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1. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Author: Naghavi, M, Ong, KL, Aali, A, Ababneh, HS, Abate, YH, Abbafati, C, Abbasgholizadeh, R, Abbasian, M, Abbasi-Kangevari, M, Abbastabar, H, Abd ElHafeez, S, Abdelmasseh, M, Abd-Elsalam, S, Abdelwahab, A, Abdollahi, M, Abdollahifar, M-A, Abdoun, M, Abdulah, DM, Abdullahi, A, Abebe, M, Abebe, SS, Abedi, A, Abegaz, KH, Abhilash, ES, Abidi, H, Abiodun, O, Aboagye, RG, Abolhassani, H, Abolmaali, M, Abouzid, M, Aboye, GB, Abreu, LG, Abrha, WA, Abtahi, D, Abu Rumeileh, S, Abualruz, H, Abubakar, B, Abu-Gharbieh, E, Abu-Rmeileh, NME, Aburuz, S, Abu-Zaid, A, Accrombessi, MMK, Adal, TG, Adamu, AA, Addo, IY, Addolorato, G, Adebiyi, AO, Adekanmbi, V, Adepoju, AV, Adetunji, CO, Adetunji, JB, Adeyeoluwa, TE, Adeyinka, DA, Adeyomoye, OI, Admass, BAA, Adnani, QES, Adra, S, Afolabi, AA, Afzal, MS, Afzal, S, Agampodi, SB, Agasthi, P, Aggarwal, M, Aghamiri, S, Agide, FD, Agodi, A, Agrawal, A, Agyemang-Duah, W, Ahinkorah, BO, Ahmad, A, Ahmad, D, Ahmad, F, Ahmad, MM, Ahmad, S, Ahmad, T, Ahmadi, K, Ahmadzade, AM, Ahmed, A, Ahmed, H, Ahmed, LA, Ahmed, MS, Ahmed, MB, Ahmed, SA, Ajami, M, Aji, B, Akara, EM, Akbarialiabad, H, Akinosoglou, K, Akinyemiju, T, Akkaif, MA, Akyirem, S, Al Hamad, H, Al Hasan, SM, Alahdab, F, Alalalmeh, SO, Alalwan, TA, Al-Aly, Z, Alam, K, Alam, M, Alam, N, Al-amer, RM, Alanezi, FM, Alanzi, TM, Al-Azzam, S, Albakri, A, Albashtawy, M, AlBataineh, MT, Alcalde-Rabanal, JE, Aldawsari, KA, Aldhaleei, WA, Aldridge, RW, Alema, HB, Alemayohu, MA, Alemi, S, Alemu, YM, Al-Gheethi, AAS, Alhabib, KF, Alhalaiqa, FAN, Al-Hanawi, MK, Ali, A, Ali, L, Ali, MU, Ali, R, Ali, S, Ali, SSS, Alicandro, G, Alif, SM, Alikhani, R, Alimohamadi, Y, Aliyi, AA, Aljasir, MAM, Aljunid, SM, Alla, F, Allebeck, P, Al-Marwani, S, Al-Maweri, SAA, Almazan, JU, Al-Mekhlafi, HM, Almidani, L, Almidani, O, Alomari, MA, Al-Omari, B, Alonso, J, Alqahtani, JS, Alqalyoobi, S, Alqutaibi, AY, Al-Sabah, SK, Altaany, Z, Altaf, A, Al-Tawfiq, JA, Altirkawi, KA, Aluh, DO, Alvis-Guzman, N, Alwafi, H, Al-Worafi, YM, Aly, H, Aly, S, Alzoubi, KH, Amani, R, Amare, AT, Amegbor, PM, Ameyaw, EK, Amin, TT, Amindarolzarbi, A, Amiri, S, Amirzade-Iranaq, MH, Amu, H, Amugsi, DA, Amusa, GA, Ancuceanu, R, Anderlini, D, Anderson, DB, Andrade, PP, Andrei, CL, Andrei, T, Angus, C, Anil, A, Anil, S, Anoushiravani, A, Ansari, H, Ansariadi, A, Ansari-Moghaddam, A, Antony, CM, Antriyandarti, E, Anvari, D, Anvari, S, Anwar, S, Anwar, SL, Anwer, R, Anyasodor, AE, Aqeel, M, Arab, JP, Arabloo, J, Arafat, M, Aravkin, AY, Areda, D, Aremu, A, Aremu, O, Ariffin, H, Arkew, M, Armocida, B, Arndt, MB, Ärnlöv, J, Arooj, M, Artamonov, AA, Arulappan, J, Aruleba, RT, Arumugam, A, Asaad, M, Asadi-Lari, M, Asgedom, AA, Asghariahmadabad, M, Asghari-Jafarabadi, M, Ashraf, M, Aslani, A, Astell-Burt, T, Athar, M, Athari, SS, Atinafu, BTT, Atlaw, HW, Atorkey, P, Atout, MMW, Atreya, A, Aujayeb, A, Ausloos, M, Avan, A, Awedew, AF, Aweke, AM, Ayala Quintanilla, BP, Ayatollahi, H, Ayuso-Mateos, JL, Ayyoubzadeh, SM, Azadnajafabad, S, Azevedo, RMS, Azzam, AY, B, DB, Babu, AS, Badar, M, Badiye, AD, Baghdadi, S, Bagheri, N, Bagherieh, S, Bah, S, Bahadorikhalili, S, Bahmanziari, N, Bai, R, Baig, AA, Baker, JL, Bako, AT, Bakshi, RK, Balakrishnan, S, Balasubramanian, M, Baltatu, OC, Bam, K, Banach, M, Bandyopadhyay, S, Banik, PC, Bansal, H, Bansal, K, Barbic, F, Barchitta, M, Bardhan, M, Bardideh, E, Barker-Collo, SL, Bärnighausen, TW, Barone-Adesi, F, Barqawi, HJ, Barrero, LH, Barrow, A, Barteit, S, Barua, L, Basharat, Z, Bashiri, A, Basiru, A, Baskaran, P, Basnyat, B, Bassat, Q, Basso, JD, Basting, AVL, Basu, S, Batra, K, Baune, BT, Bayati, M, Bayileyegn, NS, Beaney, T, Bedi, N, Beghi, M, Behboudi, E, Behera, P, Behnoush, AH, Behzadifar, M, Beiranvand, M, Bejarano Ramirez, DF, Béjot, Y, Belay, SA, Belete, CM, Bell, ML, Bello, MB, Bello, OO, Belo, L, Beloukas, A, Bender, RG, Bensenor, IM, Beran, A, Berezvai, Z, Berhie, AY, Berice, BN, Bernstein, RS, Bertolacci, GJ, Bettencourt, PJG, Beyene, KA, Bhagat, DS, Bhagavathula, AS, Bhala, N, Bhalla, A, Bhandari, D, Bhangdia, K, Bhardwaj, N, Bhardwaj, P, Bhardwaj, PV, Bhargava, A, Bhaskar, S, Bhat, V, Bhatti, GK, Bhatti, JS, Bhatti, MS, Bhatti, R, Bhutta, ZA, Bikbov, B, Bishai, JD, Bisignano, C, Bisulli, F, Biswas, A, Biswas, B, Bitaraf, S, Bitew, BD, Bitra, VR, Bjørge, T, Boachie, MK, Boampong, MS, Bobirca, AV, Bodolica, V, Bodunrin, AO, Bogale, EK, Bogale, KA, Bohlouli, S, Bolarinwa, OA, Boloor, A, Bonakdar Hashemi, M, Bonny, A, Bora, K, Bora Basara, B, Borhany, H, Borzutzky, A, Bouaoud, S, Boustany, A, Boxe, C, Boyko, EJ, Brady, OJ, Braithwaite, D, Brant, LC, Brauer, M, Brazinova, A, Brazo-Sayavera, J, Breitborde, NJK, Breitner, S, Brenner, H, Briko, AN, Briko, NI, Britton, G, Brown, J, Brugha, T, Bulamu, NB, Bulto, LN, Buonsenso, D, Burns, RA, Busse, R, Bustanji, Y, Butt, NS, Butt, ZA, Caetano dos Santos, FL, Calina, D, Cámera, LA, Campos, LA, Campos-Nonato, IR, Cao, C, Cao, Y, Capodici, A, Cárdenas, R, Carr, S, Carreras, G, Carrero, JJ, Carugno, A, Carvalheiro, CG, Carvalho, F, Carvalho, M, Castaldelli-Maia, JM, Castañeda-Orjuela, CA, Castelpietra, G, Catalá-López, F, Catapano, AL, Cattaruzza, MS, Cederroth, CR, Cegolon, L, Cembranel, F, Cenderadewi, M, Cercy, KM, Cerin, E, Cevik, M, Chadwick, J, Chahine, Y, Chakraborty, C, Chakraborty, PA, Chan, JSK, Chan, RNC, Chandika, RM, Chandrasekar, EK, Chang, C-K, Chang, J-C, Chanie, GS, Charalampous, P, Chattu, VK, Chaturvedi, P, Chatzimavridou-Grigoriadou, V, Chaurasia, A, Chen, AW, Chen, A-T, Chen, CS, Chen, H, Chen, MX, Chen, S, Cheng, C-Y, Cheng, ETW, Cherbuin, N, Cheru, WA, Chien, J-H, Chimed-Ochir, O, Chimoriya, R, Ching, PR, Chirinos-Caceres, JL, Chitheer, A, Cho, WCS, Chong, B, Chopra, H, Choudhari, SG, Chowdhury, R, Christopher, DJ, Chukwu, IS, Chung, E, Chung, S-C, Chutiyami, M, Cindi, Z, Cioffi, I, Claassens, MM, Claro, RM, Coberly, K, Cogen, RM, Columbus, A, Comfort, H, Conde, J, Cortese, S, Cortesi, PA, Costa, VM, Costanzo, S, Cousin, E, Couto, RAS, Cowden, RG, Cramer, KM, Criqui, MH, Cruz-Martins, N, Cuadra-Hernández, SM, Culbreth, GT, Cullen, P, Cunningham, M, Curado, MP, Dadana, S, Dadras, O, Dai, S, Dai, X, Dai, Z, Dalli, LL, Damiani, G, Darega Gela, J, Das, JK, Das, S, Dascalu, AM, Dash, NR, Dashti, M, Dastiridou, A, Davey, G, Dávila-Cervantes, CA, Davis Weaver, N, Davletov, K, De Leo, D, de Luca, K, Debele, AT, Debopadhaya, S, Degenhardt, L, Dehghan, A, Deitesfeld, L, Del Bo', C, Delgado-Enciso, I, Demessa, BH, Demetriades, AK, Deng, K, Deng, X, Denova-Gutiérrez, E, Deravi, N, Dereje, N, Dervenis, N, Dervišević, E, Des Jarlais, DC, Desai, HD, Desai, R, Devanbu, VGC, Dewan, SMR, Dhali, A, Dhama, K, Dhimal, M, Dhingra, S, Dhulipala, VR, Dias da Silva, D, Diaz, D, Diaz, MJ, Dima, A, Ding, DD, Ding, H, Dinis-Oliveira, RJ, Dirac, MA, Djalalinia, S, Do, THP, do Prado, CB, Doaei, S, Dodangeh, M, Dohare, S, Dokova, KG, Dolecek, C, Dominguez, R-MV, Dong, W, Dongarwar, D, D'Oria, M, Dorostkar, F, Dorsey, ER, dos Santos, WM, Doshi, R, Doshmangir, L, Dowou, RK, Driscoll, TR, Dsouza, HL, Dsouza, V, Du, M, Dube, J, Duncan, BB, Duraes, AR, Duraisamy, S, Durojaiye, OC, Dwyer-Lindgren, L, Dzianach, PA, Dziedzic, AM, E'mar, AR, Eboreime, E, Ebrahimi, A, Echieh, CP, Edinur, HA, Edvardsson, D, Edvardsson, K, Efendi, D, Efendi, F, Effendi, DE, Eikemo, TA, Eini, E, Ekholuenetale, M, Ekundayo, TC, El Sayed, I, Elbarazi, I, Elema, TB, Elemam, NM, Elgar, FJ, Elgendy, IY, ElGohary, GMT, Elhabashy, HR, Elhadi, M, El-Huneidi, W, Elilo, LT, Elmeligy, OAA, Elmonem, MA, Elshaer, M, Elsohaby, I, Emeto, TI, Engelbert Bain, L, Erkhembayar, R, Esezobor, CI, Eshrati, B, Eskandarieh, S, Espinosa-Montero, J, Esubalew, H, Etaee, F, Fabin, N, Fadaka, AO, Fagbamigbe, AF, Fahim, A, Fahimi, S, Fakhri-Demeshghieh, A, Falzone, L, Fareed, M, Farinha, CSES, Faris, MEM, Faris, PS, Faro, A, Fasanmi, AO, Fatehizadeh, A, Fattahi, H, Fauk, NK, Fazeli, P, Feigin, VL, Feizkhah, A, Fekadu, G, Feng, X, Fereshtehnejad, S-M, Feroze, AH, Ferrante, D, Ferrari, AJ, Ferreira, N, Fetensa, G, Feyisa, BR, Filip, I, Fischer, F, Flavel, J, Flood, D, Florin, BT, Foigt, NA, Folayan, MO, Fomenkov, AA, Foroutan, B, Foroutan, M, Forthun, I, Fortuna, D, Foschi, M, Fowobaje, KR, Francis, KL, Franklin, RC, Freitas, A, Friedman, J, Friedman, SD, Fukumoto, T, Fuller, JE, Fux, B, Gaal, PA, Gadanya, MA, Gaidhane, AM, Gaihre, S, Gakidou, E, Galali, Y, Galles, NC, Gallus, S, Ganbat, M, Gandhi, AP, Ganesan, B, Ganiyani, MA, Garcia-Gordillo, MA, Gardner, WM, Garg, J, Garg, N, Gautam, RK, Gbadamosi, SO, Gebi, TG, Gebregergis, MW, Gebrehiwot, M, Gebremeskel, TG, Georgescu, SR, Getachew, T, Gething, PW, Getie, M, Ghadiri, K, Ghahramani, S, Ghailan, KY, Ghasemi, M-R, Ghasempour Dabaghi, G, Ghasemzadeh, A, Ghashghaee, A, Ghassemi, F, Ghazy, RM, Ghimire, A, Ghoba, S, Gholamalizadeh, M, Gholamian, A, Gholamrezanezhad, A, Gholizadeh, N, Ghorbani, M, Ghorbani Vajargah, P, Ghoshal, AG, Gill, PS, Gill, TK, Gillum, RF, Ginindza, TG, Girmay, A, Glasbey, JC, Gnedovskaya, EV, Göbölös, L, Godinho, MA, Goel, A, Golchin, A, Goldust, M, Golechha, M, Goleij, P, Gomes, NGM, Gona, PN, Gopalani, SV, Gorini, G, Goudarzi, H, Goulart, AC, Goulart, BNG, Goyal, A, Grada, A, Graham, SM, Grivna, M, Grosso, G, Guan, S-Y, Guarducci, G, Gubari, MIM, Gudeta, MD, Guha, A, Guicciardi, S, Guimarães, RA, Gulati, S, Gunawardane, DA, Gunturu, S, Guo, C, Gupta, AK, Gupta, B, Gupta, MK, Gupta, M, Gupta, RD, Gupta, R, Gupta, S, Gupta, VB, Gupta, VK, Gurmessa, L, Gutiérrez, RA, Habibzadeh, F, Habibzadeh, P, Haddadi, R, Hadei, M, Hadi, NR, Haep, N, Hafezi-Nejad, N, Hailu, A, Haj-Mirzaian, A, Halboub, ES, Hall, BJ, Haller, S, Halwani, R, Hamadeh, RR, Hameed, S, Hamidi, S, Hamilton, EB, Han, C, Han, Q, Hanif, A, Hanifi, N, Hankey, GJ, Hanna, F, Hannan, MA, Haque, MN, Harapan, H, Hargono, A, Haro, JM, Hasaballah, AI, Hasan, I, Hasan, MT, Hasani, H, Hasanian, M, Hashi, A, Hasnain, MS, Hassan, I, Hassanipour, S, Hassankhani, H, Haubold, J, Havmoeller, RJ, Hay, SI, He, J, Hebert, JJ, Hegazi, OE, Heidari, G, Heidari, M, Heidari-Foroozan, M, Helfer, B, Hendrie, D, Herrera-Serna, BY, Herteliu, C, Hesami, H, Hezam, K, Hill, CL, Hiraike, Y, Holla, R, Horita, N, Hossain, MM, Hossain, S, Hosseini, M-S, Hosseinzadeh, H, Hosseinzadeh, M, Hosseinzadeh Adli, A, Hostiuc, M, Hostiuc, S, Hsairi, M, Hsieh, VC-R, Hsu, RL, Hu, C, Huang, J, Hultström, M, Humayun, A, Hundie, TG, Hussain, J, Hussain, MA, Hussein, NR, Hussien, FM, Huynh, H-H, Hwang, B-F, Ibitoye, SE, Ibrahim, KS, Iftikhar, PM, Ijo, D, Ikiroma, AI, Ikuta, KS, Ikwegbue, PC, Ilesanmi, OS, Ilic, IM, Ilic, MD, Imam, MT, Immurana, M, Inamdar, S, Indriasih, E, Iqhrammullah, M, Iradukunda, A, Iregbu, KC, Islam, MR, Islam, SMS, Islami, F, Ismail, F, Ismail, NE, Iso, H, Isola, G, Iwagami, M, Iwu, CCD, Iyamu, IO, Iyer, M, J, LM, Jaafari, J, Jacob, L, Jacobsen, KH, Jadidi-Niaragh, F, Jafarinia, M, Jafarzadeh, A, Jaggi, K, Jahankhani, K, Jahanmehr, N, Jahrami, H, Jain, N, Jairoun, AA, Jaiswal, A, Jamshidi, E, Janko, MM, Jatau, AI, Javadov, S, Javaheri, T, Jayapal, SK, Jayaram, S, Jebai, R, Jee, SH, Jeganathan, J, Jha, AK, Jha, RP, Jiang, H, Jin, Y, Johnson, O, Jokar, M, Jonas, JB, Joo, T, Joseph, A, Joseph, N, Joshua, CE, Joshy, G, Jozwiak, JJ, Jürisson, M, K, V, Kaambwa, B, Kabir, A, Kabir, Z, Kadashetti, V, Kadir, DH, Kalani, R, Kalankesh, LR, Kaliyadan, F, Kalra, S, Kamal, VK, Kamarajah, SK, Kamath, R, Kamiab, Z, Kamyari, N, Kanagasabai, T, Kanchan, T, Kandel, H, Kanmanthareddy, AR, Kanmiki, EW, Kanmodi, KK, Kannan S, S, Kansal, SK, Kantar, RS, Kapoor, N, Karajizadeh, M, Karanth, SD, Karasneh, RA, Karaye, IM, Karch, A, Karim, A, Karimi, SE, Karimi Behnagh, A, Kashoo, FZ, Kasnazani, QHA, Kasraei, H, Kassebaum, NJ, Kassel, MB, Kauppila, JH, Kaur, N, Kawakami, N, Kayode, GA, Kazemi, F, Kazemian, S, Kazmi, TH, Kebebew, GM, Kebede, AD, Kebede, F, Keflie, TS, Keiyoro, PN, Keller, C, Kelly, JT, Kempen, JH, Kerr, JA, Kesse-Guyot, E, Khajuria, H, Khalaji, A, Khalid, N, Khalil, AA, Khalilian, A, Khamesipour, F, Khan, A, Khan, G, Khan, I, Khan, IA, Khan, MN, Khan, M, Khan, MJ, Khan, MAB, Khan, ZA, Khan suheb, MZ, Khanmohammadi, S, Khatab, K, Khatami, F, Khatatbeh, H, Khatatbeh, MM, Khavandegar, A, Khayat Kashani, HR, Khidri, FF, Khodadoust, E, Khorgamphar, M, Khormali, M, Khorrami, Z, Khosravi, A, Khosravi, MA, Kifle, ZD, Kim, G, Kim, J, Kim, K, Kim, MS, Kim, YJ, Kimokoti, RW, Kinzel, KE, Kisa, A, Kisa, S, Klu, D, Knudsen, AKS, Kocarnik, JM, Kochhar, S, Kocsis, T, Koh, DSQ, Kolahi, A-A, Kolves, K, Kompani, F, Koren, G, Kosen, S, Kostev, K, Koul, PA, Koulmane Laxminarayana, SL, Krishan, K, Krishna, H, Krishna, V, Krishnamoorthy, V, Krishnamoorthy, Y, Krohn, KJ, Kuate Defo, B, Kucuk Bicer, B, Kuddus, MA, Kuddus, M, Kuitunen, I, Kulimbet, M, Kulkarni, V, Kumar, A, Kumar, H, Kumar, M, Kumar, R, Kumari, M, Kumie, FT, Kundu, S, Kurmi, OP, Kusnali, A, Kusuma, D, Kwarteng, A, Kyriopoulos, I, Kyu, HH, La Vecchia, C, Lacey, B, Ladan, MA, Laflamme, L, Lagat, AK, Lager, ACJ, Lahmar, A, Lai, DTC, Lal, DK, Lalloo, R, Lallukka, T, Lam, H, Lám, J, Landrum, KR, Lanfranchi, F, Lang, JJ, Langguth, B, Lansingh, VC, Laplante-Lévesque, A, Larijani, B, Larsson, AO, Lasrado, S, Lassi, ZS, Latief, K, Latifinaibin, K, Lauriola, P, Le, NHH, Le, TTT, Le, TDT, Ledda, C, Ledesma, JR, Lee, M, Lee, PH, Lee, SW, Lee, SWH, Lee, W-C, Lee, YH, LeGrand, KE, Leigh, J, Leong, E, Lerango, TL, Li, M-C, Li, W, Li, X, Li, Y, Li, Z, Ligade, VS, Likaka, ATM, Lim, L-L, Lim, SS, Lindstrom, M, Linehan, C, Liu, C, Liu, G, Liu, J, Liu, R, Liu, S, Liu, X, Llanaj, E, Loftus, MJ, López-Bueno, R, Lopukhov, PD, Loreche, AM, Lorkowski, S, Lotufo, PA, Lozano, R, Lubinda, J, Lucchetti, G, Lugo, A, Lunevicius, R, Ma, ZF, Maass, KL, Machairas, N, Machoy, M, Madadizadeh, F, Madsen, C, Madureira-Carvalho, ÁM, Maghazachi, AA, Maharaj, SB, Mahjoub, S, Mahmoud, MA, Mahmoudi, A, Mahmoudi, E, Mahmoudi, R, Majeed, A, Makhdoom, IF, Malakan Rad, E, Maled, V, Malekzadeh, R, Malhotra, AK, Malhotra, K, Malik, AA, Malik, I, Malta, DC, Mamun, AA, Mansouri, P, Mansournia, MA, Mantovani, LG, Maqsood, S, Marasini, BP, Marateb, HR, Maravilla, JC, Marconi, AM, Mardi, P, Marino, M, Marjani, A, Martinez, G, Martinez-Guerra, BA, Martinez-Piedra, R, Martini, D, Martini, S, Martins-Melo, FR, Martorell, M, Marx, W, Maryam, S, Marzo, RR, Masaka, A, Masrie, A, Mathieson, S, Mathioudakis, AG, Mathur, MR, Mattumpuram, J, Matzopoulos, R, Maude, RJ, Maugeri, A, Maulik, PK, Mayeli, M, Mazaheri, M, Mazidi, M, McGrath, JJ, McKee, M, McKowen, ALW, McLaughlin, SA, McPhail, SM, Mechili, EA, Medina, JRC, Mediratta, RP, Meena, JK, Mehra, R, Mehrabani-Zeinabad, K, Mehrabi Nasab, E, Mekene Meto, T, Meles, GG, Mendez-Lopez, MAM, Mendoza, W, Menezes, RG, Mengist, B, Mentis, A-FA, Meo, SA, Meresa, HA, Meretoja, A, Meretoja, TJ, Mersha, AM, Mesfin, BA, Mestrovic, T, Mettananda, KCD, Mettananda, S, Meylakhs, P, Mhlanga, A, Mhlanga, L, Mi, T, Miazgowski, T, Micha, G, Michalek, IM, Miller, TR, Mills, EJ, Minh, LHN, Mini, GK, Mir Mohammad Sadeghi, P, Mirica, A, Mirijello, A, Mirrakhimov, EM, Mirutse, MK, Mirzaei, M, Misganaw, A, Mishra, A, Misra, S, Mitchell, PB, Mithra, P, Mittal, C, Mobayen, M, Moberg, ME, Mohamadkhani, A, Mohamed, J, Mohamed, MFH, Mohamed, NS, Mohammad-Alizadeh-Charandabi, S, Mohammadi, S, Mohammadian-Hafshejani, A, Mohammadifard, N, Mohammed, H, Mohammed, M, Mohammed, S, Mohan, V, Mojiri-Forushani, H, Mokari, A, Mokdad, AH, Molinaro, S, Molokhia, M, Momtazmanesh, S, Monasta, L, Mondello, S, Moni, MA, Moodi Ghalibaf, A, Moradi, M, Moradi, Y, Moradi-Lakeh, M, Moradzadeh, M, Moraga, P, Morawska, L, Moreira, RS, Morovatdar, N, Morrison, SD, Morze, J, Mosser, JF, Motappa, R, Mougin, V, Mouodi, S, Mousavi, P, Mousavi, SE, Mousavi Khaneghah, A, Mpolya, EA, Mrejen, M, Mubarik, S, Muccioli, L, Mueller, UO, Mughal, F, Mukherjee, S, Mulita, F, Munjal, K, Murillo-Zamora, E, Musaigwa, F, Musallam, KM, Mustafa, A, Mustafa, G, Muthupandian, S, Muthusamy, R, Muzaffar, M, Myung, W, Nagarajan, AJ, Nagel, G, Naghavi, P, Naheed, A, Naik, 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Shahsavari, HR, Shahwan, MJ, Shaikh, A, Shaikh, MA, Shakeri, A, Shalash, AS, Sham, S, Shamim, MA, Shams-Beyranvand, M, Shamshad, H, Shamsi, MA, Shanawaz, M, Shankar, A, Sharfaei, S, Sharifan, A, Sharifi-Rad, J, Sharma, R, Sharma, S, Sharma, U, Sharma, V, Shastry, RP, Shavandi, A, Shayan, M, Shehabeldine, AME, Sheikh, A, Sheikhi, RA, Shen, J, Shetty, A, Shetty, BSK, Shetty, PH, Shi, P, Shibuya, K, Shiferaw, D, Shigematsu, M, Shin, M-J, Shin, YH, Shiri, R, Shirkoohi, R, Shitaye, NA, Shittu, A, Shiue, I, Shivakumar, KM, Shivarov, V, Shokraneh, F, Shokri, A, Shool, S, Shorofi, SA, Shrestha, S, Shuval, K, Siddig, EE, Silva, JP, Silva, LMLR, Silva, S, Simpson, CR, Singal, A, Singh, A, Singh, BB, Singh, G, Singh, J, Singh, NP, Singh, P, Singh, S, Sinha, DN, Sinto, R, Siraj, MS, Sirota, SB, Sitas, F, Sivakumar, S, Skryabin, VY, Skryabina, AA, Sleet, DA, Socea, B, Sokhan, A, Solanki, R, Solanki, S, Soleimani, H, Soliman, SSM, Song, S, Song, Y, Sorensen, RJD, Soriano, JB, Soyiri, IN, Spartalis, M, Spearman, S, Sreeramareddy, CT, Srivastava, VK, Stanaway, JD, Stanikzai, MH, Stark, BA, Starnes, JR, Starodubova, AV, Stein, C, Stein, DJ, Steinbeis, F, Steiner, C, Steinmetz, JD, Steiropoulos, P, Stevanović, A, Stockfelt, L, Stokes, MA, Stortecky, S, Subramaniyan, V, Suleman, M, Suliankatchi Abdulkader, R, Sultana, A, Sun, HZ, Sun, J, Sundström, J, Sunkersing, D, Sunnerhagen, KS, Swain, CK, Szarpak, L, Szeto, MD, Szócska, M, Tabaee Damavandi, P, Tabarés-Seisdedos, R, Tabatabaei, SM, Tabatabaei Malazy, O, Tabatabaeizadeh, S-A, Tabatabai, S, Tabish, M, TADAKAMADLA, J, Tadakamadla, SK, Taheri Abkenar, Y, Taheri Soodejani, M, Taiba, J, Takahashi, K, Talaat, IM, Talukder, A, Tampa, M, Tamuzi, JL, Tan, K-K, Tandukar, S, Tang, H, Tang, HK, Tarigan, IU, Tariku, MK, Tariqujjaman, M, Tarkang, EE, Tavakoli Oliaee, R, Tavangar, SM, Taveira, N, Tefera, YM, Temsah, M-H, Temsah, RMH, Teramoto, M, Tesler, R, Teye-Kwadjo, E, Thakur, R, Thangaraju, P, Thankappan, KR, Tharwat, S, Thayakaran, R, Thomas, N, Thomas, NK, Thomson, AM, Thrift, AG, Thum, CCC, Thygesen, LC, Tian, J, Tichopad, A, Ticoalu, JHV, Tillawi, T, Tiruye, TY, Titova, MV, Tonelli, M, Topor-Madry, R, Toriola, AT, Torre, AE, Touvier, M, Tovani-Palone, MR, Tran, JT, Tran, NM, Trico, D, Tromans, SJ, Truyen, TTTT, Tsatsakis, A, Tsegay, GM, Tsermpini, EE, Tumurkhuu, M, Tung, K, Tyrovolas, S, Uddin, SMN, Udoakang, AJ, Udoh, A, Ullah, A, Ullah, I, Ullah, S, Umakanthan, S, Umeokonkwo, CD, Unim, B, Unnikrishnan, B, Unsworth, CA, Upadhyay, E, Urso, D, Usman, JS, Vahabi, SM, Vaithinathan, AG, Valizadeh, R, Van de Velde, SM, Van den Eynde, J, Varga, O, Vart, P, Varthya, SB, Vasankari, TJ, Vasic, M, Vaziri, S, Vellingiri, B, Venketasubramanian, N, Verghese, NA, Verma, M, Veroux, M, Verras, G-I, Vervoort, D, Villafañe, JH, Villanueva, GI, Vinayak, M, Violante, FS, Viskadourou, M, Vladimirov, SK, Vlassov, V, Vo, B, Vollset, SE, Vongpradith, A, Vos, T, Vujcic, IS, Vukovic, R, Wafa, HA, Waheed, Y, Wamai, RG, Wang, C, Wang, N, Wang, S, Wang, Y, Wang, Y-P, Waqas, M, Ward, P, Wassie, EG, Watson, S, Watson, SLW, Weerakoon, KG, Wei, MY, Weintraub, RG, Weiss, DJ, Westerman, R, Whisnant, JL, Wiangkham, T, Wickramasinghe, DP, Wickramasinghe, ND, Wilandika, A, Wilkerson, C, Willeit, P, Wilson, S, Wojewodzic, MW, Woldegebreal, DH, Wolf, AW, Wolfe, CDA, Wondimagegene, YA, Wong, YJ, Wongsin, U, Wu, A-M, Wu, C, Wu, F, Wu, X, Wu, Z, Xia, J, Xiao, H, Xie, Y, Xu, S, Xu, W-D, Xu, X, Xu, YY, Yadollahpour, A, Yamagishi, K, Yang, D, Yang, L, Yano, Y, Yao, Y, Yaribeygi, H, Ye, P, Yehualashet, SS, Yesiltepe, M, Yesuf, SA, Yezli, S, Yi, S, Yigezu, A, Yiğit, A, Yiğit, V, Yip, P, Yismaw, MB, Yismaw, Y, Yon, DK, Yonemoto, N, Yoon, S-J, You, Y, Younis, MZ, Yousefi, Z, Yu, C, Yu, Y, Yuh, FH, Zadey, S, Zadnik, V, Zafari, N, Zakham, F, Zaki, N, Zaman, SB, Zamora, N, Zand, R, Zangiabadian, M, Zar, HJ, Zare, I, Zarrintan, A, Zeariya, MGM, Zeinali, Z, Zhang, H, Zhang, J, Zhang, L, Zhang, Y, Zhang, Z-J, Zhao, H, Zhong, C, Zhou, J, Zhu, B, Zhu, L, Ziafati, M, Zielińska, M, Zitoun, OA, Zoladl, M, Zou, Z, Zuhlke, LJ, Zumla, A, Zweck, E, Zyoud, SH, Wool, EE, and Murray, CJL
Published: 2024

2. Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000–2018

Author: Haeuser, E, Serfes, AL, Cork, MA, Yang, M, Abbastabar, H, Abhilash, ES, Adabi, M, Adebayo, OM, Adekanmbi, V, Adeyinka, DA, Afzal, S, Ahinkorah, BO, Ahmadi, K, Ahmed, MB, Akalu, Y, Akinyemi, RO, Akunna, CJ, Alahdab, F, Alanezi, FM, Alanzi, TM, Alene, KA, Alhassan, RK, Alipour, V, Almasi-Hashiani, A, Alvis-Guzman, N, Ameyaw, EK, Amini, S, Amugsi, DA, Ancuceanu, R, Anvari, D, Appiah, SCY, Arabloo, J, Aremu, O, Asemahagn, MA, Jafarabadi, MA, Awedew, AF, Quintanilla, BPA, Ayanore, MA, Aynalem, YA, Azari, S, Azene, ZN, Darshan, BB, Babalola, TK, Baig, AA, Banach, M, Bärnighausen, TW, Bell, AW, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bijani, A, Bitew, ZW, Bohlouli, S, Bolarinwa, OA, Boloor, A, Bozicevic, I, Butt, ZA, Cárdenas, R, Carvalho, F, Charan, J, Chattu, VK, Chowdhury, MAK, Chu, D-T, Cowden, RG, Dahlawi, SMA, Damiani, G, Darteh, EKM, Darwesh, AM, das Neves, J, Weaver, ND, De Leo, D, De Neve, J-W, Deribe, K, Deuba, K, Dharmaratne, S, Dianatinasab, M, Diaz, D, Didarloo, A, Djalalinia, S, Dorostkar, F, Dubljanin, E, Duko, B, El Tantawi, M, El-Jaafary, SI, Eshrati, B, Eskandarieh, S, Eyawo, O, Ezeonwumelu, IJ, Ezzikouri, S, Farzadfar, F, Fattahi, N, Fauk, NK, Fernandes, E, Filip, I, Fischer, F, Foigt, NA, Foroutan, M, Fukumoto, T, Gad, MM, Gaidhane, AM, Gebregiorgis, BG, Gebremedhin, KB, Getacher, L, Ghadiri, K, Ghashghaee, A, Golechha, M, Gubari, MIM, Gugnani, HC, Guimarães, RA, Haider, MR, Haj-Mirzaian, A, Hamidi, S, Hashi, A, Hassanipour, S, Hassankhani, H, Hayat, K, Herteliu, C, Ho, HC, Holla, R, Hosseini, M, Hosseinzadeh, M, Hwang, B-F, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Islam, RM, Iwu, CCD, Jakovljevic, M, Jha, RP, Ji, JS, Johnson, KB, Joseph, N, Joshua, V, Joukar, F, Jozwiak, JJ, Kalankesh, LR, Kalhor, R, Kamyari, N, Kanchan, T, Matin, BK, Karimi, SE, Kayode, GA, Karyani, AK, Keramati, M, Khan, EA, Khan, G, Khan, MN, Khatab, K, Khubchandani, J, Kim, YJ, Kisa, A, Kisa, S, Kopec, JA, Kosen, S, Laxminarayana, SLK, Koyanagi, A, Krishan, K, Defo, BK, Kugbey, N, Kulkarni, V, Kumar, M, Kumar, N, Kusuma, D, La Vecchia, C, Lal, DK, Landires, I, Larson, HJ, Lasrado, S, Lee, PH, Li, S, Liu, X, Maleki, A, Malik, P, Mansournia, MA, Martins-Melo, FR, Mendoza, W, Menezes, RG, Mengesha, EW, Meretoja, TJ, Mestrovic, T, Mirica, A, Moazen, B, Mohamad, O, Mohammad, Y, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, S, Mokdad, AH, Moradi, M, Moraga, P, Mubarik, S, Mulu, GBB, Mwanri, L, Nagarajan, AJ, Naimzada, MD, Naveed, M, Nazari, J, Ndejjo, R, Negoi, I, Ngalesoni, FN, Nguefack-Tsague, G, Ngunjiri, JW, Nguyen, CT, Nguyen, HLT, Nnaji, CA, Noubiap, JJ, Nuñez-Samudio, V, Nwatah, VE, Oancea, B, Odukoya, OO, Olagunju, AT, Olakunde, BO, Olusanya, BO, Olusanya, JO, Bali, AO, Onwujekwe, OE, Orisakwe, OE, Otstavnov, N, Otstavnov, SS, Owolabi, MO, Mahesh, PA, Padubidri, JR, Pana, A, Pandey, A, Pandi-Perumal, SR, Kan, FP, Patton, GC, Pawar, S, Peprah, EK, Postma, MJ, Preotescu, L, Syed, ZQ, Rabiee, N, Radfar, A, Rafiei, A, Rahim, F, Rahimi-Movaghar, V, Rahmani, AM, Ramezanzadeh, K, Rana, J, Ranabhat, CL, Rao, SJ, Rawaf, DL, Rawaf, S, Rawassizadeh, R, Regassa, LD, Rezaei, N, Rezapour, A, Riaz, MA, Ribeiro, AI, Ross, JM, Rubagotti, E, Rumisha, SF, Rwegerera, GM, Moghaddam, SS, Sagar, R, Sahiledengle, B, Sahu, M, Salem, MR, Kafil, HS, Samy, AM, Sartorius, B, Sathian, B, Seidu, A-A, Shaheen, AA, Shaikh, MA, Shamsizadeh, M, Shiferaw, WS, Shin, JI, Shrestha, R, Singh, JA, Skryabin, VY, Skryabina, AA, Soltani, S, Sufiyan, MB, Tabuchi, T, Tadesse, EG, Taveira, N, Tesfay, FH, Thapar, R, Tovani-Palone, MR, Tsegaye, GW, Umeokonkwo, CD, Unnikrishnan, B, Villafañe, JH, Violante, FS, Vo, B, Vu, GT, Wado, YD, Waheed, Y, Wamai, RG, Wang, Y, Ward, P, Wickramasinghe, ND, Wilson, K, Yaya, S, Yip, P, Yonemoto, N, Yu, C, Zastrozhin, MS, Zhang, Y, Zhang, Z-J, Hay, SI, Dwyer-Lindgren, L, Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Microbes in Health and Disease (MHD), Haeuser, Emily, Serfes, Audrey L., Cork, Michael A., Yang, Mingyou, Ahmed, Muktar Beshir, Dwyer Lindgrena, Laura, HUS Comprehensive Cancer Center, Helsinki University Hospital Area, Department of Oncology, Epidemiologie, and RS: NUTRIM - R3 - Respiratory & Age-related Health
Subjects: Male, Adult, Settore MED/17 - Malattie Infettive, Adolescent, Settore MED/42 - Igiene Generale e Applicata, HIV Infections, Settore MED/01 - Statistica Medica, Young Adult, HIV Infections/prevention & control, Pregnancy, Seroepidemiologic Studies, General & Internal Medicine, Prevalence, Humans, Geostatistics, Africa, Demographics, HIV, HIV prevalence, Mapping, Spatial statistics, 11 Medical and Health Sciences, Africa South of the Sahara, Acquired Immunodeficiency Syndrome, Acquired Immunodeficiency Syndrome/epidemiology, General Medicine, Middle Aged, Settore SECS-S/04 - Demografia, Africa South of the Sahara/epidemiology, 3142 Public health care science, environmental and occupational health, 3121 General medicine, internal medicine and other clinical medicine, Female
Abstract: Background Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.
Published: 2022

3. Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000-2018

Author: Bhattacharjee, NV, Schaeffer, LE, Hay, SI, Lu, D, Schipp, MF, Lazzar-Atwood, A, Donkers, KM, Abady, GG, Abd-Allah, F, Abdelalim, A, Abebo, ZH, Abejie, AN, Abosetugn, AE, Abreu, LG, Abrigo, MRM, Abu-Gharbieh, E, Abushouk, AI, Adamu, AL, Adedeji, IA, Adegbosin, AE, Adekanmbi, V, Adetokunboh, OO, Agudelo-Botero, M, Aji, B, Akinyemi, OO, Alamneh, AA, Alanezi, FM, Alanzi, TM, Albright, J, Alcalde-Rabanal, JE, Alemu, BW, Alhassan, RK, Ali, BA, Ali, S, Alinia, C, Alipour, V, Amit, AML, Amugsi, DA, Anbesu, EW, Ancuceanu, R, Anjomshoa, M, Ansari, F, Antonio, CAT, Anvari, D, Arabloo, J, Arora, A, Artanti, KD, Asemahagn, MA, Asmare, WN, Atout, MMW, Ausloos, M, Awoke, N, Quintanilla, BPA, Ayanore, MA, Aynalem, YA, Ayza, MA, Azene, ZN, Darshan, BB, Badiye, AD, Baig, AA, Bakkannavar, SM, Banach, M, Banik, PC, Bärnighausen, TW, Basaleem, H, Bayati, M, Baye, BA, Bedi, N, Belay, SA, Bhagavathula, AS, Bhandari, D, Bhardwaj, N, Bhardwaj, P, Bhutta, ZA, Bijani, A, Birhan, TA, Birihane, BM, Bitew, ZW, Bohlouli, S, Bohluli, M, Bojia, HA, Boloor, A, Brady, OJ, Bragazzi, NL, Brunoni, AR, Budhathoki, SS, Nagaraja, SB, Butt, ZA, Cárdenas, R, Castaldelli-Maia, JM, Castro, F, Cernigliaro, A, Charan, J, Chatterjee, P, Chatterjee, S, Chattu, VK, Chaturvedi, S, Chowdhury, MAK, Chu, D-T, Collison, ML, Cook, AJ, Cork, MA, Couto, RAS, Dagnew, B, Dai, H, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Darwesh, AM, Darwish, AH, Daryani, A, Das, JK, Gupta, RD, Dávila-Cervantes, CA, Davis, AC, Weaver, ND, Denova-Gutiérrez, E, Deribe, K, Desalew, A, Deshpande, A, Dessie, A, Deuba, K, Dharmaratne, SD, Dhimal, M, Dhungana, GP, Diaz, D, Didarloo, A, Dipeolu, IO, Doan, LP, Duko, B, Duraes, AR, Dwyer-Lindgren, L, Earl, L, Zaki, MES, Tantawi, ME, Elema, TB, Elhabashy, HR, El-Jaafary, SI, Faris, PS, Faro, A, Farzadfar, F, Feigin, VL, Feleke, BE, Ferede, TY, Fischer, F, Foigt, NA, Folayan, MO, Franklin, RC, Gad, MM, Gaidhane, S, Gardner, WM, Geberemariyam, BS, Gebregiorgis, BG, Gebremedhin, KB, Gebremichael, B, Ghaffarpasand, F, Gilani, SA, Ginindza, TG, Glagn, M, Golechha, M, Gonfa, KB, Goulart, BNG, Gudi, N, Guido, D, Guled, RA, Guo, Y, Hamidi, S, Handiso, DW, Hasaballah, AI, Hassan, A, Hayat, K, Hegazy, MI, Heidari, B, Henry, NJ, Herteliu, C, de, Hidru, HD, Ho, HC, Hoang, CL, Holla, R, Hon, J, Hosseini, M, Hosseinzadeh, M, Househ, M, Hsairi, M, Hu, G, Huda, TM, Hwang, B-F, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Inbaraj, LR, Iqbal, U, Irvani, SSN, Islam, MM, Iwu, CCD, Iwu, CJ, Jain, A, Janodia, MD, Javaheri, T, John-Akinola, YO, Johnson, KB, Joukar, F, Jozwiak, JJ, Kabir, A, Kalankesh, LR, Kalhor, R, Kamath, A, Kamyari, N, Kanchan, OT, Kapoor, N, Matin, BK, Karimi, SE, Kasaye, HK, Kassahun, G, Kassebaum, NJ, Kayode, GA, Karyani, AK, Keiyoro, PN, Kelkay, B, Khalid, N, Khan, MN, Khatab, K, Khater, AM, Khater, MM, Khatib, MN, Kim, YJ, Kimokoti, RW, Kinyoki, DK, Kisa, A, Kisa, S, Kosen, S, Krishan, K, Kulkarni, V, Kumar, GA, Kumar, M, Kumar, N, Kumar, P, Kurmi, OP, Kusuma, D, Vecchia, CL, Lad, SD, Lami, FH, Landires, I, Lansingh, VC, Lasrado, S, Lee, PH, LeGrand, KE, Letourneau, ID, Lewycka, S, Li, B, Li, M-C, Li, S, Liu, X, Lodha, R, Lopez, JCF, Louie, C, Machado, DB, Maled, V, Maleki, S, Malta, DC, Mamun, AA, Manafi, N, Mansournia, MA, Mapoma, CC, Marczak, LB, Martins-Melo, FR, Mehndiratta, MM, Mejia-Rodriguez, F, Mekonnen, TC, Mendoza, W, Menezes, RG, Mengesha, EW, Mersha, AM, Miller, TR, Mini, GK, Mirrakhimov, EM, Misra, S, Moghadaszadeh, M, Mohammad, DK, Mohammadian-Hafshejani, A, Mohammed, JA, Mohammed, S, Mokdad, AH, Montero-Zamora, PA, Moradi, M, Moradzadeh, R, Moraga, P, Mosser, JF, Mousavi, SM, Khaneghah, AM, Munro, SB, Muriithi, MK, Mustafa, G, Muthupandian, S, Nagarajan, AJ, Naik, G, Naimzada, MD, Nangia, V, Nascimento, BR, Nayak, VC, Ndejjo, R, Ndwandwe, DE, Negoi, I, Nguefack-Tsague, G, Ngunjiri, JW, Nguyen, CT, Nguyen, DN, Nguyen, HLT, Nigussie, SN, Nigussie, TTN, Nikbakhsh, R, Nnaji, CA, Nunez-Samudio, V, Oancea, B, Oghenetega, OB, Olagunju, AT, Olusanya, BO, Olusanya, JO, Omer, MO, Onwujekwe, OE, Ortega-Altamirano, DV, Osgood-Zimmerman, AE, Otstavnov, N, Otstavnov, SS, Owolabi, MO, Mahesh, PA, Padubidri, JR, Pana, A, Pandey, A, Pandi-Perumal, SR, Pangaribuan, HU, Parsekar, SS, Pasupula, DK, Patel, UK, Pathak, A, Pathak, M, Pattanshetty, SM, Patton, GC, Paulos, K, Pepito, VCF, Pickering, BV, Pinheiro, M, Piwoz, EG, Pokhrel, KN, Pourjafar, H, Prada, SI, Pribadi, DRA, Syed, ZQ, Rabiee, M, Rabiee, N, Rahim, F, Rahimzadeh, S, Rahman, A, Rahman, MHU, Rahmani, AM, Rai, RK, Ranabhat, CL, Rao, SJ, Rastogi, P, Rathi, P, Rawaf, DL, Rawaf, S, Rawassizadeh, R, Rawat, R, Regassa, LD, Rego, MAS, Reiner, RC, Reshmi, B, Rezapour, A, Ribeiro, AI, Rickard, J, Roever, L, Rumisha, SF, Rwegerera, GM, Sagar, R, Sajadi, SM, Salem, MR, Samy, AM, Santric-Milicevic, MM, Saraswathy, SYI, Sarker, AR, Sartorius, B, Sathian, B, Saxena, D, Sbarra, AN, Sengupta, D, Senthilkumaran, S, Sha, F, Shafaat, O, Shaheen, AA, Shaikh, MA, Shalash, AS, Shannawaz, M, Sheikh, A, Shetty, BSK, Shetty, RS, Shibuya, K, Shiferaw, WS, Shin, JI, Silva, DAS, Singh, NP, Singh, P, Singh, S, Sintayehu, Y, Skryabin, VY, Skryabina, AA, Soheili, A, Soltani, S, Sorrie, MB, Spurlock, EE, Steuben, KM, Sudaryanto, A, Sufiyan, MB, Swartz, SJ, Tadesse, EG, Tamiru, AT, Tapak, L, Tareque, MI, Tarigan, IU, Tesema, GA, Tesfay, FH, Teshome, A, Tessema, ZT, Thankappan, KR, Thapar, R, Thomas, N, Topor-Madry, R, Tovani-Palone, MR, Traini, E, Tran, BX, Truong, PN, Tsegaye, BTBT, Ullah, I, Umeokonkwo, CD, Unnikrishnan, B, Upadhyay, E, Uzochukwu, BSC, VanderHeide, JD, Violante, FS, Vo, B, Wado, YD, Waheed, Y, Wamai, RG, Wang, F, Wang, Y, Wang, Y-P, Wickramasinghe, ND, Wiens, KE, Wiysonge, CS, Woyczynski, L, Wu, A-M, Wu, C, Yamada, T, Yaya, S, Yeshaneh, A, Yeshaw, Y, Yeshitila, YG, Yilma, MT, Yip, P, Yonemoto, N, Yosef, T, Younis, MZ, Yousuf, AY, Yu, C, Yu, Y, Yuce, D, Zafar, S, Zaidi, SS, Zaki, L, Zakzuk, J, Zamanian, M, Zar, HJ, Zastrozhin, MS, Zastrozhina, A, Zelellw, DA, Zhang, Y, Zhang, Z-J, Zhao, X-JG, Zodpey, S, Zuniga, YMH, Local Burden of Disease Exclusive Breastfeeding Collaborators, Bhattacharjee, Natalia V, Schaeffer, Lauren E, Hay, Simon I, Duko, Bereket, Yeshaw, Yigizie, Local Burden of Disease Exclusive Breastfeeding Collaborators, Bhattacharjee N.V., Schaeffer L.E., Hay S.I., Lu D., Schipp M.F., Lazzar-Atwood A., Donkers K.M., Abady G.G., Abd-Allah F., Abdelalim A., Abebo Z.H., Abejie A.N., Abosetugn A.E., Abreu L.G., Abrigo M.R.M., Abu-Gharbieh E., Abushouk A.I., Adamu A.L., Adedeji I.A., Adegbosin A.E., Adekanmbi V., Adetokunboh O.O., Agudelo-Botero M., Aji B., Akinyemi O.O., Alamneh A.A., Alanezi F.M., Alanzi T.M., Albright J., Alcalde-Rabanal J.E., Alemu B.W., Alhassan R.K., Ali B.A., Ali S., Alinia C., Alipour V., Amit A.M.L., Amugsi D.A., Anbesu E.W., Ancuceanu R., Anjomshoa M., Ansari F., Antonio C.A.T., Anvari D., Arabloo J., Arora A., Artanti K.D., Asemahagn M.A., Asmare W.N., Atout M.M.W., Ausloos M., Awoke N., Quintanilla B.P.A., Ayanore M.A., Aynalem Y.A., Ayza M.A., Azene Z.N., Darshan B.B., Badiye A.D., Baig A.A., Bakkannavar S.M., Banach M., Banik P.C., Barnighausen T.W., Basaleem H., Bayati M., Baye B.A., Bedi N., Belay S.A., Bhagavathula A.S., Bhandari D., Bhardwaj N., Bhardwaj P., Bhutta Z.A., Bijani A., Birhan T.A., Birihane B.M., Bitew Z.W., Bohlouli S., Bohluli M., Bojia H.A., Boloor A., Brady O.J., Bragazzi N.L., Brunoni A.R., Budhathoki S.S., Nagaraja S.B., Butt Z.A., Cardenas R., Castaldelli-Maia J.M., Castro F., Cernigliaro A., Charan J., Chatterjee P., Chatterjee S., Chattu V.K., Chaturvedi S., Chowdhury M.A.K., Chu D.-T., Collison M.L., Cook A.J., Cork M.A., Couto R.A.S., Dagnew B., Dai H., Dandona L., Dandona R., Daneshpajouhnejad P., Darwesh A.M., Darwish A.H., Daryani A., Das J.K., Gupta R.D., Davila-Cervantes C.A., Davis A.C., Weaver N.D., Denova-Gutierrez E., Deribe K., Desalew A., Deshpande A., Dessie A., Deuba K., Dharmaratne S.D., Dhimal M., Dhungana G.P., Diaz D., Didarloo A., Dipeolu I.O., Doan L.P., Duko B., Duraes A.R., Dwyer-Lindgren L., Earl L., Zaki M.E.S., Tantawi M.E., Elema T.B., Elhabashy H.R., El-Jaafary S.I., Faris P.S., Faro A., Farzadfar F., Feigin V.L., Feleke B.E., Ferede T.Y., Fischer F., Foigt N.A., Folayan M.O., Franklin R.C., Gad M.M., Gaidhane S., Gardner W.M., Geberemariyam B.S., Gebregiorgis B.G., Gebremedhin K.B., Gebremichael B., Ghaffarpasand F., Gilani S.A., Ginindza T.G., Glagn M., Golechha M., Gonfa K.B., Goulart B.N.G., Gudi N., Guido D., Guled R.A., Guo Y., Hamidi S., Handiso D.W., Hasaballah A.I., Hassan A., Hayat K., Hegazy M.I., Heidari B., Henry N.J., Herteliu C., de Hidru H.D., Ho H.C., Hoang C.L., Holla R., Hon J., Hosseini M., Hosseinzadeh M., Househ M., Hsairi M., Hu G., Huda T.M., Hwang B.-F., Ibitoye S.E., Ilesanmi O.S., Ilic I.M., Ilic M.D., Inbaraj L.R., Iqbal U., Irvani S.S.N., Islam M.M., Iwu C.C.D., Iwu C.J., Jain A., Janodia M.D., Javaheri T., John-Akinola Y.O., Johnson K.B., Joukar F., Jozwiak J.J., Kabir A., Kalankesh L.R., Kalhor R., Kamath A., Kamyari N., Kanchan O.T., Kapoor N., Matin B.K., Karimi S.E., Kasaye H.K., Kassahun G., Kassebaum N.J., Kayode G.A., Karyani A.K., Keiyoro P.N., Kelkay B., Khalid N., Khan M.N., Khatab K., Khater A.M., Khater M.M., Khatib M.N., Kim Y.J., Kimokoti R.W., Kinyoki D.K., Kisa A., Kisa S., Kosen S., Krishan K., Kulkarni V., Kumar G.A., Kumar M., Kumar N., Kumar P., Kurmi O.P., Kusuma D., Vecchia C.L., Lad S.D., Lami F.H., Landires I., Lansingh V.C., Lasrado S., Lee P.H., LeGrand K.E., Letourneau I.D., Lewycka S., Li B., Li M.-C., Li S., Liu X., Lodha R., Lopez J.C.F., Louie C., Machado D.B., Maled V., Maleki S., Malta D.C., Mamun A.A., Manafi N., Mansournia M.A., Mapoma C.C., Marczak L.B., Martins-Melo F.R., Mehndiratta M.M., Mejia-Rodriguez F., Mekonnen T.C., Mendoza W., Menezes R.G., Mengesha E.W., Mersha A.M., Miller T.R., Mini G.K., Mirrakhimov E.M., Misra S., Moghadaszadeh M., Mohammad D.K., Mohammadian-Hafshejani A., Mohammed J.A., Mohammed S., Mokdad A.H., Montero-Zamora P.A., Moradi M., Moradzadeh R., Moraga P., Mosser J.F., Mousavi S.M., Khaneghah A.M., Munro S.B., Muriithi M.K., Mustafa G., Muthupandian S., Nagarajan A.J., Naik G., Naimzada M.D., Nangia V., Nascimento B.R., Nayak V.C., Ndejjo R., Ndwandwe D.E., Negoi I., Nguefack-Tsague G., Ngunjiri J.W., Nguyen C.T., Nguyen D.N., Nguyen H.L.T., Nigussie S.N., Nigussie T.T.N., Nikbakhsh R., Nnaji C.A., Nunez-Samudio V., Oancea B., Oghenetega O.B., Olagunju A.T., Olusanya B.O., Olusanya J.O., Omer M.O., Onwujekwe O.E., Ortega-Altamirano D.V., Osgood-Zimmerman A.E., Otstavnov N., Otstavnov S.S., Owolabi M.O., Mahesh P.A., Padubidri J.R., Pana A., Pandey A., Pandi-Perumal S.R., Pangaribuan H.U., Parsekar S.S., Pasupula D.K., Patel U.K., Pathak A., Pathak M., Pattanshetty S.M., Patton G.C., Paulos K., Pepito V.C.F., Pickering B.V., Pinheiro M., Piwoz E.G., Pokhrel K.N., Pourjafar H., Prada S.I., Pribadi D.R.A., Syed Z.Q., Rabiee M., Rabiee N., Rahim F., Rahimzadeh S., Rahman A., Rahman M.H.U., Rahmani A.M., Rai R.K., Ranabhat C.L., Rao S.J., Rastogi P., Rathi P., Rawaf D.L., Rawaf S., Rawassizadeh R., Rawat R., Regassa L.D., Rego M.A.S., Reiner R.C., Reshmi B., Rezapour A., Ribeiro A.I., Rickard J., Roever L., Rumisha S.F., Rwegerera G.M., Sagar R., Sajadi S.M., Salem M.R., Samy A.M., Santric-Milicevic M.M., Saraswathy S.Y.I., Sarker A.R., Sartorius B., Sathian B., Saxena D., Sbarra A.N., Sengupta D., Senthilkumaran S., Sha F., Shafaat O., Shaheen A.A., Shaikh M.A., Shalash A.S., Shannawaz M., Sheikh A., Shetty B.S.K., Shetty R.S., Shibuya K., Shiferaw W.S., Shin J.I., Silva D.A.S., Singh N.P., Singh P., Singh S., Sintayehu Y., Skryabin V.Y., Skryabina A.A., Soheili A., Soltani S., Sorrie M.B., Spurlock E.E., Steuben K.M., Sudaryanto A., Sufiyan M.B., Swartz S.J., Tadesse E.G., Tamiru A.T., Tapak L., Tareque M.I., Tarigan I.U., Tesema G.A., Tesfay F.H., Teshome A., Tessema Z.T., Thankappan K.R., Thapar R., Thomas N., Topor-Madry R., Tovani-Palone M.R., Traini E., Tran B.X., Truong P.N., Tsegaye B.T.B.T., Ullah I., Umeokonkwo C.D., Unnikrishnan B., Upadhyay E., Uzochukwu B.S.C., VanderHeide J.D., Violante F.S., Vo B., Wado Y.D., Waheed Y., Wamai R.G., Wang F., Wang Y., Wang Y.-P., Wickramasinghe N.D., Wiens K.E., Wiysonge C.S., Woyczynski L., Wu A.-M., Wu C., Yamada T., Yaya S., Yeshaneh A., Yeshaw Y., Yeshitila Y.G., Yilma M.T., Yip P., Yonemoto N., Yosef T., Younis M.Z., Yousuf A.Y., Yu C., Yu Y., Yuce D., Zafar S., Zaidi S.S., Zaki L., Zakzuk J., Zamanian M., Zar H.J., Zastrozhin M.S., Zastrozhina A., Zelellw D.A., Zhang Y., Zhang Z.-J., Zhao X.-J.G., Zodpey S., Zuniga Y.M.H., Collaborators, Local Burden of Disease Exclusive Breastfeeding, and Instituto de Saúde Pública da Universidade do Porto
Subjects: RJ101, Psychological intervention, Breastfeeding, Social Sciences, geography, Behavioral Neuroscience, 0302 clinical medicine, RA0421, Prevalence, Psychology, policy making, 030212 general & internal medicine, Policy Making, humans, media_common, CHILD GROWTH FAILURE, Developing world, 0303 health sciences, education.field_of_study, Psychology, Biological, Geography, Psychology, Experimental, Health Status Disparitie, Multidisciplinary Sciences, Breast Feeding, breast feeding, Scale (social sciences), Science & Technology - Other Topics, Life Sciences & Biomedicine, Human, AFRICA, Social Psychology, Inequality, spatial analysis, media_common.quotation_subject, public policy, Population, prevalence, Public policy, Developing country, Experimental and Cognitive Psychology, Public Policy, Local Burden of Disease Exclusive Breastfeeding Collaborators, Article, Developing Countrie, 03 medical and health sciences, Environmental health, Humans, Nutrition disorders, education, Developing Countries, 030304 developmental biology, Spatial Analysis, Science & Technology, Neurosciences, Health Status Disparities, developing countries, health status disparities, Risk factors, Neurosciences & Neurology, Breast feeding
Abstract: Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030., Bhattacharjee and Schaeffer et al. map exclusive breastfeeding (EBF) in 94 low- and middle-income countries (LMICs), finding increased EBF practice and reduced subnational variation across the majority of LMICs from 2000 to 2018. However, only six LMICs will meet WHO’s target of ≥70% EBF by 2030 nationally, and only three will achieve this in all districts.
Published: 2021

4. Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990-2019: results from the Global Burden of Disease Study 2019

Author: Ledesma, JR, Ma, J, Vongpradith, A, Maddison, ER, Novotney, A, Biehl, MH, LeGrand, KE, Ross, JM, Jahagirdar, D, Bryazka, D, Feldman, R, Abolhassani, H, Abosetugn, AE, Abu-Gharbieh, E, Adebayo, OM, Adnani, QES, Afzal, S, Ahinkorah, BO, Ahmad, SA, Ahmadi, S, Rashid, TA, Salih, YA, Aklilu, A, Akunna, CJ, Al Hamad, H, Alahdab, F, Alemayehu, Y, Alene, KA, Ali, BA, Ali, L, Alipour, V, Alizade, H, Al-Raddadi, RM, Alvis-Guzman, N, Amini, S, Amit, AML, Anderson, JA, Androudi, S, Antonio, CAT, Antony, CM, Anwer, R, Arabloo, J, Arja, A, Asemahagn, MA, Atre, SR, Azhar, GS, Darshan, BB, Babar, Z-U-D, Baig, AA, Banach, M, Barqawi, HJ, Barra, F, Barrow, A, Basu, S, Belgaumi, UI, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharjee, N, Bhattacharyya, K, Bijani, A, Bikbov, B, Boloor, A, Briko, NI, Buonsenso, D, Nagaraja, SB, Butt, ZA, Carter, A, Carvalho, F, Charan, J, Chatterjee, S, Chattu, SK, Chattu, VK, Christopher, DJ, Chu, D-T, Claassens, MM, Dadras, O, Dagnew, AB, Dai, X, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Darwesh, AM, Dhamnetiya, D, Dianatinasab, M, Diaz, D, Linh, PD, Eftekharzadeh, S, Elhadi, M, Emami, A, Enany, S, Faraon, EJA, Farzadfar, F, Fernandes, E, Desideri, LF, Filip, I, Fischer, F, Foroutan, M, Frank, TD, Garcia-Basteiro, AL, Garcia-Calavaro, C, Garg, T, Geberemariyam, BS, Ghadiri, K, Ghashghaee, A, Golechha, M, Goodridge, A, Gupta, B, Gupta, S, Gupta, VB, Gupta, VK, Haider, MR, Hamidi, S, Hanif, A, Haque, S, Harapan, H, Hargono, A, Hasaballah, A, Hashi, A, Hassan, S, Hassankhani, H, Hayat, K, Hezam, K, Holla, R, Hosseinzadeh, M, Hostiuc, M, Househ, M, Hussain, R, Ibitoye, SE, Ilic, IM, Ilic, MD, Irvani, SSN, Ismail, NE, Itumalla, R, Jaafari, J, Jacobsen, KH, Jain, V, Javanmardi, F, Jayapal, SK, Jayaram, S, Jha, RP, Jonas, JB, Joseph, N, Joukar, F, Kabir, Z, Kamath, A, Kanchan, T, Kandel, H, Katoto, PD, Kayode, GA, Kendrick, PJ, Kerbo, AA, Khajuria, H, Khalilov, R, Khatab, K, Khoja, AT, Khubchandani, J, Kim, MS, Kim, YJ, Kisa, A, Kisa, S, Kosen, S, Koul, PA, Laxminarayana, SLK, Koyanagi, A, Krishan, K, Bicer, BK, Kumar, A, Kumar, GA, Kumar, N, Kwarteng, A, Lak, HM, Lal, DK, Landires, I, Lasrado, S, Lee, SWH, Lee, W-C, Lin, C, Liu, X, Lopukhov, PD, Lozano, R, Machado, DB, Kunjathur, SM, Madi, D, Mahajan, PB, Majeed, A, Malik, AA, Martins-Melo, FR, Mehta, S, Memish, ZA, Mendoza, W, Menezes, RG, Merie, HE, Mersha, AG, Mesregah, MK, Mestrovic, T, Mheidly, NM, Misra, S, Mithra, P, Moghadaszadeh, M, Mohammadi, M, Mohammadian-Hafshejani, A, Mohammed, S, Molokhia, M, Moni, MA, Al Montasir, A, Moore, CE, Nagarajan, AJ, Nair, S, Naqvi, AA, Swamy, SN, Nayak, BP, Nazari, J, Kandel, SN, Nguyen, TH, Nixon, MR, Nnaji, CA, Ntsekhe, M, Nunez-Samudio, V, Oancea, B, Odukoya, OO, Olagunju, AT, Oren, E, Mahesh, PA, Parthasarathi, R, Kan, FP, Pattanshetty, SM, Paudel, R, Paul, P, Pawar, S, Pepito, VCF, Yigit, V, Perico, N, Pirestani, M, Polibin, R, Postma, MJ, Pourshams, A, Prashant, A, Pribadi, DRA, Radfar, A, Rafiei, A, Rahim, F, Rahimi-Movaghar, V, Rahman, M, Rahmani, AM, Ranasinghe, P, Rao, CR, Rawaf, DL, Rawaf, S, Reitsma, MB, Remuzzi, G, Renzaho, AMN, Reta, MA, Rezaei, N, Rezahosseini, O, Rezai, MS, Rezapour, A, Roshandel, G, Roshchin, DO, Sabour, S, Saif-Ur-Rahman, KM, Salam, N, Kafil, HS, Samaei, M, Samy, AM, Saroshe, S, Sartorius, B, Sathian, B, Sawyer, SM, Senthilkumaran, S, Seylani, A, Shafaat, O, Shaikh, MA, Sharafi, K, Shetty, RS, Shigematsu, M, Shin, JI, Silva, JP, Singh, JK, Sinha, S, Skryabin, VY, Skryabina, AA, Spurlock, EE, Sreeramareddy, CT, Steiropoulos, P, Sufiyan, MB, Tabuchi, T, Tadesse, EG, Tamir, Z, Tarkang, EE, Tekalegn, Y, Tesfay, FH, Tessema, B, Thapar, R, Tleyjeh, II, Tobe-Gai, R, Bach, XT, Tsegaye, B, Tsegaye, GW, Ullah, A, Umeokonkwo, CD, Tahbaz, SV, Bay, V, Giang, TV, Waheed, Y, Walters, MK, Whisnant, JL, Woldekidan, MA, Wubishet, BL, Jabbari, SHY, Yazie, TSY, Yeshaw, Y, Yi, S, Yonemoto, N, Yu, C, Yunusa, I, Zastrozhin, MS, Zastrozhina, A, Zhang, Z-J, Zumla, A, Mokdad, AH, Salomon, JA, Reiner, RC, Lim, SS, Naghavi, M, Vos, T, Hay, S, Murray, CJL, Kyu, HH, Ledesma, JR, Ma, J, Vongpradith, A, Maddison, ER, Novotney, A, Biehl, MH, LeGrand, KE, Ross, JM, Jahagirdar, D, Bryazka, D, Feldman, R, Abolhassani, H, Abosetugn, AE, Abu-Gharbieh, E, Adebayo, OM, Adnani, QES, Afzal, S, Ahinkorah, BO, Ahmad, SA, Ahmadi, S, Rashid, TA, Salih, YA, Aklilu, A, Akunna, CJ, Al Hamad, H, Alahdab, F, Alemayehu, Y, Alene, KA, Ali, BA, Ali, L, Alipour, V, Alizade, H, Al-Raddadi, RM, Alvis-Guzman, N, Amini, S, Amit, AML, Anderson, JA, Androudi, S, Antonio, CAT, Antony, CM, Anwer, R, Arabloo, J, Arja, A, Asemahagn, MA, Atre, SR, Azhar, GS, Darshan, BB, Babar, Z-U-D, Baig, AA, Banach, M, Barqawi, HJ, Barra, F, Barrow, A, Basu, S, Belgaumi, UI, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharjee, N, Bhattacharyya, K, Bijani, A, Bikbov, B, Boloor, A, Briko, NI, Buonsenso, D, Nagaraja, SB, Butt, ZA, Carter, A, Carvalho, F, Charan, J, Chatterjee, S, Chattu, SK, Chattu, VK, Christopher, DJ, Chu, D-T, Claassens, MM, Dadras, O, Dagnew, AB, Dai, X, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Darwesh, AM, Dhamnetiya, D, Dianatinasab, M, Diaz, D, Linh, PD, Eftekharzadeh, S, Elhadi, M, Emami, A, Enany, S, Faraon, EJA, Farzadfar, F, Fernandes, E, Desideri, LF, Filip, I, Fischer, F, Foroutan, M, Frank, TD, Garcia-Basteiro, AL, Garcia-Calavaro, C, Garg, T, Geberemariyam, BS, Ghadiri, K, Ghashghaee, A, Golechha, M, Goodridge, A, Gupta, B, Gupta, S, Gupta, VB, Gupta, VK, Haider, MR, Hamidi, S, Hanif, A, Haque, S, Harapan, H, Hargono, A, Hasaballah, A, Hashi, A, Hassan, S, Hassankhani, H, Hayat, K, Hezam, K, Holla, R, Hosseinzadeh, M, Hostiuc, M, Househ, M, Hussain, R, Ibitoye, SE, Ilic, IM, Ilic, MD, Irvani, SSN, Ismail, NE, Itumalla, R, Jaafari, J, Jacobsen, KH, Jain, V, Javanmardi, F, Jayapal, SK, Jayaram, S, Jha, RP, Jonas, JB, Joseph, N, Joukar, F, Kabir, Z, Kamath, A, Kanchan, T, Kandel, H, Katoto, PD, Kayode, GA, Kendrick, PJ, Kerbo, AA, Khajuria, H, Khalilov, R, Khatab, K, Khoja, AT, Khubchandani, J, Kim, MS, Kim, YJ, Kisa, A, Kisa, S, Kosen, S, Koul, PA, Laxminarayana, SLK, Koyanagi, A, Krishan, K, Bicer, BK, Kumar, A, Kumar, GA, Kumar, N, Kwarteng, A, Lak, HM, Lal, DK, Landires, I, Lasrado, S, Lee, SWH, Lee, W-C, Lin, C, Liu, X, Lopukhov, PD, Lozano, R, Machado, DB, Kunjathur, SM, Madi, D, Mahajan, PB, Majeed, A, Malik, AA, Martins-Melo, FR, Mehta, S, Memish, ZA, Mendoza, W, Menezes, RG, Merie, HE, Mersha, AG, Mesregah, MK, Mestrovic, T, Mheidly, NM, Misra, S, Mithra, P, Moghadaszadeh, M, Mohammadi, M, Mohammadian-Hafshejani, A, Mohammed, S, Molokhia, M, Moni, MA, Al Montasir, A, Moore, CE, Nagarajan, AJ, Nair, S, Naqvi, AA, Swamy, SN, Nayak, BP, Nazari, J, Kandel, SN, Nguyen, TH, Nixon, MR, Nnaji, CA, Ntsekhe, M, Nunez-Samudio, V, Oancea, B, Odukoya, OO, Olagunju, AT, Oren, E, Mahesh, PA, Parthasarathi, R, Kan, FP, Pattanshetty, SM, Paudel, R, Paul, P, Pawar, S, Pepito, VCF, Yigit, V, Perico, N, Pirestani, M, Polibin, R, Postma, MJ, Pourshams, A, Prashant, A, Pribadi, DRA, Radfar, A, Rafiei, A, Rahim, F, Rahimi-Movaghar, V, Rahman, M, Rahmani, AM, Ranasinghe, P, Rao, CR, Rawaf, DL, Rawaf, S, Reitsma, MB, Remuzzi, G, Renzaho, AMN, Reta, MA, Rezaei, N, Rezahosseini, O, Rezai, MS, Rezapour, A, Roshandel, G, Roshchin, DO, Sabour, S, Saif-Ur-Rahman, KM, Salam, N, Kafil, HS, Samaei, M, Samy, AM, Saroshe, S, Sartorius, B, Sathian, B, Sawyer, SM, Senthilkumaran, S, Seylani, A, Shafaat, O, Shaikh, MA, Sharafi, K, Shetty, RS, Shigematsu, M, Shin, JI, Silva, JP, Singh, JK, Sinha, S, Skryabin, VY, Skryabina, AA, Spurlock, EE, Sreeramareddy, CT, Steiropoulos, P, Sufiyan, MB, Tabuchi, T, Tadesse, EG, Tamir, Z, Tarkang, EE, Tekalegn, Y, Tesfay, FH, Tessema, B, Thapar, R, Tleyjeh, II, Tobe-Gai, R, Bach, XT, Tsegaye, B, Tsegaye, GW, Ullah, A, Umeokonkwo, CD, Tahbaz, SV, Bay, V, Giang, TV, Waheed, Y, Walters, MK, Whisnant, JL, Woldekidan, MA, Wubishet, BL, Jabbari, SHY, Yazie, TSY, Yeshaw, Y, Yi, S, Yonemoto, N, Yu, C, Yunusa, I, Zastrozhin, MS, Zastrozhina, A, Zhang, Z-J, Zumla, A, Mokdad, AH, Salomon, JA, Reiner, RC, Lim, SS, Naghavi, M, Vos, T, Hay, S, Murray, CJL, and Kyu, HH
Abstract: BACKGROUND: Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019. METHODS: We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates. FINDINGS: Globally, in 2019, among HIV-negative individuals, there were 1·18 million (95% uncertainty interval 1·08-1·29) deaths due to tuberculosis and 8·50 million (7·45-9·73) incident cases of tuberculosis
Published: 2022

5. Mapping routine measles vaccination in low- and middle-income countries

Author: Sbarra, AN, Rolfe, S, Nguyen, JQ, Earl, L, Galles, NC, Marks, A, Abbas, KM, Abbasi-Kangevari, M, Abbastabar, H, Abd-Allah, F, Abdelalim, A, Abdollahi, M, Abegaz, KH, Abiy, HAA, Abolhassani, H, Abreu, LG, Abrigo, MRM, Abushouk, AI, Accrombessi, MMK, Adabi, M, Adebayo, OM, Adekanmbi, V, Adetokunboh, OO, Adham, D, Afarideh, M, Aghaali, M, Ahmad, T, Ahmadi, R, Ahmadi, K, Ahmed, MB, Alanezi, FM, Alanzi, TM, Alcalde-Rabanal, JE, Alemnew, BT, Ali, BA, Ali, M, Alijanzadeh, M, Alinia, C, Alipoor, R, Alipour, V, Alizade, H, Aljunid, SM, Almasi, A, Almasi-Hashiani, A, Al-Mekhlafi, HM, Altirkawi, KA, Amare, B, Amini, S, Amini-Rarani, M, Amiri, F, Amit, AML, Amugsi, DA, Ancuceanu, R, Andrei, CL, Anjomshoa, M, Ansari, F, Ansari-Moghaddam, A, Ansha, MG, Antonio, CAT, Antriyandarti, E, Anvari, D, Arabloo, J, Arab-Zozani, M, Aremu, O, Armoon, B, Aryal, KK, Arzani, A, Asadi-Aliabadi, M, Asgari, S, Atafar, Z, Ausloos, M, Awoke, N, Quintanilla, BPA, Ayanore, MA, Aynalem, YA, Azadmehr, A, Azari, S, Babaee, E, Badawi, A, Badiye, AD, Bahrami, MA, Baig, AA, Bakhtiari, A, Balakrishnan, S, Banach, M, Banik, PC, Barac, A, Baradaran-Seyed, Z, Baraki, AG, Basu, S, Bayati, M, Bayou, YT, Bedi, N, Behzadifar, M, Bell, ML, Berbada, DA, Berhe, K, Bhattarai, S, Bhutta, ZA, Bijani, A, Birhanu, M, Bisanzio, D, Biswas, A, Bohlouli, S, Bolla, SR, Borzouei, S, Brady, OJ, Bragazzi, NL, Briko, AN, Briko, NI, Nagaraja, SB, Butt, ZA, Cámera, LA, Campos-Nonato, IR, Car, J, Cárdenas, R, Carvalho, F, Castaldelli-Maia, JM, Castro, F, Chattu, VK, Chehrazi, M, Chin, KL, Chu, D-T, Cook, AJ, Cormier, NM, Cunningham, B, Dahlawi, SMA, Damiani, G, Dandona, R, Dandona, L, Danovaro, MC, Dansereau, E, Daoud, F, Darwesh, AM, Darwish, AH, Das, JK, Weaver, ND, De Neve, J-W, Demeke, FM, Demis, AB, Denova-Gutiérrez, E, Desalew, A, Deshpande, A, Desta, DM, Dharmaratne, SD, Dhungana, GP, Dianatinasab, M, Diaz, D, Dipeolu, IO, Djalalinia, S, Do, HT, Dorostkar, F, Doshmangir, L, Doyle, KE, Dunachie, SJ, Duraes, AR, Kalan, ME, Leylabadlo, HE, Edinur, HA, Effiong, A, Eftekhari, A, El, Sayed, I, El, Sayed, Zaki, M, Elema, TB, Elhabashy, HR, El-Jaafary, SI, Elsharkawy, A, Emamian, MH, Enany, S, Eshrati, B, Eskandari, K, Eskandarieh, S, Esmaeilnejad, S, Esmaeilzadeh, F, Esteghamati, A, Etisso, AE, Farahmand, M, Faraon, EJA, Fareed, M, Faridnia, R, Farioli, A, Farzadfar, F, Fattahi, N, Fazlzadeh, M, Fereshtehnejad, S-M, Fernandes, E, Filip, I, Fischer, F, Foigt, NA, Folayan, MO, Foroutan, M, Fukumoto, T, Fullman, N, Gad, MM, Geberemariyam, BS, Gebrehiwot, TT, Gebrehiwot, AM, Gebremariam, KT, Gebremedhin, KB, Gebremeskel, GG, Gebreslassie, AA, Gedefaw, GA, Gezae, KE, Ghadiri, K, Ghaffari, R, Ghaffarifar, F, Ghajarzadeh, M, Gheshlagh, RG, Ghashghaee, A, Ghiasvand, H, Gholamian, A, Gilani, SA, Gill, PS, Girmay, A, Gomes, NGM, Gopalani, SV, Goulart, BNG, Grada, A, Guimarães, RA, Guo, Y, Gupta, R, Hafezi-Nejad, N, Haj-Mirzaian, A, Handiso, DW, Hanif, A, Haririan, H, Hasaballah, AI, Hasan, MM, Hasanpoor, E, Hasanzadeh, A, Hassanipour, S, Hassankhani, H, Heidari-Soureshjani, R, Henry, NJ, Herteliu, C, Heydarpour, F, Hollerich, GI, Rad, EH, Hoogar, P, Hossain, N, Hosseini, M, Hosseinzadeh, M, Househ, M, Hu, G, Huda, TM, Humayun, A, Ibitoye, SE, Ikilezi, G, Ilesanmi, OS, Ilic, IM, Ilic, MD, Imani-Nasab, MH, Inbaraj, LR, Iqbal, U, Irvani, SSN, Islam, SMS, Islam, MM, Iwu, CJ, Iwu, CCD, Jadidi-Niaragh, F, Jafarinia, M, Jahanmehr, N, Jakovljevic, M, Jalali, A, Jalilian, F, Javidnia, J, Jenabi, E, Jha, V, Ji, JS, John, O, Johnson, KB, Joukar, F, Jozwiak, JJ, Kabir, Z, Kabir, A, Kalani, H, Kalankesh, LR, Kalhor, R, Kamal, Z, Kanchan, T, Kapoor, N, Karami, M, Matin, BK, Karch, A, Karimi, SE, Kayode, GA, Karyani, AK, Keiyoro, PN, Khader, YS, Khafaie, MA, Khammarnia, M, Khan, MS, Khan, EA, Khan, J, Khan, MN, Khatab, K, Khater, MM, Khatib, MN, Khayamzadeh, M, Khazaei, M, Khazaei, S, Khosravi, A, Khubchandani, J, Kianipour, N, Kim, YJ, Kimokoti, RW, Kinyoki, DK, Kisa, A, Kisa, S, Kolola, T, Komaki, H, Kosen, S, Koul, PA, Koyanagi, A, Kraemer, MUG, Krishan, K, Kuate Defo, B, Kumar, M, Kumar, P, Kumar, GA, Kusuma, D, La Vecchia, C, Lacey, B, Lad, SD, Lal, DK, Lam, F, Lami, FH, Lansingh, VC, Larson, HJ, Lasrado, S, Lee, SWH, Lee, PH, LeGrand, KE, Lenjebo, TL, Li, S, Liang, X, Liu, PY, Lopukhov, PD, Machado, DB, Mahasha, PW, Mahdavi, MM, Maheri, M, Mahotra, NB, Maled, V, Maleki, S, Malik, MA, Malta, DC, Mansour-Ghanaei, F, Mansouri, B, Mansourian, M, Mansournia, MA, Martins-Melo, FR, Masaka, A, Mayala, BK, Mehndiratta, MM, Mehri, F, Mehta, KM, Memiah, PTN, Mendoza, W, Menezes, RG, Mengesha, MB, Mengesha, EW, Mestrovic, T, Mihretie, KM, Miller-Petrie, MK, Mills, EJ, Milne, GJ, Mirabi, P, Mirrakhimov, EM, Mirzaei, R, Mirzaei, M, Mirzaei, HR, Mirzaei, H, Mirzaei-Alavijeh, M, Moazen, B, Moghadaszadeh, M, Mohamadi, E, Mohammad, DK, Mohammad, Y, Mohammad, KA, Mohammad Gholi Mezerji, N, Mohammadbeigi, A, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, S, Mohammed, AS, Mohammed, H, Mohebi, F, Mokdad, AH, Monasta, L, Moosavi, MA, Moosazadeh, M, Moradi, G, Moradi, M, Moradi-Joo, M, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Mosapour, A, Mouodi, S, Mousavi, SM, Khaneghah, AM, Mueller, UO, Muluneh, AG, Munro, SB, Murray, CJL, Murthy, GVS, Muthupandian, S, Naderi, M, Nagarajan, AJ, Naghavi, M, Nangia, V, Nansseu, JR, Nayak, VC, Nazari, J, Ndwandwe, DE, Negoi, I, Ngunjiri, JW, Nguyen, HLT, Nguyen, CTK, Nguyen, TH, Nigatu, YT, Nikbakhsh, R, Nikfar, S, Nikpoor, AR, Ningrum, DNA, Nnaji, CA, Oh, I-H, Oladnabi, M, Olagunju, AT, Olusanya, JO, Olusanya, BO, Bali, AO, Omer, MO, Onwujekwe, OE, Osgood-Zimmerman, AE, Owolabi, MO, P, A, M, Padubidri, JR, Pakshir, K, Pana, A, Pandey, A, Pando-Robles, V, Pashaei, T, Pasupula, DK, Paternina-Caicedo, AJ, Patton, GC, Pazoki Toroudi, H, Pepito, VCF, Pescarini, JM, Pigott, DM, Pilgrim, T, Pirsaheb, M, Poljak, M, Postma, MJ, Pourjafar, H, Pourmalek, F, Pourmirza, Kalhori, R, Prada, SI, Prakash, S, Quazi Syed, Z, Quintana, H, Rabiee, N, Rabiee, M, Radfar, A, Rafiei, A, Rahim, F, Rajati, F, Rameto, MA, Ramezanzadeh, K, Ranabhat, CL, Rao, SJ, Rasella, D, Rastogi, P, Rathi, P, Rawaf, S, Rawaf, DL, Rawal, L, Rawassizadeh, R, Rawat, R, Renjith, V, Renzaho, AMN, Reshmi, B, Reta, MA, Rezaei, N, Rezai, MS, Rezapour, A, Riahi, SM, Ribeiro, AI, Rickard, J, Rios-Blancas, M, Rios-González, CM, Roever, L, Rostamian, M, Rubino, S, Rwegerera, GM, Saad, AM, Saadatagah, S, Sabour, S, Sadeghi, E, Moghaddam, SS, Saeidi, S, Sagar, R, Sahebkar, A, Sahraian, MA, Sajadi, SM, Salahshoor, MR, Salam, N, Salem, H, Salem, MR, Salomon, JA, Kafil, HS, Sambala, EZ, Samy, AM, Saraswathy, SYI, Sarmiento-Suárez, R, Saroshe, S, Sartorius, B, Sarveazad, A, Sathian, B, Sathish, T, Schaeffer, LE, Schwebel, DC, Senthilkumaran, S, Shabaninejad, H, Shahabi, S, Shaheen, AA, Shaikh, MA, Shalash, AS, Shams-Beyranvand, M, Shamsi, MB, Shamsizadeh, M, Sharafi, K, Sharifi, H, Sheikh, A, Sheikhtaheri, A, Shetty, RS, Shiferaw, WS, Shigematsu, M, Shin, JI, Shirkoohi, R, Siabani, S, Siddiqi, TJ, Silverberg, JIS, Simonetti, B, Singh, JA, Sinha, DN, Sinke, AH, Soheili, A, Sokhan, A, Soltani, S, Soofi, M, Sorrie, MB, Soyiri, IN, Spotin, A, Spurlock, EE, Sreeramareddy, CT, Sudaryanto, A, Sufiyan, MB, Suleria, HAR, Abdulkader, RS, Taherkhani, A, Tapak, L, Taveira, N, Taymoori, P, Tefera, YM, Tehrani-Banihashemi, A, Teklehaimanot, BF, Tekulu, GH, Tesfay, BE, Tessema, ZT, Tessema, B, Thankappan, KR, Tohidinik, HR, Topor-Madry, R, Tovani-Palone, MR, Tran, BX, Uddin, R, Ullah, I, Umeokonkwo, CD, Unnikrishnan, B, Upadhyay, E, Usman, MS, Vaezi, M, Valadan, Tahbaz, S, Valdez, PR, Vasseghian, Y, Veisani, Y, Violante, FS, Vollmer, S, Waheed, Y, Wakefield, J, Wang, Y, Wang, Y-P, Weldesamuel, GT, Werdecker, A, Westerman, R, Wiangkham, T, Wiens, KE, Wiysonge, CS, Woldu, G, Wondafrash, DZ, Wonde, TE, Wu, A-M, Yadollahpour, A, Jabbari, SHY, Yamada, T, Yaya, S, Yazdi-Feyzabadi, V, Yeheyis, TY, Yeshaw, Y, Yilgwan, CS, Yip, P, Yonemoto, N, Younis, MZ, Yousefi, Z, Yousefifard, M, Yousefinezhadi, T, Yu, C, Yusefzadeh, H, Zadey, S, Zahirian, Moghadam, T, Zaki, L, Zaman, SB, Zamani, M, Zamanian, M, Zandian, H, Zangeneh, A, Zarei, F, Zerfu, TA, Zhang, Y, Zhang, Z-J, Zhao, X-JG, Zhou, M, Ziapour, A, Hay, SI, Lim, SS, Mosser, JF, Local Burden of Disease Vaccine Coverage Collaborators, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), HUS Comprehensive Cancer Center, Clinicum, Department of Oncology, Sbarra, Alyssa N., Rolfe, Sam, Nguyen, Jason Q., Earl, Lucas, Ahmed, MB, Mosser, Jonathan F, Collaborators, Local Burden of Disease Vaccine Coverage, Bill & Melinda Gates Foundation, Alexander von Humboldt-Stiftung, Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF), Universiti Sains Malaysia (Malasia), Panjab University (India), NIHR - Oxford Biomedical Research Centre (Reino Unido), Australian Research Council, Instituto de Saúde Pública da Universidade do Porto, Local Burden Dis Educ Attainment C, Local Burden of Disease Vaccine Coverage Collaborator, and Violante FS
Subjects: and promotion of well-being, Vacunación Masiva, Internationality, Disease prevention, children under 5 years old, Geographic Mapping, Rural Health, medicine.disease_cause, Cross-reactivity, 0302 clinical medicine, RA0421, Vaccination Refusal, 030212 general & internal medicine, Child, immunity patterns, Pediatric, 0303 health sciences, Public health, Multidisciplinary, biology, Vaccination, Uncertainty, IMMUNIZATION, 3142 Public health care science, environmental and occupational health, COVERAGE, 3. Good health, TIME, 3.4 Vaccines, Child, Preschool, Infectious diseases, A990 Medicine and Dentistry not elsewhere classified, Antibody, Engineering sciences. Technology, AFRICA, General Science & Technology, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, 610 Medicine & health, Global Vaccine Action Plan (GVAP), Local Burden of Disease Vaccine Coverage Collaborators, Article, Vaccine Related, 03 medical and health sciences, measles vaccine, Measels, Low- and middle-income countries, Local burden of disease, Clinical Research, medicine, Humans, Healthcare Disparities, Preschool, PROGRESS, 030304 developmental biology, business.industry, MORTALITY, Developed Countries, Prevention, Comment, Vacunación, Urban Health, Prevention of disease and conditions, Virology, Coronavirus, Good Health and Well Being, Cobertura de Vacunación, biology.protein, Immunization, business, Measles
Abstract: The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1–4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5–8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children., Although progress in the coverage of routine measles vaccination in children in low- and middle-income countries was made during 2000–2019, many countries remain far from the goal of 80% coverage in all districts by 2019.
Published: 2021

6. Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

Author: Paulson, KR, Kamath, AM, Alam, T, Bienhoff, K, Abady, GG, Abbas, J, Abbasi-Kangevari, M, Abbastabar, H, Abd-Allah, F, Abd-Elsalam, SM, Abdoli, A, Abedi, A, Abolhassani, H, Abreu, LG, Abu-Gharbieh, E, Abu-Rmeileh, NME, Abushouk, A, Adamu, AL, Adebayo, OM, Adegbosin, AE, Adekanmbi, V, Adetokunboh, OO, Adeyinka, DA, Adsuar, JC, Afshari, K, Aghaali, M, Agudelo-Botero, M, Ahinkorah, BO, Ahmad, T, Ahmadi, K, Ahmed, MB, Aji, B, Akalu, Y, Akinyemi, OO, Aklilu, A, Al-Aly, Z, Alam, K, Alanezi, FM, Alanzi, TM, Alcalde-Rabanal, JE, Al-Eyadhy, A, Ali, T, Alicandro, G, Alif, SM, Alipour, V, Alizade, H, Aljunid, SM, Almasi-Hashiani, A, Almasri, NA, Al-Mekhlafi, HM, Alonso, J, Al-Raddadi, RM, Altirkawi, KA, Alumran, AK, Alvis-Guzman, N, Alvis-Zakzuk, NJ, Ameyaw, EK, Amini, S, Amini-Rarani, M, Amit, AML, Amugsi, DA, Ancuceanu, R, Anderlini, D, Andrei, CL, Ansari, F, Ansari-Moghaddam, A, Antonio, CAT, Antriyandarti, E, Anvari, D, Anwer, R, Aqeel, M, Arabloo, J, Arab-Zozani, M, Aripov, T, Arnlov, J, Artanti, KD, Arzani, A, Asaad, M, Asadi-Aliabadi, M, Asadi-Pooya, AA, Jafarabadi, MA, Athari, SS, Athari, SM, Atnafu, DD, Atreya, A, Atteraya, MS, Ausloos, M, Awan, AT, Quintanilla, BPA, Ayano, G, Ayanore, MA, Aynalem, YA, Azari, S, Azarian, G, Azene, ZN, Darshan, BB, Babaee, E, Badiye, AD, Baig, AA, Banach, M, Banik, PC, Barker-Collo, SL, Barqawi, HJ, Bassat, Q, Basu, S, Baune, BT, Bayati, M, Bedi, N, Beghi, E, Beghi, M, Bell, ML, Bendak, S, Bennett, DA, Bensenor, IM, Berhe, K, Berman, AE, Bezabih, YM, Bhagavathula, AS, Bhandari, D, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhattarai, S, Bhutta, ZA, Bikbov, B, Biondi, A, Birihane, BM, Biswas, RK, Bohlouli, S, Bragazzi, NL, Breusov, A, Brunoni, AR, Burkart, K, Nagaraja, SB, Busse, R, Butt, ZA, dos Santos, FLC, Cahuana-Hurtado, L, Camargos, P, Camera, LA, Cardenas, R, Carreras, G, Carrero, JJ, Carvalho, F, Castaldelli-Maia, JM, Castaneda-Orjuela, CA, Castelpietra, G, Cerin, E, Chang, J-C, Chanie, WF, Charan, J, Chatterjee, S, Chattu, SK, Chattu, VK, Chaturvedi, S, Chen, S, Cho, DY, Choi, J-YJ, Chu, D-T, Ciobanu, LG, Cirillo, M, Conde, J, Costa, VM, Couto, RAS, Dachew, BA, Dahlawi, SMA, Dai, H, Dai, X, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Darmstadt, GL, Das, JK, Davila-Cervantes, CA, Davis, AC, Davletov, K, De la Hoz, FP, De Leo, D, Deeba, F, Denova-Gutierrez, E, Dervenis, N, Desalew, A, Deuba, K, Dey, S, Dharmaratne, SD, Dhingra, S, Dhungana, GP, da Silva, DD, Diaz, D, Dorostkar, F, Doshmangir, L, Dubljanin, E, Duraes, AR, Eagan, AW, Edinur, HA, Efendi, F, Eftekharzadeh, S, El Sayed, I, El Tantawi, M, Elbarazi, I, Elgendy, IY, El-Jaafary, S, Emami, A, Enany, S, Eyawo, O, Ezzikouri, S, Faris, PS, Farzadfar, F, Fattahi, N, Fauk, NK, Fazlzadeh, M, Feigin, VL, Ferede, TY, Fereshtehnejad, S-M, Fernandes, E, Ferrara, P, Filip, I, Fischer, F, Fisher, JL, Foigt, NA, Folayan, MO, Foroutan, M, Franklin, RC, Freitas, M, Friedman, SD, Fukumoto, T, Gad, MM, Gaidhane, AM, Gaidhane, S, Gaihre, S, Gallus, S, Garcia-Basteiro, AL, Garcia-Gordillo, M, Gardner, WM, Fonseca, MG, Gebremedhin, KB, Getacher, L, Ghashghaee, A, Gholamian, A, Gilani, SA, Gill, TK, Giussani, G, Gnedovskaya, E, Godinho, MA, Goel, A, Golechha, M, Gona, PN, Gopalani, SV, Goudarzi, H, Grivna, M, Gugnani, HC, Guido, D, Guimaraes, RA, Das Gupta, R, Gupta, R, Hafezi-Nejad, N, Haider, MR, Haj-Mirzaian, A, Hamidi, S, Hanif, A, Hankey, GJ, Hargono, A, Hasaballah, A, Hasan, MM, Hasan, SS, Hassan, A, Hassanipour, S, Hassankhani, H, Havmoeller, RJ, Hayat, K, Heidari-Soureshjani, R, Henry, NJ, Herteliu, C, Hole, MK, Holla, R, Hossain, N, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Huang, J, Humayun, A, Hwang, B-F, Iavicoli, I, Ibitoye, SE, Ikuta, KS, Ilesanmi, OS, Ilic, IM, Ilic, MD, Inamdar, S, Inbaraj, LR, Iqbal, K, Iqbal, U, Islam, MM, Shariful Islam, Sheikh, Iso, H, Iwagami, M, Iwu, CCD, Jaafari, J, Jacobsen, KH, Jagnoor, J, Jain, V, Janodia, MD, Javaheri, T, Javanmardi, F, Jayaram, S, Jayatilleke, AU, Jenabi, E, Jha, RP, Ji, JS, John, O, Jonas, JB, Joo, T, Joseph, N, Joukar, F, Jozwiak, JJ, Jurisson, M, Kabir, A, Kabir, Z, Kalankesh, LR, Kamyari, N, Kanchan, T, Kapoor, N, Matin, BK, Karch, A, Karimi, SE, Kassahun, G, Kayode, GA, Karyani, AK, Kemmer, L, Khalid, N, Khalilov, R, Khammarnia, M, Khan, EA, Khan, G, Khan, M, Khan, MN, Khang, Y-H, Khatab, K, Khater, AM, Khater, MM, Khayamzadeh, M, Khosravi, A, Kim, D, Kim, Y-E, Kim, YJ, Kimokoti, RW, Kisa, A, Kisa, S, Kissoon, N, Kopec, JA, Kosen, S, Koul, PA, Laxminarayana, SLK, Koyanagi, A, Krishan, K, Krishnamoorthy, V, Defo, BK, Bicer, BK, Kulkarni, V, Kumar, GA, Kumar, M, Kumar, N, Kurmi, OP, Kusuma, D, La Vecchia, C, Lacey, B, Lalloo, R, Lami, FH, Landires, I, Larsson, AO, Lasrado, S, Lassi, ZS, Lauriola, P, Lee, PH, Lee, SWH, Lee, YH, Leigh, J, Leonardi, M, Lewycka, S, Li, B, Li, S, Liang, J, Lim, L-L, Limenih, MA, Lin, R-T, Liu, X, Lodha, R, Lopez, AD, Lozano, R, Lugo, A, Lunevicius, R, Mackay, MT, Kunjathur, SM, Magnani, FG, Prasad, DRM, Maheri, M, Mahmoudi, M, Majeed, A, Maled, V, Maleki, A, Maleki, S, Malekzadeh, R, Malik, AA, Malta, DC, Mamun, AA, Mansouri, B, Mansournia, MA, Martinez, G, Martini, S, Martins-Melo, FR, Masoumi, SZ, Maulik, PK, McAlinden, C, McGrath, JJ, Medina-Solis, CE, Nasab, EM, Mejia-Rodriguez, F, Memish, ZA, Mendoza, W, Menezes, RG, Mengesha, EW, Mensah, GA, Meretoja, A, Meretoja, TJ, Mersha, AM, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, IM, Miller, TR, Mini, GK, Miri, M, Mirica, A, Mirrakhimov, EM, Mirzaei, H, Mirzaei, M, Moazen, B, Moghadaszadeh, M, Mohajer, B, Mohamad, O, Mohammad, Y, Mohammadi, SM, Mohammadian-Hafshejani, A, Mohammed, S, Mokdad, AH, Molokhia, M, Monasta, L, Mondello, S, Moni, MA, Moore, CE, Moradi, G, Moradi, M, Moradzadeh, R, Moraga, P, Morawska, L, Morrison, SD, Mosser, JF, Khaneghah, AM, Mustafa, G, Naderi, M, Nagarajan, AJ, Nagaraju, SP, Naghavi, M, Naghshtabrizi, B, Naimzada, MD, Nangia, V, Swamy, SN, Nascimento, BR, Naveed, M, Nazari, J, Ndejjo, R, Negoi, I, Negoi, RI, Nena, E, Nepal, S, Netsere, HB, Nguefack-Tsague, G, Ngunjiri, JW, Chi, TYN, Cuong, TN, Huong, LTN, Nigatu, YT, Nigussie, SN, Nixon, MR, Nnaji, CA, Nomura, S, Noor, NM, Noubiap, JJ, Nunez-Samudio, V, Nwatah, VE, Oancea, B, Odukoya, OO, Ogbo, FA, Olusanya, BO, Olusanya, JO, Bali, AO, Onwujekwe, OE, Ortiz, A, Otoiu, A, Otstavnov, N, Otstavnov, SS, Owolabi, MO, Mahesh, PA, Padubidri, JR, Pakhale, S, Pakshir, K, Pal, PK, Palladino, R, Pana, A, Panda-Jonas, S, Pandey, A, Pandi-Perumal, SR, Pangaribuan, HU, Pardo-Montano, AM, Park, E-K, Patel, SK, Patton, GC, Pawar, S, Toroudi, HP, Peden, AE, Pepito, VCF, Peprah, EK, Pereira, J, Perez-Gomez, J, Perico, N, Pesudovs, K, Pilgrim, T, Pinheiro, M, Piradov, MA, Pirsaheb, M, Platts-Mills, JA, Pokhrel, KN, Postma, MJ, Pourjafar, H, Prada, S, Prakash, S, Pupillo, E, Syed, ZQ, Rabiee, N, Radfar, A, Rafiee, A, Rafiei, A, Raggi, A, Rahimzadeh, S, Rahman, MHU, Rahmani, AM, Ramezanzadeh, K, Rana, J, Ranabhat, CL, Rao, SJ, Rasella, D, Rastogi, P, Rathi, P, Rawaf, DL, Rawaf, S, Rawasia, WF, Rawassizadeh, R, Jr, RCR, Remuzzi, G, Renzaho, AMN, Reshmi, B, Resnikoff, S, Rezaei, N, Rezapour, A, Riahi, SM, Ribeiro, D, Rickard, J, Roever, L, Ronfani, L, Rothenbacher, D, Rubagotti, E, Rumisha, SF, Ryan, PM, Saddik, B, Sadeghi, E, Moghaddam, SS, Sagar, R, Sahebkar, A, Salahshoor, MR, Salehi, S, Salem, MR, Salimzadeh, H, Salomon, JA, Samodra, YL, Samy, AM, Sanabria, J, Santric-Milicevic, MM, Saraswathy, SYI, Sarker, AR, Sarrafzadegan, N, Sarveazad, A, Sathian, B, Sathish, T, Sattin, D, Saxena, S, Saya, GK, Saylan, M, Schiavolin, S, Schlaich, MP, Schwebel, DC, Schwendicke, F, Senthilkumaran, S, Sepanlou, SG, Servan-Mori, E, Sha, F, Shafaat, O, Shahabi, S, Shahbaz, M, Shaheen, AA, Shahid, I, Shaikh, MA, Shakiba, S, Shalash, AS, Shams-Beyranvand, M, Shannawaz, M, Sharafi, K, Sheikh, A, Sheikhbahaei, S, Shiferaw, WS, Shigematsu, M, Shin, JI, Shiri, R, Shiue, I, Shuval, K, Siddiqi, TJ, Sidemo, NB, Sigfusdottir, ID, Sigurvinsdottir, R, Silva, JP, Silverberg, JIS, Simonetti, B, Singh, BB, Singh, JA, Singhal, D, Sinha, DN, Skiadaresi, E, Skryabin, VY, Skryabina, AA, Sleet, DA, Sobaih, BH, Sobhiyeh, MR, Soltani, S, Soriano, JB, Spurlock, EE, Sreeramareddy, CT, Steiropoulos, P, Stokes, Mark, Stortecky, S, Sufiyan, MB, Abdulkader, RS, Sulo, G, Swope, CB, Sykes, BL, Szeto, MD, Szocska, M, Tabares-Seisdedos, R, Tadesse, EG, Taherkhani, A, Tamiru, AT, Tareque, MI, Tehrani-Banihashemi, A, Temsah, M-H, Tesfay, FH, Tessema, GA, Tessema, ZT, Thankappan, KR, Thapar, R, Tolani, MA, Tovani-Palone, MR, Traini, E, Bach, XT, Tripathy, JP, Tsapparellas, G, Tsatsakis, A, Car, LT, Uddin, Riaz, Ullah, A, Umeokonkwo, CD, Unim, B, Unnikrishnan, B, Upadhyay, E, Usman, MS, Vacante, M, Vaezi, M, Tahbaz, SV, Valdez, PR, Vasankari, TJ, Venketasubramanian, N, Verma, M, Violante, FS, Vlassov, V, Vo, B, Giang, TV, Wado, YD, Waheed, Y, Wamai, RG, Wang, Y, Wang, Y-P, Ward, P, Werdecker, A, Westerman, R, Wickramasinghe, ND, Wilner, LB, Wiysonge, CS, Wu, A-M, Wu, C, Xie, Y, Jabbari, SHY, Yamagishi, K, Yandrapalli, S, Yaya, S, Yazdi-Feyzabadi, V, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yousefi, Z, Yousefinezhadi, T, Yu, C, Yusuf, SS, Zaidi, SS, Bin Zaman, S, Zamani, M, Zamanian, M, Zastrozhin, MS, Zastrozhina, A, Zhang, Y, Zhang, Z-J, Zhao, X-JG, Ziapour, A, Hay, S, Murray, CJL, Wang, H, Kassebaum, NJ, Paulson, KR, Kamath, AM, Alam, T, Bienhoff, K, Abady, GG, Abbas, J, Abbasi-Kangevari, M, Abbastabar, H, Abd-Allah, F, Abd-Elsalam, SM, Abdoli, A, Abedi, A, Abolhassani, H, Abreu, LG, Abu-Gharbieh, E, Abu-Rmeileh, NME, Abushouk, A, Adamu, AL, Adebayo, OM, Adegbosin, AE, Adekanmbi, V, Adetokunboh, OO, Adeyinka, DA, Adsuar, JC, Afshari, K, Aghaali, M, Agudelo-Botero, M, Ahinkorah, BO, Ahmad, T, Ahmadi, K, Ahmed, MB, Aji, B, Akalu, Y, Akinyemi, OO, Aklilu, A, Al-Aly, Z, Alam, K, Alanezi, FM, Alanzi, TM, Alcalde-Rabanal, JE, Al-Eyadhy, A, Ali, T, Alicandro, G, Alif, SM, Alipour, V, Alizade, H, Aljunid, SM, Almasi-Hashiani, A, Almasri, NA, Al-Mekhlafi, HM, Alonso, J, Al-Raddadi, RM, Altirkawi, KA, Alumran, AK, Alvis-Guzman, N, Alvis-Zakzuk, NJ, Ameyaw, EK, Amini, S, Amini-Rarani, M, Amit, AML, Amugsi, DA, Ancuceanu, R, Anderlini, D, Andrei, CL, Ansari, F, Ansari-Moghaddam, A, Antonio, CAT, Antriyandarti, E, Anvari, D, Anwer, R, Aqeel, M, Arabloo, J, Arab-Zozani, M, Aripov, T, Arnlov, J, Artanti, KD, Arzani, A, Asaad, M, Asadi-Aliabadi, M, Asadi-Pooya, AA, Jafarabadi, MA, Athari, SS, Athari, SM, Atnafu, DD, Atreya, A, Atteraya, MS, Ausloos, M, Awan, AT, Quintanilla, BPA, Ayano, G, Ayanore, MA, Aynalem, YA, Azari, S, Azarian, G, Azene, ZN, Darshan, BB, Babaee, E, Badiye, AD, Baig, AA, Banach, M, Banik, PC, Barker-Collo, SL, Barqawi, HJ, Bassat, Q, Basu, S, Baune, BT, Bayati, M, Bedi, N, Beghi, E, Beghi, M, Bell, ML, Bendak, S, Bennett, DA, Bensenor, IM, Berhe, K, Berman, AE, Bezabih, YM, Bhagavathula, AS, Bhandari, D, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhattarai, S, Bhutta, ZA, Bikbov, B, Biondi, A, Birihane, BM, Biswas, RK, Bohlouli, S, Bragazzi, NL, Breusov, A, Brunoni, AR, Burkart, K, Nagaraja, SB, Busse, R, Butt, ZA, dos Santos, FLC, Cahuana-Hurtado, L, Camargos, P, Camera, LA, Cardenas, R, Carreras, G, Carrero, JJ, Carvalho, F, Castaldelli-Maia, JM, Castaneda-Orjuela, CA, Castelpietra, G, Cerin, E, Chang, J-C, Chanie, WF, Charan, J, Chatterjee, S, Chattu, SK, Chattu, VK, Chaturvedi, S, Chen, S, Cho, DY, Choi, J-YJ, Chu, D-T, Ciobanu, LG, Cirillo, M, Conde, J, Costa, VM, Couto, RAS, Dachew, BA, Dahlawi, SMA, Dai, H, Dai, X, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Darmstadt, GL, Das, JK, Davila-Cervantes, CA, Davis, AC, Davletov, K, De la Hoz, FP, De Leo, D, Deeba, F, Denova-Gutierrez, E, Dervenis, N, Desalew, A, Deuba, K, Dey, S, Dharmaratne, SD, Dhingra, S, Dhungana, GP, da Silva, DD, Diaz, D, Dorostkar, F, Doshmangir, L, Dubljanin, E, Duraes, AR, Eagan, AW, Edinur, HA, Efendi, F, Eftekharzadeh, S, El Sayed, I, El Tantawi, M, Elbarazi, I, Elgendy, IY, El-Jaafary, S, Emami, A, Enany, S, Eyawo, O, Ezzikouri, S, Faris, PS, Farzadfar, F, Fattahi, N, Fauk, NK, Fazlzadeh, M, Feigin, VL, Ferede, TY, Fereshtehnejad, S-M, Fernandes, E, Ferrara, P, Filip, I, Fischer, F, Fisher, JL, Foigt, NA, Folayan, MO, Foroutan, M, Franklin, RC, Freitas, M, Friedman, SD, Fukumoto, T, Gad, MM, Gaidhane, AM, Gaidhane, S, Gaihre, S, Gallus, S, Garcia-Basteiro, AL, Garcia-Gordillo, M, Gardner, WM, Fonseca, MG, Gebremedhin, KB, Getacher, L, Ghashghaee, A, Gholamian, A, Gilani, SA, Gill, TK, Giussani, G, Gnedovskaya, E, Godinho, MA, Goel, A, Golechha, M, Gona, PN, Gopalani, SV, Goudarzi, H, Grivna, M, Gugnani, HC, Guido, D, Guimaraes, RA, Das Gupta, R, Gupta, R, Hafezi-Nejad, N, Haider, MR, Haj-Mirzaian, A, Hamidi, S, Hanif, A, Hankey, GJ, Hargono, A, Hasaballah, A, Hasan, MM, Hasan, SS, Hassan, A, Hassanipour, S, Hassankhani, H, Havmoeller, RJ, Hayat, K, Heidari-Soureshjani, R, Henry, NJ, Herteliu, C, Hole, MK, Holla, R, Hossain, N, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Huang, J, Humayun, A, Hwang, B-F, Iavicoli, I, Ibitoye, SE, Ikuta, KS, Ilesanmi, OS, Ilic, IM, Ilic, MD, Inamdar, S, Inbaraj, LR, Iqbal, K, Iqbal, U, Islam, MM, Shariful Islam, Sheikh, Iso, H, Iwagami, M, Iwu, CCD, Jaafari, J, Jacobsen, KH, Jagnoor, J, Jain, V, Janodia, MD, Javaheri, T, Javanmardi, F, Jayaram, S, Jayatilleke, AU, Jenabi, E, Jha, RP, Ji, JS, John, O, Jonas, JB, Joo, T, Joseph, N, Joukar, F, Jozwiak, JJ, Jurisson, M, Kabir, A, Kabir, Z, Kalankesh, LR, Kamyari, N, Kanchan, T, Kapoor, N, Matin, BK, Karch, A, Karimi, SE, Kassahun, G, Kayode, GA, Karyani, AK, Kemmer, L, Khalid, N, Khalilov, R, Khammarnia, M, Khan, EA, Khan, G, Khan, M, Khan, MN, Khang, Y-H, Khatab, K, Khater, AM, Khater, MM, Khayamzadeh, M, Khosravi, A, Kim, D, Kim, Y-E, Kim, YJ, Kimokoti, RW, Kisa, A, Kisa, S, Kissoon, N, Kopec, JA, Kosen, S, Koul, PA, Laxminarayana, SLK, Koyanagi, A, Krishan, K, Krishnamoorthy, V, Defo, BK, Bicer, BK, Kulkarni, V, Kumar, GA, Kumar, M, Kumar, N, Kurmi, OP, Kusuma, D, La Vecchia, C, Lacey, B, Lalloo, R, Lami, FH, Landires, I, Larsson, AO, Lasrado, S, Lassi, ZS, Lauriola, P, Lee, PH, Lee, SWH, Lee, YH, Leigh, J, Leonardi, M, Lewycka, S, Li, B, Li, S, Liang, J, Lim, L-L, Limenih, MA, Lin, R-T, Liu, X, Lodha, R, Lopez, AD, Lozano, R, Lugo, A, Lunevicius, R, Mackay, MT, Kunjathur, SM, Magnani, FG, Prasad, DRM, Maheri, M, Mahmoudi, M, Majeed, A, Maled, V, Maleki, A, Maleki, S, Malekzadeh, R, Malik, AA, Malta, DC, Mamun, AA, Mansouri, B, Mansournia, MA, Martinez, G, Martini, S, Martins-Melo, FR, Masoumi, SZ, Maulik, PK, McAlinden, C, McGrath, JJ, Medina-Solis, CE, Nasab, EM, Mejia-Rodriguez, F, Memish, ZA, Mendoza, W, Menezes, RG, Mengesha, EW, Mensah, GA, Meretoja, A, Meretoja, TJ, Mersha, AM, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, IM, Miller, TR, Mini, GK, Miri, M, Mirica, A, Mirrakhimov, EM, Mirzaei, H, Mirzaei, M, Moazen, B, Moghadaszadeh, M, Mohajer, B, Mohamad, O, Mohammad, Y, Mohammadi, SM, Mohammadian-Hafshejani, A, Mohammed, S, Mokdad, AH, Molokhia, M, Monasta, L, Mondello, S, Moni, MA, Moore, CE, Moradi, G, Moradi, M, Moradzadeh, R, Moraga, P, Morawska, L, Morrison, SD, Mosser, JF, Khaneghah, AM, Mustafa, G, Naderi, M, Nagarajan, AJ, Nagaraju, SP, Naghavi, M, Naghshtabrizi, B, Naimzada, MD, Nangia, V, Swamy, SN, Nascimento, BR, Naveed, M, Nazari, J, Ndejjo, R, Negoi, I, Negoi, RI, Nena, E, Nepal, S, Netsere, HB, Nguefack-Tsague, G, Ngunjiri, JW, Chi, TYN, Cuong, TN, Huong, LTN, Nigatu, YT, Nigussie, SN, Nixon, MR, Nnaji, CA, Nomura, S, Noor, NM, Noubiap, JJ, Nunez-Samudio, V, Nwatah, VE, Oancea, B, Odukoya, OO, Ogbo, FA, Olusanya, BO, Olusanya, JO, Bali, AO, Onwujekwe, OE, Ortiz, A, Otoiu, A, Otstavnov, N, Otstavnov, SS, Owolabi, MO, Mahesh, PA, Padubidri, JR, Pakhale, S, Pakshir, K, Pal, PK, Palladino, R, Pana, A, Panda-Jonas, S, Pandey, A, Pandi-Perumal, SR, Pangaribuan, HU, Pardo-Montano, AM, Park, E-K, Patel, SK, Patton, GC, Pawar, S, Toroudi, HP, Peden, AE, Pepito, VCF, Peprah, EK, Pereira, J, Perez-Gomez, J, Perico, N, Pesudovs, K, Pilgrim, T, Pinheiro, M, Piradov, MA, Pirsaheb, M, Platts-Mills, JA, Pokhrel, KN, Postma, MJ, Pourjafar, H, Prada, S, Prakash, S, Pupillo, E, Syed, ZQ, Rabiee, N, Radfar, A, Rafiee, A, Rafiei, A, Raggi, A, Rahimzadeh, S, Rahman, MHU, Rahmani, AM, Ramezanzadeh, K, Rana, J, Ranabhat, CL, Rao, SJ, Rasella, D, Rastogi, P, Rathi, P, Rawaf, DL, Rawaf, S, Rawasia, WF, Rawassizadeh, R, Jr, RCR, Remuzzi, G, Renzaho, AMN, Reshmi, B, Resnikoff, S, Rezaei, N, Rezapour, A, Riahi, SM, Ribeiro, D, Rickard, J, Roever, L, Ronfani, L, Rothenbacher, D, Rubagotti, E, Rumisha, SF, Ryan, PM, Saddik, B, Sadeghi, E, Moghaddam, SS, Sagar, R, Sahebkar, A, Salahshoor, MR, Salehi, S, Salem, MR, Salimzadeh, H, Salomon, JA, Samodra, YL, Samy, AM, Sanabria, J, Santric-Milicevic, MM, Saraswathy, SYI, Sarker, AR, Sarrafzadegan, N, Sarveazad, A, Sathian, B, Sathish, T, Sattin, D, Saxena, S, Saya, GK, Saylan, M, Schiavolin, S, Schlaich, MP, Schwebel, DC, Schwendicke, F, Senthilkumaran, S, Sepanlou, SG, Servan-Mori, E, Sha, F, Shafaat, O, Shahabi, S, Shahbaz, M, Shaheen, AA, Shahid, I, Shaikh, MA, Shakiba, S, Shalash, AS, Shams-Beyranvand, M, Shannawaz, M, Sharafi, K, Sheikh, A, Sheikhbahaei, S, Shiferaw, WS, Shigematsu, M, Shin, JI, Shiri, R, Shiue, I, Shuval, K, Siddiqi, TJ, Sidemo, NB, Sigfusdottir, ID, Sigurvinsdottir, R, Silva, JP, Silverberg, JIS, Simonetti, B, Singh, BB, Singh, JA, Singhal, D, Sinha, DN, Skiadaresi, E, Skryabin, VY, Skryabina, AA, Sleet, DA, Sobaih, BH, Sobhiyeh, MR, Soltani, S, Soriano, JB, Spurlock, EE, Sreeramareddy, CT, Steiropoulos, P, Stokes, Mark, Stortecky, S, Sufiyan, MB, Abdulkader, RS, Sulo, G, Swope, CB, Sykes, BL, Szeto, MD, Szocska, M, Tabares-Seisdedos, R, Tadesse, EG, Taherkhani, A, Tamiru, AT, Tareque, MI, Tehrani-Banihashemi, A, Temsah, M-H, Tesfay, FH, Tessema, GA, Tessema, ZT, Thankappan, KR, Thapar, R, Tolani, MA, Tovani-Palone, MR, Traini, E, Bach, XT, Tripathy, JP, Tsapparellas, G, Tsatsakis, A, Car, LT, Uddin, Riaz, Ullah, A, Umeokonkwo, CD, Unim, B, Unnikrishnan, B, Upadhyay, E, Usman, MS, Vacante, M, Vaezi, M, Tahbaz, SV, Valdez, PR, Vasankari, TJ, Venketasubramanian, N, Verma, M, Violante, FS, Vlassov, V, Vo, B, Giang, TV, Wado, YD, Waheed, Y, Wamai, RG, Wang, Y, Wang, Y-P, Ward, P, Werdecker, A, Westerman, R, Wickramasinghe, ND, Wilner, LB, Wiysonge, CS, Wu, A-M, Wu, C, Xie, Y, Jabbari, SHY, Yamagishi, K, Yandrapalli, S, Yaya, S, Yazdi-Feyzabadi, V, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yousefi, Z, Yousefinezhadi, T, Yu, C, Yusuf, SS, Zaidi, SS, Bin Zaman, S, Zamani, M, Zamanian, M, Zastrozhin, MS, Zastrozhina, A, Zhang, Y, Zhang, Z-J, Zhao, X-JG, Ziapour, A, Hay, S, Murray, CJL, Wang, H, and Kassebaum, NJ
Published: 2021

7. Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

Author: Cork, MA, Henry, NJ, Watson, S, Croneberger, AJ, Baumann, M, Letourneau, ID, Yang, M, Serfes, AL, Abbas, J, Abbasi, N, Abbastabar, H, Abreu, LG, Abu-Gharbieh, E, Achappa, B, Adabi, M, Adal, TG, Adegbosin, AE, Adekanmbi, V, Adetokunboh, OO, Agudelo-Botero, M, Ahinkorah, BO, Ahmadi, K, Ahmed, MB, Alhassan, RK, Alipour, V, Almasi-Hashiani, A, Alvis-Guzman, N, Ancuceanu, R, Andrei, T, Anvari, D, Aqeel, M, Arabloo, J, Aremu, O, Asaad, M, Atnafu, DD, Atreya, A, Quintanilla, BPA, Azari, S, Darshan, BB, Baig, AA, Banach, M, Bante, SA, Barboza, MA, Basu, S, Bedi, N, Bejarano Ramirez, DF, Bensenor, IM, Beyene, FY, Bezabih, YM, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhutta, ZA, Bijani, A, Birlik, SM, Bitew, ZW, Bohlouli, S, Boloor, A, Brunoni, AR, Butt, ZA, Cardenas, R, Carvalho, F, Castaldelli-Maia, JM, Castaneda-Orjuela, CA, Charan, J, Chatterjee, S, Chattu, VK, Chattu, SK, Chowdhury, MAK, Christopher, DJ, Chu, D-T, Cook, AJ, Cormier, NM, Dahlawi, SMA, Daoud, F, Davila Cervantes, CA, Weaver, ND, De la Hoz, FP, Demeke, FM, Denova-Gutierrez, E, Deribe, K, Deuba, K, Dharmaratne, SD, Dhungana, GP, Diaz, D, Djalalinia, S, Duraes, AR, Eagan, AW, Earl, L, Effiong, A, Zaki, MES, El Tantawi, M, Elayedath, R, El-Jaafary, SI, Faraon, EJA, Faro, A, Fattahi, N, Fauk, NK, Fernandes, E, Filip, I, Fischer, F, Foigt, NA, Foroutan, M, Fukumoto, T, Gad, MM, Gebremariam, TBB, Gebremedhin, KB, Gebremeskel, GG, Gesesew, HA, Ghadiri, K, Ghashghaee, A, Gilani, SA, Golechha, M, Gori, U, Goulart, AC, Goulart, BNG, Gugnani, HC, Guimaraes, MDC, Guimaraes, RA, Guo, Y, Gupta, R, Haeuser, E, Haider, MR, Haile, TG, Haj-Mirzaian, A, Hanif, A, Hargono, A, Hariyani, N, Hassanipour, S, Hassankhani, H, Hayat, K, Herteliu, C, Ho, HC, Holla, R, Hosseinzadeh, M, Househ, M, Hwang, BF, Ibeneme, CU, Ibitoye, SE, Ilesanmi, OS, Ilic, MD, Ilic, IM, Iqbal, U, Jahagirdar, D, Jain, V, Jakovljevic, M, Jha, RP, Johnson, KB, Joseph, N, Joukar, F, Kalankesh, LR, Kalhor, R, Kanchan, T, Matin, BK, Karch, A, Karimi, SE, Kassahun, G, Kayode, GA, Karyani, AK, Keramati, M, Khalid, N, Khan, EA, Khan, G, Khan, MNN, Khatab, K, Kianipour, N, Kim, YJ, Kisa, S, Kisa, A, Kosen, S, Laxminarayana, SLK, Koyanagi, A, Krishan, K, Defo, BK, Kuchenbecker, RS, Kulkarni, V, Kumar, N, Kumar, M, Kurmi, OP, Kusuma, D, La Vecchia, C, Lal, DK, Landires, I, Lasrado, S, Lee, PH, LeGrand, KE, Li, B, Li, S, Liu, X, Amin, HIM, Machado, DB, Madi, D, Magis-Rodriguez, C, Malta, DC, Mansournia, MA, Manzar, MD, Marrugo Arnedo, CA, Martins-Melo, FR, Masoumi, SZ, Mayala, BK, Medina-Solis, CE, Memish, ZA, Mendoza, W, Menezes, RG, Mestrovic, T, Mirica, A, Moazen, B, Mohammad, Y, Mezerji, NMG, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, S, Mokdad, AH, Moni, MA, Moradi, M, Moradi, Y, Moradzadeh, R, Moraga, P, Khaneghah, AM, Mustafa, G, Mwanri, L, Nagaraja, R, Nagarajan, AJ, Naimzada, MD, Nascimento, BR, Naveed, M, Nayak, VC, Nazari, J, Negash, H, Negoi, I, Nepal, S, Nguefack-Tsague, G, Nguyen, CT, Nguyen, HLT, Nikbakhsh, R, Noubiap, JJ, Nunez-Samudio, V, Oancea, B, Ogbo, FA, Olagunju, AT, Otstavnov, N, Mahesh, PA, Padubidri, JR, Perumal, SRP, Pardo-Montano, AM, Patel, UK, Pawar, S, Peprah, EK, Pereira, A, Perkins, S, Pescarini, JM, Pokhrel, KN, Postma, MJ, Pottoo, FH, Prada, SI, Preotescu, L, Pribadi, DRA, Radfar, A, Rahim, F, Rahman, MHU, Rahmani, AM, Ramezanzadeh, K, Rana, J, Ranabhat, CL, Rao, SJ, Rathi, P, Rawaf, S, Rawaf, DL, Rawassizadeh, R, Renjith, V, Rezaei, N, Rezapour, A, Ribeiro, AI, Roever, L, Rubagotti, E, Rumisha, SF, Rwegerera, GM, Sagar, R, Sajadi, SM, Salem, MR, Samy, AM, Sarmiento-Suarez, R, Sathian, B, Schaeffer, LE, Schneider, IJC, Seidu, A-A, Sha, F, Shaikh, MA, Sharafi, K, Sheikh, A, Shibuya, K, Shin, JI, Silva, DAS, Singh, JA, Skryabin, VY, Skryabina, AA, Sligar, A, Soheili, A, Steuben, KM, Sufiyan, MB, Tadesse, EG, Tesema, AKT, Tesfay, FH, Thapar, R, Thompson, RL, Tovani-Palone, MR, Tran, BX, Tsegaye, GW, Umeokonkwo, CD, Unnikrishnan, B, Vasseghian, Y, Violante, FS, Vo, B, Vu, GT, Waheed, Y, Wang, Y-P, Wang, Y, Ward, P, Welay, FT, Westerman, R, Wickramasinghe, ND, Yaya, S, Yip, P, Yonemoto, N, Yu, C, Yuce, D, Yusefzadeh, H, Zamanian, M, Zastrozhin, MS, Zhang, Z-J, Zhang, Y, Ziapour, A, Hay, SI, Dwyer-Lindgren, L, Cork, MA, Henry, NJ, Watson, S, Croneberger, AJ, Baumann, M, Letourneau, ID, Yang, M, Serfes, AL, Abbas, J, Abbasi, N, Abbastabar, H, Abreu, LG, Abu-Gharbieh, E, Achappa, B, Adabi, M, Adal, TG, Adegbosin, AE, Adekanmbi, V, Adetokunboh, OO, Agudelo-Botero, M, Ahinkorah, BO, Ahmadi, K, Ahmed, MB, Alhassan, RK, Alipour, V, Almasi-Hashiani, A, Alvis-Guzman, N, Ancuceanu, R, Andrei, T, Anvari, D, Aqeel, M, Arabloo, J, Aremu, O, Asaad, M, Atnafu, DD, Atreya, A, Quintanilla, BPA, Azari, S, Darshan, BB, Baig, AA, Banach, M, Bante, SA, Barboza, MA, Basu, S, Bedi, N, Bejarano Ramirez, DF, Bensenor, IM, Beyene, FY, Bezabih, YM, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhutta, ZA, Bijani, A, Birlik, SM, Bitew, ZW, Bohlouli, S, Boloor, A, Brunoni, AR, Butt, ZA, Cardenas, R, Carvalho, F, Castaldelli-Maia, JM, Castaneda-Orjuela, CA, Charan, J, Chatterjee, S, Chattu, VK, Chattu, SK, Chowdhury, MAK, Christopher, DJ, Chu, D-T, Cook, AJ, Cormier, NM, Dahlawi, SMA, Daoud, F, Davila Cervantes, CA, Weaver, ND, De la Hoz, FP, Demeke, FM, Denova-Gutierrez, E, Deribe, K, Deuba, K, Dharmaratne, SD, Dhungana, GP, Diaz, D, Djalalinia, S, Duraes, AR, Eagan, AW, Earl, L, Effiong, A, Zaki, MES, El Tantawi, M, Elayedath, R, El-Jaafary, SI, Faraon, EJA, Faro, A, Fattahi, N, Fauk, NK, Fernandes, E, Filip, I, Fischer, F, Foigt, NA, Foroutan, M, Fukumoto, T, Gad, MM, Gebremariam, TBB, Gebremedhin, KB, Gebremeskel, GG, Gesesew, HA, Ghadiri, K, Ghashghaee, A, Gilani, SA, Golechha, M, Gori, U, Goulart, AC, Goulart, BNG, Gugnani, HC, Guimaraes, MDC, Guimaraes, RA, Guo, Y, Gupta, R, Haeuser, E, Haider, MR, Haile, TG, Haj-Mirzaian, A, Hanif, A, Hargono, A, Hariyani, N, Hassanipour, S, Hassankhani, H, Hayat, K, Herteliu, C, Ho, HC, Holla, R, Hosseinzadeh, M, Househ, M, Hwang, BF, Ibeneme, CU, Ibitoye, SE, Ilesanmi, OS, Ilic, MD, Ilic, IM, Iqbal, U, Jahagirdar, D, Jain, V, Jakovljevic, M, Jha, RP, Johnson, KB, Joseph, N, Joukar, F, Kalankesh, LR, Kalhor, R, Kanchan, T, Matin, BK, Karch, A, Karimi, SE, Kassahun, G, Kayode, GA, Karyani, AK, Keramati, M, Khalid, N, Khan, EA, Khan, G, Khan, MNN, Khatab, K, Kianipour, N, Kim, YJ, Kisa, S, Kisa, A, Kosen, S, Laxminarayana, SLK, Koyanagi, A, Krishan, K, Defo, BK, Kuchenbecker, RS, Kulkarni, V, Kumar, N, Kumar, M, Kurmi, OP, Kusuma, D, La Vecchia, C, Lal, DK, Landires, I, Lasrado, S, Lee, PH, LeGrand, KE, Li, B, Li, S, Liu, X, Amin, HIM, Machado, DB, Madi, D, Magis-Rodriguez, C, Malta, DC, Mansournia, MA, Manzar, MD, Marrugo Arnedo, CA, Martins-Melo, FR, Masoumi, SZ, Mayala, BK, Medina-Solis, CE, Memish, ZA, Mendoza, W, Menezes, RG, Mestrovic, T, Mirica, A, Moazen, B, Mohammad, Y, Mezerji, NMG, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, S, Mokdad, AH, Moni, MA, Moradi, M, Moradi, Y, Moradzadeh, R, Moraga, P, Khaneghah, AM, Mustafa, G, Mwanri, L, Nagaraja, R, Nagarajan, AJ, Naimzada, MD, Nascimento, BR, Naveed, M, Nayak, VC, Nazari, J, Negash, H, Negoi, I, Nepal, S, Nguefack-Tsague, G, Nguyen, CT, Nguyen, HLT, Nikbakhsh, R, Noubiap, JJ, Nunez-Samudio, V, Oancea, B, Ogbo, FA, Olagunju, AT, Otstavnov, N, Mahesh, PA, Padubidri, JR, Perumal, SRP, Pardo-Montano, AM, Patel, UK, Pawar, S, Peprah, EK, Pereira, A, Perkins, S, Pescarini, JM, Pokhrel, KN, Postma, MJ, Pottoo, FH, Prada, SI, Preotescu, L, Pribadi, DRA, Radfar, A, Rahim, F, Rahman, MHU, Rahmani, AM, Ramezanzadeh, K, Rana, J, Ranabhat, CL, Rao, SJ, Rathi, P, Rawaf, S, Rawaf, DL, Rawassizadeh, R, Renjith, V, Rezaei, N, Rezapour, A, Ribeiro, AI, Roever, L, Rubagotti, E, Rumisha, SF, Rwegerera, GM, Sagar, R, Sajadi, SM, Salem, MR, Samy, AM, Sarmiento-Suarez, R, Sathian, B, Schaeffer, LE, Schneider, IJC, Seidu, A-A, Sha, F, Shaikh, MA, Sharafi, K, Sheikh, A, Shibuya, K, Shin, JI, Silva, DAS, Singh, JA, Skryabin, VY, Skryabina, AA, Sligar, A, Soheili, A, Steuben, KM, Sufiyan, MB, Tadesse, EG, Tesema, AKT, Tesfay, FH, Thapar, R, Thompson, RL, Tovani-Palone, MR, Tran, BX, Tsegaye, GW, Umeokonkwo, CD, Unnikrishnan, B, Vasseghian, Y, Violante, FS, Vo, B, Vu, GT, Waheed, Y, Wang, Y-P, Wang, Y, Ward, P, Welay, FT, Westerman, R, Wickramasinghe, ND, Yaya, S, Yip, P, Yonemoto, N, Yu, C, Yuce, D, Yusefzadeh, H, Zamanian, M, Zastrozhin, MS, Zhang, Z-J, Zhang, Y, Ziapour, A, Hay, SI, and Dwyer-Lindgren, L
Abstract: BACKGROUND: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. METHODS: We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. RESULTS: All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries-apart from Ecuador-across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups-the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. CONCLUSIONS: Our subnational estimates of HIV mortality revealed significant spatial variation and divergi
Published: 2021

8. Population-based prevalence and associated risk factors of hypertension among adults in Benue State, Nigeria

Author: Osunkwo, D, primary, Mohammed, A, additional, Kamateeka, M, additional, Nguku, P, additional, Umeokonkwo, CD, additional, Abolade, OS, additional, Ibrahim, M, additional, Ibrahim, K, additional, Nwokeukwu, H, additional, and Zoakah, AI, additional
Published: 2020
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9. Appraisal of willingness to vaccinate daughters with human papilloma virus vaccine and cervical cancer screening uptake among mothers of adolescent students in Abakaliki, Nigeria

Author: Azuogu, BN, primary, Umeokonkwo, CD, additional, Azuogu, VC, additional, Onwe, OE, additional, Okedo-Alex, IN, additional, and Egbuji, CC, additional
Published: 2019
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10. Severe preeclampsia and eclampsia: A 6-year review at the Federal Teaching Hospital, Abakaliki, Southeast Nigeria

Author: Mamah, JE, primary, Onoh, RC, additional, Umeokonkwo, CD, additional, Onwe, EO, additional, Ezeonu, PO, additional, and Okafor, L, additional
Published: 2019
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11. Pattern of intestinal parasitic infections in children with malnutrition in Somalia.

Author: Osman MM, Hussein SA, Omar MA, Issack MM, Hanafi AMH, Ahmed MY, Mohamed MA, and Umeokonkwo CD
Abstract: Objectives: Children living in conflict zones plagued with adverse climatic conditions often suffer from acute malnutrition. Being coinfected with intestinal parasites could worsen the prognosis if adequate interventions are not promptly instituted. We determined the pattern of intestinal parasitic infections (IPIs) in children with acute malnutrition in the Bay and Banadir regions of Somalia., Methods: A hospital-based cross-sectional study was conducted from August to October 2023 in 222 children with acute malnutrition aged 6-59 months, using a structured questionnaire and stool examination by a trained laboratorian. The prevalence of IPI was estimated and the pattern of IPI was explored. The relationship between the presence of IPI and demographic characteristics was examined with multiple logistic regression at a 95% level of confidence., Results: The mean age was 20.4 ± 12.3 months, 125 (56.3%) were females, and 41.9% were internally displaced. The prevalence of IPI was 82.9% (95% confidence interval: 77.4-87.3), Of the infected, 73.9% (136 of 184) had single parasitic infection and 23.4% (43 of 184) had double parasitic infections. Ascaris lumbricoides (46.6%), Giardia lamblia (22.1%), and Entamoeba histolytica (17.6%) were the most common parasites identified. The age of 13-36 months (adjusted odds ratio: 1.13, P = 0.02) and eating once a day (adjusted odds ratio: 1.13, P = 0.06) were associated with being infected with intestinal parasites., Conclusions: The prevalence of intestinal parasitic infection was high in children with malnutrition in the Bay and Banadir regions. Deworming should be extended to all children with malnutrition. Food, sanitation, and water provision initiatives should be improved at the community level., Competing Interests: The authors have no competing interests to declare.
Published: 2024
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12. Maternal death surveillance and response system evaluation in Makonde District, Zimbabwe, 2021.

Author: Makanyanga TB, Madzima B, Mungati M, Chadambuka A, Gombe NT, Juru TP, Umeokonkwo CD, and Tshimanga M
Subjects: Humans, Female, Zimbabwe epidemiology, Cross-Sectional Studies, Pregnancy, Adult, Health Personnel, Surveys and Questionnaires, Population Surveillance methods, Maternal Death statistics & numerical data, Maternal Mortality
Abstract: Background: Maternal mortality is of global concern, almost 800 women die every day due to maternal complications. The maternal death surveillance and response (MDSR) system is one strategy designed to reduce maternal mortality. In 2021 Makonde District reported a maternal mortality ratio of 275 per 100 000 and only sixty-two percent of deaths recorded were audited. We evaluated the MDSR system in Makonde to assess its performance., Methods: A descriptive cross-sectional study was conducted using the CDC guidelines for evaluating public health surveillance systems. An Interviewer-administered questionnaire was used to collect data from 79 health workers involved in MDSR and healthcare facilities. All maternal death notification forms, weekly disease surveillance forms, and facility monthly summary forms were reviewed. We assessed health workers' knowledge, usefulness and system attributes., Results: We interviewed 79 health workers out of 211 workers involved in MDSR and 71 (89.9%) were nurses. The median years in service was 8 (IQR: 4-12). Overall health worker knowledge (77.2%) was good. Ninety-three percent of the deaths audited were of avoidable causes. Twelve out of the thirty-eight (31.6%) facilities were using electronic health records system. Feedback and documented shared information were evident at four facilities (21%) including the referral hospital. Nineteen (67.9%) out of 28 maternal death notification forms were completed within seven days and none were submitted to the PMD on time., Conclusion: The MDSR system was acceptable and simple but not timely, stable and complete. Underutilization of the electronic health system, work load, poor documentation and data management impeded performance of the system. We recommended appointment of an MDSR focal person, sharing audit minutes and improved data management., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Makanyanga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Published: 2024
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13. COVID-19 pandemic response and Field Epidemiology and Laboratory Training Programs in ECOWAS.

Author: Lokossou VK, Adeke AS, Umeokonkwo CD, Bonkano LCM, Usman AB, Sogbossi L, Kima A, Nguku P, Antara S, Sombie I, Agbla F, and Aissi MJC
Subjects: Humans, Surveys and Questionnaires, Laboratories organization & administration, Pandemics, Laboratory Personnel education, COVID-19 epidemiology, COVID-19 prevention & control, Public Health education, Epidemiology education
Abstract: The COVID-19 pandemic has been persistent with a huge demand for human health resources which is a vital component of its preparedness and response. Globally, the public health workforce through field epidemiology and laboratory training programme (FELTP) has been instrumental to global health security. We determined the status of FELTP in the region and its contributions to the COVID-19 pandemic response in the ECOWAS region. We conducted a desk review, shared a questionnaire among member states and organized a two-day online regional consultative meeting on field epidemiology training on 30 th -31 st March 2022 during which there were presentations, group discussions and deliberations on the status and contribution of FETP during the COVID-19 pandemic. Data collected were analyzed in themes. All countries in the ECOWAS region had established at least one tier of FELTP, 11 (73.3%) had established two tiers of FELTP and only 3 (20.0%) had established all three tiers of the program. Despite the pandemic, the cumulative number of graduates increased from 2996 to 4271 frontline, 41 to 380 intermediate, and 409 to 802 for advanced FELTP between 2019 and 2022. However, the progress has been disproportionate across countries. The key activities supported through FELTP graduates included pandemic response coordination, surveillance, data collection/management, laboratory support, case management, risk communication, infection prevention and control, COVID-19 vaccination, and research. Despite improvements in the FELTP in the Economic Community of West African States (ECOWAS) region, there is a need for continuous stakeholder engagement for its implementation, resource mobilization for sustainability, and leveraging critical partnerships., Competing Interests: The authors declare no competing interests., (Copyright: Virgil Kuassi Lokossou et al.)
Published: 2024
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14. COVID-19 vaccine hesitancy among adults in Liberia, April-May 2021.

Author: Sanvee-Blebo LM, Adewuyi PA, Whesseh FK, Babalola OJ, Wilson-Sesay HW, Akpan GE, Umeokonkwo CD, Clement P, and Amo-Addae M
Subjects: Adult, Female, Humans, Liberia, Cross-Sectional Studies, Pandemics, Vaccination, COVID-19 Vaccines, COVID-19
Abstract: Background: Vaccination is one of the most cost-effective public health interventions used to prevent diseases in susceptible populations. Despite the established efficacy of vaccines, there are many reasons people are hesitant about vaccination, and these reasons could be complex. This rapid survey estimated the prevalence of COVID-19 vaccine hesitancy and potentially contributing factors in Montserrado and Nimba counties in Liberia., Methods: A cross-sectional study was conducted among adults living in Liberia. The relationship between vaccine non-acceptance and sociodemographic characteristics was examined using chi-square statistics. The variables with a p-value less than 0.2 at the bivariate analysis were modelled in a binary logistic regression at a 5% level of significance. The adjusted odds ratio and 95% confidence interval are reported., Results: There were 877 participants in the study. Majority were 25-34 years of age (30.4%, 272/877), females (54.05%, 474/877), and Christians (85.2%, 747/877). Most of the participants were aware of the COVID-19 vaccine (75%, 656/877), single (41.4%, 363/877), self-employed (37.51%, 329/877), and live-in rural communities (56.1%, 492/877). Vaccine hesitancy was (29.1%, 255/877; 95% CI:26.2-32.2). Vaccine hesitancy was greater among adults living in urban areas (41%) compared to persons living in rural communities (59%) (aOR; 1.5, 95% CI: 1.1-2.1) and respondents aged 45-54 years (aOR:0.5; 95% CI: 0.2-0.9; p = 0.043) were 50% less likely to be hesitant to COVID-19 vaccination compared to those more than 55 years. The most common source of information was the media (53%, 492/877) and the main reason for being hesitant was a need for more information about the vaccine and its safety (84%, 215/255)., Conclusions: The majority of study participants were aware of the COVID-19 vaccines and their most common source of information was the media (television, radio). Vaccine hesitancy was moderate. This could pose a challenge to efforts to control the spread of the COVID-19 pandemic. Therefore, the health authorities should provide more health education on the importance of vaccines and their safety to the populace., Competing Interests: The authors have declared that no competing interests exists., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
Published: 2024
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15. Maternal mortality review in a major tertiary referral hospital in Liberia, 2018-2021.

Author: Thomas TK, Umeokonkwo CD, Sesay HW, Adewuyi P, Babalola OJ, Wachekwa I, and Amo-Addae MP
Abstract: Objectives: Anecdotal evidence showed increased maternal deaths at the major tertiary hospital over the past two years (2020-2021). We reviewed the maternal death audit data, identified the main causes of maternal death, and associated risk factors. Findings were shared with policymakers to help reduce maternal mortality., Study Design: We conducted a secondary data review and descriptive analysis of maternal death at the tertiary hospital located in Monrovia., Method: The maternal death data were extracted from patient medical records, including death certificates and maternal audit records. The record of live births was obtained from the delivery register. Data were analyzed using Epi Info version 7.2 Maternal mortality ratio (MMR) was estimated, the leading direct and indirect causes of maternal death were identified, and the factors associated with maternal death were explored using logistic regression at a 5% level of significance., Results: There are a total of 233 maternal deaths and 14, 879 live births giving a maternal mortality ratio (MMR) of 1565 per 100,000 live births during the period under review. The median age of the mothers at death was 29 (14-45) years. About 40.3% (94/233) of cases died within <1 day of admission, referrals accounted for 59% (137/233) of the cases. Direct causes of death accounted for 66% (147/223). Hemorrhage [30.6% (45/147)], Eclampsia [(30/147) 20.6%] and Sepsis [(30/147) 20.6%] were the main direct causes of death while cardiovascular-related [18.4% (14/76)] and HIV/AIDS [16% (12/76)] were the leading indirect cause of death. Patients from referred other facilities were 7.9 times more likely to die as compared to non-referral (pOR:7.9, 95%CI: 5.9-10.6, p < 0.001)., Conclusion: The maternal mortality ratio remained high. Referrals were done late. The Liberia Ministry of Health should equip more secondary-level health facilities and tertiary hospitals to handle maternal emergencies and sensitize the populace and healthcare workers on prompt identification and referral of obstetric emergencies. The MoH also needs to improve the blood transfusion services to help in the management of postpartum hemorrhage., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)
Published: 2024
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16. Adverse drug reactions, adherence, and virologic outcomes in adult patients on dolutegravir-based antiretroviral therapy at a tertiary hospital, southeast Nigeria.

Author: Ogbonnaya LU, Onah CK, Azuogu BN, Akpa CO, Okeke KC, Nwachukwu VN, Stephen-Emeya A, Asaga IU, and Umeokonkwo CD
Subjects: Humans, Female, Male, Middle Aged, Retrospective Studies, Adult, Nigeria, Viral Load, Treatment Outcome, Oxazines, Pyridones, Heterocyclic Compounds, 3-Ring adverse effects, Heterocyclic Compounds, 3-Ring therapeutic use, Piperazines, HIV Infections drug therapy, Tertiary Care Centers, Medication Adherence statistics & numerical data, HIV Integrase Inhibitors therapeutic use, HIV Integrase Inhibitors adverse effects, Body Mass Index
Abstract: Objective: To assess the adherence, adverse drug reactions (ADR), and virologic outcomes of dolutegravir-based antiretroviral therapy., Design: This was a retrospective chart review., Setting: A tertiary health facility-based study in Abakaliki, Nigeria., Participants: Five hundred and fifteen (515) adult patients on dolutegravir were selected using a Random Number Generator. Demographic and clinical data were extracted from patients' case notes and analysed with IBM-SPSS version-25., Main Outcome Measures: Adherence to dolutegravir, ADRs, virologic outcome, and change in Body Mass Index (BMI) were estimated., Results: The mean age of the patients was 45.5±10.8 years; 68.2% of them were females; 97.1% of them had good self-reported adherence. The majority (82.9%) of them reported no ADRs and among those (17.1%) that did, headache (9.7%), body-itching (3.1%), and skin rash (2.7%) dominated. Most achieved viral suppression (94.4%) and did not have detectable viral particles (57.4%). There was a significant increase in the BMI of the patients with a mean weight increase of 0.9kg, a mean BMI increase of 0.3 kg/m 2 , and a 2.6% increase in the prevalence of overweight and obesity., Conclusions: Patients on dolutegravir reported low ADRs, good self-reported adherence, and a high viral suppression rate. However, dolutegravir is associated with weight gain. We recommend widespread use and more population-wide studies to elucidate the dolutegravir-associated weight gain., Funding: None declared., Competing Interests: Conflict of interest: None declared., (Copyright © The Author(s).)
Published: 2024
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17. Descriptive Analysis of Measles Outbreak in Liberia, 2022.

Author: Shobayo B, Umeokonkwo CD, Jetoh RW, Gilayeneh JSM Sr, Akpan G, Amo-Addae M, Macauley J, and Idowu RT
Abstract: Background: Liberia reported a large outbreak of measles involving all the counties in 2022. We conducted a descriptive analysis of the measles surveillance data to understand the trend of the outbreak and guide further policy action to prevent future outbreaks., Methods: We analyzed the measles surveillance data from Epi week 1 to 51, 2022. All the laboratory-confirmed cases, clinically compatible and epidemiologically linked cases were included in the analysis, the variables of interest included the patient's age, sex, place of residence, measles classification, measles vaccination status, and outcome. We cleaned and analyzed the data using R version 4.2.0 and Arc GIS Pro. The demographic characteristics of the cases were presented, the progression of the cases was presented in Epicurve and the spatial distribution and the case fatality rate (CFR) of the case were presented at the district level using the Arc GIS Pro., Results: The median age of the cases was 4 years (interquartile range: 2-8 years). Children under five years of age constituted 60% of the cases (4836/8127), and females accounted for 52% (4204/8127) of the cases. Only 1% (84/8127) of the cases had documentary evidence of receiving at least one dose of measles-containing vaccine (MCV). Only 3 out of 92 health districts in the country did not report a case of measles during the period under review. The overall cases fatality rate was 1% however CFR of up to 10% were reported in some districts., Conclusion: The outbreak of measles involved almost all the districts of the country, exposing a possible nationwide suboptimal immunization coverage for MCV. The high CFR reported in some districts needs further investigation., Competing Interests: The authors have no competing interests to declare., (© 2024 The Author(s).)
Published: 2024
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18. Trend of Lassa fever cases and factors associated with mortality in Liberia, 2016 - 2021: a secondary data analysis.

Author: Dwalu E, Jetoh RW, Shobayo BI, Pewu I, Taweh F, Wilson-Sesay HW, Akpan GE, Shannon F, Joseph BO, Umeokonkwo CD, Adewuyi P, Amo-Addae M, Nagbe TK, Gilayeneh J, and MaCauley JA
Subjects: Adolescent, Adult, Child, Female, Humans, Young Adult, Health Personnel, Liberia epidemiology, Public Health, Secondary Data Analysis, Male, Lassa Fever epidemiology, Lassa Fever diagnosis
Abstract: Introduction: Lassa fever (LF) is endemic in Liberia and is immediately reportable. Suspected cases are confirmed at the National Public Health Reference Laboratory. However, there is limited information on the trend and factors associated with mortality. We described the epidemiological characteristics of LF cases and determined factors associated with mortality in Liberia from 2016 to 2021., Methods: we reviewed 867 case-based LF surveillance data from 2016 to 2021 obtained from the National Public Health Institute of Liberia (NPHIL). The cases that met the suspected LF case definition were tested with RT-PCR. Using Epi Info 7.2.5.0. We conducted univariate, bivariate, and multivariate and analysis. We calculated frequencies, proportions. Positivity rate, case fatality rate, and factors associated with LF mortality using chi-square statistics and logistics regression at 5% level of significance., Results: eighty-five percent (737/867) of the suspected cases were tested and 26.0% (192/737) were confirmed LF positive. The median age of confirmed LF cases was 21(IQR: 12-34) years. Age 10-19 years accounted for 24.5% (47/192) and females 54.2% (104/192). Bong 33.9% (65/192), Grand Bassa 31.8% (61/192), and Nimba counties, 21.9% (42/192) accounted for most of the cases. The median duration from symptom onset to hospital admission was 6 (IQR: 3-9) days. A majority, 66% (126/192) of the cases were reported during the dry season (October-March) and annual incidence was highest at 12 cases per 1,000,000 population in 2019 and 2020. The overall case fatality rate was 44.8%. Non-endemic counties, Margibi, 77.8% and Montserrado, 66.7% accounted for the highest case fatality rate (CFR), while 2018, 66.7% and 2021, 60.0% recorded the highest CFR during the period. Age ≥30 years (aOR=2.1,95% CI: 1.08-4.11, p=0.027) and residing in Grand Bassa County (aOR=0.3, 95% CI: 0.13-0.73, p=0.007) were associated with LF mortality., Conclusion: Lassa fever was endemic in three of the fifteen counties of Liberia, case fatality rate remained generally high and widely varied. The high fatality of LF has been reported to the NPHIL and is currently being further investigated. There is a need to continuously train healthcare workers, especially in non-endemic counties to improve the LF treatment outcome., Competing Interests: The authors declare that they have no competing interests., (Copyright: Emmanuel Dwalu et al.)
Published: 2024
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19. Tuberculosis cohort analysis in Zimbabwe: The need to strengthen patient follow-up throughout the tuberculosis care cascade.

Author: Mando TC, Sandy C, Chadambuka A, Gombe NT, Juru TP, Shambira G, Umeokonkwo CD, and Tshimanga M
Subjects: Humans, Follow-Up Studies, Zimbabwe epidemiology, Cohort Studies, Treatment Outcome, Tuberculosis diagnosis, Tuberculosis drug therapy, Tuberculosis epidemiology
Abstract: Introduction: Globally people with tuberculosis (TB) continue to be missed each year. They are either not diagnosed or not reported which indicates possible leakages in the TB care cascade. Zimbabwe is not spared with over 12000 missed cases in 2020. A preliminary review of TB treatment outcomes indicated patient leakages throughout the presumptive cascade and undesirable treatment outcomes in selected cities. Chegutu District had pre-diagnosis and pretreatment losses to follow-up while Mutare City among others had 22.0% of outcomes not evaluated in the second quarter of 2021, and death rates as high as 14% were recorded in Gweru District. The problem persists despite training on data analysis and use. The TB cohorts were analysed to determine the performance of the care cascade and the spatial distribution of treatment outcomes in Zimbabwe., Methods: Using data from district health information software version 2.3 (DHIS2.3), a secondary data analysis of 2020 drug-sensitive (DS) TB treatment cohorts was conducted. We calculated the percentage of pre-diagnosis, and pre-treatment loss to follow-up (LTFU). For TB treatment outcomes, 'cured' and 'treatment completed' were categorized as treatment success, while 'death', 'loss to follow-up (LTFU), and 'not evaluated' were categorized as undesirable outcomes. Univariate analysis of the data was conducted where frequencies were calculated, and data was presented in graphs for the cascade, treatment success, and undesirable outcomes while tables were created for the description of study participants and data quality. QGIS was used to generate maps showing undesirable treatment outcomes., Results: An analysis of national data found 107583 people were presumed to have TB based on symptomatic screening and or x-ray and 21.4% were LTFU before the specimen was investigated. Of the 84534 that got tested, 10.0% did not receive their results. The treatment initiation rate was 99.1%. Analysis of treatment outcomes done at the provincial level showed that Matabeleland South Province had the lowest treatment success rate of 77.3% and high death rates were recorded in Matabeleland South (30.0%), Masvingo (27.3%), and Matabeleland North (26.1%) provinces. Overall, there were high percentages of not-evaluated treatment outcomes., Conclusion: Pre-diagnosis LTFU was high, and high death and loss to follow-up rates were prevalent in provinces with artisanal and small-scale mining (ASM) activities. Unevaluated treatment outcomes were also prevalent and data quality remains a challenge within the national TB control program. We recommended strengthening patient follow-up at all levels within the TB care cascade, strengthening capacity-building for data analysis and use, further analysis to determine factors associated with undesirable outcomes and a study on why LTFU remains high., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Mando et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Published: 2023
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20. HIV and AIDS-related knowledge, HIV risk perception, uptake of HIV testing and its predictors among prison inmates in Bauchi State, Nigeria: a cross-sectional study.

Author: Amede PO, Umeokonkwo CD, Adedire E, Balogun MS, Bashir SS, and Abubakar AA
Subjects: Male, Humans, Young Adult, Adult, Female, Cross-Sectional Studies, Nigeria, Prisons, HIV Testing, Perception, HIV Infections diagnosis, HIV Infections epidemiology, HIV Infections prevention & control, Acquired Immunodeficiency Syndrome epidemiology
Abstract: Introduction: globally, HIV infection among prison inmates is significantly higher than in the general population. Therefore, it is important to identify inmates-living-with-HIV, through HIV-testing, in keeping with the target of UNAIDS vision 90-90-90. We assessed HIV/AIDS-related knowledge, HIV-risk perception and predictors of HIV-testing-uptake in Bauchi Prison., Methods: we conducted a cross-sectional study among 310 inmates selected with 2 stage sampling. Data was collected using a pretested, structured, interviewer-administered questionnaire. Inmates that consented to HIV-test were tested. We estimated inmates' knowledge about HIV/AIDS, the level of HIV testing uptake and predictors of HIV testing-uptake using multiple logistic regression at 5% significant level., Results: the mean age (SD) was 32.3 (±9.4) years and 94.8% were males, 47.1% (95% CI: 41.6-52.7) of the respondents had good knowledge of HIV/AIDS. Fifty-five percent (95% CI: 49.9-60.9) felt they were not at risk of contracting HIV. Uptake of HIV-testing was 58.1% (95% CI: 52.5-63.4). Independent predictors for the uptake of HIV-testing were age 35-44 years (aOR= 3.3; 95% CI: 1.4-7.7), positive risk perception (aOR= 3.3; 95% CI: 1.8-6.2), good knowledge of HIV (aOR= 9.6; CI: 5.1-18.0) and knowing someone who had died of AIDS (aOR= 4.1; 95% CI: 1.9-6.4)., Conclusion: good knowledge of HIV/AIDS and HIV-testing-uptake was low among the inmates. We recommended the development and implementation of targeted HIV-testing interventions that cater to the specific needs of different age-groups within the prison population. The prison authority should develop prison-specific health education programme and awareness campaigns aimed at promoting accurate HIV-risk perception, improving their knowledge and help inmates make informed decisions that will prevent them from contracting HIV., Competing Interests: The authors declare no competing interests., (Copyright: Peter Okpeh Amede et al.)
Published: 2023
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21. Seroprevalence of poliovirus antibodies in Nigeria: refining strategies to sustain the eradication effort.

Author: Bolu O, Adamu U, Franka R, Umeokonkwo CD, An Q, Greby S, McDonald S, Mainou B, Mba N, Agala N, Archer WR, Braka F, Etapelong SG, Gashu TS, Siddique AR, Asekun A, Okoye M, Iriemenam N, Wiesen E, Swaminathan M, Ihekweazu C, and Shuaib F
Subjects: Child, Female, Humans, Infant, Antibodies, Viral, Seroepidemiologic Studies, Nigeria epidemiology, Poliovirus Vaccine, Oral, Poliovirus Vaccine, Inactivated, Poliovirus, Poliomyelitis epidemiology, Poliomyelitis prevention & control
Abstract: Introduction: in 2016, a switch from trivalent oral poliovirus vaccine (OPV) (containing serotypes 1,2,3) to bivalent OPV (types 1,3) was implemented globally. We assessed the seroprevalence of poliovirus antibody levels in selected Nigerian states, before and after the switch, documented poliovirus type2 outbreak responses conducted and ascertained factors associated with immunity gaps based on seroprevalence rates., Methods: we conducted a secondary analysis of stored serum samples from the 2018 Nigeria National HIV/AIDS Indicator and Impact Survey. Serum from 1,185 children aged 0-119 months residing in one southern and four northern states were tested for serotype-specific PV neutralizing antibodies; seropositivity was a reciprocal titer ≥8. We conducted regression analysis to determine sociodemographic risk factors associated with low seroprevalence using SAS 9.4., Results: children aged 24-119 months (pre-switch cohort) had seroprevalence against PV1, PV2, and PV3, of 97.3% (95% CI:96.4-98.2), 93.8% (95% CI:92.2-95.5), and 91.3% (95% CI:89.2-93.4), while children aged <24 months (post-switch) had seroprevalence of 86.0% (95% CI:81.2-90.8), 55.6% (95% CI: 47.7-63.4), and 77.2% (95% CI:71.0-83.4) respectively. Regression analysis showed age <24 months was associated with lower seroprevalence against all PV serotypes, (p<0.0001); females had lower seroprevalence against PV1 (p=0.0184) and PV2 (p=0.0354); northern states lower seroprevalence against PV1 (p=0.0039), while well-water source lower seroprevalence against PV3 (p=0.0288)., Conclusion: this study showed high seroprevalence rates against PV 1, 2, and 3 in pre-switch children (aged 24-119 months). However, post-switch children (<24 months) had low immunity against PV2 despite outbreak responses. Strategies to increase routine immunization coverage and high-quality polio campaigns can increase immunity against polio virus., Competing Interests: The authors declare no competing interests., (©Omotayo Bolu et al.)
Published: 2023
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22. Pattern of antimicrobial prescription in Africa: a systematic review of point prevalence surveys.

Author: Okedo-Alex IN, Akamike IC, Iyamu I, and Umeokonkwo CD
Subjects: Humans, Prevalence, Anti-Bacterial Agents, Nigeria, Amoxicillin, Anti-Infective Agents
Abstract: Introduction: inappropriate use of antimicrobials is a cause for concern and contributes to the global antimicrobial resistance crises especially in Africa. This review aims to summarize the available evidence on the point prevalence and pattern of antimicrobial and/or antibiotic prescription in Africa., Methods: this review was carried out between April and September 2021 and identified published studies up until March 2021 on the point prevalence of antibiotic and/or antimicrobial use in Africa. Sources searched were OVID, PubMed, EMBASE, CINAHL, Web of Science, Google Scholar, Google, and African Journal Online (AJOL). Observational studies that reported prevalence published in English language were included. Covidence systematic review software was used for this review. A form for data extraction using domains culled from the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) was developed on Covidence. Screening of studies for eligibility was done independently by two reviewers. Critical Appraisal tool for use in Joanna Briggs Institute (JBI) Systematic Reviews for prevalence studies was used for quality appraisal., Results: a total of 17 studies that met the inclusion criteria were included in the review. The overall prevalence of antimicrobial/antibiotic use among inpatients in these studies ranged from 40.7% to 97.6%. The median antimicrobial/antibiotic use was 61.3 [IQR= 45.5-72.1]. The highest use of antimicrobials was reported among studies from Nigeria with a prevalence of 97.6%. The most prescribed antibiotics were the beta-lactam penicillin (Amoxicillin, clavulanic acid) (86.9%), and third generation cephalosporins (55.0%). There was general preference for parenteral route of administration of the antimicrobial agents (40-70%). Use for community acquired infections (28.0-79.5%) was the main reason for use. Majority of the prophylactic use of antimicrobial agents were for surgical prophylaxis. Conclusion: the high prevalence of antimicrobial use in Africa reinforces the need for continued surveillance and concerted efforts to institutionalize and support antimicrobial stewardship for prescribers in health institutions in the African region., Competing Interests: The authors declare no competing interests., (Copyright: Ijeoma Nkem Okedo-Alex et al.)
Published: 2023
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23. Readiness, barriers, and attitude of students towards online medical education amidst COVID-19 pandemic: A study among medical students of Ebonyi State University Abakaliki, Nigeria.

Author: Ossai EN, Eze II, Umeokonkwo CD, Izuagba CO, and Ogbonnaya LU
Subjects: Male, Humans, Young Adult, Adult, Female, Nigeria epidemiology, Universities, Cross-Sectional Studies, Pandemics, Students, Medical, COVID-19 epidemiology, Education, Medical, Education, Distance
Abstract: Introduction: The COVID-19 pandemic caused massive disruption to medical education in Nigeria, necessitating the call for online medical education in the country. This study assessed the readiness, barriers, and attitude of medical students of Ebonyi State University Abakaliki, Nigeria, to online medical education., Methods: A cross-sectional study design was employed. All matriculated medical students of the university participated in the study. Information was obtained using a pre-tested, semi-structured questionnaire which was self-administered. Good attitude towards information and communication technology (ICT) based medical education was determined by the proportion of respondents correctly answering 60% of nine variables. Readiness for online classes was determined by the proportion of students who preferred either a combination of physical and online lectures or only online medical education amidst the COVID-19 pandemic. Chi-square test and multivariate analysis using binary logistic regression analysis were used in the study. A p-value of <0.05 determined the level of statistical significance., Results: Four hundred and forty-three students participated in the study (response rate; 73.3%). The mean age of the students was 23.0±3.2 years. The majority of the respondents, 52.4%, were males. The students' most preferred sources for studying before the COVID-19 pandemic included textbooks, 55.1% and lecture notes, 19.0%. The commonly visited websites included Google, 75.2%, WhatsApp, 70.0% and YouTube, 59.1%. Less than half, 41.1%, have a functional laptop. The majority, 96.4%, have a functioning email address, while 33.2% participated in a webinar during the COVID-19 pandemic. Though 59.2% had a good attitude towards online medical education, only 56.0% expressed readiness for online medical education. The major barriers to online medical education included poor internet connectivity, 27.1%, poor e-learning infrastructure, 12.9% and students not having laptops, 8.6%. Predictors of readiness for online medical education included previous participation in a webinar, AOR = 2.1, (95%CI: 1.3-3.2) and having a good attitude towards IT-based medical education, AOR = 3.5, (95%CI: 2.3-5.2)., Conclusions: The majority of the students showed readiness for online medical education. Lessons from COVID-19 pandemic necessitate the initiation of online medical education. University authorities should ensure that every enrolled medical student owns or have access to a dedicated laptop through a university-mediated arrangement. Adequate attention should be given to the development of e-learning infrastructure, including steady internet services within the confines of the university., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ossai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Published: 2023
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24. Antimicrobial use among paediatric inpatients in a Nigerian tertiary hospital: A three-year point prevalence survey.

Author: Umeokonkwo CD, Onah CK, Adeke AS, Igwe-Okomiso DO, Umeokonkwo AA, Madubueze UC, Dauda SO, Okeke KC, Versporten A, Oduyebo OO, Goossens H, and Agu AP
Abstract: Aim: Antimicrobials are among the most widely prescribed therapeutic agents among paediatric population. Irrational use of these agents increases the risk of antimicrobial resistance. We described the prevalence and pattern of antimicrobial use among paediatric inpatients from 2017 to 2019., Subject and Method: The study was a repeated point prevalence survey over a 3-year period using the global point prevalence standardized tools among all paediatric inpatients. The prevalence of antimicrobial use, the prescription indicators and patterns of antimicrobial use were estimated., Result: Among 191 paediatric inpatients assessed, the 3-year period prevalence antimicrobial use was 85.9% (164/191) with prevalence of 80.6% in 2017, 94.6% in 2018, and 83.6% in 2019. Antimicrobial agents used ranged from one agent (20.1%) to five different agents (5.5%). Parenteral route (66.6%) was the preferred route of administration. The reason for the use of antimicrobial agents (92.6%) and the stop/review date (99.5%) were mostly well documented. Only 4.5% of the antimicrobial use were targeted. There were no antimicrobial guidelines or policy guiding the use of antimicrobial agents, except the national guideline on the treatment of malaria and tuberculosis. Ceftriaxone, a third generation cephalosporin was the most commonly used agent across the period under review. Community-acquired infection was the commonest indication for antimicrobial use., Conclusion: Our findings of high antimicrobial prevalence has raised the attention for the need to develop hospital-based antimicrobial guideline and antimicrobial stewardship program to protect the vulnerable children, their contacts and the environment from the impact of antimicrobial resistance., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)
Published: 2023
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25. Capacity building at points of entry during COVID-19 pandemic: harmonising training curriculum for Economic Community of West African States.

Author: Usman AB, Lokossou VK, Sawadogo K, Ward S, Umeokonkwo CD, Sawadogo B, Hanlon C, Kayita G, Balogun MS, Antara S, Merrill R, Nguku PM, Issiaka S, and Jc Aïssi MA
Subjects: Humans, Pandemics, Curriculum, Africa, Capacity Building, COVID-19
Abstract: This paper describes the process for developing, validating and disseminating through a train-the-trainer (TOT) event a standardised curriculum for public health capacity building for points of entry (POE) staff across the 15-member state Economic Community of West African States (ECOWAS) that reflects both international standards and national guidelines.A five-phase process was used in developing the curriculum: phase (1) assessment of existing materials developed by the US Centers for Disease Control and Prevention (CDC), Africa CDC and the West African Economic and Monetary Union, (2) design of retained and new, harmonised content, (3) validation by the national leadership to produce final content, (4) implementation of the harmonised curriculum during a regional TOT, and (5) evaluation of the curriculum.Of the nine modules assessed in English and French, the technical team agreed to retain six harmonised modules providing materials for 10 days of intensive training. Following the TOT, most participants (n=28/30, 93.3%) indicated that the International Health Regulations and emergency management modules were relevant to their work and 96.7% (n=29/30) reported that the training should be cascaded to POE staff in their countries.The ECOWAS harmonised POE curriculum provides a set of training materials and expectations for national port health and POE staff to use across the region. This initiative contributes to reducing the effort required by countries to identify emergency preparedness and response capacity-building tools for border health systems in the Member States in a highly connected region., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Published: 2023
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26. Predictors of Undernutrition among School-Age Children in Abakaliki, Nigeria.

Author: Umeokonkwo AA, Umeokonkwo CD, Ibekwe UM, Manyike C, Udechukwu NP, and Ibe CB
Subjects: Female, Humans, Child, Male, Cross-Sectional Studies, Nigeria epidemiology, Growth Disorders, Prevalence, Thinness epidemiology, Malnutrition epidemiology
Abstract: Background: Undernutrition remains a major public health problem, especially in developing countries. Identification of factors affecting undernutrition among school-age children will guide prioritization of interventions. We determined the predictors of underweight, thinness and stunting among this age group., Methods: A descriptive, cross-sectional study was conducted among 780 school children aged 6 to 12 years using a multistage probability sampling method. An interviewer-administered questionnaire was used to document sociodemographic information and potential predictors of undernutrition. Weight and height were measured using SECA® weighing scale and stadiometer. Body Mass Index (BMI), Z scores of the weight-for-age, BMI-for-age and height-for-age were calculated using the WHO Anthro plus software. Data was entered and analyzed using the Epi Info version 7.2. Multiple logistic regression was used to identify the predictors of undernutrition at 5% level of significance., Results: Of a total of 751 pupils, 397 (52.9%) were females and 595 (79.2%) were in public schools. Significant predictors of underweight were lower maternal education (adjusted odds ratio (aOR) 2.7; 95%CI: 1.33-5.44) and age 10-12years (aOR 5.0; 95%CI:1.49-17.05). Thinness was predicted by age 10-12years (aOR 3.1; 95%CI 1.32-7.27) and rural dwelling (aOR 2.2; 95%CI:1.2-4.08) whereas stunting was predicted by age 10-12 years (aOR 5.2; 95%CI:2.14-12.68) and rural dwelling (aOR 2.3; 95%CI 1.3-4.1)., Conclusion: Undernutrition was higher among rural dwellers, at age 10 to 12 years and with low maternal education., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2022 by West African Journal of Medicine.)
Published: 2022

27. Anthrax outbreak investigation in Tengwe, Mashonaland West Province, Zimbabwe, 2022.

Author: Hamutyinei Dhliwayo T, Chonzi P, Madembo C, Juru TP, Chadambuka A, Gombe NT, Chikerema S, Shambira G, Umeokonkwo CD, and Tshimanga M
Subjects: Male, Humans, Adult, Female, Case-Control Studies, Zimbabwe epidemiology, Disease Outbreaks, Risk Factors, Anthrax diagnosis, Gastrointestinal Diseases epidemiology
Abstract: Background: Anthrax continues to be a disease of public health concern in Zimbabwe. Between December 2021 and February 2022, Tengwe reported 36 cases of human anthrax. Gastrointestinal anthrax has the potential to cause serious outbreaks leading to loss of human life. We investigated the outbreak, identified the risk factors using one health approach to inform outbreak control., Materials and Methods: We conducted descriptive analysis of the outbreak and a 1:2 unmatched case control study to identify risk factors for anthrax. A case was any Tengwe resident who developed an ulcer and/or abdominal symptoms and epidemiologically linked to a confirmed environmental exposure. Validated, structured interviewer-administered questionnaires were used to collect data from the cases and neighbourhood controls. Soil and dried meat samples were collected for laboratory investigations. District preparedness and response was assessed using a checklist. Data was analysed using Epi Info version 7.2.5. The odds of exposure were calculated for each risk factor examined. Multivariable logistic regression analysis was performed to identify the independent factors associated with contracting anthrax., Results: Through active case finding we identified 36 cases, 31 were interviewed. Twenty-one (67.7%) were males. The median age was 33 years (Inter quartile range: 22-54). Nineteen (61.2%) cases presented with abdominal symptoms with zero deaths reported. The independent risk factor for contracting anthrax was eating under-cooked meat (aOR = 12.2, 95% CI: 1.41-105.74, p = 0.023). All samples collected tested positive for anthrax. No livestock vaccinations or zoonotic meetings were being conducted prior to the outbreak. Notification of the outbreak was done 11 days after index case presentation however one health response was instituted within 24 hours., Conclusion: The anthrax was confirmed in Tengwe. Consumption of under-cooked meat was associated with gastrointestinal anthrax. The timely one health response resulted in excellent outcomes. Using one health approach in managing zoonotic threats is encouraged., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Hamutyinei Dhliwayo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Published: 2022
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28. Awareness, knowledge, risk perception and uptake of maternal vaccination in rural communities of Ebonyi State, Nigeria.

Author: Madubueze UC, Una AFI, Okedo-Alex IN, Agha VM, Umeokonkwo CD, Eze II, Utulu R, Okeke KC, Agbo UN, Nwobashi LN, Alo C, and Azuogu BN
Subjects: Pregnancy, Female, Humans, Nigeria epidemiology, Cross-Sectional Studies, Vaccination, Surveys and Questionnaires, Health Knowledge, Attitudes, Practice, Perception, Rural Population, Vaccines
Abstract: Introduction: Knowledge and uptake of maternal vaccination has been reported to be low in low- and middle-income countries., Objectives: To determine the knowledge, uptake and determinants of uptake of maternal vaccination among women of child-bearing age., Methods: A cross sectional study was done among 607 women of childbearing age selected from rural communities in Ebonyi State using multi-staged sampling technique. A pretested, interviewer administered questionnaire was used. The proportion of maternal vaccination uptake and predictors of uptake was determined at 5% level of significant using multiple logistic regression model., Results: Most of the respondents (39.9%) were in the 15-24 years age group. Only 1.3% and 41.5% were knowledgeable and had received any form of maternal vaccines respectively. The main reasons adduced for non-receipt of the vaccine was lack of information (65.8%) and not being pregnant (23.5%). Pregnancy was the predictor for uptake of maternal vaccine among the study population., Conclusions: There was low level of knowledge and uptake of maternal vaccine among rural women and a myth that the vaccine is only given when pregnant. This calls for increase targeted enlightenment of rural women on maternal vaccine in order to improve uptake., Competing Interests: The authors declare that there is no conflict of interest, (© 2022 Madubueze UC et al.)
Published: 2022
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29. Evaluation of malaria surveillance system in Benue State, Nigeria.

Author: Amede PO, Umeokonkwo CD, Abege S, Akawe J, Derek J, Adedire E, and Balogun MS
Subjects: Pregnancy, United States, Child, Male, Humans, Female, Adult, Nigeria epidemiology, Health Facilities, Local Government, Malaria epidemiology, Malaria prevention & control, Health Information Systems
Abstract: Background: Malaria is a priority global health disease with high morbidity and mortality especially among children under-five and pregnant women. Malaria elimination requires an effective surveillance system. The malaria surveillance system in Benue State was evaluated to assess its attributes and performance in line with set objectives., Methods: The updated United States Centers for Disease Control and Prevention guideline for evaluating surveillance systems was used. The surveillance system's key attributes was quantitatively and qualitatively assessed. Semi-structured questionnaires were administered to all Local Government Area (LGA) Roll Back Malaria (RBM) focal persons and five key informants were interviewed at the State level. The Benue State District Health Information System-2 (DHIS-2) malaria data and monthly summary forms were reviewed from January 2015 to December 2019., Results: A total of 46 RBM focal persons and 5 key-informants participated. About 56.9% were males, the mean-age 43.8 (SD ± 9.3) years and 32 (62.8%) had ≥ 20-year experience on malaria surveillance with mean-year-experience 20.8 (SD ± 7.8) years. All 46 (100%) RBMs understood the case definition; 43 (93.5%) found it easy-to-fill the standardized data tools and understood the data flow channels. The malaria surveillance system in Benue is simple, acceptable and useful to all stakeholders, 36 (70.6%) found switching from the paper-based to the electronic-data tools with ease and 45 (88.2%) stated that analysed data were used for decision-making. Data flow from LGA to State is clearly defined, however majority of the data is collected from public health facilities through the DHIS-2 Platform. The overall timeliness and completeness of reporting was 76.5% and 95.7%, respectively, which were below the ≥ 80% and 100% targets, respectively., Conclusions: The malaria surveillance system in Benue State is simple, useful, acceptable, and flexible, but it is not representative and timely. Public-private and public-public-partnerships should be strengthened to encourage reporting from both private and tertiary health facilities and improve representativeness, and frequent feedback to improve reporting timeliness., (© 2022. The Author(s).)
Published: 2022
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30. Are rural pregnant women disadvantaged in accessing intermittent preventive treatment in pregnancy in Ebonyi State, Nigeria?

Author: Akpa CO, Azuogu BN, Akpa WC, Umeokonkwo CD, Denwigwe CP, Azuogu VC, Agu AP, Ogah OE, Akamike IC, Ituma IB, Umeokonkwo AA, Onah CK, Adeke AS, Usuwa IS, Ogbonnaya LU, Ossai EN, Alo C, Onwasigwe C, and Uzochukwu BS
Subjects: Female, Humans, Pregnancy, Young Adult, Adult, Sulfadoxine therapeutic use, Pregnant Women, Nigeria, Cross-Sectional Studies, Prenatal Care, Drug Combinations, Pregnancy Complications, Parasitic prevention & control, Antimalarials therapeutic use, Malaria epidemiology, Malaria prevention & control, Malaria drug therapy
Abstract: Introduction: Adequate intermittent preventive treatment (IPTp) uptake (≥3 doses) routinely delivered at antenatal clinics is effective in preventing malaria during pregnancy. Whereas, low IPTp uptake (24.0%) had been reported among pregnant women in Ebonyi State, there is paucity of studies comparing the uptake and its predictors in the urban and rural areas of Ebonyi State. We determined IPTp uptake and its predictors in the urban and rural areas of Ebonyi State., Methods: We conducted a cross-sectional comparative study among 864 reproductive age women selected using multistage sampling. Using a structured interviewer-administered questionnaire, we collected data on respondent's socio-demographic characteristics and IPTp uptake. Uptake was adjudged adequate if ≥3 doses were taken, otherwise inadequate. We estimated the proportion of women with adequate IPTp uptake and determined the factors associated with adequate uptake in rural and urban areas using chi square and multiple logistic regression at 5% level of significance., Results: The mean ages of respondents in the urban and rural areas were 28.5±4.6 and 27.4±5.0 years respectively. Adequate IPTp uptake was 82.5% and 60.8% in the urban and rural respectively (p<0.001). In the urban area, women whose husbands had attained ≥ secondary education (aOR:2.9; 95%CI:1.2-7.4; p = 0.02) and those who paid for sulfadoxine/pyrimethamime (aOR:0.2; 95%CI: 0.1-0.6; p = 0.01) were 2.9 times more likely and 5 times less likely to take adequate IPTp respectively compared to respondents whose husbands had attained ≤ primary education and those who had sulfadoxine/pyrimethamine free. In the rural area, women who had attended ANC <4 times (aOR:0.4; 95%CI: 0.3-0.7; p<0.001) were 2.5 times less likely to take adequate IPTp compared to women that had attended ANC ≥4 times., Conclusion: Uptake of IPTp was more in the urban than rural areas of Ebonyi State. Interventions that reinforce the importance of health professionals carrying out actions aimed at pregnant women and their partners (spousal) in order to guide them on preventive actions against malaria and other diseases are recommended in Ebonyi State., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Akpa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Published: 2022
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31. Urban-rural differences in health service-related factors associated with male involvement in family planning services in Abia State, Southeastern Nigeria.

Author: Amuzie CI, Nwamoh UN, Ukegbu A, Umeokonkwo CD, Azuogu BN, Okedo-Alex IN, Kalu KU, Izuka M, and Odini F
Subjects: Humans, Male, Adult, Middle Aged, Nigeria, Cross-Sectional Studies, Sexual Behavior, Rural Population, Family Planning Services, Sex Education
Abstract: Objective: To identify and compare the health service-related factors associated with male involvement in family planning services among the rural and urban areas in Abia State, Nigeria., Design: A community-based cross-sectional study., Setting: Twelve communities (six urban and six rural) in Abia State, Nigeria., Participants: Five hundred and eighty-eight (588) men aged 15-59 years and resident in the study area 6 months before the study were recruited., Main Outcome Measure: Male involvement in family planning services., Results: The mean ages of the respondents were 41.8±8.0 years and 43.1±8.0 years in the urban and rural areas, respectively. Active male involvement in family planning services was significantly higher in urban areas (62.6%, 95%CI: 56.8%-68.1%) compared to the rural areas (47.6%, 95%CI: 41.5%-53.2%. p<0.001). The predictors of male involvement included gender preference of healthcare workers (aOR=1.75, 95%CI:1.01-3.03) and attitude of the healthcare workers (aOR=2.07, 95%CI:1.17-3.67) among the urban participants, compared to occupational status of the respondents (aOR=2.50, 95% CI: 1.16-5.56) and the availability of male-friendly clinics (aOR=2.27, 95%CI:1.25-4.15) among the rural participants., Conclusion: Health service-related factors associated with male involvement varied between the urban and rural settings. Stakeholders should target addressing health service-related factors by types of settlement while designing family planning programs targeting men., Funding: No funding was obtained for this study., Competing Interests: Conflict of interest: None declared, (Copyright © The Author(s).)
Published: 2022
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32. Epidemiological characteristics of Lassa fever cases in Liberia: a retrospective analysis of surveillance data, 2019-2020.

Author: Jetoh RW, Malik S, Shobayo B, Taweh F, Yeabah TO, George J, Gbelee B, Teahton J, Jaryan F, Tegli M, Umeokonkwo CD, and MaCauley J
Subjects: Child, Humans, Lassa virus, Liberia epidemiology, Public Health, Retrospective Studies, Ribavirin, Lassa Fever epidemiology
Abstract: Objectives: Liberia is endemic to Lassa fever (LF) and has the largest reported per capita incidence of LF patients in the West African region. Cases of the disease increased unprecedentedly in 2019 and 2020, characterized by a geographical drift in epidemiology and seasonal variation of occurrence. This study aims to describe the epidemiological and clinical characteristics of LF in Liberia from 2019 to 2020., Methods: A retrospective study was conducted on cases of LF confirmed at the National Public Health Reference Laboratory from January 2019 to December 2020. Medical records were reviewed, and epidemiological and clinical data were collected in an organized manner. Descriptive and inferential statistics were carried out using Epi Info (version 7.2.5.0)., Results: A total of 382 suspected LF cases were reported, of which 103 were laboratory-confirmed, yielding a case positivity rate of 27% (103/382). The median age of the LF cases was 20 (IQR: 9-30). Children younger than 18 years accounted for 40.8% (42/103) of the cases and healthcare workers' cases constituted 7.7% of the cases. Bong, Nimba, and Grand Bass accounted for 87.4% of the cases with cases in new counties like Lofa, Margibi, and Grand Kru. Hemorrhage (aOR:10.2; 95% CI: 3.11-33.81), patients who did not receive ribavirin (aOR: 4.4; 95% CI: 1.12-17.57, P = 0.034), and patients aged 40 years or older (aOR: 6.2; 95% CI: 1.19-32.53, P = 0.049) were associated with LF mortality., Conclusion: The LF cases in 2019 and 2020 had a high case fatality rate and spread to new counties that had not previously reported LF. The disease occurred during most of the rainy season instead of the usual dry season. There is an urgent need to lower morbidity and mortality, improve early presentation to the hospital, and early initiation of appropriate medical care., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Published: 2022
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33. Determinants of male involvement in family planning services in Abia State, Southeast Nigeria.

Author: Amuzie CI, Nwamoh UN, Ukegbu A, Umeokonkwo CD, Azuogu BN, Agbo UO, and Balogun MS
Abstract: Background: Male involvement in family planning (FP) remains low in male-dominant communities. Family planning contributes to the regulation of fertility and population growth in Nigeria. Increasing male involvement in family planning services is crucial in reducing maternal morbidity and mortality in patriarchal societies such as Nigeria. This study identified the determinants of male involvement in family planning services in Abia State, Nigeria., Methods: This was a cross-sectional study conducted in twelve communities of Abia State, Nigeria. A total of 588 married men who met the eligibility criteria were recruited using a multistage sampling technique. An interviewer-administered semi-structured questionnaire was used to collect data on the variables. Univariate, bivariate and multivariate analysis was done. The level of significance was set at 5%., Results: The overall level of active male involvement in family planning services was 55.1% (95% CI:51.0-59.2%). The mean age of the respondents was 42.4 ± 8.0 years. Access to television (aOR = 1.58, 95% CI: 1.05-2.39), spouse employment status (aOR = 2.02, 95% CI: 1.33-2.06), joint decision-making (aOR = 1.66, 95% CI: 1.05-2.62), and accompanying spouse to the FP clinic (aOR = 3.15, 95% CI: 2.16-4.62) were determinants of active male involvement., Conclusion: At least, one out of every two men was actively involved in family planning services. This was determined by access to television, employment status of spouse, joint decision-making, and accompanying spouse to the FP clinic. There is a need to focus on the identified factors in order to further improve the active involvement of men in FP services., (© 2022. The Author(s).)
Published: 2022
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34. Drug-susceptible tuberculosis treatment outcomes and its associated factors among inmates in prison settings in Bauchi State, Nigeria, 2014-2018.

Author: Amede PO, Adedire E, Usman A, Ameh CA, Umar FS, Umeokonkwo CD, and Balogun MS
Subjects: Adult, Female, Humans, Male, Middle Aged, Nigeria epidemiology, Prisons, Retrospective Studies, Treatment Outcome, Latent Tuberculosis, Tuberculosis drug therapy, Tuberculosis epidemiology
Abstract: Tuberculosis (TB) is a contagious disease and its transmissibility is increased in congregate settings. TB incidence rates are five-to-fifty times higher among inmates in prison settings than the general population which has a direct impact on the outcome of TB treatment. There is paucity of information on TB treatment outcomes and its associated factors in Nigerian prison settings. We therefore assessed TB treatment outcomes among inmates in prison settings in Bauchi State, Nigeria. We conducted a retrospective data analysis of inmates with TB in the five-main prison settings in Bauchi State. We extracted socio-demographic, clinical and treatment outcome characteristics from TB treatment register of inmates treated for TB between January 2014 and December 2018, using a checklist. We calculated the TB treatment success rate (TSR) and explored the relationship between the TSR and socio-demographic and clinical characteristics. Related variables were modelled in multiple logistic regression to identify factors associated with TSR at 5% level of significance. All 216 inmates were male with mean (SD) age of 37.6±11.4 years. Seventy-six (35.2%) were cured, 61 (28.2%) completed treatment, 65 (30.1%) were transferred-out without evaluation and 14 (6.5%) died. Overall TSR was 72.9%. Factors associated with successful-treatment-outcome were age, weight, imprisonment duration and HIV status. The results indicate that inmates who are 20-29 years are at least ten times more likely to be successful (aOR = 10.5; 95%CI: 3.2-35.1) than inmates who are 55 years or older. Inmates who are 30-39 years are about four times more likely to be successful than inmates who are 55 years or older (aOR = 4.2; 95% CI: 1.3-13.1). In general, the younger an inmate, the more successful he is. Inmates with pretreatment-weight; 55kg or more are 13 times more likely to be successful (aOR = 13.3; 95%CI: 6.0-29.6) than inmates with weight below 55kg. Inmates who were imprisoned for 2 years or less are about three times more likely to be successful (aOR = 2.6; 95%CI: 1.3-5.4) than inmates who were imprisoned for more than 2 years and HIV negative inmates were three times more likely to succeed (aOR = 3.3; 95%CI:1.4-7.8) than inmates who were HIV positive. We recommended that to improve TB treatment outcome among inmates; age, duration-of-imprisonment, weight and TB/HIV co-infection should be the major consideration during pretreatment, psychological and nutritional counselling and a tracking-system be developed by the authority to follow-up inmates transferred-out to other health facilities to ensure they complete the treatment and outcomes evaluated., Competing Interests: Authors have declared that no competing interests exist.
Published: 2022
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35. Physical inactivity and perceived environmental factors: a cross-sectional study among civil servants in Abia State, Southeastern Nigeria.

Author: Amuzie CI, Ajayi I, Bamgboye E, Umeokonkwo CD, Akpa CO, Agbo UO, Nwamoh UN, Izuka M, and Balogun MS
Subjects: Adult, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Nigeria, Risk Factors, Surveys and Questionnaires, Exercise, Sedentary Behavior
Abstract: Introduction: physical inactivity has been identified as the fourth leading risk factor for global mortality due to non-communicable diseases. Prevalence rates of 91.0% and 62.2%, have been documented among civil servants in the northern and southern parts of Nigeria, respectively. There is a paucity of data regarding the relationship between physical inactivity and environmental factors among civil servants in the State. This study assessed the prevalence and perceived environmental factors associated with physical inactivity among civil servants in Abia State Nigeria., Methods: we conducted a cross-sectional study in which we recruited 440 civil servants using a multistage sampling technique. We used an interviewer-administered structured questionnaire to collect data on sociodemographic, physical activity, and neighbourhood environmental attributes. Descriptive, bivariate and multivariate analysis were done. The level of significance was set at 5%., Results: the mean age of the respondents was 39.0±9.2 years, and 61% were females. The prevalence of physical inactivity was 48.4% (95%CI: 43.7%-53.2%). The putative environmental factors included perceptions of low residential density areas, perceived absence of neighbourhood sidewalks, perceived unavailability of bicycling facilities and the perception of an unsafe neighbourhood due to night crimes. The predictor of physical inactivity was the perceived absence of neighbourhood sidewalks (aOR=2.02, 95%CI: 1.10-3.73)., Conclusion: in this study, physical inactivity is prevalent among civil servants in Abia State. The need for the stakeholders in collaboration with the Ministry of Environment to focus on the provision of sidewalk facilities, layout of residential areas and limit security risks in the State to enhance physical activity is highlighted., Competing Interests: The authors declare no competing interests., (Copyright: Chidinma Ihuoma Amuzie et al.)
Published: 2022
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36. The influence of first wave of COVID-19 outbreak on routine healthcare services, Liberia, August 2020: a mixed study approach.

Author: Babalola OJ, Sesay HW, Blebo LS, Whesseh FK, Umeokonkwo CD, Adewuyi PA, and Amo-Addae M
Subjects: Communicable Disease Control, Cross-Sectional Studies, Delivery of Health Care, Disease Outbreaks prevention & control, Female, Humans, Liberia epidemiology, Pandemics prevention & control, Pregnancy, Vaccination, COVID-19 epidemiology
Abstract: Background: The COVID-19 pandemic left countries to rapidly implement diverse and stringent public health measures without recourse to mitigate its effect on the sustenance of routine healthcare services. This study described routine health service disruption and restoration strategies at 6 months into the epidemic in Liberia., Methods: Liberia, with 15 counties, has 839 health facilities, with one-third in Montserrado County. A cross-sectional study using a mixed approach - quantitative and qualitative research with concurrent triangulation was conducted using a structured guide for group discussions among key health workers at 42 secondary and most patronized health facilities in 14 counties and 7 Montserrado districts. Additionally, routine health data between January and June 2019 and 2020 were extracted from the source documents to the electronic checklist. We performed a descriptive analysis of quantitative data and plotted the line graph of the relative percentage change. Transcribed audio recording notes were synthesized using ATLAS ti for content analysis to identify the themes and subthemes in line with the study objectives and excerpts presented in the results., Results: Liberia declared COVID-19 outbreak on March 16, 2020. From conducted interviews at 41 health facilities, 80% reported disruption in routine health services. From January to June 2020, scheduled routine immunization outreaches conducted decreased by 47%. Using a relative percentage change, outpatient attendance decreased by 32% in May, inpatient admission by 30% in April, malaria diagnosis and treatment by 40% in April, and routine antenatal obstetric care by 28% in April. The fear of contacting COVID-19 infection, redeployment of healthcare workers to COVID-19 response, restriction of movement due to lockdown, inadequate or lack of PPE for healthcare workers, lack of drugs and vaccine supplies for clients, and partial closure of routine healthcare services were common perceived reasons for disruptions. Massive community health education and strict compliance with COVID-19 nonpharmacological measures were some of the health facility recovery strategies., Conclusions: The COVID-19 outbreak in Liberia caused a disruption in routine healthcare services, and strategies to redirect the restoration of routine healthcare services were implemented. During epidemics or global health emergencies, countries should sustain routine health services and plan for them., (© 2022. The Author(s).)
Published: 2022
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37. An assessment of infection prevention and control preparedness of healthcare facilities in Nigeria in the early phase of the COVID-19 pandemic (February-May 2020).

Author: Joy Okwor T, Gatua J, Umeokonkwo CD, Abah S, Ike IF, Ogunniyi A, Ipadeola O, Attah T, Assad H, Dooga J, Olayinka A, Abubakar J, Oladejo J, Aderinola O, Eneh C, Ilori E, Ibekwe P, Ochu C, and Ihekweazu C
Abstract: Background: Infection prevention and control (IPC) activities play a large role in preventing the transmission of SARS-CoV-2 in healthcare settings. This study describes the state of IPC preparedness within health facilities in Nigeria during the early phase of coronavirus disease (COVID-19) pandemic., Methods: We carried out a cross sectional study of health facilities across Nigeria using a COVID-19 IPC checklist adapted from the U.S Centers for Disease Control and Prevention. The IPC aspects assessed were the existence of IPC committee and teams with terms of reference and workplans, IPC training, availability of personal protective equipment and having systems in place for screening, isolation and notification of COVID-19 patients. Existence of the assessed aspects was regarded as preparedness in that aspect., Results: In total, 461 health facilities comprising, 350 (75.9%) private and 111 (24.1%) public health facilities participated. Only 19 (4.1%) health facilities were COVID-19 treatment centres with 68% of these being public health facilities. Public health facilities were better prepared in the areas of IPC programme with 69.7% of them having an IPC focal point versus 32.3% of private facilities. More public facilities (59.6%) had an IPC workplan versus 26.8% of private facilities. Neither the public nor the private facilities were adequately prepared for triaging, screening, and notifying suspected cases, as well as having trained staff and equipment to implement triaging., Conclusions: The results highlight the need for government, organisations and policymakers to establish conducive IPC structures to reduce the risk of COVID-19 transmission in healthcare settings., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)
Published: 2022
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38. Prevalence and Predictors of Metabolic Syndrome among Adults in North-Central, Nigeria.

Author: Osunkwo D, Mohammed A, Kamateeka M, Nguku P, Umeokonkwo CD, Abolade OS, Ibrahim M, Ibrahim K, Nwokeukwu H, and Zoakah AI
Subjects: Adult, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Nigeria epidemiology, Prevalence, Risk Factors, Young Adult, Metabolic Syndrome epidemiology
Abstract: Background: Metabolic syndrome contributes to the burden of non-communicable diseases and is a growing public health problem in both developed and developing countries. We determined the prevalence and predictors of metabolic syndrome among adults in Benue State, North-Central, Nigeria to guide targeted interventions., Methods: We conducted a community-based cross-sectional study in Benue State, North-Central, Nigeria. Multistage sampling technique was used to recruit 823 respondents. We defined metabolic syndrome using the National Cholesterol Education Programme Adult Treatment Panel III guideline and adapted a component of the WHO Stepwise questionnaire for data collection. Prevalence of metabolic syndrome and the associated risk factors were estimated using Chi square test and logistic regression at 5% level of significance. Statistical analysis was done using SPSS version 23.0., Results: The mean age of the respondents was 40.1± 15.7 years. Most of the respondents were literate (86.8%) and married (67.0%). The prevalence of metabolic syndrome was 19.4%. One in every four of the respondents had pre-metabolic syndrome (25.6%) and this was more in females (28.2%) compared to males (22.9%). Thirty-four percent of the respondents had only one whereas 20.7% did not have any of the risk factors for metabolic syndrome. Age [aOR:10.3; 95%CI: 4.8-22.2], sex [aOR:2.4; 95% CI: 1.7-3.5] and education [aOR:2.9; 95%CI: 1.4-6.1] were significantly associated with metabolic syndrome among the respondents., Conclusion: The prevalence of metabolic syndrome was high. The associated risk factors were age, gender and educational status. Therefore, interventions should be targeted at young adults to reduce the long-term impact of the disease., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2022 by West African Journal of Medicine.)
Published: 2022

39. Timeliness of Vaccination among Children Attending Immunization Clinic at a Tertiary Hospital in South-East Nigeria.

Author: Umeokonkwo AA, Ezeonu TC, Agu AP, and Umeokonkwo CD
Abstract: Background: Timely vaccination of children is one of the most cost-effective interventions that ensure childhood survival. We determined the proportion of children who received timely vaccination and examined the factors associated with timely receipt of Bacillus Calmette Guerin (BCG) and third dose of pentavalent vaccine (Penta 3)., Methodology: We conducted a cross-sectional survey among 599 caregivers-infant pair aged less than 24months, attending the immunization clinic of a tertiary hospital in Nigeria, selected using systematic sampling methods. Using a structured questionnaire, we access the proportion of children who received timely vaccination, the relationship between the timely receipt of BCG, Penta 3 vaccine and infant/caregiver characteristics was examined using chi-square and multiple logistic regression at a 5% level of significance., Results: The mean age of the respondents was 30.1±5.0 years. The majority (73.8%) had attained tertiary education, lived in an urban setting (90.9%), had received antenatal care during pregnancy (99.3%) and was delivered in a hospital (97.0%). About half of the children (52.9%) were male. About 18% of the caregivers reported missing scheduled immunization visits, due to forgetfulness (18%), child illness (14%) and being busy (5%). About 88% (482) of the children got their BCG vaccines on time, 91.1% got timely OPV0, however, only 29.5% of the newborns got HBV0 within 24 hours of birth. Only 65.7% and 65.0% received the timely measles-containing vaccine and yellow fever vaccine. None of the factors examined predicted timely receipt of BCG and Penta 3 vaccines., Conclusion: Interventions that remind caregivers about the immunization schedules, could improve timely vaccination., Competing Interests: The authors do not have any conflict of interest to declare, (Copyright © 2021 Nigerian Medical Association.)
Published: 2022
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40. Awareness Of Occupational Hazards, Use of Personal Protective Equipment and Workplace Risk Assessment Among Welders in Mechanic Village, Abakaliki, South-East Nigeria.

Author: Agu AP, Umeokonkwo CD, Adeke AS, Nnabu CR, Ossai EN, and Azuogu BN
Abstract: Background: Occupational diseases can result in sickness absence, economic loss, disability, or death of workers. Several studies have revealed that occupational health and safety practice is still low in some occupational groups despite their knowledge and the occupational health legislation. This study assessed the level of knowledge, Background: Occupational health service delivery, includes the creation of a safe and healthy work environment. The protection and promotion of workers' health; is at its infantile stages in the informal sector such as the welding industry in Nigeria. We determined the level and determinants of awareness of occupational hazards, determinants of use of personal protective equipment (PPE) and carried out a workplace risk assessment among the welders at the mechanic village in Abakaliki, Ebonyi State., Methodology: We conducted a cross-sectional study among welders who work in the mechanic village, Abakaliki. A structured, pretested interviewer-administered questionnaire was used to extract information on awareness of occupational hazards, frequency of use of PPE, health-related complaints amongst others. Chi-square test and logistic regression analysis were conducted at a 5% level of significance., Result: All the respondents were male with a mean age of 27.6± 10.1 years. We found a good awareness of occupational hazards in 60% of the respondents and though this was associated with being older than 30years (p=0.03), being an expert compared to apprentice (p=0.003), duration of work more than 5years (p=0.004), none of these factors, when modelled in logistic regression, were predictors of good awareness. Regular use of PPE was reported in 49.79% of respondents. Cuts, sparks, foreign bodies in the eye were the most common hazards they were aware of. Cuts were the most reported health complaint. Good awareness of hazards was associated with higher odds of sustaining cuts (adjusted odds ratio [AOR]: 3.1, 95% CI:1.46 - 6.69) and a predictor of regular use of PPE (AOR:2.6, 95%CI:1.12 - 5.88). The workplace risk assessment revealed a work environment not conducive to occupational safety and health., Conclusion: A good awareness of occupational hazards was moderately high, a predictor of regular use of PPE and not protective of sustaining cuts in the suboptimal work environment., (Copyright © 2021 Nigerian Medical Association.)
Published: 2022

41. Nasal carriage of meticillin-resistant Staphylococcus aureus among children living with HIV attending Infectious Diseases Clinics in Kano, Nigeria.

Author: Sadauki AH, Olorukooba AA, Balogun MS, Dalhat MM, Waziri H, Abdulaziz MM, Umeokonkwo CD, Hassan-Hanga F, and Sabitu K
Abstract: Background: Children living with HIV (CLWH) are at risk of colonisation and infection with meticillin-resistant Staphylococcus aureus (MRSA). All S. aureus isolates from CLWH with bloodstream infections in Kano were MRSA., Aim: To estimate the prevalence of nasal colonisation with S. aureus and MRSA in CLWH in Kano State and to determine associated risk factors., Methods: A cross-sectional study was performed in the infectious diseases clinics of two public hospitals in Kano involving 214 CLWH/caregiver pairs. Children were selected from clinic registers by simple random sampling and an interviewer-administered questionnaire used to elicit factors associated with MRSA carriage from the caregivers. Clinical records were reviewed for patients' medical histories. Standard laboratory techniques were used to isolate S. aureus from nasal swabs collected from CLWH. MRSA was detected using the cefoxitin disc diffusion method and PCR for mecA gene detection. We measured the prevalence of S. aureus and MRSA carriage in the CLWH and calculated adjusted odds ratios (AOR) for factors associated with MRSA., Results: Nasal S. aureus carriage in CLWH was 18.7% (40/214). Cefoxitin disc diffusion identified 6/214 (2.8%) of CLWH were MRSA carriers, while PCR identified that 9/214 (4.2%) of CLWH were MRSA carriers. Recent hospitalisation (AOR: 61.04; 95% CI: 9.01-413.38) and recent antibiotic therapy (AOR: 7.52; 95% CI: 1.07-52.95) were independent risk factors for MRSA colonisation., Conclusions: The rate of MRSA nasal colonisation among CLWH in Kano was similar to that reported in other studies in Africa. Infection prevention and control measures including MRSA screening and decolonisation, as well as education for CLWH and their carers should be introduced to reduce MRSA spread., (© 2022 The Authors.)
Published: 2022
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42. COVID-19 reinfection in Liberia: Implication for improving disease surveillance.

Author: Akpan GE, Bawo L, Amo-Addae M, Kennedy J, Wesseh CS, Whesseh F, Adewuyi P, Sanvee-Blebo L, Babalola J, Sesay HWW, Yeabah TO, Jackson D, Shannon F, Umeokonkwo CD, Nyenswah AW, Macauley J, and Jallah W
Subjects: Disease Outbreaks prevention & control, Humans, Liberia epidemiology, Reinfection, COVID-19 epidemiology, Hemorrhagic Fever, Ebola epidemiology
Abstract: COVID-19 remains a serious disruption to human health, social, and economic existence. Reinfection with the virus intensifies fears and raises more questions among countries, with few documented reports. This study investigated cases of COVID-19 reinfection using patients' laboratory test results between March 2020 and July 2021 in Liberia. Data obtained from Liberia's Ministry of Health COVID-19 surveillance was analyzed in Excel 365 and ArcGIS Pro 2.8.2. Results showed that with a median interval of 200 days (Range: 99-415), 13 out of 5,459 cases were identified and characterized as reinfection in three counties during the country's third wave of the outbreak. Eighty-six percent of the COVID-19 reinfection cases occurred in Montserrado County within high clusters, which accounted for over 80% of the randomly distributed cases in Liberia. More cases of reinfection occurred among international travelers within populations with high community transmissions. This study suggests the need for continued public education and surveillance to encourage longer-term COVID-19 preventive practices even after recovery., Competing Interests: The authors have declared that no competing interests exist.
Published: 2022
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43. Donor Blood Procurement, Safety, and Clinical Utilization: A Study of Blood Transfusion Services in a Tertiary Care Hospital in Nigeria.

Author: Nnachi OC, Uzor C, Umeokonkwo CD, Onwe EO, Okoye AE, Ewah RL, and Nwani FO
Abstract: Background: Donated blood is an essential component of the management of many diseases, and hospital-based blood banks in Nigeria are saddled with the responsibility of provision of safe blood and coordination of its appropriate utilization for patient care., Objective: This study reviewed the extent to which the hospital blood transfusion service ensures adequate safe blood supply and utilization. Materials/Methods . This was a retrospective study of 2 years record of the blood bank service of Alex Ekwueme Federal University Teaching. Methods of donor blood procurement, transfusion transmissible infection status, the pattern of blood, and blood component usage across the hospital's clinical departments were evaluated. Statistical analysis was conducted using IBM SPSS, and data were presented as percentages. Fisher's tests were used to test significance, and p value <0.05 is significant., Results: The highest proportion of donors was male family replacement donors aged 26-35 years (3634 (39.68%)) while total voluntary donors were 315 (2.65%). Hepatitis B had the highest seroprevalence 267 (2.22%) among blood-borne diseases screened. National Blood Transfusion Service (NBTS) supplied only 3 (0.03%) of total blood units used. The accident and emergency department had the highest proportion of persons who utilized whole blood; 4568 (99.96%)., Conclusion: The hospital blood bank relies heavily on family replacement donors with little or no assistance from the National Blood Transfusion Service. Family replacement donors have the highest risk of TTIs, and hepatitis B infection has the highest prevalence. The high cost of blood component therapy increases the need for whole blood., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Oluomachi Charity Nnachi et al.)
Published: 2022
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44. Essential medicines and technology for hypertension in primary healthcare facilities in Ebonyi State, Nigeria.

Author: Adeke AS, Umeokonkwo CD, Balogun MS, and Odili AN
Subjects: Blood Glucose analysis, Community Health Workers, Cross-Sectional Studies, Drugs, Essential, Health Expenditures, Health Facilities statistics & numerical data, Health Services Accessibility, Health Status Disparities, Healthcare Disparities, Humans, Hypertension epidemiology, Nigeria epidemiology, Rural Health Services organization & administration, Rural Population, Sphygmomanometers, Stethoscopes, Antihypertensive Agents therapeutic use, Hypertension drug therapy, Primary Health Care organization & administration
Abstract: Introduction: Cardiovascular diseases (CVDs) now constitute major cause of morbidity and mortality in middle and low income countries including Nigeria. One of the major efforts at controlling CVDs in Nigeria includes expanding universal access to care through the primary healthcare (PHC) system. The study was to assess essential medicines and technology for control of hypertension in PHC facilities in Ebonyi Nigeria., Methods: The study used mixed method cross-sectional survey to assess availability, affordability and accessibility of essential medicines and technology in 45 facilities and among their patients with hypertension (145)., Results: Most of the PHC facilities (71.1%) assessed were rural. The heads of facilities were mainly community health extension workers (86.7%). One (2.2%) facility had a pharmacy technician. All facilities had been supervised by the regulatory authority in the last one year. Out of 15 anti-hypertensive drugs assessed, 10 were available in some facilities (2.2%-44.4%) but essential drug availability was low (<80%). Only mercury sphygmomanometers were available in all facilities with 82.2% functioning. Stethoscopes were available in all facilities and 95.6% were functional. Glucometers were present in 20.0% of facilities and were all functional. All the respondents (100.0%) reported they could not afford their anti-hypertensive drugs. Median monthly income was 8,000 Nigerian Naira (range = 2,000-52,000). Median monthly cost of anti-hypertensive drugs was 3,500 Naira (range = 1,500-10,000). For 99 (68.3%) of the respondents, the facilities were accessible. Median cost of transportation for care was 400 Naira (range = 100-2,000)., Conclusion: Gaps still exist in the provision of hypertension control services in PHC facilities in Ebonyi State, Nigeria. The essential drugs were not always available, and cost of the drugs were still a challenge to the patients. There is urgent need to expand health insurance coverage to rural communities to ameliorate the catastrophic out-of-pocket health expenditures and improve control of CVDs., Competing Interests: The authors have declared that no competing interests exist.
Published: 2022
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45. Risk Perception and Factors associated with Compliance to COVID-19 Preventive Measures among Commercial Drivers in Abakaliki Nigeria: An Imperative for Targeted Intervention.

Author: Onah CK, Azuogu BN, Umeokonkwo CD, Akpa CO, Utulu R, Elom PO, Adeke AS, Okoro OO, and Michael U
Subjects: Adult, Cross-Sectional Studies, Health Knowledge, Attitudes, Practice, Humans, Middle Aged, Nigeria, Pandemics, Perception, SARS-CoV-2, Surveys and Questionnaires, Young Adult, COVID-19
Abstract: Background: Despite efforts to control COVID-19 pandemic, the outbreak has continued to ravage the world with high morbidity, mortality and economic hardship. The World Health Organisation reported that people are becoming complacent and their risk perceptions are lowering. Commercial drivers play significant role in outbreak control because of their regular mix with commuters from various sources., Objectives: We investigated risk perception and factors associated with compliance to COVID-19 preventive measures among commercial drivers., Methods: This study involved 502 commercial drivers in Abakaliki Nigeria using cross-sectional analytic design. Data was collected with interviewer-administered questionnaire and analyzed with IBM-SPSS version 23. Inferential statistics were done using Chi-square and binary logistic regression tests with significance set at p-value of 0.05., Results: The response rate was 502(98.4%) and mean age was 35.5±10.8 years. Majority of them were married 368(73.3%), had secondary education 279(55.6%) and operated commercial driving for 1-5 years 297(59.2%). There was high awareness, high-risk perception and good compliance with COVID-19 preventive measures in 99.8%, 69.1% and 54.4% of respondents respectively. Attaining tertiary education (aOR=6.5, 95% CI=1.5-28.1, p=0.012) and good knowledge of COVID-19 (aOR=4.3, 95% CI=2.7-6.8, p<0.001) significantly predicted high-risk perception while good knowledge of the disease alone predicted good compliance (aOR=5.5, 95% CI=3.6-8.3; p<0.001)., Conclusion: The awareness of COVID-19 is high but there is relatively lower risk perception and compliance with the preventive measures. We recommend improved public education, sensitization and risk communication as well as review of policies and adoption of new approaches about COVID-19 outbreak control., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2021 by West African Journal of Medicine.)
Published: 2021

46. COVID-19 pandemic waves: how prepared is West Africa for managing a high COVID-19 caseload? Urgent actions needed.

Author: Lokossou VK, Umeokonkwo CD, Okolo S, Nguku PM, Ogbureke N, and Sombie I
Subjects: Africa, Western, Humans, Pandemics prevention & control, SARS-CoV-2, Vaccination, COVID-19 prevention & control
Abstract: The ECOWAS Region and the world have learnt a lot in the last year and a half concerning the pandemic. As the pandemic continues to evolve, the region needs to put together all these lessons in other to better protect its people, rebuild its economy and strengthen the regional health security for better regional prosperity. We reviewed the response mounted by the region from January 2020 to July 2021 and the existing body of knowledge. We recommend that the region quickly increase the COVID-19 immunization coverage, sustain the enhance genomic surveillance, improve testing and the strengthen point of entry surveillance., (Copyright: Virgil Kuassi Lokossou et al.)
Published: 2021
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47. Hygiene practices in abattoir and slaughter slab, determinants and assessment of abattoir and slaughter slab facilities in Abakaliki, Ebonyi State South-East Nigeria.

Author: Agu AP, Onah CK, Umeokonkwo CD, Nnabu RC, and Una AFI
Subjects: Animals, Cross-Sectional Studies, Humans, Hygiene, Nigeria, Abattoirs, Zoonoses
Abstract: Background: Workers in slaughterhouses engaging in unhygienic practices create conducive environments for zoonoses and meat contamination. Knowledge of hygiene practices and their determinants provides evidence for the design of targeted interventions., Objectives: We investigated knowledge and determinants of hygiene practices among workers in slaughterhouses and assessed slaughterhouse facilities in Abakaliki., Methods: Workers in the Central Meat Market abattoir and Slaughter slab Abakaliki were interviewed in a cross-sectional quantitative study to ascertain their knowledge and hygiene practices while abattoir facilities were assessed using a checklist. Associations were analysed with Chi-square while predictors were determined using binary logistic model., Results: We interviewed 188 workers 75.5% and 85.6% of whom had good knowledge and good hygiene practices respectively. However, hand-washing before and after handling meat (44.1%), cleaning work surfaces with soap and water (45.2%) and sanitary disposal of waste (6.9%) were suboptimal. Knowledge of good hygiene practice was a predictor of good hygiene practice (AOR: 4.6, 95% CI: 2.0-11.3, p=0.001). Well water and borehole were present in both slaughterhouses and cold rooms were available in Central Meat market abattoir., Conclusions: The level of good knowledge was high and this was a determinant of good hygienic practices. Training on hygiene practices is recommended to prevent meat contamination and zoonoses., (© 2021 Agu AP et al.)
Published: 2021
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48. Patterns of diarrhoeal disease among under-five children in Plateau State, Nigeria, 2013-2017.

Author: Jiwok JC, Adebowale AS, Wilson I, Kancherla V, and Umeokonkwo CD
Subjects: Child, Child, Preschool, Humans, Infant, Nigeria epidemiology, Prevalence, Seasons, Diarrhea epidemiology
Abstract: Background: Diarrhoea is the second commonest cause of under-five mortality accounting for over half a million deaths annually. Although the prevalence of diarrhoea in Plateau State is lower than the national figure, the level remains high despite remarkable progress in the reduction of under-five mortality. This study seeks to determine the pattern of diarrhoea disease among under-fives in Plateau State., Methods: We extracted data from the Integrated Disease Surveillance and Response platform between January 2013 and December 2017 and analysed the trends of diarrhoea, age-specific case fatality rate (ASCFR), and seasonal patterns. We modelled the quarterly pattern of diarrhoea cases using additive time series and predicted the expected cases for 2018-2020., Results: We documented 60,935 cases of diarrhoea with age group 12-59 months having the highest number of cases (49.3%). The age group < 1 month had the highest ASCFR of 0.53%. Seasonal variation showed cases peaked in the first and third quarters of each year, except for the year 2016. The time series projection estimated 16,256, 17,645 and 19,034 cases in the year 2018, 2019 and 2020 respectively., Conclusion: Seasonal variation exists, and trends show an increased pattern of diarrhoeal disease among under-fives. There is a need to strengthen the implementation of diarrhoeal preventive and control strategy in the state and to improve the quality of data reporting., (© 2021. The Author(s).)
Published: 2021
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49. Stigmatization and psychological impact of COVID-19 pandemic on frontline healthcare Workers in Nigeria: a qualitative study.

Author: Kwaghe AV, Kwaghe VG, Habib ZG, Kwaghe GV, Ilesanmi OS, Ekele BA, Umeokonkwo CD, and Balogun MS
Subjects: Health Personnel, Humans, Nigeria, SARS-CoV-2, Stereotyping, COVID-19, Pandemics
Abstract: Introduction: The COVID-19 pandemic has had a great toll on global health. Frontline healthcare workers (FHCW) directly involved in the treatment of COVID-19 patients have faced some physical and psychological challenges. This study explored the stigma and traumatic experiences of the FHCW during the COVID-19 pandemic in Nigeria., Methods: We recruited twenty FHCW directly involved in the treatment of COVID-19 patients through purposive and snowball sampling techniques. Face-to-face in-depth interviews were conducted for all participants, and qualitative analysis of data was done using Colaizzi's phenomenological method., Results: Five themes identified were: Early stage of the pandemic (fear, anxiety, public fright, other countries repatriating their citizens, the socio-economic impact of the pandemic and a call to duty for the FHCW); working with COVID-19 patients (excitement on patients recovery and duty stress); psychological, mental and emotional trauma; stigmatization (stigmatized by colleagues, family, friends or their residential communities, reasons for stigmatization which were fear of infection, limited knowledge of the virus and working at the isolation centre and the effect of stigma); and recommendations (education and awareness creation, government showing more care towards the FHCW and provision of health insurance for FHCW to take care of those that get infected in the line of duty)., Conclusion: Stigmatization has proven to be a major challenge for FHCW in conducting their duties. The psychological impact experienced by FHCW may affect the quality of the services rendered by these workers. The study reveals the need of education and awareness creation in the ongoing pandemic. There is a need for the government and society to acknowledge and appreciate the efforts of FHCW., (© 2021. The Author(s).)
Published: 2021
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50. Operationalizing the ECOWAS regional one health coordination mechanism (2016-2019): Scoping review on progress, challenges and way forward.

Author: Lokossou VK, Atama NC, Nzietchueng S, Koffi BY, Iwar V, Oussayef N, Umeokonkwo CD, Behravesh CB, Sombie I, Okolo S, and Ouendo EM
Abstract: Based on recommendations from two consultative meetings held in Dakar, Senegal (2016) and Abuja, Nigeria (2017) the Economic Community of West African States (ECOWAS) implemented a Regional One Health Coordination Mechanism (R-OHCM). This study analyzed the process, challenges and gaps in operationalizing the R-OHCM in West Africa. We utilized a scoping review to assess five dimensions of the operation of an R-OHCM based on political commitment, institutional structure, management and coordination capacity, joint planning and implementation, as well as technical and financial resources. Information was gathered through a desk review, interview of key informants, and the viewpoints of relevant stakeholders from ECOWAS region during a regional One Health technical meeting in Lomé, Togo in October 2019. It was found that political commitment at regional meetings and the countries adoption of regional frameworks were key strengths of the R-OHCM, although there are continued challenges with commitment, sustainability, and variability of awareness about One Health approach. ECOWAS formulated regional strategic documents and operationalized the One Health secretariat for strengthening coordination. The R-OHCM has technical working groups however, there is need for engagement of more specialized workforce and a harmonized reporting structure. Furthermore, inadequate focus on operational research, and weak national OHCM are identified as main gaps. Finally, the support of technical and financial partners will help to address the lack of funding which limits the implementation of the R-OHCM. West Africa has demonstrated profound effort in adopting the One Health approach at regional level but is presently deterred by challenges such as limited skilled One Health workforce, especially in the animal and environmental health sectors, and access to quality of One Health surveillance., (© 2021 West African Health Organisation.)
Published: 2021
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