomi, Akseer, Nadia, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Tahiya, Albujeer, Ammar, Alebel, Animut, Alene, Kefyalew Addis, Al-Eyadhy, Ayman, Alhabib, Samia, Ali, Raghib, Alijanzadeh, Mehran, Alizadeh-Navaei, Reza, Aljunid, Syed Mohamed, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine A, Almasi, Ali, Al-Maskari, Fatma, Al-Mekhlafi, Hesham M, Alonso, Jordi, Al-Raddadi, Rajaa M, Alsharif, Ubai, Altirkawi, Khalid, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amenu, Kebede, Amini, Erfan, Ammar, Walid, Anber, Nahla Hamed, Anderson, Jason A, Andrei, Catalina Liliana, Androudi, Sofia, Animut, Megbaru Debalkie, Anjomshoa, Mina, Ansari, Hossein, Ansariadi, Ansariadi, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Anwari, Palwasha, Appiah, Lambert Tetteh, Aremu, Olatunde, Areri, Habtamu Abera, Ärnlöv, Johan, Arora, Monika, Aryal, Krishna K, Asayesh, Hamid, Asfaw, Ephrem Tsegay, Asgedom, Solomon Weldegebreal, Asghar, Rana Jawad, Assadi, Reza, Ataro, Zerihun, Atique, Suleman, Atre, Sachin R, Atteraya, Madhu Sudhan, Ausloos, Marcel, Avila-Burgos, Leticia, Avokpaho, Euripide F G A, Awasthi, Ashish, Ayala Quintanilla, Beatriz Paulina, Ayele, Henok Tadesse, Ayele, Yohanes, Ayer, Rakesh, Azarpazhooh, Mahmoud Reza, Azzopardi, Peter S, Azzopardi-Muscat, Natasha, Babalola, Tesleem Kayode, Babazadeh, Arefeh, Badali, Hamid, Badawi, Alaa, Balakrishnan, Kalpana, Bali, Ayele Geleto, Banach, Maciej, Banerjee, Amitava, Banoub, Joseph Adel Mattar, Banstola, Amrit, Barac, Aleksandra, Barboza, Miguel A, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barrero, Lope H, Barthelemy, Celine M, Bassat, Quique, Basu, Arindam, Basu, Sanjay, Battista, Robert J, Baune, Bernhard T, Baynes, Habtamu Wondifraw, Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Behzadifar, Meysam, Béjot, Yannick, Bekele, Bayu Begashaw, Belachew, Abate Bekele, Belay, Aregawi Gebreyesus, Belay, Saba Abraham, Belay, Yihalem Abebe, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Benzian, Habib, Berhane, Adugnaw, Berhe, Abadi Kidanemariam, Berman, Adam E, Bernabe, Eduardo, Bernstein, Robert S, Bertolacci, Gregory J, Beuran, Mircea, Beyranvand, Tina, Bhala, Neeraj, Bhalla, Ashish, Bhansali, Anil, Bhattarai, Suraj, Bhaumik, Soumyadeep, Bhutta, Zulfiqar A, Biadgo, Belete, Biehl, Molly H, Bijani, Ali, Bikbov, Boris, Bililign, Nigus, Bin Sayeed, Muhammad Shahdaat, Birlik, Sait Mentes, Birungi, Charles, Bisanzio, Donal, Biswas, Tuhin, Bitew, Helen, Bizuneh, Hailemichael, Bjertness, Espen, Bobasa, Eshetu Mulisa, Boufous, Soufiane, Bourne, Rupert, Bozorgmehr, Kayvan, Bragazzi, Nicola Luigi, Brainin, Michael, Brant, Luisa C, Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Briant, Paul Svitil, Britton, Gabrielle, Brugha, Traolach, Bukhman, Gene, Busse, Reinhard, Butt, Zahid A, Cahuana-Hurtado, Lucero, Callender, Charlton SKH, Campos-Nonato, Ismael R, Campuzano Rincon, Julio Cesar, Cano, Jorge, Car, Josip, Car, Mate, Cárdenas, Rosario, Carrero, Juan J, Carter, Austin, Carvalho, Félix, Castañeda-Orjuela, Carlos A, Castillo Rivas, Jacqueline, Castro, Franz, Causey, Kate, Çavlin, Alanur, Cercy, Kelly M, Cerin, Ester, Chaiah, Yazan, Chalek, Julian, Chang, Hsing-Yi, Chang, Jung-Chen, Chattopadhyay, Aparajita, Chattu, Vijay Kumar, Chaturvedi, Pankaj, Chiang, Peggy Pei-Chia, Chin, Ken Lee, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal, Choi, Jee-Young J, Chowdhury, Rajiv, Christensen, Hanne, Christopher, Devasahayam J, Chung, Sheng-Chia, Cicuttini, Flavia M, Ciobanu, Liliana G, Cirillo, Massimo, Claro, Rafael M, Claßen, Thomas Khaled Dwayne, Cohen, Aaron J, Collado-Mateo, Daniel, Cooper, Cyrus, Cooper, Leslie Trumbull, Cornaby, Leslie, Cortinovis, Monica, Costa, Megan, Cousin, Ewerton, Cromwell, Elizabeth A, Crowe, Christopher Stephen, Cunningham, Matthew, Daba, Alemneh Kabeta, Dadi, Abel Fekadu, Dandona, Lalit, Dandona, Rakhi, Dang, Anh Kim, Dargan, Paul I, Daryani, Ahmad, Das, Siddharth K, Das Gupta, Rajat, das Neves, José, Dasa, Tamirat Tesfaye, Dash, Aditya Prasad, Davis, Adrian C, Davitoiu, Dragos Virgil, Davletov, Kairat, Dayama, Anand, de Courten, Barbora, De Leo, Diego, De Neve, Jan-Walter, De Steur, Hans, Degefa, Meaza Girma, Degenhardt, Louisa, Degfie, Tizta Tilahun, Deiparine, Selina, Dellavalle, Robert P, Demoz, Gebre Teklemariam, Demtsu, Balem, Denova-Gutiérrez, Edgar, Deribe, Kebede, Dervenis, Nikolaos, Dessie, Getenet Ayalew, Dey, Subhojit, Dharmaratne, Samath D, Dhimal, Meghnath, Dicker, Daniel, Dinberu, Mesfin Tadese, Ding, Eric L, Djalalinia, Shirin, Do, Huyen Phuc, Dokova, Klara, Doku, David Teye, Douwes-Schultz, Dirk, Driscoll, Tim Robert, Duan, Leilei, Dubey, Manisha, Dubljanin, Eleonora, Duken, Eyasu Ejeta, Duncan, Bruce B, Duraes, Andre R, Ebrahimpour, Soheil, Edvardsson, David, El Bcheraoui, Charbel, Eldrenkamp, Erika, El-Khatib, Ziad, Elyazar, Iqbal RF, Enayati, Ahmadali, Endries, Aman Yesuf, Eshrati, Babak, Eskandarieh, Sharareh, Esteghamati, Alireza, Esteghamati, Sadaf, Estep, Kara, Fakhar, Mahdi, Fakhim, Hamed, Fanzo, Jessica, Faramarzi, Mahbobeh, Fareed, Mohammad, Farhadi, Farzaneh, Farid, Talha A, Farinha, Carla Sofia e Sá, Farioli, Andrea, Faro, Andre, Farvid, Maryam S, Farzadfar, Farshad, Farzaei, Mohammad Hosein, Farzam, Hossein, Fazaeli, Ali Akbar, Fazeli, Mir Sohail, Feigin, Valery L, Feigl, Andrea B, Fekadu, Wubalem, Feldman, Rachel, Fentahun, Netsanet, Fereshtehnejad, Seyed-Mohammad, Fernandes, Eduarda, Fernandes, Joao C, Feyissa, Garumma Tolu, Fijabi, Daniel Obadare, Filip, Irina, Finegold, Samuel, Finger, Jonas David, Fischer, Florian, Fitzmaurice, Christina, Flor, Luisa Sorio, Foigt, Nataliya A, Foreman, Kyle J, Frank, Tahvi D, Franklin, Richard Charles, Fukumoto, Takeshi, Fukutaki, Kai, Fuller, John E, Fürst, Thomas, Furtado, João M, Gakidou, Emmanuela, Gallus, Silvano, Gankpe, Fortune Gbetoho, Gansevoort, Ron T, Garcia, Ana Cristina, Garcia-Basteiro, Alberto L, Garcia-Gordillo, Miguel A, Gardner, William M, Gebre, Abadi Kahsu, Gebre, Teshome, Gebregergs, Gebremedhin Berhe, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebremichael, Bereket, Gebremichael, Teklu Gebrehiwo, Gelano, Tilayie Feto, Geleijnse, Johanna M, Geramo, Yilma Chisha Dea, Getachew, Sefonias, Gething, Peter W, Gezae, Kebede Embaye, Ghadami, Mohammad Rasoul, Ghadimi, Reza, Ghadiri, Keyghobad, Ghasemi-Kasman, Maryam, Ghiasvand, Hesam, Ghimire, Mamata, Ghoshal, Aloke Gopal, Giampaoli, Simona, Gill, Paramjit Singh, Gill, Tiffany K, Giussani, Giorgia, Gnedovskaya, Elena V, Goldberg, Ellen M, Goli, Srinivas, Gona, Philimon N, Goodridge, Amador, Gopalani, Sameer Vali, Gorman, Taren M, Goto, Atsushi, Goulart, Alessandra C, Goulart, Bárbara Niegia Garcia, Grada, Ayman, Griswold, Max G, Grosso, Giuseppe, Gugnani, Harish Chander C, Guillemin, Francis, Guimaraes, Andre Luiz Sena, Guo, Yuming, Gupta, Prakash C, Gupta, Rahul, Gupta, Rajeev, Gupta, Tanush, Ha, Giang Hai, Haagsma, Juanita A, Hachinski, Vladimir, Hafezi-Nejad, Nima, Haghparast Bidgoli, Hassan, Hagos, Tekleberhan B, Haile, Michael Tamene, Hailegiyorgis, Tewodros Tesfa, Hailu, Gessessew Bugssa, Haj-Mirzaian, Arvin, Haj-Mirzaian, Arya, Hamadeh, Randah R, Hamidi, Samer, Hankey, Graeme J, Harb, Hilda L, Harikrishnan, Sivadasanpillai, Haririan, Hamidreza, Haro, Josep Maria, Hasan, Mehedi, Hassankhani, Hadi, Hassen, Hamid Yimam, Havmoeller, Rasmus, Hawley, Caitlin N, Hay, Simon I, He, Yihua, Hedayatizadeh-Omran, Akbar, Hegazy, Mohamed I, Heibati, Behzad, Heidari, Behnam, Heidari, Mohsen, Hendrie, Delia, Henok, Andualem, Heredia-Pi, Ileana, Herteliu, Claudiu, Heydarpour, Behzad, Heydarpour, Fatemeh, Heydarpour, Sousan, Hibstu, Desalegn T, Híjar, Martha, Hoek, Hans W, Hoffman, Daniel J, Hole, Michael K, Homaie Rad, Enayatollah, Hoogar, Praveen, Horita, Nobuyuki, Hosgood, H Dean, Hosseini, Seyed Mostafa, Hosseinzadeh, Mehdi, Hostiuc, Mihaela, Hostiuc, Sorin, Hotez, Peter J, Hoy, Damian G, Hsairi, Mohamed, Hsiao, Thomas, Hu, Guoqing, Huang, John J, Hughes, Caitlyn, Huynh, Chantal K, Igumbor, Ehimario U, Ikeda, Chad Thomas, Ilesanmi, Olayinka Stephen, Iqbal, Usman, Irvani, Seyed Sina Naghibi, Irvine, Caleb Mackay Salpeter, Islam, Sheikh Mohammed Shariful, Islami, Farhad, Ivers, Rebecca Q, Izadi, Neda, Jacobsen, Kathryn H, Jahangiry, Leila, Jahanmehr, Nader, Jain, Sudhir Kumar, Jakovljevic, Mihajlo, Jalu, Moti Tolera, Jamal, Amr A, James, Spencer L, Jassal, Simerjot K, Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jeemon, Panniyammakal, Jha, Ravi Prakash, Jha, Vivekanand, Ji, John S, Johnson, Catherine O, Johnson, Sarah C, Jonas, Jost B, Jonnagaddala, Jitendra, Jorjoran Shushtari, Zahra, Joshi, Ankur, Jozwiak, Jacek Jerzy, Jungari, Suresh Banayya, Jürisson, Mikk, K, Madhanraj, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kahssay, Molla, Kalani, Rizwan, Kapil, Umesh, Karami, Manoochehr, Karami Matin, Behzad, Karanikolos, Marina, Karimi, Narges, Karimi, Seyed M, Karimi-Sari, Hamidreza, Kasaeian, Amir, Kassa, Dessalegn H, Kassa, Getachew Mullu, Kassa, Tesfaye Dessale, Kassa, Zemenu Yohannes, Kassebaum, Nicholas J, Katikireddi, Srinivasa Vittal, Kaul, Anil, Kawakami, Norito, Kazemi, Zhila, Karyani, Ali Kazemi, Kazi, Dhruv Satish, KC, Prakash, Kebede, Seifu, Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Grant Rodgers, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khafaei, Behzad, Khafaie, Morteza Abdullatif, Khajavi, Alireza, Khalid, Nauman, Khalil, Ibrahim A, Khan, Ejaz Ahmad, Khan, Muhammad Shahzeb, Khan, Muhammad Ali, Khang, Young-Ho, Khanna, Tripti, Khater, Mona M, Khatony, Alireza, Khazaeipour, Zahra, Khazaie, Habibolah, Khoja, Abdullah T, Khosravi, Ardeshir, Khosravi, Mohammad Hossein, Khubchandani, Jagdish, Kiadaliri, Aliasghar A, Kiarie, Helen W, Kibret, Getiye D, Kiirithio, Daniel N, Kim, Daniel, Kim, Jun Y, Kim, Young-Eun, Kim, Yun Jin, Kimokoti, Ruth W, Kinfu, Yohannes, Kinra, Sanjay, Kisa, Adnan, Kissimova-Skarbek, Katarzyna, Kissoon, Niranjan, Kivimäki, Mika, Kocarnik, Jonathan M, Kochhar, Sonali, Kokubo, Yoshihiro, Kolola, Tufa, Kopec, Jacek A, Kosek, Margaret N, Kosen, Soewarta, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael A, Krishan, Kewal, Krohn, Kristopher J, Kuate Defo, Barthelemy, Kucuk Bicer, Burcu, Kudom, Andreas A, Kulikoff, Xie Rachel, Kumar, G Anil, Kumar, Manasi, Kumar, Pushpendra, Kutz, Michael J, Kyu, Hmwe Hmwe, Lachat, Carl, Lad, Deepesh P, Lad, Sheetal D, Lafranconi, Alessandra, Lagat, Abraham K, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lami, Faris Hasan, Lamichhane, Prabhat, Lan, Qing, Lang, Justin J, Lansingh, Van C, Lansky, Sonia, Larson, Heidi J, Larsson, Anders O, Laryea, Dennis Odai, Lassi, Zohra S, Latifi, Arman, Lau, Kathryn Mei-Ming, Laxmaiah, Avula, Lazarus, Jeffrey V, Leasher, Janet L, Lebedev, Georgy, Ledesma, Jorge R, Lee, James B, Lee, Paul H, Leever, Andrew T, Leigh, James, Leinsalu, Mall, Leshargie, Cheru Tesema, Leung, Janni, Lewycka, Sonia, Li, Shanshan, Li, Xiaohong, Li, Yichong, Liang, Juan, Liang, Xiaofeng, Liben, Misgan Legesse, Lim, Lee-Ling, Limenih, Miteku Andualem, Linn, Shai, Liu, Shiwei, Liu, Yang, Lodha, Rakesh, Logroscino, Giancarlo, Lopez, Alan D, Lorkowski, Stefan, Lotufo, Paulo A, Lucchesi, Lydia R, Lyons, Ronan A, Macarayan, Erlyn Rachelle King, Mackay, Mark T, Maddison, Emilie R, Madotto, Fabiana, Maghavani, Dhaval P, Magis-Rodriguez, Carlos, Mahotra, Narayan Bahadur, Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Mamun, Abdullah A, Manda, Ana-Laura, Mandarano-Filho, Luiz Garcia, Mangalam, Srikanth, Manguerra, Helena, Mansournia, Mohammad Ali, Mapoma, Chabila Christopher, Maravilla, Joemer C, Marcenes, Wagner, Marks, Ashley, Martin, Randall V, Martins, Sheila C O, Martins-Melo, Francisco Rogerlândio, Martopullo, Ira, Mashamba-Thompson, Tivani Phosa, Massenburg, Benjamin Ballard, Mathur, Manu Raj, Maulik, Pallab K, Mazidi, Mohsen, McAlinden, Colm, McGrath, John J, McKee, Martin, McMahon, Brian J, Mehata, Suresh, Mehndiratta, Man Mohan, Mehrotra, Ravi, Mehta, Kala M, Mehta, Varshil, Mejia-Rodriguez, Fabiola, Mekonen, Tesfa, Mekonnen, Tefera C Chane, Meles, Hagazi Gebre, Melese, Addisu, Melku, Mulugeta, Memiah, Peter T N, Memish, Ziad A, Mendoza, Walter, Mengistu, Desalegn Tadese, Mengistu, Getnet, Mensah, George A, Mensink, Gert B M, Mereta, Seid Tiku, Meretoja, Atte, Meretoja, Tuomo J, Mestrovic, Tomislav, Mezgebe, Haftay Berhane, Miazgowski, Bartosz, Miazgowski, Tomasz, Millear, Anoushka I, Miller, Ted R, Miller-Petrie, Molly Katherine, Milne, George J, Mini, G K, Minnig, Shawn P, Mirabi, Parvaneh, Mirarefin, Mojde, Mirrakhimov, Erkin M, Misganaw, Awoke Temesgen, Mitchell, Philip B, Moazen, Babak, Moghadamnia, Ali Akbar, Mohajer, Bahram, Mohammad, Karzan Abdulmuhsin, Mohammadi, Moslem, Mohammadifard, Noushin, Mohammadnia-Afrouzi, Mousa, Mohammed, Mohammed A, Mohammed, Shafiu, Mohan, Murali B V, Mohan, Viswanathan, Mohebi, Farnam, Moitra, Modhurima, Mokdad, Ali H, Molokhia, Mariam, Monasta, Lorenzo, Montañez, Julio Cesar, Moosazadeh, Mahmood, Moradi, Ghobad, Moradi, Mahmoudreza, Moradi-Lakeh, Maziar, Moradinazar, Mehdi, Moraga, Paula, Morawska, Lidia, Morgado-da-Costa, Joana, Morisaki, Naho, Morrison, Shane Douglas, Mosapour, Abbas, Moschos, Marilita M, Mountjoy-Venning, W Cliff, Mouodi, Simin, Mousavi, Seyyed Meysam, Muche, Achenef Asmamaw, Muchie, Kindie Fentahun, Mueller, Ulrich Otto, Muhammed, Oumer Sada S, Mukhopadhyay, Satinath, Mullany, Erin C, Muller, Kate, Mumford, John Everett, Murhekar, Manoj, Murthy, G V S, Murthy, Srinivas, Musa, Jonah, Musa, Kamarul Imran, Mustafa, Ghulam, Muthupandian, Saravanan, Nabhan, Ashraf F, Nachega, Jean B, Nagarajan, Ahamarshan Jayaraman, Nagel, Gabriele, Naghavi, Mohsen, Naheed, Aliya, Nahvijou, Azin, Naidoo, Kovin, Naik, Gurudatta, Naik, Nitish, Najafi, Farid, Naldi, Luigi, Nam, Hae Sung, Nangia, Vinay, Nansseu, Jobert Richie, Nascimento, Bruno Ramos, Nawaz, Haseeb, Neamati, Nahid, Negoi, Ionut, Negoi, Ruxandra Irina, Neupane, Subas, Newton, Charles Richard James, Ngalesoni, Frida N, Ngunjiri, Josephine W, Nguyen, Anh, Nguyen, Grant, Nguyen, Ha, Nguyen, Huong Lan Thi, Nguyen, Huong Thanh, Nguyen, Minh, Nichols, Emma, Nigatu, Solomon Gedlu, Ningrum, Dina Nur Anggraini, Nirayo, Yirga Legesse, Nisar, Muhammad Imran, Nixon, Molly R, Nolutshungu, Nomonde, Nomura, Marika, Norheim, Ole F, Noroozi, Mehdi, Norrving, Bo, Noubiap, Jean Jacques, Nouri, Hamid Reza, Nourollahpour Shiadeh, Malihe, Nowroozi, Mohammad Reza, Nyasulu, Peter S, Obermeyer, Carla Makhlouf, Ofori-Asenso, Richard, Ogah, Okechukwu Samuel, Ogbo, Felix Akpojene, Oh, In-Hwan, Okoro, Anselm, Oladimeji, Kelechi E, Oladimeji, Olanrewaju, Olagunju, Andrew T, Olagunju, Tinuke O, Olivares, Pedro R, Olsen, Helen Elizabeth, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin L, Ong, 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Subjects
GENDER-DIFFERENCES, SUICIDE, Medicine (all), Burden of Disease Study 2017, SDG, CONSUMPTION, 11 Medical And Health Sciences, GBD, Sustainable Development Goals, PREVENTION, ALCOHOL-USE, CARDIOVASCULAR-DISEASE, SMOKING PREVALENCE, General & Internal Medicine, factors risk, Medicine and Health Sciences, Human medicine, CESSATION, PERSPECTIVE, TRANSITION
Abstract

Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of "leaving no one behind", it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health -related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment. Methods We measured progress on 41 health-related S DG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health related SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2.5th percentile and 100 as the 97.5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings The global median health-related SDG index in 2017 was 59.4 (IQR 35.4-67.3), ranging from a low of 11.6 (95% uncertainty interval 9.6-14.0) to a high of 84.9 (83.1-86.7). SDG index values in countries assessed at the subnational level varied substantially particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attaimnent by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation The GBD study offers a unique, robust platform for monitoring the health -related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health -related SDG indicators, NCDs, NCD-related risks, and violence -related indicators will require a concerted shift away from what might have driven past gains curative interventions in the case of NCDs towards multisectoral, prevention -oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the S DGs. What is clear is that our actions or inaction today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Published
2018

23. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Roth, Gregory A., Collaborotors, G. B. D.Causes Death, Abate, Degu, Abate, Kalkidan Hassen, Abay, Solomon M., Abbafati, Cristiana, Abbasi, Nooshin, Abbastabar, Hedayat, Abd-Allah, Load, Abdela, Jemal, Abdelalim, Ahmed, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abebe, Haftom Temesgen, Abebe, Molla, Abebe, Zegeye, Abejie, Ayenew Negesse, Abera, Semaw F., Abil, Olifan Zewdie, Abraha, Haftom Niguse, Abrham, Aklilu Roba, Abu-Raddad, Laith Jamal, Accrombessi, Manfred Mario Kokou, Acharya, Dilaram, Adamu, Abdu A., Adebayo, Oladimeji, Adedoyin, Rufus Adesoji, Adekanmbi, Victor, Adookunboh, Olatunii, Adhena, Beyene Meressa, Adib, Mina G., Admasie, Aniha, Afshin, Ashkan, Agarwal, Gina, Agesa, Karelia M., Agrawal, Anurag, Agrawal, Sutapa, Ahmadi, Alireza, Ahmadi, Melidi, Ahmed, Muktar Beshir, Ahmed, Sayent, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Fddine, Akbari, Mohammad Esmaeil, Akinyeniti, Rufus Olusola, Akseer, Nadia, Al-Aly, Ziyad, Al-Eyadhy, Ayman, Al-Raddadi, Rajaa M., Alandab, Fares, Alam, Khurshid, Alam, Tahiya, Alebel, Animut, Alene, Kefyalew Addis, Alijanzadeh, Mehran, Alizadeh-Navaei, Reza, Aljunid, Syed Mohamed, Alkerwi, Ala'a, Alla, Francois, Allebeck, Peter, Alonso, Jordi, Altirkawi, Khalid, Alvis-Guzman, Nelson, Amare, Azmeraw T., Aminde, Leopold N., Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampern, Anber, Nahla Hamed, Andrei, Catalina Liliana, Androudi, Sofia, Animut, Megbaru Debalkie, Anjomshoa, Mina, Ansari, Hossein, Aniha, Mustafa Geleto, Antonio, Carl Abelardo T., Anwari, Palwasha, Aremu, Olatunde, Arnlov, Johan, Arora, Amit, Arora, Monika, Artaman, Al, Aryal, Krishna K., Asayesh, Hamid, Asfaw, Ephremi Tsegay, Ataro, Zerihun, Atique, Suleman, Atre, Sachin R., Ausloos, Marcel, Avokpaho, Euripide F. G. A., Awasthi, Ashish, Quintattilla, Beatriz Paulina Ayala, Ayele, Yohanes, Ayer, Rakesh, Azzopardi, Peter S., Babazadeh, Arefeh, Bacha, Umar, Badali, Hamid, Badawi, Alaa, Bali, Ayele Geleto, Ballesteros, Katherine E., Banach, Maciej, Banerjee, Kajori, Bannick, Marlena S., Banoub, Joseph Adel Mattar, Barboza, Miguel A., Barker-Collo, Suzanne Lyu, Barnighausen, Till Winfried, Barquera, Simon, Barrero, Lope, Bassat, Quique, Base, Sanjay, Baune, Bernhard T., Baynes, Habtamu Wondifraw, Bazargan-Hejazi, Shahrzad, Beth, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Behzadifar, Mcysam, Bejot, Yannick, Bekele, Bayu Begashaw, Belacliew, Abate Bekele, Belay, Ezra, Belay, Yihalem Abebe, Bell, Michelle L., Bello, Aminu K., Bennett, Derrick A., Bensenor, Isabela M., Berman, Adam F., Bernabe, Eduardo, Bernstein, Robert S., Bertolacci, Gregory J., Beuran, Mircea, Beyranvand, Tina, Bhalla, Ashish, Bhattarai, Suraj, Bhaumik, Sounayadeeep, Bhutta, Zulfiqar A., Biadgo, Belete, Biehl, Molly H., Bijani, Ali, Bikbov, Boris, Bilano, Ver, Bililign, Nigus, Bin Sayeed, Muhammad Shandaat, Bisanzio, Donal, Biswas, Tuhin, Blacker, Brigitte F., Basara, Berrak Bora, Borschmann, Rohan, Bosetti, Cristina, Bozorgmehr, Kayvan, Brady, Oliver J., Brant, Luisa C., Brayne, Carol, Brazinova, Alexandra, Breitborde, Nicholas J. K., Brenner, Hermann, Briant, Paul Svitil, Britton, Gabrielle, Brugha, Traolach, Busse, Reinhard, Butt, Zahid A., Callender, Charlton S. K. H., Campos-Nonato, Ismael R., Rincon, Julio Cesar Canapuzano, Cano, Jorge, Car, Mate, Cardenas, Rosario, Carreras, Giulia, Carrero, Juan J., Carter, Austin, Carvalho, Felix, Castaneda-Orjuela, Carlos A., Rivas, Jacqueline Castillo, Castle, Chris D., Castro, Clara, Castro, Franz, Catala-Lopez, Ferran, Cerin, Ester, Chaiah, Yazan, Chang, Jung -Chen, Chanson, Fiona J., Chaturvedi, Pankaj, Chiang, Peggy Pei-Chia, Chimed-Ochir, Odgerel, Chisumpa, Vesper Hichilombwe, Chitheet, Abdulaal, Chowdhury, Rajiv, Christensen, Hanne, Christopher, Devasahayam J., Chiang, Sheng-Chia, Cicuttini, Flavia M., Ciobanu, Liliana G., Cirillo, Massimo, Cohen, Aaron J., Cooper, Leslie Trumbull, Cortesi, Paolo Angelo, Cortinovis, Monica, Cousin, Ewerton, Cowie, Benjamin C., Criqui, Michael H., Cromwell, Elizabeth A., Crowe, Christopher Stephen, Crump, John A., Cunningham, Matthew, Daba, Alemneh Kabeta, Dadi, Abel Fekadu, Dandona, Lalit, Dandona, Rakhi, Dang, Anh Kim, Dargan, Paul I., Daryani, Ahmad, Das, Siddharth K., Das Gupta, Rajat, Das Neves, Jose, Dasa, Tamirat Tesfaye, Dash, Aditya Prasad, Davis, Adrian C., Weaver, Nicole Davis, Davitoiu, Dragos Virgil, Davletov, Kairat, De La Hoz, Fernando Pio, De Neve, Jan-Walter, Degefa, Meaza Girma, Degenhardt, Louisa, Degfie, Tizta T., Deiparine, Selina, Demoz, Gebre Teklemariam, Demtsu, Baleen Betsu, Denova-Gutierrez, Edgar, Deribe, Kebede, Dervenis, Nikolaos, Jarlais, Don C. 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Kassebaum, Nj, Katikireddi, Sv, Karyani, Ak, Kefale, At, Keiyoro, Pn, Kemp, Gr, Kengne, Ap, Kesavachandran, Cn, Khafaie, Ma, Khalil, Ia, Khan, Ea, Khan, Ma, Khang, Yh, Khater, Mm, Khoja, At, Khosravi, Mh, Kiadaliri, Aa, Kibret, Gd, Kidanemariam, Zt, Kiirithio, Dn, Kim, Ye, Kim, Yj, Kimokoti, Rw, Kivimäki, M, Knudsen, Ak, Kocarnik, Jm, Kopec, Ja, Koul, Pa, Kravchenko, Ma, Kumar, Ga, Kutz, Mj, Kyu, Hh, Lad, Dp, Lad, Sd, Lal, Dk, Lam, Jo, Lami, Fh, Lansingh, Vc, Larson, Hj, Lau, Km, Lazarus, Jv, Lee, Ph, Leshargie, Ct, Lim, Ll, Limenih, Ma, Lopez, Ad, Lotufo, Pa, Macarayan, Erk, Mackay, Mt, Maclachlan, Jh, Maddison, Er, Maghavani, Dp, Malta, Dc, Manda, Al, Mandarano-Filho, Lg, Mansournia, Ma, Mapoma, Cc, Maravilla, Jc, Marks, Gb, Martins-Melo, Fr, März, W, Marzan, Mb, Masci, Jr, Massenburg, Bb, Mathur, Mr, Maulik, Pk, Mcgrath, Jj, Mcmahon, Bj, Mehndiratta, Mm, Mehta, Km, Mekonnen, Tc, Memiah, Ptn, Memish, Za, Mengistu, Dt, Mensah, Ga, Mereta, St, Meretoja, Tj, Mezgebe, Hb, Millear, Ai, Miller, Tr, Miller-Petrie, Mk, Mini, Gk, Mirrakhimov, Em, Misganaw, At, Mohammad, Ka, Mohammed, Ma, Mokdad, Ah, Moreno Velásquez, I, Morrison, Sd, Moschos, Mm, Mousavi, Sm, Muchie, Kf, Mueller, Uo, Mumford, Je, Musa, Ki, Nachega, Jb, Nansseu, Jr, Nascimento, Br, Negoi, Ri, Newton, Crj, Ngalesoni, Fn, Ngunjiri, Jw, Nguyen, Aq, Nguyen, Ht, Nguyen, Lh, Nguyen, Th, Ningrum, Dna, Nirayo, Yl, Nixon, Mr, Norheim, Of, Noubiap, Jj, Nouri, Hr, Nourollahpour Shiadeh, M, Nowroozi, Mr, Odell, Cm, Ogbo, Fa, Oh, Ih, Olagunju, At, Olivares, Pr, Olsen, He, Olusanya, Bo, Olusanya, Jo, Ong, Kl, Ong, Sk, Orpana, Hm, Ortiz, Jr, Øverland, S, Owolabi, Mo, Özdemir, R, P A, M, Pakhare, Ap, Pakpour, Ah, Pandian, Jd, Park, Ek, Parry, Cdh, Patton, Gc, Paturi, Vr, Paulson, Kr, Pereira, Dm, Phillips, Mr, Piel, Fb, Pigott, Dm, Pillay, Jd, Postma, Mj, Purcell, Ca, Quistberg, Da, Rade, Kw, Radfar, A, Rafay, A, Rafiei, A, Rahim, F, Rahman, Mhu, Rahman, Ma, Rai, Rk, Ranabhat, Cl, Rao, Pc, Rawaf, Dl, Razo-García, C, Reiner, Rc, Reitsma, Mb, Renzaho, Amn, Riahi, Sm, Ribeiro, Alp, Rios-Blancas, Mj, Roba, Kt, Roberts, Nl, Robinson, Sr, Sahraian, Ma, Saldanha, Rf, Sambala, Ez, Samy, Am, Sanchez-Niño, Md, Santomauro, Df, Santos, Jv, Milicevic, Mm, Sao Jose, Bp, Sarker, Ar, Sarmiento-Suárez, R, Sawant, Ar, Schmidt, Mi, Schneider, Ijc, Schöttker, B, Schutte, Ae, Schwebel, Dc, Scott, Jg, Sepanlou, Sg, Serván-Mori, E, Shackelford, Ka, Shaheen, Aa, Shaikh, Ma, Shrime, Mg, Siddiqi, Tj, Sigfusdottir, Id, Silberberg, Dh, Silva, Da, Silva, Jp, Silva, Ntd, Silveira, Dga, Singh, Ja, Singh, Np, Singh, Pk, Sinha, Dn, Sobaih, Bh, Sorensen, Rjd, Soriano, Jb, Soyiri, In, Sposato, La, Sreeramareddy, Ct, Stanaway, Jd, Starodubov, Vi, Stein, Dj, Stewart, Lg, Stokes, Ma, Subart, Ml, Sufiyan, Mb, Sur, Pj, Sykes, Bl, Sylaja, Pn, Sylte, Do, Szoeke, Cei, Tabarés-Seisdedos, R, Tadakamadla, Sk, Tassew, Sg, Tekalign, Tg, Tekle, Mg, Temsah, Mh, Teshale, My, Tessema, Ga, Thankappan, Kr, Thrift, Ag, Thurston, Gd, To, Qg, Torre, Ae, Tortajada-Girbés, M, Tovani-Palone, Mr, Tran, Bx, Tran, Kb, Troeger, Ce, Truelsen, Tc, Truong, Nt, Tsadik, Ag, Tuzcu, Em, Ukwaja, Kn, Undurraga, Ea, Updike, Rl, Uthman, Oa, Uzun, Sb, Valdez, Pr, Vasankari, Tj, Vladimirov, Sk, Vollset, Se, Wagner, Gr, Wallin, Mt, Walson, Jl, Wang, Yp, Wassie, Mm, Weintraub, Rg, Weldegwergs, Kg, Werkneh, Aa, West, Te, Whiteford, Ha, Wilner, Lb, Wolfe, Cda, Wu, Yc, Wyper, Gma, Yahyazadeh Jabbari, Sh, Yan, Ll, Yasin, Yj, Yentür, Gk, Yimer, Em, Yirsaw, Bd, Yoon, Sj, Younis, Mz, Zaman, Sb, Zeleke, Aj, Zenebe, Zm, Zhang, Al, Zuhlke, Lj, and Murray, Cjl.

Subjects
Adult, Male, Adolescent, national age-sex-specific mortality, UNITED-STATES, Global Health, Socioeconomic Factor, Global Burden of Disease, GBD, causes of death, Young Adult, Age Distribution, Life Expectancy, General & Internal Medicine, Cause of Death, PUBLIC-HEALTH PROBLEM, mortality, 282 causes global burden of disease, Sex Distribution, Child, Aged, Aged, 80 and over, BARRIERS, DEMENTIA, Medicine (all), Infant, Newborn, Infant, 11 Medical And Health Sciences, Middle Aged, TRENDS, PREVENTION, PREVALENCE, ALZHEIMERS-DISEASE, INDIVIDUALS, 3121 General medicine, internal medicine and other clinical medicine, Child, Preschool, REGISTRATION, Female, Human medicine, Human
Abstract

Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODErn), to generate cause fractions and cause specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NC Ds) comprised the greatest fraction of deaths, contributing to 73.4% (95% uncertainty interval [UI] 72.5-74.1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 186% (17.9-19.6), and injuries 8.0% (7.7-8.2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22.7% (21.5-23.9), representing an additional 7.61 million (7. 20-8.01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7.9% (7.08.8). The number of deaths for CMNN causes decreased by 222% (20.0-24.0) and the death rate by 31.8% (30.1-33.3). Total deaths from injuries increased by 2.3% (0-5-4-0) between 2007 and 2017, and the death rate from injuries decreased by 13.7% (12.2-15.1) to 57.9 deaths (55.9-59.2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000-289 000) globally in 2007 to 352 000 (334 000-363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118.0% (88.8-148.6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36.4% (32.2-40.6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33.6% (31.2-36.1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respirator}, infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990 neonatal disorders, lower respiratory infections, and diarrhoeal diseases were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.

Published
2018

24. Population and fertility by age and sex for 195 countries and territories, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Murray, Christopher J L, Callender, Charlton S K H, Kulikoff, Xie Rachel, Srinivasan, Vinay, Abate, Degu, Abate, Kalkidan Hassen, Abay, Solomon M, Abbasi, Nooshin, Abbastabar, Hedayat, Abdela, Jemal, Abdelalim, Ahmed, Abdel-Rahman, Omar, Abdi, Alireza, Abdoli, Nasrin, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abebe, Haftom Temesgen, Abebe, Molla, Abebe, Zegeye, Abebo, Teshome Abuka, Abejie, Ayenew Negesse, Aboyans, Victor, Abraha, Haftom Niguse, Abreu, Daisy Maria Xavier, Abrham, Aklilu Roba, Abu-Raddad, Laith Jamal, Abu-Rmeileh, Niveen M E, Accrombessi, Manfred Mario Kokou, Acharya, Pawan, Adamu, Abdu A, Adebayo, Oladimeji M, Adedeji, Isaac Akinkunmi, Adekanmbi, Victor, Adetokunboh, Olatunji O, Adhena, Beyene Meressa, Adhikari, Tara Ballav, Adib, Mina G, Adou, Arsène Kouablan, Adsuar, Jose C, Afarideh, Mohsen, Afshin, Ashkan, Agarwal, Gina, Agesa, Kareha M, Aghayan, Sargis Aghasi, Agrawal, Sutapa, Ahmadi, Alireza, Ahmadi, Mehdi, Ahmed, Muktar Beshir, Ahmed, Sayem, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Akanda, Ali S, Akbari, Mohammad Esmaeil, Akibu, Mohammed, Akinyemi, Rufus Olusola, Akinyemiju, Tomi, Akseer, Nadia, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alebel, Animut, Aleman, Alicia V, Alene, Kefyalew Addis, Al-Eyadhy, Ayman, Ali, Raghib, Alijanzadeh, Mehran, Alizadeh-Navaei, Reza, Aljunid, Syed Mohamed, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Almasi, Ali, Alonso, Jordi, Al-Raddadi, Rajaa M, Alsharif, Ubai, Altirkawi, Khalid, Alvis-Guzman, Nelson, Amare, Azmeraw T, Ammar, Walid, Anber, Nahla Hamed, Andrei, Catalina Liliana, Androudi, Sofia, Animut, Megbaru Debalkie, Ansari, Hossein, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Appiah, Seth Christopher Yaw, Aremu, Olatunde, Areri, Habtamu Abera, Arian, Nicholas, Ärnlöv, Johan, Artaman, Al, Aryal, Krishna K, Asayesh, Hamid, Asfaw, Ephrem Tsegay, Asgedom, Solomon Weldegebreal, Assadi, Reza, Atey, Tesfay Mehari Mehari, Atique, Suleman, Atteraya, 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Subjects
Adult, Male, Population Density, GBD, population, fertility, Adolescent, Medicine (all), Infant, Newborn, Infant, 11 Medical And Health Sciences, Middle Aged, Global Health, Global Burden of Disease, Young Adult, Child, Preschool, General & Internal Medicine, Female, Human medicine, Mortality, Child, Population Growth, Birth Rate, Aged, Human, Maternal Age
Abstract

Background Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10-54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10-14 years and 50-54 years was estimated from data on fertility in women aged 15-19 years and 45-49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-cotnponent method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings From 1950 to 2017, TFRs decreased by 49.4% (95% uncertainty interval [UI] 46.4-52.0). The TFR decreased from 4.7 livebirths (4.5-4.9) to 2.4 livebirths (2.2-2.5), and the ASFR of mothers aged 10-19 years decreased from 37 livebirths (34-40) to 22 livebirths (19-24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83.8 million people per year since 1985. The global population increased by 197-2% (193.3-200.8) since 1950, from 2.6 billion (2.5-2.6) to 7.6 billion (7.4-7.9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2.0%; this rate then remained nearly constant until 1970 and then decreased to 1.1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2.5% in 1963 to O7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2.7%. The global average age increased from 26.6 years in 1950 to 32.1 years in 2017, and the proportion of the population that is of working age (age 15-64 years) increased from 59.9% to 65.3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1.0 livebirths (95% UI 0. 9-1.2) in Cyprus to a high of 7.1 livebirths (6.8-7.4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0.08 livebirths (0.07-0.09) in South Korea to 2.4 livebirths (2.2-2.6) in Niger, and the TFR over age 30 years (I F030; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0.3 livebirths (0.3-0-4) in Puerto Rico to a high of 3.1 livebirths (3.0-3.2) in Niger. TF030 was higher than TFU25 in 145 countries and territories in 2017.33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2.0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.

Published
2018

25. Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Dicker, Daniel, Nguyen, Grant, Abate, Degu, Abate, Kalkidan Hassen, Abay, Solomon M, Abbafati, Cristiana, Abbasi, Nooshin, Abbastabar, Hedayat, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abdel-Rahman, Omar, Abdi, Alireza, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abdurahman, Ahmed Abdulahi, Abebe, Haftom Temesgen, Abebe, Molla, Abebe, Zegeye, Abebo, Teshome Abuka, Aboyans, Victor, Abraha, Haftom Niguse, Abrham, Aklilu Roba, Abu-Raddad, Laith Jamal, Abu-Rmeileh, Niveen ME, Accrombessi, Manfred Mario Kokou, Acharya, Pawan, Adebayo, Oladimeji M, Adedeji, Isaac Akinkunmi, Adedoyin, Rufus Adesoji, Adekanmbi, Victor, Adetokunboh, Olatunji O, Adhena, Beyene Meressa, Adhikari, Tara Ballav, Adib, Mina G, Adou, Arsène Kouablan, Adsuar, Jose C, Afarideh, Mohsen, Afshin, Ashkan, Agarwal, Gina, Aggarwal, Rakesh, Aghayan, Sargis Aghasi, Agrawal, Sutapa, Agrawal, Anurag, Ahmadi, Mehdi, Ahmadi, Alireza, Ahmadieh, Hamid, Ahmed, Mohamed Lemine Cheikh brahim, Ahmed, Sayem, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Akanda, Ali S, Akbari, Mohammad Esmaeil, Akibu, Mohammed, Akinyemi, Rufus Olusola, Akinyemiju, Tomi, Akseer, Nadia, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alebel, Animut, Aleman, Alicia V, Alene, Kefyalew Addis, Al-Eyadhy, Ayman, Ali, Raghib, Alijanzadeh, Mehran, Alizadeh-Navaei, Reza, Aljunid, Syed Mohamed, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine A, Alonso, Jordi, Al-Raddadi, Rajaa M, Alsharif, Ubai, Altirkawi, Khalid, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Anber, Nahla Hamed, Andrei, Catalina Liliana, Androudi, Sofia, Animut, Megbaru Debalkie, Anjomshoa, Mina, Anlay, Degefaye Zelalem, Ansari, Hossein, Ansariadi, Ansariadi, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Appiah, Seth Christopher Yaw, Aremu, Olatunde, Areri, Habtamu Abera, Ärnlöv, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna K, Asadi-Lari, Mohsen, Asayesh, Hamid, Asfaw, Ephrem Tsegay, Asgedom, Solomon Weldegebreal, Assadi, Reza, Ataro, Zerihun, Atey, Tesfay Mehari Mehari, Athari, Seyyed Shamsadin, Atique, Suleman, Atre, Sachin R, Atteraya, Madhu Sudhan, Attia, Engi F, Ausloos, Marcel, Avila-Burgos, Leticia, Avokpaho, Euripide F G A, Awasthi, Ashish, Awuah, Baffour, Ayala Quintanilla, Beatriz Paulina, Ayele, Henok Tadesse, Ayele, Yohanes, Ayer, Rakesh, Ayuk, Tambe B, Azzopardi, Peter S, Azzopardi-Muscat, Natasha, Badali, Hamid, Badawi, Alaa, Balakrishnan, Kalpana, Bali, Ayele Geleto, Banach, Maciej, Banstola, Amrit, Barac, Aleksandra, Barboza, Miguel A, Barquera, Simon, Barrero, Lope H, Basaleem, Huda, Bassat, Quique, Basu, Arindam, Basu, Sanjay, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Behzadifar, Meysam, Béjot, Yannick, Bekele, Bayu Begashaw, Belachew, Abate Bekele, Belay, Aregawi Gebreyesus, Belay, Ezra, Belay, Saba Abraham, Belay, Yihalem Abebe, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Berhane, Adugnaw, Berman, Adam E, Bernabe, Eduardo, Bernstein, Robert S, Bertolacci, Gregory J, Beuran, Mircea, Beyranvand, Tina, Bhala, Neeraj, Bhatia, Eesh, Bhatt, Samir, Bhattarai, Suraj, Bhaumik, Soumyadeeep, Bhutta, Zulfiqar A, Biadgo, Belete, Bijani, Ali, Bikbov, Boris, Bililign, Nigus, Bin Sayeed, Muhammad Shahdaat, Birlik, Sait Mentes, Birungi, Charles, Bisanzio, Donal, Biswas, Tuhin, Bjørge, Tone, Bleyer, Archie, Basara, Berrak Bora, Bose, Dipan, Bosetti, Cristina, Boufous, Soufiane, Bourne, Rupert, Brady, Oliver J, Bragazzi, Nicola Luigi, Brant, Luisa C, Brazinova, Alexandra, Breitborde, Nicholas J K, Brenner, Hermann, Britton, Gabrielle, Brugha, Traolach, Burke, Kristin E, Busse, Reinhard, Butt, Zahid A, Cahuana-Hurtado, Lucero, Callender, Charlton S K H, Campos-Nonato, Ismael R, Campuzano Rincon, Julio Cesar, Cano, Jorge, Car, Mate, Cárdenas, Rosario, Carreras, Giulia, Carrero, Juan J, Carter, Austin, Carvalho, Félix, Castañeda-Orjuela, Carlos A, Castillo Rivas, Jacqueline, Castro, Franz, Catalá-López, Ferrán, Çavlin, Alanur, Cerin, Ester, Chaiah, Yazan, Champs, Ana Paula, Chang, Hsing-Yi, Chang, Jung-Chen, Chattopadhyay, Aparajita, Chaturvedi, Pankaj, Chen, Wanqing, Chiang, Peggy Pei-Chia, Chimed-Ochir, Odgerel, Chin, Ken Lee, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal, Choi, Jee-Young J, Christensen, Hanne, Christopher, Devasahayam J, Chung, Sheng-Chia, Cicuttini, Flavia M, Ciobanu, Liliana G, Cirillo, Massimo, Claro, Rafael M, Cohen, Aaron J, Collado-Mateo, Daniel, Constantin, Maria-Magdalena, Conti, Sara, Cooper, Cyrus, Cooper, Leslie Trumbull, Cortesi, Paolo Angelo, Cortinovis, Monica, Cousin, Ewerton, Criqui, Michael H, Cromwell, Elizabeth A, Crowe, Christopher Stephen, Crump, John A, Cucu, Alexandra, Cunningham, Matthew, Daba, Alemneh Kabeta, Dachew, Berihun Assefa, Dadi, Abel Fekadu, Dandona, Lalit, Dandona, Rakhi, Dang, Anh Kim, Dargan, Paul I, Daryani, Ahmad, Das, Siddharth K, Das Gupta, Rajat, das Neves, José, Dasa, Tamirat Tesfaye, Dash, Aditya Prasad, Weaver, Nicole Davis, Davitoiu, Dragos Virgil, Davletov, Kairat, Dayama, Anand, Courten, Barbora de, De la Hoz, Fernando Pio, De leo, Diego, De Neve, Jan-Walter, Degefa, Meaza Girma, Degenhardt, Louisa, Degfie, Tizta T, Deiparine, Selina, Dellavalle, Robert P, Demoz, Gebre Teklemariam, Demtsu, Balem Betsu, Denova-Gutiérrez, Edgar, Deribe, Kebede, Dervenis, Nikolaos, Des Jarlais, Don C, Dessie, Getenet Ayalew, Dey, Subhojit, Dharmaratne, Samath Dhamminda, Dhimal, Meghnath, Ding, Eric L, Djalalinia, Shirin, Doku, David Teye, Dolan, Kate A, Donnelly, Christl A, Dorsey, E Ray, Douwes-Schultz, Dirk, Doyle, Kerrie E, Drake, Thomas M, Driscoll, Tim Robert, Dubey, Manisha, Dubljanin, Eleonora, Duken, Eyasu Ejeta, Duncan, Bruce B, Duraes, Andre R, Ebrahimi, Hedyeh, Ebrahimpour, Soheil, Edessa, Dumessa, Edvardsson, David, Eggen, Anne Elise, El Bcheraoui, Charbel, El Sayed Zaki, Maysaa, Elfaramawi, Mohammed, El-Khatib, Ziad, Ellingsen, Christian Lycke, Elyazar, Iqbal R F, Enayati, Ahmadali, Endries, Aman Yesuf Yesuf, Er, Benjamin, Ermakov, Sergey Petrovich, Eshrati, Babak, Eskandarieh, Sharareh, Esmaeili, Reza, Esteghamati, Alireza, Esteghamati, Sadaf, Fakhar, Mahdi, Fakhim, Hamed, Farag, Tamer, Faramarzi, Mahbobeh, Fareed, Mohammad, Farhadi, Farzaneh, Farid, Talha A, Farinha, Carla Sofia e Sá, Farioli, Andrea, Faro, Andre, Farvid, Maryam S, Farzadfar, Farshad, Farzaei, Mohammad Hosein, Fazeli, Mir Sohail, Feigin, Valery L, Feigl, Andrea B, Feizy, Fariba, Fentahun, Netsanet, Fereshtehnejad, Seyed-Mohammad, Fernandes, Eduarda, Fernandes, Joao C, Feyissa, Garumma Tolu, Fijabi, Daniel Obadare, Filip, Irina, Finegold, Samuel, Fischer, Florian, Flor, Luisa Sorio, Foigt, Nataliya A, Ford, John A, Foreman, Kyle J, Fornari, Carla, Frank, Tahvi D, Franklin, Richard Charles, Fukumoto, Takeshi, Fuller, John E, Fullman, Nancy, Fürst, Thomas, Furtado, João M, Futran, Neal D, Galan, Adriana, Gallus, Silvano, Gambashidze, Ketevan, Gamkrelidze, Amiran, Gankpe, Fortune Gbetoho, Garcia-Basteiro, Alberto L, Garcia-Gordillo, Miguel A, Gebre, Teshome, Gebre, Abadi Kahsu, Gebregergs, Gebremedhin Berhe, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gelano, Tilayie Feto, Gelaw, Yalemzewod Assefa, Geleijnse, Johanna M, Genova-Maleras, Ricard, Gessner, Bradford D, Getachew, Sefonias, Gething, Peter W, Gezae, Kebede Embaye, Ghadami, Mohammad Rasoul, Ghadimi, Reza, Ghasemi Falavarjani, Khalil, Ghasemi-Kasman, Maryam, Ghiasvand, Hesam, Ghimire, Mamata, Ghoshal, Aloke Gopal, Gill, Paramjit Singh, Gill, Tiffany K, Gillum, Richard F, Giussani, Giorgia, Goenka, Shifalika, Goli, Srinivas, Gomez, Ricardo Santiago, Gomez-Cabrera, Mari Carmen, Gómez-Dantés, Hector, Gona, Philimon N, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Goulart, Alessandra C, Goulart, Bárbara Niegia Garcia, Grada, Ayman, Grosso, Giuseppe, Gugnani, Harish Chander, Guimaraes, Andre Luiz Sena, Guo, Yuming, Gupta, Prakash C, Gupta, Rahul, Gupta, Rajeev, Gupta, Tanush, Gyawali, Bishal, Haagsma, Juanita A, Hachinski, Vladimir, Hafezi-Nejad, Nima, Hagos, Tekleberhan B, Hailegiyorgis, Tewodros Tesfa, Hailu, Gessessew Bugssa, Haj-Mirzaian, Arya, Haj-Mirzaian, Arvin, Hamadeh, Randah R, Hamidi, Samer, Handal, Alexis J, Hankey, Graeme J, Harb, Hilda L, Harikrishnan, Sivadasanpillai, Haririan, Hamidreza, Haro, Josep Maria, Hasan, Mehedi, Hassankhani, Hadi, Hassen, Hamid Yimam, Havmoeller, Rasmus, Hay, Roderick J, Hay, Simon I, He, Yihua, Hedayatizadeh-Omran, Akbar, Hegazy, Mohamed I, Heibati, Behzad, Heidari, Mohsen, Hendrie, Delia, Henok, Andualem, Henry, Nathaniel J, Heredia-Pi, Ileana, Herteliu, Claudiu, Heydarpour, Fatemeh, Heydarpour, Pouria, Heydarpour, Sousan, Hibstu, Desalegn Tsegaw, Hoek, Hans W, Hole, Michael K, Homaie Rad, Enayatollah, Hoogar, Praveen, Horino, Masako, Hosgood, H Dean, Hosseini, Seyed Mostafa, Hosseinzadeh, Mehdi, Hostiuc, Sorin, Hostiuc, Mihaela, Hotez, Peter J, Hoy, Damian G, Hsairi, Mohamed, Htet, Aung Soe, Hu, Guoqing, Huang, John J, Husseini, Abdullatif, Hussen, Mohammedaman Mama, Hutfless, Susan, Iburg, Kim Moesgaard, Igumbor, Ehimario U, Ikeda, Chad Thomas, Ilesanmi, Olayinka Stephen, Iqbal, Usman, Irvani, Seyed Sina Naghibi, Isehunwa, Oluwaseyi Oluwakemi, Islam, Sheikh Mohammed Shariful, Islami, Farhad, Jahangiry, Leila, Jahanmehr, Nader, Jain, Rajesh, Jain, Sudhir Kumar, Jakovljevic, Mihajlo, James, Spencer L, Javanbakht, Mehdi, Jayaraman, Sudha, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Ravi Prakash, Jha, Vivekanand, Ji, John S, Johnson, Sarah Charlotte, Jonas, Jost B, Joshi, Ankur, Jozwiak, Jacek Jerzy, Jungari, Suresh Banayya, Jürisson, Mikk, K, Madhanraj, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kahssay, Molla, Kalani, Rizwan, Kapil, Umesh, Karami, Manoochehr, Karami Matin, Behzad, Karch, André, Karema, Corine, Karimi, Narges, Karimi, Seyed M, Karimi-Sari, Hamidreza, Kasaeian, Amir, Kassa, Getachew Mullu, Kassa, Tesfaye Dessale, Kassa, Zemenu Yohannes, Kassebaum, Nicholas J, Katibeh, Marzieh, Katikireddi, Srinivasa Vittal, Kaul, Anil, Kawakami, Norito, Kazemeini, Hossein, Kazemi, Zhila, Karyani, Ali Kazemi, K C, Prakash, Kebede, Seifu, Keiyoro, Peter Njenga, Kemp, Grant Rodgers, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Khader, Yousef Saleh, Khafaie, Morteza Abdullatif, Khajavi, Alireza, Khalid, Nauman, Khalil, Ibrahim A, Khan, Ejaz Ahmad, Khan, Gulfaraz, Khan, Muhammad Shahzeb, Khan, Muhammad Ali, Khang, Young-Ho, Khanna, Tripti, Khater, Mona M, Khatony, Alireza, Khazaie, Habibolah, Khoja, Abdullah T, Khosravi, Ardeshir, Khosravi, Mohammad Hossein, Khubchandani, Jagdish, Kiadaliri, Aliasghar A, Kibret, Getiye D Dejenu, Kim, Cho-il, Kim, Daniel, Kim, Jun Y, Kim, Young-Eun, Kimokoti, Ruth W, Kinfu, Yohannes, Kinra, Sanjay, Kisa, Adnan, Kissimova-Skarbek, Katarzyna, Kissoon, Niranjan, Kivimäki, Mika, Kleber, Marcus E, Knibbs, Luke D, Knudsen, Ann Kristin Skrindo, Kochhar, Sonali, Kokubo, Yoshihiro, Kolola, Tufa, Kopec, Jacek A, Kosek, Margaret N, Kosen, Soewarta, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael A, Krishan, Kewal, Krishnaswami, Sanjay, Kuate Defo, Barthelemy, Kucuk Bicer, Burcu, Kudom, Andreas A, Kuipers, Ernst J, Kulikoff, Xie Rachel, Kumar, G Anil, Kumar, Manasi, Kumar, Pushpendra, Kumsa, Fekede Asefa, Kutz, Michael J, Lad, Sheetal D, Lafranconi, Alessandra, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lami, Faris Hasan, Lan, Qing, Langan, Sinéad M, Lansingh, Van C, Lansky, Sonia, Larson, Heidi Jane, Laryea, Dennis Odai, Lassi, Zohra S, Latifi, Arman, Lavados, Pablo M, Laxmaiah, Avula, Lazarus, Jeffrey V, Lebedev, Georgy, Lee, Paul H, Leigh, James, Leshargie, Cheru Tesema, Leta, Samson, Levi, Miriam, Li, Shanshan, Li, Yichong, Li, Xiaohong, Liang, Juan, Liang, Xiaofeng, Liben, Misgan Legesse, Lim, Lee-Ling, Lim, Stephen S, Limenih, Miteku Andualem, Linn, Shai, Liu, Shiwei, Liu, Yang, Lodha, Rakesh, Logroscino, Giancarlo, Lonsdale, Chris, Lorch, Scott A, Lorkowski, Stefan, Lotufo, Paulo A, Lozano, Rafael, Lucas, Tim C D, Lunevicius, Raimundas, Lyons, Ronan A, Ma, Stefan, Mabika, Crispin, Macarayan, Erlyn Rachelle King, Mackay, Mark T, Maddison, Emilie R, Maddison, Ralph, Madotto, Fabiana, Magdy Abd El Razek, Hassan, Magdy Abd El Razek, Muhammed, Maghavani, Dhaval P, Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malik, Manzoor Ahmad, Malta, Deborah Carvalho, Mamun, Abdullah A, Manamo, Wondimu Ayele, Manda, Ana-Laura, Mansournia, Mohammad Ali, Mantovani, Lorenzo Giovanni, Mapoma, Chabila Christopher, Marami, Dadi, Maravilla, Joemer C, Marcenes, Wagner, Marina, Shakhnazarova, Martinez-Raga, Jose, Martins, Sheila C O, Martins-Melo, Francisco Rogerlândio, März, Winfried, Marzan, Melvin B, Mashamba-Thompson, Tivani Phosa, Masiye, Felix, Massenburg, Benjamin Ballard, Maulik, Pallab K, Mazidi, Mohsen, McGrath, John J, McKee, Martin, Mehata, Suresh, Mehendale, Sanjay Madhav, Mehndiratta, Man Mohan, Mehrotra, Ravi, Mehta, Kala M, Mehta, Varshil, Mekonen, Tesfa, Mekonnen, Tefera Chane, Meles, Hagazi Gebre, Meles, Kidanu Gebremariam, Melese, Addisu, Melku, Mulugeta, Memiah, Peter T N, Memish, Ziad A, Mendoza, Walter, Mengistu, Desalegn Tadese, Mengistu, Getnet, Mensah, George A, Mereta, Seid Tiku, Meretoja, Atte, Meretoja, Tuomo J, Mestrovic, Tomislav, Mezgebe, Haftay Berhane, Miangotar, Yode, Miazgowski, Bartosz, Miazgowski, Tomasz, Miller, Ted R, Mini, G K, Mirica, Andreea, Mirrakhimov, Erkin M, Misganaw, Awoke Temesgen, Moazen, Babak, Moges, Nurilign Abebe, Mohammad, Karzan Abdulmuhsin, Mohammadi, Moslem, Mohammadifard, Noushin, Mohammadi-Khanaposhtani, Maryam, Mohammadnia-Afrouzi, Mousa, Mohammed, Shafiu, Mohammed, Mohammed A, Mohan, Viswanathan, Mokdad, Ali H, Molokhia, Mariam, Monasta, Lorenzo, Moradi, Ghobad, Moradi, Mahmoudreza, Moradi-Lakeh, Maziar, Moradinazar, Mehdi, Moraga, Paula, Morawska, Lidia, Moreno Velásquez, Ilais, Morgado-da-Costa, Joana, Morrison, Shane Douglas, Mosapour, Abbas, Moschos, Marilita M, Mousavi, Seyyed Meysam, Muche, Achenef Asmamaw, Muchie, Kindie Fentahun, Mueller, Ulrich Otto, Mukhopadhyay, Satinath, Mullany, Erin C, Muller, Kate, Murhekar, Manoj, Murphy, Tasha B, Murthy, G V S, Murthy, Srinivas, Musa, Jonah, Musa, Kamarul Imran, Mustafa, Ghulam, Muthupandian, Saravanan, Nachega, Jean B, Nagel, Gabriele, Naghavi, Mohsen, Naheed, Aliya, Nahvijou, Azin, Naik, Gurudatta, Nair, Sanjeev, Najafi, Farid, Nangia, Vinay, Nansseu, Jobert Richie, Nascimento, Bruno Ramos, Nawaz, Haseeb, Ncama, Busisiwe P, Neamati, Nahid, Negoi, Ionut, Negoi, Ruxandra Irina, Neupane, Subas, Newton, Charles Richard James, Ngalesoni, Frida N, Ngunjiri, Josephine W, Nguyen, Ha Thu, Nguyen, Huong Thanh, Nguyen, Long Hoang, Nguyen, Michele, Nguyen, Trang Huyen, Ningrum, Dina Nur Anggraini, Nirayo, Yirga Legesse, Nisar, Muhammad Imran, Nixon, Molly R, Nolutshungu, Nomonde, Nomura, Shuhei, Norheim, Ole F, Noroozi, Mehdi, Norrving, Bo, Noubiap, Jean Jacques, Nouri, Hamid Reza, Nourollahpour Shiadeh, Malihe, Nowroozi, Mohammad Reza, Nsoesie, Elaine O, Nyasulu, Peter S, Ofori-Asenso, Richard, Ogah, Okechukwu Samuel, Ogbo, Felix Akpojene, Oh, In-Hwan, Okoro, Anselm, Oladimeji, Olanrewaju, Olagunju, Andrew T, Olagunju, Tinuke O, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Sok King, Opio, John Nelson, Oren, Eyal, Ortiz, Justin R, Ortiz, Alberto, Ota, Erika, Otstavnov, Stanislav S, Øverland, Simon, Owolabi, Mayowa Ojo, Oyekale, Abayomi Samuel, P A, Mahesh, Pacella, Rosana, Pakhale, Smita, Pakhare, Abhijit P, Pana, Adrian, Panda, Basant Kumar, Panda-Jonas, Songhomitra, Pandey, Achyut Raj, Pandian, Jeyaraj Durai, Parisi, Andrea, Park, Eun-Kee, Parry, Charles D H, Parsian, Hadi, Patel, Shanti, Patle, Ajay, Patten, Scott B, Patton, George C, Paudel, Deepak, Pearce, Neil, Peprah, Emmanuel K, Pereira, Alexandre, Pereira, David M, Perez, Krystle M, Perico, Norberto, Pervaiz, Aslam, Pesudovs, Konrad, Petri, William A, Petzold, Max, Phillips, Michael R, Pigott, David M, Pillay, Julian David, Pirsaheb, Meghdad, Pishgar, Farhad, Plass, Dietrich, Polinder, Suzanne, Pond, Constance Dimity, Popova, Svetlana, Postma, Maarten J, Pourmalek, Farshad, Pourshams, Akram, Poustchi, Hossein, Prabhakaran, Dorairaj, Prakash, V, Prakash, Swayam, Prasad, Narayan, Qorbani, Mostafa, Quistberg, D Alex, Radfar, Amir, Rafay, Anwar, Rafiei, Alireza, Rahim, Fakher, Rahimi, Kazem, Rahimi-Movaghar, Afarin, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Muhammad Aziz, Rahman, Sajjad ur, Rai, Rajesh Kumar, Rajati, Fatemeh, Rajsic, Sasa, Raju, Sree Bhushan, Ram, Usha, Ranabhat, Chhabi Lal, Ranjan, Prabhat, Ranta, Anna, Rasella, Davide, Rawaf, David Laith, Rawaf, Salman, Ray, Sarah E, Razo-García, Christian, Rego, Maria Albertina Santiago, Rehm, Jürgen, Reiner, Robert C, Reinig, Nickolas, Reis, Cesar, Remuzzi, Giuseppe, Renzaho, Andre M N, Resnikoff, Serge, Rezaei, Satar, Rezaeian, Shahab, Rezai, Mohammad Sadegh, Riahi, Seyed Mohammad, Ribeiro, Antonio Luiz P, Riojas, Horacio, Rios-Blancas, Maria Jesus, Roba, Kedir Teji, Robinson, Stephen R, Roever, Leonardo, Ronfani, Luca, Roshandel, Gholamreza, Roshchin, Denis O, Rostami, Ali, Rothenbacher, Dietrich, Rubagotti, Enrico, Ruhago, George Mugambage, Saadat, Soheil, Sabde, Yogesh Damodar, Sachdev, Perminder S, Saddik, Basema, Sadeghi, Ehsan, Moghaddam, Sahar Saeedi, Safari, Hosein, Safari, Yahya, Safari-Faramani, Roya, Safdarian, Mahdi, Safi, Sare, Safiri, Saeid, Sagar, Rajesh, Sahebkar, Amirhossein, Sahraian, Mohammad Ali, Sajadi, Haniye Sadat, Salahshoor, Mohammad Reza, Salam, Nasir, Salama, Joseph S, Salamati, Payman, Saldanha, Raphael de Freitas, Salimi, Yahya, Salimzadeh, Hamideh, Salz, Inbal, Sambala, Evanson Zondani, Samy, Abdallah M, Sanabria, Juan, Sanchez-Niño, Maria Dolores, Santos, Itamar S, Santos, João Vasco, Santric Milicevic, Milena M, Sao Jose, Bruno Piassi, Sardana, Mayank, Sarker, Abdur Razzaque, Sarrafzadegan, 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Subjects
Child mortality, Alnæmi, Dánartíðni, Heilsufar, GBD, Börn, Dauði, Almennar lyflækningar, Fullorðnir, General & Internal Medicine, parasitic diseases, Psychology, age-specific mortality, Estimating adult mortality, Medicine (all), HIV, 11 Medical And Health Sciences, General Medicine, All-cause mortality, humanities, Countries, Death, mortality, national, Sálfræði, Health, GBD, mortality, Human medicine, Trends
Abstract

The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. Data for this research was provided by MEASURE Evaluation, funded by the United States Agency for International Development (USAID). Views expressed do not necessarily reflect those of USAID, the US Government, or MEASURE Evaluation. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with licence no. SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law-2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data., Background Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing., Research reported in this publication was supported by the Bill & Melinda Gates Foundation, the University of Melbourne, Public Health England, the Norwegian Institute of Public Health, St. Jude Children's Research Hospital, the National Institute on Aging of the National Institutes of Health (award P30AG047845), and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163).

Published
2018

26. The 2024 Public Health Emergency of International Concern: A Global Failure to Control Mpox.

Author

Zumla A, Rosenthal PJ, Sam-Agudu NA, Ogoina D, Mbala-Kingebeni P, Ntoumi F, Nakouné E, Njouom R, Ndembi N, Mills EJ, Muyembe-Tamfum JJ, and Nachega JB

Abstract

On August 14, 2024, following a regional declaration by the Africa Centres for Disease Control and Prevention, the World Health Organization declared mpox a Public Health Emergency of International Concern, marking the second such declaration in two years. A series of outbreaks involving the more virulent clade I virus (compared to clade II, which caused a global outbreak in 2022), has now spread in 13 African countries, exposing the inadequacies of the public health infrastructure in these settings. There was significant investment during the 2022 global outbreak, but these efforts failed to address vaccine access and treatment in the Global South. Regulatory delays, unequal access to vaccines, and a lack of compassionate use treatments for severe cases have resulted in preventable cases and deaths, especially among vulnerable populations such as pregnant women, children, and the immunocompromised. The current outbreak also underscores critical knowledge gaps in our understanding of mpox, including its transmission, pathogenesis, and viral evolution. We join intensified calls for global solidarity and action to control mpox, emphasizing immediate containment measures and long-term local and international investment in African public health systems, to prevent future epidemics.

Published
2024
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27. Mpox in Pregnancy - Risks, Vertical Transmission, Prevention, and Treatment.

Author

Nachega JB, Mohr EL, Dashraath P, Mbala-Kingebeni P, Anderson JR, Myer L, Gandhi M, Baud D, Mofenson LM, and Muyembe-Tamfum JJ

Subjects
Female, Humans, Infant, Newborn, Pregnancy, Vaccination methods, Vaccines, Attenuated administration & dosage, Infectious Disease Transmission, Vertical prevention & control, Mpox (monkeypox) drug therapy, Mpox (monkeypox) epidemiology, Mpox (monkeypox) prevention & control, Mpox (monkeypox) transmission, Pregnancy Complications, Infectious drug therapy, Pregnancy Complications, Infectious epidemiology, Pregnancy Complications, Infectious prevention & control, Pregnancy Complications, Infectious virology, Smallpox Vaccine administration & dosage, Antiviral Agents administration & dosage
Published
2024
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28. Sustained human outbreak of a new MPXV clade I lineage in eastern Democratic Republic of the Congo.

Author

Vakaniaki EH, Kacita C, Kinganda-Lusamaki E, O'Toole Á, Wawina-Bokalanga T, Mukadi-Bamuleka D, Amuri-Aziza A, Malyamungu-Bubala N, Mweshi-Kumbana F, Mutimbwa-Mambo L, Belesi-Siangoli F, Mujula Y, Parker E, Muswamba-Kayembe PC, Nundu SS, Lushima RS, Makangara-Cigolo JC, Mulopo-Mukanya N, Pukuta-Simbu E, Akil-Bandali P, Kavunga H, Abdramane O, Brosius I, Bangwen E, Vercauteren K, Sam-Agudu NA, Mills EJ, Tshiani-Mbaya O, Hoff NA, Rimoin AW, Hensley LE, Kindrachuk J, Baxter C, de Oliveira T, Ayouba A, Peeters M, Delaporte E, Ahuka-Mundeke S, Mohr EL, Sullivan NJ, Muyembe-Tamfum JJ, Nachega JB, Rambaut A, Liesenborghs L, and Mbala-Kingebeni P

Subjects
Humans, Democratic Republic of the Congo epidemiology, Female, Male, Adult, Young Adult, Adolescent, Animals, Middle Aged, Genome, Viral genetics, Mutation, Child, Disease Outbreaks, Mpox (monkeypox) epidemiology, Mpox (monkeypox) virology, Mpox (monkeypox) transmission, Monkeypox virus genetics, Phylogeny
Abstract

Outbreaks of monkeypox (mpox) have historically resulted from zoonotic spillover of clade I monkeypox virus (MPXV) in Central Africa and clade II MPXV in West Africa. In 2022, subclade IIb caused a global epidemic linked to transmission through sexual contact. Here we describe the epidemiological and genomic features of an mpox outbreak in a mining region in eastern Democratic Republic of the Congo, caused by clade I MPXV. Surveillance data collected between September 2023 and January 2024 identified 241 suspected cases. Genomic analysis demonstrates a distinct clade I lineage divergent from previously circulating strains in the Democratic Republic of the Congo. Of the 108 polymerase chain reaction-confirmed mpox cases, the median age of individuals was 22 years, 51.9% were female and 29% were sex workers, suggesting a potential role for sexual transmission. The predominance of APOBEC3-type mutations and the estimated emergence time around mid-September 2023 imply recent sustained human-to-human transmission., (© 2024. The Author(s).)

Published
2024
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30. The surge of mpox in Africa: a call for action.

Author

Nachega JB, Sam-Agudu NA, Ogoina D, Mbala-Kingebeni P, Ntoumi F, Nakouné E, Njouom R, Lewis RF, Gandhi M, Rosenthal PJ, Rawat A, Wilson LA, Kindrachuk J, Liesenborghs L, Mills EJ, Preiser W, Rimoin AW, Sullivan NJ, Peeters M, Delaporte E, Baxter C, Harrison L, Hermans MP, Mohr EL, Gonsalves G, Ndembi N, Zumla A, and Muyembe-Tamfum JJ

Subjects
Humans, Africa, Mpox (monkeypox) epidemiology
Abstract

Competing Interests: JBN is supported by the US National Institutes of Health (grant numbers NIH/FIC 1R25TW011217-01, NIH/FIC 1D43TW010937-01A1, NIH/FIC D43TW011827-01A1, NIH/FIC 1R21TW011706-0, and NIH/NIAID 5U01AI096299-13). FN and AZ are codirectors of the Pan-African Network on Emerging and Re-Emerging Infections funded by the European and Developing Countries Clinical Trials Partnership (EDCTP) within the EU Horizon 2020 Framework Programme. FN and AZ also acknowledge support from the EDCTP Central Africa Clinical Research Network. AZ is a UK National Institute for Health Research senior investigator, and a Mahathir Science Award and EU-EDCTP Pascoal Mocumbi Prize laureate. JJM-T holds National Institutes of Health National Institute of Allergy and Infectious Diseases grants (number 75N91019D00024-P00001-759102000025-5). JK is supported by grant funding from the Canadian Institutes of Health Research and International Development Research Centre (grant numbers MRR-184813 and PPE-185821). ELM is supported by the US National Institutes of Health (grant number 1R01AI182082-01). All other authors declare no competing interests. We thank John L Johnson for critical review and helpful advice. The views and conclusions in this Personal View are those of the authors and do not necessarily represent the views of their institutions.

Published
2024
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32. Subclinical cardiovascular remodelling in HIV-infection: A multimodal case study of 2 serodiscordant, monozygotic twins.

Author

Robbertse PS, Steyn J, Rajah MR, Doubell AF, Nachega JB, and Herbst PG

Abstract

Cardiovascular abnormalities are increasingly recognised among people newly diagnosed with HIV, but subclinical pathology may be challenging to diagnose. We present a case study of subtle cardiovascular changes in identical twins, one without HIV-infection and the other recently diagnosed with HIV (serodiscordant). We hypothesise that cardiovascular parameters would be similar between the twins, unless non-genetic (environmental) factors are at play. These differences likely represent occult pathology secondary to the effects of early HIV-infection. A 25-year-old female incidentally diagnosed with HIV, and her HIV-uninfected identical twin, living with her since birth, underwent comprehensive cardiovascular assessments. The HIV-positive twin exhibited a globular left ventricle (LV), larger LV volumes, decreased LV strain, peak atrial longitudinal strain (PALS) and higher native T1 and T2 mapping values compared to her sister. Cardiac biomarkers high sensitivity cardiac troponin T and N-terminal proBNP, as well as the novel markers of fibrosis and remodelling, galectin-3 and soluble-ST2, were higher in the HIV-infected twin. Given the twins' shared environment and genetic makeup, these differences likely stem from HIV-infection. Our study supports previous findings and suggests potential screening markers for HIV-associated cardiovascular disease, including PALS. Further research is warranted to explore PALS' utility in this context., Competing Interests: Conflict of interest: none declared.

Published
2024
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33. Completion of isoniazid preventive therapy for latent tuberculosis infection among children and adolescents compared to adults living with HIV in Kinshasa, Democratic Republic of the Congo.

Author

Bidashimwa D, Ditekemena JD, Sigwadhi LN, Nkuta LM, Engetele E, Kilundu A, Chabikuli ON, and Nachega JB

Subjects
Adult, Child, Humans, Adolescent, Child, Preschool, Isoniazid therapeutic use, Antitubercular Agents therapeutic use, Democratic Republic of the Congo epidemiology, Retrospective Studies, Latent Tuberculosis, Tuberculosis drug therapy, Tuberculosis prevention & control, HIV Infections complications, HIV Infections drug therapy
Abstract

Background: Little is known about isoniazid preventive therapy (IPT) completion rates among children or adolescents compared to adults living with HIV in Kinshasa, Democratic Republic of the Congo (DRC)., Methods: We conducted a retrospective cohort analysis including children, adolescents, and adults living with HIV who were treated at FHI360 and partners-implemented HIV care programs at six health zones in Kinshasa, DRC, from 2004 to 2020. The primary outcome was the proportion of children, adolescents versus adults who did complete 6 months of daily self-administered IPT. Log-binomial regression assessed independent predictors of IPT non-completion and Kaplan-Meier technique for survival analysis., Results: Of 11,691 eligible patients on ART who initiated IPT, 429 were children (<11 years), 804 adolescents (11-19 years), and 10,458 adults (≥20 years). The median age was 7 (IQR: 3-9) years for children, 15 (IQR: 13-17) years for adolescents, and 43 (35-51) years for adults. Among those who were initiated on IPT, 5625 out of 11,691 people living with HIV (PLHIV) had IPT completion outcome results, and an overall 3457/5625 (61.5%) completion rate was documented. Compared to adults, children and adolescents were less likely to complete IPT [104/199 (52.3%) and 268/525 (51.0%), respectively, vs. 3085/4901 (62.9%)]. After adjustment, the only independent predictors for IPT non-completion were health zone of residence and type of ART regimen. Kaplan-Meier analysis showed comparable poor survival among patients who completed IPT versus those who did not (p-value for log-rank test, 0.15)., Conclusions: The overall sub-optimal IPT completion rate in adults as well as children/adolescents in this setting is of great concern. Prospective studies are needed to elucidate the specific barriers to IPT completion among children, adolescents, and adults in DRC as well as the scale-up of evidence-informed interventions to improve IPT completion, such as adoption of shorter TB preventive regimens., (© 2023 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.)

Published
2024
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34. Household air pollution and risk of pulmonary tuberculosis in HIV-Infected adults.

Author

Katoto PDMC, Bihehe D, Brand A, Mushi R, Kusinza A, Alwood BW, van Zyl-Smit RN, Tamuzi JL, Sam-Agudu NA, Yotebieng M, Metcalfe J, Theron G, Godri Pollitt KJ, Lesosky M, Vanoirbeek J, Mortimer K, Nawrot T, Nemery B, and Nachega JB

Subjects
Adult, Humans, Male, Female, Case-Control Studies, HIV Infections epidemiology, Tuberculosis, Pulmonary epidemiology, Air Pollution, Air Pollution, Indoor adverse effects
Abstract

Background: In low- and middle-income countries countries, millions of deaths occur annually from household air pollution (HAP), pulmonary tuberculosis (PTB), and HIV-infection. However, it is unknown whether HAP influences PTB risk among people living with HIV-infection., Methods: We conducted a case-control study among 1,277 HIV-infected adults in Bukavu, eastern Democratic Republic of Congo (February 2018 - March 2019). Cases had current or recent (<5y) PTB (positive sputum smear or Xpert MTB/RIF), controls had no PTB. Daily and lifetime HAP exposure were assessed by questionnaire and, in a random sub-sample (n=270), by 24-hour measurements of personal carbon monoxide (CO) at home. We used multivariable logistic regression to examine the associations between HAP and PTB., Results: We recruited 435 cases and 842 controls (median age 41 years, [IQR] 33-50; 76% female). Cases were more likely to be female than male (63% vs 37%). Participants reporting cooking for >3h/day and ≥2 times/day and ≥5 days/week were more likely to have PTB (aOR 1·36; 95%CI 1·06-1·75) than those spending less time in the kitchen. Time-weighted average 24h personal CO exposure was related dose-dependently with the likelihood of having PTB, with aOR 4·64 (95%CI 1·1-20·7) for the highest quintile [12·3-76·2 ppm] compared to the lowest quintile [0·1-1·9 ppm]., Conclusion: Time spent cooking and personal CO exposure were independently associated with increased risk of PTB among people living with HIV. Considering the high burden of TB-HIV coinfection in the region, effective interventions are required to decrease HAP exposure caused by cooking with biomass among people living with HIV, especially women., (© 2024. The Author(s).)

Published
2024
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35. Household Air Pollution and Risk of Pulmonary Tuberculosis in HIV-Infected Adults.

Author

Katoto PDMC, Bihehe D, Brand A, Mushi R, Kusinza A, Alwood BW, van Zyl-Smit RN, Tamuzi JL, Sam-Agudu NA, Yotebieng M, Metcalfe J, Theron G, Godri Pollitt KJ, Lesosky M, Vanoirbeek J, Mortimer K, Nawrot T, Nemery B, and Nachega JB

Abstract

Background: In developing countries, millions of deaths occur annually from household air pollution (HAP), pulmonary tuberculosis (PTB), and HIV-infection. However, it is unknown whether HAP influences PTB risk among people living with HIV-infection., Methods: We conducted a case-control study among 1,277 HIV-infected adults in Bukavu, eastern Democratic Republic of Congo (February 2018 - March 2019). Cases had current or recent (<5y) PTB (positive sputum smear or Xpert MTB/RIF), controls had no PTB. Daily and lifetime HAP exposure were assessed by questionnaire and, in a random sub-sample (n=270), by 24-hour measurements of personal carbon monoxide (CO) at home. We used multivariable logistic regression to examine the associations between HAP and PTB., Results: We recruited 435 cases and 842 controls (median age 41 years, [IQR] 33-50; 76% female). Cases were more likely to be female than male (63% vs 37%). Participants reporting cooking for >3h/day and ≥2 times/day and ≥5 days/weekwere more likely to have PTB (aOR 1·36; 95%CI 1·06-1·75) than those spending less time in the kitchen. Time-weighted average 24h personal CO exposure was related dose-dependently with the likelihood of having PTB, with aOR 4·64 (95%CI 1·1-20·7) for the highest quintile [12·3-76·2 ppm] compared to the lowest quintile [0·1-1·9 ppm]., Conclusion: Time spent cooking and personal CO exposure were independently associated with increased risk of PTB among people living with HIV. Considering the high burden of TB-HIV coinfection in the region, effective interventions are required to decrease HAP exposure caused by cooking with biomass among people living with HIV, especially women.

Published
2023
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36. Predictors associated with critical care need and in-hospital mortality among children with laboratory-confirmed COVID-19 infection in a high HIV infection burden region.

Author

Byamungu LN, Nachega JB, Pillay A, Katoto PDMC, Jeena P, Zurba L, and Masekela R

Abstract

Introduction: Despite the extra mortality associated with COVID-19 death globally, there is scant data on COVID-19-related paediatric mortality in Sub-Saharan Africa. We assessed predictors of critical care needs and hospital mortality in South African children with laboratory-confirmed SARS-CoV-2 infection in region with high HIV infection burden., Methods: We conducted a secondary multicentre analysis of the AFREhealth cohort (a multinational, multicentre cohort of paediatric COVID-19 clinical outcomes across six African countries) of children admitted to the Inkosi Albert Luthuli, a quaternary hospital in KwaZulu-Natal, South Africa, with confirmed RT-PCR between March 2020 and December 2020. We constructed multivariable logistic regression to explore factors associated with the need for critical care (high care/ intensive care hospitalisation or oxygen requirement) and cox-proportional hazards models to further assess factors independently associated with in-hospital death., Results: Of the 82 children with PCR-confirmed SARS-CoV-2 infection (mean ± SD age: 4.2 ± 4.4 years), 35(42.7%) were younger than one year, 52(63%) were female and 59(71%) had a pre-existing medical condition. Thirty-seven (45.2%) children required critical care (median (IQR) duration: 7.5 (0.5-13.5) days) and 14(17%) died. Independent factors associated with need for critical care were being younger than 1 year (aPR: 3.02, 95%CI: 1.05-8.66; p  = 0.04), having more than one comorbidity (aPR: 2.47, 95%CI: 1.32-4.61; p  = 0.004), seizure (aPR: 2.39, 95%CI: 1.56-3.68; p  < 0.001) and impaired renal function. Additionally, independent predictors of in-hospital mortality were exposure to HIV infection (aHR: 6.8, 95%CI:1.54-31.71; p  = 0.01), requiring invasive ventilation (aHR: 3.59, 95%CI: 1.01-12.16, p  = 0.048) and increase blood urea nitrogen (aHR: 1.06, 95%CI: 1.01-1.11; p  = 0.017). However, children were less likely to die from COVID-19 if they were primarily admitted to quaternary unit (aHR: 0.23, 95%CI: 0.1-0.86, p  = 0.029)., Conclusion: We found a relatively high hospital death rate among children with confirmed COVID-19. During COVID-19 waves, a timely referral system and rapid identification of children at risk for critical care needs and death, such as those less than one year and those with comorbidities, could minimize excess mortality, particularly in high HIV-infection burden countries., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Byamungu, Nachega, Pillay, Katoto, Jeena, Zurba and Masekela.)

Published
2023
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37. Global HIV control: is the glass half empty or half full?

Author

Nachega JB, Musoke P, Kilmarx PH, Gandhi M, Grinsztejn B, Pozniak A, Rawat A, Wilson L, Mills EJ, Altice FL, Mellors JW, and Quinn TC

Subjects
Male, Humans, Homosexuality, Male, Africa, Northern, HIV Infections drug therapy, HIV Infections epidemiology, HIV Infections prevention & control, Sexual and Gender Minorities, Acquired Immunodeficiency Syndrome epidemiology
Abstract

The massive scale-up of HIV treatment and prevention over the past two decades has resulted in important reductions in new infections and mortality globally. Reduction in HIV incidence, however, has been unequal, with worsening epidemics in regions where the reach and scale of HIV control programmes have been insufficient, especially in eastern Europe, central Asia, the Middle East, north Africa, and Latin America where HIV epidemics are concentrated among key populations, including people who inject drugs, men who have sex with men, transgender people, and some minority racial and ethnic groups. The global state of the HIV pandemic highlights disparities in HIV control efforts and provides a roadmap for what should be done, including investment to better implement the effective HIV prevention and treatment tools that are available, but whose adoption and scale-up are not yet sufficient to get us close to an AIDS-free generation. To achieve the full potential of global HIV control, we call for urgent, evidence-informed implementation at scale of our existing and novel HIV prevention and treatment strategies in ways that are better, faster, more efficient, and cost-effective, especially in key populations and regions where the HIV pandemic continues to expand., Competing Interests: Declaration of interests AP has research grants from Gilead, ViiV, Merck, and Janssen, paid to European treatment network for HIV, Hepatitis and Global Infectious Diseases Foundation, and has received speaker fees from Gilead, ViiV, Merck, and Janssen. FLA has received speaker fees from Gilead Sciences. JWM is employed by the University of Pittsburgh; is a consultant to AlloVir, Infectious Disease Connect, and Gilead Sciences; has received grant funding from Gilead Sciences to the University of Pittsburgh; receives compensation from Abound Bio that are unrelated to the current work; and holds share options in Galapagos, Infectious Disease Connect, and MingMed Biotechnology that are unrelated to the current work., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Published
2023
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38. The Human Mpox Global Outbreak: Available Control Tools and the Opportunity to Break a Cycle of Neglect in Endemic Countries.

Author

Nachega JB, Mbala-Kingebeni P, Rosenthal PJ, Rimoin AW, Hoff NA, Liesenborghs L, Vanlerberghe V, Andrei G, Rawat A, Wilson LA, Forrest J, Mills EJ, Hermans MP, Mulangu S, Ntoumi F, Zumla A, and Muyembe-Tamfum JJ

Subjects
Humans, Animals, Global Health, Monkeypox virus, Endemic Diseases prevention & control, Zoonoses epidemiology, Zoonoses prevention & control, Disease Outbreaks prevention & control, Mpox (monkeypox) epidemiology, Mpox (monkeypox) prevention & control
Abstract

The 2022 global outbreak of human Mpox (formerly monkeypox) virus (MPXV) infection outside of the usual endemic zones in Africa challenged our understanding of the virus's natural history, transmission dynamics, and risk factors. This outbreak has highlighted the need for diagnostics, vaccines, therapeutics, and implementation research, all of which require more substantial investments in equitable collaborative partnerships. Global multidisciplinary networks need to tackle MPXV and other neglected emerging and reemerging zoonotic pathogens to address them locally and prevent or quickly control their worldwide spread. Political endorsement from individual countries and financial commitments to maintain control efforts will be essential for long-term sustainability.

Published
2023
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39. PEPFAR at 20 - A Game-Changing Impact on HIV in Africa.

Author

Nachega JB, Serwadda D, Abimiku A, Sikazwe I, and Abdool Karim Q

Subjects
Humans, Africa epidemiology, United States, International Cooperation, HIV Infections drug therapy, HIV Infections economics, HIV Infections epidemiology, HIV Infections prevention & control, United States Government Agencies economics, United States Government Agencies organization & administration
Published
2023
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40. Increasing Effectiveness and Equity in Strengthening Health Research Capacity Using Data and Metrics: Recent Advances of the ESSENCE Mechanism.

Author

Kilmarx PH, Maitin T, Adam T, Aslanyan G, Cheetham M, Cruz J, Eigbike M, Gaye O, Jones CM, Kupfer L, Lindo J, Mijumbi R, Nachega JB, Nishi JB, Pantelidou I, Sarker M, and Swaminathan S

Subjects
Humans, Capacity Building, Benchmarking, Health Priorities
Abstract

Background: The ESSENCE on Health Research initiative established a Working Group on Review of Investments in 2018 to improve coordination and collaboration among funders of health research capacity strengthening. The Working Group comprises more than a dozen ESSENCE members, including diverse representation by geography, country income level, the public sector, and philanthropy., Objective: The overall goal of the Working Group is increased research on national health priorities as well as improved pandemic preparedness, and, ultimately, fewer countries with very limited research capacity., Methods: We developed a basic set of metrics for national health research capacity, assessed different models of coordination and collaboration, took a deeper dive into eight countries to characterize their national research capacity, and began to identify opportunities to better coordinate our investments. In this article, we summarize the presentations, discussions, and outcomes of our second annual (virtual) meeting, which had more than 100 participants representing funders, researchers, and other stakeholders from higher- and lower-income countries worldwide., Findings and Conclusions: Presentations on the first day included the keynote speaker, Dr. Soumya Swaminathan, chief scientist of the World Health Organization (WHO), and updates on data and metrics for research capacity, which are critical to establish targets, road maps, and budgets. The second day focused on improving collaboration and coordination among funders and other stakeholders, the potential return on investment for health research, ongoing work to increase coordination at the country level, and examples of research capacity strengthening efforts in diverse health research areas from around the world. We concluded that an intentional data- and metric-driven approach to health research capacity strengthening, emphasizing coordination among funders, local leadership, and equitable partnerships and allocation of resources, will enhance the health systems of resource-poor countries as well as the world's pandemic preparedness., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2023 The Author(s).)

Published
2023
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41. End of the Bedaquiline patent - a crucial development for moving forward affordable drugs, diagnostics, and vaccines for infectious diseases in low- and middle-income countries.

Author

Petersen E, Hui DS, Nachega JB, Ntoumi F, Goletti D, Aklillu E, Sharma A, Nyirenda T, Yeboah-Manu D, Satta G, da Costa C, Azhar EI, Bockarie M, Al-Abri S, McHugh TD, Rodriguez-Morales AJ, Varghese GM, and Zumla A

Subjects
Humans, Developing Countries, Costs and Cost Analysis, Vaccines, Communicable Diseases
Abstract

Competing Interests: Declaration of competing interest All authors declare no conflicts of interest.

Published
2023
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42. Long-acting antiretrovirals and HIV treatment adherence.

Author

Nachega JB, Scarsi KK, Gandhi M, Scott RK, Mofenson LM, Archary M, Nachman S, Decloedt E, Geng EH, Wilson L, Rawat A, and Mellors JW

Subjects
Humans, Anti-Retroviral Agents therapeutic use, Rilpivirine adverse effects, Injections, Intramuscular adverse effects, Anti-HIV Agents, HIV Infections drug therapy, HIV Infections etiology
Abstract

Intramuscular injection of long-acting cabotegravir and rilpivirine is a novel, long-acting antiretroviral therapy (ART) combination approved for use as a fully suppressive regimen for people living with HIV. Long-acting cabotegravir with rilpivirine ART has reduced required dosing frequency from once daily to once every month or every 2 months injections. This new era of long-acting ART, which includes other antiretrovirals and formulations in various stages of clinical development, holds tremendous promise to change the standard of HIV treatment. Although long-acting ART has high potential to be revolutionary in the landscape of HIV care, prevention, and treatment cascade, more data are needed to substantiate its efficacy and cost-effectiveness among patients at risk of non-adherence and across age groups, pregnancy, and post partum. Advocacy efforts and policy changes to optimise a sustained, high-quality, equitable reach of long-acting ART, especially in low-income and middle-income countries where most people living with HIV reside, are needed to realise the full benefits of long-acting ART., Competing Interests: Declaration of interests RKS reports investigator-sponsored research awards from Gilead Science and ViiV Healthcare; and awards managed by MedStar Health Research Institute. KKS reports investigator-initiated research funding paid to her institution from Organon. LMM reports funding from ViiV Healthcare provided to the Elizabeth Glaser Pediatric AIDS Foundation for a birth outcomes surveillance project in Eswatini; and serving as a paid consultant to WHO on the safety of antiretroviral drugs in pregnancy. JWM is a consultant to Gilead Sciences and a grant recipient from Gilead Sciences to the University of Pittsburgh. All other authors declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Published
2023
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43. Advancing detection and response capacities for emerging and re-emerging pathogens in Africa.

Author

Nachega JB, Nsanzimana S, Rawat A, Wilson LA, Rosenthal PJ, Siedner MJ, Varma JK, Kilmarx PH, Mutesa L, Tanner M, Binagwaho A, Forrest J, Mbala-Kingebeni P, Muyembe-Tamfum JJ, Ntoumi F, Zumla A, de Oliveira T, and Mills EJ

Subjects
Humans, Africa South of the Sahara, Disease Outbreaks prevention & control, Public Health, COVID-19 epidemiology, Hemorrhagic Fever, Ebola epidemiology, Hemorrhagic Fever, Ebola prevention & control, Mpox (monkeypox) epidemiology
Abstract

Recurrent disease outbreaks caused by a range of emerging and resurging pathogens over the past decade reveal major gaps in public health preparedness, detection, and response systems in Africa. Underlying causes of recurrent disease outbreaks include inadequacies in the detection of new infectious disease outbreaks in the community, in rapid pathogen identification, and in proactive surveillance systems. In sub-Saharan Africa, where 70% of zoonotic outbreaks occur, there remains the perennial risk of outbreaks of new or re-emerging pathogens for which no vaccines or treatments are available. As the Ebola virus disease, COVID-19, and mpox (formerly known as monkeypox) outbreaks highlight, a major paradigm shift is required to establish an effective infrastructure and common frameworks for preparedness and to prompt national and regional public health responses to mitigate the effects of future pandemics in Africa., Competing Interests: Declaration of interests JBN is supported by the US National Institutes of Health (NIH; grant numbers NIH/FIC 1R25TW011217-01, NIH/FIC 1D43TW010937-01A1, NIH/FIC D43TW011827-01A1, NIH/FIC 1R21TW011706-0, and NIH/NIAID 5U01AI096299-13). FN and AZ are Co-directors of the Pan-African Network on Emerging and Re-Emerging Infections funded by the European and Developing Countries Clinical Trials Partnership (EDCTP) within the EU Horizon 2020 Framework Programme. FN and AZ also acknowledge support from the EDCTP Central Africa Clinical Research Network. AZ is a UK National Institute for Health Research senior investigator, and a Mahathir Science Award and EU-EDCTP Pascoal Mocumbi Prize laureate. J-JM-T is supported by Africa Centre for Disease Control and Prevention and the Bill and Melinda Gates Foundation, and holds NIH grants (NIH/NIAID grant number 75N91019D00024-P00001-759102000025-5). J-JM-T was part of the group that discovered the Ebola virus in 1976, and was awarded Le Prix Christophe Merieux from Institut de France in 2015 and was the recipient of the third Hideyo Noguchi Africa Prize for Medical Research in 2019 from the Japan Government, for his research to confront Ebola and other emerging and re-emerging pathogens, and for his efforts to train legions of disease fighters in Africa. All other authors declare no competing interests. TdO led the team of South African researchers who discovered the omicron variant of SARS-CoV-2 in November, 2021., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Published
2023
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44. The effect of group support psychotherapy on adherence to anti-retroviral therapy and viral suppression among HIV positive young people: Study protocol for a pilot randomized controlled trial.

Author

Nakimuli-Mpungu E, Wamala K, Nalugya JS, Nakanyike C, Iya J, Bakeera Kitaka S, Diana Namuli J, Akimana B, Nachega JB, Mills EJ, and Seggane M

Abstract

Background: Several studies have demonstrated an association between psychological risk factors and HIV disease progression. However, there is limited information on the use of psychological interventions to improve HIV treatment outcomes in young people living with HIV., Objective: This pilot trial aims to evaluate the feasibility, acceptability and preliminary effectiveness of group support psychotherapy in improving adherence to anti-retroviral therapy and viral suppression in young people living with HIV in Uganda., Methods: We recruited 120 young people with HIV, aged 10-18 years, who had non-viral suppression 6 months after initiating first-line anti-retroviral therapy (ART) from community based HIV clinics in Kitgum district, northern Uganda. Participants were randomly assigned to receive GSP plus IAC ( N  = 60) or IAC alone ( N  = 60). Primary outcomes will be indicators of feasibility and acceptability as well as preliminary effectiveness of GSP in improving ART adherence and viral suppression analysed by intention to treat using cluster-adjusted t tests and permutation tests. Secondary outcomes will be measures of depression, anxiety and cost-effectiveness., Results: The trial has been approved by the Makerere College of Health Sciences School of Health Sciences Research Ethics Committee, and the Uganda National Council of Science and Technology. Recruitment began in June 2021 and 120 young people living with HIV with their adult caregivers have been recruited to the trial. An analysis of baseline and 6-month data is in progress. The results of this trial will not only be presented at national and international conferences but also submitted for publication in peer-reviewed journals and as a report to the funding agencies., Conclusions: This pilot trial will provide critical evidence to support the ongoing mental health integration into routine HIV care in Uganda., Trial Registration: Pan African Clinical Trials Registry (PACTR): 202006601935462., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Nakimuli-Mpungu, Wamala, Nalugya, Nakanyike, Iya, Bakeera Kitaka, Diana Namuli, Akimana, Nachega, Mills and Seggane.)

Published
2023
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45. Prevalence and influences of diabetes and prediabetes among adults living with HIV in Africa: a systematic review and meta-analysis.

Author

Peer N, Nguyen KA, Hill J, Sumner AE, Cikomola JC, Nachega JB, and Kengne AP

Subjects
Male, Adult, Humans, Aged, Middle Aged, HIV, Prevalence, Africa epidemiology, Prediabetic State epidemiology, Prediabetic State etiology, Diabetes Mellitus, Type 2 epidemiology, HIV Infections complications, HIV Infections drug therapy, HIV Infections epidemiology
Abstract

Introduction: In people living with human immunodeficiency virus (PLHIV), traditional cardiovascular risk factors, exposure to HIV per se and antiretroviral therapy (ART) are assumed to contribute to cardiometabolic diseases. Nevertheless, controversy exists on the relationship of HIV and ART with diabetes. To clarify the relationship between HIV and type 2 diabetes, this review determined, in PLHIV in Africa, diabetes and prediabetes prevalence, and the extent to which their relationship was modified by socio-demographic characteristics, body mass index (BMI), diagnostic definitions used for diabetes and prediabetes, and HIV-related characteristics, including CD4 count, and use and duration of ART., Methods: For this systematic review and meta-analysis (PROSPERO registration CRD42021231547), a comprehensive search of major databases (PubMed-MEDLINE, Scopus, Web of Science, Google Scholar and WHO Global Health Library) was conducted. Original research articles published between 2000 and 2021 in English and French were included, irrespective of study design, data collection techniques and diagnostic definitions used. Observational studies comprising at least 30 PLHIV and reporting on diabetes and/or prediabetes prevalence in Africa were included. Study-specific estimates were pooled using random effects models to generate the overall prevalence for each diagnostic definition. Data analyses used R statistical software and "meta" package., Results: Of the 2614 records initially screened, 366 full-text articles were assessed for eligibility and 61 were selected. In the systematic review, all studies were cross-sectional by design and clinic-based, except for five population-based studies. Across studies included in the meta-analysis, the proportion of men was 16-84%. Mean/median age was 30-62 years. Among 86,412 and 7976 participants, diabetes and prediabetes prevalence rates were 5.1% (95% CI: 4.3-5.9) and 15.1% (9.7-21.5). Self-reported diabetes (3.5%) was lower than when combined with biochemical assessments (6.2%; 7.2%)., Discussion: While not statistically significant, diabetes and prediabetes were higher with greater BMI, in older participants, urban residents and more recent publications. Diabetes and prediabetes were not significantly different by HIV-related factors, including CD4 count and ART., Conclusions: Although HIV-related factors did not modify prevalence, the diabetes burden in African PLHIV was considerable with suboptimal detection, and likely influenced by traditional risk factors. Furthermore, high prediabetes prevalence foreshadows substantial increases in future diabetes in African PLHIV., (© 2023 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.)

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2023
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46. Clinical risk factors of adverse outcomes among women with COVID-19 in the pregnancy and postpartum period: a sequential, prospective meta-analysis.

Author

Smith ER, Oakley E, Grandner GW, Rukundo G, Farooq F, Ferguson K, Baumann S, Adams Waldorf KM, Afshar Y, Ahlberg M, Ahmadzia H, Akelo V, Aldrovandi G, Bevilacqua E, Bracero N, Brandt JS, Broutet N, Carrillo J, Conry J, Cosmi E, Crispi F, Crovetto F, Del Mar Gil M, Delgado-López C, Divakar H, Driscoll AJ, Favre G, Fernandez Buhigas I, Flaherman V, Gale C, Godwin CL, Gottlieb S, Gratacós E, He S, Hernandez O, Jones S, Joshi S, Kalafat E, Khagayi S, Knight M, Kotloff KL, Lanzone A, Laurita Longo V, Le Doare K, Lees C, Litman E, Lokken EM, Madhi SA, Magee LA, Martinez-Portilla RJ, Metz TD, Miller ES, Money D, Moungmaithong S, Mullins E, Nachega JB, Nunes MC, Onyango D, Panchaud A, Poon LC, Raiten D, Regan L, Sahota D, Sakowicz A, Sanin-Blair J, Stephansson O, Temmerman M, Thorson A, Thwin SS, Tippett Barr BA, Tolosa JE, Tug N, Valencia-Prado M, Visentin S, von Dadelszen P, Whitehead C, Wood M, Yang H, Zavala R, and Tielsch JM

Subjects
Pregnancy, Infant, Newborn, Female, Humans, Prospective Studies, Thinness, SARS-CoV-2, Pregnancy Outcome epidemiology, Risk Factors, Postpartum Period, COVID-19 epidemiology, Premature Birth epidemiology, HIV Infections, Cardiovascular Diseases, Pregnancy Complications epidemiology, Hypertension
Abstract

Objective: This sequential, prospective meta-analysis sought to identify risk factors among pregnant and postpartum women with COVID-19 for adverse outcomes related to disease severity, maternal morbidities, neonatal mortality and morbidity, and adverse birth outcomes., Data Sources: We prospectively invited study investigators to join the sequential, prospective meta-analysis via professional research networks beginning in March 2020., Study Eligibility Criteria: Eligible studies included those recruiting at least 25 consecutive cases of COVID-19 in pregnancy within a defined catchment area., Methods: We included individual patient data from 21 participating studies. Data quality was assessed, and harmonized variables for risk factors and outcomes were constructed. Duplicate cases were removed. Pooled estimates for the absolute and relative risk of adverse outcomes comparing those with and without each risk factor were generated using a 2-stage meta-analysis., Results: We collected data from 33 countries and territories, including 21,977 cases of SARS-CoV-2 infection in pregnancy or postpartum. We found that women with comorbidities (preexisting diabetes mellitus, hypertension, cardiovascular disease) vs those without were at higher risk for COVID-19 severity and adverse pregnancy outcomes (fetal death, preterm birth, low birthweight). Participants with COVID-19 and HIV were 1.74 times (95% confidence interval, 1.12-2.71) more likely to be admitted to the intensive care unit. Pregnant women who were underweight before pregnancy were at higher risk of intensive care unit admission (relative risk, 5.53; 95% confidence interval, 2.27-13.44), ventilation (relative risk, 9.36; 95% confidence interval, 3.87-22.63), and pregnancy-related death (relative risk, 14.10; 95% confidence interval, 2.83-70.36). Prepregnancy obesity was also a risk factor for severe COVID-19 outcomes including intensive care unit admission (relative risk, 1.81; 95% confidence interval, 1.26-2.60), ventilation (relative risk, 2.05; 95% confidence interval, 1.20-3.51), any critical care (relative risk, 1.89; 95% confidence interval, 1.28-2.77), and pneumonia (relative risk, 1.66; 95% confidence interval, 1.18-2.33). Anemic pregnant women with COVID-19 also had increased risk of intensive care unit admission (relative risk, 1.63; 95% confidence interval, 1.25-2.11) and death (relative risk, 2.36; 95% confidence interval, 1.15-4.81)., Conclusion: We found that pregnant women with comorbidities including diabetes mellitus, hypertension, and cardiovascular disease were at increased risk for severe COVID-19-related outcomes, maternal morbidities, and adverse birth outcomes. We also identified several less commonly known risk factors, including HIV infection, prepregnancy underweight, and anemia. Although pregnant women are already considered a high-risk population, special priority for prevention and treatment should be given to pregnant women with these additional risk factors., (Copyright © 2022. Published by Elsevier Inc.)

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2023
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47. Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: an individual participant data meta-analysis.

Author

Smith ER, Oakley E, Grandner GW, Ferguson K, Farooq F, Afshar Y, Ahlberg M, Ahmadzia H, Akelo V, Aldrovandi G, Tippett Barr BA, Bevilacqua E, Brandt JS, Broutet N, Fernández Buhigas I, Carrillo J, Clifton R, Conry J, Cosmi E, Crispi F, Crovetto F, Delgado-López C, Divakar H, Driscoll AJ, Favre G, Flaherman VJ, Gale C, Gil MM, Gottlieb SL, Gratacós E, Hernandez O, Jones S, Kalafat E, Khagayi S, Knight M, Kotloff K, Lanzone A, Le Doare K, Lees C, Litman E, Lokken EM, Laurita Longo V, Madhi SA, Magee LA, Martinez-Portilla RJ, McClure EM, Metz TD, Miller ES, Money D, Moungmaithong S, Mullins E, Nachega JB, Nunes MC, Onyango D, Panchaud A, Poon LC, Raiten D, Regan L, Rukundo G, Sahota D, Sakowicz A, Sanin-Blair J, Söderling J, Stephansson O, Temmerman M, Thorson A, Tolosa JE, Townson J, Valencia-Prado M, Visentin S, von Dadelszen P, Adams Waldorf K, Whitehead C, Yassa M, and Tielsch JM

Subjects
Infant, Newborn, Pregnancy, Female, Humans, Prospective Studies, SARS-CoV-2, Pregnant Women, COVID-19
Abstract

Introduction: Despite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies., Methods: We screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale., Results: We screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women.Pregnant women with SARS-CoV-2 infection-as compared with uninfected pregnant women-were at significantly increased risk of maternal mortality (10 studies; n=1490; RR 7.68, 95% CI 1.70 to 34.61); admission to intensive care unit (8 studies; n=6660; RR 3.81, 95% CI 2.03 to 7.17); receiving mechanical ventilation (7 studies; n=4887; RR 15.23, 95% CI 4.32 to 53.71); receiving any critical care (7 studies; n=4735; RR 5.48, 95% CI 2.57 to 11.72); and being diagnosed with pneumonia (6 studies; n=4573; RR 23.46, 95% CI 3.03 to 181.39) and thromboembolic disease (8 studies; n=5146; RR 5.50, 95% CI 1.12 to 27.12).Neonates born to women with SARS-CoV-2 infection were more likely to be admitted to a neonatal care unit after birth (7 studies; n=7637; RR 1.86, 95% CI 1.12 to 3.08); be born preterm (7 studies; n=6233; RR 1.71, 95% CI 1.28 to 2.29) or moderately preterm (7 studies; n=6071; RR 2.92, 95% CI 1.88 to 4.54); and to be born low birth weight (12 studies; n=11 930; RR 1.19, 95% CI 1.02 to 1.40). Infection was not linked to stillbirth. Studies were generally at low or moderate risk of bias., Conclusions: This analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity, but not stillbirth or intrauterine growth restriction. As more data become available, we will update these findings per the published protocol., Competing Interests: Competing interests: CW declares a relationship with Ferring Pharmaceuticals COVID-19 Investigational Grant and NHMRC Fellowship (salary support). AP declares the following research grants to her institution: ‘H2020-Grant—Consortium member of Innovative medicine initiative call 13 topic 9 «ConcePTION», Efficacy and safety studies on Medicines EMA/2017/09/PE/11, Lot 4, WP 2 lead, Safety monitoring of COVID-19 vaccines in the EU—Reopening of competition no. 20 under a framework contract following procurement procedure EMA/2017/09/PE (Lot 3) (Euro 110,000), Federal Office of Public Health (207,000 CHF)’. EM declares a relationship with the National Institute for Health Research (project grant for PAN COVID study). DM declares a relationship with the Canadian Institutes of Health Research (payments to institution only), Public Health Agency of Canada (payments to institution only), BC Women’s Foundation (payments to institution only) and is a member of the COVID-19 Immunity Task Force sponsored by the Canadian government. TDM declares a relationship with Pfizer (site principal investigator for SARS-CoV-2 vaccination in pregnancy study, money paid to institution and member of Medical Advisory Board for SARS-CoV-2 vaccination in pregnancy study, money paid to TDM), NICHD (subcommittee chair for the NICHD Maternal-Fetal Medicine Units Network Gestational Research Assessments of COVID-19 (GRAVID) study) and Society for Maternal-Fetal Medicine (board member). EL declares a relationship with the US NIH (paid institution) and is an employee of AbbVie, but was employed at the University of Washington at the time of the study. KK declares a relationship with the Bill & Melinda Gates Foundation. VJF declares a relationship with the Bill & Melinda Gates Foundation (payments to institution), Yellow Chair Foundation (payments to institution), Robert Woods Johnson Foundation (payments to institution), CDC Foundation, California Health Care Foundation (payments to institution), Tara Health Foundation (payments to institution), UCSF Women’s Health Center of Excellence (payments to institution) and California Department of Health Care Services (payments made to institution). JS-B declares a relationship with the Ferring Pharmaceuticals, which gave a grant ($10 000) for the expenses of RECOGEST trial and is a part of the Columbian Federation of Perinatology. YA declares a relationship with the Bill & Melinda Gates Foundation (payments made to institution), CDC Foundation (payments made to institution), Robert Woods Johnson Foundation (payments made to institution) and UCLA Dean’s Office COVID-19 research (payments made to institution). RC declares a relationship with the NIH HD36801 (MFMU Network DCC). MCN declares a relationship with the BMGF (project grant made to institution), EDCTP, Sanofi, AstraZeneca, Pfizer (research grants made to institution), Sanofi Pasteur (payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events) and Sanofi Pasteur and Pfizer (payment for expert testimony). ESM declares a relationship with Pfizer (site principal investigator for phase 2/3 RCT of COVID vaccine during pregnancy). OS declares a relationship with the NordForsk Funding (Nordic research funding grant number: 105545), the Swedish Medical Products Agency (funding for reports on COVID-19 vaccines and pregnancy) and Karolinska Institutet (funding for COVID research and pregnancy: 2020-01567). EG declares a relationship with the Stavros Niarchos Foundation, Santander Foundation and ‘La Caixa’ Foundation (payments made to institution). SAM declares a relationship with BMGF (funded study in South Africa)., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Published
2023
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48. Advanced HIV Disease at Antiretroviral Therapy Initiation and Treatment Outcomes Among Children and Adolescents Compared to Adults Living With HIV in Kinshasa, Democratic Republic of the Congo.

Author

Chabikuli ON, Ditekemena JD, Sigwadhi LN, Mulenga A, Mboyo A, Bidashimwa D, and Nachega JB

Subjects
Adult, Child, Humans, Adolescent, Democratic Republic of the Congo epidemiology, Retrospective Studies, Cohort Studies, Treatment Outcome, HIV Infections drug therapy, HIV Infections epidemiology
Abstract

Background: Little is known about advanced HIV disease (AHD) at antiretroviral therapy (ART) initiation among children and adolescents living with HIV (CALHIV) and related age disparities in the Democratic Republic of the Congo (DRC). Methods: We conducted a retrospective cohort analysis of routine program data collected among adults, adolescents, and children living with HIV in 6 health zones in Kinshasa, DRC from 2005 to 2020. Results: Thirty-two percent of those who initiated ART had AHD. Compared to adults, adolescents had a 15% higher risk of AHD (RR: 1.15; 95% CI: 1.08-1.21; P <  .001). Despite their higher risk of AHD, adolescents had a lower risk of mortality (aSHR: 0.72; 95% CI: 0.52-0.99; P  = .047) and lower cumulative death events versus adults (aSHR: 0.44; 95% CI: 0.34-0.59; P  < .001). Conclusions: ADH at ART initiation is highly prevalent in Kinshasa, DRC, and adolescents are disproportionally impacted. There is a need to scale up high-impact HIV interventions targeting CALHIV., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2023
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49. Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis.

Author

Nachega JB, Sam-Agudu NA, Machekano RN, Rosenthal PJ, Schell S, de Waard L, Bekker A, Gachuno OW, Kinuthia J, Mwongeli N, Budhram S, Vannevel V, Somapillay P, Prozesky HW, Taljaard J, Parker A, Agyare E, Opoku AB, Makarfi AU, Abdullahi AM, Adirieje C, Ishoso DK, Pipo MT, Tshilanda MB, Bongo-Pasi Nswe C, Ditekemena J, Sigwadhi LN, Nyasulu PS, Hermans MP, Sekikubo M, Musoke P, Nsereko C, Agbeno EK, Yeboah MY, Umar LW, Ntakwinja M, Mukwege DM, Birindwa EK, Mushamuka SZ, Smith ER, Mills EJ, Otshudiema JO, Mbala-Kingebeni P, Tamfum JM, Zumla A, Tsegaye A, Mteta A, Sewankambo NK, Suleman F, Adejumo P, Anderson JR, Noormahomed EV, Deckelbaum RJ, Stringer JSA, Mukalay A, Taha TE, Fowler MG, Wasserheit JN, Masekela R, Mellors JW, Siedner MJ, Myer L, Kengne AP, Yotebieng M, Mofenson LM, and Langenegger E

Subjects
Female, Pregnancy, Humans, Infant, SARS-CoV-2, Retrospective Studies, Hospital Mortality, COVID-19 Vaccines, Cohort Studies, Africa South of the Sahara epidemiology, COVID-19 epidemiology, Pregnancy Complications, Infectious
Abstract

Background: Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice., Methods: We conducted a 6-country retrospective cohort study among hospitalized women of childbearing age between 1 March 2020 and 31 March 2021. Exposures were (1) pregnancy and (2) a positive SARS-CoV-2 RT-PCR test. The primary outcome for both analyses was intensive care unit (ICU) admission. Secondary outcomes included supplemental oxygen requirement, mechanical ventilation, adverse birth outcomes, and in-hospital mortality. We used log-binomial regression to estimate the effect between pregnancy and SARS-CoV-2 infection. Factors associated with mortality were evaluated using competing-risk proportional subdistribution hazards models., Results: Our analyses included 1315 hospitalized women: 510 pregnant women with SARS-CoV-2, 403 nonpregnant women with SARS-CoV-2, and 402 pregnant women without SARS-CoV-2 infection. Among women with SARS-CoV-2 infection, pregnancy was associated with increased risk for ICU admission (adjusted risk ratio [aRR]: 2.38; 95% CI: 1.42-4.01), oxygen supplementation (aRR: 1.86; 95% CI: 1.44-2.42), and hazard of in-hospital death (adjusted sub-hazard ratio [aSHR]: 2.00; 95% CI: 1.08-3.70). Among pregnant women, SARS-CoV-2 infection increased the risk of ICU admission (aRR: 2.0; 95% CI: 1.20-3.35), oxygen supplementation (aRR: 1.57; 95% CI: 1.17-2.11), and hazard of in-hospital death (aSHR: 5.03; 95% CI: 1.79-14.13)., Conclusions: Among hospitalized women in SSA, both SARS-CoV-2 infection and pregnancy independently increased risks of ICU admission, oxygen supplementation, and death. These data support international recommendations to prioritize COVID-19 vaccination among pregnant women., Competing Interests: Potential conflicts of interest. J. B. N. is an infectious disease internist and epidemiologist and Principal Investigator (PI) of NIH/FIC grant numbers 1R25TW011217-01, 1R21TW011706-01, and 1D43TW010937-01A1; and payment to University of Pittsburgh. N. A. S.-A. is a clinician-scientist in Pediatric Infectious Diseases and implementation research; she is supported by the NIH National Institute of Child Health and Human Development (NICHD) grant number R01HD089866; by an NIH/FIC award through the Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA) for the Central and West Africa Implementation Science Alliance (CAWISA) (payment to institution); and by NIH/FIC grant number 1D43TW012280-01. F. S., N. K. S., and A. P. are supported as PIs by NIH/FIC grant number 1R25TW011217-01. A. Z. is PIs of the Pan-African Network on Emerging and Re-Emerging Infections (PANDORA-ID-NET; https://www.pandora-id.net) funded by the European Developing Countries Clinical Trial Partnership (EDCTP) and the European Union Horizon 2020 Framework Program for Research and Innovation, paid to institution (University College London, London, UK). R. N. M. reports grants or contracts unrelated to this work, and payment to their institution: NIH/FIC1D43TW010547-01—The African Center for Biostatistical Excellence (ACBE). P. J. R. reports the following grants or contracts unrelated to this work and paid to their institution: 5R01AI075045-12, 5R01AI139179-04, and 5R01AI117001-07. E. R. S. reports a Bill and Melinda Gates Foundation grant for a prospective meta-analysis of COVID-19 in pregnancy, unrelated to this work, and payment to George Washington University. A. B. reports grants or contracts unrelated to this work—NIH: IMPAACT Vice-chair Funding for P1106; and UNITAID: Benefit KIDS funding for PETITE Study. P. A. reports grants or contracts unrelated to this work and paid to the University of Ibadan, Nigeria: NIH/FIC R25 grant number 1R25TW011217-01 to AFREhealth. J. W. N. reports grants paid to the University of Pittsburgh from the NIH to the Pitt-Ohio State Clinical Trials Unit (UM1 AI068636), the University of Pittsburgh Virology Support Laboratory (UM1 AI106701), the I4C Martin Delaney Collaboratory for an HIV Cure (UM1 AI126603), the REACH Martin Delaney Collaboratory for HIV Cure (UM1 AI164565), and from the National Cancer Institute through Leidos contract numbers HHSN261200800001E and 75N91019D00024 USAID; Gilead Sciences, Inc; and Janssen Pharmaceuticals. J. W. N. also reports consulting fees from Gilead Sciences, Inc (Scientific Advisory Board), Accelevir Diagnostics (Consulting Agreement), and Merck (Consulting Agreement); shares from Abound Bio, Inc, share options from Co-Crystal Pharma, Inc, and share options from Infectious Diseases Connect; a consulting agreement with Xi’an Yufan Biotechnologies; and employment with the University of Pittsburgh. M. S. reports grants or contracts unrelated to this work and paid to their institution (MGH-Boston, MA, USA): NIH/NIA R01AG059504-03 and NIH/NHLBI R01 HL141053-04. A.-P. K. reports research support unrelate to this work paid to their institution (South African Medical Research Council): NIH/FIC 1R21TW011706-01-Dolutegravir, Weight Gain and Metabolic Outcomes in South Africa. L. M. reports consulting fees from the World Health Organization on COVID in pregnancy and mother to child SARS-CoV-2 transmission (this contract is now completed); and payment from Virology Education for a talk on SARS-CoV-2 in pregnancy and possibility of mother-to-child SARS-CoV-2 transmission for continuing education sponsored by Virology Education. M. Y. is PI of the NIH/National Institute of Allergy and Infectious Diseases (NIH/NIAID) grant number 5U01AI096299-13 of the Central Africa-International epidemiology to Evaluate AIDS (CA-IeDEA). M. Y. also reports grants or contracts unrelated to this work and paid to their institution: NIH grant numbers 5U01AI096299 (NIAID), R01HD087993 (NICHD), U54CA254568 (National Cancer Institute), and R01HD105526 (NICHD). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.)

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2022
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50. Toward a New Paradigm of North-South and South-South Partnerships for Pandemic Preparedness: Lessons Learned from COVID-19 and Other Outbreaks.

Author

Nsanzimana S, Rawat A, Wilson LA, Forrest JI, Reis G, Ramagopalan S, Muyembe-Tamfum JJ, Ntoumi F, Zumla A, Sow PS, Nachega JB, Binagwaho A, Dybul M, and Mills EJ

Subjects
Humans, Disease Outbreaks prevention & control, Capacity Building, Public Health, Pandemics prevention & control, COVID-19 prevention & control
Abstract

COVID-19 underscores the need to reimagine North-South partnerships and redefine best practices for building public health and research capacity to address emergent health threats and pandemic preparedness in low- and-middle income countries (LMICs). Historically, outbreak and emergency responses have failed to ensure that the Global South has the autonomy and capacity to respond to public health threats in a timely and equitable manner. The COVID-19 response, however, has demonstrated that innovations and solutions in the Global South can not only fill resource and capacity gaps in LMICs but can also provide solutions to challenges globally. These innovations offer valuable lessons about strengthening local manufacturing capacity to produce essential diagnostic, treatment, and prevention tools; implementing high-quality research studies; expanding laboratory and research capacity; and promoting effective cooperation and governance. We discuss specific examples of capacity-building from Rwanda, South Africa, and Senegal. To fulfill promises made to the Global South during the COVID-19 pandemic, restore and resume health service delivery, and effectively prevent and respond to the next health threat, we need to prioritize equitable access to local manufacturing of basic health tools while building health systems capacities in the Global South.

Published
2022
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